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Medics get working hours opt-out Medics may get work hours choice
(4 days later)
The government has said not all doctors will have their working week cut to 48 hours in August as planned.The government has said not all doctors will have their working week cut to 48 hours in August as planned.
Ministers said the European Working Time Directive limit would not have to apply to certain doctors working in emergency medicine, or in rural areas. Ministers have opted out from the European Working Time Directive, meaning the limit will not go down to 48 hours for another two years.
Instead, they will remain able to work up to 52-hours a week.Instead, they will remain able to work up to 52-hours a week.
Doctors' associations, which had said the shorter week did not allow enough training time, welcomed the move, but said it did not go far enough.Doctors' associations, which had said the shorter week did not allow enough training time, welcomed the move, but said it did not go far enough.
The Royal College of Surgeons has also warned that staff levels could be cut too much and that there is less overlap between doctors' shifts, so handovers are more rushed - and unsafe. The opt-out means that junior doctors will be able to work four extra hours if their employer chooses.
However a small study published this week found that doctors who did work fewer hours did not make as many medical errors. The move is now being considered by the European Union, which will give its opinion in three months' time.
Delay Opt out
Two thirds of doctors in the UK already work a 48-hour week. All UK employees working more than 48 hours a week can voluntarily opt out of the hours rules of the European Working Time Directive (EWTD) and work up to 78 hours per week.
The opt-out will apply to 20 to 30 units at trusts across the country, including services providing 24-hour care, extremely specialist teams and remote and rural units. This is as long as they do not more than a 13-hour shift with one day off every week or two days a fortnight.
The Department of Health announcement will do little to ease concerns Royal College of Surgeons spokesman Two-thirds of doctors in the UK already work a 48-hour week.
The government said there were other "specific and unavoidable" reasons why some could not meet that target, including a shortage of doctors and split-site services, sites, which require more doctors than normal. The Royal College of Surgeons has warned staff levels are being cut too much and there is less overlap between doctors' shifts, so handovers are more rushed - and unsafe.
The opt-out, or derogation, is expected to last for up to three years. However, a small study published this week found that doctors who did work fewer hours did not make as many medical errors.
The government said there were other "specific and unavoidable" reasons why some could not meet that target, including a shortage of doctors and split-site services, which require more doctors than normal.
Committed
The opt-out, or "derogation", is expected to last for up to three years.
It will apply to doctors in training who have duties in services that are delivering 24-hour immediate patient care, in some extremely specialist areas or in small, remote or rural units.
But the government said it was committed to all doctors working within the 48-hour week.But the government said it was committed to all doctors working within the 48-hour week.
Health Minister Ann Keen said: "Most UK doctors in training already comply with the WTD, and the overwhelming majority will do so by 1 August this year. Health Minister Ann Keen said: "Most UK doctors in training already comply with the EWTD, and the overwhelming majority will do so by 1 August this year.
"However, we have notified the European Commission that we intend to operate a derogation for a small number of services involved in delivering urgent and emergency patient care."However, we have notified the European Commission that we intend to operate a derogation for a small number of services involved in delivering urgent and emergency patient care.
"For unavoidable and specific reasons, this small number of services is unlikely to be able to fully implement the WTD by 1 August, 2009. "For unavoidable and specific reasons, this small number of services is unlikely to be able to fully implement the EWTD by 1 August, 2009.
"Potential reasons include services in trusts which are relatively isolated from large population centres and so find it difficult to recruit more doctors, or where hospital services are in the midst of change programmes.""Potential reasons include services in trusts which are relatively isolated from large population centres and so find it difficult to recruit more doctors, or where hospital services are in the midst of change programmes."
'Far short' Sustainable
But a spokesman for the Royal College of Surgeons said: "Surgeons are clear that an impending crisis in quality patient care can only be headed off by working 65 hours a week including on call. But a spokesman for the Royal College of Surgeons said: "Surgeons are clear that an impending crisis in quality patient care can only be headed off by working 65 hours a week, including on call.
"The Department of Health announcement will do little to ease concerns."The Department of Health announcement will do little to ease concerns.
"In effect, they are approaching Europe to ask for an increase from 48 to just 52 hours which is far short of what's needed.
"We will continue to campaign for a surgical specialty opt out for both surgeons and surgical trainees to protect patient care and ensure highest standards in training can be maintained.""We will continue to campaign for a surgical specialty opt out for both surgeons and surgical trainees to protect patient care and ensure highest standards in training can be maintained."
Professor Ian Gilmore, president of the Royal College of Physicians added: "While derogation provides for only an additional four hours, this will undoubtedly afford some vitally needed breathing space for some services while the profession, with government develops a more sustainable solution to the acute challenge the service now faces in providing quality clinical care."Professor Ian Gilmore, president of the Royal College of Physicians added: "While derogation provides for only an additional four hours, this will undoubtedly afford some vitally needed breathing space for some services while the profession, with government develops a more sustainable solution to the acute challenge the service now faces in providing quality clinical care."