Doctors hours to be cut in shake-up

PATIENTS across Suffolk could be treated by nurses instead of doctors or be farmed out to other hospitals under radical plans being drawn up to curb the impact of new working laws.

PATIENTS across Suffolk could be treated by nurses instead of doctors or be farmed out to other hospitals under radical plans being drawn up to curb the impact of new working laws.

European legislation - set to hit hospitals in 2009 - will prevent junior doctors working any more than 48 hours a week.

Hospitals across the region are now drawing up plans to cope with the “fundamental” changes which, they say, are a “must do” under the European Working Time Directive (EWTD).

West Suffolk Hospital Trust in Bury St Edmunds will lose the equivalent of 408 hours a week in doctor time - the equivalent of 8.5 newly qualified doctors, or one in 12 of the trust's current junior doctor force.

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If doctors are working at the current 56-hour a week maximum, Ipswich Hospital Trust will lose the equivalent of one in six of its junior doctors - or 1,296 hours - from 2009, when the limit becomes 48 hours a week.

And at Essex Rivers Healthcare Trust, more junior doctors are to be taken on in February next year in advance of the enforcement of the working time directive in 2009.

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A spokesman for the trust said: “This will be a huge fundamental change. We achieved the previous target for 2005 and we are working towards achieving the target for 2009.”

A spokesman for the Norfolk, Suffolk and Cambridge Strategic Health Authority, said: “In 1990 a 24 hour rota would have required only three doctors - after 2009 this could go up to nine doctors and this will have significant impact.

“Hospitals have a duty to make arrangements and we know this is going to cause some issues particularly in A and E which is traditionally staffed by doctors in training.”

Plans currently being drawn up by health bosses in Suffolk include using highly trained nurses to carry out junior doctor work and transferring more patients to other hospitals.

Described as a “complex challenge”, Jan Bloomfield, the West Suffolk Hospital trust's director of human resources, said the hospital was more than half way to being fully compliant with the new laws.

Junior doctors - who are the backbone of the hospital's night service - face being sent home if they were in danger of exceeding 48 hours, she said.

Mrs Bloomfield said the hospital had already decided it would be impossible to replace the doctors because of a potential shortage of new graduates and high costs.

Instead they would look to train up existing senior nursing staff and hire cheaper staff to free up time for nurses by doing “routine” jobs.

She said: “We need to find ways to cover that loss. One key area is what happens overnight in the hospital where we are looking at creating a night team of senior nurses led by a senior doctor.

“It will cost us £100,000 to do this which is about the same as the amount we will save on paying junior doctors. It also gives nurses an opportunity to broaden their roles and that must be something to be welcomed.”

One option, she said, was to send patients to other hospitals. She pointed out a similar system already existed for certain disciplines like neurosurgery which cannot be performed in the West Suffolk.

“It could be that we may need to network other services,” she said. “We will consult on this in the coming weeks with different parts of the hospital and nothing will be done which affects patient safety.”

Ian Scott, medical director at The Ipswich Hospital Trust, said: “We are looking at similar solutions but there are a whole series of imponderables which may have an impact on the implementation of the EWTD.

“For example the Acute Services Review may have a significant impact on how we deliver care in acute services.”

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