Category Archives: Links

Static Websites of Interest and Relevance – Does not include Individual Stores in the Media.
Links are given a date of 1 January 2013 – information on the website will be current.

The Training of doctors…. unfortunately it is too late to recover in even the 5 years promised by government… Decommissioning of operations

A Times leading article alludes (correctly) that undergraduates are less value to the state than graduates who enter medical school. But Zawad Iqbal in “Doctors’ training needs streamlining before it’s too late” does highlight the problem of declining standards, and lowest common denominator medicine. The problem with the new GMC suggestion is that too low a standard may be deemed acceptable in order for us to have enough doctors in the short term. The fact that NHSreality would never have chosen to start from here is omitted. Long term rationing of medical school places, as well as too many undergraduates and too few graduates is to blame. A ten year program of capacity management may be undermined if we admit too many overseas doctors suddenly.. On the other hand, if the bar is set high enough… OK, I forget, nurses can do the job of a GP can’t they? NHSreality feels it is already too late, and it’s going to get worse… (Katie Gibbons reports from Kent: NHS operations postponed to save cash). Decommissioning is going to get worse still.

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In a letter to The Times 3rd Feb 2017 Prof Derrick Wilmot of Sheffield writes: on DOCTORS’ TRAINING..

Sir, A medical licensing assessment for doctors is long overdue (“Doctors face tough new test on basic skills”, Feb 1). There is a similar situation for dentists. A third of the dentists entered each year on the General Dental Council’s register qualified at an overseas university. UK graduates are not tested by a common examination but by the individual university dental schools, which do try, mostly with success, to maintain sufficient quality and commonality. Many of the overseas new dentists entering the UK come from EU countries and cannot be tested. Brexit is the ideal opportunity to introduce a new robust common assessment for all doctors and dentists registering in the UK.

Recent years have seen a frightening increase in medical and dental litigation. Evidence for an association is weak but if a basic clinical education is lacking problems surely lie ahead both for the practitioner and, more worryingly, for the patient.

Emeritus Professor Derrick Willmot of Sheffield University, and past dean, Faculty of Dental Surgery, Royal College of Surgeons: Doctors’ training needs streamlining before it’s too late

The news that thousands of newly qualified doctors aren’t confident enough to perform basic tasks such as taking blood is a real canary in the coal mine moment — a warning sign that the way we teach doctors urgently needs to change.

Part of the problem is that the basic structure of medical training hasn’t changed in more than a hundred years. The General Medical Council sets the standards for undergraduate medical education and supervises the training and education of students. But the content and length of a medical degree varies widely, depending on which institution you attend, and the different medical schools are allowed to set their own criteria for licensing doctors.

There is no common standard to practise in the UK. Doctors from the European Union can work here if they’ve passed relevant exams in their own country. Doctors from other parts of the world are given a separate test, resulting in a confusing system with no overall benchmark.

So it’s a relief that medical regulators now want to introduce a standard test. But that’s still some years away and frankly it’s not enough. We should seize the opportunity to conduct a bigger and more wholesale review of how we train our doctors and whether these decades-old methods are up to scratch.

What doctors needed to know ten years ago is often a world away from what they need to know today. Basic science and clinical science remain the core modules on medical courses but healthcare delivery is becoming ever more important. As well as introducing a common approach to basics such as taking blood samples and performing lumbar punctures, areas such as data analysis, IT skills and interpersonal ability must play a bigger role in medical training.

One of the biggest opportunities being missed is in postgraduate medical education. This is because postgraduate training falls under the NHS rather than a university or medical school. Our doctors need to keep learning new skills if they’re going to give their increasingly well-informed patients the best treatments. The doctor of the future will not necessarily carry a stethoscope around his or her neck but will more likely be one of a specialist team working alongside health technicians, pharmacists and nurses.

Rather than introduce a new standard test for doctors after they have qualified, they and their patients would be better served if medical schools standardised the courses they begin at 18.

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Setting up the Health Service to fail. Exhausted nurse sums up what many NHS workers think of Jeremy Hunt

David Burke in The Mirror 25th July 2015 , and the Metro carry a link to a video of Nurse Jacqui Berry telling the truth. Jacqui does not realise there is no NHS, and she may not state that health care is covertly rationed, but she speaks from the heart. NHSreality agrees that staff are working weekends.. and the reason that deaths are higher at weekends and in changeover months (August and February) is that there is not a full compliment of staff and back up services available for patients 24 hours, and the changeover August day is in Holiday time. To counter this should need an increase the budget for Health by approximately 1 or 2/7 or 14%, and a move from August/Feb to September/March or October/April for staff training changeover. The Health Services are too big and cumbersome..

 

Exhausted nurse sums up what many NHS workers think of Jeremy Hunt

An NHS nurse has left a tearful message for health minister Jeremy Hunt the morning after finishing a 14 and a half hour shift.

Jacqui Berry’s eyes well up as she tells how she took inspiration from a fortune cookie with her Chinese takeaway – which she ordered because she was too exhausted to cook.

Her voice wavers as she said: “Yesterday evening I left the hospital an hour and a half late – 14 and half hours after I first arrived. I’m not complaining that happens sometimes, it was a hard day.

