The regulations on working time, night work limits and health assessments in hospitals will be enforced by the Health and Safety Executive. The HSE will bring cases before a magistrates' court or crown court. In most cases, employers will receive an improvement notice giving them a minimum of three weeks to remedy the situation. Employers will face criminal charges and an unlimited fine or a two-year jail sentence.

The regulations on entitlement to rest breaks and annual leave will be enforced by workers taking a complaint to an employment tribunal, which can award the employee 'just and equitable' compensation. The tribunals are expected to make awards large enough to deter other employers from poor practice. While the HSE may not have the staff to monitor working hours on a regular basis, organisations which flout the directive are putting themselves at risk.

Many NHS employers believe that in the case of an accident or mistake being made, the HSE will conduct a rigorous examination of the organisation's working hours. Unions are also likely to ensure that the regulations are complied with. The British Medical Association has already made plain that it will not be shy of using the courts.

Limits on the working week and the length of night work will be enforced by the HSE and local authorities as health and safety legislation.The HSE is expected to take a light hand in the early stages, but in the long term it should be remembered that:

employers have a duty of care toward their employees and will be required to ensure that they take their entitlements;

individuals like chief executives may be liable, rather than organisations;

employers have to take cognisance of best practice.