As community services develop, medical staff are increasingly spending more time outside the hospital, despite the most severely ill patients still being in hospital. This may lead to junior medical staff and nurses feeling unsupported by the consultant. In addition, as more disturbed patients are kept out of hospital, the general practitioner and community health workers may require to contact the psychiatrist more often to talk about patients or to request urgent assessment. Therefore the importance of communication with consultants is increased both from the hospital and from the community while they are spending increasing amounts of time in their cars. In a discipline where communication is of paramount importance, a failure to meet this growing need would undermine the effectiveness of the service as a whole.
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