Ask the Working Time Directive Team

Can you tell me more about the opt out for training grades? Can they opt out of the 48 hour week? And if so, do they need to do this if they are needed for an internal locum which would breach their hours?
Opting out of the working hours requirement is entirely voluntary, so no member of staff can be pressured into signing up to it. Use of the opt out also needs to be agreed by the employer. If a person chooses to opt out and subsequently changes their mind, they need to give between one week and three months notice (depending on period agreed when signing the opt out). These features of the opt out make it difficult to plan services with confidence.

If a doctor in training chooses to opt out they cannot exceed an average of 56 hours of active work, or 72 hours including resident on call time per week, as specified in their New Deal contracts. We would not recommend building services or rotas on the ‘goodwill’ or reliance of juniors opting out, it does not lend itself to a sustainable rota / solution.

Has the European Union voted to end the opt out?
No, the council of ministers voted to retain the opt out but the European parliament voted for it to be phased out. This leaves a stalemate with no changes to the Directive likely in the near future.

Can Hospital at Night work for paediatrics and neonatal services?
Essentially, Hospital at Night was not designed for paediatrics or neonatal as it is about having teams with cross cover arrangements and transferability of skills. However, a number of larger paediatric units like Great Ormond Street Hospital, Elvalena Hospital at Guys and St Thomas’, Birmingham Children’s Hospital and Alder Hey use the principals of Hospital at Night, but they use their staff in different ways.

The report Children’s and Maternity Services 2009: Working Time Solutions is available from the healthcare workforce portal and may provide some helpful solutions. www.healthcareworkforce.nhs.uk/rcpchandrcog

Is Working Time Directive compliance being achieved at the expense of missing other targets or downgrading patient care?
On the contrary, WTD implementation supports improvements in patient services. Length of stay has been reduced by 20% at the Homerton following implementation of Hospital at Night and the Stockport and Macclesfield Urology network are cutting waiting lists.

Please refer to the many examples of positive pilot projects on the healthcare workforce portal for more. www.healthcareworkforce.nhs.uk/wtdfaq