Junior Doctors’ 48 Hour Expert Working Group: November 2019

Attendees and apologies

Present

• Professor Philip Cachia, Chair
• Dr Luke Yates, Scottish Academy of Medical Royal Colleges, Trainee Representative (via the phone link)
• Dr Michael Jones, Scottish Academy of Medical Royal Colleges (via the phone link)
• Dr Lewis Hughes, BMA 
• Mr John Keaney, MSG Management Steering Group 
• Ms Anne Dickson, NES
• Mr Sean Gallimore, BMA 
• Mr Daniel McQueen, HIS Public Partner
• Professor Clare McKenzie, NES (via phone link)
• Dr Simon Edgar, Director of Medical Education 

EWG Secretariat and support 

• Dr Alex Rice, Clinical Leadership Fellow
• Dr Chris Sheridan, Clinical Leadership Fellow
• Dr John Colvin, Professional Adviser and Senior Medical Officer 
• Callam Fowler, Policy Officer (secretariat)

Observers

• Dr Katie Ritchie, Clinical Leadership Fellow
• Michelle Currie, Clinical Leadership Fellow

Apologies

• Professor Derek Bell, Scottish Academy of Medical Royal Colleges
• Dr Jane Burns, MSG Management Steering Group
• Mr Daniel MacDonald, Medical Workforce Adviser

Items and actions

The Chair welcomed everyone, introductions and apologies were made.  The group acknowledged Jane Burns contributions and sent her  best wishes. 

The Note of 2 September meeting was discussed and the Chair proposed a change to the text at item 7, the group agreed to the change. The note was otherwise agreed.

Action point

• the Chair to update the wording at item 7 and finalise note

Matters arising

The Chair commented that he and Daniel McQueen had met with Mr Brian Connelly again in October. It was noted that the meeting of 20 November will be the final meeting before the Chair presents the final report to the Cabinet Secretary in December. The Chair requested that any further work of the group is conducted via email, the group agreed.

GMC Wellbeing Report – ‘Caring for Doctors, Caring for Patients’ (for information)

The Chair discussed the GMC Wellbeing Report with the group. The group agreed that it would be desirable to reference the GMC report and reference its recommendations in the final report. 

Fatigue: What it is and why Junior Doctors are at greater risk – Luke Yates and Lewis Hughes

The paper produced by Luke Yates and Lewis Hughes was shared with the group for discussion. The general consensus of the group was that their paper was consistent and in line with evidence sources referenced in the paper. Comment was made that there was a specific and clear focus on fatigue. This paper is the opinion of the group and will be used as such in the final report. 

Action point

• the Chair set a review time of 29 November for the group members to consider the fatigue paper in more depth, the fatigue paper is to be circulated around the EWG for suggestions. Luke Yates and Lewis Hughes to finalise the paper by 6 December

EWG public partner observations – Daniel McQueen

Daniel McQueen provided his reflections on the EWG and commented that the group made him feel welcome. He pointed out that the work conducted by the group has been fair and comprehensive. Comment was made that the Junior Doctors wellbeing has been a focus and communication within staff can cause stress. The group discussed the possibility of monitoring JD’s working hours more robustly however this may need further consideration. The group welcomed Daniel McQueen’s paper and were keen for this to be to be included in the final report as it is. The group agreed that is was delivered from a fair and open view point.

Action point

• Daniel McQueen to consider final points made and provide final paper by 6 December

Draft report

The Chair thanked Alex and Chris for their rota modelling report and the work involved with the Lanarkshire table top exercise. The Chair noted in the draft report that the naming of MSG will be updated and that BMA to show they had 2 x representatives. The group were in agreement that all views and opinions included in the draft report have been considered, overall the group agreed with the report. The group members considered the programme of work with recommendations from the following presentations and work; PCAT and e-Rostering, Rota design, Educational approval process, NHS Lanarkshire table-top exercise and Evidence on fatigue. The Chair will present the Cabinet Secretary with the findings in the final report. The Chair put forward a revised outline of the sections for the final report, the group agreed to the suggestions. The group were in agreement that the final report should be with Cabinet Secretary by the end of the year. 

Action point

• the Chair to re-arrange the sections for better coherence, this is to be shared with the group

Educational rota checklist – Clare McKenzie

The EWG discussed the paper, Clare McKenzie stated that the group has been really helpful in preparing the paper. The paper outlined a process for Scotland Deanery to use to educationally approve rotas. The group were in agreement that the Education Approval Checklist paper should be included as an appendix in the main report. 

Action point

• Clare McKenzie to make recommendations to support Rota checklist paper. The Chair set a deadline of 6 December to have the paper finalised and any suggestions to be sent to Clare prior to the deadline.

Next steps

AOB:

• Alex Rice was previously asked to clarify the number of doctors required to bring the staffing levels back up to safe working standards. Provisional modelling indicated that the number of junior doctors would need to increase by around 35% to meet all service and educational needs within a 48 hour maximum working week

Finally, the Chair of the EWG thanked all members for their time and effort. No further meetings are planned or expected to take place. The Chair will now report to the Cabinet Secretary by the end of December 2019.