NCEPOD are often reported as stating that surgery must never be performed at night when in fact this is not the case. Our recommendations highlight concerns about surgery being performed out of hours by junior staff with too little supervision during the procedure and lack of medical support when the patient had returned to the ward.
NCEPOD considers that all the appropriate resources and appropriately trained personnel should be available in order for surgery to take place whatever the time. It is acknowledged that patterns of work will vary, dependent upon local arrangements, available resources and in particular consultant availability and appropriate job planning.
It is important to recognise however, that the competence level of staff in both surgery and anaesthesia must be appropriate not only for the complexity of the surgery, but also for the general health in terms of co-morbidities of the individual patient.
It must also be recognised, that trainees should only perform duties under appropriate levels of supervision, and that consultant trainers should also be sufficiently fresh and well rested to be able to perform their supervisory role.