Psychiatric Bulletin (2005) 29: 114-115. doi: 10.1192/pb.29.3.114-b
© 2005 The Royal College of Psychiatrists
Psychiatric Bulletin (2005) 29: 114-115
© 2005 The Royal College of Psychiatrists
European Working Time Directive
Shaharyar Alikhan, Staff Grade Psychiatrist
Hallam Street Hospital, West Bromwich, West Midlands WS10 1TZ
Charles Dixon (Psychiatric Bulletin (Correspondence), November
2004, 28, 426) echoes the sentiments of many psychiatric trainees who
have to comply with European Working Time Directive (EWTD) rest requirements.
On the one hand reduction in working hours is seen as a welcome modernisation
in the life of a junior doctor, on the other hand, at the expense of senior
house officer (SHO) training, delegation of tasks traditionally performed by
medical staff means that front-line psychiatric practice becomes increasingly
multidisciplinary.
The apparent ease with which the SHO has become dispensable from the
assessment of the patient in accident and emergency (A&E) must have grave
implications for psychiatrists at all levels. Nurse-led teams assessing
A&E patients out of hours already call upon the services of the on-call
psychiatrist if faced with the possibility of the use of the Mental Health Act
1983, following their initial, often very comprehensive assessment. If there
happens to be a medical complication, there are plenty of A&E staff close
at hand to give advice.
Psychiatrists, in order to avoid being perceived as supernumerary in the
initial screening of the patient presenting to A&E, must ensure they are
represented on the teams carrying out these assessments. If the EWTD means
that this can only be achieved by implementing a shift system we can see our
future, and this is to be supported over and above a reduction of SHOs
night commitments. Not only is this significant for SHO training, but it is of
paramount importance in defining the role of the psychiatrist in the
multidisciplinary team.