I look after 5 and am just being handed my sixth. Politically they are terribly
difficult to close and I feel that I have to accept them and do as good a job as
possible. They are certainly my most potent source of litigation and we're
presently working with Purchasers etc. to tidy things up. I agree with Carlos -
they need to be heavily Risk Managed with strong protocols and audit - my
protocols, amongst other things, determine the level of action that any one
individual unit may proceed to as a satellite of the main A&E unit eg. a
larger unit with NPs might suture etc. whilst a smaller unit wihout NPs might
only be allowed to register a patient, dress a wound and refer onwards (extreme
example!!) - with a whole spectrum in between.
Nick Jenkins
Abergavenny
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