Mind the gap

RECENT mortality studies in NHS hospitals have suggested that, at weekends and during bank holidays, a reduced consultant presence at the bedside might be associated with increased patient mortality.

The competence of junior doctors is not the problem. Acute units are staffed by experienced nurses and junior doctors whose knowledge and manual clinical skills are likely to be ­superior to their peers.

The real problem is continuity of care. This does also apply to family practice.

Continuity requires continuous care by one team comprising nursing and medical staff ­familiar with the patient and each others’ level of expertise.

A reduction in hospital bed numbers has compounded the problems created by working time directives and lack of flexibility on the part of the medical profession.

Communication between nurses, clinicians and patients becomes disrupted and patients lose the key ingredients to ­successful care, namely knowing and having confidence in one’s ­carers.

(Prof) Anthony M Martin, FRCP

Eglinton Crescent

Edinburgh