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We posted this on the RCN Emergency Care Association FB page after hearing this programme: I have some concerns about the programme - an inept clinician missing a case of meningitis (especially on reattendance) can happen anywhere at anytime and is not a result of an ED becoming an UCC - crap care is crap care wherever it happens. The issue of the under-utilisation of UCC's is a separate one and I would agree that these are best co-located with ED's and given a common nomenclature to avoid confusion - given that we spent years banging on about 'inappropriate attenders' I suppose we have ourselves partly to blame for this. I think that the bottom line is that re-configuration is a financial and clinical necessity but the public need to know where to go, what the place is called and what services are offered - its either an ED with an UCC co-located or a rural MIU - Helen in my experience there does not seem to be that much confusion amongst the public about what an MIU does - particularly from locals - its probably the word 'minor' that makes it easier to understand - how do we expect an anxious parent to appreciate the difference between 'urgent' and 'emergency' care - we are just so up ourselves sometimes 20 July at 16:42 · LikeUnlike * <http://www.facebook.com/profile.php?id=831837139> <https://exch.wlv.ac.uk/Exchange/James.Bethel/Drafts/RE:%20ACAD-AE-MED%20Digest%20-%2020%20Jul%202011%20to%2030%20Jul%202011%20(%232011-38).EML/1_text.htm#> Helen Watts <http://www.facebook.com/profile.php?id=831837139> I agree Jim. A missed diagnosis can happen anywhere - and does! It does rather irritate me though when any reference to 'downgrading' an ED to a MIU is seen as an inferior move. If the greater need in an area is for an MIU rather than an ED... (as mentioned in the programme. 80% of patients attending ED were those with minor injuries) then it is better for the patients to have a MIU on the doorstep and an ED which is manned with staff who are competent and have regular experinece in the treatment of trauma and major emergencies at a greater distance. Unfortunately patients still have trouble defining what a minor injury unit can and should deal with so it is little surprise that they are then confused further by Urgent Care Centres, Walk in Centres etc.Within my own area the MIU is situated approximately 18 miles from the ED. Patients see us as the quickest option which is why we are often presented with patients with chest pain, CVA, anaphylaxis and major trauma. ENPs working in the stand alone MIUs need to think on their feet a great deal more than those working in EDs and the workload they deal with is unfiltered. MIUs tend to have fewer staff numbers and limited diagnostics but the upside of nurse led MIUs of course is that we have no doctors to manage!! :-) 20 July at 21:58 · LikeUnlike * <http://www.facebook.com/profile.php?id=1484357867> James Bethel <http://www.facebook.com/profile.php?id=1484357867> have to agree Helen - reconfiguration means just that - not downgrading - I think a big part of our work - and yours - is to convince people that nurses can do as good, or a better job, than overpaid locums put in for the sake of political expediency 28 July at 19:35 · LikeUnlike James Bethel Senior Lecturer, Emergency Care, University of Wolverhampton Nurse Practitioner, Emergency Departments, Walsall Hospitals, Sandwell & West Birmingham Hospitals, Chair, Royal College of Nursing Emergency Care Association (ECA) President, European Society of Emergency Nurses (EuSEN) ________________________________ From: Accident and Emergency Academic List on behalf of ACAD-AE-MED automatic digest system Sent: Sun 31/07/2011 00:01 To: [log in to unmask] Subject: ACAD-AE-MED Digest - 20 Jul 2011 to 30 Jul 2011 (#2011-38) There is 1 message totaling 105 lines in this issue. Topics of the day: 1. Radio 4 program ---------------------------------------------------------------------- Date: Sat, 30 Jul 2011 23:09:50 +0100 From: Ray McGlone <[log in to unmask]> Subject: Radio 4 program http://www.bbc.co.uk/iplayer/episode/b012l2yv/File_on_4_An_Emergency_Crisis/ "With many NHS hospitals facing financial problems, A&E departments are closing or being replaced by Urgent Care Centres. Allan Urry investigates the impact on patients." You might want to listen to this on iplayer. John Heyworth was interviewed Ray McGlone ------------------------------ End of ACAD-AE-MED Digest - 20 Jul 2011 to 30 Jul 2011 (#2011-38) ***************************************************************** -- Scanned by iCritical.