436 patients – and only two doctors on call
THE staffing crisis in the NHS was highlighted when just two junior doctors were left to look after 436 patients during a “very unsafe shift” at Derriford Hospital in Plymouth.
A safety report given to the board of Plymouth Hospitals NHS Trust said that one of the two doctors was pulled away from a day shift in breast surgery because otherwise there would have been just one medic left to cover the night shift, and that doctors were often left “dangerously overworked”, putting patients at risk.
The document suggest such pressure could become the norm, with plans to reduce medical cover so that two doctors routinely cover 450 patients.
Doctors said they were left angry that patients were let down, while one said they were left feeling ill with no breaks, and just “a couple of biscuits from the patient trolley” during a whole weekend.
A report to the board by one junior surgeon detailed one night in May.
“Pulled from breast surgery day job at 11am and told I must come in and cover medical nights overnight for the rest of the week, despite being on surgery,” the un-named doctor said.
The plan had been agreed because otherwise there would have been just one senior house officer looking after all medical patients, the report added.
“I did not manage much sleep before coming in for the night due to the short notice,” the surgeon continued.
“Between myself and the other SHO on ward cover we were responsible for the care of 436 patients between the two of us, while carrying the crash bleep which covers the whole hospital.”
The report made to the board in July suggests dangerous levels of shortages are likely to continue: “For the coming rotation (August-december 2017), the rota has been altered to cope with the 37 per cent doctor vacancy rate. This will reduce the medical cover at night to levels which may be unsafe with only two doctors looking after 450 patients where previously there were three.”
Phil Hughes, trust medical director, said: “Like other trusts nationally, we do have difficulties recruiting to and filling our junior doctor posts and so, as our responsibility to ensure our junior doctors and the hours they work are safeguarded, we have had to explore other options, where we can. The examples in the paper are what we call exception reporting – meaning experiences such as those included in the report are the exception, not happening all of the time, but it is imperative that they are raised, and actions taken, to ensure they do not continue to happen.”
Every NHS trust which employs junior doctors has a “guardian of safe working hours” whose job it is to check whether rotas are being covered safely.
It follows the introduction of a new contract for junior doctors last year. The trust said it had responded to shortages of doctors by appointing staff into other roles, such as doctors’ assistants and physicians associates.
37pc The doctor vacancy rate at Plymouth Hospitals NHS Trust, where a report said doctors were ‘dangerously overworked’