By Henry Guly (auth.)
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Extra info for A History of Accident and Emergency Medicine, 1948–2004
64 One of the major reasons why casualty departments had problems is that the rest of the hospital took very little interest in them. The Nuffield Report looked at the interest taken in casualty by the Hospital Medical Committee. 4. Summary Before the Platt Report, the staffing of casualty departments was very variable. There were examples of excellence and not just in Leeds which was the only department with a full time casualty consultant. However consultant supervision (where it existed) was often little more than nominal.
Orthopaedic surgeons feared that A&E consultants doing the initial management of fractures would break this continuity of care and (even worse) might not refer such patients on to orthopaedic surgeons. Hence there were statements such as: ‘there is no place for a consultant in the accident and emergency department who has no responsibility for the continuing care of the injured patient’29 and ‘orthopaedic surgeons … should insist that the management of locomotor injuries from the outset should remain their responsibility.
16 The SCO post-holders were not expected to spend all their time in casualty. The Nuffield report comments on one SCO: ‘he virtually does no surgery now. … The waiting list for “cold” hernias which the senior casualty officer is quite capable of doing, is up to three years. ’ Of an SCO appointed after nine years as a surgical registrar, it says: ‘he is, in fact, carrying on quite a fair surgical practice in the department, dealing with major compound fractures as a routine’. Three surveys were done of SCOs which enable us to obtain a picture of the kind of people they were and the work they did.
A History of Accident and Emergency Medicine, 1948–2004 by Henry Guly (auth.)