I have finally had a chance to look at the DH document on this, and it seems
excellent. Then you read closer, and find comments like this:
3.1 Streams are individually staffed and continue to function whatever the
pressure in other streams.
3.4 (paraphrased) There are to be five streams, self care, primary care,
minor injuries and moderate illness, clinical assessment and resuscitation.
4.7 Patients with minor injuries ... will be treated by personnel who will
not be diverted to the care of other patients in other streams.
I think that these are lovely ideals, just as I thought the Galasko report
was a lovely ideal. Resources to do the job were not forthcoming. What
guarantees can WEST give us that adequate resources will be made available
for this impressive-sounding project?
Well, you are directed to the Audit Commission toolkit which gives an
oversimplified method of matching doctors to numbers of patients likely to
be seen. It looks startlingly similar to a piece of work I did about 3 years
ago as a first shot at the problem, but that's by the by. What is impressive
is that throughout, this leading edge document talks about the number of
SHOs needed to staff a department. There is no mention of any other grade of
staff being involved. Man to contact with your comments? A Bill Alexander,
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Best wishes,
Rowley Cottingham
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http://emergencyunit.com
premier emergency medicine on the web.
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