The implementation of the European Working Time Directive (EWTD) in the NHS has had an adverse impact on training in certain medical specialties, including surgeons and doctors working in acute medicine, says an independent taskforce, commissioned by the Government.
The taskforce found that although some groups of doctors are able to receive the training they need within the 48-hour week, it is very challenging for others. In certain specialties, doctors work longer hours voluntarily to gain the skills they need and deliver the care they believe their patients require.
There is some evidence that the NHS could benefit from the better spread of good practice in the design of working rotas to help both staff and patients. The taskforce recommends:
• That the NHS should review best practice in the design of working practices, and share examples of the successful delivery of patient care and the training of junior doctors.
• The specific challenges faced by some specialties should be addressed in further work.
• The lack of flexibility brought about by the court judgments is tackled, while ensuring doctors don’t suffer undue fatigue.
• The possibility of creating protected education and training time for junior doctors should be explored.
• More consideration should be given to encourage wider use of the right for individual doctors to opt out of the current restricted hours.
Commenting on the taskforce findings, Professor Norman Williams, president of the Royal College of Surgeons and chair of the taskforce, said: “We are all committed to providing excellent training, fair employment practices and the highest quality of patient care. We also agree that it would be undesirable to return to the old days when doctors worked excessively long hours. However, the inflexibility of the directive is having deleterious effects on training and patient care in some specialties and there is a need for solutions. One option which deserves further exploration might be to separate the training and education of trainee doctors from their work on the wards. This will help strike the right balance between delivering patient care and ensuring that junior doctors are able to acquire the knowledge and skills they need to become
