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Having choice, control and flexible working is a powerful thing

Posted by Dr Philip Rankin 2 weeks ago Posted in NHS

There have been multiple major reports recently recognising that doctors want the way they work to be different. The foundation programme career destination report 2017 showed that only 42.6% of F2s progressed directly to specialty training. The latest GMC report on training pathways reveals that the 3 most common reasons for not entering training are:

  1. dissatisfaction with the training environment
  2. health and wellbeing
  3. uncertainty about specialty choice or career direction

Feeling some of the above, I thought about Australia, I thought about a masters, I thought about travelling, and I briefly considered training. But really, I wanted to dedicate time developing clinically in a trust I already enjoyed working in, while also having the opportunity to have paid time working on quality improvement, research and teaching – and to continue to live in a city and flat I love, to boot.

Fortunately, such a job exists… Reflecting on my short- and long-term personal and career aims I applied for one of the 12-month clinical fellow posts at Brighton and Sussex University Hospital Trust (BSUH) established by emergency department consultant Dr Rob Galloway (@DrRobGalloway) and the team.

14 months and a further reapplication later, I feel I couldn’t have made a better choice. I chose working for an organisation and department that values me and treats my work and life with equal high importance. I chose fully integrating within a team, making friends, and work colleagues who enrich my life personally and professionally.

I also chose being part of an engaged group of doctors full of quality improvement ideas who, with our split clinical and non-clinical posts, have the time and resource to effectively implement them. Through this post I have been able to support significant and lasting changes within the trust and region, be involved in award-winning improvements having national recognition, such as our single clerking and acute floor model, and learned skills that have opened doors to opportunities I didn’t know existed.

Rotas don’t have to stay the same as they have always been. Our shifts are designed ergonomically, gradually adjusting your body clock – from early, to late, to night. Your annual and study leave is guaranteed. If you want to get married in June next year and have 2 weeks off after, you can. Flexibility and cover is built into the rota, so sickness and absence has less of an impact. A large pool of doctors as fellows makes swaps for study and annual leave much easier and just a simple Whatsapp away. Moreover, we have no locum spend and no rota gaps. For the registrars and consultants, we use innovative software called Health Rota, which makes self-rostering and preserving work–life balance much easier.

Valuing doctors with jobs and rotas that respect and cultivate their personal and professional needs keeps us refreshed and motivated to keep working long term for the NHS, not only benefitting the staff but also the patients within it.

We have just been featured by the British Medical Association as an example of best practice as part of their medical rota gaps campaign and feature. Our video lets you hear more about our experience, and more detailed information is on NHS Improvement.

We need a change in culture and how our employers, regulators and educational bodies design how doctors work. Our fellow-posts and rotas at BSUH are an example of a growing resource of how we can do things differently and for the better for all doctors. We hope this is just the beginning of good things to come. Fourteen months ago I might have left the NHS, but now – provided practice like this is spread more widely – I am looking forward to the future.

@PhilipRankin

This post was edited on Sep 28, 2018 by Amy J France

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