The BMA in Scotland has called for action to ensure that NHS boards properly engage with clinicians and trade unions when making decisions affecting health services.
Boards should be actively seeking ways to ensure that clinicians have time to contribute to decision-making at an early stage in the process – rather than simply engaging with partners to validate decisions that have already been made.
Action is also needed on junior doctor welfare and on training and development, the BMA says.
In written evidence to the Scottish Parliament’s health and sport committee, which is investigating NHS staff governance arrangements, the BMA also calls for specific actions to ensure that employers live up to their obligations.
For example, the BMA has been asking NHS NES (Education for Scotland), which has responsibility for training of junior doctors, but does not employ the majority of them, to agree to protect them from detriment as a result of whistleblowing.
This follows agreement with Health Education England, which has agreed to take on legal liability for ensuring that whistleblowing trainees do not suffer detrimental treatment as a result of their action, giving junior doctors the option of legal recourse if any detriment was to take place.
‘The current whistleblowing policy that NES has in place is not sufficient to give junior doctors the option of legal recourse in the event of mistreatment by NES,’ the BMA says.
‘BMA Scotland believes that this is one area where the NHS is falling short of what is expected of it in relation to whistleblowing, in line with the staff governance standard.’
Calling for clinicians to be involved in decision-making on local service development and clinical priority settings, the BMA warns that tightening resources, a lack of provision in consultant contracts, and rising demand make it even less likely that doctors will have time to do this, as do patchy local governance arrangements.
‘Medical input into board decisions is important as it ensures that boards clearly understand the concerns of doctors and benefit from the input of clinicians who are working on the front line of service delivery.
'A clear ability to input into board decisions would also help to foster an atmosphere of mutual trust and respect between management and clinicians within the NHS.’
The BMA is also warning that continued erosion of budgets for training and continuous professional development will have long term consequences on training and development of doctors, and has called for action to improve the care and welfare of junior doctors, including proper rest breaks when working long hours.
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