Hospital doctors are being sent home from daytime shifts and told to come back and work overnight in the latest stark illustration of Britain’s National Health Service’s crippling staff shortage.
Official health service vacancy figures show the NHS is short of more than 9,000 medics and 40,000 nurses.
The Guardian reports that medics have to change their plans at the last minute because hospitals cannot find any others to plug gaps in the night shift medical rota and need to ensure they have enough doctors on duty.
Hospital bosses are forcing last-minute shift changes on junior doctors – trainees below the level of consultant up to the level of senior registrar – because staff sickness and the scarcity of locum medics has left them struggling to ensure patients’ safety is maintained overnight.
The practice has been disclosed in a dossier of evidence assembled by EveryDoctor, a network and campaign group of frontline medics, based on testimonies from doctors in England about the impact of understaffing.
One junior doctor said: “We are being told to go home after five hours into our day shift, to cover a night shift due to ‘unforeseen’ gaps.”
Another consultant told EveryDoctor how they and colleagues had been continually working extra shifts “as an emergency” for the past two years.
Enforced 11th-hour changes to working patterns are confirmed by messages a senior medic in a management role at the hospital recently sent to a WhatsApp group of about 100 trainee doctors.
Referring to “unforeseen gaps because of last-minute sickness”, the medic wrote: “In these situations we would usually ask one of you to step in at the last minute. This may require changing your day shift to a night shift at short notice.
“No one wants to be in this situation … but it is paramount to patient safety that unforeseen on-call shifts are covered, especially at night.”
However, doctors who have to work overnight without any warning will only be paid for doing those hours and not for the day shift they were scheduled to do, he added.
The hospital is being forced to ask its own staff medics to fill rota gaps partly because temporary doctors sourced from “expensive locum agencies aren’t always forthcoming”, he said.
Dr Julia Patterson, the chief executive of EveryDoctor, said: “We hear of escalating problems with NHS doctors being forced to work unsafe, unfair hours.
“Patient safety is of paramount importance to all doctors, but this situation is not sustainable. When mistakes occur, staff are blamed. But they are working in an unworkable system.”
She plans to write to the General Medical Council, which regulates doctors, and the British Medical Association, the main doctors’ trade union, to highlight the trend. “Doctors cannot shoulder the failures of this government any longer,” Patterson added.
One consultant said that at their hospital, “most wards, most days, are understaffed”. One ward for COVID patients “has no permanent consultant or junior medical staff, no pharmacy support and only 50% of the permanent nursing establishment it needs”.
The Department of Health and Social Care spokesperson said: “Local providers are responsible for ensuring they have the right staff in place. We have increased medical school places by 25% and, compared to last year, there are more than 4,000 more doctors in the NHS. The NHS will also publish the first ever 15-year workforce strategy later this year.”
An A&E consultant at a hospital in eastern England described having to work double shifts to protect patient safety.
“In the past three months I have twice had to work double shifts to cover for staff shortages due to a lack of senior doctors on our emergency department rota and because we cannot get locums.
“The first time, I was working a 2pm-10pm shift as a consultant with two very junior middle-grade doctors, neither of whom had ever been left in charge of the department before. When I suggested leaving at midnight they both looked terrified, and the senior nurses in charge of the department also expressed concerns about the patients’ safety.
“When I re-evaluated the situation at 2am it was clear it was not going to be safe to leave the department with these doctors in charge of a number of unwell patients, nor was it fair on them to ask them to work outside their comfort zones. I had no option but to stay until 8am.”
The doctor said he was “ amazed at how unaware the public seems to be of the current pressures on emergency departments and how little there has been in the press about this”.
“We recently had a patient needing a Mental Health Act assessment waiting 12 hours in the back of a police car in the car park as we had no safe space in the department.
“The system is broken, utterly and completely broken, and the public needs to be made aware of this.”
See more from MedicalBrief archives:
40% of NHS staff sick annually from work-related stress
26,000 NHS diabetic medication errors due to lack of specialist staff
Almost 12,000 people died from COVID caught in an NHS hospital in England
Report exposes ‘widespread and overwhelming’ racial discrimination in NHS