In conclusion, there is convincing and unsurprising evidence that working patterns in the specialty have direct effects on the quality of education and training of trainees across the UK. Only 56% of trainees feel their rota supports team working and continuity of care.
Rota gaps, pressure to cover colleagues, removal from training opportunities and inability to attend professional meetings and regional teaching are not insignificant problems that need innovative solutions. That said some of the inter-deanery differences are both surprising and challenging and are worthy of further investigation.
We need to carefully consider whether 16-17% of trainees feeling patient safety is compromised both in and out of hours by inadequate medical staffing levels is acceptable even if this is a perception rather than a reality.
We also need to consider how we might share good practice more effectively so that we can drive improvement across the UK in training and support schools in their efforts to undertake this regionally.
It is not possible at present to state what impact the New Junior Doctors’ Contract will have on working patterns.
- Disseminate recommendations of the working party on rota gaps
- Consider how to improve sharing of good practice between schools
- Heads of school to consider inter deanery variations
- Encourage use of TEF training data on quality visits to Trusts/Departments
- Support effective use of exception reporting to drive improvements in training and patient care within Trusts.