Patient care could be affected by interview process for new junior doctor jobs, BMA warns
(issued Wednesday 20 Dec 2006)
The quality of NHS patient care could suffer because reforms to doctors’ training are being rushed through, the BMA warns today (Wednesday 20 December, 2006).
Under the government’s Modernising Medical Careers reforms, around 20,000 new specialist training posts are to be created across the UK next summer. The process of selecting junior doctors to the posts is scheduled to take place between 28 February and 13 April 2007.
The BMA is concerned that only six weeks has been set aside for interviews and that the period may be shorter in some areas. This could leave wards struggling to provide cover for junior doctors being interviewed, and for the consultants interviewing them. In supplementary evidence to a parliamentary inquiry on NHS workforce planning, published today (Wednesday 20 December, 2006), the BMA quotes a letter from the Director of NHS Employers stating:
“The absence of 21,500 junior doctors attending up to four interviews could have a major impact on service delivery, and/or the cost of locum cover.”
Dr Jonathan Fielden, chairman of the BMA’s Consultants Committee, says:
“The possibility of a major service impact is of significant concern to consultants. Unless doctors are properly involved, there will be risks to patient care. We wish to see as smooth a process as possible, but many trusts have yet to prepare adequately. We have been pressuring employers and the Department of Health to get urgent clarification so proper planning can take place.”
The BMA is concerned that there may be too few posts at the right level of training and too few guaranteeing doctors entry to long-term programmes taking them up to consultant or GP level. The evidence states that the availability of posts could also be affected by cuts to NHS training budgets, and that competition is likely to be intense, particularly if there are high levels of applications from overseas doctors, or those currently in non-training posts. BMA research has shown that most doctors would consider leaving the UK if they were unable to find a training post.
Dr Jo Hilborne, chairman of the BMA Junior Doctors Committee, says: “Junior doctors are extremely worried about the impact these changes will have on their careers. They haven’t had nearly enough careers guidance from the government, even though the whole of their working lives will be affected. There are also potential implications for patients, both in the short-term – if wards face staffing problems – and the long-term - if doctors are forced to leave the country.”
The BMA evidence calls on the government to publish a precise timetable for the Modernising Medical Careers process, stating the daily level of doctors’ absence in every area and every specialty during the interview period.
The BMA has issued guidance to UK consultants on the steps they can take to minimise the service impact of the changes.
Read more about consultants’ concerns about the Modernising Medical Careers process on the BMA website at:
http://www.bma.org.uk/ap.nsf/Content/consultantsmmc?OpenDocument&Login
Ends
Notes to editors
Full text of supplementary evidence follows:
NHS Workforce Planning Inquiry
Modernising Medical Careers - BMA Supplemental Evidence
On 13 December, the Department of Health announced the number of places for doctors entering specialist training in England in 2007. Following this announcement, the BMA would like to take the opportunity to contribute supplemental written evidence to the Health Committee’s current inquiry on NHS workforce planning.
The BMA has taken an active interest in the implementation of Modernising Medical Careers (MMC). In particular, the BMA’s Junior Doctors Committee and the Central Consultants and Specialists Committee (CCSC) have been concerned about the progress of implementation of the Run Through Grade of Specialty Registrar (StR).
The BMA welcomed the announcement from the Department of Health that there will be at least 18,000 places for doctors entering specialist training in England in 2007. This is a major improvement on the figure of 9,500 posts previously announced by the Department of Health.
However, whilst the BMA welcomes this announcement, there are still a number of crucial issues remaining unaddressed and causing anxiety among doctors. In particular, the JDC is concerned that:
- It is not yet known how many of these posts will be entry points to long term training, and how many will be short-term appointments - nor do we know at what level they are.
- Junior doctors have not had enough careers guidance, even though many will be forced to change speciality as a result of the reform. Although money has been made available for doctors currently in Foundation programme year 2 to receive careers advice, there have been no extra resources for the approximately 16 000 doctors working at SHO level, many of whom are facing difficult decisions about their future career.
- Competition is still likely to be intense and, as the government acknowledges, no-one knows how many applications there will be from overseas, or from UK doctors in non-training posts.
- NHS Trusts have had insufficient time to prepare, and there could still be a significant service impact, particularly during the interview period.
The BMA’s CCSC is fully supportive of junior doctors’ own concerns about their training and the potential effects of MMC on their career progression. Moreover, the CCSC has a particular focus on how the recruitment to Specialty Registrar in the Spring might impact on consultant workload and, potentially, patient care through absence of doctors on the wards. A letter dated 10 November to trusts by Steve Barnet, Director of NHS Employers, states:
The absence of 21,500 junior doctors attending up to 4 interviews [between 28 February and 13 April] could have a major impact … on service delivery and/or the cost of locum cover.
1
This is a major worry for consultants whose responsibility it is to deliver the service. The need to publicise the precise timetable, stating the daily level of absence across all deaneries for each speciality in each day during the whole recruitment process is becoming increasingly urgent. It is, therefore, an issue which is growing in its prominence for the CCSC. It is essential that the timetable is published as early as possible
Together with junior doctors, the CCSC also fears that because the curricula will not be published until the New Year, junior doctors will be forced to apply for posts without a full understanding of the training which is to be provided. Furthermore, there are concerns about the potentially detrimental effect of cuts to MPET
2, especially on the availability of posts.
MMC should bring major benefits to both doctors and patients; however, the BMA is extremely concerned about the lack of planning of implementation and the speed with which the service and training is being re-organised. We particularly worry about its effect on the existing workforce making a transition to the new system.
Yours sincerely,
Dr Jo Hilborne
Chairman BMA Junior Doctors Committee
Dr Jonathan Fielden
Chairman BMA Central Consultants and Specialists Committee
1 http://www.nhsemployers.org/workforce/workforce-1944.cfm
2 MPET stands for Multi Professional Education and Training levy (MPET). It is a funding stream from the Department of Health that funds the additional costs to the NHS of supporting the practice experience of medical and dental students.