Abstract
We would like to thank Booth and colleagues for their interest in our findings. We fully agree that the salient point is not the rota pattern, but the actual average hours worked. It is important thus to clarify that we aimed to compare pre-new deal training patterns (60–68 average hours per week) with post European Working Time Directive compliant rotas. As the authors are probably aware implementation of European Working Time Directive has been phased in the UK, with the 48-h limit being mandatory from August 2009. In December 2000, when the new banding system was introduced as part of the New Deal, most of the rotas in our region changed to Band 2B rotas, limiting working hours per week to < 56 h. Over the time period we studied the average hours worked was 52–56 h per week. This variation is due to the phased implementation of European Working Time Directive and its overlap with new deal requirements, as well as the slight variation in rotas between the different hospitals in the region. We have not studied a group who are working to the 48 h limit as this is yet to be implemented. It is important to note that Sim et al. [1] stated that the average number of hours decreased from 48 h whilst on partial shift rotas to 43.5 h on full shift rotas and that this was associated with an 18% reduction in caseload for anaesthetic Specialist Registrars. This was based on departmental monitoring of hours, which may be inaccurate or not representative of the rest of the training year. We do not envisage reducing training time to less than the absolute minimum of 48 h, as despite our findings we do believe that at a certain point, reduction in working hours will inevitably result in a reduction in caseload. If the average weekly hours reported by Sim et al. is accurate, than our data would not be comparable with their’s. Our data is more likely to be comparable to the data presented by Underwood and McIndoe [2] (although again they do not specify average weekly hours worked between their groups). Finally we would agree that a loss of 0.6 of a session per week together with the Royal College of Anaesthetist’s requirement for a minimum of three training sessions per week will result in loss of solo lists important for the experience and confidence of trainees. There seems no simple solution other than perhaps extending the working day of consultants and/or working weekends so that some of the traditional out of hours work becomes supervised and contributes to training sessions.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have