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By Henry Guly (auth.)

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The only detailed description of the staffing of an individual hospital, which I have found from that era, was Guy’s Hospital and this is far from typical. In 1949 the casualty department was staffed from 0900 to 1900 hr by two outpatient officers (presumably casualty officers), three dressers (medical students) and the casualty surgeon (presumably not present all the time). From 1900 to 0900 hr, it was covered by an assistant house surgeon (who also had duties elsewhere in the hospital) assisted by two dressers.

3 Appointments of SCOs Year Number of SCO appointments 1953 1953 1955 1956 1957 1958 1959 1960 1961 1962 2 5 11 13 15 15 15 16 16 16 Source: Appendix to Memorandum produced by Senior Casualty Officers Subcommittee of CCSC 1964. of a permanent appointment was bad for morale and some were frustrated with at least one that they interviewed, wanting to return to general surgery. 16 The SCO post-holders were not expected to spend all their time in casualty. The Nuffield report comments on one SCO: ‘he virtually does no surgery now.

Of depts without paid sessions No. of depts with paid sessions No. of paid sessions Orthopaedic surgeons Others Joint responsibility No cover 174 38 5 11 156 28 4 11 18 10 1 — 73 66 16 — Total 228 199 29 155 Source: Reference 42. Who Should Run A&E Departments? 2 Staffing of 228 A&E departments 1969 Grade HO SHO Reg SR MA CA Cons Unpaid HO cover Posts Av. hrs/ week Av. 6 Note: * ENW is evenings, nights and weekend. Source: Reference 42. ’45 It was also difficult to fill vacancies with GPs. 42 The unpopularity of A&E posts was not surprising as a working party conducting a ‘time and motion’ study in 1968 showed that doctors working in A&E got 7 minutes of teaching per week compared to 29 minutes for those in general surgery and 75 minutes for those in general medicine.

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