Abstract
AimsSerious incidents according to NHS England (2015) are incidents where the consequences to patients, families and carers, staff or organisations are so significant or potential for learning are so great that a heightened response is justified. There is anectoctal evidence that this process is potentially difficult for junior doctors and the primary purpose of learning may be lost due to the stress involved.Our aim was to evaluate junior doctors perspective of serious incident reviews. A secondary aim was to organise local and regional workshops based on the outcome of our findings to address misconceptions around serious incident investigations.MethodA survey was developed using survey monkey and distributed to all trainees across the Mersey region through the Medical Education teams.The junior doctors range from core trainees to higher trainees. The survey encouraged the use of free texting if necessary.Results from the survey were then analysedResult18 junior doctors across the 3 mental health Trusts in the Mersey region responded.12 respondents have been involved in a serious incident investigation in the past and 9 of the respondents stated that they did not recieve any support during the process. Out of the 3 that were supported, one rated the support as poor and frightening.55.56% af all respondents found the process of serious incident reviews hard to understand.66% of all respondents admitted that they are aware that the purpose of the review is for learning purposes.100% of respondents agreed that a workshop to discuss the purpose and process of serious incidents investigation to aid their understanding would be useful.ConclusionFrom the survey, we concluded that junior doctors do have some understanding of incident reviews process but they still do not feel comfortable with the idea of being under ‘investigation'.It is also important that formal support is made available during the process.We organised a workshop in one of the 3 Trusts which was well attended and junior doctors asked if they could sit on review panels for experiential learning. This is to be presented to govenance teams across the mental health trusts in the region.Further workshop across the 2 remaining Trusts could not be organised due to COVID-19 pandemic.
Highlights
BJPsych OpenThe introduction of working time regulations such as the European Working Time Directive (2003) as well as local service reconfigurations leading to nurse-led liaison services and home treatment teams, have reduced the opportunity for trainees to undertake emergency assessments
100% of respondents agreed that a workshop to discuss the purpose and process of serious incidents investigation to aid their understanding would be useful
We concluded that junior doctors do have some understanding of incident reviews process but they still do not feel comfortable with the idea of being under ‘investigation’
Summary
The introduction of working time regulations such as the European Working Time Directive (2003) as well as local service reconfigurations leading to nurse-led liaison services and home treatment teams, have reduced the opportunity for trainees to undertake emergency assessments. Across the Severn Deanery, there is a discrepancy in the opportunity core trainees’ have to undertake emergency assessments – depending on their rota, stage of training, and services available. This difference in trainee experience, depending on locality, has been further impacted by COVID-19 and the introduction of cohorted wards. Initial results from two cycles of an emergency / out-of-hours experience rota suggest increased experience and confidence in first-line emergency assessments, enabling them to work towards meeting their core training requirements
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