We are once again in events season as planning for the annual Working Time Directive event and a national Hospital at Night exhibition comes into full swing.

The Working Time Directive 2009 Exhibition: The Final Countdown is a one day event taking place at the ExCel, London on July 2, 2008.

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Current workforce planning systems for healthcare are based on separate roles of health professionals and support staff - underpinned by separate funding streams and different methods of development. Is this all about to change with the direction of travel being proposed by the latest NHS operating framework? Helen Mooney reports.

Early last year the Department of Health's (DH) then new director general of workforce admitted that she thought many of the NHS' biggest personnel problems should have been tackled years ago. In a frank opening gambit to both the government and the NHS, Clare Chapman said 'a lot of the big challenges could have been predicted three years ago and probably were', but that the NHS failed to deal with them at the time.

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As hospitals work towards meeting the WTD 2009 requirement for junior doctors, the role of teamwork solutions supporting medical staff working at night and beyond becomes more focused. The Hospital at Night solution is now well established in the UK, and as such, we are holding a conference on 19th September 2008 to showcase the contribution of Hospital at Night teams, the journey to date and the future direction with special emphasis on patient safety, leadership while supporting service delivery and its contribution to meeting WTD 2009.
For further information about the conference or to register your interest in attending please fill out the interest form here>>>

The Working Time Directive annual event will take place on the 2nd July 2008 at the ExCel, London. A new approach to disseminating the learning, this event will be interactive and delegates will have the opportunity to ask direct questions to all of the exhibitors throughout the day. Key plenary sessions will also run with presentations from leading experts within the field. The 2007 conference attracted an audience of over 250 delegates from across the service and delegates were able to take away practical advice on reaching the 2009 requirement.

To secure your place for this event before registrations open, please fill out the interest form here>>>

In the wake of the DH response to the Tooke Report, what now for medical training and debate? Lynne Greenwood picks up the trail with Dr Michael Bannon's research report on the impact of WTD on postgraduate medical training.

Everyone agrees: medical education and training must be of the highest quality - professional, well-funded, delivered by qualified trainers and expertly evaluated. That is everyone from the health secretary and postgraduate medical deans to junior doctors and medical students.

In the formal DH response to the Tooke Report last month (March 2008) Secretary of State Alan Johnson said: "I want to mark the importance we attach to ensuring that the training of our doctors, and indeed all health professionals, is in keeping with Sir John's aspirations to excellence."


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The Hospital at Night (HaN) project has led to patients being seen by the right person with the right skills at the right time - care is responsive and timely. It has also led to a decrease in reportable clinical incidents.

National evaluation of the project also highlights improved communication, better team working out of hours, and improvements in support and training for junior doctors.

Alison Hendron, head of nursing inpatient services, Guy's and St Thomas' NHS Foundation Trust, discusses the role of the site nurse practitioner (SNP) and the role it plays within the hospital.

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Gerry Bolger, project director WTD/Hospital at Night, London Deanery and senior project manager, NWP, explores WTD and puts forward the case for joined up service improvement thinking.

WTD 2009 requires doctors in training to be working no more than 48 hours in a week from 1st August 2009. Fundamentally it is a safety directive and as such, is enshrined in health and safety legislation in the UK.

However implementing WTD is not as easy as just getting everyone to reduce their hours, especially when compounded by changes in service delivery, training and education of junior doctors.

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Look out for a series of new resources being launched over the coming months demonstrating the contribution of new and extended roles to achieving WTD compliance.

The 'Showcasing' series of resources, produced by Workforce Programmes at NHS East of England, will be a 'must have' for those involved in developing solutions for achieving WTD compliance in trusts and at SHA level.

"Previous research undertaken by the team, as part of our WTD Diagnostic Tools and Enabling Strategies project, identified that the introduction of new and extended roles can help overcome many of the obstacles to increasing capacity and so achieve compliance." say Nicole Callaghan and Boyd Mullins, workforce consultants at NHS East of England.

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Annabel Morris, NWP project manager, looks at the legal implications of WTD.

How is the WTD enforced?
WTD 2009 is a 'must do' change for trusts as it is enshrined in European law and in UK law through the Working Time Regulations (WTR). However, the question often arises, 'What happens if we don't implement it?' This article aims to outline the way the WTR are enforced and the wider potential legal implications of breaching the regulations.

There are two main methods of enforcement of the WTR - through the employment tribunals and through the Health and Safety Executive (HSE) in conjunction with the criminal courts.

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The results from the bi-annual Ministerial Return from October 2007 are now available. Although this Return is used to collect employers' data on doctors in training to determine compliance with the provisions of the 'New Deal', it also acts as a good proxy for measuring compliance with the provisions of the Working Time Directive.

This showed that, overall, compliance with the 2009 standard, whereby no doctor in training should be working in excess of 48 hours per week, had risen from 41% in September 2006 to nearly 52% in October 2007.

The position within each SHA has been analysed and shows levels of compliance ranging from less than 40% to more than 60%. Within groups of clinical specialties, the three biggest challenges remain in surgery, obstetrics and gynaecology and anaesthetics.

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The Hospital at Night solution is now well established in the UK, we are therefore holding a conference to showcase the contribution of Hospital at Night teams, the journey to date and the future direction with special emphasis on patient safety, leadership while supporting service delivery and its contribution to meeting the WTD.

The conference will:

• Promote the benefits of Hospital at Night
• Showcase best practice and emerging models
• Celebrate the achievements and learning over the last five years
• Show how the model is being translated internationally
• And show how to apply the real time learning to out of hours and 24:7.

This one day event will enable delegates to join the discussion and debate and gain practical guidance and support on reaching the 48 hour target.

With less than 18 months to go until the maximum working hours for junior medical staff is reduced from 56 to 48 hours per week, it is crucial that trusts continue to move towards meeting the requirements of WTD 2009.

Aimed at chief executives, WTD leads, directors, general managers, clinical leads, service improvement leads, clinical governance leads, governors and deanery staff, the conference aims to drive forward work towards 2009 - providing information on how to diagnose the impact that it will have on organisations and to find out about the national support and best practice available.

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