The 1:3 rota we have been running this last 6 months does seem to be the normal for small units.
We have an AS and 2 consultants at present, until december anyway!
Like Cliff the trust makes the right noises but like Cliff's they are without funding.
This seems universal. When will the NHSE admit the money is not getting to the front line.
Our unit is in danger of being asset stripped by a SHA initiated "merger" with a larger unit 50 miles away so that they can become a Foundation Trust, since at present the patient flows are not sufficient for them to be financially viable (according to the gossip)
this would lose all major joint surgery from this unit (what of local care?), how do we keep orthopaedics?, Vascular surgery now depends on 2 consultants. If they are away you have to survive at least 1 hour in an ambulance when your AAA goes.
I guess my job is secure since someone has to identify these patients and package them if this mayhem goes ahead.
Even more insane is the political correctness that requires the Acute Trust to keep one MIU open all night for 2 cases per night whereas the PCT can close the other two MIU's (they now control them but send the complaints to me!) whenever they feel like it and then blame us!
There are also 3 small delivery suites now left totally without doctor cover (post new GMS contract) that the trust is responsible for but can't close despite the overwhelming desire to do so by the consultants.
What a fun world we live in!
Was it always this mad and i am now in a position to know or is there a new idiocy in the NHS. Some of our more venerable collegues may be able to comment.
>We're in a similar sized dept. 3 WTE consultants soon to go to 3.5 (if we successfully recruit).
>Note the new contract:
>"Where a consultant or consultants are on a rota of 1 in 4 or more frequent, the employing organisation will review at least annually the reasons for this rota and for its high frequency and take any practicable steps to reduce the need for high-frequency rotas of this kind. The views of consultants will be taken into account" (http://www.nhsemployers.org/docs/terms_conditions_consultants_2003.pdf)
>
>We're in the daft postion in which our Trust recognises we're working unsustainably, but with 'no new money' and being 'a non-incoming generating specialty' they could only offer to reduce our on call so that the ED would be covered some nights by non-emergency physician consultants. We appreciated the gesture, but we couldn't do that to our patients and our staff. Tricky one.
>
>Cliff Reid
>
>-----Original Message-----
>From: Accident and Emergency Academic List
>[mailto:[log in to unmask]]On Behalf Of
>[log in to unmask]
>Sent: 16 October 2005 21:34
>To: [log in to unmask]
>Subject: Consultant Rota's
>
>
>Given my abject failure to attract senior staff to my department what is the list's view of the maximum on-call frequency for a DGH with 40,000 new cases per year.
>There is middle grade presence 9am to 1am, the current consultants do shop floor at the weekend from 9-2ish on both days then go away on-call.
>there is a consultant led trauma team with some input to the rota from surgery, orthopaedics and anaesthesia.
>I have been working a 1:3 weekends and had hoped to reach 1:4
>
>i had hoped given the excellent life style of a small coastal town with reasonable access to the larger northern towns and 3 hours to London by train that we would get some interest for those who wanted hands on care, could hack 1:3-4 weekends and not many calls at night.
>
>What are you guys and gals wanting?
>i need this data since the guy due to join in january has just pulled out for vague reasons and my senior partner retires in december leaving me solo with an Associate Specialist.
>The Trust are going to come to me asking how to make us attractive, or, more likely how to keep me in place, I suspect. I am NOT going to do 1:1!
>
>So what floats your boats?
>What is everyone doing out there? round here 1:4 to 1:5 seems to be the target. Does that include presence on the shop floor at weekends?
>
>
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