By Henry Guly (auth.)
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Additional info for A History of Accident and Emergency Medicine, 1948–2004
Under the recommendations of the Sir Harry Platt report, there seemed little place for specialists in casualty or pure A&E work. In addition the Sir Robert Platt report had recommended abolishing the SHMO grade and replacing it with a new grade of Medical Assistant (MA) who ‘should work as assistants to consultants and under their supervision’. The report also recommended that ‘all patients in the Hospital Service should be in the charge of consultants, and consultants in the specialty or specialties involved in the treatment of each patient should bear the responsibility for his care and the medical work required for him’.
It was not intended that these doctors would remain in casualty forever and it was thought that many might return to general or orthopaedic surgery. The Nuffield Report looked at the SCO grade (described in the report as SHMOs, though technically they were not) and found that most were carrying out a good job, often in discouraging circumstances. 3 Appointments of SCOs Year Number of SCO appointments 1953 1953 1955 1956 1957 1958 1959 1960 1961 1962 2 5 11 13 15 15 15 16 16 16 Source: Appendix to Memorandum produced by Senior Casualty Officers Subcommittee of CCSC 1964.
Apart from these four reports dealing with accident and casualty services, Sir Robert Platt in his report on medical staffing9 recognised a requirement for consultant involvement but did not appear to feel that it needed much time: ‘the first principle in the staffing of casualty departments should be that one or more consultants should have a specified responsibility for casualty work, and a definite and sufficient part of their time allotted to its supervision. Much of the work is of a kind in which a policy for treatment can be defined reasonably closely and supervised by the senior staff concerned.