Lots of discussion about Leeds and what we do and
where we want to be!

At present there are 5 consultants at each hospital.
We provide 8am to 9pm Team Leader shopfloor presence
Mon to Fri. At weekends at LGI site it is 9am-1pm
(SpRs come on at 12pm). Morning spent doing ward
round, clinic and covering the floor.Then on call.

We feel that realistically this is the best we can
provide at the moment in order to :
a) provide a uniform standard of cover prospectively
365 days a year and play for the long term
b) Maintain sanity
c) develop and maintain all the other projects that we
lead on and wish to develop (clinical governance
issues, teaching, research and improving pathways of
care with other specialities as well as fighting for
more resources). Of course time well spent on these
strategies is more likely to effect positive change.
New consultants energies can be quickly consumed in
these alone.

Our aim would be to try and get up to 8 / site in
order to further extend our coverage (but still not
enough for overnight). We do not cross cover sites -
both depts are too busy.

There is no doubt that increased consultant
involvement improves patient care in those who are
very ill (trauma is obviously small amount of the
workload, most of it is medical single/multi-system
disease)...bit more difficult to tease out the
avoidance of critical incidents for lesser conditions.


In a busy department in the evening/night critical
incidents probably still occur (unreported) on a
regular basis. One consultant can only realistically
do so much -that is why as mentioned by others we put
so much time into teaching and clinical governance. We
are a very long way away from the Attending role of
the US emergency physician model!!

Taj Hassan



--- Adrian Fogarty <[log in to unmask]> wrote:
> ----- Original Message -----
> From: "Laurence Rocke"
>
> > Listen, people, all this talk worries me greatly.
> Why should we settle
> for
> > different conditions than other consultants who do
> not come in unless a
> reg
> > asks them to do so.
> > The alternative is for us to agree to be resident
> for extended periods,
> with
> > APPROPRIATE levels of staffing.  In Leeds, they
> have agreed with the Trust
> > in principle to be there 9am to 9pm every day if
> there are EIGHT
> > consultants.  For 24/7 cover there would be
> SIXTEEN consultants.  We all
> > have a life outside medicine - well, most of us
> do.  Lets cut out the crap
> > and demand fair treatment.
>
> I'd love to know how Leeds arrived at their figures
> Rocky. Sixteen
> consultants is the sort of numbers you see in
> American or Australian units
> i.e. where every patient is signed off by an
> "attending". For consultant
> "presence" I don't believe you need these sorts of
> numbers. If you accept
> that you only need 3 or 4 consultants by day
> (clinical, management and
> teaching etc), one guy to do the night (followed by
> days off), then I figure
> you could run 24/7 cover with 8-10 consultants at
> most (someone could do the
> maths for me?). Remember we don't all need to be in
> from 9-5 like the
> obstetricians, paediatricians and anaesthetists. I
> realise I may be talking
> our specialty out of 16 consultant departments but
> if we ask for such
> numbers we'll be ignored by government!
> Realistically however we can slowly
> work towards 8 consultant departments, and
> personally I don't relish the
> thought of signing off every patient like the
> Americans do, though no doubt
> it'll happen someday! I expect BAEM are doing work
> on these numbers as we
> speak?
>
> Regards
>
> Adrian Fogarty




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