Doctors' Working Lives News
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Friday, April 30, 2004
The outlook for EWTD compliance
Hospital Doctor has a brilliant feature on EWTD which discusses the outlook for August and breaks down the issues facing different specialties.
Mentoring
BMJ Careers Focus has a useful article on mentoring for doctors.
Thursday, April 29, 2004
1 in 4 Trusts will breach EWTD in August, says RCP survey
A Royal College of Physicians survey states that "a quarter of hospitals will probably or definitely fail to meet EWTD requirements". The BBC's report on this survey suggests that "23% of hospitals in England and Wales will struggle to meet the new rules". (Only 23% will struggle? The picture's rosier than we thought....! In fact, it's more accurate to say that nearly everyone will struggle, and a quarter will probably fail.)
Tuesday, April 27, 2004
Latest research on sleep and performance
South Africa: Attention and working memory in resident anaesthetists after night duty: group and individual effects. (Bartel et al, Occup Environ Med 2004;61(2):167-70.) The study shows a significant effect on attention and memory, and the authors conclude that "The effects of sleep loss in residents cannot be overlooked, even in a relatively benign work schedule."
USA: Short-term sleep deficits do not adversely affect acquisition of laparoscopic skills in a laboratory setting. (Jensen et al, Surg Endosc 2004 Apr 21;[epub ahead of print].) The authors conclude that doctors can acquire basic skills effectively after on call, regardless of the amount of sleep disturbance.
Taiwan: Fatigue during pregnancy predicts caesarean deliveries. (Chien LY, Ko YL. J Adv Nurs. 2004 Mar;45(5):487-94) Particularly relevant to the concerns raised in BMJ Careers Focus (below). The authors conclude that "Fatigue is a significant problem for pregnant women."
(With acknowledgements to Web Sciences International and the National Center for Biotechnology Information where these abstracts are made available.)
USA: Short-term sleep deficits do not adversely affect acquisition of laparoscopic skills in a laboratory setting. (Jensen et al, Surg Endosc 2004 Apr 21;[epub ahead of print].) The authors conclude that doctors can acquire basic skills effectively after on call, regardless of the amount of sleep disturbance.
Taiwan: Fatigue during pregnancy predicts caesarean deliveries. (Chien LY, Ko YL. J Adv Nurs. 2004 Mar;45(5):487-94) Particularly relevant to the concerns raised in BMJ Careers Focus (below). The authors conclude that "Fatigue is a significant problem for pregnant women."
(With acknowledgements to Web Sciences International and the National Center for Biotechnology Information where these abstracts are made available.)
Monday, April 26, 2004
Fears over safety of pregnant junior doctors on call
BMJ Careers Focus raises serious concerns over the health and safety of pregnant junior doctors who continue to do on call in high-risk specialties.
Transfer of critically ill babies: affected by EWTD?
Concerns have been raised over the transfer of critically ill newborns, particularly in view of reductions to junior doctors' hours. Reports from Newswise and icWales.
BMJ Careers focus has a summary of pay bands. (It doesn't say anything different from us, but it has Simon Eccles's name at the bottom of it.)
BMJ Careers focus has a summary of pay bands. (It doesn't say anything different from us, but it has Simon Eccles's name at the bottom of it.)
Hutton: NHS may not be EWTD compliant in August
More on the House of Commons debate on EWTD for junior doctors. The government would only say that it was "unlikely that the whole of a trust will be not compliant". (Guardian)
Thursday, April 22, 2004
Government and BMA "to issue joint guidance to non-compliant Trusts"
The Health Minister John Hutton has met with the BMA to discuss the EWTD implementation and Trusts who will be unable to meet full EWTD compliance by 1st August 2004. The government and the BMA are looking into the possibility of issuing joint guidance on this as soon as possible.
The Tories have attacked the government on "complacency" over EWTD for junior doctors. Andrew Lansley accused the government of failing to prepare adequately for the impact of the legislation. John Hutton welcomed the overall aims of the EWTD but said that its current form would make running the NHS "immeasurably more difficult".
A Welsh GP has spoken out about potentially illegal hours when GPs are working on call. (icWales)
And in the US, the American Medical Students' Association has reacted angrily to the suggestion that hours should be increased again, less than a year after restrictions were introduced. 41% of junior doctors attribute their most serious errors to fatigue. (See also original report on potential increases to hours.)
The Tories have attacked the government on "complacency" over EWTD for junior doctors. Andrew Lansley accused the government of failing to prepare adequately for the impact of the legislation. John Hutton welcomed the overall aims of the EWTD but said that its current form would make running the NHS "immeasurably more difficult".
A Welsh GP has spoken out about potentially illegal hours when GPs are working on call. (icWales)
And in the US, the American Medical Students' Association has reacted angrily to the suggestion that hours should be increased again, less than a year after restrictions were introduced. 41% of junior doctors attribute their most serious errors to fatigue. (See also original report on potential increases to hours.)
Tuesday, April 20, 2004
Juniors "bullied into lying", says conference
The BMA's junior members forum conference has been told about juniors in Scotland "being asked to lie on hours monitoring forms", reports the Glasgow Herald. The conference also "deplored" senior staff requiring doctors to leave at the end of their shift, regardless of what they were doing.
