Hospital Dr News

Taskforce to assess impact of EWTD on NHS

An independent taskforce has been set up to investigate the implementation of the Working Time Directive and its impact on the NHS and health professionals.

Chaired by Professor Norman Williams, president of the Royal College of Surgeons, the taskforce will review the evidence on the effect the regulations are having on the delivery of patient care and the training of doctors.

The government has commissioned the taskforce, which includes representation from across the medical profession.

Williams commented: “This is a vital piece of work and I am pleased to be chairing this taskforce. There is a need for a deeper examination of the evidence on the impact and implementation of the reduced working hours on the delivery of care and training of doctors; the formation of this group will allow this.

“We will then produce expert advice and practical solutions to the Secretary of State with the aim of improving patient care.”

The taskforce will report to the health secretary Jeremy Hunt in January 2014.

Royal College of Physicians will also be part of the taskforce, and RCP president Sir Richard Thompson said: “Exploring how the EWTD is implemented within the NHS and its impact on the medical profession is an important and necessary piece of work. I look forward to the RCP working alongside other members of the group to examine the evidence and address the issues involved.

“There is still much to examine on the impact of reduced working hours; including the provision of training, and more importantly, the continuity of care for patients.”

The objectives of the review, as listed in their terms of reference, include:

– consideration what can be done to ensure that all doctors have flexibility within the current working time regulations to provide continuity of care for their patients and opportunities for training and learning;

– reviewing evidence on the impact and implementation of the reduced working hours on the delivery of care and training of medical professionals;

– identifying areas of medicine most impacted by the implementation of the regulations and identify nationally and locally driven examples of best practice and practical solutions for these issues;

– considering the impact of contractual arrangements on the implementation of the regulations and advise on practical solutions;

– making recommendations for providing continuity of care for patients and ensuring doctors receive high quality training and the experience they need.

A survey last year suggested that seven in ten surgical trainees were unhappy with the quality of their training. Most blamed the reduction in working hours introduced in 2009 by the EWTD, which limited the working week to 48 hours.

The majority of trainees believed they should be working more than 48 hours a week and nearly half (49%) agreed that the working week should be between 57-72 hours. Having more time off was not considered important.

Nearly three quarters of respondents (72%) claimed they spent at least a little of their time off seeking further surgical training in theatre or clinic and one in five (20%) spent either a lot or all of their time off gaining surgical experience.

Read the full terms of reference for the taskforce.

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3 Responses to “Taskforce to assess impact of EWTD on NHS”

  1. Leslie Hamilton says:

    It should be remembered that the EWTD limits the hours worked without rest (to 13 hours) not the total weekly hours – the 48 is averaged over 6 months. Indeed the maximum week under the EWTD is 78 hours (6 days x 13 hours).

    So if it to be changed we need to decide how many hours should be worked without rest / sleep. Working 21 hours is said to have the same effect on performance as being over the drink driving limit.

    Could the real problem be the way we have implemented the EWTD? Or too many acute hospitals? Too many resident doctors?

  2. Neelam Dugar says:

    11 hours of continuous uninterrupted rest in 24 hours is important for any person to function safely.
    Getting consultant on-call rotas to comply with this is going to be interesting with this desire to move to 7 day working.
    Legislation like EWTR are unpopular with all employers including NHS employers. Please, please BMA & professional bodies do not make doctors vulnerable to being forced to work without adequate rest periods.

  3. Clive Ramsden says:

    I do appreciate the over riding principles of the EWTD. It would be wrong to expect the 60 year old factory worker to grind away all day without a rest period or for that matter for longer than twelve hours at a time.

    Junior doctor training is different. This is a small period of time in the overall working life of a doctor. They are younger and more resilient. On one hand they are told of the sufferings of onerous overstretched trainee. On the other hand it is quite extraordinary to see the “yuff of today” able to party, maintaing long hours and yet roll into work the next day none the worse for wear. It certainly was the case in my training years and an extra On Call often less exhausting than an “all night bender” (or using present day venacular “getting wasted”).

    The older I get the less able I am able to do this.

    But surely a five or seven year stint of a rather (let’s face it) enjoyable hardship must be better than exiting a shortened training period, ill-equipped to deal with the responsibilities of a newly appointed consultant

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