Good things I have experienced in NHS trusts
I have had the pleasure of working in a few NHS trusts since I came to the UK. Each trust has its own way of doing things. Some are good, some are annoying. Some can be changed easily, some can be adopted easily by other trusts. I have mentioned a few nice things I have learnt over the last few years which I wish are adopted by every trust. These are easy to do and I will mention how junior doctors can implement these in their trusts if they like these ideas.
THE HR
THE HR
Ensuring all non trainee doctors who have not worked in the NHS before are put in touch with a IMG doctor working in their trust.
Solution:
This is very easy to sort out. An IMG working in the trust should go to the HR and let the team know that they are happy for their contact details to be shared with any IMG doctor who has accepted the post. This would enable the new doctor to ask any burning questions rather than getting anxious as at times HR does not respond to the dozens of questions every new doctor has.
Such IMG representatives can help in informing new doctors about accommodations, talk to the accommodation officers on their behalf, take pictures of hospital accommodations which would be vacant by the time the doctor comes to the UK, helps them settle into the trust when they come by showing them around, explaining how the system works, giving their number in case the junior doctor needs any help, allow the new doctor to shadow them on their on calls, etc.
Informing new doctors where they will work.
Rotas
Ensuring all doctors (trainees and non trainees) get their rota on time ( ie 6-8 weeks before starting in that trust).
This is easily achievable - most trusts do this anyway. All the rota team needs to do is change the names on the rota and add in the names of the new doctors who have accepted the post. Both trainees and non trainees accept posts at least 1-2 months before they are due to start (trainees usually accept the posts 3 months in advance).
Once the rota team has made the new rota, they should email it to all doctors so that they plan their leaves in advance.
THE MEDICAL ON CALL TEAM STAYING IN ED
Simulation courses.
Freezer vending machines are available in some trusts which have
1. Ice creams (which are quite useful for summers)
2. Microwaveable meals
A JUNIOR DOCTORS WHATSAPP GROUP
Solution:
This is very easy to sort out. An IMG working in the trust should go to the HR and let the team know that they are happy for their contact details to be shared with any IMG doctor who has accepted the post. This would enable the new doctor to ask any burning questions rather than getting anxious as at times HR does not respond to the dozens of questions every new doctor has.
Such IMG representatives can help in informing new doctors about accommodations, talk to the accommodation officers on their behalf, take pictures of hospital accommodations which would be vacant by the time the doctor comes to the UK, helps them settle into the trust when they come by showing them around, explaining how the system works, giving their number in case the junior doctor needs any help, allow the new doctor to shadow them on their on calls, etc.
Informing new doctors where they will work.
It would be amazing if the HR informs their non trainee doctors which department they will be starting in - especially those who are starting in the NHS for the first time. This is such an easy thing to sort out - the rota coordinators know which department does not have trainee doctors and may even have already made a provisional rota for the new doctors after they have been interviewed.
Solution:
The rota coordinator team and HR should liaise with each other. The non trainee doctors who have accepted a post should email the HR and ask them to CC the rota coordinators in their email and request them to let them know which department they are expected to start in ( the rota team knows already as that particular post in that department has been unfilled by trainee doctors). The advantage of this would be that the doctors would know where they would start and which specialties they will be rotating in putting their mind at ease.
A better induction:
Solution:
The rota coordinator team and HR should liaise with each other. The non trainee doctors who have accepted a post should email the HR and ask them to CC the rota coordinators in their email and request them to let them know which department they are expected to start in ( the rota team knows already as that particular post in that department has been unfilled by trainee doctors). The advantage of this would be that the doctors would know where they would start and which specialties they will be rotating in putting their mind at ease.
A better induction:
Yes, fire safety and clinical governance is important however all doctors should also be shown how to operate pods to send bloods, blood sampling in the trust (I struggle with the blood sampling equipment whenever I change trusts), where procedure packs are ( like catheterization packs, Lumbar puncture packs, pleural aspiration kits).
The induction app:
The induction app:
Every hospital should have this app: https://induction-app.com/ which is up to date with all the numbers of the relevant specialties.
