We've gone up to a 1:4 from 1:3 and
less on call is always appreciated! Much easier to squeeze in 2-3 weeks of
holiday between weekends on-call as well.
We cover 9-9 four days a week but not doing
weekends until we have 5. Managed to get double time for our 5pm-9pm PA
(helped achieve the target and was beyond recommended cover) and intend to try
and keep that principle for weekends.
Band A for on-call as first on-call but not
very frequent calls except when we were being phoned about 2 hour waits by the
management!! The banding was part of a Trust wide agreement.
It is interesting to see how many
departments are offering more cover than is recommended by BAEM with the number
of staff employed.
In any case, Andy, with only one consultant
you can do little more than be around managing the department from your office
with a few dedicated clinical sessions to maintain your skills. Agree to
1:4 weekends on-call and then it is up to the Trust to sort out the cover beyond
that.
It is sad that many smaller departments are
coming to this, perhaps BAEM should produce guidance or a document for smaller
departments suffering from just this sort of staffing crisis, its not going to
be uncommon in the next few years. Interestingly, there was a lot of help
for Leicester when they got in to big trouble but many smaller departments are
expected to muddle through. Why?
Simon McCormick
Adrian, Very good appreciation of rota psychology whether 1-in-3 0r
1-in-4. We have just gone to 1-in-4 from 1-in-3 by bringing an associate
specialist into the rota, and the difference it makes to your life is marked :
once a month is so much better.
There are 3 of us and a AS on the rota, Consultant cover on the shop
floor from 8 -5pm and 8 -1pm weekends. We get around 2 calls a week and
occasionally go in. Daily review clinic in outpatients.
We get band B, hopefully under review, what on call band are others
on?.
Duncan
----- Original Message -----
Sent: 16 October 2005 23:33
Subject: Re: Consultant Rota's
Interesting subject Andy. Although many on the list know me
as
perhaps-too-shopfloor-out-of-hours for their liking, I'd like to
think that
I still have a handle on what is acceptable for my juniors
and what is a
"bridge too far" for them or for my consultant colleagues.
The bottom line
is, when it comes to the long haul - and by that I mean
registrar level and
above - then you shouldn't aim for anything worse
than a 1-in-4 weekend
rota. There's something magical about that
"watershed" of 1-in-4. Sure,
longer rotas are better, but you can live
with 1-in-4 if there are other
perks (like a day off per week) but it's
dammed difficult to do 1-in-3 or
worse for anything other than short
term. There's a subtle psychological
barrier about a 1-in-2 or a 1-in-3
where your weekend off is always just
before or just after a weekend on
call. 1-in-4, however, is basically one
weekend per month, so you have
almost a month before your next weekend on
call and you can enjoy 3
clear weekends off (and we don't do on-call from
home during those 3
weekends). It's also one weekday night on-call per week
(Mon to Thur
making it 4).
That's my view of on-call in a nutshell. Am happy to do
one weekday per week
and one weekend per month on call (both of which
are partial resident) and I
can sustain that in the medium-to-long term
but I don't like to do anything
more than that and I don't expect my
juniors (apart from the SHOs who are
like grunts on the front line for a
defined "tour of duty") to do any more
than that either. In saying that,
it can be difficult organising leave as we
often end up swapping
weekends in order to take a two-week holiday. As I
said at the
beginning, many of my acquaintances probably think I'm mad for
the
amount of resident on call that I, and my colleagues,
do.
AF
----- Original Message -----
From: <[log in to unmask]>
To:
<[log in to unmask]>
Sent:
Sunday, October 16, 2005 9:34 PM
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?