Doctor Contract Research Articles

Analysis on Influencing Factors of Services Satisfaction with Family Doctors and Contract Signing----Take Hangzhou as an Example

This research is financed by the 2019 Zhejiang University of Science and Technology extracurricular Science and Technology Innovation and Practice project; Science and Technology Innovation Activity Plan for Zhejiang province University Students in 2020 (Grant No.2020R415022);Innovation and Entrepreneurship Training Program for University Students of Zhejiang University of Science and Technology in 2020(Grant No.2020-CXCY033); National Innovation and Entrepreneurship Training Plan for College Students in 2020(Grant No.202011057033). Abstract Family doctors, as an important part of primary medical care, are the cornerstone for the full implementation of the Healthy China policy and the realization of health for all in 2030. In order to understand the current situation of family doctor service and contract signing in Hangzhou, on the basis of a questionnaire survey with residents in various districts of Hangzhou, the importance matrix was adopted to analyze the satisfaction of contracted residents, principal component analysis and binary logistic regression were used to explore the influencing factors of signing the contract, it has been found that the service level, medical guidance, derivative services and future development significantly influenced the residents' intention to sign contracts. According to the research and analysis, some suggestions have been proposed to further improve the family doctor policy. Keywords: Family doctor; Medical services; Satisfaction; Contract situation DOI: 10.7176/JESD/11-20-01 Publication date: October 31 st 2020

Millennials - The Missing Piece in the NHS Workforce Puzzle?

UK healthcare is in the throes of a workforce crisis. There are 10,000 fewer doctors and over 50,000 fewer nurses than are required to run a safe and sustainable service. Multiple factors from removal of nursing bursaries, introduction of university fees, poor working conditions, under-resourcing of healthcare services, unmanageable workloads, learned helplessness of clinical risk and a culture of incivility or blame is driving the workforce of the future away from NHS. Several governmental agencies, arm’s length bodies and trade unions have been grappling with this challenge. A few solutions have been recommended under the new contract for junior doctors, reintroduction of support for nurses and expansion of medical school places, but some are yet to be implemented. NHS leaders continue to support blue-sky thinking in terms of workforce innovations but tend to drag their feet when it comes to adoption. This reluctance by senior clinicians, managers and policy makers may be related to a lack of understanding of the values that drive the millennial generation that most younger healthcare workforce belong to. This article will explore the challenges and solutions from a generational perspective and offer an insight to guide future decision-making.

Health department helped draft HEE letters encouraging trusts to implement junior doctor contract, shows investigation

The Department of Health in England helped to draft letters sent by Health Education England to NHS trusts encouraging them to implement a new contract for junior doctors, a newspaper investigation has found. The Independent reported that it had seen internal emails showing that the health secretary for England, Jeremy Hunt, and his officials collaborated with HEE, an arm’s length body of the health department, to introduce the new contract.1 The new contract for junior doctors in England began phased implementation in October 2016, despite BMA members voting to oppose the deal.23 HEE is a non-departmental public body that, the Independent said, provides £3.65bn worth of funding …

OP75 Implementing Risk Stratification In Primary Care: A Qualitative Study

INTRODUCTION:A predictive risk stratification tool (PRISM) to estimate a patient's risk of an emergency hospital admission in the following year was trialled in general practice in an area of the United Kingdom. PRISM's introduction coincided with a new incentive payment (‘QOF’) in the regional contract for family doctors to identify and manage the care of people at high risk of emergency hospital admission.METHODS:Alongside the trial, we carried out a complementary qualitative study of processes of change associated with PRISM's implementation. We aimed to describe how PRISM was understood, communicated, adopted, and used by practitioners, managers, local commissioners and policy makers. We gathered data through focus groups, interviews and questionnaires at three time points (baseline, mid-trial and end-trial). We analyzed data thematically, informed by Normalisation Process Theory (1).RESULTS:All groups showed high awareness of PRISM, but raised concerns about whether it could identify patients not yet known, and about whether there were sufficient community-based services to respond to care needs identified. All practices reported using PRISM to fulfil their QOF targets, but after the QOF reporting period ended, only two practices continued to use it. Family doctors said PRISM changed their awareness of patients and focused them on targeting the highest-risk patients, though they were uncertain about the potential for positive impact on this group.CONCLUSIONS:Though external factors supported its uptake in the short term, with a focus on the highest risk patients, PRISM did not become a sustained part of normal practice for primary care practitioners.