ROTA COORDINATORS
ROTA COORDINATORS
Rotas
Ensuring all doctors (trainees and non trainees) get their rota on time ( ie 6-8 weeks before starting in that trust).
This is easily achievable - most trusts do this anyway. All the rota team needs to do is change the names on the rota and add in the names of the new doctors who have accepted the post. Both trainees and non trainees accept posts at least 1-2 months before they are due to start (trainees usually accept the posts 3 months in advance).
Once the rota team has made the new rota, they should email it to all doctors so that they plan their leaves in advance.
Vacant shifts
The rota team should have a SHO WhatsApp group which all the FY2s, CTs, trust grade SHOs and acute consultants are members of. If there is any vacancy due to sickness ,etc they can message on that group. There is also a group of bank SHOs who are have been working in this hospital for a few years and they are excellent ( most of them are better than registrars ) as they know the hospital well - the rota team should contact them and usually a vacancy can be filled within a few minutes. This way all the wards will be adequately staffed , there will be a full team on the on calls and all the members of the team would understand the local guidelines well as the trust would not need to advertise this to an external agency. This is such a simple system - all you need is good organizing skills and you've a well staffed hospital 24/7.
PATHWAYS
The rota team should have a SHO WhatsApp group which all the FY2s, CTs, trust grade SHOs and acute consultants are members of. If there is any vacancy due to sickness ,etc they can message on that group. There is also a group of bank SHOs who are have been working in this hospital for a few years and they are excellent ( most of them are better than registrars ) as they know the hospital well - the rota team should contact them and usually a vacancy can be filled within a few minutes. This way all the wards will be adequately staffed , there will be a full team on the on calls and all the members of the team would understand the local guidelines well as the trust would not need to advertise this to an external agency. This is such a simple system - all you need is good organizing skills and you've a well staffed hospital 24/7.
PATHWAYS
The intranet should have pathways and guidelines for everything like chest pain pathways, rapid access chest pain clinic referral forms, DVT pathways, ambulatory pathways, headache pathways thus avoiding unnecessary admissions. There should also be pathways for high blood sugars ( a blood sugar of a patient at 1100 PM of 20 may not be significant and does not need to be treated with insulin if the ketones are negative)
POST TAKE WARD ROUNDS
Rather than a junior doctor going on the post take ward round, an ACP should do this and any sick patients can be handed over by the consultant to the junior doctors on call by the consultant directly (and immediately). This way, the junior doctors can keep clerking patients and avoid the long waiting times for patients to be seen.
GP REFERRALS
POST TAKE WARD ROUNDS
Rather than a junior doctor going on the post take ward round, an ACP should do this and any sick patients can be handed over by the consultant to the junior doctors on call by the consultant directly (and immediately). This way, the junior doctors can keep clerking patients and avoid the long waiting times for patients to be seen.
GP REFERRALS
The most annoying part is GP referrals being admitted directly to the ward without any investigations. Usually patients come via ED and they have had CXR, bloods, VBGs, ECGs done with the initial management plan initiated. However in most trusts GP admissions come to the ward directly and if the medical team is busy clerking other patients/seeing sick patients, GP admissions may not be seen till late at night.
There should be a GP admissions room in ED where a dedicated nurse quickly asks the relevant questions and requests the relevant investigations just like in the ED triage room.
CLINICAL SUPPORT TEAMS
These nurses can do bloods, ECGs, ABGs, cannulations and work out of hours supporting junior doctors. So the FY1s and SHOs can see sick patients rather than waste valuable time cannulating patients.
There should be a GP admissions room in ED where a dedicated nurse quickly asks the relevant questions and requests the relevant investigations just like in the ED triage room.
CLINICAL SUPPORT TEAMS
These nurses can do bloods, ECGs, ABGs, cannulations and work out of hours supporting junior doctors. So the FY1s and SHOs can see sick patients rather than waste valuable time cannulating patients.
