APPENDIX 40
Memorandum by Dr Jillian Pritchard, St
Peter's Hospital, Chertsey (SH64)
I have noted in "Delivering the NHS Plan"
that standards have been declared for delivery of care. I work
as a single handed consultant with no prospect of a second consultant
in the foreseeable future because my trust is heavily in debt
and other services (such as A&E and acute admissions) have
priority to meet government targets. The following facts should
serve to illustrate my problems:
1.In addition to me as a full time consultant there
are only six weekly doctor sessions with a sporadic additional
two sessions.
2.There were in excess of 15,000 patient attendances
during the last year. This does not include a large number of
telephone calls requiring professional attention, many very time
consuming.
3.Follow up appointments are kept to a minimum and
approximately 10,000 attendances were new or rebooked patients.
4.There are over 100 HIV positive patients. When
admitted this may be to either of two hospital sites within the
same unified trust but eight miles apart around a busy section
of the M25.
5.There are no junior doctors excepting those sent
to sit in for training purposes. The clinic is understaffed to
qualify for junior staff.
6.Supported by the nursing, health advising and clerical
staff I firmly believe patients should have rapid access to the
clinic and therefore operate a walk-in clinic whenever the clinic
is open. This appears to be endorsed by "Delivering the NHS
Plan". The result is that patients may wait up to three-four
hours to be seen but I guarantee they are seen.
7.Triage is difficult since an asymptomatic patient
in this specialty may have an urgent problem eg the patient may
have had contact with an infectious disease such as gonorrhoea
requiring timely intervention.
8.There have been a number of initiatives to encourage
people to recognise their risk of an STI and take prompt action.
This will place a further burden on our hard pressed services
and indeed already has done so.
9."Delivering the NHS Plan" expresses an
intention to assist patients to find the hospital with the shortest
wait. My patients already do so and my services cannot cope, much
as I wish to do so.
10.It is recommended that there be consultant cover
for all clinics. It is almost impossible to find a consultant
locum to cover my holidays and study leave. This problem is not
unique to me and appears insoluble.
I have looked at many ways to solve my problems of
manpower which are hampered by finance (there is none) and by
huge gaps in doctor provision. The longer the waiting lists in
related specialties such as dermatology and gynaecology the more
patients seek access to GUM clinics to which they can self refer.
Our clinics are innovative and wish to help the patients as much
as possible but our services are swamped. HELP.
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