scholarly journals Service innovation: psychiatrists on call – the community at night

2007 ◽  
Vol 31 (2) ◽  
pp. 65-67
Author(s):  
Laurence Mynors-Wallis ◽  
Denise Cope
Keyword(s):  
Medical Care ◽  
New Deal ◽  
Health Professionals ◽  
Service Innovation ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
European Working ◽  
Working Time Directive ◽  
The New Deal

There have been significant changes in the provision of medical care in hospitals at night. The initial catalyst for this was the New Deal for Junior Doctors but more recently the European Working Time Directive requiring doctors' hours to be reduced to 56 in 2002 and to 48 by 2009. The reduced availability of junior doctors in hospitals at night has had a range of implications, including the necessity to train other health professionals to do work previously undertaken by doctors and a reduction in the number of specialist doctors available out of hours. The expectation is that staff in the hospital at night will be equipped to deal appropriately and safely with emergency work across specialties, rather than each specialty covering their own patients.

Are patients happy with SCPs operating?

2006 ◽  
Vol 88 (3) ◽  
pp. 101-103 ◽  
Author(s):  
R Moorthy ◽  
J Grainger ◽  
A Scott ◽  
JW Powles ◽  
SG Lattis
Keyword(s):  
New Deal ◽  
Junior Doctors ◽  
Process Of Change ◽  
Out Of Hours ◽  
European Working ◽  
Shift Pattern ◽  
Full Shift ◽  
Working Day ◽  
Working Time Directive ◽  
The New Deal

The traditional model of surgical service is in the process of change. Classically, a consultant surgeon would have the services of an SpR, staff and associate specialist (SAS) and SHO in clinic and theatre. The implementation of the New Deal and the European Working Time Directive has led to a significant reduction in the number of hours worked by junior doctors. Consequently, nearly all SHOs are working a full-shift pattern and most SpRs are moving onto full-shift rotas to ensure out-of-hours service is maintained. This reduction in the number of junior doctors available during the normal working day has increased the development of extended roles for non-medical professionals.

scholarly journals The EWTD: friend or foe to quality patient care?

2006 ◽  
Vol 88 (9) ◽  
pp. 318-319
Author(s):  
MBS Brewster ◽  
R Potter ◽  
D Power ◽  
V Rajaratnam ◽  
PB Pynsent
Keyword(s):  
Patient Care ◽  
Medical Staff ◽  
Junior Doctor ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Quality Patient Care ◽  
European Working ◽  
The Uk ◽  
Working Time Directive

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.

Out-of-hours cover in oral and maxillofacial surgery

2008 ◽  
Vol 90 (8) ◽  
pp. 282-283
Author(s):  
G Reddy-Kolanu ◽  
M Ethunandan ◽  
R Anand ◽  
V Ilankovan
Keyword(s):  
Medical Staff ◽  
Maxillofacial Surgery ◽  
Working Time ◽  
European Working Time Directive ◽  
Oral And Maxillofacial Surgery ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Dental Pathology ◽  
European Working ◽  
Working Time Directive

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.

scholarly journals SHO clinical exposure following the introduction of an EWTD-compliant shift system

2006 ◽  
Vol 88 (7) ◽  
pp. 238-239
Author(s):  
HK Khan ◽  
H Hathurusinghe ◽  
F Wilson ◽  
MI Trotter ◽  
VV Raut
Keyword(s):  
New Deal ◽  
Working Time ◽  
European Working Time Directive ◽  
Clinical Exposure ◽  
The Past ◽  
European Working ◽  
Hours Of Work ◽  
The Hours ◽  
Working Time Directive ◽  
The New Deal

Over the past 12 years the hours of work for doctors' training have been markedly reduced. In 1991 the New Deal and a maximum of 72 hours per working week was first introduced. 1 In 1998 the European Working Time Directive (EWTD) came into effect but did not initially apply to doctors in training. By August 2004 all doctors in training came under the remit of the EWTD, which stipulated a maximum of 58 hours per working week.

