I assume the
> above fudging of "trolley waits" will now be
> consigned to history. The Audit
> Commission report foregoes this definition, and
> replaces it with the "wait
> for admission" which it defines simply as the "time
> from arrival in A&E to
> admission to a hospital bed". The commission states
> that the "wait for
> admission" will supesede the "trolley wait" in the
> NHS plan. This "wait for
> admission" will naturally include the "wait to see a
> doctor", but also the
> diagnosis time, the referral time and the admission
> time (only the latter
> being roughly equivalent to the old "trolley wait").
> Good news for us I
> think...
>
> Adrian Fogarty

A long rant. Sorry.
I'm not so sure Adrian..be watchful, especially if you
have a medical admissions unit or similar.
Our trust are refusing to count patients in such a
unit (ours is called EDAU cos we run it) as it is
possible(quite legally within the defintion laid down
by the DoH) to call it a ward area, so those things
the patietns lie on with black mattresses and an x ray
bucky can be considered as beds for reporting
purposes.

The big advantage of this is for managers is that all
you have to do with your ED patients who are
approaching the max wait is move them in to the EDAU
or MAU and the clock stops!
The consequence for us is that the EDAU ceases to
function as a low acuity GP referral & assessment unit
and becomes a holding bay for people brought in some
hours ago (over 50h on occasion), awaiting admission
to a bed, but held in an unwordly state, in a sort of
virtual ward where they don't show in the figures (the
ward of the 'unbed'?)

I am amazed there has not been a major expose of the
trolley wait figure fudge issue - journalists know it
goes on but don't seem to find it newsworthy. A trust
in the SouthWest sent false reports to region for
several years, it would appear with the connivance of
individuals there and centrally, and then the hospital
senior management all left for extremely prestigious
posts, having pleased their DoH bosses.
The beleaguered ED staff throughout this period
mistakenly believed the senior management were doing
their utmost to help win the necessary resources for
the trust to address this - you can imagine how
betrayed they feel. The patients, the ones who really
suffer, don't know anything about it.
I think this a scandal as serious as any health story,
when seen through the eyes of the bloke on the trolley
all night and the children who have to be resuscitated
on the floor.

Regarding the issue of why don't trusts hold their
hands up and say  'we have a serious problem
here'(cant remember who raised that, sorry), I think
it is starting. Four have done this in the SW (it
would be unfair of me to name them) reporting
projected deficits of around 10 million each for this
year. Two are DGHs, for whom this represents 10%
overspend.

Steve Meek

Finally, whoever it was, please don't attack the likes
of John H and Iain A  over the lack of publicity for
the specialty- we currently have the most progressive
leadership the specialty has ever had. If you think
you could do better, stand for office. I know I coulnt
so I just write emails.

--- Adrian Fogarty <[log in to unmask]> wrote:


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