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| Working Time Directive 2009 |
Working Time Directive 2009 About WTD Working Time Directive FAQs
WTD FAQs
WTD - The Basics >>> Please find below a comprehensive FAQ section that aims to answer possible WTD 2009 questions. There is a form at the bottom for you to submit your own question relating to the directive - answers to which will be posted in this section. However, if you have more specific WTD questions (e.g particular rota patterns) then please contact the WTD lead within your SHA. WTD contact for Scotland
WTD contact for Wales
WTD contact for your SHA
Europe The European Working Time Directive (EWTD) lays down minimum requirements in relation to working hours, rest periods and annual leave. The Directive was enacted in UK law as the Working Time Regulations from 1 October 1998. The main features are:
Note: If a rest break has to be interrupted or delayed to ensure continuity of care, compensatory rest must be taken immediately after the end of the working period. The EWTD has applied to the vast majority of employees since 1998, with a few exceptions including doctors in training. In 2004, the EWTD provisions were extended to doctors in training whose maximum working hours reduced to 56 in August 2007 and to 48 hours from August 2009.How is compliance with WTD measured? WTD law states that measurement and monitoring of the 48 hour working week should be over a 26 week reference period for junior doctors (17 weeks for other workers). Employers need to take reasonable steps to ensure that their medical staff are compliant over this period of time. It is generally accepted that continuous monitoring over 26 weeks is not an achievable method of assessing compliance, except for individual cases. For doctors in training, employers take snapshot data to measure both WTD and New Deal compliance, by diary carding over a two week period. This should measure not only hours worked but that rest breaks are being achieved, and/or adequate compensatory rest provided. What are the SiMAP and Jaeger Judgements? What about on-call time – is this work? (Impact of the SiMAP and Jaeger cases) The SiMAP and Jaeger Cases were brought before the European Court of Justice (ECJ) by a Spanish medical union and a German doctor. In both cases, the ECJ ruled that on-call time, when a doctor is obliged to be resident in a hospital or health centre, counts as working time. (For example, a doctor resident on-call but asleep counts as working). In Jaeger, the ECJ also ruled that compensatory rest for missed rest must be taken immediately after the end of the working period, rather than aggregated and taken at a later time. Although the Judgments applied to particular cases, the assumption has to be that the same interpretations would apply to any UK doctors working similar patterns. You can find further advice at: Will SiMAP and Jaeger be reversed in the foreseeable future? No. Although the European Council of Employment Ministers had agreed to end resident on-call time being counted as work and to make compensatory rest breaks more flexible. However, the European Parliament voted to block the proposed amendments to the Directive. Conciliation negotiations between the Council and the Parliament were unsuccessful. What percentage of doctors are Working a 48-Hour Week? Two thirds of doctors in training are working a 48-hour week based on an estimate obtained through the New Deal ministerial returns. In NHS North West for example 94% of rotas are compliant. What progress has been made in implementing the Directive? Significant progress has been made in introducing the Working time Directive across all clinical and staff groups within the NHS. The vast majority of the NHS has fully implemented the EWTD, the exception being junior doctors in training and steady progress is being made to meet the 48 hour working week. This has happened in incremental stages from 2004 reduction to 58 hours, 2007 reduction to 56 hours and finally 48 hours by 1st August 2009. It is expected that all services, with the possible exception of a limited number of 24 hour immediate patient care, some supra specialist services and some small, remote and rural units, will be working a maximum 48-hour week by 1st August 2009. Who is Responsible for EWTD Implementation in the NHS? It is the responsibility of local NHS employers – particularly trust Chief Executives - to implement the EWTD for doctors in training with the help of a national programme of pilots and support from their SHAs and PCTs. Can't we ignore these laws from Europe? No. This is health and safety legislation that cannot be ignored. No patient should be treated by a tired doctor and staff are entitled to fair working hours. The government agreed to implement the Working Time Regulations to improve the health and safety and working lives of all employees in this country. It is consistent with the commitment to improve working lives for all NHS staff. What are other European Union countries doing? The European Commission has told all Member States that they face legal action unless they are compliant with the EWTD. What penalties can be imposed for failing to comply with the WTD? The Health and Safety Executive are responsible for enforcing the 48 hour week limits and have powers to issue improvement notices and failure to comply with these can lead to a conviction. This could mean a fine or summary conviction (at a magistrates court) limited at the statutory maximum level or up to three months in prison but if convicted on indictment (at Crown Court) this could lead to an unlimited fine and/or two years imprisonment. Rest requirements are enforced through employment tribunals. For more information on the legal implications of non-compliance with EWTD please see the following two articles: What does it mean to derogate? This is a contingency that will enable a possible 52 hour week between 2009 and 2011 (2012) in parts of the NHS that demonstrate they cannot achieve the 48-hour week ceiling by 1st August. This will support trusts where particular challenges arise in 24 hour immediate patient care, some supra specialist services and some small, remote and rural units. To enable this to happen the Department of Health has notified the European Commission of its intention to derogate. The Commission should give their response in May 2009. Time is running out. What can trusts who are not already compliant do to meet the 1st August deadline? Skills for Health Workforce Projects Team continue to cascade learning across the NHS to help trusts to achieve compliance. Good practice can be found on the healthcare workforce portal (www.healthcareworkforce.nhs.uk) and includes:
How do we know that these programmes are helping? The independent evaluation of EWTD pilots programme by West Midlands Deanery and Birmingham and Warwick Universities has highlighted the following key lessons:
