Thursday, April 25, 2013

Strain on A&E...

Just heard Hunt on Today program, trying very hard to back-pedal and say that it isn't actually GPs' fault that A&E can't cope with the extra 4 million visits per year but the previous governement for allowing us to opt out. And to put that 4 million extra consultations into context, UK GP see 300 million consulations per year. Yes, 2 whole orders of magnitude more...

Well, for one thing, my "part-time" week (read the comments on the Telegraph website) is already 47.5 hours, and that's without the extra I put in. For another, the reason I am tapping away on the computer is two-fold: most important is I'm keeping records so I can remember what happened to you years ago; but the way GP is resourced (NOT how I get paid but how the services in YOUR surgery are funded) means that if I don't tick an increasing number of boxes (many of which will do nothing to improve either your health or well-being), the resources don't come in to pay for the nurses, reception staff, equipment etc.

So rather than blame ME for poor OOH provision, fund the bloody service properly in the first place, rather than engage in a race to the bottom with cheapest wins the tender, set proper standards that must be adhered to. How about a national strategy, given it's the National Health Service? Rather than arms-length "oh that's the fault of local commissioners", who you haven't given the resources to in the first place. And make sure that A&E departments are empowered to tell people to go to the appropriate place rather than have to see and sort them (inadequately, which is not incidentally their fault).

It isn't bloody rocket science.

1 comment:

Euan said...

In Tayside we keep all primary care stuff in primary care which helps keep A&E attendances down and lets us meet the 4 hour target more than 98% of the time. We use what is called the '3 day rule' and it works well. GP's are aware and cooperative and are able to contact an A&E consultant directly for referral or advice as required.

If you go to

http://www.shiftingthebalance.scot.nhs.uk/initiatives/sbc-initiatives/emergency-access-delivery-programme/good-practice-and-research/#Whole%20Systems%20Working

Look under unscheduled care and find 2 documents about 3 day rule it explains it quite well