Collective, collaborative and diverse - clinical management at its best in the time of Covid
By Dr Rebecca Spruce
Less than full time ST5 Radiology Trainee, currently at Great Ormond Street Hospital, London
Last summer (2021), I became part of a team of radiology registrars set up to co-ordinate shift cover by locum registrars and reduce the impact of staff absences during the pandemic. The team incorporated different training grades and sub-specialities, as well as those working less than full time, to allow a diverse range of ideas and perspectives; this greatly contributed towards innovative solutions to enable continuous around-the-clock radiology services at Guy's and St Thomas' Hospital, my previous Trust.
Before Christmas, as the Omicron variant became established, radiology, like many other departments, suffered increased pressure on services due to COVID-19-related illness and isolation. Absences during the festive period meant greater difficulty covering on-call shifts and cross-checking of staff availability became a constant and time-consuming task, often resulting in urgent cover at short notice. Being both time-efficient and well organised was the only way to stay up to date with cover arrangements. To meet tight deadlines and be responsive to multiple stakeholders (registrar and consultant bodies, clinical director, management team, etc), I found the 10-minute periods of down-time between clinical work useful in staying up to date with the rota and correspondence. These gaps were often opportunistic, at the end of clinical lists and prior to starting reporting sessions.
Occasionally, I have responded to correspondence outside of normal working hours. I am aware this is my preference and do not expect colleagues to do the same. Good Medical Practice (2019) states that we should respect colleagues’ skills and contributions alongside treating them fairly and with respect. Personally, I believe this encompasses respecting our team’s rest time and annual leave. Being part of a supportive leadership team of four registrars meant this was possible. Sharing workload and responsibility with colleagues and maintaining clear lines of communication allowed for maximising of personal time during the festive period. This level of co-operation and teamwork is something everyone can consider; we should be looking out for each other, especially if/when another pandemic wave hits.
Along with my fellow trainee team members, the senior management within the department have been incredibly supportive. They were very responsive in emails and stepped-in when problems arose. This approach has been helping to incorporate junior doctors into leadership roles and is something I am looking to emulate once I become a consultant, in a year’s time.
As a part-time trainee, the increasing flexibility of virtual meetings between team members has assisted my ability to participate in managerial roles. Throughout the pandemic, virtual technology has helped to preserve social distancing and enabled timely communication between colleagues based at different sites. These video-conferencing systems have done much to ease the juggling act between clinical work and leadership roles and despite a personal nostalgia for face-to-face meetings, I would be keen to promote the continued use of video-conferencing platforms, at least in a hybrid format, to support flexibility and improve efficiency.
As doctors we make the care of patients a key concern, however this is easier if we also prioritise our own self-care. Having a team of trainee colleagues, increasing working flexibility and supportive senior management has made this possible for me. Working efficiently and as a collective has enabled creative solutions in a time efficient manner to assist with continuation of appropriate clinical care at a testing time for my team and the department.