Wales Deanery: Hospital worry on junior doctor training
Hospital departments across Wales could close at short notice unless urgent action is taken to address the training needs of junior doctors, it is claimed.
The warning has been issued by the body responsible for post-graduate medical training in Wales.
The Wales Deanery said a "recruitment crisis" of doctors in specialisms means hospitals "are struggling to provide adequate training".
The Welsh government said it was taking robust action to recruit medical staff.
An action plan obtained by BBC Wales, based on hospital visits by the Deanery and the General Medical Council (GMC) along with the results of GMC surveys of junior doctors, also revealed serious shortcomings and inconsistencies in the standard of medical training at Welsh hospitals.
It highlighted occasions when junior doctors had been left to work unsupervised.
The sub-dean for quality at the Wales Deanery, Dr Sian Lewis, said: "It's extremely urgent. A recruitment crisis [in certain areas] means we're struggling to deliver adequate training and also services are often very very close to the edge of coping.
"Our doctors work hard, but clearly if we reach a point that we're unable to resolve our recruitment problems units would have to close unexpectedly."
Across all the health boards in Wales, junior doctors reported systemic weaknesses in the training opportunities and patient safety issues.
The report also noted patient safety concerns due to a lack of clinical supervision by consultants in obstetrics and gynaecology at Ysbyty Glan Clwyd, inadequate critical care training in anaesthetics at Glangwili Hospital in Carmarthen and junior doctors in anaesthetics at the Prince Charles Hospital in Merthyr Tydfil not having access to the minimum number of teaching sessions each week.
- Doctors with only two years experience have been the most senior on duty at night at the children's surgery department at the University Hospital of Wales in Cardiff
- A doctor with only two years experience worked in isolation at night at the A&E department of Nevill Hall Hospital in Abergavenny.
- Doctors in kidney medicine with insufficient transplant experience, and neurosurgery trainees not having enough access to operating
- Source: Action plan based on hospital visits by the Deanery and GMC and results of GMC surveys
The action plan also showed that for core surgical training Wales ranked lowest in the UK in 2011 for overall satisfaction.
It also identified problems across the board in Welsh hospitals in providing internet access to junior doctors to research or study.
The Wales Deanery said it continually worked with health boards to identify problems, implement improvements and that many concerns had already been addressed.
The chair of the junior doctors committee of the British Medical Association in Wales Dr David Samuel said Wales was falling behind other parts of the UK.
Problems with training were also making it difficult to attract junior doctors to Wales, he added.
The Leader of the Welsh Liberal Democrats Kirsty Williams said training problems are contributing to a "perfect storm" for the NHS in Wales.
"It is very clear that the botched way the Welsh Labour Government is running our NHS is having a detrimental effect on the training of our junior doctors," she said.
"Trainee doctors play a vital role in the frontline running of our NHS and it is very important that these junior doctors get the best training and further education possible."
The impact of the training issues highlighted has already been felt by the NHS in Wales.
End Quote Welsh government
We are taking robust action to recruit medical staff where there are vacancies, but it is important to note that there are UK wide shortages in some specialties”
Recently Abertawe Bro Morgannwg Health Board was forced to close acute medical services at Neath Port Talbot Hospital.
It followed a decision by the Wales Deanery to move CT2 grade doctors to other hospitals.
The Deanery warned it could remove doctors from other departments or hospitals "as a last step" if similar problems emerge.
Health boards have insisted that improving the training on offer to junior doctors is one of the key reasons why health services across the country is being reorganised.
A Welsh government spokesperson said: "The GMC survey reports a higher rate of satisfaction (81.03%) among junior doctors training in Wales than the UK average (80.4%), and we, the Deanery and the GMC are satisfied that the majority of issues raised in the survey have since been resolved.'Patient safety'
"The Deanery does not simply pull trainees out of departments.
"It works very closely with LHBs to find alternative solutions and withdrawing training does not come out of the blue but after months of preparation to ensure patient safety is not compromised."
The spokesperson added that the need to make radical and urgent change to the health service in Wales was clear.
"One of the many benefits of reconfiguration is that specialists in certain fields will be brought together in centres of excellence, providing opportunities for better training, as well as better quality care," added the spokesperson.
"We are taking robust action to recruit medical staff where there are vacancies, but it is important to note that there are UK wide shortages in some specialties and our vacancy rate of 3% is no worse than that of the rest of the UK."