Different perspectives from Transforming Care Delivery

Several key lessons learnt were taken away from the conference helping you to reach the 48 hour week.

1 “People, planning and productivity are essential”

Flora Goldhill, director of workforce and capacity at the Department of Health spoke around the national perspective on working time and how that links with productivity and the wider agenda in the service at the moment.

“Most importantly, WTD is a driver to improve services and look at creative new ways of working that can benefit staff and patients,” said Flora, highlighting a number of the WTD pilots and other examples of good practice around new role development.

2 “Good rota design is central to meeting the directive”

The rota design workshop looked at the latest thinking and practical examples of rota design that have been put in place to help plan junior medical staff’s hours in line with the 48 hour week.

However, rota design requires careful planning. “Identifying the local workload is the first step,” Yasmin Ahmed-Little, F2 trainee and WTD lead for NHS North West, explained, “Before planning the rota for WTD you need to identify who is doing what and look at the basic principles of the tasks that juniors are carrying out. Can these tasks be done earlier in the day rather than at night and what is the intensity of the work that is required? We have to look at out of hours commitments and roles being carried out before planning rotas.”

The workshop also looked at some of the models available and work that has been piloted by Royal Colleges and latest thinking on ensuring good quality training within reduced working hours.

3 “We need to consider the training issues”

Professor David Sowden, dean director at East Midlands Healthcare Workforce Deanery talked through the issues around training and education – giving an honest appraisal of the issues regards the MTAS application process and urged trusts to work through the current situation and to prepare for the longer term work around introducing Modernising Medical Careers and how it works alongside WTD 2009.

“There are a range of issues we can work towards,” explained Professor Sowden, “The need for middle grade cover is a key issues that will require careful rostering. That’s alongside providing quality emergency care in new ways building on Hospital at Night and using reconfiguration and also addressing challenges around single specialty training. We have to keep a focus on the longer benefits of restructuring training.”

4 “Clinical leadership is the key for trusts”

As well as the perspective of those involved in the detail of WTD, Transforming Care Delivery provided the views from a trust chief executive and how the 48 hour week fits in with bigger agenda for a foundation trust.

“For me the key is simple, it’s about clinical leadership,” explained Chris Burke, chief executive at Stockport NHS Foundation Trust, “It’s got to be led by my clinical directors - consultants and clinicians who know the ins and outs and can work with and lead the junior teams.”

As a board, WTD is not an agenda item in itself. “The board are very business focused and work on the basis that it will be dealt with. They are much more interested in how we use this to look at the bigger picture, using the appropriate skills for the appropriate role so we’re using cost effective solutions that allow us to provide excellent patient care in an efficient way.”

You can download all the plenary speeches as webcasts and view the presentations at www.healthcareworkforce.nhs.uk/wtd2007conference