Working time rules must be kept after Brexit, say medical leadersBMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5917 (Published 21 December 2017) Cite this as: BMJ 2017;359:j5917
All rapid responses
The Games People Play: The onus of providing evidence regarding fatigue and the facade of Working Time Regulations compliance in the NHS
I am curious that in the letter to the Prime Minister, various health organisations asserted the following:
"It is not in the interests of either staff or patients to relax or move away from the safeguarding protections introduced by the WTR, namely the limit of an average 48 hour working week, rest breaks and statutory paid leave, especially when there is, of course, the existing option for all workers to voluntarily opt out of these regulations.
Even with these regulations, we know that fatigue caused by excessive overwork remains an occupational hazard for many staff across the NHS, with tragic and not uncommon reports of road accidents after falling asleep at the wheel." (ref 1)
Is there any evidence that the staged introduction of the Working Time Regulations enacted since 1998 (partially and fully implemented by 2003 and 2009 respectively) actually reduced or stabilised the incidence of occupational hazard, clinical errors or road traffic accidents during these period?
The 48 hour WTR is also a double-edged weapon and can be used against NHS staff at the same time as (allegedly) protecting them.
Keeping in mind that "over half of NHS staff work unpaid overtime every week and a significant minority say they did not feel able to deliver the care they aspired to" (ref 2), the likely true scenario is that the actual weekly working hours for most staff is significantly more than the gazetted 48 hours but it is just that these overtime as a result of the WTD rules remains unrecorded, unclaimed and unpaid.
Let's stop playing games and pay people for the work they do rather than put a limit across the board and pretend some fairy godmother will sort things out without human hands and brain.
While some non-essential work can be limited to working hours, often clinical caseload does not conveniently occur between rostered working hours.
Either the NHS have to hire more staff right away to account for these unrecorded workload, or drop the facade that somehow all the work in NHS can be managed by staff adhering to the WTR, the letter to the PM does nothing to address these issues.
And I have not even touched on the issue of training yet, but judging by the concerns by some others (ref 3) the views of some medical colleges were not shared by some of their members.
Competing interests: No competing interests