Report finds outdated handovers putting East Midlands patient care at risk

Patient care at East Midlands hospitals is potentially at risk due to inadequate handovers between teams of doctors on different shifts our review has found.

During its review of medical education and training in the region, we spoke to doctors in training who told us handovers lacked continuity of care and could be unsafe for patients. The issue was raised by doctors at Sherwood Forest Hospitals NHS Trust and United Lincolnshire Hospitals NHS Trust.

"Ensuring the safety of patients is absolutely essential, and handovers between teams of doctors need to reflect that, as well as the continuity of care that patients deserve."

Dr. Colin Melville

Director of Education and Standards

In its region-wide review, our inspectors said they were ‘impressed’ with the educational governance systems they encountered, but issues around workload and resources meant doctors in training often struggled to fit in their learning. 

Protecting education and training

Issues raised included:

  • At Nottingham University Hospitals NHS Trust doctors said they regularly worked longer than they should, and had to attend clinics or teaching session - and even take medical exams - as personal holiday time rather than study leave.
  • At Sherwood Forest NHS Foundation Trust, doctors reported needing to use their own time to stay on top of their workload, and difficulties fitting in opportunities for learning.
  • At University Hospitals of Leicester NHS Trust doctors said that, at its worst, they were only able to attend 40% of local teaching sessions and often had to work on their days off to try to meet their training requirements.
  • Doctors at United Lincolnshire Hospitals NHS Trust told us that while their duty rotas were designed to protect their education and training, there were sometimes gaps that had to be filled, and timetable clashes, which impacted on their training.
  • Some female medical students at University Hospitals of Leicester reported they had been subject to inappropriate comments based on their gender. They had been undermined in career advice they were given, including being told to pursue careers as GPs rather than in surgery if they planned to have children.

Ensuring the safety of patients

Dr. Colin Melville, Director of Education and Standards, said: ‘Ensuring the safety of patients is absolutely essential, and handovers between teams of doctors need to reflect that, as well as the continuity of care that patients deserve.

‘We know that the pressure front line care is under, and that it can have a damaging impact on the education of doctors in training. The East Midlands is similar in that respect to other parts of the UK, and it is vitally important that training time is protected as far as possible, without compromising patient care.

‘There are areas of concern that we have asked training providers to address, but overall we were pleased at the high standards and commitment across the region.

The state of medical education and training in the region was generally positive:

  • Health Education England East Midlands’ structure drives improvements in quality and gives a good oversight of issues.
  • Both Leicester and Nottingham medical schools had good systems in place to deliver high quality education.
  • Education and training were valued across the region.
  • Systems for reporting and dealing with patient safety concerns were good.