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 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 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 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.

An In-House Course for First Assistants (Advanced Scrub Practitioners) in Theatres

2005 ◽  
Vol 15 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Sarah Turner ◽  
Sarah McLaughlan
Keyword(s):  
General Hospital ◽  
Operating Room ◽  
Medical Staff ◽  
Working Time ◽  
European Working Time Directive ◽  
Training Package ◽  
European Working ◽  
Working Time Directive

It has become commonplace to see theatre practitioners undertaking the role of the first assistant to the surgeon in the absence of medical staff in the operating room (Martin 2004). At Kettering General Hospital we have devised, implemented and are in the process of evaluating a first assistant training package to facilitate a solution to the increasing problems arising from the challenges of the European Working Time Directive.

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.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

scholarly journals Near-misses and Missed Opportunities: Poor Patient Handover In General Surgery

2008 ◽  
Vol 90 (3) ◽  
pp. 96-98 ◽  
Author(s):  
M Tokode ◽  
L Barthelmes ◽  
B O'Riordan
Keyword(s):  
General Surgery ◽  
Working Hours ◽  
Junior Doctors ◽  
Learning Potential ◽  
Missed Opportunities ◽  
Near Misses ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Patient Handover

Since the introduction of shift systems for junior doctors as part of the European Working Time Directive, different teams of doctors look after patients over the course of a day. This requires ro bust handover mechanisms to pass on inf ormation between differ ent teams of doctors to avoid misses and near-misses in patients' care. Modernising Medical Careers shortens the placements of doctors in foundation programmes in general surgery to four months compared with six-month placements as pre-registration house officers in the past. The reduction in working hours will therefore adv ersely aff ect exposur e and experience of junior doctors in general surg ery unless the learning potential of time spent at work is maximised.

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 Establishing a District Psychiatric Service without Psychiatric Trainees

1986 ◽  
Vol 10 (12) ◽  
pp. 338-340 ◽  
Author(s):  
D. G. Kingdon ◽  
T. K. Szulecka
Keyword(s):  
General Hospital ◽  
Social Services ◽  
Early Development ◽  
Royal College ◽  
Medical Staff ◽  
Psychiatric Service ◽  
District General Hospital ◽  
Short Report ◽  
House Of Commons ◽  
The Social

The Report of the Social Services Committee of the House of Commons in 1981 (the ‘Short Report’) recommended the establishment of consultant posts without the support of trainee medical staff as part of a strategy to correct the situation where too many doctors occupied training posts for the number of consultant posts available.1 The Royal College of Psychiatrists has endorsed this policy,2 and the withdrawal of approval for training from an increasing number of hospitals around the country is leading rapidly to a situation where a large number of them need to look at alternative arrangements for providing medical cover. We would like to report the establishment and early development of such an arrangement based in a district general hospital.

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