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Enhancing working lives

The junior doctors’ contract dispute highlighted a number of issues involving their training and working environment. To address this, working with partners, we have been looking at how we can enhance the working lives of doctors in training.

We have committed to improving the quality of education and training for doctors, ensuring that they feel valued and supported and that they are key components in all aspects of care, and starting to re-build morale.

However, the junior doctors’ contract dispute highlighted a number of issues involving their training and working environment. Reports of low morale, unhappiness, anger and disillusionment were widespread. Common concerns involved issues that sat outside the contract itself and included:

  • lack of timely information about rotations and on-call duties
  • different interpretations of the many rules around flexibility in  training; and
  • the rising costs of developing as a professional.

In response, working with partners including the British Medical Association Junior Doctors’ Committee, General Medical Council, NHS Employers, Academy of Medical Royal Colleges and trainee representatives, we established a working group to look at 10 targeted issues for action.

The resulting progress report, available to view below, provides an update on initiatives over the past 18 months, and includes new legal protection for doctors in training raising patient safety concerns and the impact this may have on their training and looking at how we can enable joint applications from couples. The below table, taken from the report, summarises these:

As part of this work, we undertook a listening exercise to gather together the themes affecting morale and to understand their experiences of the best training environments. This report highlights the work taking place across the NHS to address these problems, and suggests ways for health organisations to move forward, and includes a helpful case study of excellent training environments, to help trusts develop their own action plans to improve morale.

We have also proposed next steps for further action, including:

  • increasing the focus on valuing healthcare staff including doctors in training
  • committing to reducing inequity in study leave ensuring that essential costs of training are not borne by doctors in training;
  • creating more flexibility to doctors with regard to deployment which will benefit doctors with special circumstances who need to train in a certain area, and those who want to train in the same areas as their partner and those who want to move region;
  • pilots planned to look at different ways to increase flexibility in training, optional reductions in hours, and allowing doctors to pursue less pressured training opportunities in parallel to standard training programmes.

Professor Wendy Reid, Director of Quality and Education and Medical Director, Health Education England said:

It is important that we demonstrate to junior doctors that we have listened to their concerns and issues and that we have acted to resolve them. Junior doctors should not have to compromise their training to deliver the service.

I am grateful to all those who have contributed to this work over the past 18 months. There is clearly more to do, and HEE will work with all concerned to continue to raise the quality of training and the quality of doctors’ working lives.

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