> One thing which will defintely help is and ENP service.
> Properly trained these can take a lot of strain from the
> department. We have been able to set up a minor injuries
> service from 12 noon till 8 pm at the weekends using the
> first of our ENPs to be trained and they are able to see
> about 20% of what comes throught the door.
>
Can be useful sometimes, but I think that part of the point of Danny's post
is that you need 8 SHOs to run an acceptable full shift system including
teaching even if your daytime workload isn't too high. One problem we seem
to have is that we do a disproportionate amount of unsocial hours work
(worsened by in some cases doing the 'out of hours' work of other
specialities)- this may be worsened if GPs take on more minor injury work
within office hours with the new contract (reducing our attendances and
making the case for reducing staffing without reducing our out of hours
work).
Same issue with SAS doctors- I'd like 24/ 7 staff grades, but it does seem a
bit rough to ask someone in a permanent post to do more than 1:8 resident
nights even if you can work the rota with 5.
Kind of links into Nick Jenkins' post- 1.5 times evenings; double weekends
and nights for up and working seems a compromise. I think though that there
is a bit of intransigence here- at this rate a lot of SAS doctors probably
wouldn't do it (don't want to do nights at all) and a lot of managers would
think it too high. Be interested to hear of any acceptable compromises.
Matt Dunn
Warwick
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