NHS working hours must be addressed by employers, warns BMA

NHS employers were today urged to develop safe working rotas for doctors and encourage rest breaks during night shifts – or run the risk of endangering public safety.

A new British Medical Association (BMA) report, Shift-work, Rest and Sleep: Minimising the Risks, warns that medics who work irregular shift patterns are more prone to health risks and sleep deprivation, which could threaten patient safety.

The report, by the BMA’s Scottish Junior Doctors Committee (SJDC), claims that many junior doctors work a combination of shifts such as a week of nights followed by a week of late shifts with a day or two off in between.

Although this pattern would be compliant with the European Working Time Directive (WTD), the report argues such long periods of unsociable hours could have serious implications for the health and wellbeing of doctors and negatively affect patient care.

“It has become evident that poor rota design of working time regulations (WTR)-compliant shift patterns may also result in a shift structure predisposed to high-intensity work that may lead to fatigue and may carry unacceptable burdens of risk to doctors and patients,” the report says.

Recommendations include making shift lengths as short as practicable and encouraging doctors to rest during night shifts as much as possible.

Dr Gordon Lehany, chair of the SJDC, said: “It is important that as NHS boards try to become compliant with European WTR they also consider safe shift-working patterns. To do this effectively, junior doctors should be involved in drawing up rotas. It is essential that the problem associated with working irregular shift patterns are recognised and reduced.”

But Bill McMillan, head of medical pay and workforce at NHS Employers, told Personnel Today that employers already work with doctors to ensure that shift work arrangements maximise patient care, patient and doctor safety and doctor training.

“This was reflected in our written evidence to the Temple Review looking into working hours and quality training in England, and we await detailed recommendations arising from that review,” he said. “NHS organisations have effectively implemented related working hour arrangements, such as the European Working Time Directive, and are able to make any adjustments necessary to ensure the safety of both patients and doctors.”

Last year Personnel Today reported how poor workforce planning by NHS HR functions had led to a rise in medical staff vacancies.