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Reaction: strike balance between care and training

The government has accepted the recommendations of an independent taskforce into allowing doctors to work and train more flexibly than the Working Time Rules currently allow.

Professor Norman Williams, former president of the Royal College of Surgeons and chair of the independent taskforce

“As a taskforce we were clear that the one size fits all approach of the Working Time Directive in medicine is detrimental for training and patient care in some specialties. Our recommendations set out a clear path to getting to much needed solutions.

“The taskforce, which drew support from across the health service, was unified that action is needed now but solutions should not lead to a return to doctors’ working excessively long hours.

“I am pleased the government has accepted our report and committed to explore our key recommendations. In particular the separation of training and education of trainee doctors from their work on the wards has the opportunity to strike the right balance between delivering patient care and ensuring that junior doctors have the right knowledge and skills.

Dean Royles, chief executive of the NHS Employers organisation

“Employers were clear in the review that patient and staff safety are our prime concern. We have no desire to return to excessive working hours which would be bad for patients and for doctors.

“It is clear that the majority of professional bodies believe the Working Time Directive has been implemented in a way that maintains safe and effective training of doctors. It is ten years after implementation of the Directive and they have provided the Taskforce with plenty of evidence.

“It is important this is shared widely. We wanted recommendations that give stability and enable effective planning.

“The participation of NHS Employers and the British Medical Association in the Taskforce means the parties have already been able to consider the report’s carefully developed recommendations in the current talks about junior doctors’ contracts, particularly all the evidence and case studies showing how careful, considered implementation is key. It is through those contract negotiations that doctors can have a framework to work in that puts patients first and supports sensible working hours.

“Effective training of junior doctors is of course hugely dependent on the availability and presence of consultant doctors and, as we move ever closer to seven day care, having more consultants on site for more of the week will add to that training experience. The sooner we conclude the consultant contract negotiations, the better for patients and for those that care for them.”

Elisabetta Zanon, director of the NHS European Office

“We don’t want to see a return to the bad old days when doctors in training worked dangerously long hours. But like the Independent Taskforce, we recognise that certain specialties in particular are finding it difficult to deliver quality training and services within the constraints of the current working time rules, especially the rules about exactly when healthcare staff can take rest periods.

“The NHS European Office is actively pressing for sensible changes that would allow greater flexibility in providing round the clock services for patients, whilst continuing to safeguard healthcare workers from excessive tiredness. We are working for the NHS by putting these views to the European Commission, who are currently looking at the impact of European working time rules across a range of countries, including the UK.

“They will take these views into account when consulting on possible changes to the Working Time Directive. We expect the Commission to issue a new proposal for Working Time rules next year.

“We agree with the Taskforce that changes to the directive could help improve health services, and we’re pushing hard for that to happen. But in the meantime it’s important to take forward the Taskforce’s other recommendations and to do everything possible in England at local and national level to make the changes needed to provide top class services and training.”

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