Oliver Loi-Koe and Anya Göpfert: HEE report seeks to address junior doctors’ morale crisis

A new report from Health Education England details plans to tackle the junior doctors’ morale crisis. Two FY2’s argue why change is urgently needed.

Low morale, extortionate exam fees, and a poor work-life balance are inherent to being a junior doctor in the NHS. Junior doctors would say these issues have been ignored. Health Education England (HEE) have just released a report, “Enhancing junior doctors’ working lives: A progress report” that details plans to tackle this. They propose cutting the costs of exam fees and making training more flexible. Will these changes make junior doctors smile again?

Less than Full Time Training (LTFT) is a tempting offer of greater flexibility and improved work-life balance. Until now it was only open to doctors with a “well founded individual reason.” The HEE report proposes that everyone should be eligible. This could encourage junior doctors to stick with specialities like A&E where up to 50% leave before completing training. However, this may not help gaps in the rota. More doctors working fewer hours will mean fewer on the scheduled rota—how will this work in an NHS already struggling to provide a service? HEE are introducing an LTFT pilot scheme from spring 2017 for all emergency medicine higher trainees across England. If successful, other specialties struggling with recruitment could adopt a similar programme. This is the first indication of a system willing to be flexible to the needs of junior doctors.

HEE is also to be applauded for finally tackling a huge source of frustration for junior doctors. Training is expensive and disruptive with endless moving and long commutes. First of all HEE have promised to analyse the effects of rotations across large geographical areas. This should provide evidence on which to base changes to the current unfair and rigid system. With postgraduate training costing an average of £17 114, juniors have long called for financial support from their respective royal colleges. Vague promises of “best practice principles” are all that is currently offered by HEE. Undoubtedly, proposals for reducing costs will be welcomed by junior doctors.

Ideas on paper and real-life implementation are two worlds apart. The current state of the medical workforce demands rapid and effective improvements. Solutions such as LTFT pilot schemes show that HEE will be pragmatic in moving forwards. Prioritising progress in reducing the cost and disruption of training is however essential. As junior doctors working in the NHS, we are concerned that promises will not materialise when faced with the constraints of staffing rotas. These proposals may be viewed as unnecessary extras. Yet the morale crisis within the workforce will only worsen if things do not change. We desperately hope that HEE will ensure that the NHS understands that this report is long overdue, and its implementation is urgently needed.

Oliver Loi-Koe is an FY2, Kent and Canterbury Hospital.

Anya Göpfert is an FY2, Bristol Royal Infirmary.

Competing interests: None declared.

Note: This piece was amended on 3 March to take out the cost of anaesthetics training.