Intended for healthcare professionals

Letters Sleep for night shifts

Optimising rotas, not doctors’ behaviour, will improve safety

BMJ 2018; 361 doi: (Published 17 April 2018) Cite this as: BMJ 2018;361:k1663
  1. Francesco P Cappuccio, professor of cardiovascular medicine and epidemiology and consultant physician
  1. Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
  1. f.p.cappuccio{at}

Frequent shifts in junior doctors’ rotas cause harm to patients and doctors due to tiredness, fatigue, attentional failures, and cognitive impairment.1234 A recent article in The BMJ may give the false impression that changing individual behaviour will solve the problem.5 The authors underestimate the barriers to implementing the measures suggested; individual choices are frustrated by unfavourable environmental and organisational structures. Unsafe working patterns …

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