Journal of the Royal Society of Medicine
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Anaesthetists provide services throughout acute hospitals in areas such as the delivery floor and the intensive therapy unit as well as working in their traditional role in the operating theatre. Consensus standards of the number of staff needed to provide a satisfactory level of acute anaesthetic services, their qualifications and experience and the resources they require have been produced by a number of organizations. It is probable that many small and medium-sized district general hospitals will be unable to meet these standards without changes to traditional UK staffing structures.
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This article seeks to discover and recognize the importance of clinical governance within a new and emerging quality National Health Service (NHS) system. It evaluates the present state of prehospital care and recommends how change, via clinical governance, can ensure a paradigm shift from its currently fragmented state to a seamless ongoing patient care episode. ⋯ A frank and open view of immediate care doctors is presented, with recommendations to improve the quality of skill delivery and reduce the disparity that exists. Finally, it reviews the current problems with pre-hospital care and projects a future course for quality and patient care excellence.
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The Clinical Standards Advisory Group report on urgent and emergency admissions to hospital identified several important issues regarding emergency care. This paper examines what we know about the costs of a quality emergency service. ⋯ It must, however, be recognized that such work by itself will not automatically lead to increased funding within emergency care. Further consideration must be given to the funding arrangements for emergency care if long-term improvements are to be secured.