Junior doctors say what BMA should do now to stop the new contract.

The BMA’s Junior Doctors Committee announced last Saturday that it was planning other action to resist a new contract for junior doctors in England, after it suspended three rounds of strikes.1 So far details of the actions have not been released. Junior doctors express their views on what should happen next

BMA invites health secretary to symposium on seven day services.

The BMA has invited the health secretary for England, Jeremy Hunt, to take part in a symposium on seven day NHS services as it starts work to oppose the imposition of a new contract for junior doctors in England. In a statement the association said that the meeting on the quality and consistency of healthcare delivered across the week was planned for November. It said that it would include health professionals, royal colleges, patients’ organisations, and professional associations. The …

Contract imposition will be Pyrrhic victory for government, says Royal College of Surgeons

Imposing a contract on junior doctors in England will be a Pyrrhic victory for the government, given the damage the plans have done to morale, the Royal College of Surgeons of England has said. In an open letter to its trainee members, sent on Friday 16 September, the college’s council and its president, Clare Marx, said that it was unclear what the proposed new contract for junior doctors aimed to achieve. “Although patients could benefit …

Junior doctors call for further strikes from September

The BMA’s Junior Doctors Committee is calling for escalated industrial action from September to resolve issues over the proposed new contract that the committee says the government has not dealt with. In a letter sent to members on Thursday 11 August, Ellen McCourt, the committee’s chair, said that the committee had decided to reject the proposed new contract for junior doctors in England in full and to call for formal renegotiations https://twitter.com/McCourtEllen/status/763815538460065792. “In response to the government’s silence, the JDC [executive] has today made a formal request for a special meeting of BMA Council to authorise a rolling …

NHS bodies should work to improve relations between junior doctors and government, Keogh says

NHS organisations should improve junior doctors’ working and training conditions to try to repair relations between the profession and the government, NHS England’s national medical director has said. Speaking at an evidence session of the parliamentary health committee on 19 July, Bruce Keogh told MPs that he wanted to help change the bad feeling between the two parties. Relations have been strained because of the recent industrial dispute over a new contract for junior doctors in England, which led to a full strike by BMA junior doctor members in April.1 The new contract, which will be imposed …

DH will consider juniors’ rejection of new contract, Hunt says

The Department of Health for England will consider the outcome of a BMA ballot on the proposed new contract for junior doctors, the health secretary has said. On Tuesday 5 July the BMA announced that 58% of junior doctors who took part in the ballot had voted to reject the proposals for a new contract. The ballot received responses from 37 000 junior doctors and medical students, a 68% response rate.1 After the result …

Proposed junior contract is a good deal, Malawana tells ARM

The chair of the BMA’s Junior Doctors Committee has said that the proposed new contract for junior doctors in England was a good deal. Speaking at the BMA’s annual representatives meeting in Belfast on Thursday 23 June, Johann Malawana said that he recognised that juniors had different views on the contract but that he thought it was a good deal. Junior doctors and final …

ARM to debate whether new junior contract disadvantages women

Doctors from across the profession are set to discuss whether the proposed new contract for junior doctors in England will disadvantage women, particularly those who train part time or have children. Delegates at the BMA’s annual representative meeting (ARM) in Belfast will discuss the issues on Thursday 23 June. The motion is one of several that focus on issues related to the new contract. It says, “This meeting is appalled that changes in the junior doctor contract will disadvantage women, particularly those who are training part time, or who are carers or lone parents.” Doctors previously raised concerns that the new contract discriminated against women when the government published an equality analysis …

