The Royal College of Physicians (RCP), along with the BMA and a number of the UK's Royal Colleges, has signed a joint letter to prime minister Theresa May calling for the government to retain the provisions of the Working Time Regulations (WTR) directive in law when Britain leaves the European Union.
The RCP joined the other organisations in sending the message because it believes the 48 hour limit to the working week, rest breaks and statutory paid leave are in the interests of both doctors and their patients. Before the European Working Time Directive, 90 hour working weeks - and the attendant risks these posed - were all too common in the NHS. Even with these regulations, fatigue caused by excessive overwork remains an occupational hazard for many staff across the NHS, as evidenced by a number of tragic, albeit not uncommon, road accidents where doctors have fallen asleep while driving following 'punishing night shifts'.
[The RCP] believes the 48 hour limit to the working week, rest breaks and statutory paid leave are in the interests of both doctors and their patients
The NHS remains Underfunded, underdoctored, overstretched, and we must make sure Brexit does not exacerbate the situation. The NHS needs proper resourcing and investment to increase the size and improve the morale of the workforce. That said, the RCP understands the impact the WTR have had on some specialties, particularly disciplines in which trainees develop practical skills that are best learned through direct experience with patients. Greater flexibility in working patterns may help the quality of training and continuity of patient care.
Brexit creates opportunities to review the relevant aspects of the regulation of working time. In particular, how 'working time' is defined following the SiMAP and Jaeger rulings of the European Court of Justice (ECJ), especially given the jurisdiction of the ECJ will no longer extend to the UK. The SiMAP ruling means that any time that a doctor is on call counts as working time, if the doctor is expected to be available immediately. And the Jaeger ruling means that any doctor who is resident and on call is considered to be working even if asleep or otherwise resting, and any compensatory rest needs to be taken before the next shift starts. Some members of the profession believe the SiMAP and Jaeger rulings have had a negative impact on training and patient care. They cite the rulings as contributing to rota gaps, and short-notice cancellation of elective procedures and outpatient appointments.
The WTR are a key issue for physicians as Brexit progresses, and any changes must be discussed with the healthcare workforce. The RCP will discuss the impact of SiMAP and Jaeger with our members and fellows to make sure the UK has the right regulations to deliver the highest level of patient care.
If you have any questions, queries or comments about any of the issues raised, please do contact us via policy@rcplondon.ac.uk.