The abiding memory of this week has been getting to grips with the Red Flags from the GMC NTS Survey @gmcuk.
The Survey is still on going but two types of issue, if raised, require an emergency response from the Trust. In practice this means the response is rapidly delegated to the College Tutor with responsibility for that area of education. These issues are Patient Safety and Bullying & Undermining.
It is disappointing to hear that a trainee has felt Undermined via the medium of the anonymous NTS survey because it inevitably means it is too late for me to help them in real time.
The Red Flag that popped up in T&O seems to have come from a particularly robust trauma meeting in the last three weeks of the attachment & by the time it surfaced through the Survey changeover had already happened and the trainee is lost in the wind.
Bullying & Undermining is endemic in the NHS, reportedly affecting 1:3 healthcare professionals. You'll know from a more recent paper drawn from the NHS Staff Survey results @ASPHFT came in the bottom third of Trusts for Staff happiness - but what is being done to address this?
It's a difficult problem. The Trust has a 'Dignity in the Workplace' Policy which will guide you but it may seem a daunting process. For trainees of any discipline, there is the shadow cast by concern that 'making a fuss' might jeopardise future references or employment. There's no denying that's a big issue and you may look on it as perhaps a four month attachment you've just got to power through & put behind you. But I put it to you that is not solution: it is a waste of valuable training time, a waste of talent and a risk, a very high risk that communication breakdowns such as this leave open the possibility of patient safety issues not being communicated either.
I have started completing Datix on 'challenging staff behaviours' on behalf of trainees just to get the bally things logged. I've done it three times so far, the first two keeping the trainees' names anonymous at their request & the third with their name in as they were quite happy for a number of reasons to go formal.
Haven't heard any more about any of them, which is disappointing but not surprising in the case of the anonymous entries as the Trust cannot get into the nuts & bolts of the problems without talking to the complainant.
But I will keep trying for you so if that's something you want to consider if you've experienced challenging behaviour, let me know.
The Trauma Meeting
Other things we're doing - the Trauma Meeting is on the move. It's now in Fracture Clinic, a huge big space in comparison with the pressure cooker of a tiny room we were trying to shoehorn us all into.
This is a temporary solution till we find a space nearer to theatres & Swan. Clinics still need to start on time and the room needs to be reset so having a space closer to the activity of the day makes more sense.
Consultant of the Week
Once our next two appointments come to pass (hope June) we will have enough bodies to man a Consultant of the Week roster, freeing someone up from elective work to stay on site at SPH, do a teaching ward round and an afternoon #clinic. This should give the longed-for continuity, availability, education & decision-making that we've all wanted but couldn't get agreed upon as we couldn't take the hit in the 18 week pathway (losing the elective commitment every time someone's on call).
Now however the LETB Visit highlighted to senior Board members that off-site on call as poor practice, and the perceived lack of senior decision-making commented upon as part of the Red Flag, we have the external support to put this plan into practice.
So let's see. It may help. It may not. But if you can, tell someone (your AES for starters) if you are feeling pressured at work so we can change things for you in time. It is such a shame to lose the training opportunity.
Competition
To celebrate the centenary of Lord Lister’s death and to recognise the significant contribution that he made to medicine and surgery, The Royal College of Surgeons of England and Johnson & Johnson are offering the annual RCS/J&J Lister Essay Prize Award.
The task is a 2,500 word essay on this topic: "What would Lord Lister have thought of the Shape of Training recommendations regarding the future of NHS surgical training and patient care?"
