Understaffing crisis sparked by EWTD

19 March 2010

ALMOST half of UK junior doctors work in understaffed teams because of the European Working Time Directive, according to a new BMA survey.

More than 1500 junior doctors responded to the survey which examined the impact of the introduction of a 48-hour working week. Four out of 10 doctors said they were working on teams that do not have enough people. A&E was the hardest hit with six out of 10 doctors saying their team was short of staff.

Seven out of 10 rota vacancies reported were for doctors who have completed their foundation training but four out of 10 were for experienced specialist trainees.

Results also showed almost half of UK junior doctors are missing out on vital training because of understaffing. BMA leaders fear staff shortages and missed training will have a negative effect on patient care.

Dr Shree Datta, Chairman of the BMA's Junior Doctor Committee said: “In August last year the Department of Heath declared that rota gap vacancies accounted for only two per cent of posts yet, six months on, our survey paints a very different picture. It is clear that it is an everyday experience for junior doctors to be working on inadequately staffed rotas.

“Given that inadequate staffing levels have been identified as a major factor in the delivery of substandard care – it is essential for patient safety that this problem is taken seriously."

A total of 14,754 junior doctors were sent an electronic questionnaire in December 2009 asking them how the EWTD has affected their job. Replies were sent in by 1567 doctors – or five per cent of junior doctor BMA members.

Three-quarters blamed time restrictions for missing lectures and training days while six out of 10 had missed out on supervision and opportunities to complete new procedures. Two in five juniors said they felt the need to work during their time off to complete enough formal training to do their jobs.

The 48-hour week has caused difficulties for a number of hospitals across the UK since it was introduced in August, with many reporting staffing problems.

Dr Datta added: “Clearly many hospitals are struggling to cope with the introduction of the 48-hour week. Running understaffed rotas cannot be the answer. Hospitals need to look more closely at how they organise their rotas. They need to look at reducing unnecessary bureaucracy and inappropriate work so that healthcare teams can offer patients the high quality care they deserve.

“The government needs to face the cold realities of our survey and work with the profession to address the understaffing epidemic.”

A Department of Health spokesman said trainee doctor numbers have increased by 59 per cent since 1998 to 18,330 with a 56 per cent rise in consultant numbers to 12,586.

He added: “There will always be gaps in doctors’ rotas due to annual leave, maternity, out of programme opportunities amongst other reasons and the NHS is extremely adept at managing this.” He said a small number of emergency departments have been allowed to work 52-hour weeks until next year.