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Do we really need a duty consultant?

Published online by Cambridge University Press:  02 January 2018

Daniel Vincent Riordan*
Affiliation:
New Craigs Hospital, Inverness IV3 8NP
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Abstract

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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2005. The Royal College of Psychiatrists.

Do consultant psychiatrists really need to provide a conventional out of hours service? How often does a clinical insight, resulting from a face-to-face, out-of-hours interview with the duty consultant psychiatrist, genuinely contribute to the management of a situation, in a way that could not have waited until the following day? Between 17.00 h and 09.00 h, could it not be replaced by telephone advice? A single consultant (working a reasonable shift of say 8 h) could provide advice to junior doctors, and others, for a large catchment of several million people, with a local consultant still available to review patients between 09.00 h and 17.00 h on weekends and public holidays.

There are two strong arguments for making such a change. First, the effort and expenditure invested by the National Health Service in ensuring the physical presence of a consultant psychiatrist at all times could be better spent on other service developments. Second, recruitment and retention are major challenges for the psychiatric profession (Reference StorerStorer, 2002) and we compete with other specialties for recruits. A significant attraction of psychiatry has traditionally been its ‘family friendly’ image (Reference EaglesEagles, 1996). The new general practitioner (GP) contract, with GPs no longer obliged to work out of hours, is likely to have significant effects on recruitment and retention in psychiatry. Psychiatry competes with general practice for recruits, and general practice has become much more attractive.

References

Eagles, J. M. (1996) Gender differences in attitudes and recruitment into psychiatry. Psychological Reports, 78, 653654.Google Scholar
Storer, D. (2002) Recruiting and retaining psychiatrists. British Journal of Psychiatry, 180, 296297.Google Scholar
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