• Laura Tincknell, Sarah Burton, Claire Cooke, Stephen Black, Stefano Andreani, Iain Jourdan, and Mark Gudgeon.
• Department of Colorectal Surgery, Frimley Park Hospital, Frimley, Surrey, UK.
• Ann R Coll Surg Engl. 2009 Jan 1;91(1):18-22.

IntroductionWith reduced working hours and shift patterns, surgical training and continuity of patient care is being put at risk. We have devised a system for managing the emergency surgical patients in an effort to counteract these perceived problems. This study describes the emergency surgical team and audits its activity.Patients And MethodsThe emergency surgery team concept is described in detail. Over a 2-week period, general surgical referral data, patient management and operative activity were audited.ResultsA total of 229 patients were referred to the emergency surgical team with 159 treated conservatively, 45 underwent operative intervention and 25 were discharged without admission. Of the emergency surgical team referrals, 58% had gallstone pathology, appendicitis or constipation/non-specific abdominal pain. Average daily number of patients under the care of the emergency surgical team was 26 (range, 10-40).ConclusionsThe consultant-led emergency surgical team look after many of the acutely sick surgical patients. Our system not only provides good teaching opportunities but ensures optimal continuity of patient care in a busy district general hospital. Such an approach to emergency surgical care has been successfully developed to optimise training opportunities and improve patient care in a setting of reduced working hours and shift systems in our hospital.

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