title: Consultant-based otolaryngology emergency service: a five-year experience.
abstract: OBJECTIVE
  To present our experience of running a consultant-based otolaryngology emergency care service for more than five years.
  
  
  METHODS
  In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled.
  
  
  RESULTS
  Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service.
  
  
  CONCLUSIONS
  Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Ninewells Hospital and University of Dundee Medical School, Dundee, Scotland, UK.
authors.forename: M L
authors.initials: ML
authors.lastname: Barnes
authors.forename: S S M
authors.initials: SS
authors.lastname: Hussain
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration*; D002983:Clinical Competence; D003253:Consultants; D003266:Continuity of Patient Care / Q000458:organization & administration; D004502:Education, Medical, Continuing / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D018166:Health Care Reform; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education / Q000458:organization & administration*; D009936:Organizational Innovation; D010036:Otolaryngology / Q000193:education / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration; D012606:Scotland; D014940:Work Schedule Tolerance; D016526:Workload