Junior Doctors’ 48 Hour Expert Working Group: June 2019

Attendees and apologies

Present

• Professor Philip Cachia, Chair
• Dr Luke Yates, Scottish Academy of Medical Royal Colleges, Trainee Representative
• Dr Lewis Hughes, BMA
• Dr Simon Edgar, Director of Medical Education (via video link)
• Mr Sean Gallimore, BMA
• Mr Daniel McQueen, HIS Public Partner
• Professor Clare McKenzie, NES

Professional advisors 

• Dr John Colvin, Professional Adviser and Senior Medical Officer
• Mr Daniel MacDonald, Medical Workforce Adviser

EWG Secretariat and support

• Dr Alex Rice, Clinical Leadership Fellow
• Dr Chris Sheridan, Clinical Leadership Fellow
• Dr Pavel Stroev, Policy Manager (secretariat)

Apologies

• Dr Jane Burns, MSG Management Steering Group
• Dr Annie Ingram, MSG Management Steering Group
• Professor Derek Bell, Scottish Academy of Medical Royal Colleges
• Ms Anne Dickson, NES

Items and actions

1. The Chair welcomed everyone and introductions and apologies were made.

2. The Note of 22 May meeting was agreed.

Criteria for educational approval of rotas

3. Clare McKenzie presented an update paper on progress within NES to revise the process for awarding educational approval for new or revised rotas. A discussion took place about which measures could potentially be taken to ensure the rotas receive fully considered educational approval which recognises the needs of all trainees. Prof McKenzie informed the group that the current system is not robust enough and an improved process will be developed and implemented. This represents a positive outcome from the EWG work.

4. NES will continue to work towards a standardised, consistent national process for educational approval.

Lanarkshire table-top exercise

5. The remit and agenda for Lanarkshire table-top exercise on 9 July were discussed and agreed.

6. Facilitators are to have a teleconference on 1 July to discuss practical arrangements.

Actions: Secretariat

Public Partner’s reflections

7. Daniel McQueen shared his thoughts on what use of technology can be made to accurately record working hours of Junior Doctors. He suggested a possible swipe in - swipe out system to accurately record and control hours. The group considered this and the general consensus was that medicine, unlike other professions, does not work on a stop - start basis. It is important that working patterns accurately reflect the hours doctors work but are also flexible enough to respond to the unpredictable nature of healthcare. Concerns were raised that clocking in and out would take away doctors’ professional autonomy. There is also anecdotal evidence of the adverse impact of introducing swipe cards in medical training.

External Engagement

8. The GMC wellbeing working group will publish in September. It was agreed that it was pragmatic to wait for this data and the outcome of the Lanarkshire table-top exercise before deciding on whether to engage external experts to support the work of the EWG.

9.  A paper from Peter Johnston and Jen Cleland describing a NES funded research project developing their published work on how trainee doctors prioritise career and specialty application decisions. It was noted that this work does interface with current national initiatives in trainee doctor wellbeing and the EWG should monitor the outcomes and synergies with our work.

AOCB

10. A discussion took place of the NHSE juniors' contract and the evidence for some of the current/new proposed safeguards there, and what we might learn from that.

11. Alex Rice and Chris Sheridan also spoke through the rotas they prepared looking at 48 hours in any seven days (as opposed to Mon-Sun) as requested by the group at the last meeting. The take-home point from this is that even when trying to maximise working hours, with all the various hours safeguards already in place, introducing this would result in all doctors on the rotas studied working less than 40 hours per week average, and thus becoming less than full time.

Dates of the future meetings:

12. The following dates were agreed:

• Monday 2 September, 2.00 pm – 5.00 pm, St Andrew’s House
• Wednesday 20 November, 2.00 pm – 5.00 pm, St Andrew’s House