Surgeons are keen on working. They like the work, they like to make people better some even like the money. It therefore comes as no surprise that a survey of 70 surgeons on the EWTD suggests that 91% thought it would have a negative impact on their training, with 90% feeling that patient care would suffer. Seventy three percent wanted to opt out, with 74% wanting either standard pay or time and a half.
The initial survey was a small sample with only 70 doctors involved but ASiT and BOTA are planning a bigger study for the early autumn. Should be interesting!
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The EWTD is not there to save money, indeed a great deal of extra money is available to make it work. Surgeons should look very carefully at the Non-Resident On-Call Solution devised by RotaGeek.com ... it provides an awful lot of extra flexibility, if the average over-night workload is <8h.
ReplyDeleteAny craft speciality requires a certain degree of performane of that craft to become proficient. There is a balance of quality of teaching and time/oportunity beyond which it is impossible to be trained adequately. EWTD combined with the constrains of the New Deal and withdrawal of F1 out of hours cover gets us past the tipping point. In the USA surgeons are lamenting the reduction in maximum training hours to 80 per week.
ReplyDeleteCreative rota-ing helps up to a point but the out of hours cover still has to be provided, and patients on the ward have to be cared for out of hours. With the withdrawal of F1s to save money with complicit supoprt for foundation schools, CT trainees are being required to provide cover for jobs previously done by the F1s. This has the double effect of taking the CT trainees away from day time training oportunities to recover fom over night on call but also not allowing access to theatre for training as a surgeon during the night. (Cover could be provide by consultants of course, but compensatory days off would cripple the heath service in moments.) Consequently numbers of appenicetomies, abscesses performed etc are woefully low by the end of CT training in most, meaning ST trainees are being taught skills previously learned at CT stage. We have to maximise daytime and out of hours training but if EWTD/New deal is to be complied with then either trainig should be lengthened (at ST level as another year at CT would only prolong the perpectual house officer agony), or what we expect consultants to be able to do has to change. A parallel is often draw between avaition and medicine - who'd want a pilot with only a few hours under their belt flying them and their family to their holiday destination?