Thank you for posting this one, Danny. This has always been one of my
concerns with trick or treat- with existing resources it seemed impossible
to combine senior doctors assessing minors with senior doctors being
directly involved with all critically ill patients in the ED. As you say,
however, it is unlikely to alter practice (if a patient attends with a minor
or self limiting disorder and is seen and treated by a consultant within 15
minutes of arrival, they go away thinking the NHS is being well run; if as a
result of the consultant being tied up in minors they don't see a sick
patient and that patient dies, it is the clinicians not the managers who are
criticised).
According to David Lammy, the main concern of patients attending A and E is
how long they have to wait for treatment rather than whether they survive to
discharge, so its actually you and me who are out of step rather than those
who would leave the sickest patients to the least skilled clinicians.
My understanding from the presentations on see and treat is that in this
particular department at the time concerned although consultants were seeing
minors, there was not 24/ 7 availability of A and E consultants for
critically ill patients.
Matt Dunn
Warwick
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