THE MEDICAL ON CALL TEAM STAYING IN ED
There should be an office for the medical on call team where there is a SHO and registrar who take all medical referrals from the ED team after their initial assessments and investigations, see the patients and then discharge them as appropriate. This way sick patients are seen immediately and potential discharges are discharged directly from ED before they breech. There should be one SHO in AMU to see the sick patients and carry out any jobs for patients admitted via ED the medical team. The registrar covering wards should see the sick patients in AMU ensuring that the medical team in ED stays in ED.
SUMMARY CARE RECORDS:
Summary care records are electronic records of patients which have the following information:
1. Co morbidities
2. Medications - current and previous
3. Allergies
This is incredibly helpful to have when clerking confused patients who do not know their medication history. In my trust, the ward clerk in ED uploads the SCR of every patients on to our electronic system. So the ED team knows the aforementioned information. Patients admitted directly to the acute medical unit also have their SCRs uploaded by the acute medical ward clerks.
If there is any issue out of hours, the ED ward clerk is more than happy to upload the SCR of patients.
AN ACTIVE AMBULATORY CARE TEAM
This can be run by the AMU consultants and junior doctors should be rotated here so that they know what patients can be seen as outpatients and which ones need to be admitted enhancing their knowledge which they can use to triage patients ( and discharge most) when they are on call. Ambulatory care services run from 9 AM to 9 PM on weekdays and even on weekends from 9 AM to 3 PM in some trusts. In some, they run from 9 AM to 5 PM on weekdays only.
MEDICAL CONSULTANT IN ED
This is a very useful system whereby a medical consultant (other than the on call medical consultant) carries a phone and takes referrals from GPs directly. (S)he stays in ED and discharges medical patients from there directly saving beds and time of the medical juniors. This is only on weekdays but it makes a huge difference.
Different medical consultants carry the phone - some renal, gastroenterolgy, endocrinology and acute medical consultants do this and they have their own rota.
HIGH EWS SYSTEM
SUMMARY CARE RECORDS:
Summary care records are electronic records of patients which have the following information:
1. Co morbidities
2. Medications - current and previous
3. Allergies
This is incredibly helpful to have when clerking confused patients who do not know their medication history. In my trust, the ward clerk in ED uploads the SCR of every patients on to our electronic system. So the ED team knows the aforementioned information. Patients admitted directly to the acute medical unit also have their SCRs uploaded by the acute medical ward clerks.
If there is any issue out of hours, the ED ward clerk is more than happy to upload the SCR of patients.
AN ACTIVE AMBULATORY CARE TEAM
This can be run by the AMU consultants and junior doctors should be rotated here so that they know what patients can be seen as outpatients and which ones need to be admitted enhancing their knowledge which they can use to triage patients ( and discharge most) when they are on call. Ambulatory care services run from 9 AM to 9 PM on weekdays and even on weekends from 9 AM to 3 PM in some trusts. In some, they run from 9 AM to 5 PM on weekdays only.
MEDICAL CONSULTANT IN ED
This is a very useful system whereby a medical consultant (other than the on call medical consultant) carries a phone and takes referrals from GPs directly. (S)he stays in ED and discharges medical patients from there directly saving beds and time of the medical juniors. This is only on weekdays but it makes a huge difference.
Different medical consultants carry the phone - some renal, gastroenterolgy, endocrinology and acute medical consultants do this and they have their own rota.
HIGH EWS SYSTEM
If a patient has a high EWS (above 7), the medical registrar, the on call SHO and FY1, ITU registrar, outreach nurse should be fast bleeped so that the patient can be managed before the patient arrests/ peri arrests.
HANDOVER
HANDOVER
Electronic handovers
Electronic handovers are amazing! Most hospitals have an electronic whiteboard for all patients in the hospital. The IT team can easily design this without spending millions of pounds by tweaking the current IT system a bit.
This would be very useful for handing over patients to the night team and weekend teams. All you have to do is click on the"handover to FY1/SHO/reg/consultant" tab and type in a reason for handing over ( eg- chase bloods, which a FY1 can do, monitor fluid status and adjust diuretics which a SHO can do, palliate if deteriorates, family aware which a SHO/reg can do).
