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Aims and Method  To identify deficits in senior house officer (SHO) on-call experience since the advent of accident and emergency (A&amp;E) liaison nurse cover, by retrospectively examining records of 267 A&amp;E patients between October 2004 and January 2005. We collated our data in terms of presenting symptoms.    Results  The majority (59%) of A&amp;E referrals received no SHO attention. In particular, SHOs had no involvement in 69% of ‘social’ presentations, 72% of presentations involving drug or alcohol misuse and 63% of presentations with associated suicidality, self-harm or overdose.    Clinical Implications  Clinical experience is being lost in key areas, and is not yet being replaced via other routes. There is a pressing need to consider methods to ensure development of these skills, at the same time as adhering to the European Working Time Directive.

Adherence to the European Working Time Directive and its influence on clinical experience