Some of the things we need to think about…
Population needs are changing which means we have to adapt our services. People are living longer and we need care as close to home as possible to help them stay well and independent. We already have examples of services provided in this way but we need to do more.
There are national standards around 24/7 access to a consultant in emergency departments that we must meet. These are to make sure that people have the best chance of survival and a good recovery.
Medical advances have greatly improved people’s chances of recovery from serious accidents and serious illnesses.As a result more services are being provided in bigger hospitals to make sure that patients are treated by doctors with the right levels of expertise. For example patients with very serious injuries are already taken directly to the major trauma centre at The James Cook University Hospital. Patient who have had a heart attack and those who need treatment after a stroke also go directly to Middlesbrough. These changes are in line with national policy.
The Friarage Hospital is one of the smallest district general hospitals in the country and doctors often choose to work in larger hospitals, in bigger teams, where they treat more patients so they can maintain and develop their clinical skills.
There are national shortages of doctors in some specialties, particularly anaesthetics, which is making recruitment difficult (not just at the Friarage).
Anaesthetists play a very important role in operating theatres and caring for the most seriously ill patients in critical care and must be present 24/7 for patients who need emergency care.
Trainee doctors have an important role in bigger hospitals. Due to its size, the Friarage has never been a training site for doctors in emergency medicine. National rules mean since 2016 we have not been able to have anaesthetic trainees covering the overnight period.
For patients requiring emergency care, there are key services that a hospital needs to provide and all are dependent upon each other.
An A&E department where you are seen by a professional who works in emergency medicine
An admissions unit – where further tests may be undertaken to provide a diagnosis and a treatment plan
A critical care unit – this service supports patients who are more critically ill if they need more emergency care and support. A Consultant specialising in critical care medicine usually called an Intensivist looks after patients here.
An overnight anaesthetic service – this service support patients who may deteriorate overnight.