GP trainees who take strike action 'could face competency review'

GP trainees who take full part in all three of the proposed five-day junior doctor strikes could be subject to a competence review for missing out on training experience, Health Education England (HEE) has warned.

Education bosses have warned that junior doctors undergoing specialty training who miss more than two weeks of work time outside of annual leave could lose out on vital experience and have their training compromised.

There are three all-out, five-day strike actions planned for 2016, totting up to 15 days in total – which would push any specialty trainee who strikes for the full duration over this limit.

GMC guidance states that prolonged absences should trigger an Annual Review of Competence Progression (ARCP) to assess whether their training should be extended.

It comes as the GMC suggested it could take action against junior doctors should the strikes cause direct harm to patients. BMA leaders say strike action can be averted if the government shelves plans to introduce next month a contract that was earlier rejected by junior doctors.

In advice to junior doctors, HEE warned that prolonged industrial action – and the resultant loss of training experience – could adversely affect a doctor’s ability ‘to demonstrate competence and the satisfactory completion of the curriculum’.

Any doctor taking 14 days out of specialty training within 12 months will have the matter raised in an ARCP to determine whether this had an impact on them reaching the necessary competency levels.

Junior doctor strikes

Trainees would be assessed on a case by case basis, and could have their training extended to make up for days lost, a HEE spokeswoman said. But she stressed that the process was ‘totally supportive and not seen to be detrimental’.

In a statement, HEE said it ‘respects the rights of doctors in training to take industrial action’, but its primary concern was patient safety.

It added: ‘Whilst industrial action in the short term may not necessarily compromise their training, there could be circumstances where prolonged industrial action and loss of training experience impact on a doctor’s ability to demonstrate competence and the satisfactory completion of the curriculum.

‘To manage this issue, HEE will comply with GMC guidance that states if a trainee misses more than two weeks (when a trainee would normally be at work), over and above annual leave, that the satisfactory training progression of a trainee should be reviewed at their next Annual Review of Competence Progression (ARCP).’

HEE also announced a raft of initiatives designed to tackle non-contractual concerns that have been highlighted by junior doctors, including stronger protection for whistleblowers and improving how rotations work.

Professor Wendy Reid, HEE medical director said: ‘The anger and disillusionment shown during the recent dispute has drawn into sharp focus the need for a new approach to make sure that they feel valued and able to work in supportive and accountable environments.

Training competency

‘We know that being a junior doctor is challenging and stressful without any additional pressures such as poor rota planning, unsupportive senior colleagues and lack of family time.

‘HEE continues to work to improve the lives of doctors in training, with junior doctors themselves, as well as the wider NHS. However, to do this effectively we need support and collaboration, as well as challenge when things need improvement, from the whole NHS and medical profession.

‘We cannot afford to lose a generation of junior doctors either through disengagement or a lack of ambition from those charged with their training.’

A BMA spokeswoman said: ‘Patient safety remains doctors’ priority and since the announcement last week of further action, the BMA has been liaising with NHS leaders so that plans can be put in place swiftly to minimise disruption for patients.

‘This action is still avoidable. The BMA has said it will call off next week’s action if the government puts a halt to plans to force junior doctors to work under a contract they have rejected because they don’t believe it is good for the future of patient care or the profession.’

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