Provision of on-call urology services in the United Kingdom: A national survey of current practice

Objective: The aim of this study was to establish an evidence-base of how UK emergency urological services are provided. Methods: An online survey of members of BAUS looked at out-of-hours support dependent upon location, hospital type, age, occupational grade, multi-site working and urological experience. Rota types, and the need to work routinely when providing emergency cover, were defined. The frequency of being called between midnight and 8 am, rest periods after activity during these times, and individual’s opinion about how on-call activity compared to their expectations, were measured. Results: Most UK urologists take part in on-call with consultants having a median allocation of 4 hours per week in their job plans for out-of-hours working. Consultants mostly followed a ‘Consultant of the week’ rota format and there was variable confidence in the support they had for this function. Most out-of-hours activity was undertaken by individuals on mid-grade rotas, while consultants in district general hospitals were twice as likely to have their sleep disturbed as colleagues in other hospital types. 18.4% of urologists had unfulfilled expectations of what on-call working was like. Conclusion: BAUS and GIRFT recommendations for on-call working are broadly followed but with substantial variation in local practice. Rest periods for consultants working after midnight are a consistent issue. Level of evidence: Not applicable