Headlines: June 17th, 2005

Experts are warning today that the European Working Time Directive – introduced last year to reduce working hours as a means of improving health and safety – may be putting doctors’ and patients’ lives at risk.An article in the British Medical Journal, by Professor Roy Pounder and colleagues, says the current NHS shift system could be a threat to safety. The Directive means that junior doctors’ working hours are now limited to a shift of no more than 13 hours followed by a break of at least 11 hours. But a survey in December, by the Royal College of Physicians, found most trainee doctors in National Health Service Trusts were now forced to work a 91-hour week as a series of night shifts. This is due to the move, since the implementation of the Directive, away from working patterns based on an on-call system.

Professor Pounder points to recent studies from the United States that have proved the risks to patients and doctors of long working hours. He says any shift system should have as few successive night shifts as possible, with a maximum of three in succession. The studies show a single night shift, with a day off before and after, gives the least distortion of circadian rhythms.

The article says the aviation industry has taken note of research on short periods of sleep and it urges the health service to reassess shift work patterns to maximise doctors’ safety and efficiency. This, the authors say, would safeguard the interests of patients. They recommend that doctors are rostered for single nights, with one or two night shifts over a weekend. They also want health and safety measures built into every shift with doctors being taught how to cope with night work.

The article concludes, “Those who arrange junior doctors’ working schedules should put patients’ and doctors’ safety first and foremost. It is ironic that the working time directive, introduced to protect workers’ health and safety, should have led to the imposition of 91 hour nocturnal working weeks for most trainee doctors.”