Policy responses and statements
- Name of organisation:
- Academy of Medical Royal Colleges
- Name of policy document:
- The Benefits of Consultant Delivered Healthcare
- Call for Evidence
- Deadline for response:
- 6 May 2011
Background: The Chairman of the Academy of Medical
Royal Colleges invited views for a study being undertaken by the Academy
into the evidence for benefits to patients of secondary medical healthcare
in the NHS being delivered primarily by consultants.
This study is being led by Professor Terrence Stephenson, the Vice-Chairman
of the Academy and President of the Royal College of Paediatrics and
Child Health. The Academy plans to produce a report of its findings
based on published literature across the world and evidence submitted
from interested parties.
COMMENTS ON
ACADEMY OF MEDICAL ROYAL COLLEGES
THE BENEFITS OF CONSULTANT DELIVERED HEALTHCARE
- CALL FOR EVIDENCE
The Royal College of Physicians of Edinburgh (RCPE) is pleased to
respond to the Academy of Medical Royal Colleges on its call for evidence
on The Benefits of Consultant Delivered Healthcare.
The RCPE supports strongly the benefits of consultant delivered care
as demonstrated by experiential evidence, but is unable to offer further
published evidence beyond that already available to the Academy in
the 2008 report “Medical Workforce Report to identify the added
value doctors bring to the healthcare team”; in particular, the
evidence available in annex C on acute medicine to which the College
contributed previously.
However, we have consulted with a range of our Fellows and offer the
following observations/opinions from front line consultants.
What are your views on the benefits of consultant delivered
care?
Experienced doctors:
- make rapid, appropriate decisions;
- make the best use of resources, particularly investigations (imaging,
endoscopy etc), minimising investigations for patients and contributing
to budget saving;
- expedite timely discharge of patients;
- facilitate clear communication to patients and relatives;
- reduce mis-information and complaints.
Do you have any particular evidence or examples of the benefits
of consultant delivered care?
- training in endoscopy by flexible working by consultant and trainees
- rapid training to competent level in 7 months, average is 2 years;
- Anecdotal: higher discharge rates on ward with higher consultant
input;
- UGI bleeding rota - though no reduction in mortality.
What changes are required to have medical care primarily delivered
by consultants?
- use skills for tasks consultants can best do, rather than burdening
them with tasks that can be achieved equally well by others;
- reduce routine administrative tasks;
- increase time for patient ward rounds from a standard 2 per week
to 3;
- improve continuity at ward level to make those ward rounds more
efficient and productive;
- move to 7 day working with flexible job planning;
- team-based allocation of patients.
What difficulties do you see with medical care being delivered
primarily by consultants?
- loss of other activities, both within the specialty and also outside
the hospital (eg contribution to quality initiatives, training and
service development).
- “Burn out” unless step down arrangements are available
later in careers.
Copies of this response are available from:
Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.
Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939
[9 May 2011]
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