Junior Doctors’ 48 Hour Expert Working Group: March 2019

Attendees and apologies

Present

• Professor Philip Cachia, Chair
• Dr Luke Yates, Scottish Academy of Medical Royal Colleges
• Mr Sean Gallimore, BMA
• Dr Lewis Hughes, BMA
• Dr Simon Edgar, Director of Medical Education
• Mr Daniel McQueen, Healthcare Improvement Scotland, Public Partner
• Dr Jane Burns, Management Steering Group
• Dr Annie Ingram, Management Steering Group
• Professor Claire McKenzie, NHS Education for Scotland
• Ms Anne Dickson, NHS Education for Scotland

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
• Mr Chris Raftery, Head of NHS Pay and Conditions
• Dr Pavel Stroev, Policy Manager (secretariat)

Apologies

• Professor Derek Bell, Scottish Academy of Medical Royal Colleges

Items and actions

The Chair welcomed everyone and introductions and apologies were made.

The note of 20 November meeting was discussed. Simon Edgar raised concerns with point 4 and that it did not accurately reflect the discussion. Dr Edgar agreed to redraft the paragraph. These will then be recirculated.

Action: Simon Edgar, secretariat.

Terms of reference (ToR)

The Chair informed the group that the Cabinet Secretary for Health and Wellbeing has approved the terms of reference. These were circulated along with copies of communication between the Chair and the Cabinet Secretary.

Programme of work for EWG

The current work of the GMC Wellbeing group was raised, and where it may link into the work of the EWG. John Colvin would speak to Denise Coia to get an update on this.

Action: John Colvin to contact Denise Coia for an update on the GMC wellbeing group.

Daniel MacDonald updated on the modelling work which will be undertaken with NHS Lanarkshire to measure the impact of a 48 hour working week. This will involve General Medicine, General Surgery and A&E, and will include around 70 junior doctors. It will cover the rotation period of February to July 2019. Mr MacDonald asked the group to consider what should be included in the testing framework. The group discussed and made suggestions including (but not limited to):

• service impact
• waiting times
• staff experience
• fatigue and safety
• attractiveness
• continuity and access to education

Work will be taken forward in partnership with NHS Lanarkshire and an update brought back to the next meeting of the EWG.

Action: Daniel MacDonald, Alex Rice and Chris Sheridan to take forward rota modelling and impact assessment.

Clare McKenzie updated the group of the process for educationally approving rotas. This focuses on local knowledge with involvement of educational leads and trainees, to allow a decision to be made as to whether a rota is likely to meet the educational needs of trainees. The group agreed that local knowledge would be key to assessing the educational impact of any changes. Clare McKenzie and Anne Dickson tabled a paper on educational approval process.

Action: Secretariat to circulate the paper among the members of the group.

The group then focused on how fatigue can be objectively measured in any working pattern. Chris Sheridan detailed various publications which may help with setting criteria. The group considered and agreed that it is likely to require the engagement of an expert in this field at some point in the near future when modelling has progressed.

Date of the next meeting:

Wednesday 22 May 2019 at St Andrew’s House, Edinburgh.

Further meeting dates will be agreed and circulated.

Action: Secretariat

March 2019