Australian doctors are more engaged than UK doctors: why is this the case?

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000372
Author(s):  
Paul W Long ◽  
Peter Spurgeon ◽  
Erwin Loh ◽  
Patti Mazelan ◽  
Fred Barwell

BackgroundDespite reports highlighting the need for greater medical engagement and the benefits of being widely understood, very little information is available on the status of medical engagement in Australia, and how this compares to the UK. Answering this question will no doubt assist training bodies, curriculum designers and policy makers better understand relevant issues.MethodsThe medical engagement questionnaire (MES) was emailed to all medical staff working at 159 UK National Health Service Trusts and 18 health service organisations in Australia. The questionnaire consists of 30 predetermined items seeking responses using a 5-point Likert scale.ResultsOverall, doctors in the Australian dataset are slightly more engaged, or more positive, than their UK colleagues. Good interpersonal relationships was the only variable that UK doctors scored more positively than their Australian counterparts. At the lower end of the responses, that is the least engaged, we found this even more apparent. Where doctors in Australia are less disengaged, that is still more positive than the UK colleagues.ConclusionWhile the profiles of medical engagement vary at the sites and also across the MES and subscales, the data illustrate that overall doctors in Australia feel valued and empowered, and they have purpose and direction and work in a collaborate culture. At the most disengaged end of the scale, Australian doctors are markedly less disengaged than their UK counterparts. There may be numerous factors that influence and change how engaged doctors are in both countries. The most prominent of these are appear to be working conditions and lifestyle, driven by funding and other economics issues. This research is likely to be of great interest to regulators and training bodies in both countries.

2015 ◽  
Vol 45 (1) ◽  
pp. 83-99 ◽  
Author(s):  
MARK EXWORTHY ◽  
PAULA HYDE ◽  
PAMELA MCDONALD-KUHNE

AbstractWe elaborate Le Grand's thesis of ‘knights and knaves’ in terms of clinical excellence awards (CEAs), the ‘financial bonuses’ which are paid to over half of all English hospital specialists and which can be as much as £75,000 (€92,000) per year in addition to an NHS (National Health Service) salary. Knights are ‘individuals who are motivated to help others for no private reward’ while knaves are ‘self-interested individuals who are motivated to help others only if by doing so they will serve their private interests.’ Doctors (individually and collectively) exhibit both traits but the work of explanation of the inter-relationship between them has remained neglected. Through a textual analysis of written responses to a recent review of CEAs, we examine the ‘knightly’ and ‘knavish’ arguments used by medical professional stakeholders in defending these CEAs. While doctors promote their knightly claims, they are also knavish in shaping the preferences of, and options for, policy-makers. Policy-makers continue to support CEAs but have introduced revised criteria for CEAs, putting pressure on the medical profession to accept reforms. CEAs illustrate the enduring and flexible power of the medical profession in the UK in colonising reforms to their pay, and also the subtle inter-relationship between knights and knaves in health policy.


2021 ◽  
Vol 66 (4) ◽  
pp. 168-174
Author(s):  
Jenni Lane ◽  
Rahul Bhome ◽  
Bhaskar Somani

Background and aims Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19. Methods Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009–2019 (2009/2010 to 2018/2019 financial years). Results The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010. Conclusions Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.


2020 ◽  
Vol 21 (17) ◽  
pp. 1237-1246
Author(s):  
Richard M Turner ◽  
William G Newman ◽  
Elvira Bramon ◽  
Christine J McNamee ◽  
Wai Lup Wong ◽  
...  

Despite increasing interest in pharmacogenomics, and the potential benefits to improve patient care, implementation into clinical practice has not been widespread. Recently, there has been a drive to implement genomic medicine into the UK National Health Service (NHS), largely spurred on by the success of the 100,000 Genomes Project. The UK Pharmacogenetics and Stratified Medicine Network, NHS England and Genomics England invited experts from academia, the healthcare sector, industry and patient representatives to come together to discuss the opportunities and challenges of implementing pharmacogenomics into the NHS. This report highlights the discussions of the workshop to provide an overview of the issues that need to be considered to enable pharmacogenomic medicine to become mainstream within the NHS.


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