scholarly journals Hospital at Night and the surgical middle grade: An Observational Study from a District General Hospital

2006 ◽  
Vol 88 (1) ◽  
pp. 24-26 ◽  
Author(s):  
SR Aspinall ◽  
DM Bradburn ◽  
SJ Mills
Keyword(s):  
Observational Study ◽  
General Hospital ◽  
New Deal ◽  
Emergency Surgery ◽  
Cumulative Effect ◽  
District General Hospital ◽  
Middle Grade ◽  
European Working ◽  
Working Time Directive ◽  
The New Deal

The cumulative effect of Calmanisation, the New Deal, the European Working Time Directive (EWTD) and the Jaeger and SiMAP rulings has been to reduce trainees' exposure to emergency surgery. The Hospital at Night project has been designed to create a generic team of doctors to maximise the number of doctors available for any task by removing boundaries between teams. This project is currently being piloted in a number of centres around the country, including Wansbeck General Hospital (WGH) a 323-bed district general hospital (DGH) serving a population of 240,000 in Northumberland.

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.

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.

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 Universal SHO and SpR shift rotas adversely influence SHO operative experience

2006 ◽  
Vol 88 (7) ◽  
pp. 244-246 ◽  
Author(s):  
C Beaton ◽  
MR Stephens ◽  
AN Hopper ◽  
WG Lewis
Keyword(s):  
General Hospital ◽  
Shift Work ◽  
Clinical Experience ◽  
Surgical Training ◽  
General Surgery ◽  
District General Hospital ◽  
European Working ◽  
Training Post ◽  
Operative Experience ◽  
Working Time Directive

The European Working Time Directive (EWTD) will reduce the clinical experience obtained by surgeons prior to attaining consultant status from 21,000 surgical hours to 7,640 hours, 1 with shift work obligatory for compliance. We have shown previously that the operative experience of SHOs in general surgery is on the wane in our own hospital, varies with subspecialty interest 2 and has witnessed further erosion by the introduction of the EWTD. 3 The aim of this study was to assess the influence of an all tier shift rota on the emergency and elective operative experience of SHOs in a category 1 general surgical training post working in a large district general hospital serving a population of 600,000.

scholarly journals Comparison of SHO surgical logbooks a generation apart

2009 ◽  
Vol 91 (10) ◽  
pp. 356-359 ◽  
Author(s):  
RL Thomas ◽  
N Karanjia
Keyword(s):  
New Deal ◽  
Working Conditions ◽  
Working Hours ◽  
Improve Working ◽  
Department Of Health ◽  
European Working ◽  
Current Concern ◽  
Operative Experience ◽  
Working Time Directive ◽  
The New Deal

There is current concern regarding operative experience obtained by senior house officers (SHOs) during basic surgical training prior to beginning registrar level. Anecdotally, working hours are greatly reduced compared to 20 years ago. The reduction in experience is attributed to the New Deal, which was introduced by the Department of Health in 1991 to improve working conditions for doctors, primarily through reduction of working hours to 76 per week maximum by 1996. In addition, Calmanisation, ie the introduction of the specialist trainee registrar grade of training, and the recent introduction of the European Working Time Directive (EWTD) have both had an effect on juniors' working hours.

Changing times? Doctors' sick leave in a district general hospital

2008 ◽  
Vol 90 (4) ◽  
pp. 130-132
Author(s):  
DJ Duffy ◽  
L Jeys ◽  
NJ London
Keyword(s):  
General Hospital ◽  
Medical Staff ◽  
Career Guidance ◽  
District General Hospital ◽  
Junior Doctors ◽  
Firm Structure ◽  
Junior Staff ◽  
European Working ◽  
Changing Times ◽  
Working Time Directive

Most junior doctors now work shifts to comply with the European Working Time Directive (EWTD) and the New Deal. Increasingly there has been general concern among senior medical staff that this has undermined the traditional medical team or 'firm' structure. The effect of this has been witnessed most acutely with the fragmentation of many units, with lead clinicians often struggling to develop and foster a working relationship with their junior staff. The net effect has been a loss of clear line management, team support and in some cases, career guidance. As a result an increase in absenteeism in junior doctors has been perceived to occur. This study set out to investigate the rates of such absenteeism among medical staff in a district general hospital.

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.

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 668 The Consequences to Emergency Surgery During COVID19 Pandemic in a UK District General Hospital in The North East of England

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Evans ◽  
C Ng
Keyword(s):  
Surgical Treatment ◽  
General Hospital ◽  
Emergency Surgery ◽  
Early Identification ◽  
District General Hospital ◽  
Public Confidence ◽  
Surgical Services ◽  
North East ◽  
The North ◽  
Initial Reduction

Abstract Aim COVID19 pandemic has significantly affected surgical services. We aim to review its effects on our theatre output and risk of encountering COVID 19 cases. Method Serial record of operations performed locally were reviewed from start of UK COVID19 pandemic lockdown on 23rd March 2020 to 13th July 2020 after it was lifted. A weekly average by month of operations and the percentage of COVID19 cases diagnosed within 30 days of the procedure were noted. Results 733 operations performed through this period. In March, 33 operations/week performed, 88.4% emergency and 7% diagnosed with COVID19. April, 31 operations /week performed, 95.9% emergency and 10.6% diagnosed with COVID19. May 46 operations /week performed, 94.5% emergency and 3.3% diagnosed with COVID19. June 56 operations /week, 80.9% emergency and less than 0.01% diagnosed with COVID19. By July 80 operations/week, 59.4% emergency and none diagnosed with COVID 19. Since testing capacity increased, only 6 of the 27 operated were diagnosed with COVID19. Conclusions There was initial reduction to non-emergency workload. However, this has gradually shifted as protocols are in place improve public confidence to return for surgical treatment. Mandatory admission testing allows early identification and remains essential for planning of services and protecting the workforce.

Sign in / Sign up

Export Citation Format

Share Document