The Hospital Authority has welcomed the recommended work reform strategies of the Steering Committee on Doctor Work Hours and supported the reform directions.

Speaking after the committee's administrative and operational meeting today, Hospital Authority Board Chairman Anthony Wu said the doctor work reform involves quality patient care through teamwork, risk management, enhanced patient safety, and service and training.

The authority will follow the committee's recommendations of optimising total workload, changing existing work patterns for doctors, training under the new work hour arrangements and targeted deployment of resources.

The authority said it will reduce doctors' average weekly work hours to a maximum of 65 by the end of 2009, targeting 16 on weekdays and 24 on weekends and holidays in the long term.

It will also look to granting post-call half-day time-off for doctors on overnight on-site calls, and four consecutive hours of mutual-cover sleep time for doctors taking on overnight on-site call duties exceeding 24 hours.

Pay rise

The committee also made recommendations on doctors' pay. The authority agreed on the principle of nominal recognition in a broad-brush approach.

The salaries of 2,000 serving doctors who joined after April 2000 will rise by 15% to 38%.

Doctors who have passed specialist examinations will have pay increments, and the authority will offer a nine-year employment contract to retain doctors undergoing specialist training.

The authority has committed an annual recurrent expenditure of more than $350 million for those measures.

Patient safety

To improve patient safety the authority will implement continual facilitation and encouragement of doctor training, gradual reduction of overnight on-site call hours and frequency, enhancement of clinical protocols and care pathways to streamline patient management.

The authority will conduct test runs of call teams with enhanced core-competency in selected hospitals as well as development of a common ward language to identify potentially critical patient conditions for timely specialist intervention.

The authority also agreed on reform strategies to achieve more efficient use of resources. They include the establishment of Emergency Medicine wards to reduce avoidable admissions, expansion of service capacity during daytime and evening to reduce unnecessary activities at night, setting up a structured and comprehensive multi-disciplinary handover system for critically ill and unstable patients, extension of roles of non-medical staff in patient care and enhancement of diagnostic imaging support for services.

Pilot programmes

The authority will launch pilot programmes in seven hospitals of four clusters by year's-end to facilitate the gradual rollout of reforms to all public hospitals.

The Kowloon West cluster will be the major site for pilot reform, while individual pilot programmes will be implemented in the Hong Kong East, Kowloon East and New Territories East clusters.

The authority will spend $12 million in 2007-08 to run four pilot programmes - opening extra weekday operating theatre sessions, establishing emergency medicine wards, introducing 24-hour Technical Care Assistant service, and employing part-time doctors.