The Facts about A&E 

This is an excellent video from the college. As a British trained doctor now working in Sydney as an A&E registrar (i'm sorry taxpayers!), i would love nothing more than to be back in England with my family and friends, working for the NHS which is something I believe in and am so proud of. However, I am surprised income isn't even in the top 5 reasons and that you don't think it's a problem of 'poor salaries'. I agree, a better rota is a really important factor for a work/life balance and family, but a lot of British A&E doctors (and other specialities) working in Australia and NZ will tell you how nice having a better income is with better working hours, in comparison to an income in England (particularly London) that seems to just about cover rent, Oyster card, bills, exams, courses to maintain CPD and GMC fees, and then maybe some money for living ..... good luck saving for a mortgage, wedding or dream holiday while still having a social life. Where as in Sydney - it's all possible, while still having that important work/life balance for fun, friends and sanity - just not family (which is incredibly tough), because you have to work on the other side of the world to have a decent life while pursing a career you love. It's frustrating that money is a big factor (as well as a better rota) but i don't think we should feel guilty for wanting a decent income when we've worked so hard. Whilst working in England I often had fleeting thoughts of pursuing a job in the city in envy of all my friends who have a better income and stable working hours of Mon-Fri. I know a lot of people have a lot to say about this video and my comment. This is just my view, there are plenty who will have different things and experiences to share. I'm returning to work in the UK in 2017 and have mixed feelings, dreading a salary cut for worse working hours and conditions; but happiness to be back with my family, be back home, and at the end of the day supporting the NHS and being in a job that is a blessing to have because at the end of the day being a Doctor is incredibly precious and rewarding, and i'm grateful for the training i received in the UK to give me the skills and knowledge to do what I love.

This is a very well put together and presented case. The issue is not just resources fed to where the patients flow to ... it is also the required skills to design an integrated unplanned care hub that works ... collaborative design capability. Building this capability first will be critical to success too ... and it is possible.

Excellent video. Patient focused, seeing it from a 'where do we add value' point of view. Explains that preventing referrals to such a strong brand is nigh on impossible. A few points: A&E is 'busiest' on a Sunday but doesn't have the highest number of attendances on Sunday. Staff overburdening from work in progress i.e. patients waiting/backlog is one of the causes of SpR burnout. No mention is made of repeat over-processing e.g. multiple assessments by A&E staff then by acute speciality juniors. In production terms, it's a flow problem with multiple constraints. Improvement science has a lot to offer this problem. A&E is one part of the complex adaptive system that is a hospital. www.saasoft.com