Involving junior doctors and trainee staff every step of the way to Working Time Directive (WTD) 2009 compliance was a major priority in the Trust-wide pilot project run by Cheshire and Wirral Partnership (CWP) NHS Foundation Trust.

CWP wanted to ensure that junior doctors and trainee healthcare staff were given a voice in the process of fully conforming to WTD, which was achieved in August 2008.

By involving them in the process of producing a suitable rota that maintains high quality patient care, fits with service delivery, as well as training and education from the beginning of the project in February 2008, the trust were able to achieve 100% compliance this past summer.

The trust provides mental health services for children, adults and older people, as well as learning disability and drug and alcohol services. CWP has eight trainees in Chester, eight across Wirral, seven in Crewe from Mersey Deanery, with a further eight in Macclesfield as part of Manchester Deanery.

Colin Jones, EWTD project manager at CWP said: “We wanted to ensure from the outset that the trainees were involved, so we had to consider how best to do this. The junior doctors in each of the geographical areas had regular meetings with myself, the medical director and human resources to listen to their concerns and agree a workable rota.

“WTD has also been a regular item on the agenda of the Local Negotiation Committee, to ensure communication and helped to deliver 48 hours and service redesign in such a short time frame to create solutions for WTD compliance.”

A split night rota of 3/4 was agreed, which was requested by trainees, following evidence provided by the Royal College of Physicians that this was best practice.

As well as having strong support from the junior doctors and trainees, the WTD directive project was also given approval from director level. Updates were presented to the trust’s operational board on four occasions, with Colin citing continued hard work and ensuring the executive were kept up to date with developments.

CWP have now been WTD compliant for five months, eight months before the directive comes into force, Colin believes trusts that have yet to begin preparations may have left it too late, he said: “There will be a great deal of work to do, as you have to be very clear about your aims and the steps you need to get there. You must ensure junior doctors are involved, and constantly communicate the latest information to them. Also you have to identify all the relevant stakeholders and explain the situation as it can change extremely quickly.”

From February 2009, CWP plans that one junior doctor will cover Chester and Wirral inpatient services out of hours, plus learning disabilities and children and adolescent mental health services, whilst one will cover Leighton and Macclesfield inpatient services out of hours, including learning disabilities. In both cases the trust aims to provide a liaison psychiatry service in all areas.

CWP also aims that all qualified nurses will have received training in physical healthcare, iBleep will be implemented across the trust area, whilst the impact of service users and other professionals will be constantly assessed.

Five main outcomes:

1. Start preparing now for 2009
2. Beneficial presenting at staff meetings to aid engagement
3. Keep trust board informed
4. Involve directors and the executive
5. Project lead and team to drive.