Case Study - Wrightington, Wigan and Leigh NHS Foundation Trust

Obtaining support for EWTD

Support from senior staff is the single most important factor in achieving European Working Time Directive (EWTD) compliance.

That is the message from Gertie Nicphilib, HR business partner at Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust, who received the sign-off for their compliant rotas in January 2007. WWL began its journey to EWTD compliance in 2005, believing that it was better to begin working early as the directive would have to be implemented by 2009 in any case. Also they felt it would help to maintain and increase high quality patient services, plus gain benefits of collaboration between staff.

Gertie said: “I’d experienced EWTD 2004 in my previous position and knew the importance of preparing early.

Make sure you get senior backing from the outset as it is vital, as we started in September 2006 and had all our rotas signed off the following January. It seems like a massive mountain to climb, but there is still time and compliance is still achievable.
Gertie Nicphilib

“We decided that we shouldn’t make any further changes to rotas unless we were making them 2009 compliant. The deadline of 31st July 2007 was a great opportunity to focus on as a deadline, so in September 2006 this was proposed to the trust’s board and it was accepted.”

With the board backing the plan, a timetable was put in place to ensure EWTD compliant rotas were fully set up by January 2007.

WWL began by performing a gap analysis of their rotas as well as reviewing them to assess the impact of compliance, a consideration of the impact of a reduction in hours as well as external factors like service reviews. Potential savings needed to be identified, plus how to fill lost hours and ensure solutions are flexible and practical.

Through the changes like Modernising Medical Careers (MMC) and the 18 Week Patient Pathway, Gertie said doctors had faced a great deal of changes to their ways of working in a short space of time, but had been supportive of the work to achieve compliance. She said: “Senior staff have accepted the EWTD, they realise it’s the law and must be followed.

“We’ve involved them throughout the process of implementing the new rotas, and found that dealing with them face to face is best as it keeps them fully involved in the process.

“The juniors had some trepidation about some of the proposals. For example there was one service the trust felt didn’t require an out of hours provision, whereas the juniors disagreed because they believed its absence would be detrimental to their training. We were eventually able to offer a compromise that was agreeable for everyone.”

To ensure support is ongoing for the programme, the trust recommends providing regular updates to the board on progress, including risks and solutions, setting up a stakeholder working group and being flexible with issues whilst maintaining focus on objectives.

With less than eight months to go to the introduction of the EWTD, Gertie believes there is still plenty of opportunity for trusts to become compliant if they haven’t already done so, she said: “Make sure you get senior backing from the outset as it is vital, as we started in September 2006 and had all our rotas signed off the following January. It seems like a massive mountain to climb, but there is still time and compliance is still achievable.”

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