Junior contract will ensure fair weekend pay for part time trainees, says BMA

The proposed new contract for junior doctors in England is being changed to ensure that trainees who work less than full time (LTFT) receive a fair level of pay for working at the weekend, the BMA has said. The chair of the BMA’s Junior Doctors Committee, Johann Malawana, said that the Department of Health and NHS Employers had confirmed on Thursday 2 June that changes would be made to the proposed contract in regard to LTFT trainees. Writing on Facebook on Saturday 4 June, Malawana said, “On Thursday the DH/NHSE side were able to confirm a few modifications as to the intent with LTFT trainees. Particularly in regard to pro rating the weekend supplement for LTFT.” A BMA spokesperson confirmed that the government had agreed to respond to concerns that the association had raised over LTFT pay. “The …

Consultant trainers could face increased workload under junior contract

Consultants who supervise trainees could see an increase in their workload under the proposed new contract for junior doctors in England, doctors have warned. Under the proposed new terms and conditions for junior doctors, educational supervisors, who oversee the education of trainees, will be required to agree a personalised work schedule with their trainees and regularly discuss their progress.1 In changes to the way that junior doctors’ hours are monitored, educational supervisors will also be required to process exception reports submitted by trainees who have worked too many hours, and discuss what action is required. Nirmal Kumar, director of medical education at Wrightington, Wigan and Leigh NHS Foundation Trust, said that the …

GPs express support for junior doctors

GPs have expressed their support for junior doctors and have strongly condemned the imposition of a new contract on the junior workforce. GPs attending the BMA’s conference of local medical committees (LMCs) held in London on Thursday 19 May voted overwhelmingly in favour of a motion that “condemns the imposition of the new unsafe and unfair contract on junior doctors.” After the announcement that the BMA and the government had reached an agreement on a new contract for junior doctors in England, subject to a ballot of BMA members, the conference motion was amended.1 Rather than stating …

Junior doctor contract talks continue for fifth day

Talks between the BMA and the government on a new contract for junior doctors are continuing for a fifth day. The discussions, being held in a hotel in Lincolnshire, began on Monday 9 May. Talks reconvened after the government agreed to pause the introduction of a new contract for junior doctors in …

Royal colleges welcome renewed junior contract talks

Medical royal colleges have welcomed the renewal of talks between the BMA and the government on a new contract for junior doctors in England. The BMA announced on Saturday 7 May that it would re-enter talks with the government on a new contract, after the government said that it would pause the introduction of the contract for five days.1 The talks, which are scheduled to take place over …

Scotland and Wales have not seen increase in trainee applications

Scotland and Wales have not seen a significant increase in the number of junior doctors applying for foundation and specialty training in 2016 compared with previous years. Ahead of the introduction of a new contract for junior doctors in England in August, both countries launched recruitment drives to attract …

Junior contract could undermine recruitment, warns former Tory health minister

A former Conservative health minister has expressed concern over the impact a new junior doctor contract could have on recruitment and retention of female trainees. Speaking on BBC Radio 4’s Woman’s Hour on Tuesday 5 April, former Conservative health minister Dan Poulter discussed the new contract for junior doctors in England.1 “Certainly I have concerns over the impact that this will have on the potential recruitment and retention of particularly female trainees,” he said. “We know that 15% of GPs are part time for family reasons, and I think there is …

Royal colleges concerned about junior contract’s impact on women

Medical royal colleges have expressed concerns that a new contract for junior doctors in England could unfairly disadvantage women. On Thursday 31 March, NHS Employers published the new contract.1 At the same time the Department of Health published an equality analysis of the draft contract.2 Following its publication, a number of doctors expressed concerns about the analysis, which said that some aspects of the new contract would be “disadvantageous” to those who worked part time.3 The Royal College of Obstetrics and Gynaecology (RCOG), the Royal College of Physicians of Edinburgh …