The UK Department of Health has ordered National Health Service hospitals to make concerted efforts to reduce the number of hours being worked by trainee doctors. The hospitals have been given 18 months to comply with the European Working Time Directive, which is being extended to junior doctors by August 2004. By then, their average work week must be reduced to 58 hours.
Current government guidelines are well within this target, with trainee doctors being contracted to work a maximum of 56 hours per week as of this August. Tough action is now being taken to enforce the new plan — a hospital trust in Scotland is set to lose 4 training posts after continually failing to come up with staff rotas that comply with the new ceiling.
Solutions suggested by the Department of Health include new working patterns, cross cover between related specialties, and the use of other health professionals; £7 million is being spent on pilot projects to conduct a baseline assessment of the impact of the directive.
The Royal College of Physicians welcomed the new guidelines, saying that they “recognized the very real problems” facing small hospitals “that need to provide high-quality in-patient service for acutely ill medical patients yet have few doctors — juniors or consultants. There are many emergencies where only immediate help from a skilled doctor is appropriate.”
Although the Academy of Medical Royal Colleges also supports the aims of the proposals, it drew attention to potential pitfalls, including the dependence on doctors-in-training to deliver care and the reduction in training time available to them. — Cathel Kerr, Fife, Scotland