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OCT 07/2014

Do working time laws require a rethink for those in healthcare jobs?

Healthcare professionals across the country could see changes to the way they manage their working days following a government review of the European Working Time Directive.

In their ongoing efforts to modernise and improve the way the NHS operates, the Department of Health recently carried out an assessment of the an independent review of the impact and implementation of the European Working Time Directive on the NHS and Health Professionals.

The results of the review are now being considered by the government. Its response to the findings could lead to changes in the way doctors and nurses attend training and provide care.

The review's conclusions
The purpose of the Working Time Directive is to ensure EU workers are not burdened with overly long hours. As such, they dictate that doctors and trainees are restricted to working a maximum of 48 hours per week on average over a six-month period, unless they voluntarily opt out.

To see how this worked in practice, former Royal College of Surgeons president Professor Norman Williams and a taskforce of experts examined the law's impact and implementation within the NHS. It was found that broadly speaking, it is having a beneficial impact, preventing doctors from working overly long hours that would jeopardise patient safety.

However, it also revealed that it has contributed to overly rigid shift patterns within the NHS, increasing the necessity of frequent handovers between doctors, increasing the risk of errors, while the need for enforced rest breaks can result in clinics being cancelled.

It also means that many doctors struggle to find the time to undertake training within the fixed 48-hour limit, which can be particularly problematic for staff in training-intensive specialty areas, such as surgery, who often end up needing to catch up by working longer hours voluntarily.

The government's plan
As such, the government is exploring a number of options to get around these problems. One of these possible steps will be to identify training time that could be separated from work-related activities, meaning doctors will have more opportunities to train outside of their regular duties and improve their skills.

Additionally, working patterns and rotas will be reviewed, with Health Education England set to develop a national programme that will help trusts so they can redesign staff rotas to give doctors more time to access training.

Finally, efforts will be made to raise awareness of the voluntary opt-out for those who wish to do so, and for whom it would be safe. This, again, will make it easier for doctors who require extra training to receive it.

The industry's response
Responding to the government's proposals, Professor Williams expressed satisfaction with the acceptance of his taskforce's key recommendations, as he believes the current "one-size-fits-all approach" of the Working Time Directive in medicine needs improvement.

The Royal College of Physicians also reacted positively to the findings, citing its own surveys that suggest junior doctors are dissatisfied with current training arrangements - a problem that the proposed changes could help to solve.

Meanwhile, the British Medical Association (BMA) agreed that the present state of affairs requires tweaking, but reminded the government that any reforms should not overlook or undo the positive impact the Working Time Directive has had on bringing doctors' hours down to safe levels.

Dr Mark Porter, chair of the BMA Council, said: "Patient safety and continuity of care are paramount, and safe and effective working patterns for doctors are key to delivering both." 

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