I didn't think I needed to explain it to this list.
This may expand the list' insight into why something like this is happening.
First of all let me say that this is not some mad paramedic wanting to do
inappropriate prehospital care (OK I may be the first but not the second) -
this is one of 14 pilot schemes in the UK which has been thought up (rightly
or wrongly) by the government!
There are basically three drivers to this programme...
1. In the UK we are nearing saturation point with patients visiting A&E.
There is a push toward EMS systems to initiate more treat and release
programmes OR finding alternative pathways for the patients other than the
A&E depts.
2. At the same time GPs have had a change of contract. As of next April the
GPs do not have to work out of hours. Their pay will drop by six thousand
pounds but many are prepared to absorb this loss rather than do night
shifts.
3. The last is that the EMS system here in the UK is being swamped with
inappropriate calls from patients for minor conditions simply because of the
difficulties in accessing their own GPs (GP receptionist - 'make an
appointment in two weeks time sir...' type of thing). This is having a knock
on effect on the resources the EMS system has available for Cat A calls and
as a result many systems are not hitting their performance targets.
So, what the government has decided to do is set up this new breed (for the
UK anyway) of paramedics called 'Paramedic Practitioner'. They will be based
in Minor Injury Units and also work from GP surgeries. Their role will be
that of a Paramedic and a minor injury practitioner with a few extra skills
on top of that.
If a call comes into the surgery or MIU then the Practitioner can go out in
the response car and treat and release on scene rather than take the patient
back into their MIU or GP surgery for the practitioner to treat the patient.
At the same time the Practitioners will also be on call for the ambulance
service for all Cat A calls and may also start identifying Cat C calls so as
to release the ambulances and placing more resources back into the system.
The scope of practice is evolving and we as a profession are looking for
alternative care pathways. This subject (tetanus) is one of many we are
looking at and it forms part of a basic treatment plan. As I stated before,
the concept of Practitioners giving Tetanus is still to be agreed. It will
need a PGD to agree it and it will be people such as yourselves who will
make that decision. Based on that, we probably not go ahead with it!
You are probably right though. So if we continue under the existing
regime...
A front-line paramedic ambulance takes minor injuries to A&E
The patient waits in excess of 4 hours in A&E
Ties up the nurses and doctors in A&E
A PTS vehicle takes them home
The next day a PTS vehicle picks them up and goes to the GP surgery
A practice nurse or GP then gives Tetanus
PTS vehicle takes them home again
Am I the only one here that thinks this is an out dated way of treating such
patients in overstretched EMS/PTS ambulance service, A&E depts and GP
practices.
Mike
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