Junior doctor forums to improve junior doctor engagement
The best predictors of junior doctor engagement are being valued, acknowledged, heard and involved (Spurgeon, Clark, Ham, 2011). A recent HEE publication [REF: Health Education England (2017) – junior doctor morale: understanding best practice working environments] has focused on implementing changes to tackle disengagement on junior doctors.
There are multiple barriers to effective engagement of junior doctors. This is both from an organisational perspective, including issues such as:
- frequent rotation and turnover of staff
- variety of required approaches for different grades and specialties of junior doctor
- poor connections between front-line staff and senior leadership
as well as from the junior doctor perspective, including:
- poor work-life balance
- mismatch between training and service delivery experiences
- time required to settle in a new post and gain tacit knowledge of the organisation
- fears over possible negative ramifications on career progression of reporting themselves or senior colleagues
Wathes & Spurgeon (2016) suggest that forums for junior doctors could address a number of these barriers and thus improve medical engagement. Their work makes reference to informal, organic groups in keeping with communities of practice (CoP) – often defined as a group of people who share a concern or passion and learn how to do it better as they interact regularly. Forums of this nature already exist as vehicles of employee-driven innovation in corporate settings.
This toolkit is designed to help junior doctors build, design and run their own representative structures. The next section will describe the potential structure of these groups and showcase some that have already been set up at various trusts.
N.B. Since 2016, the Junior Doctor Terms and Condition of Service (TCS) has placed a non-negotiable requirement on all NHS employers in England to establish Junior Doctor Forums (JDFs). These are contractually focussed and act as a tool to protect training and safeguard working conditions as well as the well-being of junior doctors at trusts. We distinguish these two distinct bodies within this toolkit. Contractually focussed bodies are referred to as JDFs, whilst organic groups based around a CoP are described as Junior Doctor Representative Groups (JDRGs). We outline the differences between these bodies in a later section of this toolkit.