Working Time Directive may put ‘lives at risk’
The adoption of the European Working Time Directive into the NHS may put both doctors’ and patients’ lives at risk, according to an editorial in the British Medical Journal.
The WTD was implemented for doctors in training in the NHS in August 2004. Junior doctors’ hours are now limited to a shift of no more than 13 hours, followed by a break of at least 11 hours.
The BMJ argues that this has led to a fundamental shift in junior doctors’ work patterns, from providing on-call cover to working in shifts.
It suggests that more than 75 per cent of senior house officers (SHOs) were working seven consecutive night shifts when surveyed in December, with many other ranks working multiple night shifts. Many doctors are working up to 91 hours during the night in one week.
These doctors are “exhausted”, the editorial argues and suggests that studies in America show that the rate of serious medical errors leaps when working over 65 hours a week.
The BMJ also argues that the risk of a crash whilst commuting to work is increased by 16 per cent when working these shifts.
And the paper argues that the risks increase exponentially with each consecutive night shift worked.
It calls for staffing patterns to be reassessed and staff scheduled for only a single or double nightshift, with a scheduled two-hour sleep break during the night.
Simon Eccles, chairman of the BMA’s junior doctors’ committee, said that it supported many of the report’s recommendations.
Mr Eccles said: “The problem is not necessarily the Working Time Directive itself, but the way hospitals have responded to it. With the same workload, and less time in which to do it, some trusts have introduced working patterns made up of serial night shifts.
“For many junior doctors, this has meant more intense and antisocial rotas, less sleep and a lower quality of training. But moving everyone onto shifts isn’t the only way to deal with the problems thrown up by the working time directive. In trusts where work is organised more efficiently – for example by cutting junior doctors’ administrative workload and introducing a more team-based approach – patient safety has improved.”
In addition, he added that trusts should stop removing doctors’ on-call accommodation.
