Trainee doctor changeover 'impacts on patient safety'

Image caption The survey looked at the month when trainee doctors take up their posts

The vast majority of doctors believe patient safety is compromised by the August intake of medical trainees, a survey has suggested.

The latest intake of medical trainee doctors start their training posts in the NHS at the beginning of the month.

The figures come in a study from the Society of Acute Medicine and the Royal College of Physicians of Edinburgh.

It found that 90% of doctors who responded said the changeover had a negative impact on patient safety.

The report authors called for an urgent reform to the system to be examined by the UK and Scottish governments.

On the same day trainees start doctors already in training rotate into other positions.

An estimated 50,000 doctors in the UK change over on the first Wednesday in August.

The RCPE said evidence in recent years had also suggested that there may be a higher early death rate for patients admitted at this time than at other times.

The survey of just under 750 doctors throughout the UK, published in the journal Clinical Medicine, found:

  • 93% believed the August changeover had a negative impact on patient care
  • 90% believed the changeover had a negative impact on patient safety
  • 58% believed the changeover had a negative impact on doctors' training

The effects of the changeover on care and training were perceived to last for up to one month.

Most doctors believed a staggered transition by grade, over a period of over a month, could mitigate the impact. One respondent reported: "August is always a nightmare."

Dr Louella Vaughan, honorary consultant physician in acute medicine, and lead author of the study, said: "The results of this survey add to the emerging evidence base which indicates that the current August changeover system increases a number of risks for patients, including an increased early death rate for patients admitted to hospital at this time."

She called for "urgent reform" to the current system.

Dr Neil Dewhurst, president of the Royal College of Physicians of Edinburgh, added: "Formal evidence in support of our concerns has, however, been limited, but is now increasing and has reached the level where it should not be ignored.

"Other changes to established systems within healthcare have been shown to deliver real improvements for patients and similar consideration must be given to making the changeover in training safer.

"We would urge the Scottish and UK governments to review this matter as a matter of urgency."

A spokesperson for the Scottish government, said they would consider the findings of the study.

'Established feature'

But added: "We have absolutely no evidence to link the national training changeover of doctors in August to any increased risks to patient safety in NHS Scotland.

"Since the launch of the Scottish Patient Safety Programme in 2008 we have seen major improvements, and it is vital for patients to have confidence that when they access any part of the healthcare system, they will receive the best available treatment without fear of harm.

"The national training changeover of doctors is an established feature of the national postgraduate medical training curriculum, and boards have systems in place to ensure the maintenance of high quality care at the changeovers for doctors in training.

"These include induction progresses and pre-August shadowing arrangements for newly qualified doctors.

"The arrangements are supported by senior medical staff and advanced nurse practitioners and patient safety is a key focus."

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