Hospital at Night: Not for ENT?

The introduction of the European Working Time Directive has meant a reduction in the number of hours that junior doctors may spend at work. The impact that this legislation will have on training and the continuity of patient care may be significant. In an attempt to reduce the number of doctors required to look after patients after hours, the Hospital at Night programme has been introduced. The basis of the project is to have a team of generically skilled surgeons on call to handle emergencies and routine ward work from all surgical specialties. The reasoning behind this move is that most SHOs have sufficient training to deal with most surgical problems; any more advanced problems are to be referred to the SpR or consultant surgeon for that specialty.

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Impact of the European Working Time Directive on trainees and trainers 3 years post-implementation

The Psychiatrist ◽

10.1192/pb.bp.112.041285 ◽

2013 ◽

Vol 37 (9) ◽

pp. 286-289

Author(s):

Farshad Shaddel ◽

Subimal Banerjee

Keyword(s):

Working Time ◽

European Working Time Directive ◽

Junior Doctors ◽

Positive Effects ◽

European Working ◽

Negative Effect ◽

Negative Impacts ◽

Working Time Directive ◽

The Impact

Aims and methodTo assess the views of trainees and trainers of the impact of the European Working Time Directive (EWTD). The study was conducted in two stages. First, a qualitative survey of trainees and trainers in the Oxford Deanery was carried out on the positive and negative aspects of the EWTD to identify key areas. Second, a self-completed questionnaire was developed separately for trainees and trainers and the results collated. Twenty trainers and nineteen trainees took part in the study.ResultsAbout 70% of trainees and trainers were aware of the EWTD objectives. Ninety per cent of trainers and 30% of trainees believed that the introduction of the EWTD was a negative development. Compared with 42% of trainees, 80% of trainers believed that the EWTD had not improved the quality of care and instead had a negative effect on doctor–patient alliance and continuity of care. Although 53% of trainees believed that the quality of training was not compromised by the introduction of the EWTD, 84% of trainers thought otherwise. Less hands-on experience and some doctors' roles being given to other professionals were the most stated negative impacts of the EWTD on the quality of doctors' training. Positive effects of the EWTD from both trainees' and trainers' points of view were a better work-life balance and less burnout for junior doctors.Clinical implicationsThe EWTD may not have been successful in achieving all of its intended objectives. Further studies on different sample groups would help clarify the wider impact of the EWTD.

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Perceived impact of EWTD on UK doctors

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363509x424264 ◽

2009 ◽

Vol 91 (4) ◽

pp. 132-134 ◽

Cited By ~ 6

Author(s):

Ryckie G Wade ◽

James Henderson

Keyword(s):

Patient Care ◽

Working Hours ◽

Working Time ◽

European Working Time Directive ◽

Junior Doctors ◽

European Working ◽

Perceived Impact ◽

Working Time Directive ◽

A Current

Doctors have historically worked long hours to provide patient care but also to gain experience. Over the last decade, working hours have decreased significantly, and the introduction of the European Working Time Directive (EWTD) has formalised this. In August 2009, junior doctors (but not consultants) will be limited to a 48-hour working week (see http://www.dh.gov.uk/en/Managingyourorganisation/Huma nresourcesandtraining/Modernisingworkforceplanninghome/Europeanworkingtimedirective/index.htm). There are concerns at all levels of the profession that doctors will not be adequately trained to function at the standard of a current NHS consultant. Doctors with the least experience make the most errors and familiarity with situations and equipment is directly related to competency.

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The impact of the European Working Time Directive on surgeons' work life balance, patient care and surgical training in the UK

PsycEXTRA Dataset ◽

10.1037/e604062012-299 ◽

2012 ◽

Author(s):

Jessica Tang ◽

Alexander Harris ◽

Stavroula Leka ◽

Roger Kneebone

Keyword(s):

Patient Care ◽

Surgical Training ◽

Work Life ◽

Work Life Balance ◽

European Working Time Directive ◽

Life Balance ◽

European Working ◽

The Uk ◽

Working Time Directive ◽

The Impact

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EWTD: maintaining the pressure

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363509x470722 ◽

2009 ◽

Vol 91 (8) ◽

pp. 258-259 ◽

Cited By ~ 6

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.

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The EWTD: friend or foe to quality patient care?

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363506x148183 ◽

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.

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Surgical assistance - who can help?

Bulletin of The Royal College of Surgeons of England ◽

10.1308/rcsbull.2014.96.7.244 ◽

2014 ◽

Vol 96 (7) ◽

pp. 244-246 ◽

Cited By ~ 4

Author(s):

Susan Hall ◽

Julie Quick ◽

Andrew Hall ◽

Adrian Jones

Keyword(s):

Patient Care ◽

Surgical Training ◽

Perioperative Care ◽

Working Time ◽

European Working Time Directive ◽

Surgical Assistance ◽

European Working ◽

High Standards ◽

Working Time Directive

Changes affecting surgical training, together with the implementation of the European Working Time Directive, have necessitated increased reliance on non-medically qualified assistants. Such assistance must be performed by suitably educated personnel. The RCS, The Perioperative Care Collaborative (PCC) and The Association for Perioperative Practice (AfPP) all play a role in ensuring high standards of patient care. In so doing, they have determined the circumstances and the level at which such assistance may be given by three grades of perioperative personnel. It is essential that surgeons understand and support such non-medically qualified colleagues in adhering to these standards.

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Tomorrow's surgeon—who cares for the patient? The impact of the European working time directive

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2004.09.030 ◽

2005 ◽

Vol 40 (1) ◽

pp. 10-16 ◽

Cited By ~ 8

Author(s):

David A. Lloyd

Keyword(s):

Working Time ◽

European Working Time Directive ◽

European Working ◽

Working Time Directive ◽

The Impact

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Out-of-hours cover in oral and maxillofacial surgery

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363508x333518 ◽

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.

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