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Doctor's Working Hours Project

Revolving Globe

The European working time directive was implemented for doctors in training in the UK NHS and elsewhere in Europe in August 2004. This represented a change from on−call cover to working in shifts. The reason for this was to improve doctors well being and effectiveness at work. Available research evidence indicates that doctors working shorter periods of time are less likely to make medical errors through tiredness and are less likely to have road accidents on the way home after work. Currently, junior doctors are restricted to working 56 hours a week.

In 2009 the legal working time drops to 48 hours per week. The UK Multidisciplinary Working Group has suggested an ideal rota to minimise errors. There is a need to evaluate the impact on doctors effectiveness and well being, patient safety, financial costs and organisational issues of this rota. This study will be important in gaining information about the impact of the changes before they are implemented.

Aim of Research:

To evaluate the impact of a change in junior doctors working hours from 56 to 48 hours/week so that information will be available before the changes are introduced in 2009.

University Hospitals Coventry & Warwickshire (UHCW) NHS Trust in Coventry will allow the pilot study to be carried out over a 6-months period (Feb-Jul 2007) on the Acute Medical Rota in that Trust. This large progressive NHS trust has been chosen for the complexity of the rota systems which involve many different medical sub-specialities. This enables us to test the effects of change in a highly complex system – one that has had to make several ‘real-life’ adaptations in order to implement the desired intervention.

We propose to use methodologies that have been previously used extensively in the study of work hours, sleep and fatigue in medical residents and police officers. Following completion of data collection, we will compare these parameters in doctors working on the traditional versus the intervention schedule. Throughout the study rotations, subjects will wear an activity monitoring device and will complete a daily sleep and work hours log. Alertness, mood and general well-being will also be assessed.



  • Cappuccio FP & Lockley SW. Safety and the flying doctor. Br Med J 2008; 336: 218
  • Cappuccio FP, Lockley SW & Landrigan CP. EWTD is to improve health and safety of patientys and doctros. Br Med J 2008;337:a3080 
  • Cappuccio FP, Bakewell A, Taggart FM, Ward G, Ji C, Sullivan JP, Edmunds M, Pounder R, Landrigan CP, Lockley SW & Peile E on behalf of the Warwick EWTD Working Group. Implementing a 48h EWTD-compliant rota for junior doctors in the UK does not compromise patients' safety: assessor-blind pilot comparison. Q J Med 2009; accepted for publication

Project leaders

Prof FP Cappuccio (PI)
Warwick Medical School, Coventry, UK

Prof E Peile(Co-PI)
IME, Warwick Medical School, Coventry, UK

Prof R Pounder
Royal College of Physicians, London, UK

Dr CP Landrigan

Dr SW Lockley
Harvard Medical School, Boston, USA

Dr M Edmunds
UHCW NHS Trust, Coventry, UK


Dr FM Taggart
Research Fellow, UK

Mrs G Ward
Research Fellow, UK

Mrs A Bakewell-Kuehnisch
Research Fellow, UK

Mr C Ji
Research Associate, UK

Dr JP Sullivan
Senior Research Assistant, USA


NHS National Workforce Projects