Patient Flow

Specialties do a lot of complaining about EM. And sometimes it's justified. But what I'd love to do is look at EVERY patient we admit and ask the specialities:

- if it was appropriate
- what tests they felt were missing
- whether we did anything that didn't need doing
- whether we provided appropriate treatment

And see whether the problem is that specialties are lagging behind in their knowledge, or we really really are providing poor care.

And then we can create pathways and address learning and see what happens. Chances are a lot of our "medical" admissions could go to CDU if we had the space... ...

I like the idea someone else had - one CDU + one elderly admissions CDU - full of "elderly med" specialist physio, social etc. Aim for a quick turn around. It'd be great.

But I think we need to engage with people, and not always be seen as the bad people. Emergency Medicine is great - we know a lot, we do a lot, but we also get a lot of grief for doing it...

Central Employment

Still being scared and never quite the same from induction, I think central employment would be a good idea. Why can't we be employed by the deaneries (or what ever they are now). They can induct us once...occy heath us once etc. The whole thing would be  a lot less stressful for everyone. It might even save some money. We might even get paid right.

I suggested this idea to a colleague. 

They took it further.

Why can't the NHS just be a big single employing authority. Why indeed. 

The variation each time you change trust is amazing. And exhausting. Job swap - over is stressful enough without adding the paperwork to it! Different expenses. Different study leave. And everything that goes with it. 

Added to that..other companies are much more supportive - help finance houses etc. I know we didn't join the NHS for the money but... ... sometimes a bonus would be nice!