Doctor rebellion concerns amid A&E overhaul plan

Trainee doctors have revealed their fears at St John's
Trainee doctors have revealed their fears at St John's
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A PROPOSED staffing overhaul in A&E services in Lothian could lead to widespread rebellion among doctors, as a shock leaked memo revealed the pressure the region’s health workers are already under.

NHS Lothian has said it is planning to introduce a new model, with services “streamlined” at St John’s Hospital, Livingston, potentially increasing workloads.

The health board hopes the changes, which include the creation of 12 new short-term training posts, will avert the need for more A&E patients to be sent to Edinburgh overnight.

But the Evening News understands that there is growing unrest among doctors at the hospital, who fear the new model could be “unsafe”.

It also today emerged that trainee doctors at St John’s Hospital had raised concerns through the General Medical Council (GMC) about workloads in recent months, claiming dangerously-low staffing levels put patients in danger.

The shock fears were outlined in a leaked internal document, which says “we are short staffed to an extent [where] it is not possible to provide the quality of care we’d like . . . we genuinely believe this is unsafe and do not think it is fair”.

NHS Lothian said that it was “not aware” of staff refusing to work the new plan, which is set to be introduced in August, and said measures had been put in place since doctors had ­complained to the GMC.

But one senior health board source maintained that doctors had explicitly said there was no support for the new plan and that medical staff had advised it would be safer to close A&E in Livingston at night.

The source said: “Doctors and general physicians have said categorically that they will not do this. The workload among the hospital night team is already so great that they will not be able to provide support to the emergency department.

“The staff feel very concerned that they are being forced into doing something they have rejected.”

Under the NHS Lothian proposals, the hospital at night team, which traditionally deals only with inpatients, would also work to help out in the emergency department.

A&E would be supported by new doctors who work in emergency departments for six or 12-month periods. The inexperienced staff at St John’s could call on consultants at the Royal Infirmary by video link.

The source added: “These hybrid doctors are not ­specialists in A&E and are of a much lower grade than existing people.

“The doctors have said the safest thing to do is to shut the A&E from 11pm until they can staff it properly.”

The Evening News revealed yesterday that there was a growing staffing crisis across a series of departments in Lothian hospitals, with failures in long term planning blamed.

Dr David Farquharson, NHS Lothian’s medical director, said: “We have been up front about the scale of the challenge we face and about our determination to maintain the 24-7 emergency department service at St John’s Hospital.

“We recognise staff are under pressure and our efforts to recruit additional doctors will support this.”

daniel.sanderson@edinburghnews.com