RT Journal Article
SR Electronic
T1 Achieving compliance with the European Working Time Directive in a large teaching hospital: a strategic approach
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 427
OP 430
DO 10.7861/clinmedicine.4-5-427
VO 4
IS 5
A1 Gareth J Jones
A1 Mark PJ Vanderpump
A1 Mark Easton
A1 Daryll M Baker
A1 Carol Ball
A1 Michael Leenane
A1 Heather O'Brien
A1 Nigel Turner
A1 Martin Else
A1 Wendy MN Reid
A1 Margaret Johnson
YR 2004
UL http://www.rcpjournals.org/content/4/5/427.abstract
AB This paper describes the strategy which achieved European Working Time Directive (EWTD) compliance at the Royal Free Hampstead NHS Trust in medicine and surgery. Compliance with EWTD regulations was assessed by diary card exercise, clinical care assessed through critical incident reports, electronic handover documents and nursing reports, training opportunities assessed by unit training directors, cost controls assessed by finance department analysis, and workload assessed by staff attendance on wards, in casualty and in theatres. There was a change in focus of care to a consultant-led, specialist registrar- (SpR-)driven service extending into evenings and on weekends, coupled with a move to a multi-skilled team for night cover, and to a move from traditional on-call shifts to a full shift system across both medicine and surgery. Compliance with the EWTD was achieved whilst maintaining good standards of clinical care, ensuring training opportunities for doctors in training, controlling payroll costs, removing the need for locums, and reducing workload for both junior doctors and consultants.