I agree. Fracture clinic congestion and overbooking is a perennial UK
problem. Ours offers routine slots around one week out from request, which
happens to suit most situations in terms of medical need. If we need earlier
review we usually discuss with the on-call ortho reg who arranges it
directly. Clinic slots beyond, say, ten days from request become
increasingly valueless as many fractures reach the stage where
intervention - should it be required - is ineffective so long after the
initial fracture.
I'm increasingly sending more minor fractures back to their GPs for review
in an effort to reduce lengthy fracture clinic waits, but also because I
don't believe such cases need specialist ortho review. It's also important
to give GPs something to do these days, since they've given most of their
primary care to A&E...
AF
----- Original Message -----
From: "Andy Webster" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, July 18, 2006 10:47 AM
Subject: Re: Fracture clinic time scales
> Is it not more sensible to send patients when they need to be reviewed or
> for some things good discharge advice from at the initial ED visit? For
> example the patient with a colles successfully reduced, send them at a
> week
> for a review with a check x-ray, or for kids with simple torus fractures
> and
> uncomplicated clavicle fractures discharge on the initial visit. If we
> avoid
> the historical everything goes to fracture clinic next day then we avoid
> unnecessary early review for everyone. In Perth when I worked there last
> year. They did not see anyone for a week, unless they need MUA. The
> reduction in the number of appointments meant they could see them within
> their standard clinic time.
>
>
>
> _____
>
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Black, John
> Sent: 18 July 2006 10:26
> To: [log in to unmask]
> Subject: Fracture clinic time scales
>
>
>
> Dear colleagues,
>
>
>
> I would be interested in your views about the maximum acceptable period of
> time patients should be reviewed in a fracture clinic after initial
> management in the ED, accepting that this should be a short time as
> possible. I am aware that clinical practice varies around the UK.
>
> Please feel free to contact me off list if you prefer.
>
> John Black
>
> Oxford
>
>
>
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