There have been significant changes in the provision of medical care in hospitals at night. The initial catalyst for this was the New Deal for Junior Doctors but more recently the European Working Time Directive requiring doctors' hours to be reduced to 56 in 2002 and to 48 by 2009. The reduced availability of junior doctors in hospitals at night has had a range of implications, including the necessity to train other health professionals to do work previously undertaken by doctors and a reduction in the number of specialist doctors available out of hours. The expectation is that staff in the hospital at night will be equipped to deal appropriately and safely with emergency work across specialties, rather than each specialty covering their own patients.
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