Junior doctors' shifts and sleep deprivation

doi:10.1136/bmj.330.7505.1404

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Alice Murray, research assistant,
Roy Pounder, emeritus professor of medicine (roypounder@hotmail.co.uk),
Hugh Mather, consultant physician,
Dame Carol Black, president

Centre for Gastroenterology, Royal Free Hospital, London NW3 2QG
Centre for Gastroenterology, Royal Free Hospital, London NW3 2QG
Ealing Hospital, Southall, Middlesex UB1 3HW
Royal College of Physicians, London NW1 4LE

The European working time directive may put doctors' and patients' lives at risk

The European working time directive was implemented for doctors in training in the UK NHS and elsewhere in Europe in August 2004. Junior doctors' working hours are now limited to a shift of no more than 13 hours followed by a break of at least 11 hours.1 As a result, the work pattern out of hours for most junior doctors at the front line of acute medicine has changed completely from providing on-call cover to working in shifts.2 The directive aims to reduce working hours in order to improve workers' health and safety, but the current NHS shift system could threaten doctors' and, moreover, patients' safety.

More than three quarters of medical senior house officers and nearly half of specialist registrars in NHS trusts were working seven consecutive night shifts when surveyed in December 2004 by the …