We received a petition asking:
“We the undersigned petition the Prime Minister to listen to the voice of the surgical profession and elected patient groups in allowing surgeons the flexibility to work hours in excess of the European Working Time Directive.”
Details of Petition:
“From August 2009, it will become illegal for NHS Surgeons to work more than 48 hours per week. As a result, continuity of care and access to training opportunities for surgeons in training will be severely affected with potentially disastrous outcomes for quality of care and patient safety. Stark warnings about this impending crisis have been issued by the Surgical Royal Colleges, the surgical trainee bodies and by elected patient representatives, with evidence that care is already being compromised. The profession is best placed to advise on optimising patient safety and we would urge the Prime Minister to consider urgent changes to UK legislation, to allow the modest increase in working hours, to a maximum of 65 hours per week, which is required to maintain a first rate standard of care for NHS patients.”
· Read the petition
· Petitions homepage
Read the Government’s response
The European Working Time Directive (EWTD) is health and safety legislation introduced in 1998. It will benefit patient safety and the wellbeing of those healthcare professionals who treat and care for them. By complying with the EWTD average 48-hour working week averaged over 26 weeks, we can ensure we have well-rested doctors who make good use of their training time and provide high-quality care for their patients. No one wants or deserves to be treated by a tired doctor who may make mistakes. Implementation of the Directive means that all NHS staff can enjoy a sensible work-life balance.
Junior doctors in training are the only group within the NHS whose working hours are not yet fully compliant with the EWTD. There have been reductions in maximum average hours to 58 hours in 2004, to 56 hours in 2007 and finally to 48 hours by 1 August 2009.
NHS North West is demonstrating that EWTD compliance can be achieved consistent with the provision of effective services and training. By October 2008, about 95 per cent of doctors in the North West and 36 out of 38 organisations were compliant, a year ahead of the 2009 requirement. Most UK doctors in training already comply with the EWTD, and the overwhelming majority will do so by 1 August this year.
We recognise that EWTD has meant challenges. We have listened to and acted upon concerns raised, for example through many surveys, conducted at different times. We appointed Dr Wendy Reid from the London Deanery as national EWTD Clinical Advisor. We have also established a EWTD Reference Group co-chaired by Dr Judith Hulf, President of the Royal College of Anaesthetists, and Professor Patricia Hamilton, Director of Medical Education at the Department of Health. The Reference Group includes the British Medical Association (BMA), the Royal Colleges, Strategic Health Authorities (SHAs) and the Deaneries. In addition, there is a task and finish and steering group.
In January 2009, we notified the European Commission of our intention to derogate so that those services at risk of non-compliance on 1 August, that is, round-the-clock emergency patient care, supra-specialists (specialists who cover wide geographical areas, for example in neurosurgery and paediatrics), and some services in rural remote parts of the country, would be given additional support to embed sustainable solutions and practices. The services were identified through a rigorous assurance process agreed by the Royal Colleges, the BMA, NHS Employers and SHAs. The applications were scrutinised by an independent panel chaired by Dr Hulf. Those services recommended for derogation now inform the Statutory Instrument that will amend the working time regulations on 1 August.
The assurance process and reporting mechanisms will continue until at least December 2009. If further support is needed to sustain services then we can consider further derogation. While utilising this time-limited derogation, the UK reaffirms its absolute commitment to enabling all doctors in training to work and train safely, in full compliance with the EWTD.
It is the quality of training that needs to be considered, and for this reason, a review of junior doctors’ training in a 48-hour working week will be undertaken. Sir Christopher Edwards, Chairman of Medical Education England, has written to the Secretary of State for Health with proposals to take this forward. This is being considered and the Secretary of State will respond in due course.
There is no evidence that training is any less effective since the gradual reduction in junior doctors’ hours over the last ten years. The number of those who fail training has remained static. The new competency-based system that the Royal College of Surgeons pioneered ensures that junior doctors progress as they demonstrate the competencies required.
The NHS Workforce Census issued in 2009 highlighted significant increases in consultants and doctors in training. There are 34,910 consultants, which shows an increase of 3.7 per cent on the previous year and represents a 56.4 per cent increase over ten years. The overall number of doctors in training is 49,178, an increase of 5.1 per cent from last year and 59.4 per cent compared with ten years ago. There are more doctors than ever working in the NHS.
The Government has also provided funding by including £110million in allocations to Primary Care Trusts in England in 2008/09 to help support NHS compliance with the EWTD. This has been increased to £310million for 2009/10 and includes £50million to support changes needed for specialties such as paediatrics, obstetrics and anaesthetics.
Finally, the Health Select Committee’s report on patient safety said, of EWTD and the Working Time Directive rules, that the Committee was not convinced by the more alarmist claims being made that these will seriously jeopardise patient safety when they are introduced on 1 August. The Committee consulted with a wide range of stakeholders in coming to its conclusions.
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