scholarly journals A qualitative investigation of Foundation Year 2 doctors’ views on the European Working Time Directive

2015 ◽  
Vol 29 (3) ◽  
pp. 367-380 ◽  
Author(s):  
Myanna Duncan ◽  
Cheryl Haslam

Purpose – The purpose of this paper is to examine the personal views and experiences of Foundation Year 2 doctors operating under the European Working Time Directive (EWTD). Design/methodology/approach – In total, 36 Foundation Year 2 doctors from a single UK-based Deanery participated in this semistructured interview study. Findings – Findings indicated that Foundation doctors typically welcomed a regulation of working hours, but reported frustration at the manner in which the Directive had been implemented. Participants reported concerns at reducing hours by removing out-of-hours working in order to meet EWTD requirements. Out-of-hours shifts were highly valued owing to their increased opportunities for autonomous clinical decision making. By contrast, day-shifts were regarded as heavily administrative in nature and were perceived as service provision. Foundation doctors discussed the unique nature of the out-of-hours working period which appeared to provide specific learning opportunities as doctors draw on time management and prioritisation skills. Originality/value – Given the challenges the EWTD presents, careful rota planning is essential. First, the authors would encourage the restructuring of day-shift work to provide a greater emphasis on hands-on skills experience in a supportive, supervised environment. Second, where possible, Foundation doctors might benefit from the opportunity to engage in some out-of-hours working, such as with multi-professional “Hospital at Night” teams. Third, the authors would encourage junior doctor involvement in rota design and planning which may increase their perceived autonomy and therefore buy-in of working practices.

2007 ◽  
Vol 89 (6) ◽  
pp. 206-209 ◽  
Author(s):  
WH Allum ◽  
NI Markham

The introduction of the European Working Time Directive (EWTD) has created specific and predictable pressures on surgical training and education. In many hospitals the emphasis has been on ensuring a safe service, particularly out of hours. This has been to the detriment of training opportunities. The changes inherent in Modernising Medical Careers with the introduction of progressive training will further limit the amount of time for postgraduate surgical training to a total of six or seven years.


2008 ◽  
Vol 90 (8) ◽  
pp. 282-283
Author(s):  
G Reddy-Kolanu ◽  
M Ethunandan ◽  
R Anand ◽  
V Ilankovan

The European Working Time Directive (EWTD) has required all departments to re think staffing arrangements to provide out-of-hours ser vices. Large departments with man y junior doctors can continue to have oral and maxillofacial surgery (OMFS) SHOs covering the out-of-hours ser vice without exceeding the constraints of EWTD. For smaller departments the choice has been either to close the on-call service and centralise it in a larger department or to have a specialty cross-cover arrangement. The problems of cross-cover might be more apparent in OMFS than in other hospital specialties due to other medical staff possessing a negligible knowledge of dental pathology.


2009 ◽  
Vol 2 (3) ◽  
pp. 134-136 ◽  
Author(s):  
Bo Parys ◽  
Sam McClinton ◽  
Graham M. Watson ◽  
Kenneth M. Anson ◽  
Neil Burgess ◽  
...  

The European Working Time Directive (EWTD) poses challenges for out of hours management of the acute urological patient. With the introduction of the “Hospital at Night” team or cross specialty cover, there may be limited onsite urological experience out of hours. One of the commonest urological emergencies is acute stone colic. For the on call team to provide a safe and quality service, the BAUS Section of Endourology has produced guidelines for the emergency management of urolithiasis.


2006 ◽  
Vol 120 (7) ◽  
pp. 587-590 ◽  
Author(s):  
S J Davis ◽  
S McDonald

Background: The implementation of the European working time directive has led to an increase in cross-speciality out-of-hours cover. This survey illustrates ENT out-of-hours cover arrangements and assesses the implications for senior house officers (SHOs) responsible for managing emergencies.Methods: A telephone survey of 100 ENT departments was conducted, asking the on-call SHO about departmental structure, on-call rota design, their previous ENT experience, access to SHO training and their confidence in managing emergencies.Results: 44 per cent of departments used only ENT SHOs on the on-call rota. 73 per cent always had an ENT middle grade on call. In 60 per cent of hospitals, the ENT consultant was sometimes on call with only a non-ENT SHO. At the time of the study, 5 per cent of SHOs had no ENT experience, no access to training, were not confident in managing simple emergencies and were on-call without middle-grade cover.Conclusion: The current junior on-call structure for ENT has implications for patient management.


2009 ◽  
Vol 91 (8) ◽  
pp. 258-259 ◽  
Author(s):  
John Black

The ill-judged introduction of the 48-hour week demanded by the European Working Time Directive (EWTD) was the first news item on every television and radio programme on Saturday 1 August, indicating just how successful the College has been in raising public concern. It was encouraging that the British Medical Association (BMA) speakers were for the first time expressing serious anxiety, largely about the effects on training and about pressure being put on junior doctors to falsify their hours returns. All conversions to the cause are welcome, however late in the day. It is disappointing that the BMA is not yet stressing the dangers to patients, which they are surely hearing about from their members working in the acute specialties.


2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Simon Schimmack ◽  
Ulf Hinz ◽  
Andreas Wagner ◽  
Thomas Schmidt ◽  
Hendrik Strothmann ◽  
...  

2006 ◽  
Vol 120 (7) ◽  
pp. 583-586 ◽  
Author(s):  
J Wasson ◽  
N Jacobsen ◽  
D Bowdler ◽  
C Hopkins

Implementation of the European Working Time Directive and the Modernising Medical Careers initiative will mean junior surgeons must be trained in fewer hours over a shorter period. For this reason, junior surgeon training opportunities must be optimized. We undertook a departmental audit to identify where opportunities to train senior house officers (SHOs) in theatre were being lost, so that appropriate timetable changes could be made in order to optimize exposure to suitable surgical cases. During the first audit cycle, the SHOs followed their existing timetable and theatre attendance was monitored prospectively over a two-week period. Only 30 per cent of theatre sessions were attended and case participation was only 27 per cent. Simple timetable changes were made to maximize SHO theatre attendance, and a second prospective two-week audit was undertaken. The new rota yielded 46 per cent theatre attendance and 48 per cent case participation.


2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent

For the last few years all the hospitals in the UK have been changing junior doctors' rotas to become compliant with the European Working Time Directive (EWTD). The first stage, requiring a junior doctor to work a maximum of 58 hours per week averaged over a 6-month period, became law in August 2004. In addition to new posts for junior doctors there have been schemes to facilitate the transition, such as the Hospital at Night programme. This was designed to use the minimum safe number of doctors from appropriate specialties with supporting medical staff to cover the hospital out of hours. It was required to make the most efficient use of this team and allow the junior doctor rotas to be compliant with the appointment of as few new posts as possible.


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