Time off
- Correspondence to: Dr Malcolm Bateson, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK; batesonm{at}smtp.sdhc-tr.northy.nhs.uk
Resolving the problems of staffing for the proposed 48 hour week needs radical thinking
Managers are keen to develop the 24/7 philosophy in the NHS, realising that many facilities, overburdened during the 9–5 day, are empty or at least underused for the majority of the time. Operating theatres, secretarial offices, and outpatient clinics tend to be deserted at night and weekends, and many departments such as radiology and technical laboratories offer restricted out-of-hours service.
We are bidden to adopt flexible working patterns to use accommodation better, for example evening clinics and weekend operating lists. There is a mood to provide fuller support services out-of-hours.
However, it is simultaneously the case that the European Union and government are concerned about the culture of overwork, which is a curiously British phenomenon. The idea of the 48 hour week seems a pretty distant prospect to most clinicians. Indeed the new prospective consultants’ contract version of this is that doctors will work at least a 48 hour NHS week before engaging in private practice. This is hardly in the spirit of the concept to avoid overstretched and tired doctors trying to offer a full service. The analogy of plane pilots is apt. Airlines do not allow moonlighting when the normal working week has clocked up the appropriate number of flying hours. This is on the grounds of safety for passengers: surely patients deserve as much consideration. Anyone involved in acute medical specialties will be familiar with excessively long hours, and the drawbacks of disrupted personal lives and fatigue which results.
How to resolve this problem is not …
