Junior Doctors Working Hours: The Challenge Ahead

Main Category: Primary Care / General Practice
Article Date: 10 Apr 2008 - 5:00 PDT

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Continuity of care for patients, the quality of training for doctors and the efficiency of hospitals could be compromised when junior doctors hours have to be reduced further next year to meet the requirements of the European Working Time Directive (EWTD). The difficulties of moving from the current 56 to 48 hours per week are highlighted in the latest edition of Clinical Medicine, published by the Royal College of Physicians.

Professor Roy Pounder, the RCP's lead on EWTD, argues that there are limited options available to trusts in dealing with the reduction in hours. It is likely that savings in hours worked will be made mainly by reducing the numbers of doctors available during the daytime, from Monday to Friday - staffing at other times has less scope for reductions.

The change in working patterns could result in less formal teaching and losing valuable learning from continuity of exposure to the progress of illness. Patients may also see even more different doctors during an admission.

Professor Pounder said "The vast majority of countries in Europe are struggling with the same difficulties arising from EWTD. The Department of Health is working with NHS organisations in seeking innovative approaches. However, trusts need to think carefully about their arrangement of rotas. It is possible to create legal rotas that are not best for patient care, training or cost effective overall. It may be that the solution is to recruit more junior doctors and consultants."

The April issue of Clinical Medicine also includes concise guidelines on long term neurological conditions: management at the interface between neurology, rehabilitation and palliative care.

Some 10 million people in the UK are living with a neurological condition which has a significant impact on their lives, and they make up 19% of hospital admissions. This article provides a brief summary of guidelines that explore how specialist neurology, rehabilitation and palliative care services can work together and how they can best provide support for people with long term neurological conditions and the family members who care for them.

Other features in this issue the second in our series 'Medicine, music and the mind', which examines the nature of musical genius. Author Paul Robertson argues that while musical genius must have neuro-biological basis it is defined and understood within prevailing cultural frameworks and in order to measure it historic and aesthetic traditions and assumptions need to be considered.

Royal College of Physicians