A study of acute care at Royal Liverpool University Hospital has highlighted how a new system of assessing patients can clash with the training of junior NHS doctors.

Findings published in Clinical Medicine, the journal of the Royal College of Physicians, show that accident and emergency waiting times and time to assessment by a consultant in acute settings have improved.

But because of new restrictions on working hours, junior doctors are often not present when the patients they have admitted are seen by the consultant.

But it is at this stage that as many as half of all diagnoses are changed. And because the system has no means of relaying the change back to the junior doctor, he or she is not told.

Consultant physician Dr Solomon Almond said: “Ideally, all emergency admissions would be seen straight away by consultants accompanied by the junior doctors.

“This would re-establish the link between hands-on clinical medicine, training and experience that was for many years the foundation of post-graduate medical education in this country.”

RCP director of workforce planning Dr Andrew Goddard said: “This study shows that increasing the input of consultants into the care of medical patients admitted to hospital changes the way doctors are trained.

“The short-term benefits to the patient of seeing a consultant first may be offset by loss of training opportunities for the consultants of the future.”