There is a Consultant in the Department all day Monday to Friday. There is always a Consultant on-call. There is a Middle Grade Doctor (Associate Emergency Physician, Specialist Registrar or Registrar) in the Department 24 hours a day, seven days a week.
Certain categories of patients in the Resuscitation Room should be seen initially by an SHO and Middle Grade Doctor together. These include:
- All major trauma
- All children
- All cardiac arrests
- All patients who make an unexpected return with the same complaint should be reviewed by a senior doctor
SHOs should discuss the following categories of patients with the duty Middle Grade Doctor or Consultant:
- All patients that they are uncertain about. They should ask advice from a more senior ED doctor and not from SHOs in other specialities.
- Patients should not be sent to review clinic for a further opinion if there is a more senior ED doctor in the department.
- All trauma that they intend to admit (apart from fracture neck of femur).
This does not alter in any way the responsibility for notifying the duty Consultant of any problems, clinical or otherwise, which occur in the department.