European Working Time Directive – Implementing Organisational Culture That Improves Patient Safety

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Organisational Change European Working Time Directive – Implementing organisational culture that improves patient safety Introduction The European working time directive (EWTD) was implemented in October 1998, there was as a staged reduction in junior doctors working hours initially the maximum time that doctors could spend resident in a hospital was 58 hours a week. After august 2009 this was reduced to 48 hours. This cap on the number of hours that junior doctors can legally work has meant that the NHS has needed to readdress the way it provides a safe service for patients and develop new ways of working (Department of Health 2009). It has been over 3 years since the latest implementation of the European Work Time Directive. The demand on the NHS to keep making changes and amendments to ensure better working conditions for junior hospital doctors remains. This reduction in hours has proved to be difficult with not all hospital being compliant with the new legislation due to staffing shortages or resistance from within the organisation. The effect of reduced training time has led to a paradigm shift in training from an apprenticeship model to a competency based model. The Hospital at Night initiative was implemented to cope with the reduction in the number of junior doctors working hours, especially at night and weekends. This would allow the most appropriately trained member of the skeleton team to respond to calls (mainly a specially trained nurse). Therefore this would lead to the safe running of hospital at night despite the reduced number of doctors. Historical Structure By tradition medical training has been long and intense. New patient admissions were managed by teams or ‘firms’. This consisted of a house officer (1st year doctor), a senior house officer (2nd or 3rd year doctor), a registrar (4th or 5th year doctor), a senior registrar (greater

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