Key stage in treatment of A&E
THIS week's announcement that the hospital's Accident and Emergency department will shortly be run in-house by the States marks the latest in a long line of recent changes for the service. Yet whilst it is clear that from September Health and Social Care will be in charge, what is less so is just exactly how the new arrangement will work. Currently contracted out to the Primary Care Company Ltd – which was set up by the island's GPs to provide doctors for A&E – it appears more thought is still needed over the finer details.
While PCCL looks happy to hand over the reins next month, questions, over future staffing for instance, remain unanswered.
Does H&SC plan to use PCCL's existing bank of doctors, or will it employ its own staff instead?
Then there is cost. PCCL received £900,000 a year of taxpayers' money for the A&E contract. (This, combined with patient charges, adds up to a total annual income from the service of around £2.2m.)
Health say there will be no extra expense for bringing the service under its control, although detailed figures have not been released.
To the onlooker, the uncertainty feels rather unsettling – although we have been assured the committee envisages an enhanced delivery, no changes during transition and a 'smooth transfer of services within an agreed timeframe'.
The reassurance sits less easy, though, next to comments from PCCL's former chairman on Monday, who said GPs remained unsure if they would be involved in future, although a number would like to be.
It would make sense. As he points out, they have an ongoing role and level of experience it would be a shame to lose.
Either way, what we need quickly is a steadying hand and consistent message.
There have been numerous changes at A&E in recent years, following a report from CICRA on the transparency of the contract, and criticisms from a 2011 review by the College of Emergency Medicine. The latter identified several shortcomings, including the lack of an emergency medicine consultant, which has now been addressed.
This latest development will hopefully bring stability and afford the flexibility that the island's lifeline service needs.
Regardless of who is in charge of the contract, patient care is paramount.
