An ordinary meeting of the Society was held on Wednesday 7th February 2007. The President was in the chair. The minutes were read, corrected, and then approved.
The President then introduced the speaker, Mr John Heyworth, Consultant in Emergency Care at Southampton General Hospital, who spoke to the title ‘The Emergency Department Unmasked’.
Mr Heyworth said that the Speciality of Accident and Emergency care is no longer a Cinderella speciality, it is now the core speciality of the NHS. It is in the process of creating its own Royal College.
He was very insistent that we call it the Emergency Department and not Casualty – and got us to repeat this out loud! The Emergency department is the hub of emergency care operating 24 hours day, every day of the year, treating the acutely ill, the injured, children, the mentally ill, toxicological problems etc.. He wanted to dispel the myths that it is all trivia, minor, inappropriate stuff that anyone can do. Only 8-10% of attendances in Southampton are for primary care problems.
He said that annual attendances were on the up and up- which is an international trend. Last year they treated 99,000 patients and in the first 6 months of the current accounting year they treated 50,000. He said that numerous solutions have been proposed but none make any difference. One difficulty is that everyone is an expert.
Coping strategies were the answer: paramedics making decisions at the site of the call, emergency care practitioners attending, and he thought NHS direct was a good idea. Best of all were 4 hour targets, from the time of arrival to discharge or admission to a ward. These made the chief executives take notice and the local trust target is 98%. He said it was quite possible to see 98% in 4hours but they would need the staff – experienced doctors and nurse practitioners at the front door doing rapid assessment triage. It is intense work but is unsustainable without enough staff. They also need beds downstream. And every day is a surprise to management, he said, with beds not available until evening – capacity is never there at the right time. What they need is their own observation ward where patients can be observed for a time before safe discharge or referral onwards.
There being no other business the meeting finished at 10.05 pm.