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ACAD-AE-MED  July 2005

ACAD-AE-MED July 2005

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Subject:

Re: Taking health care to the patient: Transforming NHS Ambulance Services

From:

Martyn Hodson <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Fri, 1 Jul 2005 21:38:44 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (65 lines)

> -----Original Message-----
> From: Accident and Emergency Academic List 
> [mailto:[log in to unmask]] On Behalf Of Andy Webster
> Sent: 01 July 2005 00:29
> To: [log in to unmask]
> Subject: Re: Taking health care to the patient: Transforming 
> NHS Ambulance Services
> 
> 
> Mike
> 
> You seem very sensible, in fact most paramedics/ECP's are. 
> But however 
> as in medicine where you will get doctors of all grades practising 
> beyond their expertise, you are bound to get ECP acting out their 
> expertise. There are bound to be problems.

This just  does not happen, non Medicla health Professionals do not have
a culture of not asking for help, we don't of the culture of humiliation
still practiced by some senior doctors.  The limitations of roles are
drilled into paeopel from day one and remain so. 

We still have systems where medicla staff acquire new skills without
proper supervision and support, where the other HCPs  acquiring the very
same skills do so through structured programmes with formal assesmsents
and occaisionally extremely prolonged periods of supervised and /or
supported practice  

> 
> My main problem is in a resource limited system I can not see 
> much money 
> being saved. At least as much as the Pete Bradeley claims 
> will be seen. 
> Ambulances can be expensive taxis. But an ECP driving around the city 
> maybe seeing 5-8 patients in a shift with some being referred 
> on is an 
> expensive reduplication of services. It is interesting in the case 
> histories they put in they put in all the positive pieces of 
> research. 
> But miss out on research that did not show benefit. For 
> example the one 
> by the London ambulance service which tried to reduce 
> carriage of cat C 
> patients by empowering a group of paramedics to divert to alternative 
> providers. I think the end result was no difference compared 
> to standard 
> practice.

Was there the support in place ?

Even as a VAS ambulance bod doing NHS Ambulance support my other half
has identifed patients that didn't need transport ( and I have agreed
with the decisions - but was aware  that  ther wasn't the ability to
act)  and could have been better served by an ECP or being seen by the
ECP and then  referred on to intermediate care  or such like - saving
the ambulance journey to A+E , saving time in A+E  and saving the
ambulance journey or hospital taxi home ....

Martyn

-- 
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