News Release

Emergency care scheme does not tackle real problems

Inversion of emergency pyramid BMJ Volume 326, pp 553

Peer-Reviewed Publication

BMJ

A new scheme designed to reduce waits in emergency departments is simply massaging the figures to meet government targets, warn senior doctors in this week's BMJ.

The "see and treat" concept involves having senior staff as the first clinical contact rather than a triage and wait approach. However, there are serious concerns that diverting senior clinicians from treating ill patients will be detrimental.

Adrian Fogarty, a consultant in accident and emergency medicine at the Royal Free Hospital, argues that there simply aren't yet sufficient numbers of trained emergency doctors to take on this workload.

Those senior emergency doctors currently in post find their time occupied with critically ill patients, together with complex medical and surgical cases. They simply do not have the time to deal with "minor" cases as they walk through the door, he says.

The NHS Modernisation Agency needs to realise that there will not be a quick fix solution to emergency care access in this country, at least not without substantial and sustained investment in appropriately trained staff, he concludes.

In another letter, Bruce Finlayson, a consultant in accident and emergency medicine at the Norfolk and Norwich University Hospital, writes: "Such schemes as see and treat, while laudable in the big picture, are methods of massaging the figures towards the government's four hour emergency targets without adequately addressing the real problems."

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