Transcript When is a GP not a GP?
When is a GP not a GP?
When he/she works in an Emergency Department
Dr Marion McNaught,Associate Specialist Emergency Medicine
EADT
• Shift balance of unscheduled care • Emergency care at most appropriate level:quickly and conveniently • SPECIFICALLY –Reduce A&E attendances
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RCGP manifesto
• More local community services • Better access to diagnostic service • Specialists in the community e.g. geriatricians/paediatricians • More say in commissioning OOH services-(despite mostly opting out of responsibility for 24 hour care)
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CEM
• At most,25% of urgent attendances may be cared for in primary care setting • Believe that improved access to GPs and out of hours Primary care services is best way of dealing with problem • Support co-location of primary care OOH • Do NOT support urgent care centres (triage of ambulatory patients by non-ED staff deciding whether ED attendance required)
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GPs in ED
• Spectrum of patients?
• Work to ED protocols/guidelines?
• Different clinical setting:on-site diagnostics • Different patient population?
• Who has clinical responsibility? GP?Consultant? ED middle grade?
• In litigation-who are you peers?
GPs in Emergency depts
• Reduce admissions?
• Increase attendances?
• Sustainable?-already difficult to staff OOH service • Improve ED/GP interface?
• Improve education?-different experience • Effect on ED staff retention-relative pay rates • How many GPs really want to do it?
GPs in ED
• Some areas employing “salaried GPs” to work in EDs-By definition if they are working full time in ED they are not a GP.
• Some GPs work in ED in middle grade role.See more than Primary Care patients.Tend to be those with an interest in emergency medicine-small numbers