Plans for shake-up of doctors on call system (From Western Telegraph)

Plans for shake-up of doctors on call system

Plans to improve access to patients' medical records for doctors on call, are being developed by Pembrokeshire's Local Health Group (LHG). The issue received attention after the death of Mrs Diane Midgely, an asthmatic treated by a doctor on call in January. Pembrokeshire Coroner, Mr Michael Howells, questioned whether the treatment given to Mrs Midgely, specifically a morphine injection, would have been different had medical notes been available. Although a post-mortem revealed the injection was unlikely to be a significant factor in her death, the incident tied in to an ongoing review of doctors on call information systems. Recording a verdict of death by natural causes, the Coroner said: "By setting up this co-operative scheme to cover the whole county of 60,000 patients, doctors' practices are delegating the care of their patients to a doctor who doesn't know them and has no access to their medical records." However, in a meeting with the Western Telegraph, LHG acting-general manager, Stuart Moncur, said the system was not as different as people might think from that at work in GPs' surgeries and hospitals. He said: "Ideally, everyone would want to see the doctor they are registered with. In a large practice that may be possible with a few days' notice but, for urgent cases, it is not. The same is true in hospital. Your medical records may be in the hospital and can be obtained, but it may take some time." The current doctors on call system involves 63 GPs from 16 practices providing night cover for the county on a rota basis. The LHG, and particularly the group's clinical governance team, has been in discussion for some time with doctors on call about ways to improve access to information. Possibilities include a computer database, 'smart card' technology and information cards which could be stored in patients' homes. While the hi-tech options would be easier to update, they would require a national system to operate properly. A card system, though technologically simple, would be difficult to keep up to date. Mr Moncur said: "Information would have to be continuously updated. If information was wrong, it could be worse than having none at all." Chris Martin, LHG chairman, is confident the clinical governance team can continue to improve the doctors on call system. He said: "The team has representatives from all areas of medicine and, most importantly, a lay member to ensure the patient remains at the heart of all decisions."