Improving 'new deal' shifts for junior house officers.

Since the 'new deal' was introduced, new working patterns such as shift systems have become increasingly common. The current study examines how these shifts might be improved. The results suggest that organizational changes such as increased numbers of ward clerks and support workers can minimize the negative impact of shift systems. However, shifts remain unpopular among junior staff and the authors conclude that new working initiatives must be properly evaluated before their widespread implementation.