UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis

Maisonneuve, Jenny; Lambert, Trevor W; Goldacre, Michael J

doi:10.1136/bmjopen-2013-004391

Cited by 23 publications

(14 citation statements)

References 34 publications

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“…Accordingly, for our next scheduled surveys, which were of the qualifiers of 1999 and 2000, undertaken in 2012, we added a specific section on views about the EWTD, inviting all doctors to reply to it. We report on this in the accompanying paper 25. In summary, in that paper we show that the implementation of the EWTD is not widely endorsed.…”

Section: Discussionmentioning

confidence: 85%

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

et al. 2014

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ObjectivesTo report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS).DesignAll medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010.SettingThe UK.MethodsUsing qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors.ResultsOf 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance.ConclusionsFurther work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

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Section: Discussionmentioning

confidence: 85%

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

et al. 2014

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“…More negative views were reported by doctors in surgical specialities. 33 How doctors in Norway perceive the relationship between the quality of postgraduate training for junior doctors and the actual work-week is unknown.…”

Section: Introductionmentioning

confidence: 99%

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

Rosta¹,

Aasland

2014

BMJ Open

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ObjectivesTo examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD).DesignPanel study based on postal questionnaires.SettingNorway.ParticipantsUnbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012.Outcome measuresSelf-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors.ResultsFrom 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer.ConclusionsThe weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations.

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“…Our findings on the implementation of the Directive accord with our previous study which found strong disagreement that the Directive had benefited senior doctors or the NHS. 10 Other studies and reviews have also reported reduced opportunities for training. 6 , 7 , 11 One study found that junior doctors do not want to work longer hours and do not believe that the Directive has had an adverse effect on their training.…”

Section: Discussionmentioning

confidence: 99%

“…In two previous studies, in 2012, of doctors who had experience of working before and after the implementation of the Directive, we found that doctors were critical of the Directive. 10 , 11 Only one-third of doctors agreed that the Directive had benefited junior doctors (31%). Much smaller percentages agreed that the Directive had benefited senior doctors (12%) or the NHS as a whole (9%).…”

Section: Introductionmentioning

confidence: 99%

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The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014

2016

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ObjectivesTo report doctors’ views about the European Working Time Directive (‘the Directive’).DesignSurvey of the medical graduates of 2002 (surveyed in 2013–2014).ParticipantsMedical graduates.SettingUK.Main outcome measuresQuestions on views about the Directive.ResultsThe response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work–life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors’ training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care.ConclusionsSenior doctors agreed that the Directive benefited doctors’ work–life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.

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UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis

Cited by 23 publications

References 34 publications

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014

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