BMA fatigue and facilities charter makes inroads into staff safety

by Tim Tonkin

Funding from the BMA’s fatigue and facilities charter continues to improve working conditions for junior doctors, with staff reporting successes at their trusts.  

Location: UK
Last reviewed: 13 August 2020
Resting facilities for junior docs illustration

Trainees across England continue to benefit from charter funding totalling £10m, with each trust entitled to a minimum of £30,000.

Published in 2018, the charter is designed to serve as a good-practice framework for trusts to sign up to, to help ensure staff working conditions were improved and met minimum standards.

Not messing around

Speaking about improvements made at his trust, one Essex-based junior doctor has credited the charter for helping him to realise a two-year ambition to improve staff rest areas at his hospital.

Core trainee 2 and president of the junior doctors’ mess Rasanga Wijesinha has spoken of his elation at getting a dedicated mess area for doctors opened at his workplace, the Princess Alexandra Hospital NHS Trust in Harlow.

Dr Wijesinha, who has been at the trust for two years, had already been exploring options around improving the staff mess area prior to the charter funding being received.

He said that after signing up to the charter, funding for which has to be spent within a certain period of time and must meet minimum basic standards in terms of its design, had helped drive forward plans.

Secure space

Dr Wijesinha said that for many years there had been no on-site mess facilities for doctors at the trust, with staff having to rely on a small off-site area without running water or cooking facilities.

One of the first challenges was finding a suitable area on site to build the mess, a challenge given the relative shortage of space at the hospital.

After working closely with the trust’s head of estates, Dr Wijesinha was able to design a dedicated mess area consisting of lockers for securing personal belongings, a dining area and open plan kitchen, TVs, computers and telephones, an on-call room and toilet and shower facilities.

He credited the trust for their support and for giving him free rein to work with contractors and draw up plans, and for using their own funds to supplement the £30k received through the charter.

He said: ‘The trust deserves a lot of commendation because they put in a lot of effort in securing space for the mess and then giving me the freedom to for junior doctors to create an area for junior doctors.

‘The response [from staff] has been overwhelming. Previously we had a small room that was a five to 10-minute walk from the main hospital building that was just a shell of a space that no one really used.

‘It has been a very positive response and it’s been nice to see the new cohort of foundation year 1 doctors have the opportunity to meet each other and sit together in a dedicated space.’ 

Staff safety

It was a similar story for Somerset paediatrics specialty trainee 6 Emma Coombe, who told how her trust’s on-call accommodation had improved thanks in part to funding through the charter.

Dr Coombe, who is based at Musgrove Park Hospital in Taunton and is the Severn RJDC chair, said the main improvement had been the increased number of rest rooms available to staff, with her and her colleagues persuading the trust to open up further space in addition to the eight rooms already available.

Under the terms of the 2016 contract, trusts have an obligation to provide accommodation to provide a place of rest to junior doctors too tired to make their way home safely. 

Dr Coombe said that negotiation of the improvements took place over a year, but that the difference the accommodation had made to staff safety had been significant.

She said: ‘It means that I don’t ever have to take a decision to compromise my safety by driving when too tired, as I will always have somewhere to stay on site.  

‘Certainly for me, I feel like I am working at my best on night shifts when I’m not having to do two-and-a-half hours of driving between each shift, and it means that my colleagues and patients get the best out of me.’

Financial help

Dr Coombe further added that with junior doctors in her region unable to claim expenses for travel to and from home unless they owned their own property, having access to free-of-charge accommodation also made a difference financially.

She said: ‘For a lot of junior doctors it gets very costly either having to pay for trains or fuel and car maintenance, so these facilities have taken that financial stress away from them as well.

‘It also makes you feel as though the hospital cares about you as a person not just as somebody in a rota slot.’ 

As part of the 2018 junior doctors contract review, the Government agreed to provide £10m in funding to trusts in England to help install or revamp staff rest facilities, with all trusts receiving a minimum of £30,000.

Under the terms of the funding settlement, any planned improvement works will need to be approved by the relevant trust’s junior doctors’ forum and senior management team, with the JDF and trust director of medical education also required to sign-off and monitor any financial allocation to ensure funds are spent appropriately.

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