Medicopolitical Digest

Accident departments can appoint more staffHelping GPs to provide better out of hours servicesHuman rights will be emphasised at Istanbul meetingMaintaining Medical Excellence will impose new costsIn brief

BMJ 1996; 312 doi: (Published 20 January 1996) Cite this as: BMJ 1996;312:188
  1. Linda Beecham

    Accident departments can appoint more staff

    NHS trusts and health authorities are being allowed to appoint more staff grade doctors outside the agreed national ratio to consultants of 10% to ensure full cover in accident and emergency departments. In a letter to trust and authority chairmen the minister for health, Mr Gerald Malone, said that this would help those hospitals which might face difficulties in filling senior house officer (SHO) posts next month. These appointments will also free up sessions to allow the SHOs more time to take advantage of educational opportunities and improve the training element of the posts. SHOs will also be offered the opportunity of year long posts (instead of six months) linked to other inpatient specialties.

    In a separate letter to chief executives of NHS trusts the medical director of the NHS Executive, Dr Graham Winyard, has recommended that hospitals review the work patterns in the accident and emergency departments. For example, patients with clear cut diagnoses or sent in by general practitioners could go direct to the appropriate team and patients could be seen directly by the relevant inpatient doctor and bypass the SHO.

    Dr Winyard suggests that the working capacity of SHOs could be improved by providing dictaphones, secretarial support, reducing non-clinical and administrative tasks, and arranging for other appropriate staff to arrange discharge and follow up. As much as possible of the administrative workload of senior doctors should be transferred to non-medical staff.

    The chief medical officer, Sir Kenneth Calman, is to review emergency care services outside hospital. This will focus on the organisation and delivery of services and the role of different professional staff including …

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