A new deal for ENT surgeons--The Manchester experience 1992-3.

Abstract

OBJECTIVES: To reduce junior doctors' hours by introducing an on-call system involving cross-cover at SHO level between two separate ENT units. DESIGN: Prospective collection of data on the cross-cover system introduced in September 1992 with analysis after 12 months. SETTING: ENT departments within Salford and Central Manchester. SUBJECTS: Five SHOs and four registrars within the two ENT units. RESULTS: SHOs work a 1 in 5 rota providing first on-call cover for two adjacent ENT units. The system has proved to be an effective means of decreasing junior doctors' hours, though actual hours exceed the contracted hours by approximately 8 hours per week. Initial problems of contacting SHOs were overcome by the introduction of new bleep arrangements while the system produced a number of unforeseen benefits. The experience in Manchester suggests that major ENT units do not necessarily require resident first on-call staff, though formal arrangements are recommended to cope with acute emergencies requiring immediate attention. CONCLUSIONS: An effective on-call system has been devised which decreases junior doctors' hours by combining the on-call rotas of two adjacent ENT units. Recommendations for the successful implementation of such a system are presented.