Lack of weekend NHS consultants 'risking patients' lives' Dr Chris Roseveare, president of the Society for Acute Medicine, said: "Clearly, when you go to hospital as an emergency you are vulnerable. You need to be cared for by someone with the skills to deal with the acute problem. Consultants have those skills. Going into a hospital where there isn't a consultant available is something we want to avoid. But he said: "There's a culture in which consultants are traditionally reluctant to provide weekend working." He explained: "Traditionally the consultant's job plan has been geared around providing a weekday service, plus a weekend service shared with colleagues." What the Society and the RCP wanted to do was create weekend emergency care which mirrored that provided in the week, as closely as possible without damaging the weekday service. Hospitals could be "smarter" at making rotas to this aim, he said. The report, a series of recommendations - or "toolkit"- to improve acute ward care, enables hospitals to work out how many staff they need. But Dr Roseveare argued it was "inevitable" that some hospitals would need more acute medical unit (AMU) consultants. The joint report itself notes: "Most units are likely to require additional AMU consultant appointments in order to deliver 12-hour consultant presence seven days a week." Number had expanded greatly over the last decade, but Dr Roseveare warned: "Finances now are considerably more constrained." Dr Mark Temple, an acute care fellow at the RCP, said consultant-led care was "key" to delivering the highest quality care. Even when consultants were at hand, he said, they were often torn between their AMU duties and responsibilities elsewhere. "They are pulled in two directions," he said. The organisations want this "doubling up" to stop. Consultants should also start by 8am so they can do their ward rounds and give patients admitted overnight a full and prompt assessment, the report recommends. Last week the RCP warned that the "erosion" of the ward round meant that some doctors were not giving patients the time by the bedside they needed to properly gauge their needs, recognise them as people rather than 'conditions', and share vital information with nurses. They also say consultants should be banned from working one day on, one day off, because this leads to disjointed care. Earl Howe, the Health Minister, said the toolkit was "a great example of doctors leading the way in driving up standards of care in the NHS." He said: "We recommend hospitals take note of this guidance to ensure their patients are getting access to the best quality of care seven days a week." Nevertheless, thorny issues remain. Smaller hospitals which struggle to deliver consultant-led emergency services daily will come under increasing pressure to close wards. In addition, consultant-led care at weekends is more costly. Earlier this year Dr Mark Porter, now chairman of the British Medical Association, said a seven-day-a-week NHS was "unaffordable." Dr Paul Flynn, chairman of the BMA's consultants" committee, said the increased salary costs would at least be partially offset by savings from better care, meaning shorter hospitals stays. But he said it was unrealistic to expect all NHS hospitals to move to seven-day consultant-led acute care immediately, as the doctors did not exist. The change could take years, he said. He also said most consultants were happy to work weekends, where there was evidence that doing so benefited patients.