Shadow doctors to end 'Black Wednesday'

A mentoring scheme could help the 7,000 new junior medics from making catastrophic errors on their first day in hospital this week

Abigail Downing, a 24-year-old junior doctor at Bristol Heart Institute, is pacing the floors of her ward. She checks on each and every one of her 24 patients, arduously writing down every minute detail in their exchange. She is responsible not only for documenting the ins-and-outs of each patient's illness and the happenings on her floor, but today, she is also showing me, how we can put an end to what has been dubbed the National Health Service's "Black Wednesday", once and for all.

In only three days' time, an estimated seven thousand new junior doctors will arrive in hospital wards to start their new jobs, fresh out of medical school. Research suggests death rates rise by on average six per cent on this day, with the most marked difference apparent in medical cases such as heart attacks and strokes, where they rise on average by eight per cent. Some have said it is the most dangerous day of the year to fall ill.

Ms Downing is just one of the many doctors now being relied on by the NHS to counter this phenomenon. Just as I am by her side today, thousands of young medics will have to shadow their predecessors for a minimum of four days before they take up their jobs on August 1, from next year. They will be paid for their induction days, at a cost of £1.6m.

It is hoped the initiative will reduce the number of errors made in the early stages of their careers. University Hospitals Bristol (UH Bristol), which has run a pilot scheme for four years, found that mistakes new doctors made in their first four months were reduced by 52 per cent after a week of shadowing and targeted teaching was made mandatory. While they recorded five incidents leading to permanent patient harm in 2008 – where patients ended up in intensive care – there was only one in the first four months of 2009.

Dr Rebecca Aspinall, consultant anaesthetist and programme director for doctors training at UH Bristol, said it was "common sense". Fresh from presenting to 39 of her incoming junior doctors on the "near misses" of last year's cohort – including taking blood from the wrong person, misprescribing patients, delaying care, and giving penicillin to those allergic to the antibiotic – she stressed first year doctors remained the hospital's "gateway to safety".

After saying the study, carried out by researchers from the Dr Foster unit and the department of acute medicine at Imperial College London, was a "little over dramatic", she added "something had to be done.

"There is a dramatic change between being a student and working as a doctor – it is a much bigger transition than a doctor will ever do again in their work life," she said.

"There was the argument that when we're seeing military reduction, the number of firemen reduced, and other public sector workers losing their jobs, how can we justify lengthening the contractual employment of new doctors? I say if we spend money now it will save money later by stopping patients going into intensive care."

Sir Bruce Keogh, medical director of the NHS, who was behind the national roll-out of the scheme, agreed. It was a "no-brainer", he said, adding: "I suspect the changeover does put patients at risk and a lot of people in the NHS would agree with that. This has been a problem in other countries too, like North America, when it happens around December and July [the 'July Phenomenon'], but the difference is, the NHS can deal with it."

Katy Day, a 26-year-old from Bristol, who will begin her career as a doctor this week, said she sees the shadowing as a "great opportunity". She has spent two days shadowing in Bristol so far, and said it was her first time in the hospital, where she would soon work. "It's quite a daunting prospect to start and there's massive responsibility working with the public. I'm glad I'm able to ease myself in." Her peer, John Frawley, 34, from County Mayo on Ireland's west coast, said his shadowing experience had left him feeling "prepared", adding that "no-one wants to make any mistakes".

Alastair Henderson, chief executive of the Academy of Medical Royal Colleges, said he was "very supportive" of the scheme and agreed the sector needed to do everything they could to "mitigate" risks to patient's health during the transfer period. He added, however, that the shadowing scheme only dealt with foundation doctors and not the estimated 50,000 doctors who transfer jobs in the NHS twice a year in August and February – around one third of the total work force.

"The other issues to be considered are the inductions given to all doctors who change and about the consultant presence at that time. We are also considering how easy it is to stagger the whole process, so all doctors in training don't transfer at the same time," he said.

As for Ms Downing, she recognises that "everyone feels scared" when they start. "I just try and give them tips, like how to fill out the medical forms, how to survive nights and being on call, and even where to find food and shortcuts around the hospital. It saves a lot of time, and in this job, you really have to be organised," she said.

