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Foundation doctors and quality improvement: frustrations from the frontline
  1. Michael Grant1,2,
  2. Zain Chaudhry3,
  3. Marianne Jane Shawe-Taylor4,
  4. James Lam3
  1. 1Immunotherapy Clinical Trials, Barts Health NHS Trust, London, UK
  2. 2Renal Cancer Unit, Royal Free London NHS Foundation Trust, London, UK
  3. 3Oncology, University College London Hospitals NHS Foundation Trust, London, UK
  4. 4Oncology, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Michael Grant, Immunotherapy Clinical Trials, Barts Health NHS Trust, London EC1A 7BE, UK; michael-grant{at}outlook.com

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Quality improvement (QI) is a concept enshrined in the General Medical Council’s good medical practice guidance and has been a growing focus of the NHS over the past decade.1 Born in the automotive industry, the practice of improvement science began to build momentum in healthcare around the turn of the millennium.2 3 Since that time, the value of QI has been endorsed by medical organisations across the world and has become a mandatory component in the curriculum for junior doctors within the NHS.4 This is true for even the most junior grade of doctors within the UK Foundation Programme—Foundation Year 1 (FY1).5

The idea that clinicians should strive to promote patient care by actively seeking to evaluate and improve the service provided is well accepted by the majority of Foundation Doctors in the NHS. Participation in and contribution to the design of effective QI projects can be a source of great personal satisfaction, as well as provide benefits to patients and services.6 Understanding and applying QI methodology, in itself, have also been shown to empower Foundation trainees to be an agent for change in the workplace and improves perceptions of their professional role within a team.6 7 A growing evidence base indicates that organisations who actively engage clinicians in QI have higher assessed staff medical engagement scores. This, in turn, is positively associated with resource utilisation, care quality indicators and patient experience measures.8 Benefits to patients, individual clinicians and the organisation are self-evident. These are invaluable lessons for junior trainees who may be at risk of burnout or who may feel like frontline cogs in a service provision machine. Further incentive to junior doctors comes from QI forming a major source of point-scoring currency for specialty training programme applications.9

For trusts, the …

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