Hi Matt,
matt baskerville wrote:
>
> I think most ambulance services now have the paperwork to "treat and
> release" in the formof a patient disclamer form wich basiclly says that the
> patient is happy not to travel to A/E and are happy for you to leave or
> contact the GP and he will visit instead of transporting to a/e.
This is a real can of worms - basically, we have to show that the
patient has got the capacity to consent to refuse transport - very
difficult, and the lawyers run rings round us if the patient is on any
psychotropic medication or is emotionally distressed (never see any of
those!!).
Basically, the paperwork is not worth the paper it is written on unless
a formal assessment of capacity is also conducted and recorded.
We are also reluctant to "dump" the duty of care on to primary care -
the point of Community Paramedic Officers (CPO) is to try and reduce the
load to the WHOLE NHS, not just A&E - to this end, we encourage GPs to
contact the telemedicine desk so that a CPO can go out and assess a
patient if the GP is going to be delayed visiting a patient - the
history and obs are then relayed back to the GP, who can tailor patient
management accordingly - in some cases, following a 12 lead for general
shortness of breath, the patient has been taken in on blues following a
diagnosis of silent MI; in other cases, the CPO will pop the patient
into his car and take him to the GP surgery. No 999 call ever took
place, but it is about working together to try and stop patients
defaulting to A&E if they meet the least resistance to accessing care,
such as a delay in a GP visiting.
Anton
Staffs
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