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CAMHS won't see you now

Notes over the ether

Dr Deborah Halsley

London SW11

I tend to agree with Dr Shah (Letters, 29 October) about nurse-led clinics.

Yesterday I saw a patient after a follow-up appointment at the breast clinic. She had had a mastectomy for breast cancer. She had symptoms relating to her chest and a chest X-ray had shown pleural effusion. She did not volunteer her symptoms, but no general questions were asked, either. She was seen by a nurse.

I have also seen a patient with serious arterial disease diagnosed with soft tissue condition by a physiotherapist in an orthopaedic clinic.

I don't think it is fair to expect nurses or physiotherapists to have the wider knowledge necessary for these clinic situations. We shouldn't ask them to do it.

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