Seventy three additional rotas for junior doctors have been granted a derogation delaying the full implementation of the Working Time Directive.
Following moves in the House of Commons earlier this week, a total of 273 clinical rotas now have a two-year exemption from the 48-hour week which came into force in August, with juniors being allowed to work 52 hours instead.
Applications for a delay were made on behalf of 79 rotas but six were turned down.
Dr Shree Datta, chair of the BMA’s junior doctors committee, said: “We recognise the need for pragmatism in cases where the safe delivery of patient care cannot be guaranteed within a 48 hour week. However, there is an urgent need to rethink how junior doctors work and train.
“Trusts have known the WTD was coming for over ten years, and it is worrying to find that some are so poorly prepared. The crux of the matter is that hospitals must work with doctors to find solutions which avoid disruption to patient services, and maintain the quality of training.”
Earlier this year health secretary Andy Burnham created controversy when he announced that just 3% of the rotas involved in a review of 6,646 across 247 NHS trusts needed the derogation.
A survey, in September, by pressure group Remedy revealed that the level of rota compliance with the WTD only looked good on paper. It claimed 47% of junior doctors believed their rotas failed to comply with the 48-hour week regulations.
Commenting on the increase in rota derogations, Dr Richard Marks, head of policy at Remedy, said: “This number is still probably the tip of the iceberg but at least the problem is being recognised and something is starting to happen.”
Earlier this month, research by the Royal College of Surgeons revealed that 64% of surgeons thought quality of care had worsened due to the 48-hour week.
College president Mr John Black said: “We now have the ridiculous situation where the Department of Health in public moralises over fears that trainees are being coerced into working over 48 hours while privately relying on these doctors to stay longer or cover additional dead-end shifts as locums because there is no way the service could keep running otherwise.”
The government had set an original deadline of 28 May for trusts to request the derogation.
Dr Wendy Reid, the government’s national clinical advisor for WTD, said: “Patient safety is our top priority in the NHS. We have always said that we would keep the situation under close review and where there is a genuine need for extra time to safely implement the directive we would allow derogation. A very small number of services have made this request in order to effectively implement plans and be able to sustain them by 2011.
“The UK remains absolutely committed to enabling all junior doctors to work and train safely, in compliance with the working time directive.”
Read more on the Royal College of Surgeons report.
Tags: Derogation, Training, WTD
