SummaryThis study explored whether patients' preference for particular types of anaesthesia could be influenced pre-operatively by giving them the addresses of various relevant websites. Patients at an orthopaedic pre-assessment education clinic completed a questionnaire, which included a short multiple-choice general knowledge quiz about anaesthesia, and also questioned them as to their choice of anaesthesia (general or neuraxial). Patients were randomly assigned to intervention or control groups. Intervention group members were given the addresses of three relevant anaesthesia and health related websites to access at home. All patients were asked to complete the questionnaires on a second occasion, before surgery. Initially, most patients stated a preference for general anaesthesia. Subsequently, the intervention group altered their preference towards neuraxial anaesthesia compared to the control group (p £ 0.0001).

This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version.

Junior doctors' working hours are regulated by the current New Deal Junior Doctors' contract and European Working Time Directive. Failure to adhere to these requirements results in substantial financial penalties for the employing organisation. Working hours in general surgery are the most frequent sources of such infringements, affecting patient safety, workforce morale and the attractiveness of a surgical career. In this article, we present our data analysing the financial metrics of a 6-month workforce modernisation pilot study introducing a novel clinical and administrative support role of the ‘clinical assistant’ into a busy tertiary general surgical unit; which had a persistent history of working hour non-compliance. We present our results on a successful ‘spend to save’ pilot, which resulted in a significant reduction in working hours negating all financial penalties, while delivering on additional soft metrics including career development and workforce morale.

Discussion There is evidence to show staff satisfaction has an impact on patient safety. We hope to improve local recruitment and retention by focussing on the wellbeing of the transient, but critical, workforce of junior doctors. In order to monitor impact an annual survey will be carried out. This is a challenging and multifaceted project requiring dedication, leadership and engagement from junior doctors, senior management, postgraduate departments and rota teams to name a few.

No abstract