What follows is my letter to the Editor of the Chronicle Herald in response to their editorial in support of the CEC experiment.
I confess to considerable confusion over the recent supportive review of the Collaborative Emergency Centre experiment in Nova Scotia. The review has indicated that they should be deemed a success because they have improved access to primary care, reduced nighttime visits and reduced (but not eliminated) facility closures.
Improved access to primary care is truly a laudable goal but should never be confused with improved access to emergency services. We think a note of caution is required before the program is expanded.
From the perspective of a rural response to life threatening emergencies here’s what else was in the report: Nurses and paramedics feel that low patient volumes may lead to a deterioration in their clinical skills, fragile staffing arrangements, limited access to diagnostic services, fragmented health information services, lack of understanding by regional emergency partners, unnecessary time spent in validating a potential emergency transfer and ambulance delays.
To me this seems like a recipe for a clinical disaster. How on earth can this be considered a success?