Patients are being left in the hands of junior doctors because there is no adequate consultant cover on weekends, according to a new report.
The head of the Royal College of Physicians (RCP) said patients were not “getting the care they deserve” on weekends and during the night.
The college is calling on hospitals to ensure consultants are available every day of the week for at least 12 hours each day.
Its study found that none of the 126 hospitals it surveyed had weekend cover for more than 12 hours from specialists in acute medicine, and just 3% provided nine to 12 hours of cover.
Some 73% of hospitals in the survey had no cover at all over the weekend from specialists in this area, whose job it is to look after the most seriously ill patients and provide seniority in medical admissions units.
The study comes after reports over the summer revealed people admitted as emergencies on a weekend were more likely to die than if they were brought in during the week.
The death rate among people admitted as an emergency increased by 7% at weekends in one year - or 3,369 more deaths than would normally be expected, one study found.
A separate government-ordered review from Professor Sir John Temple said too many junior doctors were left unsupervised on wards outside normal working hours.
It said the NHS was “too reliant” on trainees to provide out-of-hours care for patients and that some older consultants were reluctant to work later hours, preferring to stick to a standard week.
The RCP said it was concerned about relying on trainees, and research showed that a service led by consultants was “best for patient treatment and recovery”.
RCP president, Sir Richard Thompson, said patients “are still not getting the care they deserve at night and at weekends”.
He added: “Too many junior doctors are covering too many very ill patients, and this has to change.
“Our evidence shows that a predominantly consultant-delivered medical service is the best way to improve patient care.”
Health secretary Andrew Lansley said: “Sir Richard Thompson is right, patients do deserve better care at night and weekends and senior doctors should be available to provide acute medical care as needed.
“I have already asked Medical Education England to consider with the profession, the service and medical Royal Colleges, how best to secure better patient outcomes and the right level of supervision for trainees through greater consultant involvement in direct clinical care at night and at weekends.”