I've recently developed a protocol directing the A&E triage nurse to
re-direct "category blue" patients to NHS Direct rather than giving them the
option of waiting to be seen in A&E. Presently waiting to see if NHSD are
willing to take on the extra work. If it gets off the ground we will then
look at ways of identifying primary care patients in higher triage
categories who may also benefit from a bit of redirection!
Best wishes
Bill Bailey
----- Original Message -----
From: Dunn Matthew Dr. (RJC) ACCIDENT & EMERGENCY - SwarkHosp-TR
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, November 19, 2001 3:52 AM
Subject: Re: GP's in A&E
> The question is not whether GPs are better than A and E doctors at seeing
> primary care conditions- clearly they are (and I think that the original
> paper to which Dr Ray refers is Dale J. Lang H. Roberts JA. Green J.
> Glucksman E. Cost effectiveness of treating primary care patients in
> accident and emergency: a comparison between general practitioners, senior
> house officers, and registrars. BMJ. 312(7042):1340-4, 1996 May 25- which
> showed GPs to more cost effective than A and E registrars, not just SHOs.
> Not sure about consultants.). It is whether A and E or general practice is
> the best place to see these patients. If you've triaged a patient as
having
> a primary care problem, why not just send them to a GP? (Our departments
> don't employ specialists in any other areas- we refer the patients).
> Reinforcing the message that it is appropriate to call 999 because the GP
> out of hours is busy is not a good idea. (Also, I'm a bit opposed to the
> general idea that A and E deals with other specialties patients if it's
out
> of hours).
> Agree with comments from others that the triage category is not a good
guide
> as to which patients have primary care problems.
> Does anyone have any protocols for nurses directing patients to more
> appropriate or cost effective services from triage?
>
> Matt Dunn
>
|