Authors: Jones, Gareth J.; Vanderpump, Mark P.J.; Easton, Mark; Baker, Daryll M.; Ball, Carol; Leenane, Michael; O'Brien, Heather; Turner, Nigel; Else, Martin; Reid, Wendy M.N.; Johnson, Margaret

Source: Clinical Medicine, Journal of the Royal College of Physicians, Vol. 4 No. 5 September/October 2004 , pp. 427-430(4)

Publisher: Royal College of Physicians

Abstract:

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.

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Keywords: COMPLIANCE; EUROPEAN WORKING TIME DIRECTIVE; EWTD; MEDICINE; SURGERY; TRAINING

Document Type: Research article

Publication date: 2004-09-01

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• Clinical Medicine is published six times a year and circulated to 20,000 Fellows and Members of the Royal College of Physicians. The journal is read by physicians both established and in training in hospitals across the world. It features a wide range of articles including original papers, professional issues, clinical guidance, medical humanities, ethics and clinical governance. The journal publishes the key features from the College lectures and conferences. Each issue has a CME section which reviews the latest advances in a chosen specialty.
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• By this author: Jones, Gareth J. ;  Vanderpump, Mark P.J. ;  Easton, Mark ;  Baker, Daryll M. ;  Ball, Carol ;  Leenane, Michael ;  O'Brien, Heather ;  Turner, Nigel ;  Else, Martin ;  Reid, Wendy M.N. ;  Johnson, Margaret

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