48-hour week rule for junior doctors ‘unlikely to be met in full’
Thursday, 19 March 2009
The NHS in Wales is unlikely to comply fully with the 48 hour a week working time limit for junior doctors when it comes into force on 1 August this year. A report, published today by the Auditor General, says the European Working Time Directive is unlikely to be met without either a substantial investment of effort and money or, in some areas, the extension of the deadline for compliance.
The report says that almost all junior doctors have been working an average of 56 hours a week or less since the end of 2006 (this 56 hour limit came into force from 1 August 2007). And, as at July 2008, all junior doctors in Velindre NHS Trust, Powys Local Health Board and the former Ceredigion and Mid Wales NHS Trust (now part of Hywel Dda NHS Trust) were already working less than 48 hours a week. But many trusts were far from this position and lacked a clear overall plan to comply with the 48 hour limit by August 2009. Across the NHS in Wales as a whole more than half of all junior doctors were still working more than 48 hours a week.
Trusts had also made variable progress in making the types of changes that could support a reduction in junior doctors' hours. These changes include: improved rota management; the implementation of Hospital at Night (see Notes to Editors); wider workforce remodelling; and service reconfiguration.
The Assembly Government has forecast that no more than 12 per cent of junior doctors will be working more than 48 hours a week by August 2009. But this forecast is optimistic – as it assumes that trusts will fully deliver the compliance plans that they have been discussing with the Assembly Government since July 2008. Planned changes may prove difficult to implement and sustain in practice - potential barriers include finance, recruitment problems and staff resistance to change. Even if rota patterns comply in principle with the Directive, there is the risk that junior doctors may still be being required to work longer hours to meet the demands of the job.
The UK government is seeking an extension of the deadline for achieving the 48 hour week target in certain areas, but trusts still need to do everything possible to comply by August 2009. The requested extension has yet to be approved by the European Commission. To qualify for extension, trusts would have to demonstrate that all reasonable steps have been taken to achieve compliance and would still have to reduce junior doctors' working time to 52 hours a week or less from August 2009. In the meantime the Welsh Assembly Government and Trusts have been discussing how further progress can be made on the overall compliance position.
The Auditor General, Jeremy Colman, said today:
"Trusts should not let the possible extension of the August deadline in certain areas distract them from making every effort to comply fully with the 48 hour week rule for junior doctors. Trusts, Local Health Boards, the Assembly Government and other partners will need to work more closely together over the coming months to discuss and agree what needs to be done to support compliance."
Compliance with the European Working Time Directive for junior doctors across NHS Wales http://howis.wales.nhs.uk/doclib/EWTD_report_eng.pdf
Source: Wales Audit Office http://www.wao.gov.uk/home.asp