Rota gaps and increasingly heavy workloads are leaving doctors exhausted, sleep deprived and without enough time for vital training.
That is the stark picture highlighted in two damning new reports which reveal the extent of the pressure on an ‘underfunded, underdoctored and overstretched’ NHS – with patient safety suffering as a result.
The GMC’s annual survey of medical education and training in the UK reveals that more than half of doctors in training are working beyond their rostered hours and a quarter say the demands of the job leave them without sleep on a weekly basis.
The survey also highlights that four in 10 doctors in training feel their workload is heavy or very heavy – with those figures in specialties under the greatest pressure like emergency medicine, where it rises to eight in 10 doctors.
The RCP (Royal College of Physicians) has also released a report, Being a Junior Doctor, which reveals that four out of five junior doctors believe their job ‘sometimes’ or ‘often’ causes them excessive stress – and one in four say it impacts their mental health.
BMA junior doctors committee chair Peter Campbell said the reports highlight how urgently the Government needs to address the ‘workload, staffing and funding challenges that are overwhelming our health service and compromising patient care and doctors’ training’.
Dr Campbell said: ‘Patients and the public may rightly be shocked by these findings, but no junior doctor will be surprised. It is far too common that junior doctors are left sleep deprived after regularly working beyond their rostered hours on rotas that are desperately short of doctors.’
In the new junior doctors contract, a system of exception reporting will enable junior doctors to flag up if their actual work has varied significantly or regularly with their rostered work schedule. This was something 'the BMA pushed for and delivered … to ensure that junior doctors can report when they have to work above their rostered hours, or have missed training opportunities, so these can be immediately addressed', said Dr Campbell.
He added: ‘We cannot accept a situation where vital training time is being sacrificed in the face of rising pressures on services. This is a short-sighted approach that is already having an impact on the quality of patient care.
‘We need to maintain a highly trained medical workforce if the NHS is to continue to deliver world-class services for patients, and protecting and valuing training time is absolutely vital to achieving this.’
Many doctors in training used the GMC survey to express their concerns about the contract dispute and imposition of the Government’s new junior doctor contract and one in 10 said they did not feel supported by their trust or board.
The report also raised concerns about the impact of strain on services on training – with a third of the 23,000 trainers who responded saying they did not have enough time to carry out their responsibilities.
GMC chief executive Charlie Massey has written to employers – trusts and boards – reminding them of their obligations to ensure training of doctors is protected.
He said: ‘We know the very real pressures our healthcare services are under and appreciate the challenges organisations involved with the training of doctors are facing, but it is vital training is not eroded.
‘Those responsible and accountable for the delivery of medical education locally must take appropriate steps to ensure the training of doctors remains protected. Medical training is so often a bellwether for the quality and safety of patient care and patients are directly at risk if support and supervision of doctors in training is inadequate.’
The RCP report also finds that 50 per cent of junior doctors feel morale is now so low that it is having a negative impact on patient safety in their places of work.
RCP president Jane Dacre said: ‘Yet again we have more evidence that our NHS is underfunded, underdoctored and overstretched. Junior doctors are the future of medicine and as such we all have duty to ensure that the NHS they work in is a supportive environment, one where they feel like they can learn and grow but ultimately is a place where they can provide high-quality patient care.
‘The findings today show that poor access to even basic facilities, gaps in rotas and the constant pressures of administration, often taking them away from treating patients, is having a stark impact on the mental and physical health of our junior doctors.
‘Medicine is a brilliant profession with so many possibilities to enhance the lives of the patients we treat. We need to fund our NHS and social care services so that all staff are able to provide safe and effective care, but also have the ability to thrive.’