-----Original Message-----
From: Accident and Emergency Academic List [mailto:[log in to unmask]] On Behalf Of Marco Bennett
Sent: 19 December 2004 21:00
To: [log in to unmask]
Subject: Re: Four hour waits and on-call
- his wife had made him attend A&E as "she did not believe in attending GPs" as "they would only send him up to A&E anyway" - this is certainly not the first time I have heard such comments in A&E!
To John Chambers - I DO work in A&E by the way...
Marco Bennett
But not in primary care, clearly…isn’t it about time we stopped blaming the patients for accessing different pathways? Is it not the response to that so called inappropriate attendance that is actually wrong, and that is something you DO control. In the patient’s defence, your honour, they may have thought it quite appropriate to attend A&E with a musculoskeletal problem. They may have tried their GP before and discovered that sports and musculoskeletal medicine and orthopaedics is not a strong point for all, they were given some painkillers after a bit of leg wobbling and told to return in a week or two if it wasn’t any better. It may be that they were referred to physio – 2-4 weeks urgent six months routine – or ortho outpatients – say 13-26 weeks. Thanks Doc, bloody marvellous. At least when they attend A&E, they sit up on a trolley with bright lights, leg fully exposed, in a fully equipped hospital treatment room carefully examined by an eager SHO – they come away satisfied and impressed…I personally doubt (without trying to become too political) that fully equipped primary care centres/ walk in centres will ever replace the genuine need for fully comprehensive emergency departments that are now being removed from major towns and cities throughout the country because of cost. It’s crap, and I don’t understand why the public isn’t aware and up in arms about the denigration of emergency care throughout the Country – there really should be marches through the streets over this…
Ditto Cat C calls for 999 – of course it’s irresponsible and careless to dial 999 for a small finger laceration (well sometimes but lets not go there) but it is even far more stupid for a responsible emergency response organization to send an ambulance hurtling through the streets when you know it is not life threatening, causing stress and fatigue for staff, embarrassment for the patient, a real danger to emergency staff and other road users from unnecessary emergency driving and so on. It’s about finding a more appropriate response to that 5% of “inappropriate” callers that will continue to attend forever however much you don’t like it…
Last word on four hours – it’s the Chief Exec’s problem and their job on the line if they don’t achieve it. The pressure is enormous because Labour rely on it to show the genuine progress made through nhs reforms and improving access to patients. Don’t take any crap and if you do have to come in and be active on call make sure the pay makes it worthwhile because they will only pay what they can get away with and could probably go double if it would sort the problem out – what’s £2-300,000 on patient care when facing a 10 million overspend as a Trust? The new contract for GPs make NHS incomes of 100K plus routine…
Maybe we should all go to NZ!!!
Jeremy Mayhew (Medical Director, Kent Ambulance)
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