Suggested Topics
Arts and Entertainment
The Doctor and Clara have their first real heart to heart since he regenerated in 'Deep Breath'
TV
Life and Style
Apple showed no sign of losing its talent for product launches with the new, slightly larger iPhone 6 making headlines
techSecurity breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
Arts and Entertainment
Jamie Oliver
filmTV chef Jamie Oliver turned down role in The Hobbit
News
The official police photograph of Dustin Diamond taken after he was arrested in Wisconsin
peopleDownfall of the TV star charged with bar stabbing
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
tvReview: Top Gear team flee Patagonia as Christmas special reaches its climax in the style of Butch and Sundance
News
people
Sport
Ashley Barnes of Burnley scores their second goal
footballMan City vs Burnley match report
Arts and Entertainment
Peter Mayhew as Chewbacca alongside Harrison Ford's Han Solo in 'Star Wars'
film
News
i100
Arts and Entertainment
Man of action: Christian Bale stars in Exodus: Gods and Kings
film
Arts and Entertainment
Tracy Emin's 1998 piece 'My Bed' on display at Christie's
artOne expert claims she did not
Arts and Entertainment
Catherine (Sarah Lancashire) in Happy Valley ((C) Red Productions/Ben Blackall)
TV
News
Hackers revealed Oscar-winning actress Lawrence was paid less than her male co-stars in American Hustle
people
Arts and Entertainment
Clueless? Locked-door mysteries are the ultimate manifestation of the cerebral detective story
booksAs a new collection of the genre’s best is published, its editor explains the rules of engagement
Sport
Robin van Persie is blocked by Hugo Lloris
footballTottenham vs Manchester United match report
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Business Manager

    £32000 - £40000 per annum: Recruitment Genius: A Business Manager is required ...

    Recruitment Genius: Operations Manager

    £45000 - £55000 per annum: Recruitment Genius: This is an exciting opportunity...

    Recruitment Genius: Panel & Cabinet Wireman

    £20000 per annum: Recruitment Genius: Panel Wireman required for small electro...

    Recruitment Genius: Electronics Test Engineer

    £25000 - £27000 per annum: Recruitment Genius: An SME based in East Cheshire, ...

    Day In a Page

    A timely reminder of the bloody anniversary we all forgot

    A timely reminder of the bloody anniversary we all forgot

    Who remembers that this week we enter the 150th anniversary year of the end of the American Civil War, asks Robert Fisk
    Homeless Veterans appeal: Former soldiers pay their respects to a friend who also served

    Homeless Veterans appeal

    Former soldiers pay their respects to a friend who also served
    Downfall of Dustin 'Screech' Diamond, the 'Saved By The Bell' star charged with bar stabbing

    Scarred by the bell

    The downfall of the TV star charged with bar stabbing
    Why 2014 was a year of technological let-downs

    Why 2014 was a year of technological let-downs

    Security breaches and overhyped start-ups dominated a year in which very little changed (save the size of your phone)
    Cuba's golf revolution: But will the revolutionary nation take 'bourgeois' game to its heart?

    Will revolutionary Cuba take 'bourgeois' golf to its heart?

    Fidel Castro ridiculed the game – but now investment in leisure resort projects is welcome
    The Locked Room Mysteries: As a new collection of the genre’s best is published, its editor Otto Penzler explains the rules of engagement

    The Locked Room Mysteries

    As a new collection of the genre’s best is published, its editor explains the rules of engagement
    Amy Adams on playing painter Margaret Keane in Tim Burton's Big Eyes

    How I made myself Keane

    Amy Adams hadn’t wanted to take the role of artist Margaret Keane, because she’d had enough of playing victims. But then she had a daughter, and saw the painter in a new light
    Ed Richards: Parting view of Ofcom chief. . . we hate jokes on the disabled

    Parting view of Ofcom chief... we hate jokes on the disabled

    Bad language once got TV viewers irate, inciting calls to broadcasting switchboards. But now there is a worse offender, says retiring head of the media watchdog, Ed Richards
    A look back at fashion in 2014: Wear in review

    Wear in review

    A look back at fashion in 2014
    Ian Herbert: My 10 hopes for sport in 2015. Might just one of them happen?

    Ian Herbert: My 10 hopes for sport in 2015

    Might just one of them happen?
    War with Isis: The West needs more than a White Knight

    The West needs more than a White Knight

    Despite billions spent on weapons, the US has not been able to counter Isis's gruesome tactics, says Patrick Cockburn
    Return to Helmand: Private Davey Graham recalls the day he was shot by the Taliban

    'The day I was shot by the Taliban'

    Private Davey Graham was shot five times during an ambush in 2007 - it was the first, controversial photograph to show the dangers our soldiers faced in Helmand province
    Revealed: the best and worst airlines for delays

    Revealed: the best and worst airlines for delays

    Many flyers are failing to claim compensation to which they are entitled, a new survey has found
    The stories that defined 2014: From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions

    The stories that defined 2014

    From the Scottish independence referendum to the Ice Bucket Challenge, our writers voice their opinions
    Stoke-on-Trent becomes first British city to be classified as 'disaster resilient' by the United Nations

    Disaster looming? Now you know where to head...

    Which British city has become the first to be awarded special 'resilience' status by the UN?