On an entirely different Tas - ETC topic, is this how it is in Australia? Talking about death is not outrageous – reducing it to a tickbox exercise is BRITISH MEDICAL JOURNAL | Online – 29 August 2014 – The Daily Telegraph was outraged. The headline read, Elderly patients asked during home visits by nurses: Would you want to be resuscitated?1 The offending question is part of the direct enhanced service for unplanned admissions. Essentially, GPs are being paid to try not to send people to hospital. On the basis of recent attendance patterns we are meant to identify patients at high risk of being admitted and work out a plan, as the NHS [National health Service] specification puts it, to identify factors which could have avoided the admission or future A&E (accident and emergency) attendance with a view to taking appropriate action to prevent future episodes. The bias is obvious: no equivalent specification pays doctors for admitting patients to hospital when it is the best place for them. But millions of pounds are being spent on the illusory idea that millions more pounds can be saved if GPs make a plan for patients that avoids admitting so many to hospital. This is patently nonsense; evidence has shown that this kind of case management doesnt reduce admissions. And where is the evidence of safety or the search for harms? How do we know that GPs’ time is being well used? We don’t. We are all living longer, with more long term conditions, but (as if planned in a parallel universe) the number of NHS beds is going down. We need what weve always needed: highly trained GPs with the professional freedom to listen and respond tactfully when people want or need to talk about death. bmj/content/349/bmj.g5369.full
Posted on: Tue, 09 Sep 2014 08:11:17 +0000
Trending Topics
Recently Viewed Topics
© 2015