Monday, April 19, 2004
How's the US coping with hours restrictions?
The Association of American Medical Colleges has published preliminary findings on the 80-hour work week. Surgery was the most problematic area and the 24-hour on call was the most problematic shift. No surprises there, then.....
EWTD changes in Buckinghamshire
Bucks Free Press has an article on EWTD changes at Buckinghamshire Hospitals Trust, including their "Shaping Health Services" plan.
The report also mentions the House of Lords' estimate that 7,000-10,000 new doctors will be needed to meet EWTD requirements.
The report also mentions the House of Lords' estimate that 7,000-10,000 new doctors will be needed to meet EWTD requirements.
Friday, April 16, 2004
Anxiety across Europe over EWTD
The BMJ reports on mounting political pressure over the EWTD. In particular, EU member states are highly concerned over the impact of the Jaeger ruling. The House of Lords claims that the requirement for immediate compensatory rest will make the EWTD "impossible to implement by August". The Dutch government has requested urgent action "before the summer".
Wednesday, April 07, 2004
Doctors "undervalued" / EU responds to concerns over SiMAP/Jaeger
Doctors leave the NHS because they feel undervalued, according to a BMA report out today. Problems identified include lack of support, poor work-life balance and poor working conditions. Some factors have improved, the report concludes, but others need serious intervention.
New EU commissioner Stavros Dimas has said that he recognises the EWTD will cause "practical difficulties" for the health sector, according to a BBC News report. Dimas has said that he will have some legislative proposals to deal with the fallout of the SiMAP/Jaeger rulings in the summer.
However this is unlikely to affect the August 04 EWTD deadline, and could take 2 years to implement. BMA JDC chairman Simon Eccles commented "We would like to see the government preparing for the changes rather than investing all its energy in trying to get around them."
New EU commissioner Stavros Dimas has said that he recognises the EWTD will cause "practical difficulties" for the health sector, according to a BBC News report. Dimas has said that he will have some legislative proposals to deal with the fallout of the SiMAP/Jaeger rulings in the summer.
However this is unlikely to affect the August 04 EWTD deadline, and could take 2 years to implement. BMA JDC chairman Simon Eccles commented "We would like to see the government preparing for the changes rather than investing all its energy in trying to get around them."
Tuesday, April 06, 2004
Outrage just in
Philip Johnston of the Telegraph has referred to the Jaeger ruling as "patently ridiculous", suggesting that to comply with it the NHS will need to recruit "as many as 12,000 extra doctors by 2009, at a cost of £780 million".
Does it work? New journal articles
A range of US articles have come out looking at the effect of working hours restrictions on hospital care.
The effect of house staff working hours on the quality of obstetric and gynecologic care. (Obstet Gynecol) No statistically significant effect found in this study.
Psychological well-being of surgery residents before the 80-hour work week: a multiinstitutional study. (J Am Coll Surg) Study finds that "more than one-third of general surgery residents meet criteria for clinical psychologic distress".
Regulation of junior doctors' work hours: an analysis of British and American doctors' experiences and attitudes. (Soc Sci Med) Apparently barriers to the success of the measures mean that they have had only limited success. Shock!
Resident duty hours in american neurosurgery. (Neurosurgery) Reviews the results of the US hours restrictions.
The effect of house staff working hours on the quality of obstetric and gynecologic care. (Obstet Gynecol) No statistically significant effect found in this study.
Psychological well-being of surgery residents before the 80-hour work week: a multiinstitutional study. (J Am Coll Surg) Study finds that "more than one-third of general surgery residents meet criteria for clinical psychologic distress".
Regulation of junior doctors' work hours: an analysis of British and American doctors' experiences and attitudes. (Soc Sci Med) Apparently barriers to the success of the measures mean that they have had only limited success. Shock!
Resident duty hours in american neurosurgery. (Neurosurgery) Reviews the results of the US hours restrictions.
Monday, April 05, 2004
UK: The BMA's JDC is offering support to junior doctors who are being illegally forced to opt out of EWTD.
USA: The Accreditation Council for Graduate Medical Education is considering increasing (yes, that's increasing) the maximum hours for some surgical specialties from 80 to 88.
Australia: The Medical Journal of Australia has an opinion piece on medical workforce planning including new roles and skill mix.
USA: The Accreditation Council for Graduate Medical Education is considering increasing (yes, that's increasing) the maximum hours for some surgical specialties from 80 to 88.
Australia: The Medical Journal of Australia has an opinion piece on medical workforce planning including new roles and skill mix.
Friday, April 02, 2004
"In my day....."
Great articles in this week's BMJ Career Focus include:
What doctors think about Modernising Medical Careers
A medical SHO's opinion on the new system and the good old days
Advice on swapping shifts
What doctors think about Modernising Medical Careers
A medical SHO's opinion on the new system and the good old days
Advice on swapping shifts
This site is maintained by Ellie Pattinson. All rights reserved. This website is maintained independently of the NHS and the views expressed are not necessarily a reflection of the views of that organisation. For any queries, contributions or amendments, please email me on admin@idwl.info.
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