Perils, Pitfalls and Perils, Pitfalls and Solutions Solutions

in Acute Medicinein Acute Medicine

Dr Martin PattrickDr Martin PattrickConsultant in Acute MedicineConsultant in Acute Medicine

BackgroundBackground

Being a Doctor wasn’t my first choice of career

My credentials

Been around a long time !Experience with various types of hospitals

Experience……………Experience……………

…is what you get when you’re looking for something else.

Experience3 Hospitals:• Pennine Acute Hospitals NHS

Trust – North Manchester General site

• University Hospital of South Manchester (UHSM)

• Tameside General Hospital

Main problem

Protecting the site at night

Some suggestions

1.Nurse recruitment2.Doctor recruitment

Solve these and there’s usually no other

recruitment problems

Local workforce pressures

Nurse recruitment

Mainly working conditionsPhysicalLow absence / sickness vacancies

Training – an important aspect

Doctor Recruitment

Supportive environmentOffice space !Camaraderie

Advanced Nurse Practitioners

–Not cheap–Can be extremely effective

–Develop protocols–Organise themselves

Band 3 / 4 – HCAs / APs

–Great help with ward rounds

–Results retrieval–Bloods, cannulas, ECGs–Handover facilitation

Pharmacy

– Train to prescribe– TTOs– Use in PTWR– Discharge summaries in the

morning– Early discharge

Ambulatory CareAmbulatory Care

If you have one strategy If you have one strategy to survive winter…..to survive winter…..

choose this!choose this!

Ambulatory CareAmbulatory Care

• If it walks… put it in ambulatory care

• It’s not about closing beds, it’s about making beds work harder

• Income generation

Concept of urgent care

–End dichotomy of MAU / ED

– Involve the surgeons–Close working relationships

– Joint meetings

Usual System

Emergency Dept in-Emergency Dept in-reachreach

OR

Top Tips– Get a clinical champion but don’t pay

extra!

– Arrange for” boots on the ground”

– Get ambulatory care up and running efficiently

Questions ?Questions ?

Thank YouThank You