Release date- 01092016 - Poor conditions for junior doctors working in the NHS are harmful to patients who need emergency surgery, a new study has highlighted.
The research from Birkbeck has discovered a significant disparity in the experiences of patients who have emergency surgery, comparing NHS hospitals with good and poor working conditions for junior doctors.
The Birkbeck research was inspired by The Royal College of Surgeons of England's emergency surgery policy briefing highlighting concerning variation across hospitals in the standards of emergency surgery care and the rate of patient mortality.
The mortality rate after some types of emergency surgery is 4% in some hospitals yet in other hospitals as many as 42% of patients died after the same procedure. Organizational problems, such as poor levels of staffing within emergency contexts, and poor working conditions for junior doctors working in A&E are contributing factors.
Birkbeck organizational psychologist, Dr. Caroline Kamau, conducted a naturalistic experiment using data taken from the national in-patient survey and Care Quality Commission (CQC) reports about junior doctors' experiences in five randomly-selected English NHS trusts:
.Chelsea and Westminster Hospitals NHS Foundation
.East Kent Hospitals University NHS Foundation Trust
.Frimley Park Hospital NHS Foundation Trust
.Northampton General Hospital NHS Trust
.Sherwood Forest Hospitals NHS Foundation Trust
The quality reports show that Chelsea and Westminster, Frimley Park and Sherwood Forest hospitals have good working conditions for junior doctors whereas in Northampton General and East Kent hospitals the conditions need improvement.
Quality data show that East Kent hospitals need better staffing and training support for junior doctors, and their plans to improve the issues are said by the CQC to be not effectively mitigating the risks to junior doctors.
In Northampton General, junior doctors spoke to the CQC of being brutally busy and the CQC wrote that the Trust lacked full compliance with mandatory training and personal development planning.
The research shows how different variables interact in determining the quality of patients' experiences.
Stressing the importance of improving working conditions for junior doctors, the study author, Dr. Kamau, said:
'Between 30% and 40% of emergency patients undergo surgery, which has an increased risk of serious complications and death yet junior doctors are often responsible for reviewing patients who go to emergency. Delays of diagnosis or investigation can be lethal.
'Organizational support for junior doctors in the NHS is pivotal if we want to address these problems.'
This is the first study to triangulate CQC data and in-patient data in this context.
Among the study's recommendations are:
.Increase the number of NHS consultants in A&E
.Increase the number of NHS registrars and consultants with expertise in emergency surgery
.Give junior doctors inductions that speed up their decision-making about patients who need urgent surgery
.Increase government funding for research into emergency surgery
The report, titled Vulnerability of emergency surgery to the working conditions of new doctors is published today (01.09.16) in The Bulletin of the Royal College of Surgeons of England.
Yesterday it was announced that junior doctors are to stage five days of industrial action in the row over the controversial new contract for training medics. This research shows that improving working conditions for junior doctors in the NHS has a positive impact on patients.
Dr. Kamau, who works within Birkbeck's Department of Organizational Psychology, added: 'Hospitals should listen to junior doctors and find ways of improving their working conditions. Hospitals that are supportive of their junior doctors end up with better patient experiences.'