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Surgeons say new 48 hour working week a risk to training and patient care: Exclusive survey figures revealed

18th March 2009

Surgeons have warned that patients' lives could be at risk if new regulations restricting the number of hours doctors can work come into force - as planned - this summer - drastically cutting down training hours for junior doctors.

A survey of consultant surgeons - seen exclusively by Channel 4 News - reveals 78% feel that complying with a 48-hour week has ALREADY had a detrimental affect on the training of surgeons... And nearly two thirds feel it's been at the expense of patient care. (Relating to a pilot scheme already running in the North West of England - see below).

While some professions remain exempt from the European Working Time Directive the Government has decided that trainee doctors should be covered by the rules from August this year, despite widespread resistance.

However, the 48 hour working week has already been introduced by the strategic health authority in the North West of England as a pilot scheme. BUT a survey by the Royal College of Surgeons of its fellows in the North West shows there are concerns around training and patient care.

In the survey (of those respondents whose service/speciality is currently compliant with 48 hour week):

  • 78% of respondents believe that "compliance had been at the expense of core trainees training"
  • 70% thought "compliance had been at the expense of speciality trainees training"
  • 63% thought "compliance had been achieved at the expense of patient care".
  • And 50% thought compliance had been "achieved by filling gaps on rotas with staff already employed in the Trust".

Ben Cresswell, President of the Association of Surgeons in Training (ASiT) told Channel 4 News (in terms of reduced hours):  "the ultimate fear for doctors in training and for qualified doctors is that we'll be left with a less experienced and less well trained workforce" adding that as a consequence "patients may suffer serious harm or death as a result of a either a misdiagnosis or a delayed diagnosis."

For a profession that has been known to work in excess of 100 hours a week, cutting that down to 48 could result in training hours being halved. The Royal College of Surgeons believe that trainees need to work up to 65 hours a week to cope with their work load and get adequate training.

The Department of Health said it will only consider allowing some doctors to work up to 52 hours a week in extreme circumstances, but not 65.
 
An anonymous trainee, a surgeon, working outside the North West, but at a hospital also trying to bring in the 48 hour week, spoke to Channel 4 News about how little training he gets.  He didn't want to be identified because he's worried speaking out will damage his career or cost him his job. 

He said: "I have such a lack of skill at the moment that it concerns me.  I've got six and a half months before I'll be expected to do a certain amount of key operations like half hip replacements and fixing of wrist fractures.  In six months time I wouldn't send my grandmother to me to do an operation."

Dr Yasmin Ahmed-Little of the North West Strategic Health Authority told the programme that she thinks "patients will be safer with rested doctors. At the end of the day, we are in a situation where these same patients wouldn't get on a plane if the pilot had worked some of the hours that our doctors have worked and are currently still working."

Dr Wendy Reid from the Department of Health told Channel 4 News that she thinks there is "no reason why somebody will be signed up as competent at training unless they are" adding "there are safety checks within all the curricula developed by the colleges to allow for that so I feel that we can deliver both safe patient care and training."

 

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