Rota Working Pattern

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Anaesthetics Training

Written by Dr Kubli

All the training posts in anaesthetics and intensive care medicine are currently banded at Band 1a. There are currently 24 doctors who participate in the 24 slots on the rota at the St Peter's site. The 24 doctors are in 3 separate rotas of 8. There are 8 people on the rota for ICM (intensive care medicine), 8 people on the rota for Obstetric anaesthesia & Analgesia, and 8 people on the rota for Emergency theatre work. There is a mixture of normal and long days in each of the ICM, Obstetric anaesthesia & Emergency theatre rotas. A normal working day is from 0800 - 1800 hrs. A long day is from 0800 - 2000 hrs. The night shift is from 1930hrs to 0800 hrs. The rotas are compliant (46.2hours of work per week) with the European working time directive for 2009 and are banded at 1a.It is a full shift rota. The rotas are rolling. The rotas have prospective cover meaning that if you take annual leave day and you are due to be working a long day 0800 - 2000hrs or a night shift 1930 - 0800hrs then you will need to arrange a swap with one of the other 7 people in your ICM, Obstetrics or Emergency theatre to cover the out of ours cover. Specifically the time 1800hrs to 2000hrs and the 1930 - 0800hrs will need to be swapped by you.

Please see the attached Charts and DRD (Doctors Rostering system) analysis.

Trainees do not do any on call on the Ashford Hospital site at night. This is covered by the staff grades and Locum staff grade anaesthetists. Occasionally you will be asked to carry the on call bleep for emergencies on the Ashford site. This arrangement may occur if there is unexpected absence for the day shifts.

Out of hours on call commitments on the St Peter's site is covered by 3 Non-consultant grade personnel (trainees & Specialty doctors) and 2 consultants at any one time. There is a mixture of experience at all three area's (Obstetric anaesthesia, ICM & Emergency Theatre). CT1's at present do not cover out of hours on call commitments for ITU or Obstetric anaesthesia. Senior ST trainees may have an opportunity to cover emergency theatres. There is a dedicated consultant for out of hours Intensive care medicine (ICM) and one consultant for Obstetric and Emergency theatres. Consultants on call is non resident for both ICM & Emergency Theatre/Obstetric Anaesthesia.

The bleep holder for Obstetric anaesthesia (5011) is responsible to obstetric anaesthesia & labour analgesia and for general acute pain enquiries from the hospital wards. If the 5011 bleep holder cannot address the acute pain enquiries then it is important to contact the Emergency Theatre bleep older (5007) to address the acute pain enquiry. If the Emergency theatre bleep holder is also busy then the ICM bleep holder (5066) will need to address the acute pain issue. During normal hours (Monday to Friday) the acute pain team will address all acute pain issues.

Cardiac & Paediatric Cardiac arrests are attended by the ICM bleep holder 5066. Trauma calls are attended by the Emergency theatre bleep holder. If the designated bleep holder cannot attend (e.g. solo in theatre) then is important that he/she urgently contacts the other bleep holders to signify the event. Note if the work load is heavy then the on call consultant must be informed and he/she will come into hospital to help.

Although there are designated areas of work it is anticipated that a team approach is adopted and that the more experienced or free person will enquire with the other bleep holders to see if they need help or a rest break.