ABSTRACT
This chapter discusses key changes to working patterns in both secondary and primary care. The resulting alterations made to rotas have in turn affected the structure and function of medical teams and how care is delivered by them to patients. The recent changes in working hours described have led to many hospital specialties moving to a shift pattern of working. In most hospitals, for most specialties the rotas for junior doctors are not completely aligned to those for other members of the team, or, indeed, to the consultant of that team; often there is no alignment and they only work together while on-call occasionally by chance. In the traditional National Health Service (NHS) model, on-call specialist teams generally covered patient care at night. Hospital at Night (H@N) describes an approach to providing night cover in hospitals using multidisciplinary teams with the ability to call in specialist expertise if required.
