England abandons monitoring of compliance with working time directiveBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5553 (Published 01 September 2011) Cite this as: BMJ 2011;343:d5553
The NHS in England has abandoned its national monitoring of whether doctors’ rotas comply with the 48 hours a week limit stipulated in the European Working Time Directive.
The “ministerial return” that hospital trusts previously submitted on compliance with the directive was cancelled in August 2010 “to reduce bureaucracy.” As such the Department of Health in England was unable to provide information on the proportion of rotas that comply with the directive, unlike the health departments in Wales, where all junior doctor rotas comply; Scotland, where compliance is 99%; and Northern Ireland, where compliance is currently 78%.
Furthermore, none of the 10 strategic health authorities in England collects data on compliance from trusts, with many responding that such information was available at the level of trusts.
“It’s certainly surprising that there isn’t regional oversight,” said Shree Datta, who co-chairs the BMA’s Junior Doctors Committee. “SHAs [strategic health authorities] have got so much on their plate over the next 18 months or so, it’s very unlikely that they would take ownership of the working time directive off their own backs. I think we’re talking about patient safety as well as doctor safety, so it would be really useful to see the ministerial returns back in place.”
The governments in Wales, Scotland, and Northern Ireland regularly collect and review data on whether rotas comply with the “new deal” contract for doctors in training, which is used as a proxy for compliance with the 48 hour limit in the European Working Time Directive.
Wales collects data from live rotas and monitoring software used by trusts, which is reviewed every couple of months by a group comprising the Welsh government, health boards, the Wales Deanery, the Welsh NHS Employers Unit, the BMA, medical students, junior doctors, staff and associate specialist doctors, and consultants.
In Northern Ireland the Board Liaison Group of the Health and Social Care Board monitors trusts’ compliance with the directive for doctors in training and provides twice yearly returns on compliance rates to the Department of Health, Social Services and Public Safety.
The Scottish government’s health directorates undertake twice yearly monitoring for compliance with the new deal contract, and all NHS boards in Scotland have to keep records which show that employees comply with the limits.
A spokesperson for the Department of Health in England said, “As part of the government’s commitment to reduce bureaucracy in the NHS, the secretary of state has stopped the central collection of new deal compliance data which was used as a proxy to demonstrate compliance with the working time directive. Local organisations are still required to ensure compliance with the working time directive and to monitor that compliance.”