Much smaller percentages agreed that the Directive had benefited senior doctors (12%) or the NHS as a whole (9%).
10, 11 Only one-third of doctors agreed that the Directive had benefited junior doctors (31%). 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. 7 The aforementioned review recommended that ‘opt-outs’ by doctors from the provisions of the Directive should be encouraged and more widespread. For example, there has been an increase in the number of handovers and list cancellations. 5, 7 – 9 A recent review of the Directive in the UK found that, among other things, aspects of patient care have been affected. 2 – 6 Training in some specialties, such as surgery, is difficult to carry out effectively within the 48 hour week. In the United Kingdom, the Directive was first applied to senior doctors in 1998 and then phased in for junior doctors in 2004.Ĭoncerns about the Directive have primarily focussed upon its impact on doctors’ training and patient care. 1 Essentially, the Directive restricts the average length of the working week to 48 hours, although individuals can opt out if they wish. The European Working Time Directive (‘the Directive') was introduced within the European Union with the aim of improving working practices with regard to working hours, rest breaks, and holidays. Fifty-two per cent reported a negative effect on efficiency in managing patient care. 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. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (62%) reported a positive effect upon work–life balance. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. 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 (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. 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.
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