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Urgent Care Update
3rd June 2016
OOH Bloods
There has been a recent surge in D-Dimer and Troponin bloods being sent to Mastercall in the OOH period. The clincians there can have difficulties as they have not seen the patient and so can default to admission. If a clinician takes a blood test of this type – mark it URGENT and either ensure the result is received before practice closes or discuss with Mastercall to improve decision making.
DVT/PE Pathway
On a separate but related note the FT have redesigned their DVT/PE pathway and are using the Wells Pre-test Probability to help direct patients. I thought it would be useful to highlight this in case anyone wasn’t aware of this scoring system – see NICE CG144 for further info (https://www.nice.org.uk/guidance/CG144/). Primary care should be using the Well’s score to direct patient’s and inform decisions re management.
Direct Referrals
In a recent Quality review of Urgent Care it was noted by FT clinicians that they regularly receive referrals to “Dear ED”. Could I encourage us all to have a “best guess” at speciality required and refer direct. Although this patient may be streamed through the ED as a direct referral they do not consume the ED Clinicians time to the same extent. If GPs/ANPs etc have difficulty getting timely responses please let me know and I will feed this back in. Similarly I have asked the FT to inform me of this and will discuss with relevant clinician’s as appropriate.
Dr Simon Woodworth