The Problem

The forum was founded in February 2016 when concerns were raised around low trainee morale and trainees were leaving paediatric training. Our aim was to improve the training experience, morale and retention of trainees in Leeds Children’s Hospital (LCH) and to work with management to embed changes, and facilitate timely and transparent communication between all junior doctors and senior management to improve quality of care and patient safety across the hospital.

Aims

Junior Doctors Forum (JDF) has five objectives as key activities it aims to achieve:

1. Develop new and utilise existing training and educational opportunities for all junior doctors in LCH.
2. Promote LCH, the largest children’s hospital in the region, as a desirable centre for trainees, preparing them for their professional exams and future careers.
3. Provide feedback and support to senior management in optimising junior doctors’ working environment, promoting safe service provision whilst maintaining desirable levels of training opportunities.
4. Provide peer support and sense of community across all specialties in LCH.
5. Engage and provide support in any areas of concern raised by junior doctors in LCH.

Making the Case For Change

Workforce Planning

• Monthly meetings with Trust and senior management to provide feedback and ensure trainee input into the design of rotas.

Morale and retention

• Exit interviews for trainees that had left paediatric training.
• Thematic analysis of interviews and present feedback to deanery and college tutors.
• Develop peer led mentoring scheme for paediatric trainees and expand across Yorkshire for paediatric trainees.
• Creation of GR8X (positive DATIX) to celebrate success in the workplace and provide learning for excellence.
• Organise an Inaugural Children’s Hospital Summer Ball.

Exams

• Create clinicals revision course delivered by consultants and senior registrars to help trainees pass membership exams.
• Run courses every 4 months and make accessible to trainees across the deanery.

Training and teaching

• Recreation of weekly grand rounds to be more trainee focused.
• Initiation of in-situ simulation to help management of critical and complex scenarios.

QI and Research

• Introduction of standardised cannulation trolleys.
• Research on collection of neonatal blood samples – ‘make every drop count’.
• Support workgroups on a number of other projects across the hospital – see QI Forum poster in list of resources below.

Your Improvement

JDF is organised into a Steering Committee that meets regularly and decides on the future direction of its actions. Meetings are held within the working day and trainees involved are able to attend as well as monthly meetings with senior management team and the college tutors to discuss progress and plans. There are two co-chairs and it is part of the role of the chief paediatric registrar to chair the JDF along with a secretary and workstream leads.

We try to have the chairs in post for one year but the other posts can rotate on 6-monthly basis based on trainees’ rotations around the region. JDF workgroups are defined by needs and concerns raised by junior doctors themselves and tackle active issues within JDF’s objectives to deliver new and better solutions together with the management.

The forum and its workgroups are now embedded in the organisational structure of the hospital – see the Terms of Reference in list of resources below.

Learning and Next Steps

• Doctors’ rotations – Associate Members who remain members despite rotating keep projects going.
• Project sustainability – projects need people running them and taking responsibility to have effect. Think in advance where projects will go, whether they’re feasible and have a long-term JDF liaison to embed into Trust structures elsewhere.
• Leadership – share roles and assign a chief paediatric registrar to oversee JDF.
• Engagement with trainees – JDF attracts keen involved trainees but Open Forums attendance is variable. Word of mouth and events are best ways of communication. A Trello project management platform was trialed but later abandoned due to incompatibility across platforms.

The project was presented at the Faculty of Medical Leadership and Management Conference in October 2019 – see JDF poster in list of resources below.

Project lead: Dr Rebecca Powell, ST7 Paediatric Emergency Medicine, Chief Paediatric Registrar and Dr Amanda Newnham, Paediatric Nephrology Consultant.

Organisation: Leeds Children’s Hospital

Published: April 2020