Clin Med
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This article explores the role of a GP with a special interest in acute medicine working with secondary care. The reasons why such a role may be helpful are outlined. ⋯ It is argued that while the primary/secondary care interface is widening, objectives on both sides are the same. It is suggested that future training programmes should allow enough flexibility for this role to evolve.
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Capacity and demand theory suggests that the presence of a queue is not necessarily an indication of a shortage of capacity in a system. It is much more likely that either there is a demand and capacity variation that creates queues or there is a delay designed into the system. A shortage of capacity is only really indicated where a backlog is not stable and continues to grow. ⋯ It is believed that these data are representative of most locations within the NHS in England and therefore suggest an immediate shortage in effective follow-up capacity. To avoid compromise to patient care, the problem will have to be addressed before the situation becomes unmanageable. The paper highlights options to reduce or deflect demand or to increase effective capacity.
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Comparative Study
Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency.
Patient safety incidents involving insulin are frequent and cause considerable distress to people with diabetes and anxieties to their families and carers. This article describes an analysis of the National Reporting and Learning System database of patient safety incidents concerning insulin reported from NHS providers in England and Wales over six years. The main causes are discussed and the ongoing developments by the National Patient Safety Agency and partner organisations to reduce insulin errors are described.