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Solving doctors


Blog headlines

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

  • Virtual Consultations– the patient perspective
    1 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article - Virtual Consultations– the patient perspective.

  • Celebrating innovation in eye research
    24 September 2020

    This week Julian Jackson from VisionBridge has shared a report on eye research.

  • Link of the week: Comprehensive Spending Review and Covid-19
    24 September 2020

    This week we are sharing a blog that outlines the funding pressures and uncertainties faced by the health and care system

  • Risk stratifying elective care patients
    10 September 2020

    This blog has been shared by MBI healthcare technologies. As services are starting to treat routine patients those on waiting lists are making enquiries as to where they are on the list, and if they are still on the list.

  • Link of the week
    4 September 2020

    This week the link we would like to share are reflections from physiotherapy students on placement at Alzheimer Scotland https://letstalkaboutdementia.wordpress.com/

  • Link of the week
    28 August 2020

    This week we would like to share a blog published on the Mind website about being a BAME health worker in the pandemic.

  • Remote clinical triage model
    20 August 2020

    This week we are sharing how a remote clinical triage model was implemented at Tollgate Medical Centre. This has been shared with us by Sarah Portway, a Nurse, and Clinical Services Manager at Tollgate Medical Centre.

  • Can the Community Pharmacy become the gateway to integrated care in the NHS?
    13 August 2020

    The NHS is a continually evolving innovative demand led public service the role of the Community Pharmacist is becoming the public face on a journey to the more responsible public engagement in the personal care of individuals and their family. There are currently over 11000 Pharmacies many are single or small chain service providers, while multiples occupy the urban shopping centres and more densely populated conurbations, the value of the rural High Street can’t be understated.

  • Crunch time for patient involvement
    7 August 2020

    There are new challenges for primary care, which could really do with patient input. Mike Etkind, chair of a PPG and founding member of his PCN’s patient group, recognises the size of the task clinical directors have managed over the last few months but identifies two particular issues where patients have a necessary and valuable contribution, that need to be addressed now – the 2020 vaccination programme and primary care from a distance- total triage, remote consultations, and the use of telemedicine.

  • Link of the week - Visionbridge
    31 July 2020

    The link we are sharing this week was submitted by Julian Jackson, Visionbridge.

  • Links of the week
    23 July 2020

    This week we are sharing two articles with you.

  • Link of the week
    21 July 2020

    The blog is from the perspective of the Company Chemist Association's Chief Executive Malcolm Harrison.

  • Link of the week
    9 July 2020

    This week we are sharing a blog from the NHS Confederation’s “NHS Reset” looking at the work of Healthwatch, the role of volunteers in supporting patients being discharged from hospital and the importance of the community.

  • Virtual education sessions on spinal cord injury from Spinal Injuries Association
    2 July 2020

    This week Karen Mikalsen from the Spinal Injuries Association shares some information on their work and events for healthcare professionals.

  • Guest blog:Karen Chumley
    25 June 2020

    Thank you to Karen Chumley for a second blog –this time on the local use of an Electronic Palliative Care Coordination system during the Covid-19 pandemic. Karen is the Clinical Director and Deputy CEO at St Helena.

  • Link of the week
    19 June 2020

    This week's link of the week is article by Yasmin Khanagha published in Nursing Times – Why we need to open the conversation about racism.

Thursday, 2 November 2017

Solving doctors

It’s been a week of helpful interventions. NHS England has told sustainability and transformation partnerships (STPs) to sort out the GP recruitment crisis. NHS Improvement has taken high-impact steps to enrich the lives of junior doctors. Two different initiatives, two different sets of doctors, two national bodies determined to make the world more doctor-based and success-centric.

Magic Kingdom

We have the HSJ to thank for the story that NHS England has set STPs targets for GP recruitment. Only lack of statutory powers, resources and candidates stand in their way.

Otherwise it’s a great idea. Devolution has been focused for too long on the vulgar business of funding and not enough on finding really practical solutions to problems that Big Government is too sausage-fingered to solve.

STP unorganisations already have secondary care deficits, hospital performance and decaying social care on their plates. Added to which they have the job of plotting the route to the Magic Kingdom, the fairytale world of accountable care organisations and new care models featured in Walt Disney’s Forward View. Sorting out the primary care workforce is a breeze by comparison. 

