Hospital Dr News

Dangerous work patterns for consultants risk patient safety in the NHS

Few consultants are getting time off to rest before treating patients after a busy night on-call which is a patient safety risk and must be guarded against in the new consultant contract.

This is the message from the chair of the BMA consultants committee following a survey of 847 consultants which shows that 71% never have access to rest time following a night spent on-call when their sleep had been disturbed.

A further 10% said that such rest was rare, and only 11% said that they had rest time.

Addressing the BMA’s annual representative meeting, Dr Paul Flynn said: “Our concerns about consultants’ fatigue and burnout are well-founded. Sleep deprivation can impair judgement and decision making, skills that are vital for doctors. Studies have shown it can have similar effects to drinking.

“We would never allow a consultant under the influence of alcohol to treat patients, but continue to turn a blind eye to doctors who are sleep deprived. This has the potential to lead to the same problems that consultants experienced as junior doctors – no one wants to see a return to the dark days of doctors working dangerously long hours.”

The vast majority of consultants (88%) reported being on an on call rota during the week. Almost half of consultants reported being called to attend hospital; varying between one and six occasions. Anaesthetists (74%) and surgeons (71%) were most likely to be required to attend hospital if called.

Almost half of consultants reported their sleep had been disturbed in order to attend hospital on one night when on call during a Monday to Friday.

At the weekend, consultants on-call reported receiving five calls on average. Almost two-thirds of consultants on-call at the weekend reported attending hospital between one and six times (higher than equivalent for Monday to Friday).

Consultants reported working an average six hours when called to attend hospital at weekends.

One-third of respondents were required to break their normal sleep pattern to attend hospital on a night at the weekend. One-fifth said their sleep was disturbed on both nights when on call at the weekend

Flynn added: “The consultant contract must continue to have robust protections against the acute fatigue that poses risks to patients and the chronic fatigue that risks burnout for consultants.

“With workloads rising and moves to deliver more services out of hours, the government must make safe working a priority.”

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