This in no way replaces the face to face (or via phone) handover we do but this makes things easier for the on call team. All they have to do is print out the handover for FY1/SHO/reg/consultant list and tick off whatever they have done.
Solution:
Contact the IT team.
On call handovers
This would be very useful for handing over patients to the night team and weekend teams. All you have to do is click on the"handover to FY1/SHO/reg/consultant" tab and type in a reason for handing over ( eg- chase bloods, which a FY1 can do, monitor fluid status and adjust diuretics which a SHO can do, palliate if deteriorates, family aware which a SHO/reg can do).
This in no way replaces the face to face (or via phone) handover we do but this makes things easier for the on call team. All they have to do is print out the handover for FY1/SHO/reg/consultant list and tick off whatever they have done.
Solution:
Contact the IT team.
On call handovers
Most trusts have a regular handover at 8 or 9 AM/PM. This should be attended by the on call teams ( junior doctors, registrars, consultants), outreach team, discharge nurses, matrons, ITU registrars and if there are any other specialties who would like to handover an urgent patient (ie a surgical/ITU step down patient to the medical team), they should also attend.
Ward handovers
Ward handovers
There should also be a ward handovers at the following times:
9 AM - The consultants and their junior teams sit down and go through the list of ward patients and specialty referrals.
2 PM - The nursing staff, OTs, PTs and one doctor of the team who knows all the patients well should go through potential discharges and any outstanding jobs ( ie L/S BPs, urine dips, etc) and update the MDT about the estimated date of discharge.
4 PM - consultant/registrar handover. The same team from 9 AM sits down and goes through the list of patients again to ensure all jobs are done. There is enough time to do the outstanding jobs or any jobs which are generated from this handover ensuring everyone leaves on time.
4:45 PM - Mini handover from bay nurses - the junior doctors should ask the nurses in charge of the bays about any outstanding jobs ( ie warfarin prescriptions, fluids prescriptions,etc). This way all the nurses are aware of any outstanding jobs and have informed the doctors in charge. Everyone leaves on time!.
Friday handover at noon - The specialty team (including consultants, reg, SHOs, FY1s, OTs,PTs, dietitians, discharge coordinators, nurse in charge) sit together and goes through all of the patients - potential weekend discharges are discussed and any outstanding jobs are delegated before the weekend. Escalation plans of sick patients can be discussed here and the nurses can ensure that the medical team makes decisions about patients they are concerned about.
Monday consultant to consultant handover at 9 AM- This only applies to specialties which have a consultant of the week - ie, like in renal medicine. The consultants sit with the junior doctors at 9 AM and go through all of the patients they have been looking after during the previous week. This ensures safe handover and the whole team is updated about all of the patients.
These handovers take around 30 minutes and ensures patient safety. This should be adopted by all specialties.
PROCEDURES
9 AM - The consultants and their junior teams sit down and go through the list of ward patients and specialty referrals.
2 PM - The nursing staff, OTs, PTs and one doctor of the team who knows all the patients well should go through potential discharges and any outstanding jobs ( ie L/S BPs, urine dips, etc) and update the MDT about the estimated date of discharge.
4 PM - consultant/registrar handover. The same team from 9 AM sits down and goes through the list of patients again to ensure all jobs are done. There is enough time to do the outstanding jobs or any jobs which are generated from this handover ensuring everyone leaves on time.
4:45 PM - Mini handover from bay nurses - the junior doctors should ask the nurses in charge of the bays about any outstanding jobs ( ie warfarin prescriptions, fluids prescriptions,etc). This way all the nurses are aware of any outstanding jobs and have informed the doctors in charge. Everyone leaves on time!.
Friday handover at noon - The specialty team (including consultants, reg, SHOs, FY1s, OTs,PTs, dietitians, discharge coordinators, nurse in charge) sit together and goes through all of the patients - potential weekend discharges are discussed and any outstanding jobs are delegated before the weekend. Escalation plans of sick patients can be discussed here and the nurses can ensure that the medical team makes decisions about patients they are concerned about.
Monday consultant to consultant handover at 9 AM- This only applies to specialties which have a consultant of the week - ie, like in renal medicine. The consultants sit with the junior doctors at 9 AM and go through all of the patients they have been looking after during the previous week. This ensures safe handover and the whole team is updated about all of the patients.
