‘Trainee doctors too scared to come to work’
That is the headline of a damning news story by the BBC’s Welsh Health Correspondent. The story describes a report by the Royal College of Physicians following a visit to the newly opened Grange Hospital in Cwmbran. You can read the story here: https://www.bbc.co.uk/news/uk-wales-58967159 .
Junior doctors described facing numerous problems trying to make the Health Board’s model of care work. Many of the problems sound eerily similar to those we can expect to see with the New Velindre Cancer Centre.
The problems at the Grange stem from decisions to centralise Critical Care and specialist services at the Grange. This leaves the other hospitals run by Aneurin Bevan Health Board (Royal Gwent, Nevill Hall and Ysbyty Ystrad Fawr) without the capacity to investigate and manage very sick patients.
A similar model to the isolated Velindre, with no critical care and very limited diagnostic capability.
Dr Olwen Williams, Vice President of the Royal College of Physicians, said :”the new clinical model sees both the workforce and patients moving between multiple sites”
One trainee said ‘there’s so much patient movement with this model. I recently sent someone from Nevill Hall to the Grange to get a scan, then to Royal Gwent for a follow up procedure, then back to Nevill Hall. That’s three bed moves, three ambulance crews and three medical people all dealing with the same patient. It’s extremely inefficient‘.
This story will sound all too familiar to many staff and patients who experience fragmented cancer care in Cardiff- travelling from Velindre to UHW or Llandough for investigations and procedures, or waiting for emergency transfer when critical care is needed.
‘Scared to come to work’
The Royal College of Physicians listened to Junior and Senior doctors describing their fears about working, fearing referral to the General Medical Council if ‘at some point, something bad is going to happen It wouldn’t have anything to do with your abilities as a doctor, it’s just your bad luck if it happens’.
Again, there is a parallel to the interviews carried out by the Nuffield Trust on behalf of Velindre Trust. Junior doctors described feeling exposed to worrying levels of risk when they were on call. https://colocate-velindre.co.uk/are-ambulance-pressures-putting-velindre-emergency-transfers-at-risk/
Not surprisingly, doctors told the Royal College that they would not want to work at the Health Board in future. What will happen in Velindre? New Velindre leadership has so far been remarkably complacent about the impact of continuing with their out of date model on future recruitment. We know that they have already lost staff who prefer to build their careers in Centres which can provide all the services needed on one site. This trend can only continue, leaving South East Wales a poor relation in in terms of training and recruitment.
Just like Velindre, staff tried to arise their concerns with management before the Grange opened. Sixty doctors wrote to the Chief Executive. This echoes the letter written by Senior staff to their Chief Executive last year. In addition, 163 Senior Clinicians from Health Boards across South Wales wrote to the Health Secretary. Nothing changed, and we now see the results in the Grange.
There is still time
Unlike the Grange, the New Velindre Cancer Centre remains simply a concept. No design has been approved and preliminary ‘enabling works’ are yet to gain planning permission.
Clinicians and, more importantly, patients are now paying the price for the misguided persistence with the Grange Hospital in the face of serious concerns. There is still time for a re-think in Cardiff.
If you’re concerned, contact your MS- (the link gives instructions)https://colocate-velindre.co.uk/your-hopes-for-a-world-class-cancer-centre-can-stile-snatched-from-destruction/ and ask that they use their influence to call for an independent clinical review of the plans before it is too late.
Or if you have an experience of disjointed care that you’d like to share you can contact us in confidence at firstname.lastname@example.org