Junior doctors "clueless" in major emergenciesUnprepared for terrorist attacks or other incidents
Junior doctors in NHS hospitals are "clueless" about what they should be doing in the event of a major incident such as a terrorist attack.
The Department of Health defines a major incident as "any event whose impact cannot be handled within routine service arrangements." It involves special procedures by one or more of the emergency services, the NHS, or a Local Authority.
All UK hospitals have a pre-set plan of action to be used in a major incident - the Major Incident Contingency Plan - and all such plans have clearly defined detailed procedures for each class of healthcare professional, including junior doctors.
So the survey results are worrying for two reasons. First, the UK terrorism threat level is currently set to "severe" - defined as a terrorist attack being highly likely. And second, the NHS is heavily reliant on junior doctors in Accident and Emergency departments, especially outside non-standard hours.
The new findings are from a survey of 89 junior doctors in three NHS hospital trusts in Wales in which 9 out of 10 responded that they did not know what would be expected of them in the event of a major incident.
This is despite that fact that in Wales the standard response for junior doctors in these situations is clearly defined - they should go to their ward, contact the senior nurse in charge, and compile a list of patients who could safely be discharged while managing the others who can't.
But when asked, the survey found that:
- almost half (47%) would initially go the emergency care department;
- more than one in four (27%) had no idea where they should go;
- and only 3% would first go their ward.
Nearly a third did not know who they should contact, and 16% said they would call the switchboard - even though it would be shut according to standard major incident procedure.
On a positive note, most of the doctors surveyed recognised that they had gaps in their knowledge of such procedures, and had asked for specific training.
Commenting on the survey, published in BMJ Open, the authors said: "NHS trusts in Wales are not alone within the UK in regard to poor awareness during a major incident - throughout the last 10 years have shown that despite continuing catastrophes within the UK, major incident awareness throughout hospitals is poor and vital teaching is absent from most staff timetables."
But they also warn that the lack of awareness could be costly - "staff [who are] unaware of their roles and responsibilities will turn a major incident into a major disaster" they conclude.
This article was published on Thu 30 June 2011
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