The implementation of the European Working Time Directive, safer childbirth requirements and changes to the structure of training continue to impact upon maternity care provision. Consultant decision-making is crucial to optimise safety in labour. There is little data on pregnancy outcomes during resident consultant shifts.^1,2 In York Hospital, consultant resident on-call was introduced from July 2010. We have published preliminary retrospective data on the impact of the introduction of these posts in the unit.¹

Objectives To examine the impact of consultant resident on-call over one year in York Teaching Hospital with 3400 deliveries annually.

Methods We present retrospectively collected data comparing outcomes of two resident consultant night shifts versus two registrar (with non-resident consultant) night shifts each week between January 2012 and December 2012.

Results There were fewer patients taken to theatre, fewer low arterial cord pH results and more successful vaginal deliveries during the resident consultant shifts.

Conclusions Our work suggests that having resident consultants on-call can reduce the caesarean section rate, ‘trials in theatre’ and the incidence of low cord arterial gases. The short term benefits of resident consultant presence have to be balanced with the sustainability of this work pattern, professional development and the overall impact on junior doctors’ training as innovative ways emerge for the future consultant led service to provide safe and effective care.

References

1. Tang JW, Dwyer JP, Rajesh U. Impact of introducing consultant resident on-call in a district general hospital. Journal of Obstetrics and Gynaecology 2012 Nov; 32(8):736–9

2. Freites J, Ruprai C, Paul H, Lindow SW. Resident consultant presence in labour ward after midnight - a retrospective cohort study of 5318 deliveries. J Perinat Med. 2012 Jun 20; 0(0):1–4. Epub 2012 Jun 20