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

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.