Aims
In spring 2017 a morale survey was designed by clinical leadership fellows (CLFs) working at Leeds Teaching Hospitals NHS Trust (LTHT), and distributed to Leeds junior doctors. Over 200 responses were collected. The comments were grouped into themes, mapped onto ‘Maslow's hierarchy of needs’ (Fig 1)1 and related to the actions in the NHS improvement publication Eight high impact actions to improve the working environment for junior doctors.2 The CLFs and myself as chief registrar have implemented several interventions which we hope will improve morale.
Maslow's hierarchy of need and corresponding responses from the LTHT junior doctor morale survey.
LGI = Leeds General Infirmary; LTHT = Leeds Teaching Hospitals NHS Trust
The Junior Doctor Body with chief executive officer Julian Hartley.
The winners of the junior doctor awards.
Methods
Examples of interventions:
The Junior Doctor Body – chaired by myself, and meets monthly with the aim of improving communication between junior doctors and managers and sharing quality improvement work (Fig 2).
Junior doctor awards – the CLFs and I organised the inaugural junior doctor awards, the ceremony of which was held on 4 July 2018 (Fig 3).
‘Walk in my Shoes’ – a manager shadowing scheme which enables specialist trainees to shadow a general manager. The scheme intends to improve relationships between junior doctors and managers, as well as giving doctors management experience.
Doctors’ Digest – the CLFs and I have published four editions so far of a junior doctor newsletter, featuring educational articles, a leadership role interview and prescribing tips amongst other articles.
Forward App – we are currently in the process of conducting pilot trials using this secure messaging app in a variety of clinical areas in the hope of reducing distractions and waste in the workstreams which affect junior doctors.
Results
A variety of sources have demonstrated a positive impact so far, such as: 100% of doctors participating in the ‘walk in my shoes’ scheme saying that the scheme enabled them to fulfil their learning objectives.
When asked ‘on a scale of 1–5 where 5 = extremely well, how well do you think the awards celebrated excellence?’ in a formal feedback questionnaire after the awards ceremony, 52% of junior doctors present scored a 5 and 38% a 4 (the remaining 10% failed to respond). We will also use data from surveys such as the General Medical Council trainee survey when published.
Conclusion
Addressing junior doctor morale is essential if we are to maintain a robust workforce and ensure patient safety and satisfaction. Morale is complex and requires a multi-faceted approach, time and dedication to address successfully.
Conflict of interest statement
None.
- © Royal College of Physicians 2019. All rights reserved.
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