Last week, in a letter to the Independent, Sir Richard Thompson, president of the Royal College of Physicians (RCP) commented on the leak of an NHS London report which concluded that London's hospitals are failing to provide a safe level of out-of-hours emergency care.
Sir Richard and other RCP spokespeople are available for comment today.
Your article ‘Hospital staff shortages ‘cause 500 deaths a year’ (8 September) shows too few junior doctors are caring for too many patients over night and at the weekend. Patients who are admitted to hospital in the evening and at the weekend risk receiving sub-standard care. Despite the best efforts of consultants who work above their contracted hours, patients are not getting sufficient input to their care from senior doctors during these periods. The supervision and training of junior doctors is also adversely affected by a lack of senior input during these periods. More doctors are required to provide this high level service.
The Royal College of Physicians believes that there is an urgent need to review workforce patterns in hospitals to ensure that medical in-patients receive direct input from consultant physicians on a seven day a week basis. We previously issued guidance for physicians caring for very sick patients. Hospitals admitting acutely ill medical patients should have a consultant physician on-site for at least 12 hours per day, seven days per week, at times related to peak admissions. Consultants should have no other duties during this period.
We can begin now by reconfiguring acute services. Concentrating specialist services in centres of excellence will improve standards and help to provide a consultant delivered service.
Furthermore, junior doctors’ contract, the New Deal, and the European Working Time Directive must be renegotiated to provide more local flexibility when designing staff rotas in hospitals.
The RCP calls on the government to take urgent action to ensure that extended consultant delivered services, providing safer care for patients and the opportunity for excellent training of the next generation of doctors, can be achieved.
Sir Richard Thompson, president, Royal College of Physicians
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