Family medicine

The government’s Long Term Plan for the NHS, published earlier this month; sets out its vision for quality health serviceable to cope with aging and expanding the population. But; as many commentators point out; without the workforce, it needs to support it; the plan will not meet its objectives.  More than 100,000 healthcare posts are currently vacant across the NHS and the number is likely to rise after Brexit.

Difficulty of recruiting

Indeed, the difficulty of recruiting, retaining, and ensuring the well-being of doctors has recently been described as a ‘crisis’  with health organizations warning it’s a greater threat to the NHS than lack of funding. Nationally; a quarter of doctors in training say they feel burnt out by high workloads and many are planning to reduce their hours or leave the profession early. And doctors report working in a culture of blame and fear which is jeopardizing patient safety and discouraging learning and reflection.
Yet all this is set against a background of an aging population with complex health needs – increasing the demands we put on doctors and making it even more important that they can operate at their best. Healthy life expectancy at birth is currently 63 years (against overall life expectancy of well over 80); with nearly half the population living much of their older years managing one or more chronic health condition.

Medical training

Claire Pulford is the incoming Director of Medical Education for Oxford University Hospitals NHS Foundation Trust and explains the situation here. She says: ‘Oxford and Thames Valley is lucky not to have some of the recruitment challenges to our medical training programmes which are face by other parts of the country; but we still see vacancies and rota gaps in many essential specialties such as acute and emergency medicine.

In recent years, there has been a marked drop-off after Foundation-level training; with doctors choosing not to move immediately into more senior or specialist training posts. And morale and engagement are adversely affected, with high levels of burning out increasingly evident.’

Professional satisfaction

How then should we prepare and educate students and junior doctors for modern medical practice and enable doctors to maintain professional satisfaction throughout their careers Advancing Medical Professionalism (AMP); argues that enabling and supporting doctors to develop their professional identities is an important part of the answer.

AMP took as its starting point the RCP’s 2005 definition of professionalism as the ‘set of values; behaviors and relationships that underpin the trust the public has in doctors’. because It built on this with a series of workshops with healthcare staff; patients and other stakeholders to explore what professionalism might mean for doctors in 2018 and beyond.

The RCP’s Dr. Jude Tweedie, a co-author of AMP; says: ‘Medical professionalism is extremely hard to define. As doctors; we recognize immediately when it’s absent and instinctively know that it’s essential to great patient care and physician satisfaction – but it can be very hard to quantify. So; we went out to talk not only to doctors but to patients; academics, practitioners; and others to find out what they thought.