I spent a thrilling 3.5hours at urgent care strategy meeting yesterday going
over same debate as last year but with different stakeholders...new faces in
post as the two PCTs of mid and east cheshire merged.
we did agree on:
1.not too invest in walk in centres
2.wait for sir george albertis next document on urgent and emergency care
out soon (according to bma news last week ),
3. invest IT integration can Extramed CRISystem transfer registration info
from ED over to GP OOH service (Adastra)- yes, but who's going to pay for
that integration
4.would review split tarriff-I understand (2nd hand)that Bedford have split
tarriff when pt registered and triaged by ED to then go to GP OOH.
5.would review resource demand matching of all relevant disciplines and
specialties across the 7 days of the week-why do rapid response intermediate
care not work across 7 days, why dont' heart failure respiratory community
nurses work across PCT patch 7 days a week
6.develop care bundles for those 15 top admission diagnoses whch are
actually homogenous enough to be suitable for care bundles- probably only 6
(inclusive of exisiting acute MI, chest pain).
7.cautioned against long term strategies based on theoretical models of
reduced activity(projected at 15% reduction in our patch) has anyone yet
seen a reduction in demand on ED service from changes in the prehospital
setting.....
where are you working [log in to unmask]
mark at macc
>From: Doc Holiday <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: Changes in EM[Scanned]
>Date: Wed, 23 May 2007 10:10:28 +0000
>
>From: John Paskins <[log in to unmask]>
>>Our PCT has decided to "re-configure" the "A/E" services locally...
>>Emergency Department will care for only those patients suffering
>>"life-threatening illness or injury". > This has the backing of the
>>Department of Health and will be copied in many other areas.
>>Does anyone have a view?
>
>--> How about this view:
>Let's say a consultant in EM works in an ED which, by some miracle DOES
>manage to exclude all non-emergency presentations. (and I don't think it
>will ever happen, no matter who backs it and ESPECIALLY if it is the DoH).
>
>As Paul's pointed out - they never will manage it, but let's assume they
>did... This EM consultant will be seeing a very acute and emergent spectrum
>of pathology... Day in, day out, for months and then a year and more...
>
>With a year or more of this on his/her CV, I would not hire such a
>consultant to transfer to my ED, as he/she would be that many years out of
>practice with about 2/3 of a normal ED caseload... I'd advise any
>consultant who is about to have their experience NARROWED to this extent to
>consider carefully their future job prospects in the UK, or OZ or NZ or the
>USA or Planet Earth...
>
>Lucky for you - there are many "less progressive" (i.e. normal) EDs about
>for you to escape to before this happens, even in major trauma centres...
>
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