Sir: In a radical new approach to caring for accident victims, trauma consultants at the John Radcliffe Hospital have begun to work a shift system of 24 hours on followed by 24 hours off (1 January). Anyone severely injured in the early hours of a Sunday morning will now be treated by a consultant-led trauma team. In every other accident and emergency department junior doctors, sometimes inexperienced and often exhausted, will continue to admit patients in the early morning hours, and wonder whether or not to disturb the 'on call' consultant asleep at home.
The immediate availability of a trauma consultant in the critical first hour after a serious accident is expected both to save lives and to reduce long-term disabilities. It will also cut the hours of junior doctors in casualty from more than 70 a week to 58, a reform long
M. I. HEATLEY