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EWTD – a view from the shop floor Dr Andrew Goddard Director, Medical Workforce Unit

EWTD – a view from the shop floor Dr Andrew Goddard Director, Medical Workforce Unit. Conflicts of interest. Hospital workforce 1991-2003. 58%. 12%. 17%. 2%. 1%. 7%. 3%. Workforce demands and availability.

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EWTD – a view from the shop floor Dr Andrew Goddard Director, Medical Workforce Unit

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  1. EWTD – a view from the shop floor Dr Andrew Goddard Director, Medical Workforce Unit

  2. Conflicts of interest

  3. Hospital workforce 1991-2003 58% 12% 17% 2% 1% 7% 3%

  4. Workforce demands and availability Since 2004 the available medical workforce (man/hours) has increased by 12% but the workload has increased by 19% A reduction in hospital trainee numbers of 5% is expected over the next 3 years Consultant expansion is unlikely to continue due to the financial climate Changes in working practices are needed to cope with increasing demands

  5. EWTD – the junior doctor’s view 2010 RCP SpR survey

  6. EWTD – junior doctors view • 4.7% trainees say rotas not compliant • 21.9% foundation doctors work over their hours daily • 35.4% of trainees rarely or never exceed 48 hours per week • 62.9% of trainees feel training needs are met in 48 hour week GMC trainee survey 2011

  7. EWTD – the consultants view • 81% of consultants report training is worse or much worse since the implementation of EWTD in 2009 • 70% report patient care is worse or much worse • 89% report continuity of care is worse or much worse • The average consultant works 48.5 hours/week

  8. Can consultants work harder?

  9. Solutions • Renegotiate EWTD (WTR) • Renegotiate New Deal • Utilise available CCT holders • Mobilise money spent on locums • Physicians assistants

  10. SiMAP & Jaeger • Sindicato de Medicos de Asistencia Publica (Primary Care) • Any time on-call is working time if expected to be available • Norbert Jaeger (Hospital) • Resident on-call is working time • Compensatory rest must be taken immediately

  11. New Deal

  12. Will junior doctors work longer hours? • 40.9% of medical registrar would work up to 56 hours if able • 8.4% would work over 56 hours • ASiT want surgical trainees to work 65 hours per week

  13. CCT holders 1 year later %

  14. How often do you use locums?

  15. Physician’s Assistants

  16. Summary • EWTD has reduced quality of patient care and training • Making best use of current workforce with limited finances is the key

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