Dr Fiona Pathiraja is a radiology registrar with interests in public health, health policy and clinical leadership. Follow her on Twitter @dr_fiona

Dr Fiona Pathiraja is a radiology registrar with interests in public health, health policy and clinical leadership. Follow her at @dr_fiona

“You have two jobs: doing your job and improving your job”

Junior doctors are the eyes and the ears of the NHS. We often see opportunities for change but don’t always get a chance to make that change. As a senior house officer I was told that I should wait to become a senior registrar before getting involved with management. Undeterred, I gained management skills by taking a year out to work as a healthcare management consultant and later working at the Department of Health as clinical advisor to Sir Bruce Keogh, NHS medical director.

I am keen to bring some of the skills I learned during that time to UCLH. Doctors are so keen to make changes at the beginning of their careers but we risk becoming jaded by the system over time. FY1 doctors have the potential to be the most enthusiastic change agents in the hospital. They haven’t had a chance to become jaded and believe they can change the world. Inspired and encouraged by Rob Bethune, I set up the UCLH FY1 QI programme to enable FY1 doctors to lead QI projects at UCLH.

I was looking for a group of perhaps six FY1s with whom to run the pilot. However, interest was so great that I accepted thirteen FY1s for the pilot. We have been meeting on Monday evenings and are using QI principles and project management skills to develop two exciting FY1-led QI projects. We recognise that not all change is an improvement but believe that our grassroots initiative might have a positive organisational impact.

BMJ Quality have a great platform to help support QI projects and their idea of #smallthingsbigwins resonated with me. I am struck by the energy and enthusiasm of the FY1 doctors who clearly love their work but are also keen to improve their jobs for the next cohort of FY1 doctors. Senior buy-in has been easy to obtain due to the supportive nature of our organisation. We have secured support from the medical director, director of medical education and the lead for the Foundation Programme at UCLH. Senior backing has been useful to gain traction on projects and to help overcome potential pitfalls and obstacles to quality improvement at the early stages of this programme.

Our FY1s will be writing blogs about their QI initiatives over the next few months and we look forward to sharing our journey with you. If you have any ideas or tips to help our FY1 QI team please tweet us with #UCLHQI at @UCLHmeded and @BMJQuality.

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