Trusts are “frequently” failing to change the way consultants work, leading to an over-reliance on junior doctors, an independent review has found.

The report, commissioned by Medical Education England, considers the impact of the European working time directive on junior doctors’ training.

It urges employers to ensure consultants are available for more hours in the day and through the night rather than depending on junior doctors.

It says: “With a reduction in the number of hours available for trainees the NHS can no longer afford to sacrifice the training of the medical workforce of tomorrow to cover service today.”

It adds: “Many consultants still work in traditional ways.

“The mechanisms to support consultant working such as the consultant contract and consultant job plans are frequently not used effectively to support training and service needs in reduced hours.”

The report, Time for Training, was carried out by surgeon Sir John Temple at the request of former health secretary Alan Johnson.

It calls for clearer objectives in job plans and better attempts to measure consultants’ performance.

Supporting professional activities - which make up roughly a quarter of consultants’ paid time - are not always properly used, leading to projects that “neither justify the time for the consultant nor deliver benefit for the trust or patient”, it says.

Earlier this year an HSJ investigation revealed few trusts routinely evaluate the benefits of SPAs.

A series of hard-hitting reports have criticised the NHS for failing to use the 2003 consultants contract to increase productivity.

NHS Employers head of doctors’ pay and workforce Bill McMillan told HSJ improvements happened by a “process rather than an event”.

He said: “What we want to see is employers and consultants doing things together, like job planning. Many employers do make use of that model effectively… We see consultants already changing their ways.”

The report praised some specialties, such as paediatrics, for changing ways of working, but said others, like anaesthetics, medicine and surgery were trailing.