A bump in the night: a 15-year retrospective analysis of urgent inpatient and emergency CT reporting out of hours in a tertiary referral centre.

Aim: To assess the impact on specialty trainee (ST) experience of out-of-hours (OOH) working, focusing on what might be improved with both patient safety and staff wellbeing in mind.

Materials And Methods: The number of acute computed tomography (CT) examinations reported OOH over the last 15 years (2007-2021) at Oxford University Hospitals NHS Foundation Trust was analysed. Qualitative data from the radiology STs participating in the acute OOH rotas were obtained using questionnaires during winter months in 2019 and 2021, before and after the introduction of an OOH CT outsourcing service in 2020.

Results: Overnight acute CT has increased over 10-fold over the last decade to almost 50 CT examinations in 2021, and similar increases were observed during evening and weekend shifts. The option to outsource acute CT on an ad hoc basis was introduced in 2020 to manage the increase in demand. This resulted in a statistically significant improvement in the STs' level of reported satisfaction for OOH shifts (p<0.018), despite significantly increased perception of how busy the shifts were (p<0.035).

Conclusion: OOH acute CT reporting at Oxford NHS Foundation Trust has increased dramatically over the previous 15 years. Working patterns and resources have changed incrementally to absorb this increase in demand, most recently with the option for outsourcing at times of peak demand. The trend for increasing OOH CT demand has considerable implications for future resource planning.