Consultants criticise urgent care facility

Swiftcare centre : Consultants in accident and emergency medicine have strongly criticised the new Swiftcare clinic in Dublin…

Swiftcare centre: Consultants in accident and emergency medicine have strongly criticised the new Swiftcare clinic in Dublin, the first of a number of urgent care facilities set up by the VHI and The Well, a primary care medical company.

The Swiftcare clinic, a walk-in urgent care centre aiming to treat unexpected injuries/illness, is located at Balally Luas Station in Dundrum.

Dr James Binchy, secretary of the Irish Association of Emergency Medicine (IAEM), the representative body for accident and emergency consultants in the Republic, said the new urgent care clinics would not reduce A&E attendances or improve the lengthy waiting times experienced by most patients in hospital emergency departments.

He also questioned whether clinical staff at Swiftcare were experienced in A&E medicine or urgent care.

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The information on Swiftcare states that it is staffed by doctors with accident and emergency experience and also by registered nurses who have experience in urgent care.

"What is their experience in A&E and what is their experience in urgent care?" he said.

Dr Binchy, a consultant at University College Hospital Galway, also claimed that the new facilities were not regulated, "whereas accident and emergency units are bound by the rules of the Royal College of Surgeons in Ireland in relation to training, supervision and audit to ensure high standards of care".

"Some 10-15 per cent of patients who attend the minor side of an emergency department require admission or follow up at a specialist clinic. How is this going to be achieved?" he said.

Both the VHI and doctors associated with the Swiftcare development have firmly rejected the IAEM criticisms.

Dr Ray Power, one of the founders of The Well, said the Swiftcare Clinic in Dundrum was staffed by a consultant in A&E medicine who had worked in both New Zealand and the Republic and three full-time GPs, "with a combined medical experience of more than 60 years. They have experience in providing urgent care abroad".

"We have never claimed that we will help the [ A&E] trolley crisis" he said.

On the need for possible hospital admission for patients attending Swiftcare, Dr Power said a protocol was in place to refer adults to St Vincent's University Hospital and for children to attend Tallaght Hospital.

"We have fully fitted out a resuscitation room and there is easy ambulance access so that patients can be stabilised before transfer to hospital."

Both Dr Power and Dr Alan Forrester, a consultant in emergency medicine and medical director of Swiftcare, said their experience after three weeks was that between 1 per cent and 2 per cent of patients seen needed hospital care. Some 85-95 per cent of patients presented to Swiftcare with minor injuries.

Addressing the issue of regulating urgent care centres, Dr Forrester said: "If Irish standards were in place we would welcome them but in their absence we have approached the Urgent Care Association of North America in an effort to meet their professional standards of best practice guidelines."

Responding to IAEM criticism that it has yet to develop proper emergency departments in private hospitals, a spokeswoman for the VHI said: "The VHI Swiftcare Clinic is simply an alternative for those patients who have an urgent condition that can be treated in the community without waiting for long periods of time in an A&E department."