Sunday, January 10, 2016

FAQ "Junior Doctors Strike"

So it has come to pass. A doctors strike. I will be very honest- I don't like it, I don't want it and I sincerely hope the future ones won't go ahead. But we are where we are- and plenty of rainforests have been burnt down already trying to justify or refute the reasons for the dispute- so let's not go there.

One has seen on twitter and elsewhere a lot of conjectures as to what will happen on strike day- some genuine, some political, some trying to show themselves as neutral- a whole lot of reasons- so thought would make an attempt at doing a FAQ (Frequently asked Questions -in case you didn't know) as to what will happen on Tuesday as regards patients.

To start with a clear statement...there is NO precedence of this. So all theories, scare stories are only conjectures at best- as are the opinions below. They are based on experience to a degree and an assumption that seniors will do their bit to help their junior doctor colleagues.

Theory 1: Patient care will be compromised:

It shouldn't as - going by the planning of where I work- and as per contract regulations too- Consultants are indeed going to be more on the wards than a "normal" day. Will they be filling each shift as per a normal day? No -they will do enough as well as have the experience to keep patients safe- and ensure no harm comes to them. The juniors doing their emergency shifts will still be there- as well as nurses. med techs etc.
If we believe that much that without junior docs,care will be compromised, maybe we should put more attention to their concerns- as getting them disgruntled or indeed if they leave would compromise patient safety by that argument? If they are THAT special, maybe that's where the thinking needs to be centred on?

Theory 2: Patient "flow" will be compromised:

Not any more than the weekends to be honest. Aha- I hear the detractors say- calm down, the "flow" is compromised due to many a service not being 7 days. There is this thing called social service- ironically they will be there on the strike day as well as all GP surgeries open- so the sheer load through the front door could be lower- as well as easier movement as regards discharges-as compared to a Sunday. You want to improve 7 day care? Try investing into social care.

Theory 3: Electives will be compromised:

Yes- to an extent- and lets be clear- any patient having their hip op or clinic cancelled- is not nice. The system may call it an "elective"- for the person concerned, it is anything but- its the one thing they may have been waiting for a significant time. And i have no issues with that angst- but heres my view- if YOU feel that strongly about electives being cancelled, it maybe worth raising that angst to that occurrence happening on a daily basis due to surgical beds swallowed up by medical outliers or a 4 hour target- which penalises an acute trust selectively- while we whip ourselves into a froth talking about system changes.

Theory 4: Consultants will have to cancel something for patients to do this:

Not quite. All Consultants have non-patient facing activity built into their job plans- an advantage over their GP colleagues. What are they-do you say? Well, things like- teaching, personal professional development, audits of their services etc...the time allocated maybe variable and debates can happen whether they deserve it anymore than others...the point is they have it- and for a day, cancelling those non-patient activity to help on wards/be extra hands for surgical lists depends on the assumption that seniors will pull out the stops to help their junior docs. Time allocated for such work in job plans? Anything from 2-10 hours / week.
If we are worried that a patient death/harm will undermine the junior doctors cause in eyes of the public, then its up to US as seniors to ensure it doesn't happen- as simple as that.

So, to patients, rest assured- at least where we are, as seniors, we will- and have- made plans to ensure patients are safe. Beyond the arguments of whether the junior docs are right or wrong, lets say this- this is NOT just a bunch of socialists up in arms. Calling me a socialist would make pretty much all my friends fall apart in laughter- apart from my college political rivals have major acid burn. Heck, I am not even a member of the BMA- beyond the support, I,as a senior, have a responsibility to ensure patients are safe on Tuesday- and many many others, I am sure, will do the same.

Post Tuesday- let's all hope that we have no such further days- but for THAT day, lets all try to forget our differences and assure patients that we will be there as seniors working with the many many others who form an MDT to help keep them safe.



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