No, there aren't.
If however you want to pay for the consultant dermatologist to be sat in clinic at 3am Saturday night, and pay the ambulance transport people to bring patients to see him then, and pay the heating, lighting and electricity costs to keep outpatients busy at that time then fine.
If however you want to assume that all consultants are dealing with life-threatening emergencies, but then are all swanning off to the golf course to leave people to die, then you have been watching far too much Holby City.
Consultants were accused of not putting the hours in, so the last lot introduced stringent checks on exactly what they do, and paid by the hour worked in hospital (DCC PAs) as well as all the supporting paperwork and training that is mandatory (SPA PAs).
They thought a baseline should be 10 PAs of 4 hours each, yet were surprised that most consultants were doing 12 or so, yet only being paid for 10. There was no mechanism to allow consultants to continue working for free, so many trusts had to give the consultant body a pay rise OR DELIBERATELY BRING THEIR HOURS DOWN AGAINST THE WISHES OF THE CONSULTANTS DOING THE EXTRA WORK FOR FREE!!!
To then blame lazy consultants for the understaffing and underfunding is would be laughable if it were not so tragic
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da5id <YOUR SIG HERE>, Thu 23 Jul 2015, 9:15,
Reply)
I'm talking about consultants on high dependency wards like neo natal.
Not dermatologists.
Bedfordshire Hospital, neo natal unit, 2 months ago. Consultants at weekends were hardly seen doing rounds. compared to during weekday hours.
Nursing staff told me that they have problems tracking down a consultant at weekends.
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Cerebus Sticky! Sticky! Stick! Stick!, Thu 23 Jul 2015, 9:25,
Reply)
OK. Just as a matter of interest, does the hospital actually employ consultants to do this?
Most hospitals are happy paying for 'on call availability' which means a consultant is available to come in to work if there is an exceptional emergency. If you want routine availability on the ward, in A&E etc then you need the staff.
It's the difference between paying a plumber full fee for standing next to your boiler all day in case there's a problem vs paying him when needed (or not in the case of on call availability). Look upon it as a type of zero hours contract.
When most 50 year old consultants were training, they worked 120 hour weeks commonly, and there were outcries about tired doctors making mistakes. The EWTD has limited this to 48 hours (though most consultants voluntarily 'opt out')
Who therefore is there on NICU at weekends? There are not enough NICU consultants to go around. This has been known for years, and the obvious solution is to have full shift consultant care in larger centres.
This has happened since the Darzi review of trauma services centred trauma care in London to The Royal London, Kings, Georges and Mary's. All these centres have 24/7/365 consultants in A&E, ITU, theatres etc.
So what does Joe Public do? whines that they want to close the poor quality, understaffed and underexperienced local A&E departments.
Unfortunately the same holds true for NICU. If you want high quality care, there are minimum volumes compatible with being able to staff with consultants and this means supra-regional centres I'm afraid. It may mean you have to travel to GOSH, but at least you'd have the care when there.
It may also be in your specific case that the consultant was operating (NICU consultants are usually paediatric anaesthetists and as such may have been providing a GA for little George's broken wrist.
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da5id <YOUR SIG HERE>, Thu 23 Jul 2015, 10:05,
Reply)
How they employ them is not something they deemed to share with me.
All I know is what I saw and was told I didn't get to inspect the wording of their contracts.
Monday to Friday, adequate cover by consultants.
Weekends inadequate cover.
Source nursing staff on a neo natal ward.
If there is deemed a need for a certain amount of staff monday to friday, why is there less staff on a weekend?
The nurses seem pretty fucked off that they were expected to take up the slack when there was reduced cover.
So, there is already a 7 day a week NHS for Nursing staff.
But not for Doctors, G.Ps etc. Reduced cover is not the same.
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Cerebus Sticky! Sticky! Stick! Stick!, Thu 23 Jul 2015, 10:59,
Reply)
OK, we agree. There is inadequate cover at weekends by consultants.
What i object to is the implication that it is consultants who are employed to work then not turning up. It is in fact that the trusts do not employ enough to be able to staff the place at weekends and the weekdays.
If they shifted people around, you'd just end up with a bit less cover spread out through the week, and the same mortality/ morbidity.
All I'm saying is that it is the employing trusts that decide to have fewer staff on at weekends to save money, not the consultants themselves skiving off.
Anyway, back to clinic!
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da5id <YOUR SIG HERE>, Thu 23 Jul 2015, 11:35,
Reply)