Doctors' Working Lives News
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Wednesday, August 17, 2005
EWTD - DH consultation on proposed changes
The Department of Health is consulting on the European Commission's proposed changes to the EWTD.
These changes include a change to the definition of the workplace (possibly to include the home), the exclusion of "inactive on call time" from both rest and work calculations, and a more flexible approach to compensatory rest - all highly critical issues in junior doctors' working patterns. The DH is seeking comments on each of these proposed changes.
One area which is worth considering is the extended definition of the workplace, coupled with the proposal that "inactive on call time" should not count as rest. What does this mean for non-resident on call doctors - will they still get their 11 hours rest overnight?
Please read the DH consultation paper and respond if you can. All comments should be sent to Jeremy Orr at NHS Employers.
Hospital at Night has improved patient care, says new report
A report just published says that H@N has improved patient care. A press articl states that H@N has:
* Helped improve patient care during the night by prioritising acutely ill patients, and ensures that patients are treated more quickly and are seen by doctors who are more alert
* Had no negative impact on doctors training
* Not affected the achievement of national performance targets in the areas of A&E waiting times, cancelled operations and inpatient waiting times. (Noticias.info)
This is also reported as an EWTD having a positive impact on hospital care (epolitix.com).
Related to this, in BMJCF article Bridging the orthopaedic gap, Dr Toby Briant-Jones explains how he went to Australia to gain valuable experience between SHO and first year SpR posts. It's particularly interesting because his Australian placement was a 1 in 3 non-resident on call with up to 100-hour weeks, but a different method of compensation.
However, a new piece of research provides more evidence that long hours are a risk to health (BBC News).
Germany: Doctors strike over pay and long hours, comparing their conditions unfavourably with that of UK doctors. (Deutsche Welle)
Queensland, Australia: Forster Report finds 30% of hospital staff are regularly bullied, and patient safety compromised by factors including "poor supervision of junior doctors and long working hours". (Sydney Morning Herald)
General advice for doctors
Tips on starting a new junior hospital job (BMJCF) - another one worth printing out and distributing to all new F1s. And note tip 6: "You need to take breaks to stay safe. Try not to feel guilty about keeping patients waiting while you carry out this essential activity." Perhaps this should go to every new starter.
How to ensure your CV is unsuccessful (BMJCF)
Tips on marking a patient for surgery (BMJCF)
BMJ Career Focus has a special edition on Interviews.
Research - Shift Work Sleep Disorder
Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder (NEJM) Shows a small but significant effect in improving wakefulness. However....
Shift Work Sleep Disorder - The glass is more than half empty (NEJM) ...this article criticises flaws in the Modafinil study, and emphasises that it is not an adequate solution in itself. Author Robert C. Basner notes: "Safety risks associated with shiftwork sleep disorder have been shown to accrue over the increasing length of shifts, as well as length of time working these shifts, whereas such risks can decrease almost linearly over the course of a single night shift" - aspects not addressed by this study.
Patient safety
A basic guide to patient safety (BMJCF)
PDAs - improving patients' safety (BMJCF)
Fifteen minutes with... a paediatrician with a passion for patient safety (BMJCF)
The FT has an article on patient safety at August house change.
0 Comments:
These changes include a change to the definition of the workplace (possibly to include the home), the exclusion of "inactive on call time" from both rest and work calculations, and a more flexible approach to compensatory rest - all highly critical issues in junior doctors' working patterns. The DH is seeking comments on each of these proposed changes.
One area which is worth considering is the extended definition of the workplace, coupled with the proposal that "inactive on call time" should not count as rest. What does this mean for non-resident on call doctors - will they still get their 11 hours rest overnight?
Please read the DH consultation paper and respond if you can. All comments should be sent to Jeremy Orr at NHS Employers.
Hospital at Night has improved patient care, says new report
A report just published says that H@N has improved patient care. A press articl states that H@N has:
* Helped improve patient care during the night by prioritising acutely ill patients, and ensures that patients are treated more quickly and are seen by doctors who are more alert
* Had no negative impact on doctors training
* Not affected the achievement of national performance targets in the areas of A&E waiting times, cancelled operations and inpatient waiting times. (Noticias.info)
This is also reported as an EWTD having a positive impact on hospital care (epolitix.com).
Should surgeons be able to work longer hours?
New RCS President Bernie Ribeiro says that trainee surgeons should be able to opt out of the EWTD (Telegraph).Related to this, in BMJCF article Bridging the orthopaedic gap, Dr Toby Briant-Jones explains how he went to Australia to gain valuable experience between SHO and first year SpR posts. It's particularly interesting because his Australian placement was a 1 in 3 non-resident on call with up to 100-hour weeks, but a different method of compensation.
However, a new piece of research provides more evidence that long hours are a risk to health (BBC News).
Other news
World newsGermany: Doctors strike over pay and long hours, comparing their conditions unfavourably with that of UK doctors. (Deutsche Welle)
Queensland, Australia: Forster Report finds 30% of hospital staff are regularly bullied, and patient safety compromised by factors including "poor supervision of junior doctors and long working hours". (Sydney Morning Herald)
General advice for doctors
Tips on starting a new junior hospital job (BMJCF) - another one worth printing out and distributing to all new F1s. And note tip 6: "You need to take breaks to stay safe. Try not to feel guilty about keeping patients waiting while you carry out this essential activity." Perhaps this should go to every new starter.
How to ensure your CV is unsuccessful (BMJCF)
Tips on marking a patient for surgery (BMJCF)
BMJ Career Focus has a special edition on Interviews.
Research - Shift Work Sleep Disorder
Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder (NEJM) Shows a small but significant effect in improving wakefulness. However....
Shift Work Sleep Disorder - The glass is more than half empty (NEJM) ...this article criticises flaws in the Modafinil study, and emphasises that it is not an adequate solution in itself. Author Robert C. Basner notes: "Safety risks associated with shiftwork sleep disorder have been shown to accrue over the increasing length of shifts, as well as length of time working these shifts, whereas such risks can decrease almost linearly over the course of a single night shift" - aspects not addressed by this study.
Patient safety
A basic guide to patient safety (BMJCF)
PDAs - improving patients' safety (BMJCF)
Fifteen minutes with... a paediatrician with a passion for patient safety (BMJCF)
The FT has an article on patient safety at August house change.
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