Nottingham have a streaming system that has been up and running for ?
about a year or so. We in Leeds went to visit in Dec as we are trying to
do the same. We are being 'promised' PCT money/staff to fund this but
the staffing has proved difficult (not unexpectedly from our point of
view) I can give you more in depth details off list if you like.
We were trying to develop protocols as how to do it, but having been to
Nottingham we discovered that they use their 'triage' nurse to simply
refer to GP or self care based on pretty much gut feeling of the
presenting complaint. It seems to work safely and efficiently and mostly
seems to have been accepted by the patients, although there were initial
complaints regarding 'not being treated'. I think they turn around 5%ish
of their daily numbers at triage.
We are in the process at the moment of trialling a PCT bank nurse who
stands at reception and says to pts 'have you tried to see your GP with
this?' and if they say 'No' or 'he couldn't see me' etc. She then phones
up the GP and as you would expect usually can get appointments pretty
quickly, even occasionally the same day.
We have had a few 'interesting' events so far but no harm has been done
to anyone and we are turning around approx 15 pts a day (not latest
figures). You could of course argue til the cows come home as to wether
the resources are being best used for 15 pts!
Still it is some recognition of our problems at the moment.......now if
only the in pt teams would be prepared to make some chnages too.....
Cheers
Peter
Dr Peter A Cutting
Consultant in Emergency Medicine
Leeds General Infirmary
Tel 0113 3926470
Fax 0113 3922810
>>> [log in to unmask] 22:26:51 05/01/2005 >>>
Does anyone have a good streaming tool they use to feed patients into a
primary care stream?
My local PCT has at long last discovered that they are paying a shed
load of money for an OOH service that is diverting most of their work to
the A&E.
Since the whole thing has gone belly up and is now in recievership,
they are coming to me to help them out.
I will try and develop an integrated unit with them but I want to make
sure there is a benefit for the A&E department as well as the patients.
I keep getting the "triage is evil" phrase from the residual Emergency
Services Collaborative, so what do you call a streaming system that
pushes the primary care stream to the primary care physician so as to
get them off your back?
I know some of you out there have got this up and running, I met some
of you at the various ESC meets but have had great difficulty with my
local GP's so far. They are keen that we stream them all to our ENP's or
the department allowing them to earn their cash asleep.
Also this "don't triage" mantra is a serious obstacle round here.
Andy V
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