A ‘whole-of-hospital’ approach needed for weekend rostering- IMO

The IMO has said it is “unrealistic and unhelpful” to assume weekend rostering for consultants in hospitals can be introduced in an “effective manner” without all other hospital staff being rostered in the same way.

The Organisation was responding to an HSE internal audit on the implementation of the public-only consultant contract (POCC).

The audit stated there was inadequate oversight of increased rostering of consultants at weekends and evenings.

According to RTÉ, the audit found the contract did not have a significant impact on the number of consultants available to work weekends or evenings. Of the 2,954 consultants on the POCC in February 2025, 80 per cent were rostered Monday to Friday, 12 per cent on weekday evenings, 11 per cent on Saturday daytime and 56 per cent were on call on a Saturday.

The IMO said it “welcomed” the fact that the audit “dispelled the myth that consultants don’t work on weekends”, as it showed over half (56 per cent) work on call on a Saturday.  

Prof Matthew Sadlier, President of the IMO and Consultant in Old Age Psychiatry, said that it made “little sense” for consultants to be rostered on weekends in isolation. “We welcome the fact that this audit shows consultants regularly work on-call at weekends, so working weekends in and of itself is not a problem.”

“However, it is unrealistic and unhelpful to assume this can happen effectively without all other staff in a hospital being rostered in a similar manner so consultants can practice safely with a full team present.”

He said that moving to weekend rostering must include an assessment on how this will affect mid-week services and continuity of care.

“While the POCC has been successful in attracting new consultants to posts that previously could not be filled, we are still critically below OECD averages for numbers of consultants per head of population and have no safe staffing framework in an environment of rising demand,” he said.

“In this context, it makes little sense to introduce weekend rostering if it detracts from mid-week services. If the right resources were available, this could be easily introduced but unfortunately, we are not at that stage yet.”

Prof Sadlier noted that consultants were rostered on a work plan agreed with management, and that while more consultants were now working on weekend discharges, a whole-of-hospital approach was needed to extend this to elective services.