This the abstract of a paper prepared by Mr. S. Sharma on the impact of moving to a full shift rota at Stirling Royal Infirmary
Background: Across the country junior doctors working patterns are being changed in order to make rotas compliant. Full shifts are increasingly seen as a solution for many NHS trusts as it solves the issue of compensatory rest periods. We present data on the impact of a full shift rota on training.
Methods: The orthopaedic department at SRI adopted a full shift rota involving 6 trainees (2 SpRs, 2 SHO-3s, 2 Trust grades). The full shift rota involved working a week of 13-hour day shifts and a week of 13-hour night, shifts. Interspersed between the weeks of night and day shifts were 4 weeks of a mixture of normal working days, half days and days off. This rota was introduced 3 months into our 6-month posting, which meant that we did an on-call rota for 3 months and a full shift rota for 3 months.
Results: The number of operations that the trainee assisted or performed dropped to 33 during the full shift rota. Clinic sessions dropped to 60 %. Clinic sessions in the firm where the trainee was posted dropped to 34 %. Apart from the week of nights and days, continuity of care for patients on the ward was affected. Productivity was affected as consultants reduced their clinics on the assumption that they would not have a trainee to help in the clinic. In addition 21 of the 145 clinics and 22 out of a possible 145 theatre sessions were cancelled when the consultants were on leave.
Conclusions: Our data illustrates the reduction in training as a consequence of shift work. Shift work though may be inevitable in some NHS trusts. We do believe that trainees should be consultant / team based even if working a shift rota. Secondly shift rota with a minimum of 8 people will provide more opportunity for training.