In article <[log in to unmask]>, Peter Fox
<[log in to unmask]> writes
>Actually current evidence is that trained nurses triaging with computer
>lead algorithic systems are as good as the best GP on his best day and
>rather better than the worst GP on his best day.
Can you remember this evidence as the only literature I have seen is
that computer-led algorithmic systems lie above average but below best.
I would agree that, on average, they perform better than individual
human decision-making if they are knowledge-based. My problem is with
the definition of 'best'.
>How many GPs have
>triage training and why should we spend our time OOH sifting through the
>dross to find the real cases which need our expert care.
The NHS-D triage is not meant to be the same as GP triage. I am in
favour of more comprehensive 24 hour care, but funded and resourced
appropriately. If the argument is that protocols will provide this 'best
care', then the nurse herself is redundant and a receptionist will be
adequate, something c0-ops already have - or perhaps even an automated
response? Why not reduce those protocols to paper and send them to every
household - cheaper still than NHS-D. If nursing skills are necessary
then wouldn't GP skills be even more appropriate clinically?
>If new standards are clinically better for patients then should we not
>embrace them?
I still have not seen any evidence that _clinical_ standards would be
better, although I agree that non-emergency OOH will be improved. This
is a change of paradigm, not an improvement of the existing service.
Comparing the USA to the UK is hardly like for like. What I do see is a
populist vote catcher. I hope I'll be proven wrong.
Regards
George
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|