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Trust warns it could lose junior doctors

Published on: 2 Nov 2021

An acute trust is warning that some of its junior doctors could be withdrawn, putting patient safety at risk.

There are long-standing concerns about the experience of trainees in general, internal and acute medicine at Medway Foundation Trust, according to a report to this week’s board meeting,

But the recent General Medical Council training survey raised a number of red flags, which is likely to lead to a visit from Health Education Kent, Surrey and Sussex, the report says.

“Given the long-standing concerns, we believe that trainee placements are jeopardised ie we may face actual or threat of trainee withdrawal from the trust. This carries patient safety and financial risk to unplanned care as well as serious reputational risk to the trust,” it concludes.

Trusts which have trainee doctors’ posts removed often struggle to continue with services because of the role juniors play in providing them, especially at night and weekends. In 2017, 38 juniors were removed from the Kent and Canterbury Hospital on the recommendation of HEE. East Kent Hospitals University Foundation Trust had made changes to the way emergency and urgent care was provided at the hospital but this was not enough to keep the trainees.

And earlier this year a group of trainees were removed from Weston Hospital. Colin Melville, GMC medical director and director of education and standards, said at the time that working conditions were “unacceptable” and the trust had not taken “sufficient or sustainable” actions.

The report to Medway’s board, which was written by the director of medical education Janette Cansick and colleagues, said there had been “significant ingoing issues which have remained unresolved for over five years, including lack of bleep filtering at night, significant rota gaps and lack of feedback following Datix.”

Other concerns included unsupervised clinics,lack of opportunities to attend clinics, a reported lack of support from the on-call consultant, workload on call and departmental training sessions. “We believe there needs to be a change in how medical education and training is prioritised by unplanned care as a whole to facilitate resolution of many of the issues,” they wrote.

The GMC’s training survey for 2021 shows that general internal medicine at Medway had an overall satisfaction of just 52 per cent and teamwork was rated at 49 per cent, with 13 out of 17 areas with red flags, meaning they are in the bottom quartile for trusts.

Dr George Findlay, chief executive of Medway FT, said: “We are committed to improving the experience and education of our junior doctors. We take issues raised by our junior doctors very seriously, and we are addressing them so that we can deliver on this commitment.

 “We have not had any indication from the school of medicine of Health Education Kent, Surrey and Sussex that they are intending to remove our medicine trainees.”