Noel Corser

It might make sense to start the preamble with "All regulated members have a professional and ethical obligation to ensure continuity of care...", followed by the sentence describing various primary care permutations, locums, and specialists? I'm curious what's meant by "service" (i.e. "an appropriate healthcare provider(s) and/or service"), and whether that should perhaps be added to the glossary? Would a telephone answering service be included? Does this mean a hospital-based specialist "service"? Particularly with the advent of fly-by-night tele-medicine, it might be prudent to head off problems by clarifying that handing over continuity of care to a 24-hour Babylon-type service isn't acceptable? Although 1.b is a wonderful concept - "have a system in place to identify and track when an investigation ordered has not been completed by the patient or a referral request has not been responded to by a consultant in a timely manner" - I've yet to see it in action in the real world. If the CPSA is truly wanting to both promote and enforce this part of the Standard, practical workflows (i.e. computerized, and/or "won't bog the system down to the point of collapse") must be available to members. Once the CPSA starts looking into this more, I think you'll realize it's much easier said than done. I'm unclear whether 2.a ("must document who's taking over care") is truly a subset of 2 ("CC'ing another doc doesn't remove one's responsibility for follow-up"), or if these are two separate requirements? Does 2.a only apply for patients where information is CC'd, or any patient where doc A gets doc B to accept follow-up responsibilities? Also on that point, it's probably more common that "another healthcare provider" accepts responsibility for the follow-up of a day-sheet, or panel, or other grouping of patients, than to accept care for individual patients. This makes the requirement that documentation be made in each patient's chart quite problematic, and sometimes impossible? Current advice to short-term locums working in non-AHS settings where lab/DI are live on Connect Care, is for the locum to order tests under the name/Connect Care IDs of a local clinic doc, to allow appropriate routing of results (and we're told there is no other way to ensure such results are routed to the appropriate clinic EMR). Apparently, this has been vetted by the CPSA as well as CMPA, but it's in direct opposition to point 7 of the draft SoP. It's likely that residents/fellows would also frequently run into problems with how #7 is worded. Again, the spirit makes sense, but the practical application is going to cause a few hiccups.

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