FEARS have been raised over the safety of junior doctor training at an Ayrshire hospital, as a separate report reveals patients in the region are waiting nearly a year for routine physiotherapy.
The medicine department at University Hospital Ayr has been placed under "enhanced monitoring" by the General Medical Council over concerns that patient safety was being jeopardised by unsupervised trainee medics and complaints from trainees about the conduct of some locum doctors brought in to plug rota gaps.
The alarm was raised after a routine visit on November 9 by inspectors from the Scotland Deanery, a branch of NHS Education Scotland, who subsequently referred the department to the GMC. Failure to achieve the required improvements could see the hospital stripped of its university status.
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The details emerged in a report to the NHS Ayrshire and Arran board which noted that the unit had been struggling with "significant staffing issues" and had been forced to fill up to six consultant posts at any one time with locums since August last year.
The report stated: "The quality and experience of locum consultants in a training environment can be highly variable and this situation contributed significantly to the poor trainee feedback."
One locum was accused of "undermining" junior doctors while others were said to have had a "deleterious impact on the training environment". They have since been dismissed.
The report added that staff shortages had left some trainees "dealing with issues beyond their competence or 'comfort zone'", while sick leave and resignations among junior doctors - combined with a fall in the number of new trainee medics allocated to the unit in last August's intake - has left the department with its lowest ever cohort of trainees.
It added: "As all Boards are facing challenges with gaps in their trainee establishment the competition for competent individuals to fill these gaps is high".
Most of the shortfall has been plugged by international medical training initiative fellows, clinical development fellows and locum trainees, but the report notes that this comes with "cost implications" for the health board which is already forecasting an £11 million overspend in the current financial year.
The report added that the unit would be subject to "regular review" by the Scotland Deanery and GMC, but that "issues potentially affecting patient safety have been immediately addressed".
Meanwhile, a separate report revealed that waiting times for Ayrshire's Musculoskeletal Service (MSK) have spiralled to more than 50 weeks for routine patients, and 11 weeks on average, against a national target of four weeks.
The service helps rehabilitate patients with painful conditions or injuries to bones, joints, muscles or nerves so that they can return to work or avoid orthopaedic surgery.
However, the report notes that demand for physiotherapy in particular has "significantly outstripped capacity since 2012" with the waiting list ballooning by 155 patients a week in recent months.
The report states: "Waiting times for routine appointments have risen to over 50 weeks causing significant delays for all service users. As a result of delays in accessing treatment more referrals are being re-classified as urgent (now over 50 per cent of all referrals) and are generally seen within four weeks.
"The average time that people wait is therefore 11weeks but the increased number of urgent referrals reduces the capacity for the routine waiting list extending the waiting time for those people further.
"This is creating inefficiency across the system with General Practice, the Emergency Department and Orthopaedics all reporting significant impact. There is also clinical risk for those with serious pathology."
A spokeswoman for NHS Ayrshire and Arran said measures including the creation of three new GP-based physiotherapist posts and fewer referrals recently had "led to a significant reduction in the number of patients now waiting".
She added: "We offer our sincere apologises to anyone who has waited longer than expected for an MSK physiotherapy referral. We anticipate that this recovery plan, together with our work with NHS24, will reduce waiting times further."