PATIENTS lives are being put at risk because overstretched doctors lack basic comforts such as hot meals and beds which heightens fatigue levels in hospitals and raises the prospect of serious errors being made, a new report has warned.
In a critical evaluation of the country’s A&E departments, prominent physicians from Royal College of Surgeons Edinburgh (RCSEd) has called for a return of the "doctors' mess" – a room where duty medics can rest – in a bid to improve their well-being.
They have also recommended the reintroduction of the daily consultant-led ward visit, a radical overhaul of staff rotas and much greater interaction between senior and junior staff.
Herald View: Medical staff are also in need of care and attention
The report says: "These recommendations, such as a hospital mess to ensure doctors have somewhere to eat and rest while on long shifts, are far from a luxury or perk. "An exhausted, hungry doctor is more likely to make a mistake. These simple measures will help medical staff deliver better care and ensure less mistakes are made. "
The report comes ahead of Black Wednesday – so-called because it is the day junior doctors traditionally begin their careers and others move to different departments – which is said to increase the chances of dying in hospital by six per cent.
Now a report by Britain's oldest Royal Surgical College, has published a number of recommendations to greatly improve safety in the delivery of surgical treatment and patient care.
It highlights inefficiencies on the frontline which impact the working environment and the delivery of a safe health service.
Herald View: Medical staff are also in need of care and attention
The report identifies how already extremely stressful working environments for doctors are compounded by a lack of team structure, poor communication, high stress levels and limited training opportunities. It comes six years after junior doctor Lauren Connelly died during the early stages of her training as she drove home from a night-shift after frequently working exhausting 100-hour weeks.
Lauren Connelly
The 23-year-old's death just seven weeks into her career provoked outcry and a government promise to stop junior doctors working more than 48 hours a week. But in May, Shona Robison withdrew that pledge despite surveys showing that 45 per cent of junior doctors in Scotland feel short of sleep on duty.
Under European legislation, junior doctors’ working hours are limited to 48 hours a week. Health boards in Scotland comply with this though the figure can be arrived at by averaging hours worked over six months.
Herald View: Medical staff are also in need of care and attention
The RCSEd has made a series of recommendations that would improve the service at no extra cost. They include re-establishing a traditional team structure, reintroducing a communal area such as the hospital mess, maximising training during daylight hours, minimising use of shift systems and provide rotas six to eight weeks in advance.
Professor Michael Lavelle-Jones, RCSEd president and consultant general and colorectal surgeon, said: "While the issues facing the NHS are broad and complex, we should not lose sight of the fact that strain within the system ultimately has an impact upon individual lives. "As a College, we have been deeply saddened and concerned in recent years by the deaths of several doctors in training, in circumstances believed to be associated with work-based stress or tiredness.
"This report offers a snapshot into what a cross-section of UK healthcare profession thinks is lacking from their working environment. "It is the College’s responsibility to represent the views and offer potential solutions to the wider profession and to the government.”
The report’s co-authors Simon Paterson-Brown and Richard McGregor, added: “With the immense financial strain and staffing problems facing the NHS it is essential we look seriously at how we can improve the whole working environment for all those delivering front line surgical care. "This is a team effort and action needs to involve everyone in the team. While lack of additional resources is clearly one of the problems, it is also about much better use of current resources and changing how we do things to become more efficient and more productive.”
Herald View: Medical staff are also in need of care and attention
This report follows publication of a separate survey which showed that half of Scotland's nurses have reported that patient care was compromised on their most recent shift due to staffing shortages.
The Royal College of Nursing (RCN) research also uncovered concerns over the use of agency staff and the "skill mix" during shifts.
Scottish Conservative shadow health secretary Miles Briggs said the problems within Scotland's hospitals are "complex and significant".
“It’s not just a case of hospitals needing enough doctors," he said. "We also need ensure the ones in place have the time and energy to do their job properly.
“This report would suggest that isn’t the case north of the border, and that could have a potentially severe consequence for patient safety.”
Labour MSP Colin Smyth said: "This is another expert group speaking out about the lack of support given to our frontline staff in the health service. While unfilled posts soar under the SNP, staff are under resourced and under pressure. "Earlier this year the SNP government broke a promise to cut the hours worked by junior doctors. "That was a promise made in the aftermath of a tragedy following the death of Lauren Connelly in 2011. Labour has established a workforce commission, comprised of medical experts, to come up with long term solutions to the staffing crisis in our NHS."
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