No. 18 - Common problems with Trust Inductions and moving trusts - surely these can be solved?
tldr
25 areas for improvement with Trust Inductions for new jobs.
During my post graduate medical training, I have been very lucky to have been in the same Trust for most of it. Today, I moved trust for the first time in a few years and the experience has been pretty shocking!
It has reminded me just how bureaucratic and inefficient the whole system is. Some trainees are unlucky enough to have to go through this process multiple times a year.
Issues:
1. HR personal details forms are always different to the previous trusts requiring you to fill them in from scratch.
2. HR forms often have weird grid tables that require typing individual letters into tables – why?
3. So many forms asking for my demographic details.
4. Requirement to prove who I am, where I live and my right to work in this country… despite already doing this to be offered a training job in the first place. Why can’t HEE and Oriel talk to NHS trusts? Why isn’t there a simple database that all our details are on centrally that each trust could then access? Or they could just ask the GMC?
5. Some trusts request you send in photocopies of your vaccination record and then fill in a separate occupational health form where you also enter all of your vaccination dates again. Why can’t they talk to each other?
6. I was asked multiple times if I had been COVID vaccinated and then emailed multiple times by different people to ask if I had been COVID vaccinated and what were the details. Then had to fill in a separate COVID vaccination form, despite me already filling this in on the separate vaccination online form!
7. I had to fill in a COVID risk form about myself, which also seemed totally pointless because its not going to change the work I do.
8. There were many more forms about COVID.
9. Rotas are often sent late, with no key explaining the various colour coding and short hand. Why is it so difficult to include a key?
10. The rotas that are sent, have no contact details on them, so even if you wanted to book leave you have no way of doing this.
11. After calling the Hospital and being bounced around various departments you can eventually get the name of someone who is your “rota coordinator” but they aren’t in today. So you email them and then never hear from them. You call again, but now they are on annual leave and so you email again and still don’t hear. Then the day before your shift starts you get an email from this individual asking why you haven’t submitted any leave requests yet because you should give 6 weeks notice. Also, it turns out that the leave I did want to request is actually during a before of night shifts which were clearly labelled on the rota as “N”, without any other explanation.
12. You get sent an on-call rota and a ward rota from different people, at different times, in different formats and they don’t match. Which one is right?
13. Having to attend a face to face induction on site, early in the morning, to then be sent home for a zoom induction in the afternoon. The bit that was face 2 face could also have been an hour shorter if it wasn’t so waffly. The waffly bit could also have been done on Zoom in the afternoon.
14. The induction time table you get sent is only emailed to you a day or two before you start.
15. The induction day timetable doesn’t make it clear whether you are expected on the wards before or during breaks in the induction time table. And only after emailing the educational admin team directly can you confirm if you are meant to be doing clinical work on that day.
16. If you are due to start on call, then no one tells you where and when you are meant to meet for your on call shift or where to collect bleeps from or even how long the shifts are.
17. Changing trusts requires having hours of IT inductions and training because almost every trust and every department in each trust uses a different computer system. These systems all require different logins and ID and all work differently and can’t talk to each other. As an SHO you will never use most of these systems or their functions and yet the IT guru will spend a great deal of time explaining exactly how you upload a PDF of something you will never do.
18. IT training by watching someone else click through an online system is not really helpful because normally they are just reading out the labels on the buttons. Running through a practice patient yourself would be far more useful.
19. IT training via Zoom is even more helpful when the signal is so poor that it keeps freezing or that pop up windows keep showing on a different screen that isn’t being shared, requiring the audience to point this out and start a section of explanation again.
20. Some Trusts have electronic patient records but hand written blood test request forms. Other trusts only accept printed electronic blood test request forms but all other patient notes are on paper. Surely, there is a healthy balance somewhere between the two? Also the trust that only accepts printed forms then doesn’t have enough computers or printers to make this an easy job to do and so you spend longer try to print than you do trying to take the blood.
21. The mandatory training had to be done on eLFH and on a trust moodle site. Their modules were different to other modules already done at another trust and needed to be repeated.
22. Induction and mandatory training done at other sites was completed but then no certificates were ever sent and now there is no record that we did the training and so I have to book onto mandatory training again.
23. BLS training was repeated. Blood transfusion training was repeated. Well being training was repeated.
24. Has anyone got any evidence that repeatedly telling staff they need to improve their well being does anything for their staff except lower morale?
25. My summary of all of this is that moving between trusts and jobs is a massive faf that is made more difficult because of government regulation and well intentioned seniors. If the goal of induction was to tick as many mandatory boxes as possible, then it is probably a success. If the goal of an induction programme is to ensure a new employee is ready to do their job on day 1, then most of these programmes fail.
Most of the useful learning is done through experience and talking to other members of the team who are already doing the job. So, my advice is tick the boxes, do some deep breathing exercises, endure the wasted time and then get on with the job. Good luck!
Hopefully, the next article will be more useful and less moany but as I have been told many times recently, it is really important to avoid “burn out” by off loading your stresses. So thank you for listening/reading.
Please let me know if you have any more irritations to add to the list.