In message <[log in to unmask]>,
Haines <[log in to unmask]> writes
>
>Why don't A&E departments use experienced Nurse Practitioners to Triage
>patients and fast track them through to X Ray, Nurse Treatment, Doctor,
>back to GP, Practice Nurse, Health Visitor, District Nurse, Social Services
>etc..? Absolutely everybody seems to have to wait to see the junior
>houseofficer.
>
I wonder why GPs in urban areas bother to do out of hours at all. It's a
common complaint by A+E departments that patients who live nearby use
them as OOH primary care - but what's so crazy about OOH being
concentrated in A+E? With the obvious caveat that rural areaas are
different from urban, why not scrap co-ops, scrap the requirement for
GPs to provide 24 hour cover as individuals and concentrate all OOH in
A+E depts? You could have Maresahs assessing the patients, casualty
officers as now, GP registrars as part of their rotation and GP
principals (like consultants!) on call on a rota basis. Maybe each
practice should share in the rota or (better for ongoing education in
the OOH department) one or two practices could have contracts to provide
this cover plus educational input. Most patients would be seen in the
department or dealt with over the 'phone, but transport would be
available if they really needed it. In the rare event of patients
genuinely needing an OOH visit by a Dr, the Dr would be driven there.
If the IT folk got their act together, the A+E could even have access to
the patients' GP notes (and the GPs would have records of the encounter
transferred electronically by the next day).
I can't help feeling this solution is too rational to be adopted
Toby
--
Toby Lipman 7, Collingwood Terrace, Jesmond, Newcastle upon Tyne. Tel
0191-2811060 (home), 0191-2437000 (surgery)
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