We have been co-habiting for the past 3 years. We do not have written
protocols to cross refer, but this is happening all the time (the reasons
are variate). We are triaging them via their nurse (telephone) or our nurse
(flesh and bones) at the point of entry. Even if directed wrongly by them,
the doctors can talk to each other once they have sen the patient. The
system works very well. There are some key points however:
1. us and them are very careful what is referred (much more difficult to do
than over the phone)
2. GPs do not have access to OOH labs and X-rays
3. A&E if not that busy can see GP patients if the GP is at a home visit(s)
and will be missing for 2 hours
4. patients are instructed to report any deterioration in status while
waiting (especially the GP ones)
5. monthly liaison meeting and discuss any marriage problems in the open.

Hope this helps a bit, Tudor

Dr. Tudor Codreanu MSc(Med)
Staff Grade
Accident and Emergency Dept.
Dr. Gray's Hospital
Elgin
tel: 01343 543131 ext 67360
dir: 01343 567360
fax: 01343 552612
e-mail: [log in to unmask]

> -----Original Message-----
> From: Ray McGlone [SMTP:[log in to unmask]]
> Sent: 19 September 2003 18:42
> To:   [log in to unmask]
> Subject:      Re: Working Co-operatively [Scanned By SOPHOS Anti-Virus]
>
> Thank you, but my question was......"Do any of you have any agreed
> protocols
> between GPs and A&E when they are working in adjacent units.... about
> which
> patients can be referred either way?"
>
>
> Ray
>
>
> ----- Original Message -----
> From: "Robbie Coull" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, September 19, 2003 9:55 AM
> Subject: Re: Working Co-operatively
>
>
> > > One GP thought he'd come around to A&E to help out and see some of the
> GP
> > > patients..... and has been severely criticised by his colleagues.
> >
> > I've seen this before.
> >
> > The problem is that most GPs do OOH shifts on top of their normal 9-5
> week
> > (to varying degrees).  Also, the remuneration for OOH work is based on
> GP
> > workload.  GPs worry about work being shifted to them when they are
> already
> > under enormous pressure.  Some have been bitten before by the 'first one
> was
> > done as a favour, the next 30,000 were done at gunpoint' style of NHS
> > management.
> >
> > If GP workload goes up, but their payments stay the same, they may find
> that
> > their OOH cover collapses from lack of people willing to do shifts, or
> they
> > end up tied into a punishing OOH centre and unable to find locums for
> love
> > or money.
> >
> > Do you have an agreed policy for workload control, patient
> > categorisation/triage, and remuneration?
> >
> > If so, then
> > (1) I think this is brilliant step in the right direction
> > (2) Co-operative working is a great way to break down  primary/secondary
> > care barriers
> > (3) A problem shared is a problem halved
> > (4) Don't listen to his colleagues, trapped in the old paradigm of 'them
> and
> > us'
> > (5) The job is so much better when we all get along and help each other.
> >
> >
> > If not, then
> > (1) I think he should see a psychiatrist
> > (2) I've got a family to feed, and he's doing me out of a job.
> > (3) If he wants to help humanity (as opposed to rich westerners who are
> just
> > too selfish to pay more tax) then I'm sure MSF would be delighted to
> hear
> > from him.
> > (4) It's this kind of 'I want to help people' nonsense that has allowed
> the
> > NHS to get to the state it's in now - to really help people we need to
> argue
> > for more proper funding, not more charity doctors.
> > (5) It's unfair on your colleagues to set a precedent that they may have
> to
> > follow without discussing it with them first.
> >
> >
> >
> > --
> > Robbie Coull
> > email: [log in to unmask]             website: http://www.coull.net
> >
> > https://www.locum123.com contact locum doctors by SMS and email
> >