Workforce Supply What about the gaps appearing in rotas? Trusts may find alternative solutions to address gaps rather than just expanding rotas. Skills for Health Workforce Projects Team commissioned 30 innovative pilots across the NHS. Many are demonstrating that WTD 2009 compliance is achievable whilst supporting the quality of patient care and medical training. Best practice is shared through the website www.healthcareworkforce.nhs.uk There is also extensive guidance on NHS Employers website on managing gaps in medical staff cover and the keys to successful vacancy management.How can the medical training initiative help fill staffing gaps? International recruitment remains a valid and helpful way to secure additional capacity for services and specialties. The Medical Training Initiative is gaining ground since Ann Keen’s announcement of expansion plans on 26th February and this will help match training opportunities with suitable international candidates. Recent changes to the immigration rules support international medical recruitment and we need to encourage both employers and international doctors to use these routes. The new international medical portal on NHS Jobs is a useful gateway to help match vacancies and suitable applicants. More Trusts are advertising on the site and international doctors need to be directed to the site as a quick entry point into the NHS medical jobs market. We need to do more to make this facility more widely known and used. WTD Implementation & Pilots The 30 pilots in the national EWTD programme have been led by clinicians and many of these have demonstrated creative solutions that support the quality of patient care, medical training and work / life balance of staff. Pilots Evaluation Learning from the independent evaluation of the pilots programme continues to be disseminated through the Securing Change, Identifying Options and EWTD six case study booklets. The full evaluation report by West Midlands Deanery and Birmingham and Warwick Universities is being published for the 15th May EWTD Conference for sharing learning to help EWTD solutions across the country. The three documents already published can be accessed here >>>
Where can we get help and advice with about implementing the WTD and/or H@N in our Trust?
Have the pilot sites involved the public and patients in WTD implementation? Yes. How do I contact pilot sites to talk about their experience? Contact details (usually email) are listed on the pilot’s page of the healthcare workforce portal and are printed at the foot of related calling time articles. The contact details for many pilots are also linked to the Signposting EWTD Solutions report Is WTD compliance being achieved at the cost of missing other targets, or downgrading patient care? No. There are innovative ways to implement the EWTD and support improvements in patient services. For example, Stockport and Macclesfield Urology network have cut waiting lists. Evaluation of the pilots programme by West Midlands Deanery will be published at the WTD Conference in London on 15 May. General Will the WTD result in more reconfiguration / fewer local service? The emphasis needs to be on redesigning service around patients and moving care out of hospital and into the community. Services will be provided in different ways whilst retaining local access for patients. Are GPs covered by the EWTD? Traditional GPs do not fall within the remit of the EWTD because they are self employed. However, some GPs are directly employed and are therefore covered by the Directive. Where can I find guidance from the Department of Health on EWTD? Guidance issued by the Department can be found on the DH website (search `working differently’ on www.dh.gov.uk). This includes advice on exceptional circumstances when there is not a legal requirement to provide immediate compensatory rest. What are the Maximum Working Hours for a Trust Grade doctor working the same rota as a doctor in training? A Trust grade doctor is already entitled to a maximum 48-hour week under the Working Time Regulations 1998. A Trust or career grade doctor can voluntarily opt to work more than 48 hours per week but they cannot opt-out of the EWTD rest break requirements. Where can I find additional NHS resources on employer issues for EWTD?
The Opt Out Can Trusts simply ask junior doctors to sign the opt-out from the WTD? Opting out of the working hours requirement is entirely voluntary, so no member of staff can be pressured into signing up to it. If an individual chooses to opt-out and changes their mind, they need to give between one week and three months notice (depending on period agreed when signing the opt-out). These features of the opt-out can make it difficult to plan services with confidence. If a doctor in training chooses to opt-out they cannot exceed an average of 56-hours of active work, or 72 hours including on-call time per week, as specified in their New Deal contracts. The employer must also agree for a doctor to opt-out in their trust. Can’t doctors 'opt out' together? There is no sectoral opt out. The legislation does not allow for this.What rest facilities should a doctors working a night shift be provided with? All staff working a night shift should be provided with an appropriate place to go for breaks and refreshments. There is no national requirement for a member of staff working a night shift to be provided with a bed as you would normally expect people on a night shift to be working through the night. Training The WTD will surely cut available training time? The better structured training arrangements set out in MMC will lead to more meaningful training. This will enable trainees to make the best use of their time as the new training programmes will focus on developing the skills required and ensuring that the most is made of all the educational opportunities available. This should be a benefit in developing WTD compliant rotas. The MMC Quality of Training group has published a report about getting the best out of all available learning opportunities and ensuring medical training is a priority at every level throughout the NHS: It’s on the MMC website at: http://www.mmc.nhs.uk/default.aspx?page=510 Challenged Specialties What are you doing to support challenged specialties such as mat & paeds? We are working together with the Royal Colleges and healthcare professionals to identify and promote sustainable models of workforce and service delivery. WTD 2009 projects have been undertaken in partnership with the Royal Colleges of Obstetrics and Gynaecology, Paediatrics & Child Health, Surgeons, Anaesthetists and Physicians with the reports published on the healthcare workforce portal. The vast majority of the pilots include collaborative working across hospitals and teams, offering help across the range of specialties. Costs / Finance What Funding has been Provided to Support WTD Implementation? The Department of Health has allocated £310million to help the NHS with WTD 2009 implementation. Submit an FAQ Use the form below to submit an FAQ. We will endeavour to answer it and publish it on this page as soon as possible. |
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