We read with interest the article by Kilroy and Southward1 on their experiences of the Foundation Programme. The Mersey Deanery was a pilot site for the Foundation Programme, with the first Foundation Year 2 (FY2) doctors appointed in 2004. Originally our department employed 20 senior house officers (SHOs). In August 2004, half of these became FY2 posts. From August 2004 to July 2005, we maintained a 50:50 split between traditional 6‐month posts and 4‐month FY2 posts. This gave our department a unique opportunity to study the effect of the transition to the Foundation Programme on workload.
Data were obtained from the hospital information technology system on the number of patients seen by all SHOs during the year. The mean number of patients seen by each set of doctors was compared. Variations over time during the posts were also analysed. Statistical analysis with the unpaired t test was carried out using SPSS V.13.
The department had 80 981 attendances from August 2004 to July 2005, of which 38 416 patients were seen by SHOs. FY2 and 6‐month doctors saw 18 928 and 19 488 patients, respectively. At the end of their placements, there were no marked differences between the mean numbers of patients seen by the two types of SHOs. Over the course of the year, FY2 doctors saw a mean of 159 patients per month, whereas 6‐month doctors saw 162 patients per month. The stem and leaf plot (fig 1) shows that the means for the number of patients seen are almost identical. Table 1 shows the wide range for the mean number of patients seen during the course of the year, which was greater for those in the 6‐month posts. A small number of FY2 doctors saw considerably more patients than their colleagues. No overall differences were identified between the two types of placement. For those doctors in 6‐month posts, the numbers of patients seen per month tailed off after 4 months.
Figure 1 Stem and leaf plot of the mean number of patients seen by the type of senior health officer (SHO) placement. FY2, Foundation Year 2; m, months.
Table 1 Mean number of patients seen by different types of senior health officers.
| Total patients seen | Range of SHO monthly mean | Monthly mean | |
|---|---|---|---|
| FY2 Aug–Nov 04 | 6557 | 115–191 | 149 |
| FY2 Dec 04–Mar 05 | 6830 | 124–350 | 190 |
| FY2 Apr–Jul 05 | 5541 | 110–200 | 139 |
| 6 months Aug 04–Jan 05 | 10388 | 133–232 | 173 |
| 6 months Feb–Jul 05 | 9100 | 107–232 | 152 |
FY2, Foundation Year 2; SHO, senior house officer.
In conclusion, the transition to the Foundation Programme has had no effect on the number of patients seen by SHOs. The ability of the individual doctor has a greater influence than the type of post he or she held. In terms of numbers seen, doctors in the 6‐month posts peaked 4 months into the placement and tailed off thereafter. Therefore, rotating the FY2 posts every 4 months will not affect the workload of the emergency department.
Footnotes
Competing interests: None.
References
- 1.Kilroy D A, Southward S A. The Foundation Programme and the emergency department: a review of the curriculum and experience of a UK pilot. EMJ 200623167–171. [DOI] [PMC free article] [PubMed] [Google Scholar]