Doctor 'danger weeks' spark casualty warning

Inexperienced juniors are under pressure in their first weeks

The traditional changeover weeks in which junior doctors move to take up new posts could be placing patients at risk, say staff.

Inexperienced newly-qualified doctors are given a succession of six-month jobs in different areas of medicine to gain experience.

Across the NHS, the first weeks of August and February are the traditional times for juniors to change jobs.

It has long been a widely-held belief in the health service that even with supervision, mistakes are more likely in certain specialities during these weeks.

In August, the situation is often worsened because some senior staff are likely to be taking holidays.

Patients unaware

Many patients are unaware that the "senior house officer" treating them may be only a year out of medical school.

All training programmes for juniors involve a stint in casualty early in their careers, as this offers the chance of gaining experience in recognising a wide variety of medical conditions.

But this week the president-elect of the Association of Accident and Emergency Medicine warned that unless the NHS could increase the numbers of more experienced doctors in A&E departments, patient care might suffer.

Mr John Heyworth, a consultant in A&E medicine, told the BBC: "These are young doctors, just 12 months after qualification.

I'm still quite nervous as I don't know what I'm going to come across.

New senior house officer

"A lot of them become senior house officers but are still very junior doctors, and find it difficult to cope in A&E.

"Patients there have a very serious acute illnesses and the doctors need supervision and training.

"The situation in this regard has improved but is still very satisfactory. There is a significant shortfall in the number of middle grade, more experienced doctors."

He said that the number of these more experienced junior doctors, called registrars or specialist registrars, varied widely between different hospitals.

Junior doctors told the BBC about their anxiety on taking up their first senior house officer jobs.

One said: "I'm still quite nervous as I don't know what I'm going to come across.

"In A&E there isn't a fixed category of patient - anything could come through that door."

A spokesman for the Department of Health said the government was working with the profession to improve working conditions in A&E departments, but said that placing younger doctors there to work gave them "valuable experience".