Dear Doctor,

As you are aware, your hospital has been chosen as one of nine pilot sites where proposals for work practice changes are being invited by the National Implementation Group (NIG) which is overseeing the implementation of the European Working Time Directive.

It is important to understand that the NIG, chaired by Dr Cillian Twomey , is not dealing with contractual or industrial relations changes which are being discussed separately by the IMO and the HSE.

In fact, the terms of reference of the Twomey Group are as follows:

1. Coordinate the work of the existing Local Implementation Groups and help them plan and support the implementation of EWTD in line with the following three reports:
   
1. The report of the National Joint Study Group on the working hours of non-consultant hospital doctors
2. The Report of the National Task Force on Medical Staffing
3. Training principles issued by the Medical Education & Training Group
   
2. Issue of agreed guidance to health employers and other parties on issues related to the implementation of the European Working Time Directive,
3. Assist in the development and evaluation of local implementation plans,
4. Initiate such research or data gathering exercises as are considered necessary,
5. Be responsible for communication with all national stakeholders on progress in the EWTD implementation process,
6. Review of the operation of the Body six months after the implementation of the Directive.
   

Recently, the Twomey Group wrote to the Local Implementation Groups established in each of the nine pilot sites inviting proposals for initiatives which would reduce NCHD hours (see copy of Guidance enclosed).

It is important to understand that doctors will not suffer any adverse change in their pay or conditions of employment for the duration of any such pilot projects.

In fact, it is hoped that some additional medical staffing will be approved to support some of these projects. Equally, any changes introduced are not binding on the IMO in terms of separate contract negotiations. Any changes will be temporary in nature and will not be implemented on a permanent basis without agreement.

The Organisation supports this process of developing pilot initiatives and would encourage you and colleagues in your speciality or Department to meet to consider preparing proposals for submission.

We believe that these initiatives should establish the real medical staffing needs flowing from full and proper implementation of the EWTD, the implications for the training of doctors and also the impact on service delivery and continuity of care. It will be as important to establish what cannot work as well as what can work and an evaluation of the initiatives is to be arranged.

To assist you in considering proposals, I am pleased to enclose jointly agreed documentation from Northern Ireland where the Department of Health, Social Services and Public Safety and the British Medical Association detail possible solutions to working pattern problems, examples of good practice from England and examples of good practice by speciality. I would ask that you study the documents and consider how it might trigger ideas for pilot initiatives in your hospital.

Finally, we are aware that doctors in some hospitals state they are not being briefed sufficiently on this exercise, both locally and nationally, and that some doctors are experiencing particular difficulties in being enabled to attend meetings of their Local Implementation Groups. If you are experiencing difficulties in terms of how the Local Implementation Groups or have any other concerns, please contact IMO House immediately and we will arrange to advise and assist you.

Yours sincerely,

Fintan Hourihan
Director, Industrial Relations

Encl:

Department of Health Social Services and Public Safety / British Medical Association – ‘Guidance on Working Patterns for Junior Doctors'
National Implementation Group – Guidance for local Implementation Groups
Cc: Dr Cillian Twomey , Chair, National Implementation Group – EWTD
Mr. John Bulfin, HSE