These handovers take around 30 minutes and ensures patient safety. This should be adopted by all specialties.
PROCEDURES
Simulation courses.
All trainees have access to simulation courses for procedures they are expected to know:
FY1- catheters, cannulations, ABGs, NG tubes
SHOs- Lumbar punctures, ascitic drains, chest drain, ascitic drains, knee aspirations, cardioversions.
The trainee doctors have to attend these simulation courses. This way they are up to date with the local guidelines. Unfortunately not all non trainee doctors get to do these. But if the trust makes it mandatory for ALL doctors ( trainees and non trainees) to attend these simulation courses, it would be incredibly useful for them and ensure safety of the patients as well.
Solution:
Non trainee doctors should talk to the college tutor/ TPD/ their supervisors and request them to make these courses mandatory for them as well as they would be doing these procedures anyway ( under supervision, of course).
Procedures bleep
There should be a procedures bleep in every trust carried by a SHO every week. If there are any lumbar punctures, ascitic drains, knee aspirations, chest drains, pleural aspirations to do, the team (usually the AMU team) can bleep them and they can do these procedures (under supervision of the on call registrar) IF the on call SHOs have been signed off for these procedures.
This way all SHOs would be signed off for all procedures they are expected to know.
REPLACING BLEEPS WITH PHONES
FY1- catheters, cannulations, ABGs, NG tubes
SHOs- Lumbar punctures, ascitic drains, chest drain, ascitic drains, knee aspirations, cardioversions.
The trainee doctors have to attend these simulation courses. This way they are up to date with the local guidelines. Unfortunately not all non trainee doctors get to do these. But if the trust makes it mandatory for ALL doctors ( trainees and non trainees) to attend these simulation courses, it would be incredibly useful for them and ensure safety of the patients as well.
Solution:
Non trainee doctors should talk to the college tutor/ TPD/ their supervisors and request them to make these courses mandatory for them as well as they would be doing these procedures anyway ( under supervision, of course).
Procedures bleep
There should be a procedures bleep in every trust carried by a SHO every week. If there are any lumbar punctures, ascitic drains, knee aspirations, chest drains, pleural aspirations to do, the team (usually the AMU team) can bleep them and they can do these procedures (under supervision of the on call registrar) IF the on call SHOs have been signed off for these procedures.
This way all SHOs would be signed off for all procedures they are expected to know.
REPLACING BLEEPS WITH PHONES
Some trusts already have phones for on call and specialty registrars and consultants. These phones cost more or less the same as bleeps ( some switchboard teams say that phones costs less in the long run as they do not need disposable batteries which run out in a week, do not break when dropped and last longer). It would be very useful if the on call junior doctors had phones rather than bleeps. They can answer their calls while walking in the corridor and do not have to leave everything to go to the ward phone.
SPECIALTY TEACHING SESSIONS
SPECIALTY TEACHING SESSIONS
These can be arranged every week in the education center once a week. A drug representative can provide lunch ( given that they cannot provide any other financial incentive to the team) and you will always get loads of doctors willing to come when there is free lunch. Every specialty can have their teaching sessions in which junior doctors get to present audits, QIPs, teach what they have learnt so far and this way get signed off for teaching and get feedback.
Everyone gets to learn, juniors get more confident as they can address a crowd and this encourages learning and teaching in the trust.
This is easy to organize - talk to the consultant in charge who will already be in touch with drug reps who are willing to do this. The education center team is more than willing to encourage teaching and they can set days for each specialty.
Just imagine - free lunch every day!
EXCEPTION REPORTING.
Everyone gets to learn, juniors get more confident as they can address a crowd and this encourages learning and teaching in the trust.
This is easy to organize - talk to the consultant in charge who will already be in touch with drug reps who are willing to do this. The education center team is more than willing to encourage teaching and they can set days for each specialty.
Just imagine - free lunch every day!
EXCEPTION REPORTING.
