Maxi_77 said:I hear what you say about the availability of doctors for deployemnt and I can see the logic used, but is it the correct logic. Yes if you have a consultant or a consultant led team you have the ability to deal with almost 100% of the problems expected, but if that means if no consultant is available then you have no doctor at all then you are in a situation where a very low percentage of the problems can be dealt with. Deploying a slightly less qualified doctor will actually give yo a better level of cover than no doctor at all, and in reality with modern communication your consultant supervision is still availlable.
My father was a consultant and in the 60s he supervised in several hospitals up to 4 hours drive away, with modern communications this remote supervision can be done much more effectively.
Perfection is rarely possible, but to effectively give up because of that is in my view foolish.
I agree with some of what you're saying, but the days of junior trainees being the forward deployed surgeon/anaesthetist are long gone. The consultant 3000 miles away via a satellite link is not going to help with the horrifically unstable trauma anaesthetic, nor with the difficult vascular injury.
I understand that NHS standards of care are the minimum benchmark for the DMS - this effectively means a consultant-delivered service. Are you suggesting we should abandon that on the grounds of expediency? I agree that perfection is rarely attainable; however, is it appropriate to have someone straight out of house jobs (& maybe 6 months' A&E) providing the primary care service for a deployed unit?
Things have changed since the 1960's; things that were acceptable then may not be now, even wit improved communication.