The General Medical Council (GMC), which is responsible for regulating doctors in the UK, conducts an annual survey of junior doctors to evaluate the training and education they receive. The conclusions from its latest survey have been shared with The Guardian newspaper and highlight profound concern at the expectations being placed on junior doctors as a result of staffing shortages in hospitals and the clear risks this presents to patient safety.
The survey of the country’s 55,000 junior doctors received many reports of junior staff being left in situations for which they lacked the clinical knowledge and experience needed for patients to be managed safely. Over half of junior doctors work beyond their rostered hours on a daily or weekly basis and 40% consider their workload to be heavy or very heavy.
Examples included junior doctors fresh from medical school put on overnight rotation in A&E without any prior assessment of their clinical knowledge and skills and with minimal supervision from senior staff to ensure the care they gave was within their clinical competence. In one hospital, senior A&E staff described the problem as so acute that junior doctors displayed symptoms of post-traumatic stress disorder. Elsewhere, a junior doctor was put on duty in a resuscitation unit and had to take critical decisions about patient care when three calls for senior help went unanswered, knowing that she lacked the necessary experience.
The GMC makes clear that it does not consider more senior staff, who are themselves under intense pressure with heavy workloads, to be at fault. Its chief executive is, however, reported as expressing that the regulator is “very worried” that trainee doctors are being put in a position where they are asked to act above and beyond their clinical competence and capability. The situation risks junior doctors making decisions that jeopardise their licence to practise, compounding the NHS’s staffing problems. Aside from the professional implications, junior doctors are left unsupported and anxious.
Commenting on the report, Andrew Clayton of Penningtons Manches’ clinical negligence team, explains: “Understaffing is widely recognised across the NHS and the warning from the GMC is a grave one. Demand on senior doctors is leaving junior staff unsupported in situations for which they lack the necessary knowledge and experience. While the risks to patient safety are clear, far more needs to be done to ensure that staffing levels and management keep pace with the demands the NHS faces. Attracting new staff is likely to be increasingly difficult if the current problems are not addressed head-on. In the meantime, we continue to receive many enquiries from those whose care has fallen short and left them suffering the often life-long consequences of poor clinical decisions.”