Trainee doctors in ‘meltdown’ at major hospital maternity department

‘Decisive action’ was needed from Birmingham trust as junior doctors report being near ‘meltdown’, regulator warns

The General Medical Council has placed maternity services at University Hospitals Birmingham under supervision (PA Wire)

Regulators have raised serious concerns over trainee doctors within the maternity department at one of the largest trusts in the country.

The NHS’ training regulator said it had concerns over the treatment of trainee doctors within the obstetric and gynaecology department at University Hospitals Birmingham Foundation Trust, while some medics report being in ‘meltdown’.

Reviewers raised an incident where a consultant had refused to respond to an obstetric emergency in A&E which had been requested by a junior doctor.

“The panel unanimously agreed that Consultant presence was required without delay,” the report added.

The latest review follows concerns in November 2020 and June 2021 when patient safety issues were also identified.

It warned there was a “real risk” trainees would soon become “hesitant and reluctant” to call for consultant support when need.

The review follows the publication of the Shrewsbury Maternity Inquiry report which highlighted problems of midwives and junior doctors not wanting to escalate issues to consultants.

According to the HEE report, there was a culture of long working within UHB’s maternity department, with trainees reporting they were unable to take breaks when on call in the labour ward.

It added: “Decisive action was needed as Trainees described being near ‘meltdown’. High sickness levels and low morale had led to a vicious cycle, and the present trajectory was not sustainable.”

Trainees across the department allegedly reported a “very worrying” lack of experience in gynaecology surgery, while the curriculum was not being delivered due to “service pressures and chronic short staffing.”

As a result of the review, the trust’s trainees have been placed under intensive support and concerns escalated to the General Medical Council.

The GMC confirmed to The Independent that it has placed the department, based across Good Hope Hospital and Heartlands Hospital under “enhanced monitoring” due to the concerns over training.

The key concerns prompting this include the “high burden” of on-call requirements and last minute rota changes, the lack of adequate training opportunities and available support from consultants out of hours.

Professor Colin Melville, medical director and director for education and standards at the GMC, said: “We’ll keep working closely with the Trust and Health Education England Midlands to make sure an improvement plan is implemented, and we will check that progress is being made to ensure a safe, supportive and sustainable training environment.”

A spokesperson for University Hospitals Birmingham NHS Foundation Trust said: “Since the HEE report was published in March, the Trust has implemented a number of changes.

“They include: additional consultant and registrar support to the Gynaecology Assessment Unit (GAU) at Heartlands Hospital; development of revised rotas, in conjunction with the trainees, incorporating additional training opportunities; increasing the number of junior staff to support the service.

“Further work is being undertaken with the consultant team to improve access to, and the quality of, training in Gynaecology, both in outpatients and in theatre.”