New Recommendations for Improving Junior Doctors’ Working Environment

RECOMMENDATIONS for improving the working environment and morale for junior doctors have been published by NHS Improvement in conjunction with the Faculty of Medical Leadership and NHS Providers. The document comes amid concerns of staff retention and stress amongst junior doctors in the NHS.¹

It is hoped that the guidelines will lead to significant benefits in staff engagement and performance, ultimately resulting in cost savings and a higher quality of patient care. The eight high-impact actions, based on the British Medical Association (BMA) recommendations, are summarised below:

• Tackle work pressure by reducing the number of administrative and basic clinical tasks that junior doctors currently undertake. Possible solutions include the creation of new administrative positions and widespread use of electronic task management software.
• Ensure staff are well rested and travel home safely by guaranteeing they take regular breaks and introducing a policy for rest facilities or alternative arrangements when staff are too tired to travel home.
• Guarantee food and drink are available around the clock, including easily accessible drinking water in clinical areas, and healthy and hot food for staff.
• Encourage engagement between trainees and the board through junior doctors being shadowed by board members, board members attending junior doctor forums, and having representatives of junior doctors on executive committees.
• Promote clearer communication between trainees and managers by enabling easy and fast contact between senior trainees and divisional managers, and the introduction of paired learning between doctors and managers.
• Develop rotas that promote work-life balance by making sure junior doctors are sent work schedules and duty rosters a minimum of 8 and 6 weeks ahead of time, respectively, and involving junior doctors in the design and management of these rotas.
• Reward excellence by introducing formal structures to celebrate accomplishments and creating events to celebrate staff achievements.
• Increase the mental and physical wellbeing of junior doctors by providing support and mentoring through the appointment of a dedicated pastoral lead and providing tailored resilience and stress management training.²

“It is important that junior doctors, like all healthcare professionals, have a constructive and safe working environment that gives them the time and facilities they need to deliver care to their patients. This new guidance sets out common sense proposals that echo the BMA’s recommendations in this area,” commented Dr Jeeves Wijesuriya, Chair of the Junior Doctors Committee, BMA. “It is particularly encouraging to see an emphasis on the wellbeing of junior doctors throughout this report, as this is a critical issue affecting both workforce recruitment and retention. This issue remains a high priority for the BMA and we will continue to work with a range of organisations on this across the NHS.”

References

1. Farand C. NHS ‘wake-up call’: Six out of seven young doctors at risk of burning out, survey finds. Independent, 2017. Available at: http://www.independent.co.uk/news/uk/home-news/burning-out-survey-royal-college-anesthetists-nhs-a7576196.html. Last accessed: 31 October 2017.
2. NHS Improvement. Eight high impact actions to improve the working environment for junior doctors. October 2017. Available at: https://improvement.nhs.uk/resources/eight-high-impact-actions-to-improve-the-working-environment-for-junior-doctors/. Last accessed: 31 October 2017.

James Coker, Senior Editorial Assistant