Bad inductions can be a killer for the NHS

Good handovers and inductions are vital in every organisation - particularly the NHS.

Last Updated: 31 Aug 2010

A study out this morning suggests that patient mortality rates increase slightly in the first week of August, when the latest round of junior doctors hit the hospitals. According to researchers at Imperial College, the average death rate is about 6% higher than in the previous week. Now it may be that there are perfectly good reasons for this other than the changeover. But it doesn't seem beyond the realms of possibility that the NHS - along with many other organisations - could still do a better job of training and inducting its new staff...

The researchers, who examined 300,000 emergency admissions between 2000 and 2008, found no real difference in the raw data - but when they adjusted for various factors (like age and pre-existing illness), there was a slight but 'statistically significant' jump of 6%. For medical patients (i.e. non-surgical or cancer patients), the increase was more like 8%. Cue the inevitable hysterical tabloid headlines about the 'killing season'...

In truth, we should probably be a bit wary about reading too much into these figures. As the researchers were keen to stress, the numbers involved are pretty small - and there may be other factors influencing the results that weren't taken into account (perhaps the junior doctors just got sicker patients, for example). After all, there are so many variables at work in a sample of this size. And previous - albeit smaller - studies have failed to show any great difference.

Nonetheless, even the smallest increase in mortality rates is worth worrying about. Unlike most organisations, the success or otherwise of the NHS's induction programme is literally a matter of life and death; so any indication that it's not working properly needs to be taken very seriously. Patient groups are still convinced that junior doctors are just thrown in at the deep end without sufficient training, supervision or handover notes from the previous incumbents - all three of which should be central to any decent induction programme. The NHS protests that the situation has been much improved in recent years - but with public sector cost-cutting imminent, it wouldn't be a surprise if this was one of the affected areas. These figures highlight the risks of that.

It also serves as a reminder to the business world. Although a bad induction might not have equally dire consequences for private sector firms, its importance - both in terms of employee morale and retention, and the client/ customer experience - shouldn't be underestimated...

In today's bulletin:

Builders tap the City for £1bn as business picks up
Bad inductions can be a killer for the NHS
German bankrupts go for broke in Tunbridge Wells
Credit-crunched public giving less to charity
1,400 jobs to go at Vauxhall now Magna's at the wheel?

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