It’s been nearly a year since I became Chair of SJDC. It’s also very nearly been a year since we published our wellbeing document and which was shortly followed by the (already delayed by nearly 2 years) Scottish Government expert working group (EWG) report on the 48 hour maximum working week. I’m disappointed to say that with only a few weeks to go until the anniversary of this publication and the cabinet secretary for health and social care’s public full commitment to implementing the recommendations, we have made little progress. Combined with this year’s real terms pay cut, and a surprise monitoring suspension as our Christmas present last year, it’s genuinely hard to believe our government take our wellbeing seriously.
I don’t say any of this lightly. But it just is simply not good enough. Be under no illusion here as to where the fault lies. We have been pushing and pushing, and at times fighting government on this. We have been reasonable, and tried to have all the conversations we can, but it is incredibly frustrating to still have no way forward clearly marked out. Yes, we have made progress on limiting the number of long shifts in any 7 days – a key priority for SJDC and recommendation from the Scottish Government’s EWG report – and it has of course been reassuring to hear of positive rota changes across Scotland. But just the other week I was disappointed to learn of a colleague still working 5 consecutive long shifts despite having personally been told that there was 100% compliance within that same health board. We will of course be escalating this and other concerns locally, regionally, and nationally – to medical staffing, deanery, and government representatives. My optimism may be fading but be assured that my persistence isn’t.
I’ve had more people talk to me about industrial action, which isn’t surprising with strikes happening across Scotland in other sectors and many of our wider NHS colleagues preparing to ballot in the coming weeks and months. In our recent pay survey, it was clear that the junior doctors who responded are angrier and more prepared for potential sustained strike action than the other branches of practice in Scotland. Understandable given the situations we’re working in – understaffed, undervalued, overworked and at points dangerous for ourselves and our patients. No one wants to strike, and it isn’t a decision we should take lightly, but as a trade union we know it is a tool open to us, as a last resort, and sadly it is looking increasingly likely that we could need to use it.
At the same time, I’ve had increasing conversations with colleagues about the fears they have about unsafe working environments. During the summer?! Concerned about the potential consequences for them, for patients, for the very existence of our once great NHS in Scotland. Moral injury, burnout, and simply sheer physical and mental exhaustion. There is no resilience left in the system. Many of us are struggling and it is unsurprising when waits for both elective treatments and emergency care are breaking records – for all the wrong reasons. We know this winter is going to be the worst ever, worst even than last year.
We simply can’t go on like this. So, what should we do? What can we do? This will be the question facing our new SJDC when we meet next month. For our LNC-JDSs and NES LNC also. All committees across BMA Scotland (and beyond) are fully considering priorities and next steps. And we’ll be pushing government and employers to act. Not just words but meaningful action, action that is long overdue. Please do get involved. Elections may be complete, but your local and regional committees will always welcome enthusiastic reps. Our union is as strong as its members and that’s all of us.
So today, we’re also launching a survey (not another one, I hear some of you say) to get a measure of some of the wider issues affecting junior doctors. We know pay is a big issue, but we know many other things are too. We aren’t a one trick pony. SJDC represents you on issues ranging from pay and working hours to your training and progression and so much more in-between. We need to seriously assess where we are, and where we need to be, and how we can get there. So please take a few minutes and fill it in. This data will be invaluable and will build on some of the many conversations we’ve been having over the summer – with members at our Q&A events, with NHS Education for Scotland (NES), employers, government and beyond.
It’s now 6 weeks since changeover, and hopefully everyone is feeling more settled into new posts. This also means that we will shortly be starting a new round of rota monitoring across Scotland. This is important to make sure you are getting the breaks you are contractually entitled to and are necessary to keep you and patients safe. Often this is an area where people have historically been misinformed but you shouldn’t be going more than 5 hours without a break, and any shift longer than 9 hours requires 2 breaks. You can see a quick summary of the guidance, routes of escalation and other important wellbeing resources below.
So, try and get your breaks, fill in your monitoring forms (should now be online and you most definitely don’t need any kind of sign off other than your own), chase your results, and if something doesn’t seem right get in touch with us. You can see the guidance here on what should be happening in terms of monitoring.
I know monitoring is far from perfect, but it’s the tool we have right now at our disposal to hold employers to account. Engagement with it has been low, because it hasn’t always worked, but I know many of you are being overworked and not getting the breaks you are entitled to, and as such are likely being underpaid. Band 3 exists as a financial penalty for boards when rotas are unsafe – and too many hours are worked, or more than 25% of breaks being missed. This is still happening too often. Try and get your breaks, work the hours you are supposed to. Remember that teaching and handover are work too. If there are issues escalate them – supervisors, seniors and your local BMA reps and our employment advisers. We need to all be more aware of our #JnrDocRights and make sure we stand up for ourselves, and each other. Check your payslips, fill your monitoring forms in, make sure rota safety limits are being applied, you’re getting the teaching and study leave you need. Any issues – tell us. We are here to help. 0300 1231233 or email@example.com or you can use this form if it’s a more general issue or of course you can always email me: firstname.lastname@example.org
Lailah Peel, chair SJDC