No experience of cross speciality cover. I don't think that an orthopod is able to practice emergency medicine (and an orthopod that thinks that they can just doesn't understand and so should certainly not be allowed to).
I have some good experience of cross Department cover - very dependent on Geography (all of the hospitals in the East London A&E Consortium are a couple of miles apart).
Even if long distances are involved, it might be better for an ED to have more distant cover from an emergency specialist rather than close cover from someone who is not a specialist in Emergency Medicine. Maybe an agreement from the local orthopods / surgeons that they would support the ED by coming in for major trauma (which they probably could cope with) might assist this system.
To go one step further. My guess is that on-site late shifts followed by consortium on-call overnight (ie. one, or two, A&E consultant shared between several hospitals) will be a future pattern for emergency service provision. Closer integration with the pre-hospital care services would enable the night shift consortium consultants to focus their time in the right areas. Do we need to start taking a Regional rather than a Departmental view of the provision of nightime Emergency Care, to develop a more flexible system?
(Puts on flame proof suit and hits send)
Tim. Coats.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of MICHAEL DUDLEY
Sent: 27 September 2005 23:53
To: [log in to unmask]
Subject: A&E On - call Rota
Dear All
Does anyone know of A&E Departments that have an on-call consultant cover
arrangement shared with another specialty, e.g. Orthopaedic Consultants?
I know it is suboptimal, but I am sure that many DGHs like us, have found
that they would be unable to recruit new A&E Consultants with an on-call
rota more onerous than 1 in 4.
I would be very interested to hear of/from A&E Departments that run such an
arrangement.
Many thanks
Mike Dudley
Consultant in Emergency Medicine
Airedale General Hospital
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