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Are accident and emergency senior house officers getting slower?
  1. P Gilligan1,
  2. R N Illingworth1,
  3. S Crane2,
  4. D Hegarty3
  1. 1Accident and Emergency Department, St James’s University Hospital, Leeds, UK
  2. 2Accident and Emergency Department, York District Hospital, York, UK
  3. 3The Avenue Practice, Alwoodley, Leeds, UK
  1. Correspondence to:
 Dr P Gilligan
 Accident and Emergency Department, The Leeds General Infirmary, Leeds, Yorkshire, UK; hegartydeirdreireland.com

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You sometimes hear people saying that senior house officers (SHOs) in emergency departments are not what they used to be.

We studied data collected over a five year period (1996–2001) on the number of patients seen by all SHOs who completed a six month post in our A&E department.

The 118 SHOs (62 male and 56 female) worked a full shift rota averaging 52 hours per week. The influence of the sex of the doctor and their future career plan on the number of patients they saw was also assessed.

The number of patients seen by each SHO in six months ranged from 1069 to 2659 (mean 1774, SD 346). On average the SHOs working between August 1996 and January 1999 saw 154 more patients than those working between February 1999 and July 2001 (p = 0.015; unpaired t test). Male SHOs saw on average 217.5 patients (range 1121 to 2659) more than female SHOs (range 1069 to 2644) (p = 0.001; unpaired t test). The median number of patients seen by SHOs with a surgical interest was 1831 (interquartile range 1624 to 2024), and by those with a medical one was 1684 (interquartile range 1497 to 1847) (p = 0.042; Mann-Whitney U test).

We acknowledge that there have been changes in the delivery of emergency care over the time frame of this study. We did not study the quality of care given by the SHOs and it would be difficult to quantify this. It is possible that the slower SHOs were more thorough but our impression is that some SHOs (male or female) saw a lot of patients with a high standard of care. Our results show that A&E SHOs are seeing fewer patients than they used to. We need to be aware of this and consider the implications for the future of emergency care.

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