European Working Time Directive (EWTD)
Since August 2004 the Medical Workforce has complied with the European Working Time Directive. The average working week should be 58 hours (maximum duty 13 hours followed by an 11 hour break). Being resident on-call is defined as working. The aim is to reduce the 58 hour average working week to 56 hours by 2007and to 48 hours by 2009.
The government stipulates that:
- EWTD must be achieved.
- No recruiting of extra doctors is permitted.
- Service targets must be met.
In addition to that, The Royal College of Ophthalmologists and other medical Royal Colleges would wish to see minimum disruption to the delivery of training and no extension to the duration of training.
Whether all this can be achieved without detriment to any of the component parts is arguable. However, ophthalmology may be better placed than many other medical disciplines because of our work pattern. Despite this, our current working practices will need to be reorganised to facilitate compliance with the EWTD. No one solution will be applicable to every department.
This document will put forward some scenarios of appropriate practice. Each unit will need to produce local proposals. The needs of a small rural unit with three consultants will be quite different from the needs of a large inner-city unit with many consultants. The number of trainees and other doctors will also differ.