Patient care is at risk from inadequate handovers, GMC finds

Authors: Abi Rimmer 

Publication date:  24 Jul 2017


Patient care at hospitals in the East Midlands is potentially at risk because of inadequate handovers between teams of doctors, a General Medical Council review has found.[1]

On 19 July the GMC published a report on medical education and training throughout the East Midlands after visits to five local education providers, two medical schools, and Health Education England’s local office in the region from October to December 2016. At the time around 3013 doctors were training in the East Midlands, the report found.

It said that trainees at Sherwood Forest Hospitals NHS Trust and United Lincolnshire Hospitals NHS Trust had told the GMC that handovers at the trusts lacked continuity of care and may be unsafe for patients.

“At both Pilgrim Hospital and Lincoln County Hospital [part of United Lincolnshire Hospitals NHS Trust] doctors in training told us they consider handover at the weekend to be inadequate and potentially unsafe for patients,” the report said. “We heard the current system relies on a paper handover which is passed between work shifts.”

It added, “Similarly at Sherwood Forest, the doctors in training we met perceive the current paper based system to lack continuity of care and to be unsafe. In addition, we were told about sporadic instances in which patients have been missed as they have not been added to the paper based system.”

Overall, the GMC said that the state of medical education and training in the region was generally positive, but it warned that issues around workload and resources meant that junior doctors often struggled to fit in their learning.

For example, doctors at Nottingham University Hospitals NHS Trust regularly worked longer than they should and had to take holiday to attend clinics or teaching sessions or even to take medical exams.

Doctors at University Hospitals of Leicester NHS Trust were sometimes able to attend only 40% of local teaching sessions and often had to work on their days off to try to meet their training requirements, it added.

During its visits to the Leicester trust the GMC also found that medical students were occasionally subjected to inappropriate comments. For example, female students were being advised to pursue a career in general practice rather than surgery if they wished to have children.

Commenting on the East Midlands review, Colin Melville, director of education and standards at the GMC, said, “There are areas of concern that we have asked training providers to address, but overall we were pleased at the high standards and commitment across the region.”

Sue Carr, director of medical education for Leicester University Hospitals, said that the GMC had identified a number of positive points and good practices overall that worked well within the trust.

“We take any allegations of undermining or bullying extremely seriously and are committed to improving in this area,” said Carr. “The department of clinical education works closely with human resources to improve systems and ensure that learners feel supported.”

Andy Haynes, medical director for Sherwood Forest Hospitals, said that electronic handover technology would be rolled out in the trust in the autumn “to help improve the quality and safety of handovers.” He said that the trust discusses the GMC survey results every year and formulates an appropriate action plan to deal with the matters raised.

Richard Andrews, associate medical director at United Lincolnshire Hospitals, also said that his organisation was implementing measures to improve handover, “particularly at weekends, including the use of electronic handover tools.”

He added, “We are pleased that that the review highlighted the overall good standard of medical education in the East Midlands and particularly in Lincolnshire.”

After its visits the GMC set requirements and recommendations for each organisation, and they will report back to the GMC on their progress.

References

  1. General Medical Council. Outdated handovers putting East Midlands patient care at risk, GMC report finds. 19 July 2017. [Link] .

Abi Rimmer BMJ Careers

 arimmer@bmj.com

Cite this as BMJ Careers ; doi: