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Night emergency cover for ENT in England: a national survey

Published online by Cambridge University Press:  08 March 2017

D Biswas*
Affiliation:
Department of Otolaryngology, Hull Royal Infirmary, The University of Hull, Kingston upon Hull, UK
A Rafferty
Affiliation:
Department of Otolaryngology, Hull Royal Infirmary, The University of Hull, Kingston upon Hull, UK
P Jassar
Affiliation:
Department of Otolaryngology, Hull Royal Infirmary, The University of Hull, Kingston upon Hull, UK
*
Address for correspondence: Mr D Biswas, Department of Otolaryngology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JB, UK. E-mail: mrdbiswas@googlemail.com

Abstract

Objectives:

To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the ‘Modernising Medical Careers’ initiative, in England.

Methods:

We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England.

Results:

One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents’ hospitals (51 per cent), these courses were of varying duration.

Conclusion:

Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the North of England – Otolaryngology biannual meeting, 12 September 2008, Sunderland, UK.

References

1 Newbegin, RM, Rhodes, JC, Flood, LM, Richardson, HC. Student-selected components: bringing more ENT into the undergraduate curriculum. J Laryngol Otol 2007;121:783–5CrossRefGoogle ScholarPubMed
2 Mace, AD, Narula, AA. Survey of current undergraduate otolaryngology training in the United Kingdom. J Laryngol Otol 2004;118:217–20CrossRefGoogle ScholarPubMed
3 Sharma, A, Machen, K, Clarke, B, Howard, D. Is undergraduate otorhinolaryngology teaching relevant to junior doctors working in accident and emergency departments? J Laryngol Otol 2006;120:949–51CrossRefGoogle ScholarPubMed
4 Powell, S, Doshi, J. Career choices in otolaryngology: implications for modernising medical careers. Clin Otolaryngol 2007;32:219–20CrossRefGoogle ScholarPubMed
5 Fisher, EW, Moffat, DA, Quinn, SJ, Wareing, MJ, Von Blumenthal, H, Morris, DP. Reduction in junior doctors’ hours in an otolaryngology unit: effects on the ‘out of hours’ working patterns of all grades. Ann R Coll Surg Engl 1994;76:232–5Google Scholar
6 Davis, SJ, McDonald, S. Covering ENT out of hours: how confident are senior house officers? J Laryngol Otol 2006;120:587–90CrossRefGoogle ScholarPubMed
7 Morris-Stiff, GJ, Sarasin, S, Edwards, P, Lewis, WG, Lewis, MH. The European Working Time Directive: one for all and all for one? Surgery 2005;137:293–7CrossRefGoogle ScholarPubMed
8 Whiticar, R, Webb, H, Smith, S. Re-attendance to the emergency department. Emerg Med J 2008;25:360–1CrossRefGoogle ScholarPubMed
9 Wasson, J, Jacobsen, N, Bowdler, D, Hopkins, C. Optimizing training opportunities for otolaryngology senior house officers: an audit. J Laryngol Otol 2006;120:583–6CrossRefGoogle ScholarPubMed
10 Derrick, S, Badger, B, Chandler, J, Nokes, T, Winch, G. The training/service continuum: exploring the training/service balance of senior house officer activities. Med Educ 2006;40:355–62CrossRefGoogle Scholar
11 Garvin, JT, McLaughlin, R, Kerin, MJ. A pilot project of European Working Time Directive compliant rosters in a university teaching hospital. Surgeon 2008;6:8893CrossRefGoogle ScholarPubMed