1. Community-Based Specialist
Dr Richard Everts Infectious Diseases Specialist

2. What is a Specialist? Inpatient care (ward rounds) Surgery/procedures
Advice/consultation
Primary care (GPs, nurses, Pharmacists)
Hospital doctors
Outpatient care (clinics)
Face-to-face
Virtual H H
Committees and meetings
System development
Guidelines
Audit
Education of others
Primary care
Hospital staff
Education of self
Research H H H H

3. The Problem with Hospitals
The fortress
Ambulance at bottom of cliff
KPI illogical
‘80% clinical’
Limited space and resources
Patients don’t like hospitals
Parking
Bad things happen in hospital
Long wait for appointments, Doctor

4. The Advantages of Being Community-Based
Focus on prevention and early intervention
More available to 10 care by phone
Rapid-access face-to-face clinics
Guidelines, audit and education for 10 care
Research in 10 care
More virtual outpatient care
Patients attend clinic in community
Co-location with other community teams (e.g. District Nurses, HPO)

5. The Advantages of Being Community-Based
Supportive Managers
Nourishing work environment

6. Which Specialists could be Community-Based?
Infectious Diseases is ideal
90% of antibiotics prescribed in the community
90% of consults require urgent action
90% of work does not require location in hospital
Others
Hepatitis C
Rheumatology
Diabetes
Skin
Heart failure
Respiratory