Absolutely not (to your last paragraph). I see consortium cover as a classic
compromise, existing only because you don't have enough specialists in your
own unit. There are some ridiculous examples of this around the country,
where a consultant covers two, sometimes three, units at nights and
weekends. The result? The consultant doesn't actually do any work, or does
minimal work, in any of the units; he merely "covers from home" whatever
that means. I suspect some specialists prefer this system because of its
perceived "flexibility", which to my mind is just a euphemism for wanting a
Surely it's about time our specialty provided decent levels of internal
cover, and by that I mean resident shop-floor cover by day and increasingly
at evenings and part-weekends, with dedicated single-unit cover at night,
just as most other acute specialties do?
----- Original Message -----
From: "Coats Tim - Professor of Emergency Medicine"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, September 28, 2005 9:02 AM
Subject: Re: A&E On - call Rota
No experience of cross speciality cover. I don't think that an orthopod is
able to practice emergency medicine (and an orthopod that thinks that they
can just doesn't understand and so should certainly not be allowed to).
I have some good experience of cross Department cover - very dependent on
Geography (all of the hospitals in the East London A&E Consortium are a
couple of miles apart).
Even if long distances are involved, it might be better for an ED to have
more distant cover from an emergency specialist rather than close cover from
someone who is not a specialist in Emergency Medicine. Maybe an agreement
from the local orthopods / surgeons that they would support the ED by coming
in for major trauma (which they probably could cope with) might assist this
To go one step further. My guess is that on-site late shifts followed by
consortium on-call overnight (ie. one, or two, A&E consultant shared between
several hospitals) will be a future pattern for emergency service provision.
Closer integration with the pre-hospital care services would enable the
night shift consortium consultants to focus their time in the right areas.
Do we need to start taking a Regional rather than a Departmental view of the
provision of nightime Emergency Care, to develop a more flexible system?
(Puts on flame proof suit and hits send)
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of MICHAEL DUDLEY
Sent: 27 September 2005 23:53
To: [log in to unmask]
Subject: A&E On - call Rota
Does anyone know of A&E Departments that have an on-call consultant cover
arrangement shared with another specialty, e.g. Orthopaedic Consultants?
I know it is suboptimal, but I am sure that many DGHs like us, have found
that they would be unable to recruit new A&E Consultants with an on-call
rota more onerous than 1 in 4.
I would be very interested to hear of/from A&E Departments that run such an
Consultant in Emergency Medicine
Airedale General Hospital