The effect of the European Working Time Directive on anaesthetic working patterns and training

Abstract

SummaryThere is concern that the European Working Time Directive 2009 has led to reduced time available for training, and this study examined if this has been the case. For two identical six-month periods in 1999 (pre-Directive) and 2009 (postDirective), weekly data were collected on the total number of sessions attended by trainees, the number of supervised sessions and the leave days taken. A total of 5925 theatre sessions were analysed (2353 in 1999 and 3572 in 2009). For ST1-2 trainees, there was a 37% increase in theatre sessions attended (p = 0.02), with a 77% increase in the number of these sessions supervised by a consultant (p = 0.02). For ST3-7 trainees, there was a reduction in the number of theatre sessions attended of 27% (p = 0.03), but this was not accompanied by a significant increase in the number of consultantsupervised sessions (11% increase; p = 0.18). The aggregate median increase in weekly consultant-supervised theatre sessions per trainee increased for ST1-2 trainees (70% increase; p = 0.0016) but not for ST3-7 trainees (11% increase; p = 0.31). For neither trainee group did training time decline. Our data contradict the hypothesis that the European Working Time Directive has reduced access to training, or suggest that if it has, other factors (such as improved trainee rostering) have overridden its effect.

An analysis of the delivery of anaesthetic training sessions in the United Kingdom

“…Traditionally, rotas are written to plan activity for the week ahead, but changes occur throughout the week and are not always captured by monitoring systems. The electronic rota system, CLWRota (Rotamap Ltd, London, UK; see http://clwrota.com) , has become widely used throughout the UK. It provides an accurate, electronic record of actual staffing of sessions, rather than the planned allocation, as changes are tracked in real time throughout the life‐cycle of a week's rota.…”

Time for training?

“…It has been well documented that the EWTR has reduced the individual's time for training . However, a more recent issue has surfaced, namely workforce difficulties.…”

Can doctors be trained in a 48 hour working week?

“…The anaesthesia literature contains no evidence of any reduction in anaesthetic trainees' caseload or access to training opportunities and shows consistent exam success rates, no increase in referrals to regulatory bodies, 5 6 and a reduction in sick leave among trainees since the regulations were introduced. 7 Data from the Royal College of Anaesthetists show that most trainees continue to complete workplace based assessments on time. 8 The Royal College of Paediatrics and Child Health reported that reconfiguration of acute services and implementation of consultant delivered care in response to the working time regulations had maintained adequate exposure to training opportunities.…”