Maurice Clayton <[log in to unmask]>typed
> Maybe I was being a little tongue in cheek, and I'm not tying to deny
> anything that you have written, except that I missed the point. As part of
> the 999 delivery system that is seeing circa 3% call volume growth per annum
> (some 3500 to 4000 calls per day pan London) the current major outlet is
> going to be A&E until suitable alternatives become available pan London. The
> increased admission rates are suggestive that there is a sicker population
> (or exponential population growth) and is also suggestive of the fact they
> need to be somewhere rather than the community to be treated. One wonders
> how many could be discharged home early if the support network required was
> fully established.
I am not sure they are actually sicker.
IMO the increases are multifactorial. Suggested factors are
Difficulty of GP access, both OOH and during office hours  and
inexperienced/cautious staff admitting patients 'just in case'.
We also actively treat more conditions than previously; MIs were treated
at home when I were a lass!
Arranging timely home review for some of these patients is also
sometimes so difficult that it's not attempted.
 When the surgery is open, the phone is engaged, when it's closed
it's the ****ing machine!
I wonder if the 48 hour target ties up GP phones more...
Helen D. Vecht: [log in to unmask]