Joint Project with RCPCH
The report of this project is available to download here.
The Project
National Workforce Projects has funded a project which has been undertaken jointly by the Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health. The project has evaluated the impact of implementing the 2009 Working Time Directive on maternity and children's services in England and has defined examples of good practice.
The 2009 Directive will have a major effect on shaping obstetric and paediatric services in England and it is extremely important that the Colleges have a full understanding of its implications. The assistance of Obstetric Clinical Directors is essential to developing that understanding.
Background
In 2004, the maximum amount of time that doctors in training could be resident in the hospital was reduced to 58 hours per week. The rota issues that resulted from this directive were largely solved by extra funding and an increase in the number of resident doctors. In August 2009, the maximum amount of resident time for junior doctors will be reduced to 48 hours per week and it is unlikely that hospitals will be able to extend the same solutions for this phase of the directive. The Colleges have undertaken this project to assess the impact of these changes on Obstetrics and Paediatric Services and to look at the possible consequences for safety, training, sustainability and cost for any proposed staffing models.
First phase: solutions to meet WTD
During July 2007, a project officer from each College contacted all Obstetric or Paediatric Clinical Directors in England. The Obstetric Clinical Directors were asked to complete a questionnaire on current level of compliance with the 2009 Working Time Directive as well as plans for future compliance. After analysis of the data from the questionnaires, members of the project team have undertaken follow up visits to a small number of hospitals in order to gather more detailed information about the experience of trying to achieve compliance with the Directive.
Second phase: evaluation of solutions and formulation of recommendations
Each College hosted panel meetings with wide stakeholder representation which evaluated the initiatives that hospitals have implemented to become compliant.
The evaluation examined the impact on:
- safety and risk management
- how effectively they meet other policy initiatives such as Improving Working Lives, Every Child Matters and the National Service Framework.
- training of clinicians
- financial costs.
The implications for current services or planned reconfiguration of services have been studied and recommendations made.