One in five emergency operations at night is done by an unsupervised trainee surgeon and nearly half of the patients are anaesthetised by a trainee, a survey has found.

NHS hospitals, under pressure to cut waiting lists, are accused of neglecting the needs of emergency patients, who are left until the end of the day when senior staff have gone home. Anthony Gray, chief author of the survey, said: "Emergency patients don't get as much political attention as elective patients [those who are booked in] do."

More than one third of NHS hospitals made no provision for patients needing emergency surgery, which meant they had to be squeezed in between routine cases. The survey, by the National Confidential Enquiry into Perioperative Deaths, found a fall in the number of operations by unsupervised trainees compared with its study in 1996, but said consultant cover at night was still inadequate.

Patients who are operated on at night or by unsupervised junior staff are believed to be at greater risk.