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  1. Simon Carley, Associate Editor

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What's the point of ED consultants?

Whilst all EDs are consultant led there is no doubt that for the most part they are not consultant based in that senior doctors are rarely present overnight and during all ‘out of hours’ periods. Perhaps ‘out of hours’ is an anachronism for our specialty as the patients still come, and still need help. Traditionally the night and late shifts are not led by consultants, but are there really any advantages to basing a service with consultants on the shop floor overnight? Perhaps it makes little difference? Aruni Sen and colleagues in Wrexham have a service delivery model that does put consultants on overnight and they have clearly shown the advantages of senior presence in the department (see page 366). This is really important data that we can use to argue for additional expansion of consultant numbers and I urge you to read this and quote it often.

Zoned out at the front door of the ED

A common suggestion to ED overcrowding in recent years has been the development of rapid assessment areas/zones where early assessment is thought to speed patient journeys and, of course, move departments to achieving their targets. We have instituted similar methods locally and at first glance there seems little to argue with this concept. Interestingly though, we are …

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