Download
Skip this Video
1 / 77
Unscheduled care Skye & Lochalsh - PowerPoint PPT Presentation
- 132 Views
- Uploaded on
Unscheduled care Skye & Lochalsh. Who am I?. Dr Leo Murray. FRCSEd MRCP MRCGP DA FFAEM Variety of clinical experience 10 years running A&E service Ayr Then to Skye 1999. What have I prepared. Standard presentation 5 years stats - the facts! Unscheduled care stationery.
Download Presentation 
An Image/Link below is provided (as is) to download presentation
PowerPoint Slideshow about 'Unscheduled care Skye & Lochalsh' - jayme-holloway
An Image/Link below is provided (as is) to download presentation
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.
While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Dr Leo Murray
- FRCSEd MRCP MRCGP DA FFAEM
- Variety of clinical experience
- 10 years running A&E service Ayr
- Then to Skye 1999
What have I prepared
- Standard presentation
- 5 years stats - the facts!
- Unscheduled care stationery
What am I going to say?
- What is unscheduled care?
- Outline our service
- Can it be exported?
- Questions & Discussion
What is unscheduled care?
- Is it an Accident?
- Is it an Emergency?
- Is it a GP case?
- Is it an appropriate/inappropriate attender?
What is unscheduled care?
- Needs sorted out - triaged
- Tends to be more acute
- Happens round the clock
What are “OOH” hours
- 1800 to 0800 overnight - 14 hours
- 1800 Friday to 0800 Monday - 60 hours
- Public Holidays
Remember Public Holidays
- Can mean 4 days in a row – 96 hours
What is left?
- Less than 50 hours a week
- Still a requirement for unscheduled care
MMH
Edinburgh Royal Infirmary
Frontline ambulances at Lochcarron, Kyle, Broadford, Portree, Dunvegan
for simultaneous distant crises
- allow 2 doctor procedures
- allow a doctor to escort
for simultaneous distant crises
- used twice in 6 months
based weekday evenings Portree
- wee hours & weekends Broadford
Accept patients via
- self presentation
- referral by NHS24
- 999 ambulance
- GPs
- DNs
- CPNs
- Police………..etc.
Dec to May MMH and PH
- Total contacts 1556
After 2400 at PH?
- 8 in wee hours 0000 to 0300
Problems?
- Very few with service itself
- NHS24 best avoided if you are ill
See and assess
- Resuscitate
- Evacuate
- Keep what?
How to provide local intermediate care - i.e. care provided across specialty boundaries which can be provided to a good enough standard, rather than care requiring specialist attention.
Need generally trained doctors with extra resuscitation skills Rural Practitioners!
School-leavers
- Perform all succesful intubations
- Perform all neurosurgery worldwide
- Perform all open heart surgery worldwide
Current plan
- Generally trained doctors
- Work 40 hours
- Pay £90,000
- Provide airway training
- ABLE TO RECRUIT!!!
Resuscitation training
- ATLS
- ALS
- EPLS
- ALSO
Skill maintenance in a low volume situation
- 10 days per year study leave
- 6 weeks per annum in major hospitals
Generalists needed
- Generalists comfortable with emergencies
GP trained
- Pre-registration medicine
- Pre-registration surgery
- 1 year in General Practice
- medicine
- paediatrics
- o&g
- other specialties
Resuscitation training
- ATLS
- ALS
- PALS
To paralyse and ventilate
- 6 months anaesthetic experience
- minimum acceptable standard
- annually refreshed
Skill maintenance in a low volume situation
- 10 days per year study leave
- 6 weeks per annum in major hospitals
To provide A&E service
- To triage
- To resuscitate
- To provide in patient supervision
- To provide locally appropriate care
- To re-integrate hospital with GP community
4 appointments
- To provide a sustainable and recruitable roster, since most of the time 1:3
Think again!
- Doctors will not work 1:3
- EWTD
- Good GP = Consultant salary
Think again!
- The pool of doctors with 6/12 anaesthetic experience is shrinking - have to provide this experience in future specifically for doctors in these situations
Current plan
- Generally trained doctors
- Work 40 hours
- Pay £90,000
- Provide airway training
- ABLE TO RECRUIT!!!
6 weeks skill maintenance, 2 weeks study leave
- 6 weeks plus 2 weeks plus 6 weeks leave = 14 weeks away
- 38 weeks x 40 hours = 1520 hours
- 365 days x 24 hours = 8760
- So need 6 doctors
