Thousands of juniors start jobs in NHS 'killing season'

Trials in Bristol reduced mistakes by junior doctors by 50 per cent over their first four months.

Gayna Hart, managing director of Quicksilva, a private company which has provided computer software to the NHS for prescribing and appointment booking, said: "In a bid to counteract this “killing season” the Department of Health has prescribed targeted training to better prepare trainees for the reality of life on the wards this week.

"But it’s a bit like giving a man a crutch for his broken leg for only four days - he needs on-going support, not a quick fix.

"A long-term prescription is needed here - we need to be pre-empting problems earlier on and providing sustained support to junior staff in the UK by better nurturing their skills.

"It’s encouraging to see that trials in Bristol of week-long shadowing and additional teaching have reduced mistakes made by new doctors by 50 per cent. If this is truly representative of the benefits, I’d say that we’d be short-sighted to set this kind of skills development at just four days."

Surveys have shown that junior doctors are asked to carry out operations and procedures on patients which are beyond their capabilities and often have responsibility for large numbers of hospitals patients overnight when fewer senior staff are on duty.

Dr Anthea Martin, senior medical adviser at the Medical and Dental Defence Union of Scotland, which provides legal advice for doctors and dentists nationwide, said junior doctors should not be asked to carry out tasks they are not confident doing and should always seek help from senrio colleagues if tehy are unsure.

She said: “Starting life as a junior doctor is a daunting experience. There is a steep learning curve when medical students make that transition from student to doctor.

“Many feel they are being thrown in at the deep end and the nature of medicine means that it is inevitable doctors have to learn on the job.

“Newly qualified trainees beginning their role as doctors today should not have to cope with clinical problems that are beyond their competence as this can put patients at risk. They should not feel pressurised into working outwith their capabilities.

“It is important they do not feel afraid to seek help and advice from colleagues and supervisors. By asking questions, they are reducing the risk of stress and ensuring patient safety is not compromised. Given the correct support, juniors will become more confident and assured in the tasks they perform.

"Junior doctors themselves have to recognise the limits of their expertise and competence, otherwise patients are placed at risk and this increases the possibility of a complaint or clinical negligence claim. If in doubt, juniors should always seek advice and support from senior or more experienced colleagues.”

Announcing the new shadowing scheme, Professor Sir Bruce Keogh, NHS Medical Director, said: “There is some evidence of increased risk to patients as new doctors take their first steps. So, learning from pilots across the country, we have agreed that all new first year doctors should undertake a period of paid shadowing the doctor they will be replacing, for a period of at least four days.

"That scheme will start this year, and will operate in late July every year.

“Patient safety and providing a high quality service is at the heart of a modern NHS. This shadowing period could potentially save lives, and will equip new junior doctors with the local knowledge and skills needed to provide safe, high quality patient care, from their first day as a doctor.”

Dr Tom Dolphin, chairman of the BMA's junior doctor committee, said: “The BMA has been calling for the introduction of a shadowing scheme for new doctors for many years as it has been shown that having an experienced pair of hands to show new doctors the ropes improves patient safety.

"It means new doctors will be ready to go on the first day, familiar with the hospital's systems and ready to focus on patient care rather than worrying about where to find the X-ray request forms.

"It will go some way to making sure that patients get good care whatever day of the year they present and we're pleased this is now in place nation-wide.”