Rules limiting doctors’ hours ‘failing patients’

03 August 2010

RULES introduced last year to protect patient safety by limiting doctors’ working hours have “failed spectacularly” a new study has found.

The European Working Time Directive was introduced last August to end the culture of doctors working long hours by restricting the average working week to 48 hours.

But since it came into force, patient safety has deteriorated, with operating theatres increasingly short-staffed and less time available for essential surgical training, according to a survey by the Royal College of Surgeons (RCS). Eighty per cent of consultant surgeons and 66 per cent of surgical trainees said patients were less safe due to the EWTD.

The RCS questioned 980 consultant and trainee surgeons across the UK and found the cut in working hours has led to 61 per cent of consultants operating without assistants and two-thirds of trainees having less time for practical experience in theatre.

Sixty-five per cent of trainees said their training time has decreased while a further 45 per cent of consultants and 37 per cent of trainees reported “inadequate handovers”. And more than half of those surveyed said they frequently worked more than the allowed hours because of rota gaps.

A Department of Health spokesman said the way the directive was being applied was "clearly unsatisfactory".

RCS President John Black said surgeons not only thought patient safety was worse, but doctors' work and home lives were also poorer for it. "To say the European Working Time Regulations has failed spectacularly would be a massive understatement,” he said. “There is not a moment to lose in implementing a better system which would enable surgeons to work in teams, with fewer handovers and with the backup of senior colleagues.”

And Charlie Giddings, president of the Association of Surgeons in Training, said "new innovative solutions" were needed, "rather than the minor short-term tweaks that artificially produced compliance at the expense of training and patient care".

Howard Cottam, president of the British Orthopaedic Trainees Association, said the directive had "largely failed" and the system "remained reliant on the professional integrity of trainees who continue to cover the gaps in the rota".

A spokesman for the Department of Health said health secretary Andrew Lansley would be involved in future negotiations about the directive. He said: “The health secretary will support the business secretary in taking a robust approach to future negotiations on the revision of the European Working Time Directive, including maintenance of the opt-out.

"We will not go back to the past with tired doctors working excessive hours, but the way the directive now applies is clearly unsatisfactory and is causing great problems for health services across Europe."