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Joseph O’Keeffe: The junior doctors’ strike—voices from the ward

28 Apr, 16 | by BMJ

joseph_okeeffeJunior doctors are arguing that the contract changes compromise patient safety. I agree. But do those we treat? It’s hard to tell. Social media appears dominated by the junior doctors, whereas the newspapers and the broadcasters merely present a succession of politicians and “experts.” The patient’s voice seems lost amidst the acrimony between the Department of Health and the BMA, especially that of some of our most poorly patients: the elderly. The official polls focus on getting nationally representative surveys, lumping our older patients into a “60+” category. As any healthcare worker knows, there’s a stark generational difference between patients in their 60s and those in their 80s. With the strikes raging all around me this week, I crossed lines and snuck back onto the wards to ask the patients what they have to say. more…

Duncan Steele: To strike or not to strike

27 Apr, 16 | by BMJ

duncan_steeleTo strike or not to strike, that is the question we have all asked ourselves over the last few months. To walk away from our patients, albeit to leave them in the care of some of the most qualified doctors in the world, is an incredibly difficult and tormenting decision. The contractual intricacies are complex. The reason why the message from doctors about why this contract is unfair and unsafe has sometimes felt jumbled is because for each of us a particular point of this contract is most important. The list is long: it openly discriminates against women, penalises trainees switching specialty or doing research, extends the week meaning what little social life we have will further be destroyed, pay will be as little as £1.50 to be on call out of hours, we will have shorter breaks and longer days, and there are practical implications for rota design and complex supplements for out of hours work. These are all valid reasons to throw this out. more…

Elizabeth Wortley: And strike I did

27 Apr, 16 | by BMJ

Yesterday I did not cross a picket line. I don’t yet know the figures for how many junior doctors did choose to work, aside from those who were unable to strike, but I would not blame anyone who chose to. I almost did.

I woke up at 5am and my heart was racing with moral indecision. This ultimate question of where my ethical and public service role as a doctor lies; with the individuals today, or the systems of the future, has had me on edge for days.

After the deliberation that went into my blog “should I strike” I realised yesterday morning that the question I was really battling was, “Do I need to answer this question for every junior doctor, or just for me, in my own context?” more…

Michelle Sinclair on the GP forward view

26 Apr, 16 | by BMJ

pounds_healthIt’s not about the money sings Jesse J.

Well yes, actually, it is.

The release this week of the General Practice Forward View sounds good, doesn’t it?

£2.4bn recurrent investment in general practice, £500m sustainability and transformation package to include a practice resilience programme, redesigning of services and support for collaborative work, a reduction in workload and bureaucracy, an expanded workforce, and a commitment to reduce the regulatory burden of CQC.

Sounds great in theory, except that as ever, the devil is in the detail. more…

Taryn Youngstein: “No doctor wants to strike”

26 Apr, 16 | by BMJ



Ethical dilemmas are the essences of medicine. As doctors, we frequently have to act in our patient’s best interests; when they are confused, demented, or suicidal for example. We have to act fast, and make decisions they can’t, for their own good. At medical school great lengths are taken to prepare us for these situations and GMC guidance and the law are both very clear on this issue. This is our job, it is what we do and its preservation is what we are fighting for.


Elizabeth Wortley: Should I strike?

26 Apr, 16 | by BMJ

junior_doctors_contractI am in a moral quandary, I am in a personal quandary, and I am in a professional quandary. I cannot answer the question “Should I strike?”

As a doctor, I’m very used to questioning, reviewing evidence, and coming to a conclusion. One of my favourite topics for discussion is bias and avoiding it every day. With regards to this contract, I don’t know what’s bias or not, I’m tired of thinking about it and I’m scared of getting the answer wrong. And I’m not alone. more…

Alice Gerth: Taking sides in the junior doctors’ strike

25 Apr, 16 | by BMJ

junior_doc_strike_April2016As a full walk out is planned for this week, juniors need to ensure that they have carefully considered which side of the picket line they will stand on. Full disclosure, I have not been participating in strike action and my reasons can be found in a previous blog post: Strike action is not the answer.

I continue to engage with my colleagues on their plans for this week and I have noticed the mood shifting. They are disheartened and deeply concerned for two reasons. Firstly, the strikes have been going on for a long time with little evidence of progress; secondly, the prospect of withdrawing all junior doctor care is daunting.


Junior doctors’ strike 26 – 27 April 2016: Live blog

25 Apr, 16 | by BMJ Group

Demotix 28/09/2015This week, junior doctors in England will be undertaking a full withdrawal of labour between the hours of 8am and 5pm on Tuesday 26 and Wednesday 27 April, as the ongoing industrial dispute between the BMA and the government shows no sign of ending peacefully. This latest action marks an escalation from previous strikes this year as junior doctors will not be providing emergency cover. It is also a historic moment; the first time an all out strike has been called by junior doctors in the history of the NHS.  If you have any news, pictures, thoughts, or tweets to offer us for the blog, please send them to Gareth Iacobucci at


Chris Ham: Statesmanship among medical leaders could help resolve the junior doctors’ dispute

18 Apr, 16 | by BMJ

Whatever the rights and wrongs of the standoff between the government and junior doctors, failure to reach agreement on a new contract is bad for patients and for staff. The all out strike planned for the end of the month will cause disruption and delay for patients, and add to the pressures on staff who cover for absent colleagues. It will also create dilemmas for junior doctors torn between loyalty to their peers and their primary—and strongly felt—duty to patients.

The dispute may also affect recruitment into medicine and the willingness of newly qualified doctors to practise in England. It will have an impact too on the discretionary effort of junior doctors who form the backbone of patient care throughout the NHS. more…

Jennifer Stein: To Rio or not to Rio—that is the question

13 Apr, 16 | by BMJ

jennifer_steinShakespeare’s question about being springs to mind when as doctors we are faced with change. Do we “take Arms against a Sea of troubles, And by opposing end them?” That is, of course, if we are able to do this.

Rio is now a relatively common, though not ubiquitous, NHS IT replacement to medical notes, which is presented as a technological advance in relation to patient records. It involves all information taken during contact with patients, and in subsequent letters to GPs etc., being uploaded directly to the internet, therefore allowing widespread and immediate access by professionals with the appropriate clearance. more…

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