NHS reliance on junior doctors hinders their training

Too many junior doctors are missing out on vital training and being left unsupervised, while consultants need to take more direct responsibility for “24/7 care”, says a new report by Professor Sir John Temple.

Professor Temple’s report, Time for Training – a review of the impact of the European Working Time Directive (EWTD) on the quality of training doctors, dentists, pharmacists and healthcare scientists – was commissioned by the former Labour government.

The review reveals that, despite an increase of more than 60% in consultant numbers over the past 10 years, hospitals remain too reliant on junior doctors to provide out-of-hours services. It found that young doctors could still receive high-quality teaching in a 48-hour week, but not if they continued to provide so much out-of-hours care.

Sir John recommended that the service needed to be redesigned so consultants worked more flexibly and were more “directly responsible” for patient care around the clock, leading to better quality of diagnosis, better decision making, and better patient outcomes and safety.

Bill McMillan, head of medical pay and workforce at NHS Employers, said: We are pleased that many of Professor Temple’s recommendations echo the evidence that we submitted to the review on behalf of NHS organisations. We believe that employers in the service are committed to ensuring that doctors are able to work and train in a way that is safe and effective for both them and their patients.”

However, John Black, president of the Royal College of Surgeons, said: “We are relieved that this report openly acknowledges that the European Working Time Regulations have critically damaged medical training in the UK. However, we are deeply disappointed that the remedies proposed are unworkable. It is unrealistic to put training concerns above those of patients, and there are not the bottomless resources available to fund these proposals. The one obvious solution for the acute specialties – that of removing the EWTD itself – is not assessed at all.”

Sir John said: “I recognise that the EWTD may be reviewed in due course. However, the transformation of training needed now is paramount and must be addressed regardless of any modifications in order to produce well-trained professionals for the future.”

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