{"id":772,"date":"2016-01-19T12:46:01","date_gmt":"2016-01-19T12:46:01","guid":{"rendered":"http:\/\/hr-management-dimensions.co.uk\/HRMDmn\/?p=772"},"modified":"2019-09-30T13:10:07","modified_gmt":"2019-09-30T12:10:07","slug":"junior-doctors-dispute-re-pay-and-working-hours","status":"publish","type":"post","link":"https:\/\/hr-management-dimensions.co.uk\/HRMDmn\/junior-doctors-dispute-re-pay-and-working-hours\/","title":{"rendered":"Junior Doctors\u2019 Dispute re Pay and Working Hours"},"content":{"rendered":"

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In our first article about the junior doctors\u2019 pay and hours dispute, we queried whether the negotiators for the doctors will avoid the mistakes of previous years.\u00a0 Those agreements left some junior doctors in specialities, such as general medicine, feeling the deal was unfair as colleagues, in other specialities, were not liable to be called in after hours as often but earned more.\u00a0 You can read that article on our Facebook business page and also on this blog by clicking on this link.<\/a><\/p>\n

This article looks at the dispute from a different but important angle.<\/p>\n

Shorter Working Hours \u2013 Adverse Effect on Experience?<\/span> <\/strong><\/p>\n

It is right that excessive working hours are not a routine requirement but the hours worked also have a bearing on the exposure that doctors gain to the diagnosis and treatment of less common illnesses\/conditions.\u00a0 When discussions took place in previous years, one concern was how a junior doctor would gain appropriate experience especially as patients with interesting or less common conditions may be admitted outside of \u2018normal\u2019 working hours.<\/p>\n

When medical Consultants voiced this issue in the past, that was perceived as an attempt by consultants to avoid them providing longer periods of cover for junior doctors.\u00a0 Many consultants worked long hours before previous disputes occurred as well as during such disputes.<\/p>\n

Many junior doctors seek to qualify via the appropriate medical body such as the Royal College of Physicians or Surgeons.\u00a0 Long working hours and on call duties make studying more difficult.\u00a0 Doctors value the opportunity to take one or two weeks of study leave to revise and cram for their examinations.\u00a0 Studying to rigorous standards helps with knowledge but it is not a substitute for dealing with actual cases.<\/p>\n

Balancing Appropriate Working Hours with Developing Experience\/Skills<\/span> <\/strong><\/p>\n

Attaining this balance needs more thought. There are significant problems to overcome such as the provision of appropriate levels of cover.\u00a0 That includes the need for experienced locum cover for study leave\/professional development absences.\u00a0 The seeds of potential solutions are outlined below.<\/p>\n

Learning technology \u2013 <\/em><\/strong>it should be possible to create inter-active learning opportunities via videos etc. that give doctors the chance to see less common conditions and diagnosis in action. \u00a0\u00a0 Developing observations skills and \u2018what if\u2019 type approaches need to be covered to ensure that doctors weigh up their observations, available test results and question and examine further, if appropriate.\u00a0 Time to participate in such training will need to be made.<\/p>\n

Personal development time and accountability <\/strong><\/em>\u2013 doctors should be entrusted with planning their development with practical support from consultants who are gifted at mentoring.\u00a0 Study leave should be incorporated into an annual development time\u00a0 allowance which should become a flexible part of the contract (flexible because operational cover is still a priority).\u00a0 Gaps in experience\/exposure should be reviewed to see whether an individual should be encouraged or required to take time off to participate in specific observations\/training.\u00a0\u00a0 At the same time, doctors should be made aware that their development is not optional in the sense that if they do not take up such learning opportunities, including on wards and in education centres, they may be curtailing their career path.<\/p>\n

Career routes<\/strong> <\/em>\u2013 at one stage, junior hospital doctors started to leave hospitals in greater numbers to join general practices.\u00a0 There tends to be more opportunities for flexible and\/or part time work in GP practices. \u00a0 Another reason was the long period of time it takes to attain consultant status in a hospital compared to the shorter time to achieve a partnership in a GP practice.\u00a0 Changes in recent years to the management of general practice life may make such roles less attractive but that remains to be seen.<\/p>\n

The exit data indicates that 48% of junior doctors left the NHS after their two year foundation training [see note 1].<\/p>\n

A further review of the career structure of \u2018junior\u2019 doctors.may be appropriate to see whether there are blockages especially at grades just below consultant level and also whether flexible working across the grades is a practical option for wider application.<\/p>\n

Recruiting more career doctors <\/strong><\/em>\u2013 training a doctor is costly so the scale of loss is of concern and inefficient.\u00a0 If working hours are shortened,\u00a0 it may make more financial sense to:<\/p>\n