Taking action on 2009

Analysing and diagnosing is a key first step that every trust needs to take in order to work towards 2009 compliance. A new range of tools are being developed to enable the NHS to do this.

Analysing and diagnosing the impact of WTD in NHS organisations

“The message is a simple one. A big challenge faces the NHS. The majority of trusts need to make significant changes to achieve WTD compliance.”

Where are we now – a snapshot across the NHS.

Many trusts are asking themselves how it will be possible to reduce working time to 48 hours in the next three years. Firstly, it’s important to recognise what the situation is now.

The Workforce Review Team (WRT), working alongside Skills for Health - Workforce Projects Team, has undertaken a study based on March 2005 ministerial data returns to pinpoint the current status of WTD 2009 compliance. The results of the study are significant and showed that:

• Over 50% of doctors are not currently meeting WTD 2009 compliance
• In 15 strategic health authorities that figure is below the 30% mark
• WRT analysed 11 broad specialty groups and found anaesthetics, medicine, obstetrics and gynaecology and surgery had the most doctors working more than 48 hours – all professions which have a high out-of- hours commitment.

This is a clear indication that the service is a long way off the 2009 target, and needs to seriously start to tackle the issue, to be able to achieve WTD compliance on time.

In a similar piece of work, WRT has also identified a distinct cultural shift in the male to female ratio of doctors, after analysing a ‘snap shot’ of the medical workforce, from pre registration house officer level up to consultant level. The work focused on the effect of a decreased ‘participation rate’ (known as the amount of flexible working undertaken within a given specialty) due to an increasing number of female doctors joining the medical workforce. The national medical school intake for 2004/05 was 40% male and 60% female.

This cultural change is even clearer when you focus on the different grades. At consultant level, the proportion of male doctors currently sits at around 70%, compared to 30% of female consultants. However, it’s a different story for medical graduates entering the service at PRHO/Foundation 1 level. The number of female junior doctors is around 55% compared to 45% of male junior doctors. This has a potential major impact on the future number of part-time workers.

A conclusion of this is that the trusts need to factor in more creative rostering solutions to take into account an increased female to male workforce split and the potential increase in flexible and part-time working that this might bring. The message is a simple one. A big challenge faces the NHS. The majority of trusts need to make significant changes to achieve WTD compliance. However, support in finding the solutions is on the way.

Martyn Dell, medical workforce development manager for the Workforce Review Team, comments: “Future WRT work will enable trusts to compare themselves against each other to identify the actual level of compliance against the trajectory towards 2009, together with highlighting trusts which have made particularly good progress, and encouraging those identified to share best practice.”

Watch this space for news on this work and potential solutions to the challenges that it highlights. For further information, please contact: martyn.dell@wrtnhs.org or
ian.weller@wrtnhs.org