Trust's Recruitment Procedures For A&E Doctors Challenged

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http://www.bbc.co.uk/programmes/b00xt33v (last three days available on the iPlayer  – 4/5 ths through the programme.) While arguments about the sustainability of the A&E service abound, a Belfast City Hospital middle grade doctor, Jeremy McCammon, speaking personally on the Talkback show said that he acknowledged there were UK-wide difficulties in recruiting middle grade doctors by hospital Trusts but added the the reasons for this need to be examinied. He further added that the associate level emergency trained doctors often have between 5-20 years experience in the job and are capable in fields such as major trauma and resuscitation. Dr McCammon said that locum agencies are for employing temporary doctors and if a hospital Trust wished to employ middle grade doctors it should advertise through channels where doctors would notice. When questioned by Wendy Austin, he said he was not aware of the South Eastern HSC Trust having advertised in Northern Ireland for the middle grade doctor posts required at the Downe Hospital A&E department. He said, “Northern Ireland is a small place particularly in emergency medicine”, and he added that the Trust needed to advertise formally through different channels than locum agencies. [caption id="attachment_10720" align="alignleft" width="300" caption="The South Eastern Trust has responded to a storm of criticism about its recruitment procedures of middle grade doctors at the Downe Hospital."][/caption] He also expressed his concern that the payments being made to locum GP’s covering the night shift at the Downe Hospital A&E was a considerable drain on Trust finances and could be used to help pay properly qualified middle grade (associate specialist ) doctors. Health Taskforce Chairman Calls for Re-Examination Of Downe Hospital Case Down District Chairman Councillor  Eamonn O’Neill who chairs the All-Party Council health taskforce  group has called on Health Minister Michael McGimpsey to re-open the Downe Hosptial case following further revelations that rigorous recruitment procedures were not followed to attract doctors to the facility. Speaking following the BBC interview with Dr Jeremy McCammon on Talkback, Councillor O’Neill said, “This interview is further evidence that the information the Health Minister has been given by the Trust on their inability to recruit middle grade doctors is incorrect. “It clearly contradicts what the Trust has said, further exposing their pathetic effort to recruit doctors to the Downe Hospital. For them use this as an argument to shut down our health services is totally unacceptable. “When the SDLP researched the matter through freedom of information, we discovered that the Trust had only once asked for a set of advertisements to look for doctors which have proven to be totally inadequate. “The minister is duty bound to protect the health of the public and to fully live up to his responsibilities we feel that he must reopen and re-examine the Downe Hospital case rather than axing services at this vital state-of-the-art facility.” SDLP  Down  Council Health Spokesman Councillor McGrath Voices Anger Down District Councillor Colin McGrath has written to the Minster of Health, Michael McGimpsey, and demanded an independent inquiry into the handling of hospital recruitment at the Downe Hospital. Councillor McGrath has already received considerable information from the South Eastern HSC Trust over its handing of the advertising for A&E posts after making a Freedom of Information request to the Trust. He said, “We were always led to believe that the Trust had searched the world over to try and get medical positions at the Downe filled and were subsequently told that they had no one apply for the posts. “Then, under Freedom of Information they told me that they had simply placed a handful of advertisements in local papers to try and recruit for the positions and that this was an unsuccessful process. “Now we have medical professionals calling into the BBC and stating that the process followed was not adequate and had they known they would have applied for the positions. This questions directly the work undertaken by the Trust to recruit for the positions in the Downe. “The Trust appears to have presided over a flawed process of recruitment and it is the people of Down District and beyond that will lose out. “There are a number of key questions that must be asked and I feel an independent inquiry is the only possible manner that will adequately address the concerns of the people of Down. “We must know: *  Were the proper procedures to fill the posts at the Downe followed? *  Were all appropriate avenues to fill the posts explored? *  How was the response levels, and in this case the lack of responses, evaluated to determine if anything different could have been done? *  What direct impact did the lack of people to fill the posts have on the reduction of opening hours at our A & E Unit – ie. did a flawed recruitment  process result in reduced services at the Downe? “The Downe hospital is a magnificent building with skilled nursing and caring and other ancillary staff ready and willing to work