IMO: Whole-of-hospital approach needed for weekend rostering

IMO responding to HSE internal audit on the implementation of the public-only consultant contract (POCC)

 Thursday June 11, 2026. The Irish Medical Organisation (IMO) has said that it is “unrealistic and unhelpful” to assume weekend rostering for consultants in hospitals can be introduced in an effective manner without all other hospital staff being rostered in the same way.

It was responding to a HSE internal audit on the implementation of the public-only consultant contract (POCC), which found inadequate oversight of increased rostering of consultants at weekends and evenings.

The IMO also welcomed the fact that the audit dispelled the myth that consultants don’t work on weekends, as it showed over half (56%) work on call on a Saturday.  It added that the complexities of work in different medical specialties meant a ‘one-size-fits-all’ approach for consultants regarding weekend working was unsatisfactory.

Prof Matthew Sadlier, President of the IMO and a consultant psychiatrist, said that it made no sense for consultants to be rostered on weekends in isolation. “We welcome the fact that this audit shows consultants regularly work on-call at weekends, so working weekends in and of itself is not a problem. However, it is unrealistic and unhelpful to assume this can happen effectively without all other staff in a hospital being rostered in a similar manner so consultants can practice safely with a full team present.”

He said that moving to weekend rostering must include an assessment on how this will affect mid-week services and continuity of care. “While the POCC has been successful in attracting new consultants to posts that previously could not be filled, we are still critically below OECD averages for numbers of consultants per head of population and have no safe staffing framework in an environment of rising demand.

“In this context, it makes little sense to introduce weekend rostering if it detracts from mid-week services. If the right resources were available, this could be easily introduced but unfortunately we are not at that stage yet.”

Prof Sadlier noted that consultants were rostered on a work plan agreed with management, and that while more consultants were now working on weekend discharges, a whole-of-hospital approach was needed to extend this to elective services.

He concluded by saying that the POCC was designed to be an enabling contract to allow consultants to be rostered where service required it, where sufficient staff (medical and other healthcare professionals) are available and where it would not diminish services mid-week.