No abstract

On the basis of the products tested here, it seems that isopropyl nitrite is toxic to the fovea and can cause significant visual disturbance. The production of poppers is unregulated and their popularity is concerning, particularly given their exemption from the Psychoactive Substances Act 2016, which might suggest that they are harmless chemicals.

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.