Local GP training initiatives could obviate the need for Health Education England, local education and training boards, royal colleges and other expensive bureaucratic paraphernalia. We could even finish the job started by Lord Lansley, and get rid of the Department of Health altogether. Think of the money we’d save.


It’s no coincidence that this news comes in the same week that the department announced a consultation on relaxing medical regulation. The current rules requiring years of training and learning on the job were designed for an age where doctors were compelled to practise medicine before they were allowed to practise medicine.

But there is little to be gained by harking back to the 1950s. We need to redefine “GP” for the new world. You wouldn’t dream of training someone for ten years to flip burgers, paint your home or drive an Uber taxi, so what makes doctors so special?

GP training could open up in a variety of innovative ways. They could include opportunities for stay-at-home mums planning a return to work, retraining for eastern European plumbers and builders seeking post-Brexit job security, and courses at local colleges enabling medicine to be combined with media studies, sociology and modern dance. E-learning would allow doctors to upskill at their own pace and still leave time for evening bar work.

We don’t need stuffy old colleges and mentoring schemes. There are thousands of qualified docs on social media who trainee community doctors and wellbeing assistants could turn to for advice and support.


In other news, junior doctors responded with gratitude to a guide from NHS Improvement to making their working lives better. It turns out that traditional forms of stress-relief - alcohol, drugs, sex and contract disputes - do not work. Eight High Impact Actions to Improve the Working Environment for Junior Doctors advises, among other top tips, that they should be given access to fresh water – leading one medic to wonder if the authors were confusing junior doctors with ducks.

Animal husbandry is a recurring theme. We also learn that hospitals could employ a “dedicated pastoral lead”, who would presumably ensure that busy doctors get a break for fresh air, exercise and grazing.

Other suggestions include “promoting rest”, “rewarding excellence”, and “better engagement with the board”. The authors may be on to something here. A couple of hours in a board meeting could be just the thing to make a long shift in an understaffed emergency department suddenly seem appealing.   


Concerned that NHS Improvement may have missed some even higher impact actions, we canvased doctors. Here are some of their ideas for enhancing the working environment.

  1. Take turns to have a go on the ride-on floor cleaners
  2. Do ward rounds/surgery outside if it’s nice
  3. Customise your pager’s ring-tone or choose your own call-sign, eg Iceman, Maverick
  4. A non-smoking room with retro nicotine décor and faux ashtrays
  5. Biscuits/stickers to reward excellence and celebrate success
  6. Allotments for growing vegetables
  7. Workshops on proactive chatting, compassionate breathing and mindful positivity led by NHS Horizons
  8. Complementary sanitising hand gel.

Hospitals that adopt these innovations can expect to see an up to 1000% improvement in the morale of junior doctors, albeit from a lowish base. Don’t forget to choose a suitably high-impact way to mark each achievement along the way. The Dam Busters theme played at high volume goes down particularly well on geriatric wards. Staff in other departments will have their own ideas.

Improvement editor: Julian Patterson 


Dee Gray
Dee Gray says:
Nov 03, 2017 07:59 AM

Motivational talks from Chief Execs have been overlooked. They are really good at getting doctors to deliver on targets, especially those that make money for NHS.

Anonymous says:
Nov 03, 2017 03:23 PM

Thanks JP. Glad to see Top Gun directly referenced in this week’s dispatches.

With reference to doctors training - I think the NHS should be looking to harmonise its approach around shared life experiences. This would help reduce the natural anxiety most feel when first encountering clinical environments. I am of course referring to the happy days spent by most flipping burgers, pulling pints and de-constructing lattes.

Suggest a bell at the nurse base would help promote an overall feeling of familiarity. For example, this could dinged every time a patient is discharged with an added incentive of two dings if the patient makes it onto transport before 1000am (Refer 2017 Top 10 high impact changes affecting discharge ).

Possibly for balance we should also look at a similar approach to re-admissions? The jury would need to decide whether introducing a Two Ronnie’s sound effect from the Phantom Raspberry Blower of Old
London Town would be an effective deterrent?

b/rgs ‘Goosed’