with medical practitioners to meet the medical needs that local people have. “We must determine that all that can be done was done to deliver this much needed service in Down District”, he added. South Eastern HSC Trust Responds To Councillor McGrath The Trust has responded to Councillor McGrath’s criticism of their recuitment policy. Down News has presented the full Trust statement below as there is much confusion and strong feeling around this issue. A Trust spokesperson said,”There is a Northern Ireland and UK-wide shortage of middle grade doctors for Emergency Departments. A third of Health Trusts across the UK are experiencing a significant shortage of this grade of doctor and in fact St Mary’s Hospital in Sidcup, which serves a population of a million people, had to close its Emergency Department for the entire winter due to a shortage of middle grade doctors. “Other models of care had to be recently put in place in Rochdale, Burnley and Coventry due to the shortages of middle grade doctors. More locally the decision to close the Mid –Ulster hospital Accident and Emergency unit and replace it with a minor injury unit was significantly influenced by the shortage of adequate middle grade doctors in emergency Medicine. “When the South Eastern HSC Trust was established in 2007, there were 6 middle grade doctors working in the Downe all of whom had contracts that did not require them to work weekend nights. This model was heavily locum dependent. Eleven doctors would be required to make this more sustainable in the long term. If we actually could recruit 11 middle grade doctors we would have more middle grades than any other hospital in Northern Ireland – including the Royal Victoria Hospital which is the major trauma centre. Following negotiation there was agreement with some of the middle grade staff that they would work more at the weekends but 3 doctors did leave post for a variety of reasons. “The Trust has used recruitment agencies and advertised for middle grade doctors for the Downe Emergency Department. We have found that advertising has largely been unproductive and that using recruitment agencies has resulted in more permanent appointments. Two of the last three permanent appointments have been made through a recruitment agency and the other appointment was in response to an advertisement which was placed because there was an available candidate in the market place. “Our aim is to only appoint highly competent and experienced doctors with significant NHS experience. We would not recruit doctors for the Downe Emergency Department who did not meet this criteria. Provision of a safe and sustainable service has been at the foremost of our thoughts. Because of inadequate staffing of the Downe, it has been locum dependent for a very long time this has created a situation where frequently the Trust was not in a position to name the doctor who was working the weekend nights on Friday morning. We avoided this problem only when locums were being paid significantly enhanced rates that frequently exceeded £100 per hour at premium bank holiday weekends. This is neither a safe nor sustainable solution going forward. “We are currently 6 doctors short of having a sustainable 24/7 rota in the Downe Emergency Department, however there has been a recent resignation and the Trust will be advertising for replacement and additional staff. Because of the lack of supporting services on site in an emergency situation, there is a need to have an experienced doctor at the front door if very sick patients are to be brought there by ambulance. This is simply not possible in the foreseeable future given the national shortage of middle grade doctors. There have been occasions when the Consultant has had to live-in overnight and this causes issues with Consultant cover for other hospitals within the Trust and their work schedule the following day. “By harnessing the experienced group of GPs in the area who work in the out of hours service in partnership working with Emergency Department Consultants, it is possible to retain an open door policy at the front door of the Downe Hospital to medical admissions throughout the night. This will maintain the maximum number of appropriate patients in the Downe area. These plans have been piloted over a few nights and no significant issues have arisen. “In summary, the Trust believes that blindly advertising for middle grade staff to work in the Emergency Department of the Downe Hospital is the wrong approach when local intelligence, previous experience and the national picture clearly indicate there is little prospect of attracting suitable applicants. There has been a reluctance of this grade of staff on a national basis to provide the full spectrum of 24/7 cover as they are in permanent posts and there are sufficient posts available for them regionally and nationally not to have to work overnight on a regular basis. The new model will make their working arrangements more stable and hopefully attract additional doctors when we next go to advert. The Trust believes that the new model tested by the Trust and approved by the Minister for Health remains the best opportunity to save the Downe.”]]>

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