Alice Nichols - Speciality Doctor in Paediatrics, York Hospital
I am given the same opportunities as rotational trainees within the department and am encouraged to progress my career
As a child I wanted to be a paediatric doctor and initially it all appeared to be plain sailing I got my training post straight after foundation year and although the commutes were hard spread across a large geographical deanery it was manageable. Just after becoming a paediatric registrar, I became pregnant and had my first child.
My partner works in a job with unpredictable hours and very long days through harvest. We had no local childcare provision I could not come up with no workable solution which would allow me to continue with paediatric training, without travelling long distances across the deanery and the upheaval of moving my child to different childcare settings.
I contacted the clinical lead of the local paediatric unit where I had most recently worked and went to chat to her about the possibly of a trust grade post limited to normal working hours, that would be manageable alongside a local nursery.
A job was created, for which I applied and involved teaching medical students and acute service provision in a level 2 DGH (district general hospital) contracted to normal working hours which is fantastic for family life. I have been in a very supportive and enthusiastic department for seven years now and have had another child in this time.
I am given the same opportunities as rotational trainees within the department and am encouraged to progress my career toward the Portfolio Pathway by the consultant team. The stability and continuity that comes with this has allowed to take on extra roles during this time such as managing the rotas.
The stability of the job has allowed me to have a great work life balance, be at home for bedtime every night and a flexibility to pick up extra shifts when convenient to family life.
Liz Baker - Consultant Paediatrician, York Hospital
The department has gained exponentially from the experience, skill, and continuity these doctors provide
York and Scarborough NHS Trust have a longstanding tradition of supporting non-traditional training posts. More recently, within paediatrics we have significantly expanded these roles and currently employ several SAS and locally employed doctors at both tiers 1 and 2 level.
We recognise the value and potential of excellent trainees who for different reasons may not be suited to more traditional training pathways – exam difficulties, family commitments, burnout, and commuting. Our initial SAS roles were created for individual trainees who were working in the department but had made the difficult decision not to continue with the paediatric training programme, but whose experience, contribution and value we were keen to support and develop. We were able to incorporate these posts into the rotas, also helping to try and futureproof for rota gaps.
Regarding our subsequent appointments, these were also created in response to rota vacancies, which remains a longstanding issue regarding paediatric rotas, especially given the flexibility of LTFT (less than full time) working becoming more attractive and popular. Given ongoing workforce pressures throughout the NHS, it is well recognised that there is the need to be more innovative and imaginative with regard the make-up of our workforce.
In York we are fortunate that the practice and process of employing SAS and locally employed doctors is fully supported by our operational management and medical staffing teams, together with our post-graduate department. Once a trainee and/or rota gap is identified, a business case is submitted, and once approved the post application and interview process takes place.
It is also worth keeping an eye out for other revenue sources for funding additional posts, especially given current financial constraints. Our most recent appointment has come about as a result of a successful bid for funding from the regional neonatal ODN (operational delivery network) to help support rota cover for our neonatal unit.
The department has gained exponentially from the experience, skill, and continuity these doctors provide, and it has also been rewarding to see the benefits on their own wellbeing and development.
Moving forward, we are encouraging career progression for these doctors, ensuring they are not just seen as service provision but with additional senior management roles within governance, neonatology, outpatient clinics, rota management, teaching, and induction, together with pastoral care and mentoring roles, with the ultimate aim of becoming consultant or specialist colleagues in the near future.