A recent survey carried out by the Royal College of Physicians found that junior doctors have to care for too many patients at weekends and in the evenings, as there are not enough consultants on duty during these times.
The RCP says, “There is mounting evidence of poor out-of-hours care in hospitals.”
The RCP carried out a survey of 126 hospitals in England, Wales and Northern Ireland. As a result of the survey, it is calling for a consultant to be on duty for at least 12 hours a day, seven days a week.
Furthermore, it found that out of all the hospitals surveyed, none had more than 12 hours of weekend cover from senior specialists in emergency medicine. Only 3% provided nine to 12 hours of cover, and nearly 75% of the surveyed hospitals had no specialist cover at all.
The Royal College of Physicians survey was carried out following research published in the summer, which revealed that patients admitted as emergencies on a weekend were more likely to die than if they were admitted during the week.
The RCP went on further to add, “Consultants should be freed up to concentrate on the care of seriously ill patients rather than holding clinics and performing other duties.”
The president of the Royal College of Physicians, Sir Richard Thompson, said, “There have been some major improvements in the care of seriously ill patients in recent years, but out of hours is still falling short.”
“Too many junior doctors are covering too many ill patients, and this has to change.”
“Our evidence shows that a predominantly consultant-delivered medical service is the best way to improve patient care.”
Health secretary Andrew Lansley agrees, “Patients do deserve better care at night and weekends and senior doctors should be available to provide acute medical care as needed.”
Furthermore, Mr Lansley added, “I am already looking at ways to increase the involvement of consultants in direct clinical care at night and at weekends.”
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD), which reviews the care of patients and has looked at problems in emergency care has welcomed the RCP report and has used some of its findings to support their arguments.
Dr James Stewart of NCEPOD says, “There is a bigger issue that needs to be looked at. Junior doctors need to be better trained to care for the very ill and to spot those who are falling ill on other wards.”
“Concentrating on consultant involvement alone will not resolve this important issue unless junior doctors are educated and trained to a higher standard.”
“Currently doctors are already working long hours, with the latest census showing consultants work an average 50 hour week,” says the RCP.
“That is four and a half hours longer than their contracts and more than the 48-hour limit set by the European Working Time Directive.”
A survey carried out in April showed junior doctors were covering an average of 61 patients overnight, but one junior doctor was looking after 400 patients.
The RCP says, “That rather than increasing the hours of doctors still further, new shift patterns will have to be worked out.”
This latest survey by the Royal College of Physicians into the hours worked by junior doctors highlights that government’s electoral promise to maintain frontline services and improve patient care is still falling short of their promise. Junior doctors in England, Wales and Northern Ireland are still working longer hours than the European Directive on working hours has set. As the government reforms continue, MPP Locums understands the changing nature of the NHS in providing first class medical professionals.
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