If doctors stay late on the ward, they should exception report. This is a form which they fill and send to a "guardian" or their rota team which then liaises with the consultants to ensure there is adequate staffing on the ward. The juniors who stay late on the ward are paid extra for the additional out oof hours time they have spent in hospital. A one off thing is acceptable ( ie a patient having a MI at 5 PM ), but if it is a regular thing then it must be escalated. A lot of juniors are afraid of doing this as they think this may make their consultants think they are not efficient enough - this is not true. This is to ensure that the ward is adequately staffed so that everyone leaves on time. So exception report!
FREEDOM TO SPEAK UP
As doctors, we never stop learning. I have seen a lot of consultants say " I never knew that" and they are a specialist in that field with a few years to retire. In medicine, you can never know enough. However knowledge is not only limited to work - it is also maintaining a good relationship with your colleagues and junior doctors. Some consultants may say something quite degrading ruining the junior doctors morale ( Yes, we are supposed to stay strong however some us are at that breaking point already and have so much going through our minds). Hence, it is important that the consultants are informed about something which they should not have said or done.
The best way to do it is via the Guardian of Freedom to Speak Up the role of whom is explained in more detail here:
https://www.cqc.org.uk/national-guardians-office/content/national-guardians-office
https://improvement.nhs.uk/resources/freedom-speak-guidance-nhs-trust-and-nhs-foundation-trust-boards/
These members of the NHS ( not necessarily doctors) feedback to the staff members who have a "bullying" attitude and ensure that they change themselves. And the best thing about this is that it can be done anonymously.
So if you are struggling and cannot talk to the person who is demoralizing you, then try talking to the Guardian of Freedom to Speak Up.
These are very helpful people and have helped a few junior doctor colleagues of mine- They have also changed the behavior of certain individuals.
SUPPORT FOR FOUNDATION YEAR DOCTORS WHEN ON CALL:
In my current job, on nights we have 2 SHOs who are clerking, a FY1 on the wards and a registrar who covers both wards and clerking. The FY1 doctors always escalated to the registrar when they struggled but at times, they were busy in ED resus. Therefore it was decided that the FY1 would have the mobile number of one of the clerking SHOs and they would immediately message them ( and if it was very urgent, call them directly) for anything they would struggle with - be it a difficult cannula or reviewing a sick patient.
The ward nurses were also asked to bleep the registrar if there was a patient who was EWSing high and this way, the FY1 would feel more supported. This improved the satisfaction levels of the FY1 doctors and they felt better. A small thing has made a huge difference.
STAFF DISCOUNTS
FREEDOM TO SPEAK UP
As doctors, we never stop learning. I have seen a lot of consultants say " I never knew that" and they are a specialist in that field with a few years to retire. In medicine, you can never know enough. However knowledge is not only limited to work - it is also maintaining a good relationship with your colleagues and junior doctors. Some consultants may say something quite degrading ruining the junior doctors morale ( Yes, we are supposed to stay strong however some us are at that breaking point already and have so much going through our minds). Hence, it is important that the consultants are informed about something which they should not have said or done.
The best way to do it is via the Guardian of Freedom to Speak Up the role of whom is explained in more detail here:
https://www.cqc.org.uk/national-guardians-office/content/national-guardians-office
https://improvement.nhs.uk/resources/freedom-speak-guidance-nhs-trust-and-nhs-foundation-trust-boards/
These members of the NHS ( not necessarily doctors) feedback to the staff members who have a "bullying" attitude and ensure that they change themselves. And the best thing about this is that it can be done anonymously.
So if you are struggling and cannot talk to the person who is demoralizing you, then try talking to the Guardian of Freedom to Speak Up.
These are very helpful people and have helped a few junior doctor colleagues of mine- They have also changed the behavior of certain individuals.
SUPPORT FOR FOUNDATION YEAR DOCTORS WHEN ON CALL:
In my current job, on nights we have 2 SHOs who are clerking, a FY1 on the wards and a registrar who covers both wards and clerking. The FY1 doctors always escalated to the registrar when they struggled but at times, they were busy in ED resus. Therefore it was decided that the FY1 would have the mobile number of one of the clerking SHOs and they would immediately message them ( and if it was very urgent, call them directly) for anything they would struggle with - be it a difficult cannula or reviewing a sick patient.
