As I said in an earlier post the future is thought to lie with a real common
front door where the aim really will be to direct patients away from A/E to a
cheaper alternative. Triage will be by protocols. The comissioners can't
afford the numbers we have coming to A/E and need to find a cheaper
alternative. Trusts will need to bid to be that (and there's the challenge for
the next few years) because the trusts can't afford A/E without PBR from
"minors". As Simon says there would not have been this muddle if someone had
thought through the new GP arrangements.
BTW our trust is trying to impose late starts 10am, and late finishes, 7pm. I
know this is not premium time so it costs them nothing but 3 nights a week
finishing at 7pm is a bit anti social and I thought the BAEM had said
something about this being OK only if it was what happened before the new
contract. (It also wants 9.5 shop floor sesions out of an 11.5 PA contract)

>>> McCormick Simon Dr, Consultant, A&E 10/28/05 10:03am >>>
Hmmm, isn't this sort of thing just an example of trying to divert stuff away
from A&E that only turned up because the situation in place wasn't working
properly.  Sort out ease of access to quality Primary Care and you just don't
need that sort of thing.  There will always be a bit of crossover between A&E
and GP, I think we all accept that, but when one tries to 'divert' patients
away in to an already overloaded/failing system aren't we failing these
patients?  It might not, technically, be our problem but it doesn't always
make staff feel any better about it and the patients certainly don't always
appreciate it!!
 
Simon McCormick
 
Rotherham
 

-----Original Message-----
From: Brown, Ruth [mailto:[log in to unmask]] 
Sent: 28 October 2005 07:46
To: [log in to unmask] 
Subject: GPs triage



Dear list 
does anyone work in a UK ED where there is a GP or primary care nurse doing
triage of unselected patients at the front door? Our SHA CEO is very keen on
the idea and I would like to hear from anyone how it works. Does the GP do
24/7 triage, do they triage only minors or majors as well and what are the
outcomes in terms of patients sent to primary care vs secondary (ED) and
benefits/costs/risks.

Thanks Ruth 

Ruth Brown FRCS FFAEM 
Emergency Medicine Consultant