Effect of changing work patterns on ENT training in a UK district general hospital

2007 ◽  
Vol 89 (6) ◽  
pp. 220-221 ◽  
Author(s):  
RL Heywood ◽  
PM Patel ◽  
J Hern
Keyword(s):  
New Deal ◽  
Quality Care ◽  
District General Hospital ◽  
Work Patterns ◽  
Out Of Hours ◽  
European Working ◽  
Call System ◽  
The Hours ◽  
Working Time Directive ◽  
The New Deal

The New Deal in 1991 and the extension of the European Working Time Directive (EWTD) to doctors in training in 2004 were intended to improve working conditions for juniors and to ensure quality care for patients by limiting the hours worked. Their implementation forced Trusts to introduce radical changes to the established resident on-call system, including shift work and cross cover of specialities to maintain out-of-hours cover in specialities where on-site residence is required.

scholarly journals EWTD: maintaining the pressure

2009 ◽  
Vol 91 (8) ◽  
pp. 258-259 ◽  
Author(s):  
John Black
Keyword(s):  
Medical Association ◽  
Working Time ◽  
European Working Time Directive ◽  
News Item ◽  
Junior Doctors ◽  
Public Concern ◽  
European Working ◽  
Working Time Directive ◽  
First Time ◽  
Radio Programme

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.

The changing role of the otolaryngology Senior House Officer

2006 ◽  
Vol 88 (2) ◽  
pp. 66-68 ◽  
Author(s):  
AK Arya ◽  
KP Gibbin
Keyword(s):  
Patient Safety ◽  
Junior Doctor ◽  
House Officer ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Senior House Officer ◽  
European Working ◽  
Working Time Directive ◽  
Changing Role

The European Working Time Directive (EWTD) has led to a reduction in the number of hours that a junior doctor is allowed to work. The Hospital at Night project aims to reduce juniors' presence at night through more efficient working. Otolaryngology has been considered to be one of the surgical specialties in which generic junior doctors covering more than one specialty could effectively function. The hope is to reduce junior doctors' hours sufficiently without compromising their training or patient safety.

The Lost Generation: Impact of the 56-hour EWTD on Current Surgical Training

2010 ◽  
Vol 92 (3) ◽  
pp. 102-106 ◽  
Author(s):  
CR Chalmers ◽  
S Joshi ◽  
PG Bentley ◽  
NH Boyle
Keyword(s):  
Shift Work ◽  
Surgical Training ◽  
New Deal ◽  
Working Hours ◽  
Lost Generation ◽  
Surgical Trainees ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
The New Deal

The reform of specialist surgical training – the New Deal (1991), the Calman report (1993) and the implementation of the European Working Time Directive (EWTD, 1998) – has resulted in shorter training periods with reduced working hours. The Calman reform aimed to improve and structure training with regular assessment and supervision whereas the New Deal and the EWTD have concentrated predominantly on a reduction in hours. The adoption of full or partial shift work to provide surgical cover at night compliant to a 56-hour working week, as stipulated by phase one of the EWTD, has resulted in daytime hospital attendance for surgical trainees of an average three days per week despite almost universal acknowledgement of the limited training opportunities available at night.

scholarly journals Working time regulations and the new deal

2009 ◽  
Vol 5 (11) ◽  
pp. 339-342
Author(s):  
Michael Bird
Keyword(s):  
New Deal ◽  
Working Time ◽  
Junior Doctors ◽  
Clinical Services ◽  
University Hospitals ◽  
The Hours ◽  
The University ◽  
Working Time Directive ◽  
The New Deal ◽  
And Training

The Working Time Directive (WTD) has now been applied to limit the hours worked by junior doctors. Can the University Hospitals of Morecambe Bay Trust (UHMBT) rise to the challenge of implementing this directive for consultant staff while maintaining clinical services and training? This summary of the WTD (see below) is taken from the Trust’s newsletter, published as the Weekly News, and edited by Rachael Whitaker, whose contribution we acknowledge. The Journal has adapted the document to fit the consultant contract: is it achievable for consultants? The Journal asked Mike Bird, a member of the Local Negotiating Committee for Consultants.

scholarly journals Surgical training and EWTD – can it be done?

2007 ◽  
Vol 89 (6) ◽  
pp. 206-209 ◽  
Author(s):  
WH Allum ◽  
NI Markham
Keyword(s):  
Surgical Training ◽  
Working Time ◽  
European Working Time Directive ◽  
Training And Education ◽  
Out Of Hours ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
Postgraduate Surgical Training

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.

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