Junior doctors’ fears spark report into Fife hospital

Main entrance to Victoria Hospital, Kirkcaldy
Main entrance to Victoria Hospital, Kirkcaldy

NHS Fife has been told to improve its management of trainees by inspectors.

The deanery of NHS Education for Scotland (NES) – which is responsible for managing medical training programmes – has handed health bosses dates for improvements to be made.

The panel visited the Kirkcaldy hospital after a national training survey delivered some red flags

One area of concern was patient boarding – when a patient is put in a bed borrowed from another ward because of a lack of capacity.

Another centred on a lack of detail on weekend hand-overs where some trainees said going on-call changing from days to nights quickly left then “exhausted.”

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They were also left with patients whose medical history they didn’t know, and have to handle calls asking for details about them.

The panel expressed “serious concern” over the issue of patient boarding.

The report said it had examples of patients being deemed medically unfit to board, but, overnight, this was over-ruled, and the patient was boarded – while some deteriorated because their treatment was not maintained.

It also noted Ward 13 had “no allocated medical staffing” which mean nursing staff were on a daily rota “which affects continuity of care and familiarity with patients.”

The panel noted work had been done to improve the handover but “this has not been effective so far” and all trainees “expressed anxiety” about the process.

It described weekend handovers as “inadequate” noting: “Trainees are given a list of patients, often 100, and are unable to identify sick patients from. Trainees spent the first hour of the shift deciding who to see first, and it is a random selection usually based on geography.”

The panel gave NHS a deadline of December 22 to develop effective boarding policies, and improve handover processes – and it plans a return visit to ensure changes have been made.

Dr Chris McKenna, NHS Fife medical director, said: “Since the publication of this report, we have been working closely with our trainee doctors to inform a significant programme of work that will improve the areas that were highlighted.

“We look forward to demonstrating these improvements when the NHS Education for Scotland Deanery returns to Victoria Hospital next month.”