From Discontent to Driving Change – A Junior Doctors Startup Story

Dafydd Loughran

NHS Clinical Leadership Fellow & Surgical Consent Co-Founder

Let’s change the tone. We’ve heard a lot about junior doctors recently, and in our own little echo-chambers the anger has bubbled and boiled for months. It’s time we cast our gaze at the positives coming from the ashes of discontent.

In response to spiralling numbers of doctors leaving the NHS in search of greener grass there are some enticing those looking further afield to stay and give the NHS a helping hand back to its feet.

Two such schemes are the Clinical Leadership and Clinical Entrepreneur schemes. The FMLM Clinical Leadership scheme places trainees in high powered organisations with the challenge to lead on patient care projects around the UK, far beyond those usually delegated to bright thinkers in their late 20’s/early 30’s who are “only a trainee”… Many have seen the potential of transformational change & are striding forward to tackle ‘saving’ the NHS. Crucially, the aim is not stuffy leadership, but frontline “lets bloody make this better” leadership.

The Clinical Entrepreneur scheme is just hatching and I suspect you will hear much more about Tony Young’s (National Clinical Director for Innovation) brainchild in the next few years. The idea is to harness some of that entrepreneurial fire & passion being locked down in the ranks of the NHS, and give it the freedom to thrive for the good of the wider NHS. With the first cohort having started in August 2016 & given influential HealthTech mentors, I suspect its success will be a key catalyst for change.

There are lots of problems in the NHS. I suspect you know that already. For me the little corner that I wanted to tackle was the problems around patients not really having a clue what their operation entailed, and not being in a position to know if it was the right option for them. I knew from my own experiences that there were a few reasons for the problem, some easy to solve, and some would need time & transformation. With Surgical Consent we are working out how to make this little corner of the NHS work again.

Surgical Consent is one of a number of examples where if we get it right it will save the NHS millions of £’s, and empower our patients, meaning they are far more likely to be happy and healthy. I’m not going to go into lots of detail, this isn’t a sales pitch, but there’s lots more info at, and there’s lots going on in the world of informed consent (new RCS guidelines and podcasts ) that are worth a look. Keep an eye out for the launch of our resource for Doctors in January!

Surgical Consent: The Benefits

  1. Better informed patients make decisions that are more suited to them, and are usually more conservative treatment decisions. The King’s Fund estimated that truly informed patients would opt to undergo 20% fewer elective operations. That’s a lot of operations, and a lot of money saved.
  1. NHS Litigation authority spend over £40 million per year on claims relating to poor informed consent. If we do it right that’s avoidable.

The NHS is full of bright individuals. Bright, and often frustrated individuals. If we mobilise and channel the discontent, rise from the ashes of the boiling echo-chamber, then we can make the NHS succeed. Whatever the plans of the Government. There are more of us than problems, honest. Tackle one problem, tackle it well, and convince others to set their sights on another.


Dafydd Loughran

Surgical Trainee & Co-Founder of Surgical Consent

Surgical Consent is being developed to improve the whole process of shared decision making & consent in hospitals. Initially as a clinician-facing mobile resource Surgical Consent equips you with the information you need.

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