The ward nurses were also asked to bleep the registrar if there was a patient who was EWSing high and this way, the FY1 would feel more supported. This improved the satisfaction levels of the FY1 doctors and they felt better. A small thing has made a huge difference.
STAFF DISCOUNTS
Cafeteria
There should be a 20% discount for all staff members when they buy hot food from the cafeteria - not all staff can bring food from home and this encourages them to buy from the cafe. Specialty teams can go together and have lunch together and this way allows them to socialize and give them an opportunity to discuss things other than work.
Staff discounts shop.
This can be run by a team which buys snacks at wholesale and then sells them at a discounted price to staff members. They can have all sorts of paraphernalia like ID badge reels, pens, chocolates, discounted tickets for plays, cinemas, local attractions.
A list of staff benefits
The local intranet can have a list of local businesses in the area which provide NHS staff discounts like driving schools, restaurants, shops, etc.
A FULLY FUNCTIONAL VENDING MACHINE
There should be a 20% discount for all staff members when they buy hot food from the cafeteria - not all staff can bring food from home and this encourages them to buy from the cafe. Specialty teams can go together and have lunch together and this way allows them to socialize and give them an opportunity to discuss things other than work.
Staff discounts shop.
This can be run by a team which buys snacks at wholesale and then sells them at a discounted price to staff members. They can have all sorts of paraphernalia like ID badge reels, pens, chocolates, discounted tickets for plays, cinemas, local attractions.
A list of staff benefits
The local intranet can have a list of local businesses in the area which provide NHS staff discounts like driving schools, restaurants, shops, etc.
A FULLY FUNCTIONAL VENDING MACHINE
These are essential for doctors on call and for relatives of patients especially out of hours. They should be fully stocked with
1. Soft drinks
2. Energy drinks
3. Squashes
4. Water
5. Energy bars
6. Crisps
1. Soft drinks
2. Energy drinks
3. Squashes
4. Water
5. Energy bars
6. Crisps
Freezer vending machines are available in some trusts which have
1. Ice creams (which are quite useful for summers)
2. Microwaveable meals
A JUNIOR DOCTORS WHATSAPP GROUP
This would be a social group on which no work related things are discussed except for swaps for shifts and socials. All new junior doctors should be informed about this at induction.
A WARD WHATSAPP GROUP
I found this very useful when I was working in renal and gastroenterology wards. All the consultants, registrars junior doctors working in that specialty were part of this group. This way, we could keep in touch and get any updates. We would let the other team members know if there was any sick patient on the ward or if there was any outstanding job. The details of patients are kept anonymous. Here is a sample of a WhatsApp message from a consultant:
"Mr A.H in ward 6 is MFFD. Can someone please do the discharge summary. Please see my notes for the plan as outpatient"
From junior doctors
"Mrs KH in ward 12, bed 5 is EWSing high. Reviewing her now . Can someone kindly help ?"
Or even messages like:
"Free food today, please come to the education center at 12 PM"
A WARD WHATSAPP GROUP
I found this very useful when I was working in renal and gastroenterology wards. All the consultants, registrars junior doctors working in that specialty were part of this group. This way, we could keep in touch and get any updates. We would let the other team members know if there was any sick patient on the ward or if there was any outstanding job. The details of patients are kept anonymous. Here is a sample of a WhatsApp message from a consultant:
"Mr A.H in ward 6 is MFFD. Can someone please do the discharge summary. Please see my notes for the plan as outpatient"
From junior doctors
"Mrs KH in ward 12, bed 5 is EWSing high. Reviewing her now . Can someone kindly help ?"
Or even messages like:
"Free food today, please come to the education center at 12 PM"
FOOD PARTIES
Food party every Friday ( which can be done during the Friday MDT mentioned above)
All members of the team bring a few snacks on one particular day of the weak and everyone sits and eats together , talking about things other than work allowing them to socialize and get to know each other.
