During the last week, our team had to see outlier patients. Basically I review patients first and I discussed with my consultant if needed. You may don’t know what outlier patient is. For example, if a patient with nerve or brain problem is placed in chest ward for some reason, he or she is the outlier patient of neurology and the neurologist has to go and see that patient as his outlier.
In this hospital, outlier patients are a little bit different. Those who are not medically serious and ready to go home, but still need to be sorted out their social and other issues, are put under the care of outlier team.
Well, on Last Wednesday, 36 year-old-chap who is a known
multiple sclerosis came in with some minor recurrent attack. Plan was to give 5 day course of intravenous injection. He is apparently well and no reason to stay in hospital for once a day injection. So I have to organize to get intravenous injection as an out-patient.
I never thought that it was a difficult job. But in the real situation……
In fact,
his wife is a sister working in our hospital. But British rules and regulations do not allow doctors and nurses to give medical care to the close relatives and next of kin.
I phoned to his
GP who declined to do so. They did only intra-muscular injection in surgery, not intravenous injection.
So I tried the
district nurse who normally does home visit for dressing and medication and so on. The same answer was given.
And then I contacted to
the Intermediate Care Team whose function is to look after recently hospital discharged patient if needed. They said they don’t have enough capacity to do so.
There is a
day treatment centre in our hospital. They said they open only 3 days a week. So not possible for 5 consecutive day injection.
A&E department is out of question. They only deal with emergency patients.
I tried MAU,
Medical Assessment Unit. They declined again as they have got a great deal of workload with acute patients all the time. ( I know that fact very well)
Finally CDU in-charge sister agreed to give intravenous injection to my pity patient in her department. CDU is
Clinical Decision Unit who takes GP referral. At that department, hospital doctors see patients referred by GP and deicide to admit them or not.
On that evening time, patient went home after waiting for an intravenous injection agreement for nearly the whole day.
