Lindsey Davies: Q&A - Royal College of Physicians

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Letters to the editor
The RCP published a survey on the management of care for very ill patients in England, Wales and
Northern Ireland in December 2010. Commentary April 2011 also reported on the various work streams
on acute care underway at the RCP. Here’s what you had to say
Dear Commentary,
In your recent issue (April 2011) you
highlight the deficiency in the provision of
consultant-led care by acute physicians at
weekends, which was identified in the RCP
survey in December 2010. This issue has
been brought into sharp focus with the
advent of consecutive four-day weekends
in late April. The Society of Acute Medicine
(SAM) strongly supports the need to move
towards a seven-day consultant-led service,
and there are data which suggest that
mortality for patients admitted outside
‘normal working hours’ may be higher.
One of the main limiting factors in
providing this level of care remains the
numbers of consultants in acute medicine
currently working in the UK. This situation
is improving slowly: significant numbers
of trainees will attain a certificate of
completion of training in acute medicine
during 2011–12. This gives an ideal
opportunity for trusts to develop or
expand their acute medical consultant
team so that a greater number of hours
of consultant-led care can be provided
on the acute medical unit. A recent
survey undertaken by SAM indicates
that many existing acute physicians and
trainees strongly support a move towards
greater seven-day working. Over 80% of
respondents indicated that they would be
willing to consider the public holiday on
29 April as a ‘normal working day’. Many
free text comments indicated strong views
regarding the need to provide seven-day
working practices in acute specialties, both
in hospital and primary care. These views
need to be aired more openly with the
engagement of all royal colleges.
Acute illness is a seven-day problem
and our modern health service needs to
be able to respond in the same timely
fashion irrespective of the day on which a
patient presents.
Chris Roseveare BM FRCP
The SAM survey is available on their website:
www.acutemedicine.org.uk
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Commentary Community brings you
more news and features this month
including the full interviews with
Professor Lindsey Davies (p10) and
Dr Ian McCurdie (p18), and more views
from our public health experts (p14).
We have an article from international
sponsorship scheme prize winner,
Dr Manoji Gunathilake, about her
experiences of working in the UK, and
columns from our regional advisers.
Visit our online magazine to comment
on these features and officer columns:
www.rcplondon.ac.uk/commentary. n
www.rcplondon.ac.uk n June 2011 n Commentary 25