I accept that this will lead to a change in work practices for consultants. A vital element in any move to a consultant provided service will be agreeing different work practices for consultants. The task force recommends that consultants will participate in rostered work, night work and extended cover, as required. In some instances, where clinical needs and caseloads require it, this may involve an on-site consultant presence on a 24-hour basis. These proposals are quite stark and careful negotiation will be required in respect of them.