"Reduced weekend service"

My father - who is in the late stages of lung cancer that has spread through his body - was recently admitted to the Carlton/Coleby ward with a suspected respiratory problem.

He has been suffering a lot of pain in recent weeks and was prescribed decently sized doses of strong painkillers, which were just about coping with the pain. Then on admittance to the Carlton/Coleby ward, the pain management team lowered his dosage. He suffered a long drawn out night of high pain on the Friday night of his admittance, continuing through the Saturday morning.

He was clearly suffering when I went to see him Saturday afternoon. We asked the nurse about getting a higher dosage of pain relief, who initially said that this wasn't possible. After a bit of persistence, it transpired we could call the doctor, who would be able to assess and potentially prescribe a higher dosage. The nurse told us the doctor would be around in "5 - 10 minutes".

Minutes came and went, while my father continued to suffer - reduced to tears because of the pain. Eventually, over two hours after initially being called, the doctor arrived. After a couple of questions, the doctor was then distracted and disappeared for 10 minutes. After re-appearing and asking a few more questions, she agreed to increase his pain relief medication, although I wasn't instilled with a high confidence in this assessment. When I left the hospital, almost 3 hours after the initial call to the doctor, he still hadn't been given his new medication.

During this whole process, it was revealed to us that a "reduced service" runs at the weekends. In this case, from 24 doctors serving up to 168 patients during the week, to just 1 doctor at the weekend. This is obviously a drastic reduction, and is unacceptable. It's not just a reduced service, it's pretty much non-existent. My father was essentially forced through hours and hours of pain because the pain management team under-dosed, and there were no doctors available to increase the dosage. Had he been admitted at the start of the week, this would not have been the case.

The nurses, despite some early reticence, were very co-operative once pushed, and were visibly doing a good job on the ward. And despite my lack of confidence in the young doctor, I realise she was in a difficult position being on call to 6 wards, and it wasn't her fault she was doing this work alone. The problem is obviously with the numbers of doctors available. I would expect a reasonable (maximum) reduction of service to be of the order of 4 doctors per ward to 1 per ward - I. e. a 75% reduction. Instead, they are running at a 96% reduced service for 2 days of the week. I'm not quite sure how this is acceptable, and is particularly unfortunate for those who happen to suffer at the weekend.