Influence of changing work patterns on training in anaesthesia: an analysis of activity in a UK teaching hospital from 1996 to 2004.
BACKGROUND
We aimed to assess the influence of reduced working hours on training in a UK teaching hospital as the specialist registrar grade was introduced in 1996, the New Deal was implemented in 2001 and the Working Time Directive (WTD) took effect for doctors in training in 2004.


METHODS
We analysed data from operating theatres in our hospital looking at grade of anaesthetist, time of day, emergency category, and specialty for more than 50,000 cases.


RESULTS
Although direct supervision of trainees increased from 32 to 37 to 47%, senior house officer (SHO) and specialist registrar (SpR) caseload reduced by 20 and 21%, respectively, while that of the consultants rose.


CONCLUSIONS
The reduction in total operating theatre cases for our trainees was evident across the epochs analysed, case numbers fell after introduction of the New Deal as well as more recently following the WTD, particularly for SHOs who are now doing a larger proportion of their work at night. SHOs and SpRs are doing more obstetric cases than in previous times but these are regional and not general anaesthetics.
Underwood
S M
SM
Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UK. susan.underwood@ubht.swest.nhs.uk
McIndoe
A K
AK
D000773:Anesthesia, Obstetrical / Q000706:statistics & numerical data / Q000639:trends; D000776:Anesthesiology / Q000193:education* / Q000458:organization & administration / Q000639:trends; D002585:Cesarean Section / Q000706:statistics & numerical data; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data / Q000639:trends*; D004739:England; D005260:Female; D006302:Health Services Research; D006784:Hospitals, Teaching / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education* / Q000458:organization & administration; D008611:Mentors / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration / Q000639:trends; D011247:Pregnancy; D016526:Workload / Q000706:statistics & numerical data