Monday, 5 December 2011

Hospital A&E Walk-In Centres

You'll have seen my earlier comments about NHS PC Walk-In Centres. In the main these are being closed, though sometimes a Walk-In Centre will be attached and managed by Acute Trust personnel rather than senior primary care medical staff. With the PCT WICs the emphasis is on successfully treating the person who walks through the door with subsequent follow-up by that person's GP. Where the need is serious andurgent the PCT WIC nurses will refer the case to the nearest A&E dept, usually following phone discussion between the WIC and A&E medics. The objective is to divert less urgent and less serious cases to the WIC.

When the WIC is managed by an acute trust and located close to an A&E department the nature of the service changes. The focus is much more dealing with unwarranted non-urgent patients to direct them away  from A&E. The focus is reducing the queues at A&E rather than treating the patients.

There's a case reported in the Daily Mail web site where a person who should have been treated by an A&E doctors was turned away by an A&E receptionist and told to go the WIC next door. The details in the Daily Mail report are not extensive but it appears the poor chap left the WIC with just eardrops and subsequently died from blood poisoning and brain damage. Here's the BBC report. It is very sad and my heart goes out to his family.

I do wonder however what the outcome would have been had the patient initially attended a PCT WIC where the nurses are trained to work autonomously (on their own) and give a through examination. Any urgent/serious cases are then passed immediatly to A&E, if necessary using a blue light emergency ambulance. There are clearly defined medical protocols the nurses are trained to follow which provide "red flag" markers of serious conditions.

In any event, patients presenting with a medical condition should not be turned away on the word of a clerical receptionist.

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