Moving towards a 48 hour week

National statistics help identify areas of best practice

The latest statistics looking at how the NHS is performing in the move towards a 48 hour working week for junior medical staff have recently been released. The figures show an average rating of 35 percentacross strategichealth authority areas against what will be the 2009 Working Time Directive target.

With these statistics being takenfrom returns in September 2005 – where there were four years to gountil Working Time Directive 2009 – this gives an indication of the work that needs to be done to movetowards compliance with the next stage of the directive.

26 of the former 28 SHAs in England provided data which in total cover theworking hours of some 32,000 doctors.The figures, produced by the Workforce Review Team, are also available for analysis at individual trust level for the first time. The statistics give a clear point in time picture of compliance at a local level which is now being used to drive a range of supportive work across the service.

The schedule showing the position of individual trusts also shows some major variations with many organisations having a long way to go to achieve WTD 2009 but others already well on the way to moving towards the 48 hour week. When analysed by broad specialty thosefacing the greatest challenges are perhaps not surprisingly those with the most onerous emergency/out ofhours commitments such as surgery, obstetrics and gynaecology, medicine and anaesthetics.

Skills for Health - Workforce Projects Team are now using the Workforce Review Team data to look at the trusts making good progress to identify casestudies that can be shared across the service. There are similarities in many of the organisations in the way that they have approached and tackled the move towards a 48 hour week.

One of the key aims of developing this data has been to raise awareness within the service – particularly amongst directors, senior clinicians and managers – of their own compliance position and the work that they need to undertake. It is vital in establishing a firm baseline, identifying the scale of the challenge for organisations and offering the opportunity to identify and share good practice. For further information please contact Martyn Dell, medical workforce development manager, WRT martyn.dell@hants-wdc.co.uk

WTD work programme – steps you should be taking:

1 Identify your own position against the 48 hour week – the information should be available in your trust as the figures are provided directly as part of the ministerial returns process.

2 Identify the specialties in your trust with particular compliance challenges.

3 Look at the diagnostic work carried out by Essex Workforce Development Confederation. This identifies common features of trusts who have good compliance rates and key steps that can be taken.

4 Ensure your trust board receives reports on current compliance rates andagrees the work plan for moving forward.

Current compliance rates by specialty. As expected, specialties with the greatest emergency and out of hours commitments currently have the lowestpercentage of compliant doctors.

Source: Department of Health ministerial returns. Sept. 2005

Variations betweencompliance rates in the old strategic health authority areas from the September 2005 returns. 26 of the 28 areas provided information as part of the returns.

Source: Department of Healthministerial returns. Sept. 2005