> Maybe so, but it isn't going to happen anytime soon!
> Here is why. To run our department safely and to cope
> with the new targets for treatment times I reckon we
> will need on average 2.5 docs on the shop floor 24/7.
> That is 420 hours of consultant time needed per week.
> Now to allow for admin, annual leave, sick leave,
> study leave etc. I reckon you will get about 28 hours
> of shop floor time per consultant! That means 15
> consultants for this department. You can see the
> problem. Where are the other 13 going to come from and
> the wages bill for medical staff busts £1,000,000 for
> ONE department in ONE DGH!!
I agree with your points but put a different slant on them. Service input
from trainees will be reduced. You will not be able to increase consultant
numbers sufficiently to cover the workload. Therefore you have to have some
of the workload done by other people. Hence NPs, physicians assistants. A
possibly scenario is 1 consultant at a time covering for the sicker patients
only, with 'minors' seen by NPs. Whatever happens, costs will rise (SHOs are
a cheap way of seeing patients).
A worrying development is the appointment of the new Emergency Care Czar.
George Alberti (a London based academic endocrinologist) has been appointed
to this post on a half time basis. As many of you may be aware, Professor
Alberti has no great regard for the ability of A and E departments to deal
with medical emergencies and has repeatedly called for these to be under the
care of Emergency Physicians with general subacute medicine but no A and E
or anaesthetic training. we may be heading for a situation where minor
injuries, minor medical problems and medical emergencies are hived off
leaving A and E consultants on call to assist with the svut work from other
specialities.
Matt Dunn
Warwick
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