title: Night emergency cover for ENT in England: a national survey.
abstract: OBJECTIVE
  To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England.
  
  
  METHODS
  We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England.
  
  
  RESULTS
  One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration.
  
  
  CONCLUSIONS
  Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.
authors.affiliation: Department of Otolaryngology, Hull Royal Infirmary, The University of Hull, Kingston upon Hull, UK. mrdbiswas@googlemail.com
authors.forename: D
authors.initials: D
authors.lastname: Biswas
authors.forename: A
authors.initials: A
authors.lastname: Rafferty
authors.forename: P
authors.initials: P
authors.lastname: Jassar
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration / Q000592:standards; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D004739:England; D019538:Health Care Surveys; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education* / Q000592:standards; D010036:Otolaryngology / Q000193:education* / Q000592:standards; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D013997:Time Factors; D016526:Workload