Surgeons’ representatives have called the working time directive “a spectacular failure” following new research suggesting care has deteriorated since its introduction a year ago.
Eighty per cent of consultant surgeons and 66% of trainees say that patient care has deteriorated under the working time directive.
The Royal College of Surgeons, Association of Surgeons in Training and British Orthopaedic Trainees Association are all campaigning for a 65-hour week, which they believe offers the best balance between adequate training opportunities, good patient care and work-life balance.
The survey’s results – taken from 980 surgeons covering all nine surgical specialties in England as well as those based in Scotland, Northern Ireland and Wales – compare unfavourably to a similar research undertaken last year.
Sixty five per cent say their training time has decreased – a quarter more than in October 2009.
More than a quarter of senior surgeons are no longer able to be involved in all of the key stages of a patients’ care, compared to 18% in 2009.
Two thirds of trainees have reported a decline in training time in the operating theatre and 61% of consultants report that they are operating without trainee assistance more frequently since the directive was introduced in August 2009.
Forty one per cent of consultants and 37% of trainees reported ‘inadequate handovers’.
This follows Hospital Dr research which showed that shift working and multiple handovers top the list of problems doctors face in delivering good care.
Almost three quarters of trainees and two thirds of consultants are consistently working more than the permitted hours. Over half of trainees say they cover rota gaps which result in them working in excess of their contracted hours, compared to 44% in 2009.
One consultant surgeon, who responded to the survey, said: “The European Working Time Directive has been a training disaster. We are raising a generation of demotivated, demoralised and poorly trained surgeons. The UK will pay for this and regret it for at least 30 years.”
Mr John Black, president of the Royal College of Surgeons, said: “To say the European Working Time Regulations has failed spectacularly would be a massive understatement. Despite previous denial by the Department of Health that there was a problem, surgeons at all levels are telling us that not only is patient safety worse than it was before the directive, but their work and home lives are poorer for it.
“The new government have indicated they share our concerns, but there is not a moment to lose in implementing a better system which would enable surgeons to work in teams, with fewer handovers and with the backup of senior colleagues.”
Mr Charlie Giddings, president of the Association of Surgeons in Training, said: “The survey shows that 12 months after the full implementation of the WTD there has been little progress with improvements to quality of training or to the quality of life of trainees and the subsequent impact on patient safety.
“New innovative solutions are required rather than the minor short-term tweaks that artificially produce compliance at the expense of training and patient care, which trusts have attempted so far.”
A spokesman for the Department of Health said: “The health secretary will support the business secretary in taking a robust approach to future negotiations on the revision of the European Working Time Directive, including maintenance of the opt-out.
“We will not go back to the past with tired doctors working excessive hours, but the way the directive now applies is clearly unsatisfactory and is causing great problems for health services across Europe.”
Meanwhile, additional RCS research suggests that the proportion of NHS patients having to wait longer than the 18-week target for non-emergency surgery had almost doubled from 1.5% 18 months ago to nearly 3% in March 2010. It blames the WTD.
Commenting on the findings, Royal College of Physicians president Sir Richard Thompson said: “We are not providing the service or the training that we require. I cannot over-emphasise the damage to service provision and to training.”