The scheduled rotation of thousands of non-consultant doctors between hospitals across the State will go ahead in July, the Health Service Executive has said. This is despite concerns raised by medical staff and the Irish Medical Organisation (IMO).
Rotation of interns and senior house officers (SHOs) happens every three months, and at six-monthly intervals for the other grades of non-consultant hospital doctors during their training.
The planned rotation for interns and SHOs in April was cancelled by the HSE on safety grounds because of the Covid-19 crisis.
Doctors, however, now worry about the risks posed by transferring large numbers of staff between hospitals.
Responding to questions from The Irish Times, the HSE said the changeover of non-consultant hospital doctors would go ahead as normal on July 13th.
Non-consultant hospital doctors, who have recently arrived from outside the State, will self-isolate for 14 days before starting work.
"This is being factored in by the HSE and non-consultant hospital doctors from overseas will be arriving into Ireland, in the majority of cases, earlier than usual in order to facilitate the period of self-isolation.
“The HSE is putting arrangements in place for intern doctors to undertake a significant amount of the induction online”, it said.
The IMO has proposed to the HSE that it should examine a staggered changeover of non-consultant hospital doctors given the current Covid-19 situation.
“The IMO have been in contact with the HSE regarding the July 2020 changeover of non-consultant hospital doctors (NCHDs). Given the unprecedented backdrop against which this changeover takes place and the possibility that doctors moving hospitals may have to self-isolate for a period, we have suggested that the HSE explore the possibility of a changeover that would be staggered.”
Medics’ reaction
Medical and nursing personnel who spoke to The Irish Times expressed concerns about the forthcoming rotation.
A nurse in University Hospital Waterford said: “The doctors’ rotations [are] a growing concern... Lifting restrictions will already give us some increase in numbers but it has to be done and they’re going about it the right way, but I just dread July when they all swap around hospitals and things are all up in the air.”
The nurse added that she believes it would be “just common sense to either postpone them rotating by a few months or swab them before they move hospitals but at the moment it’s going ahead as normal.”
“Since the pandemic began we’ve all been upskilling and training and making plans … to make sure everyone’s prepared and on the same page to provide the best care. But then they’ll upheave all the doctors and move them around so you have interns starting their first days as doctors … and their superior could be an SHO or a registrar who’s new to the hospital too.”
A trainee doctor in University Hospital Galway felt that, while the chances of the virus spreading due to the mass movement of hospital doctors in July may be a “reasonable fear”, many doctors would lose out on further training (some of which has already been put on hold due to elective procedures being cancelled), if the changeover didn’t go ahead.
He said it is a “big deal … as some people [are] supposed to become consultants in July or go into the community from hospitals to be GPs… so it complicates training hugely.”
“The benefits of the rotation is a continuation of education, training competent doctors to improve our constantly under-pressure health system, the downside is the potential transfer of disease, which can be mitigated by correct precautions.”
Testing rotating doctors before they move hospital would not work either, he said, as the “tests … are only about 65 per cent sensitive, we’ve had cases with full-blown Covid and two negative swabs and only positive on 3rd. So they’re not that helpful.”
“If you could test doctors’ antibodies then you could say who’s had it, but then there’s an argument that maybe this doesn’t give protection against further infection.”
The doctor said an option could be delaying the rotation until later in the year after the loosening of restrictions.
A nurse in University Hospital Galway said she was apprehensive about the changeover and worried that moving doctors during the pandemic could undo “all the great work we have done”.
She said Galway’s low case rate “is not the case everywhere and moving doctors may increase these numbers. Their exposure to Covid patients is a lot more, therefore their chance of contracting it is higher.”
“I feel doctors should be quarantined for two weeks or perhaps swabbed before moving hospital. Especially if they are moving from a hospital with a large volume of Covid patients.”
A registrar in Galway University Hospital who is moving to Dublin in July said there is a small chance of doctors having the virus and bringing it to another area.
However, he said training must go ahead, “in favour of delaying until September”.
“They will begin to lift restrictions on May 18th. We won’t see the effects of that until the first week of June.”
Meanwhile a spokesperson for the Irish Association for Emergency Medicine sit it didn’t foresee any particular issues arising from these scheduled moves, which are often within the same hospital or geographical region.