St Mary’s slammed by whistle-blowing doctors

St Mary’s Hospital has been slammed by the General Medical Council after a review of medical education and training revealed some patients “suffered as a result” of alleged shortcomings.

Trainee doctors have turned whistle-blowers leading to serious concerns being raised by the GMC into patient safety and support given to doctors in training at the hospital in Newport.

The GMC review, published Friday (October 19), takes in medical education and training at sites across Health Education England’s (HEE) Wessex region. The GMC sets, upholds and aims to raise the standards of medical education and practice across the UK. But the review reveals:

• Trainee doctors at St Mary’s Hospital told the GMC they were sometimes asked to make decisions beyond their level of competence, and the regulator was told that in some cases patients had suffered as a result.
• The GMC, which oversees medical education and training across the UK, heard that some trainees on the Island felt they had inadequate clinical supervision when working at night.
• The suitability of some locum doctors, brought in to cover gaps in staff rotas to provide safe clinical supervision and patient care, was also questioned by trainees.
• Trainees in General Internal Medicine, which involves treating patients with a wide range of acute and long-term conditions, were being signed off as competent for their curriculum by trainers whose methods for assessing them were questionable.

Concerns identified by the GMC were raised with the Isle of Wight NHS Trust and HEE Wessex immediately following the visit. Both have given the regulator assurances that the issues are being addressed, and monitoring is ongoing to ensure standards are maintained.

Professor Colin Melville, director of education and standards at the GMC, said: “We set high standards for medical education and make no excuses for doing so. Patients rightly expect and deserve good care from their doctors, and it is important doctors have the support they need to do the job well.

“The serious concerns on the Isle of Wight fall below the high standards we set. It is a site we have been monitoring for some time and we have been given assurances that the issues are being addressed as a priority. We will continue to check on progress to make sure that is the case.”

The GMC’s concerns on the Island contrasts with the general conclusions of the review.

Overall, across the HEE Wessex region, the GMC found that education and training remained a “valued part of organisational culture”, even at trusts where understaffing was putting a strain on services, and that doctors in training reported a good educational experience.

NHS response

The Isle of Wight NHS Trust was swift to respond to the GMC’s concerns.

Trust medical director Mr Alistair Flowerdew, said: “The General Medical Council has identified a number of key areas relating to junior doctors that require improvement. These have been actively addressed over the course of the last six months and, since my appointment in June, I am personally taking steps to ensure that all the outstanding requirements are completed.

“These include greater supervision and support of junior doctors by their consultants and restructuring the handover processes to ensure that continuity of care and patient safety are maintained at all times. Work is already in progress in collaboration with both junior doctors and senior medical staff.

“The improvements will be monitored by the Trust Board in order to assure the GMC and the people of the Isle of Wight that high quality of care is provided to our patients and is delivered at all times.”

Regional praise

Meanwhile, a confidential support service provided across the region by HEE Wessex, where staff are trained in coaching and careers support, was particularly praised by the GMC.

Prof Melville added: “Health care services are under pressure like never before, and that puts a strain on doctors and other health care workers. HEE Wessex’s Professional Support Unit, where trained staff can give advice to those experiencing difficulties in their careers or personal lives, offers a fantastic and valuable resource.”

The GMC visited sites across HEE’s Wessex region, setting out requirements and recommendations for each organisation it reviewed. Each education provider, including Isle of Wight NHS Trust, must update HEE Wessex on steps being taken to address any concerns, and an action plan will be published on the GMC’s website.

The GMC’s Regional review of medical education and training in Wessex: 2018 will be available on the GMC’s website.