THE NHS urgently requires more funding – as well as a clear strategy for the future. But one of the most striking elements of the report from The Royal College of Surgeons of Edinburgh (RCSEd) on the working conditions of surgical staff is that many of the improvements it suggests depend not on more funding but on a change to the way the present funding is allocated, as well as a few simple adjustments to the way departments work. Indeed, it is shocking that most of the report’s suggestions, such as common rooms for doctors, are not already a daily part of hospital life.
The report makes seven recommendations in all, including the reintroduction of the hospital mess. Doctors need a place in which they can relax and talk to colleagues, says the report, and yet most hospitals do not provide a rest room. It means that staff often have no place where they can get the basics such as some hot food, a good rest or simply get away from the stress for a while.
Professor Michael Lavelle-Jones, president of the RCSEd, says this lack of basic amenities can have a serious impact on doctors and we already know what can happen when the pressure gets too much. In September 2011 Dr Lauren Connolly was killed driving home from Inverclyde Royal Hospital after working a nightshift as part of a rota where it was normal to work 10 days without a day off. Her parents believe she was suffering from fatigue. We also know that a tired doctor is more likely to make a mistake.
Providing a rest room would be one way to help, but the report’s other recommendations could also make a significant difference, especially a clear team structure that provides staff with direction and support when they need it. The report also makes the simple suggestion that rotas should be circulated to staff six to eight weeks in advance so they can better plan their lives. A recommendation like that could be introduced almost immediately and make a great difference to doctors’ working lives.
There are other recommendations that would require some serious funding but the report makes a convincing case for them. Better IT, for example, would help doctors and trainees to focus on their patients rather than poor or malfunctioning IT systems. It is also clear that while the hours that junior doctors work have been reduced, they are still under tremendous pressure and require more support, and more – and better – training.
As the report says, none of these recommendations is particularly radical and many who do not work in the NHS will be surprised that the RCSEd is having to make them at all. However, one of the bottom lines for the health service should be care for its staff and the RCSEd report points to a number of ways in which the NHS could do this better.
In considering whether to implement the report’s recommendations, the Scottish Government should also consider this: more resources and better morale for staff mean a better service for patients too.
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