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Published byDaniela Christenbury Modified over 9 years ago
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Consultant resident on-call system: Salisbury
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Salisbury DH Rural Relatively isolated – nearest unit 25 miles Full obstetric and A&E service Regional burns and plastics Child pop. C 40 000 2500 deliveries p.a. 18 bedded children’s ward Level 2b NICU
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Paediatric dept. 10 consultants (8 on 11 PAs, 2 on 8 PAs) 4 middle grades 5 junior grades 4 GP trainees, 1 FY2 4 GP trainees, 1 FY2 Night on-call shared with 5 O&G SHOs Night on-call shared with 5 O&G SHOs
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Resident consultant system All 10 do resident on call: part-timers pro rata Out-of-hours time divided between 4 MGs and 10 cons Cons also do on call from home covering either MG or cons colleague 13 hour shifts same as juniors
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Resident on call workload Resident shifts about 1 night per 2 weeks and 1 weekend (3 shifts, days or nights) every 10 weeks Always on with SHO Day off afterwards Contract: Daytime work: 6.5 PAs (including 2.5 SPAs) Daytime work: 6.5 PAs (including 2.5 SPAs) Resident shifts 3.5 Pas Resident shifts 3.5 Pas Other emergency work 1 PA Other emergency work 1 PA
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Typical night shift 2100 – 2130: handover 2130- 2230: reviewing ward attenders and in- patients 2230- 0000: admin with interruptions 0000-0030: review patients 0030-0200: admin with interruptions 0200-0700: rest, with interruptions: Calls to ward, NICU, ED, Burns, labour ward Calls to ward, NICU, ED, Burns, labour ward 0700-0930: reviews and handover
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Accommodation Consultant flat, superior to juniors accommodation About 100m from labour ward Bedroom, bathroom, kitchen, lounge with TV and network computer
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Accommodation
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Bedroom
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Kitchen
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Lounge
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Back up consultant Resident cons always has back-up colleague on call from home for: 2 skilled people needed at once 2 skilled people needed at once Transfers Transfers Advice Advice
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Advantages for service Better out-of-hours care Fewer unnecessary admissions Better continuity Better supervision of juniors & nurses
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Advantages for individual Financial More day time off during week More ‘hands-on’ work
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Disadvantages for service Fewer consultants around during the day Less time for supporting activities Cost
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Disadvantages for individual Tiredness Less continuity for own patients Less time for career development
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