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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…

Reena Aggarwal: Are junior doctors going to vote for the new contract proposal?

27 Jun, 16 | by BMJ

reena_aggarwalJunior doctors are caught in a maelstrom; voting for or against a contract that is the best offer yet proposed, but with questions about its fairness, safety, and practical application especially now in the post Brexit era. Since the contract was published, as one of the public facing grass roots junior doctors over the past ten months, I am increasingly alarmed and dismayed at the nature and content of the debate that has raged over social media platforms by my profession. In many ways this bitter and protracted dispute has captured many years of simmering discontent, anger, and angst over junior doctor working conditions. Declining morale has come to the fore, within the context of ever-increasing public and societal expectation. more…

Gemma Wright: Supporting military reserves in the NHS

24 Jun, 16 | by BMJ

Gemma_WrightAs we approach Armed Forces Day tomorrow, this is the time to consider the 4000 healthcare staff who, as reservists, give up their spare time to train and serve in either the Royal Navy, Army, or Royal Air Force. Most of them work in the NHS and combine their military commitments with a civilian life and career. More than a million people work in the NHS so NHS Employers want to raise awareness and help bust myths about what it means to be a reservist.

We are often asked what happens when a reservist is asked to take part in military or civil relief operations and complete their mandatory training as part of their reservist role. more…

Nigel Edwards: The NHS workforce crisis may be irreversible

14 Jun, 16 | by BMJ

nigel_edwards_june_2015A great deal of the current focus in the NHS is on the financial challenges it faces. These are undoubtedly severe, but I think they may be obscuring a problem that is at least as serious: the state of the workforce. There are a number of inter-related components, including poor morale, bullying and looming shortages in key areas.

In our latest survey of 100 health leaders, the majority of panellists report worsening morale in their area over the last six months. Some of their comments are very telling, and many point to the extent to which financial problems—and the local uncertainty this creates—are themselves becoming a factor in deteriorating morale: more…

How does Salford Royal Hospital’s decision to close its kitchen fit with the aims of new Devo Manc?

2 Jun, 16 | by BMJ

Elizabeth Atherton_2016Good health is not equally distributed throughout society, a fact that has been well established since the publication of the controversial “Black Report” in the 1980s. There are a number of socio-economic factors—such as housing, skilled employment, and education—that influence health, and subsequently those living in the most deprived communities tend to also be burdened with the worst health outcomes. Fears around overstretched NHS services have led to increasing emphasis being placed on the need for disease prevention and better public health services. more…

Céline Miani and Eleanor Winpenny: Can hospital services work in primary care settings?

2 Jun, 16 | by BMJ

As Martin Roland explained in an editorial in The BMJ a few months ago, general practice is facing substantial challenges. Contributing factors include problems recruiting, rising workload, increasing stress, and doctors retiring early. Recent proposals put forward by NHS England on primary care as part of its General Practice Forward View have been positively received, with a series of funding commitments and reforms geared toward galvanising primary care.

This includes a commitment to increase general practice funding to over 10% of the NHS budget by 2020 (an extra £2.4 billion a year) and provide an additional 5000 GPs by 2020. However, the NHS Five Year Forward View envisages more…

Edward Wernick and Steve Manley: Meaningful patient collaboration—the end of the beginning . . .

1 Jun, 16 | by BMJ

ed_wernick_2steve_manley_2The delay between this blog and the last one in November on the new King’s Fund Collaborative Pairs Programme reflects the level of work that we have been dealing with over the past few months. We write this after our final session on the Collaborative Pairs course at the King’s Fund headquarters in Cavendish Square. We have written before about the nature of the course, but now that it has come to an end it is time to reflect on what we have learned.

By way of a brief update, the course brought us together as patient representative and clinician to work on a “shared issue” facing our local community. more…

Anne Marie Rafferty: Whose responsibility is the workforce anyway?

24 May, 16 | by BMJ

anne_marie_raffertyIt’s the workforce stupid! That is the key message of the Nuffield Report, “Reshaping the workforce to deliver the care patients need.” Workforce solutions are rarely quick fixes so policy makers often find it is more appealing to introduce new types of workers rather than grind away at trying to make what we already have work better. So it is gratifying that the Nuffield Trust report takes such a measured view of what might help to make the system work better and rightly focusses on the largest part of what we’ve got in the system, the so-called non-medical workforce (though no one likes to be referred to as a “non” anything). more…

John Appleby: New NHS inflation figures underline funding pressures facing the NHS

20 May, 16 | by BMJ

john-applebyThe latest Quarterly Monitoring Report from the King’s Fund surveying NHS trust finance directors reveals deepening pessimism about local finances and concern about the outturn for the current financial year. New NHS inflation figures from NHS Improvement reveal the true extent of the financial pressures facing the NHS this year and up to 2020/21.

How much money the NHS has been allocated over the next few years is a somewhat contested fact. It shouldn’t be of course; how much the government has decided to spend on healthcare should be —in one sense at least—an uncontroversial figure. more…

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