> *From:* "McCormick Simon Dr, Consultant, A&E"
> <[log in to unmask]>
> *To:* [log in to unmask]
> *Date:* Fri, 17 Nov 2006 14:08:45 -0000
>
> I find this discussion interesting because we are moving towards a
> system which desires less face to face attendances for emergency
> calls,
> more assessment at the scene if attended and ultimately fewer patients
> transported to hospital.
>
> Clearly there are concerns about the system's ability to do this.
>
> Simon
>
I don't think this is news. There has been a concerted move towards an
HMO style of access to emergency care for over 10 years. I'm not sure
that the Government is in tears that GPs aren't providing OOH services
any more as they were expensive and less amenable to controls such as
these.
NHS Direct was the first try, and that has resulted in large numbers of
people who phoned for a bit of advice being directed to EDs. There is
now a concerted move to train nurses in the community to provide
services previously provided (by doctors) in hospital. Although I don't
know the paper, I caught a discussion on the R4 news the other morning
where this had been reviewed and found to be ineffectual at preventing
admission. This is not good news for the bean counters, and there will
be some quiet satisfaction in some clinical quarters. Certainly I see no
evidence locally that demand management is having any impact at all.
/Rowley./
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