Posted by: Witch Doctor | March 27, 2009

Mid-Staffordshire and St Elsewhere

witchround

The Witch Doctor has been under an Ancient Bottle Spell for some time now trying to make her brain young again in order to work out something very complicated.

Ancient Bottle Spells are very exhausting so the Witch doctor has reversed the spell for a while to catch up with some of the things that are happening in UK healthcare. She felt it was time to have another look at the document:

“Investigation into Mid-Staffordshire NHS Foundation Trust.”

Here is what she is reading now:

“The A and E department was understaffed and poorly equipped. There were too few nurses to carry out an immediate assessment of patients. This was left to the receptionists, who had no clinical training.”

It does not stop there.

“The patients in the waiting room could not be seen from the reception area.”

If there is insufficient money spent on appropriate staff, training of staff, space, maintenance and equipment, then some kind of rationing is necessary.

In A and E departments, the type of rationing used is the one intended for the battlefield or a national emergency ie TRIAGE.

CREEP….

For a long time now, Triage has now been the norm in A and E Departments up and down the land.

Why did this happen?

To save money.

When did this happen?

It happened a long time ago. Gradually.

So Triage (A and E rationing) is now well established.

CREEP….

Enter Agenda for Change, The Skills Escalator, Fistfuls of Competencies (or maybe just one, or none), and lots of boxes eagerly waiting to be ticked.

CREEP….

Lets turn some people into Competent Clinical Decision Makers.

Eh?

What’s that?

CREEP….

Competent receptionists can surely keep an eye on patients page somebody or other if they are worried.

CREEP….

Note the nonchalant way that history taking and examination are dismissed.

CREEP….

Goodness, we haven’t invested in a safe place to keep these patients while they are being triaged by receptionists.

Ah, give them the skills so they can see round corners and through walls…….

_________________________________________________

REVERSING CREEP….

Is Mid-Staffordshire exceptional?

I think not.

Could Mid-Staffordshire be avoided in the future?

Yes.

For starters:

In The Witch Doctor’s opinion, patients arriving in an A and E department should be seen immediately by a senior registered medical practitioner ie a consultant or someone very closely overseen by a consultant, and then directed to trained others as appropriate to initiate their further investigations and management.

When The Witch Doctor mentions this, people look aghast!

“Too expensive”

“Unnecessary”

“Waste of consultant expertise”

“Others can do this just as well”

“Give the consultants peace to do much more important things”

The Witch Doctor’s reply is simple: Nothing short of this would be a “Consultant Delivered Service.”

Is a Consultant Delivered Service needed?

Yes.

Is a Consultant Delivered Service wanted?

No.

Why not?

Because the brains of The Humankind have crept into believing that a Consultant Led Service will do.

A Consultant Led Service can, in truth, also be a Consultant Delivered Service.

But more often that not, A Consultant Led Service is light years away from a Consultant Delivered Service.

In a Consultant Led Service the consultant may spend most of his/her time on the moon.

And often does.

But no matter.

The consultant roaming around the committees of the moon while he/she is notionally leading the service will take the blame!

Surely!

N.B. In this context, “Consultant” refers to a registered medical practitioner with that title.

news.jpg

BREAKING NEWS FROM ONE OF THE ST ELSEWHERES

Picked up from a post and comment on Jobbing Doctor

redapple.jpg a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE


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