CRISIS A SURVEY by the GMC has revealed that 21 per cent of 45 to 54-year- old doctors and two-thirds of those aged 55 to 64 intend to take early retirement by 2021, presaging a workforce crisis that could be compounded by Brexit. These findings emerged from research commissioned by the

regulator for its 2018 The state of medical education and practice in the UK report, which it says “paints a stark picture of unabated pressure on health services”. The survey of around 2,600 doctors indicates that many are

considering career changes to escape the heavy workload in primary and secondary care. Around a third are considering reducing hours in the next three years, a fifth plan to go part time and a further fifth plan to leave the UK to work abroad. These findings are further supported by research from the RCGP which found that 31 per cent of GPs said they are unlikely to be working in general practice in the next five years - many citing stress and plans for early retirement. The GMC report has also revealed that some doctors are employing

measures to cope with patient demand that may be piling more pressure on other parts of the system. These include making unnecessary referrals, ordering excessive blood tests or bypassing clinical checklists in order to get through workload. The possibility of a “no deal” Brexit is adding to uncertainty, with

worries about how EEA qualified doctors, who make up nine per cent of licensed doctors in the UK, will be able to join the UK medical register after the UK leaves Europe. The status of EEA qualified doctors already registered in the UK is guaranteed but the GMC has warned that it is crucial that the “tap is not turned off” after March 2019, enabling EEA doctors to come and work in the UK in future. The GMC is proposing the development of a UK database to record

which doctors have what skills and in which locations. It also wants more flexibility in processes for joining the GP and specialist registers. The GMC also proposes increasing capacity at its testing centre to

accommodate the rise in international doctors wishing to sit the two-part skills and language test needed to work in the UK.


GUIDANCE A REPORT looking at ‘never events’ in 18 hospital trusts in England found that staff struggle to cope with large volumes of safety guidance, with little time and space to implement it effectively. This is a key conclusion from the Care Quality Commission’s (CQC)

report, Opening the door to change, which examines the issues that contribute to the occurrence of never events and wider patient safety incidents in NHS trusts in England. It found that, while staff try to implement guidance, this is often

on top of demanding and busy roles which make it difficult to give such measures the required priority. The report also concluded that within the wider healthcare

system, different parts at national, regional and local level do not always work together in the most supportive way, with confusion over the roles of different bodies and where trusts can find the most appropriate support. Education and training for patient safety also

could be significantly improved with more appropriate training at undergraduate level and after staff have embarked on clinical careers. CQC’s chief inspector of hospitals Professor Ted Baker praised the work of NHS staff but said: “[T]here is a wider challenge for us all to effect the cultural change that we need, to have the humility to accept that we all can make errors – so we must plan everything we do with this in mind.”


NEW guidance has been released to help doctors, nurses and other NHS staff safely use instant messaging and other digital technology to co-ordinate patient care during emergencies. It is in response to the use by medics of

communication channels such as WhatsApp to deal with emergency situations like the Croydon tram crash, Grenfell Tower fire and terrorist attacks at the London Bridge and Manchester Arena. The aim is to help NHS organisations and staff make sound judgements on how and when to use such technologies safely in acute clinical settings, taking into account data sharing and privacy rules. Among other precautionary steps it advises that staff should only use apps and other messaging tools that meet the NHS encryption standard. Message notifications on device lock-screens should be disabled to protect patient confidentiality and devices used for work

should not be accessible to other users. Original messaging notes should be deleted once any advice has been transcribed and attributed in the medical record. The guidance (

yads2zh3) is provided for staff using instant messaging, videoconferencing, mobile devices including cameras, smartphones and tablets, and also personal devices (BYOD). Dr Simon Eccles, Chief Clinical

Information Officer for Health and Care, said: “Helping people during a crisis like the Grenfell fire demands a quick response and instant messaging services can be a vital part of the NHS toolkit. Health service staff are always responsible about how they use patients’ personal details and these new guidelines will help our doctors and nurses to make safe and effective use of technology under the most intense pressure.”

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