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Benefits of Consultant Delivered Care

The most comprehensive and focused review into the benefits to patients of consultant delivered medical care has been published by the Academy of Medical Royal Colleges (AOMRC) today (24 January).

The review was commissioned by the Academy and carried out by a Steering Group led by Professor Terrence Stephenson (Academy Vice-Chair and President of the Royal College of Paediatrics and Child Health).

The review’s Steering Group called for written and oral evidence from professional organisations and individuals. It also commissioned an independent and systematic review of existing literature on the subject which identified over 70 relevant studies published between 1992 and 2011 (although much was from the last 3 years).

On the basis of the best evidence available, the Academy concluded that medical care delivered by fully trained consultant doctors has demonstrable benefits in terms of:

  • Rapid and appropriate decision making
  • Improved outcomes for patients
  • More efficient use of resources
  • GP’s access to the opinion of a fully trained doctor
  • Patient expectation of access to appropriate and skilled clinicians and information
  • Benefits for the training of junior doctors.

The Academy recommends:

  • That the identified  benefits of consultant-delivered care need to be taken into account alongside cost implications when considering the future shape of the medical workforce at local or national level
  • Current contractual arrangements for consultants need to be separated from the question of the benefits of consultant-delivered care
  • The benefits of consultant-delivered care should be available to all patients throughout the whole day and the whole week
  • Implementing a full system of consultant-delivered care will require  different thinking about consultant working patterns
  • Work should be undertaken between clinicians and employers to map out the staffing requirements and service implications of implementing a consultant-delivered service throughout the week.

This report is not suggesting that it should only be consultants who deliver medical or clinical care. The Academy and Medical Royal Colleges fully recognise and support the principle that successful care depends on a team based approach where a range of healthcare staff contribute to the delivery of a successful outcome.

Professor Terence Stephenson, Academy Vice-Chair and Lead of the Steering Group said:

“This review provides real evidence that patients are likely to have better outcomes to their care and resources will be used more effectively when medical care is delivered by consultants.

The weight of evidence makes it clear that it can no longer be acceptable for some patients to have to risk poorer outcomes because consultants may not be available at some times of the day or week. This will mean changes to the working patterns of consultants but also to how services need to be staffed and configured in a local area to provide safe care.”

Mr Sol Mead, Chairman of the Academy Patient Lay Group said:

“Consultants play a crucial role in the modern health service; providing essential specialist advice and knowledge needed to treat people to the very highest standards.

The benefits that come from their leadership are equally important in working with other doctors and health service staff to guide them and the patient along the treatment pathway”

Download the full report