DOCTORS MESS
These are essentials for the doctors mess:
1. A television which has all sorts of channels ( Freeview TV is fine- its free and no one has to bother paying for subscription)
2. PS4/PS3 with games - Yes, I have seen doctors mess with this. They have all sorts of games too.
3. Clean sofas which can be converted into sofa beds. Leatherite sofas are the best - they last longer and are comfortable.
4. Clean linen - there should be a linen cupboard in the mess just like there is one in every ward which has pillows, pillow covers, blankets and sheets. There should also be a laundry bin like in the wards.
5. A fully functional fridge - and not a mini fridge! A lot of doctors bring their food and it is very difficult to put everything especially if the fridge is small. Whatever is placed in the fridge should be labelled and dated - if it is less than a few days old, it should be discarded. The fridge should be defrosted every 4 months.
6. Unlimited supply of bread, cereal, coffee, tea,sugar, biscuits and milk.
7. A free pizza party every 2 weeks.
8. Regular get togethers and socials. The doctors can go out for bowling or drinks every few weeks.
9. A charging dock for mobile phones like we see at airports.
This can all be done if there is a mess committee and a mess fund ( most trusts deduct 5 to 10 GBP from every doctors pay for this).
10. A clean bathroom with shower.
Unfortunately most doctors ( especially trainees) move to different trusts in one year but there are a lot of non trainee doctors who stay here for a longer period of time and they can help run it.
MY WISH LIST
All members of the team bring a few snacks on one particular day of the weak and everyone sits and eats together , talking about things other than work allowing them to socialize and get to know each other.
DOCTORS MESS
These are essentials for the doctors mess:
1. A television which has all sorts of channels ( Freeview TV is fine- its free and no one has to bother paying for subscription)
2. PS4/PS3 with games - Yes, I have seen doctors mess with this. They have all sorts of games too.
3. Clean sofas which can be converted into sofa beds. Leatherite sofas are the best - they last longer and are comfortable.
4. Clean linen - there should be a linen cupboard in the mess just like there is one in every ward which has pillows, pillow covers, blankets and sheets. There should also be a laundry bin like in the wards.
5. A fully functional fridge - and not a mini fridge! A lot of doctors bring their food and it is very difficult to put everything especially if the fridge is small. Whatever is placed in the fridge should be labelled and dated - if it is less than a few days old, it should be discarded. The fridge should be defrosted every 4 months.
6. Unlimited supply of bread, cereal, coffee, tea,sugar, biscuits and milk.
7. A free pizza party every 2 weeks.
8. Regular get togethers and socials. The doctors can go out for bowling or drinks every few weeks.
9. A charging dock for mobile phones like we see at airports.
This can all be done if there is a mess committee and a mess fund ( most trusts deduct 5 to 10 GBP from every doctors pay for this).
10. A clean bathroom with shower.
Unfortunately most doctors ( especially trainees) move to different trusts in one year but there are a lot of non trainee doctors who stay here for a longer period of time and they can help run it.
MY WISH LIST
(Which is harder but if someone wants to do business these might be helpful).
1. A fast food restaurant with delivery next to the hospital- Papa John's, Domino's can keep medical staff and patients well fed during out of hours.
2. An accommodation complex near the hospital. Someone can buy a few houses/apartment complex near the hospital, furnish it and then give out for rent to medical staff. There should be a cleaning company which comes every week to ensure the communal areas are clean. This can be a good (and constant) source of money for anyone working in the hospital.
3. Parking space for hospital staff - every hospital has dedicated parking space but it is never enough. Unfortunately it will never be enough even if they expand this.
1. A fast food restaurant with delivery next to the hospital- Papa John's, Domino's can keep medical staff and patients well fed during out of hours.
2. An accommodation complex near the hospital. Someone can buy a few houses/apartment complex near the hospital, furnish it and then give out for rent to medical staff. There should be a cleaning company which comes every week to ensure the communal areas are clean. This can be a good (and constant) source of money for anyone working in the hospital.
3. Parking space for hospital staff - every hospital has dedicated parking space but it is never enough. Unfortunately it will never be enough even if they expand this.
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