I agree, for example in my department there was no change in consultant
numbers from 1992 to 2002. Over those 10 years there was a modest and
informal increase in out-of-hours cover by consultants to reflect increased
patient numbers generally, but very little change overall. Any increase in
ISS-16ers being treated by SHOs might however simply reflect the time of
such patients' arrival (i.e. after midnight). I'm not sure if Fiona's paper
specifically looked at this in detail though, nor can I speak for other
departments' experience.
Our recent London wide audit showed severe injury was most common at 7.30pm,
and motoring organisations generally report that accidents are commonest at
dusk (but not dawn, strangely). In the same journal it's also interesting to
note a paper from Birmingham studying temporal patterns of attendance at A&E
departments: minimal from 2am to 8am, but peaking from 10am to 10pm. Clearly
our traditional "office hours" of 9 to 5 do not fit with our patients'
pathologies. Any expansion in consultant numbers must be accompanied by more
flexible working patterns.
Adrian Fogarty
----- Original Message -----
From: "Danny McGeehan" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, November 11, 2002 11:54 AM
Subject: Re: Lack of change in trauma care
> Against a background of massive consultant
> > expansion (and increase in hours with a consultant present in the
> > department). This would seem counterintuitive and kind of begs the
question
> > of why are we expanding consultants if they are not getting involved in
the
> > sickest patients.
> But there is not a consultant expansion. I have been working single
handed for 3 years and was previously in a dept with 2 consultants. A dept
just to the North of here will be done to 2 consultants and at one stage
there were 6. You only have to look at Leicester. More are being trained
but not being appointed consultants. I strongly suspect a lot are going
overseas to the Antipides.
>
> Danny McGeehan
>
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