article: Mr Arulampalam is already talking to colleagues on the phone as he arrives for work at 7.45am on Sunday. During a 20-minute handover, when he finds out about the most seriously ill patients under his care, he has to contend with the arrival of a "code red" patient who needs immediate treatment in the "resus" area of Emergency. He quickly delegates that job to a senior doctor, asking to be kept informed on the patient's progress, and starts his ward rounds. It's his first big decision of the day - many more will follow, because there's a lot to do. Mr Arulampalam is in charge of all patients admitted for general surgery at the hospital this weekend. His role also involves reviewing patients who have already been admitted during the last few days, who have had surgery and whose care is ongoing. He must also supervise operations, particularly those involving junior staff, and talk to the families of patients who are seriously ill, especially those who have a high risk of dying during surgery. Weekends start on a Friday morning at 8am and finish at the same time on a Monday. Although he is contracted to work just three hours on each of Friday, Saturday and Sunday, Mr Arulampalam usually only goes home at night to sleep. He also has to be on the end of a phone in case he is called back in for an emergency. "On a weekend, my family don't expect to see me," he says. Such is the workload over the period that he often swaps one day with a colleague because "doing a three-day weekend is not safe", he says. First on his ward round is patient Nancy Fuller, who was admitted on Thursday evening with a painful wound after surgery. She says she has no complaints about the weekend care she has received. "I wasn't feeling too good this morning and they immediately did something about it and got medication for me," she says. An hour into his shift, Mr Arulampalam has spoken to the consultant gastroenterologist about an emergency operation, chatted to the orthopaedic surgeon who's preparing to fix fractures and is under pressure to book a CT scan, which will mean liaising with the consultant radiologist. Among senior doctors, he says the staffing levels are "really very good" at the hospital outside of normal hours and that helps when difficult decisions on patients have to be made. Meanwhile, the "code red" patient brought in from a residential home with bleeding needs more tests in a hurry. This requires more conversations with specialists - asking for their advice and sharing knowledge. "Communication is really, really important," he says. At 10am Mr Arulampalam has seen about half of the patients on the emergency ward and he's stacking up work for the rest of the day with two patients already needing to go to theatre. Sometimes he can get away early, but not today. With a house officer, a core trainee, two junior doctors and a registrar working with him, it only takes two or three
summary: Tan Arulampalam, consultant colorectal and general surgeon, let the BBC follow him on a weekend shift at Colchester General Hospital, where he's been a consultant for 12 years - and he gives his personal view on the plan to make the NHS a seven-day operation.