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Sara Martin on emotional labour

22 Aug, 16 | by BMJ

sara_martinI work at a great place in the UK. We have gorgeous facilities, friendly staff, great benefits, and—most important to this American doctor—unlimited free coffee (and tea if you’re British).

But this summer, I will be heading back to clinical medicine. In preparation, I have been thinking a lot about what I have mentally termed the “emotionals:” emotional labour, intelligence, and resilience. more…

Peter Thomson: Would revoking the European Working Time Directive improve surgical training?

17 Aug, 16 | by BMJ

shift_workThe President of the Royal College of Surgeons of England suggested recently that leaving the EU will allow surgeons to undergo thousands of hours of extra training. Following the Brexit result, we are faced with the potential revoking of the European Working Time Directive (EWTD). The anti-EWTD-ers may now see their dreams come true, and this argument evokes significant similarities between the anti-EWTD debate and the mendacious EU referendum campaign. more…

Tony Woolfson: How can we fill vacant consultant posts?

17 Aug, 16 | by BMJ

tony_woolfsonA Public Accounts Committee report suggested that the large number of unfilled consultant posts was due to bad workforce planning. Hardly surprising really. Obviously true, but not really the point. If we are to engage with and solve the problem, we need to look at what lies beneath.

Having been involved with doctors’ careers since the mid-1980s, I have become increasingly concerned that changes in funding and management would make NHS medicine a less and less desirable option. Sadly, many of my fears seem to have been justified and now we have low morale, vacant posts, and doctors leaving in alarming numbers. more…

Alex Scott-Samuel: Tory plans for NHS privatisation released during parliamentary recess

5 Aug, 16 | by BMJ

Dr Alex Scott-SamuelDirector of Liverpool Public Health Observatory and a Unite member. This week as the governments controversial Health and Social Care Bill enters its final stages in the House of Lords, patients, health workers and campaigners are to come together on Wednesday for a TUC-organised Save Our NHS rally in Westminster. On Wednesday (7 March 2012) over 2,000 nurses, midwives, doctors, physiotherapists, managers, paramedics, radiographers, cleaners, porters and other employees from across the health service will join with patients to fill Central Hall Westminster. Once inside they will listen to speeches from politicians, fellow health workers, union leaders and health service users.

July 2016 saw the very quiet publication of two key documents charting the route to the privatisation of the NHS in England. Firstly, from NHS England, came Strengthening Financial Performance and Accountability in 2016-17. This is the latest set of instructions on the implementation of NHS chief executive Simon Stevens’s Five Year Forward View (5YFV).

The 5YFV is increasingly coming to resemble one of Stalin’s Five Year Plans from the 1950s. As the new guidance makes clear, Stevens’s latest collectivisation strategy, the Sustainability and Transformation Plans (STPs), is being rigidly imposed across England. more…

Martin Kaminski: What I’ll miss about the NHS

2 Aug, 16 | by BMJ

martin_KaminskiAs another first Wednesday in August approaches, I feel pensive and wistful that this year I won’t be spending changeover day in the heart of the National Health Service. Although you probably don’t hear it, I’m writing this in an American accent and am setting off for a spell to Boston, Massachusetts, where I grew up and my family still remain, to start a specialty registrar training post in infectious diseases.

All of my medical training has been in Europe, with all of my postgraduate training from foundation onward in London. So while I do look forward to learning new lessons from working in medicine in a different country more…

Helen McKenna: The consequences of living within your means

2 Aug, 16 | by BMJ

HELEN_MCKENNA,The technicality (or “administrative error” as the National Audit Office described it) that enabled the Department of Health to avoid breaching expenditure controls set by parliament may have spared it from the full wrath of the National Audit Office, MPs, and the Public Accounts Committee; but it did little to hide the bottom line—a serious financial crisis engulfing the NHS.

In 2015/16, NHS providers overspent by an eye-watering £2.8 billion (reduced to £2.5 billion by one-off measures). Although a commissioning underspend of £700 million helped to offset this figure, the NHS (commissioners and providers in aggregate) still ended 2015/16 with the largest deficit in its history. more…

Samir Dawlatly: Who are the casualties of the battle against cancer?

25 Jul, 16 | by BMJ

The NHS is expected to find efficiency savings of £22 billion over the next four years or so. As well as implementing new structures and coping with the potential financial fallout from Britain’s exit from the EU, it is also expected to perform better in many sectors in terms of health outcomes. One such area is cancer diagnosis, treatment, and survival.

Assuming that cancer statistics between European countries are comparable and equally valid, then the UK is a consistently poor performer when it comes to cancer care. There is a drive for earlier diagnosis and treatment in the hope and belief that it will improve survival. more…

Clare Marx: Making the best of Brexit for the NHS

20 Jul, 16 | by BMJ

Change, challenges, setbacks, and advances are the hallmarks of modern medical careers. We can either let “Brexit” type moments consume us, whispering from the sidelines, or show the leadership necessary to deal with the uncertainty which now confronts us.

It is in this latter spirit that I believe the NHS must respond to leaving the European Union.

Maintaining and enticing staff to work here has to be a top priority. Over 40% of surgeons trained outside of the UK. Attracting and training more UK graduates is clearly important but losing our non-UK colleagues would be cataclysmic. Within surgical teams are the thousands of technicians, porters, and cleaners who have moved to the UK to serve our NHS. Toughened migration rules often particularly affect such groups of workers and we must send a clear message to the Government that the NHS also needs to retain these vital staff.  more…

Alice Gerth: What to do about junior doctor morale?

11 Jul, 16 | by BMJ

junior_docs_disputeNegotiations, four emergency care only strikes, a threatened imposition, one full strike, a referendum rejecting the contract and an imposition. It’s been an interesting few months. Many junior doctors are jaded by the experience and struggling with the continuing uncertainty: will there be further strikes, what impact will “Brexit” have upon the NHS, what will my job look like in two, let alone 10 years time?

To exacerbate things the yearly migration of junior doctors approaches. For many this means new city, new job, new responsibility. We await rotas and as such are unable to plan beyond the end of July, we do not know when we will next have a holiday or if we can attend that good friend’s wedding. Rotas this year are likely to be further delayed and covering a shorter time period as trusts awaited the results of the junior doctor vote and need to accommodate staggered transitions onto the new contract. This uncertainty is bad for morale and resilience. more…

Ruth Bonnington: Thoughts on the NHS from a GP

6 Jul, 16 | by BMJ

ruth_bonningtonAs I sit at the bedside of my dying father at 04h30 in a small palliative care unit in the Scottish Borders I wonder about lots of things and about how I love the NHS (and NHS Scotland).

I’ve worked in the NHS since I qualified in 1987 and have been a GP in Gateshead for 21 years.

I love my work—the patients, the dedicated practice staff, my varied and supportive colleagues, those in the practice and the locality and those in secondary care. The place is filled with caring, conscientious, and intelligent practitioners. That’s not to say things don’t go wrong but there is a lot of endeavoring. Endeavoring to care well, be patient centered, to get it right for each person, to set up systems that work to keep patients safe, and protect staff from harmful errors. more…

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