Findings from a regional survey published online in BMJ Quality and Safety show that junior doctors in the NHS are prepared and able to help improve health services, but they do not feel valued or heard. Based on the findings, the BMJ authors conclude that junior doctors are “an untapped NHS resource,” at a time when the NHS needs all the help it can get.

The authors conducted an online survey in the South Central Region, one of the 10 strategic health authority regions, questioning 3,766 doctors in training, including those in their first year after qualifying (foundation year 1), up to pre-consultant level.

The questionnaire contained a variety of questions, including information concerning the doctors’ working life, such as their views on their role and future. Overall, slightly less than 1,500 doctors replied, a response rate of just under 40%.

According to 89% of the respondents, feeling part of a team within their organization was “extremely” or “very important”, with a similar numbers reporting that they felt they needed to be effective leaders to “a very great” or “great extent.” The great majority, i.e. nine out of 10 respondents (91%) said they had ideas for improving services, however only one in ten (10.7%) reported to have implemented their ideas.

Four out of ten of all responding doctors (slightly less than 44%) reported that they had tried and failed to implement an idea or felt unsure on how to go about it. In response to the questions concerning how they rated their value as a doctor, over 84% reported to feel “not valued at all” or only “sometimes valued.” Over 78%, or more than three out of four doctors believed to be undervalued by their chief executive, with a similar proportion (77%) feeling that they are undervalued by their employing organization and 79% of respondents reported to feel undervalued by the NHS as a whole.

Even though three quarters of the participants felt highly valued by their non-consultant medical colleagues, nearly 60% reported they felt their senior consultant colleagues did not value them equally.

According to the authors, the survey results suggest that junior doctors are adjusting to new roles within the NHS, yet they feel unable to realize their full potential in order to make changes. The authors highlight the fact that junior doctors are in a position to identify good and bad practice, due to their frequent rotations between different hospitals, organizations, and specialties, and that all doctors on the front-line play a major part in improving the quality of care.

They conclude:

“We have demonstrated that the junior doctor medical workforce has both the desire and the ability to start contributing to improvement in the NHS, but feels that the environment in which they work is not sufficiently receptive to their skills. If the government is to achieve the aim of improving productivity and quality in the NHS on a restricted budget then all employees need to feel valued and engaged to optimize organizational performance.”

Written by Petra Rattue