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CAMHS won't see you now

Referral threshold for paramedics is bound to be lower

I share Dr Hume's concerns over suggestions by one of our local hospital consultants that a 10 per cent rise in hospital referrals was due to GPs' worries over litigation (News, October 27).

In the same issue there was an item headed 'Paramedics replace GPs for out-of-hours care'. I fear PCTs may grossly overestimate the potential abilities of such 'trained' paramedics.

I work with both a highly experienced nurse practitioner and paramedic within my practice who both have greatly extended roles, but they know when they reach the boundaries of their capabilities and then hand cases over to us that they feel unhappy dealing with.

The Government and PCTs feel they can produce suitably-trained emergency care staff by putting them on 12-week courses ­ and there was me thinking I still have a lot to learn despite 15 years plus of medical school, postgraduate posts and several years in general practice!

I also suspect that such 'emergency care practitioners' whether they be paramedics, nurse practitioners or nurses (as has in the latter case been proved with NHS Direct) will never be prepared to take risks.

GPs take risks on a day-to-day basis, often done on instincts and intuitions, but usually the patients end up with the right result. Non-GPs would err on the side of caution and refer a very high proportion to hospital.

If consultants think a 10 per cent rise in referrals is bad then God help them in the days to come. Once the patients get wind of such seemingly ill-conceived plans there will for once be a justifiable outcry. The hospital will just grind to a halt.

Perhaps PCTs should canvass opinion from those of us who spend a lot of time at the coalface rather than the boardroom. They might actually learn something!

Dr Pete Henley



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