Emergency Departments: Current and potential future overnight working patterns of Consultants

NIHR CLAHRC Wessex are helping University Hospitals Southampton NHS Foundation Trust answer the question ‘Should this Trust invest in consultant doctors working in the Emergency Department overnight at the weekend?

Dr Thomas Monks, Dr Marion Penn, and Prof Catherine Pope from CLAHRC Wessex, and  Dr Mike Clancy from the Emergency Department are examining current and potential future overnight working patterns of Consultants.

At present Consultant doctors work overnight (in shifts between 7pm and 7am) Monday–Thursday. To extend this to cover at the weekend could require 10 additional Consultants, and means considerable expense for the Trust. The lack of data from other hospitals about their night staffing and limited literature mean that guidance on this topic is limited – hence our work. 

We are combining operational research  -to analyse patterns and build models of the flow of work at night - with interviews to explore what emergency care staff think about extending consultant night working. The data we are using includes 

•total time patients spend in the emergency department
•percentage of patients admitted or discharged within 4 hours;
•time taken between decision to admit and actual admission ;
•time first seen

We can use these data to see how the department works now, and look at past performance, to help predict the impact of different models of consultant staffing.

The CLAHRC Wessex Analytics and Data Science team are experienced at doing this kind of applied research which builds on their broad background of health systems modelling. The team has previously worked with Portsmouth’s Queen Alexandra Hospital’s emergency department to inform their emergency medical pathway. For this new project they have been joined by Professor Catherine Pope - an internationally recognised expert in qualitative research who delights in going to the hospital late at night to find out about the work they do and how many staff they need.

The project will report before December to inform the Trust’s strategic decision making.

If you are interested in knowing more about this project please contact cjp@soton.ac.uk

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Patient and public involvement is vital to the success of the CLAHRC.

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