Over half of English hospitals responding to a survey are unprepared for the August 2009 48-hour per week European Working Time Directive (WTD) deadline and are running out of time. Patient safety and medical training could be compromised unless there is adequate funding and engagement from senior NHS management to see the changes through. This is the warning from new research published by the Royal College’s of Anaesthetists (RCoA) and Surgeons (RCS).
The report, entitled WTD-Implications and Practical Suggestions to Achieve Compliance, found:
- Hospital compliance with 2009 WTD is “very poor”. Only 49 per cent of anaesthetic and 42 per cent of surgical rotas in the responses to a questionnaire were within next year’s limit.
- Taking Trusts as a whole the situation is worse still – only 18 per cent of responding Trusts said all their surgery staff were meeting the target; the figure for anaesthesia was 33 per cent.
- There is no simple route to compliance – the Trusts that have been successful have each done so from a variety of starting points and with a range of different solutions.
- Of those who report they are ready, it had taken them between six to twelve months to properly plan and implement the necessary changes.
- Of those who are yet to meet the 2009 WTD requirement, less than 15 per cent report they have a costed and agreed plan to meet the deadline.
The study shows that creating a rota which ensures staff work under the 48 hour per week limit is relatively simple, but to create one which also ensures patients have good continuity of care and clinical staff get proper training is complicated. Hospitals face heavy fines every time an employee breaches the working hours limit. The report recommends a range of broad and flexible solutions that 2009 WTD compliant Trusts have adopted in reducing working hours while safeguarding quality, patient safety and training.
“If there is one lesson to be drawn from the data presented in this report it is that getting working hours down while offering proper, safe patient care and retaining medical training is not straightforward and takes time,” said Royal College of Surgeons President, John Black. “With the deadline looming, surgeons and anaesthetists are worried that NHS Trusts will be tempted to simply cobble together rotas that fit the law but don’t take proper account of night-time staffing, ensure patients have as few handovers as possible or provide junior doctors with the varied training needed to give us the consultants of tomorrow.”
“The most important message to get across is that compliance requires full engagement of senior management to provide a strong clinical governance lead, adequate resources and recognition of the value of maintaining standards of teaching,” said Dr Anne Thornberry, WTD Council lead for the Royal College of Anaesthetists.
Sue Dean, director, Workforce Projects Team said, “ The report highlights some of the challenges trusts face in complying with WTD 2009, but it also show that the challenges can be and have been met. You can see the evidence and take learning from the many best practice examples on the healthcare workforce portal. With only nine months to go to next year’s deadline, using tried and tested solutions are a practical way forward.”
The project was managed jointly by a team from the two medical Royal Colleges and is funded by the Skills for Health - Workforce Projects Team. Copies of WTD-Implications and Practical Suggestions to Achieve Compliance will be going to clinical leads and senior NHS managers throughout the health service and will be available on both the College websites and the healthcare workforce portal: http://www.healthcareworkforce.nhs.uk/.
Notes to Editors
1. The Royal College of Surgeons of England is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care. Registered charity number: 212808. For more information please visit www.rcseng.ac.uk.
2. If you have any queries please contact:
Matthew Worrall – Email: email@example.com; T: 020 7869 6047
Elaine Towell – Email: firstname.lastname@example.org; T: 020 7869 6045
Out-of hours: 07966 486 832