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.

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.

scholarly journals Perceived impact of EWTD on UK doctors

2009 ◽  
Vol 91 (4) ◽  
pp. 132-134 ◽  
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.

scholarly journals Hospital at Night: Not for ENT?

2006 ◽  
Vol 88 (4) ◽  
pp. 134-136 ◽  
Author(s):  
DD Pothier ◽  
S Ahluwalia ◽  
P Monteiro
Keyword(s):  
Patient Care ◽  
Continuity Of Patient Care ◽  
Working Time ◽  
European Working Time Directive ◽  
Junior Doctors ◽  
Consultant Surgeon ◽  
European Working ◽  
After Hours ◽  
Working Time Directive ◽  
The Impact

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.

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.

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.

Surgical assistance - who can help?

2014 ◽  
Vol 96 (7) ◽  
pp. 244-246 ◽  
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.

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.

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