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Last Updated: Wednesday, 17 May 2006, 23:02 GMT 00:02 UK
Training reforms 'risk patients'
Junior doctors
Junior doctors now spend less time in each specialty
Nearly two out of three doctors fear changes to medical training put patient safety at risk, a poll suggests.

The survey of 1,089 doctors, carried out by the website Doctors.net.uk, found 62% thought the changes had led to a deterioration in patient safety.

More than one in seven (15%) said safety had been greatly worsened.

Doctors are concerned the reforms do not allow enough time to master medical skills, or to provide continuity of care for individual patients.

It is very different to what has gone before
Dr Jo Hilborne

The reforms, introduced last year, saw a two-year foundation course, beginning after medical school replacing the system of house officer posts.

The foundation course includes shorter placements across a broader range of specialties, including primary care. The aim is to give junior doctors as wide an experience as possible.

Not enough time

However, doctors expressed concern that two years was not long enough to gain a thorough grounding across many disciplines.

They were also concerned that trainees spent such a short time in individual placements that patients failed to receive continuity of care - often being passed from one trainee to another in quick fire fashion.

Patient safety and care is always top priority for the NHS
Department of Health

Only 12% of doctors who responded thought patient safety had been improved by the reforms.

Some argued the issue had been compounded by the European working time directive, which had stretched resources across the hospital sector.

Dr Neil Bacon, founder of the website, said: "What stands out from the survey is the consistent concern of doctors of all grades about the impact of these changes, not only on their careers, but also how it is affecting the safety of patient care.

"This sends a clear signal not just to our own profession, but also to all those responsible for the delivery of safe, quality care across the NHS."

Very different

Dr Jo Hilborne, chair of the British Medical Association's Junior Doctors Committee, said the new system was designed to give a basic, generic knowledge across a wider range of medical specialties.

She said: "It is very different to what has gone before, and patient safety is a valid concern which needs to be properly investigated.

"However, the scheme has only been in operation since last August, and it is probably a bit too early to tell."

The survey also highlighted that 32% of doctors who responded have been unwillingly unemployed and 56% are concerned or very concerned their employment is at risk as a result of job cuts in the NHS.

A Department of Health spokesman said the survey was a very small sample of opinion.

"Of course patient safety and care is always top priority for the NHS and the new junior doctors training programme was devised by doctors to improve patient safety by producing doctors who are trained to an explicit set of standards.

"Junior doctors are well-supervised and regularly assessed on their clinical competence, as well as being taught new professional skills required by the well-informed patients of today."


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