Primary Survey
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We have some papers this month that reflect on some recent or proposed NHS reforms. Nicholl and colleagues from Sheffield give us an observational study on mortality risk and pre-hospital journey distance for certain patient categories. This is germane to the government proposal to reconfigure emergency care and emergency departments (EDs). It is intuitive to believe that longer journey distances can be detrimental to outcomes; the Sheffield group offer some science to feed the debate.
See page 665
Another paper from Sheffield, but from a different unit, is a study that assesses the experience of junior doctors in performing practical procedures. There is widespread anecdotal comment amongst senior members of our specialty that ED juniors are less experienced, less willing to take on responsibilities and less able to make decisions than they were in the not so recent past; if true, is this a generation Y phenomenon or a result
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