Impact of the European Working Time Directive on trainees and trainers 3 years post-implementation

Farshad Shaddel,Subimal Banerjee

doi:10.1192/pb.bp.112.041285

Abstract

Aims and methodTo assess the views of trainees and trainers of the impact of the European Working Time Directive (EWTD). The study was conducted in two stages. First, a qualitative survey of trainees and trainers in the Oxford Deanery was carried out on the positive and negative aspects of the EWTD to identify key areas. Second, a self-completed questionnaire was developed separately for trainees and trainers and the results collated. Twenty trainers and nineteen trainees took part in the study.ResultsAbout 70% of trainees and trainers were aware of the EWTD objectives. Ninety per cent of trainers and 30% of trainees believed that the introduction of the EWTD was a negative development. Compared with 42% of trainees, 80% of trainers believed that the EWTD had not improved the quality of care and instead had a negative effect on doctor–patient alliance and continuity of care. Although 53% of trainees believed that the quality of training was not compromised by the introduction of the EWTD, 84% of trainers thought otherwise. Less hands-on experience and some doctors' roles being given to other professionals were the most stated negative impacts of the EWTD on the quality of doctors' training. Positive effects of the EWTD from both trainees' and trainers' points of view were a better work-life balance and less burnout for junior doctors.Clinical implicationsThe EWTD may not have been successful in achieving all of its intended objectives. Further studies on different sample groups would help clarify the wider impact of the EWTD.

Highlights

About 70% of trainees and trainers were aware of the European Working Time Directive (EWTD) objectives
Just over half of trainees (53%) believed that the quality of training was not compromised by implementation of the EWTD, whereas the majority of trainers (84%) believed otherwise
Fifty per cent of trainees felt that there was a clear impact of the EWTD on their on-call experience, 37% described it as positive and 16% believed that it had a negative impact

Summary

Results

A total of 68% of trainees and 70% of trainers were aware of the main objective of the EWTD: to reduce the working hours of junior doctors to a maximum of 48 h per week. The majority of trainers (80%), clearly believed that the introduction of the EWTD had a negative impact on the overall quality of patient care. Just over half of trainees (53%) perceived the implementation of the EWTD as a positive change in clear contrast to the overwhelming majority of trainers (90%), who considered it to have a negative effect (Table 1). Both trainees and trainers considered that a more balanced work-life situation and less burnout was the most positive effect of the EWTD (Table 2 and Fig. 1). Thirty-five per cent of trainers believed that the introduction of the EWTD led to an increase in their workload and consequent burnout (Table 3 and Fig. 2)

Method

Discussion