Consultant job planning for a 7-day service

Editor – Being a gastroenterology trainee, I read with great interest Dr Lewis’ article on ‘Consultant job planning for a 7-day service’ and how consultant cover was provided on a 7 day basis from 08:00–21:15.¹ I was surprised to see no inclusion of a consultant gastroenterologist on call overnight, particularly with National Institute for Health and Care Excellence guidance stating that urgent endoscopy is required in unstable patients who present with an upper gastrointestinal bleed.² With the number of consultants on this rota, one would feel that it would be just for a 1:10 out-of-hours gastrointestinal bleed cover, which should count for at least 1 PA. This is not just a gastroenterology problem, cardiology have obvious need for 24-hour cover and, given the changing nature of medicine, will we need more specialties to be on call overnight? Within Clinical Medicine, it has been highlighted that junior colleagues are less confident at performing procedures.³ Junior colleagues soon become senior colleagues – will we reach a stage that we are required to ring the chest physician on call for an emergency chest drain or the haematologist on call for a sickle patient requiring an exchange transfusion? How will we compensate these consultants for this? The NHS is a 24-hour 7 day a week machine that is supported by consultants at all times; job planning needs to represent this.

Conflicts of interest

The author has no conflicts of interest to declare.