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Arch Hellen Med, 25(2), March-April 2008, 221-223


The "hospital at night" medical cover in the UK

1University College, London
2Department of General Surgery, University College Hospital, London, UK

In 2004 the European Union introduced changes in the legislation which affects all doctors working within its jurisdiction. In particular, the European Working Time Directive stipulates that doctors in training should work on average no more than 48 hours per week. Greece has a responsibility to apply these regulations to the National Health Service. The response of the UK was to produce the "hospital at night" project which was designed to redefine provision of out-of-hours medical cover, with particular emphasis on multidisciplinary teamwork, improved communication, more efficient use of time and cover based on competence rather than staff grade. Night shifts begin with an organized handover meeting that acts as an opportunity to review acutely unwell patients, aids continuity of care, provides a forum for staff education and teamwork and improves information transfer. During the night a nurse co-ordinator with an extended clinical role is responsible for assessing patients with problems before doctors are called to attend to them. The "hospital at night" project has been implemented successfully in the UK. Greece could draw on the scheme as a model for change in its own hospital system. A pilot study in the Greek National Health Service, based broadly on the UK project, would be a useful way to assess its effectiveness in the context of the Greek healthcare delivery system.

Key words: European working time directive, Hospital at night, Out-of-hours cover.

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