“When I got home I didn’t have the time or the energy to make a healthy, nutritious meal so I got a Chinese takeaway.

“Hopefully this pattern doesn’t cause me to develop a costly and complicated long-term condition like diabetes.

“Anyway I got this fortune cookie which read: ‘Sooner or later those who win are those who think they can.

“We have to fight them [Government] and we have to start thinking we can win.”

Mr Hunt has recently come under attack for his plans to enforce seven-day working for NHS staff.

More than 175,000 people have signed a petition calling for him to be sacked or tweeted messages on #ImInWorkJeremy.

Open letters from medics have gone viral on Facebook, including one from 34-year-old Janis Burns.

She blasted the £7,000 MPs’ pay rise and complained many doctors earn less than the £41,000 for managers in coffee chain Pret a Manger.

One furious nurse on £26,000 told Mirror Online of the horrors of an average shift – comforting a dead patient’s wife as she collapsed screaming in hysterics.

And junior doctor Benjamin Carter blasted Jeremy Hunt as a ‘totalitarian Disney villain’, telling him: “My colleagues have children that they only fleetingly see because of work.”

Anti-austerity campaigner Ms Berry added in her message posted on You Tube: “Last week health minister Jeremy Hunt accused of of being a bunch of 9 to 5-ers which is ironic coming from someone heading off for a seven-week break.

“It may surprise the minister to learn that people don’t become critically ill exclusively within office hours

“The truth is we already have seven day working in the NHS it just this government doesn’t want to pay us for it.”

Is there a future for the NHS? Live Debate – The Guardian

Call for public debate on NHS finances post-Budget – NHS …

Medical leaders call for debate on funding NHS in England …

The PFI hospitals costing NHS £2bn every year

NHS drugs to be stamped ‘Funded by the Taxpayer’ to reduce waste

Lydia Wilgress for Mailonline reports 25th July 2015: ‘I’m in work Jeremy… are you?’: Angry doctors take to Twitter to post pictures of themselves on duty after Jeremy Hunt claimed medics weren’t doing enough weekend shifts 

August comes around again – don’t be ill this month

Dont be Ill in August & particularly on the 11/12th …. A reminder that nothing much has changed and how hard it is to make the change

Improving safety needs a “buy in” by professionals. Scapegoating and denial, and causing antagonism are not the way to treat professionals.. but they might start a war.

A new philosophy, what I believe: allow Trust Board members to use the language of rationing in media press releases

Let hospitals go bust, says watchdog – What I believe

 

 

Public services ombudsman for Wales wants more privacy power … Gag the press as well as the professionals

BBC News reports 5th May 2013:

“Wales could become the first UK nation to have an independent watchdog with the power to stop the publication of some of its reports and to prosecute those who go against its wishes.

Public Servicers Ombudsman Peter Tyndall wants more confidentially powers to protect vulnerable people.

It would mean complainants could face contempt of court charges if they go to the media.

But some warn it would mean less transparency.

Mr Tyndall has legal powers to review complaints about public services such as hospitals or councils in Wales…..”

So once this is law, the people of Wales won’t necessarily know what is going wrong! It will affect us all. The differences will have to be explained to them from outside Wales, in the same way broadcasting uses propaganda to undermine Middle Eastern despotic regimes, and inform its people of the truth! Not much chance of public confidence in stopping gagging, reducing post-code rationing, encourage commissioning for quality, and provides an immediate perverse incentive not to correct problems.

The Healthier Life

The Healthier Life say on their website “We are the web’s leading natural and alternative health resource! Our pioneering experts report the latest breakthroughs in natural medicine often years before you’ll ever hear about them in the mainstream media.”

Cure the NHS

This [Cure the NHS] site is firstly dedicated to Bella Bailey 16/02/1921 – 08/11/2007

… and also to the many others who have lost their lives needlessly on wards in Staffordshire General Hospital. We launched this campaign after witnessing 8 weeks of elderly care in this hospital. What we saw after the first few days left us fearing for my Mother’s life and too frightened to leave her. We stayed by her side sleeping on a chair for the first four days without a blanket, on the fourth night a nurse took pity and gave us one.”

NHS Institute For Innovation

The NHS Institute for Innovation was established in July 2005 to support the transformation of the NHS, through innovation, improvement and the adoption of best practice. We enable and support the NHS system to transform health and healthcare for patients through a strategy of creating inventive, clinically-led and tested practical ideas which will build skills and capability for continuous improvement.

It will be closing on 31 March, 2013 to be replaced by NHS Improving Quality.

So, in case it is not available under the new organisation we have taken a pdf copy of a report by Helen Bevan on Cost and Quality and quote a section from the report below.

“One of the most promising approaches for the future is a focus on reliability. Reliability is the capacity of the system to deliver what it should deliver without it going wrong. Reliability in a NHS context means the consistent execution of effective, evidence-based care processes across the organisation or the system. In our improvement work in the NHS, we typically see ‘defect rates’ in clinical processes averaging around 30 per cent. This means that NHS patients do not get the service they should get nearly a third of the time. NHS organisations that have been applying ‘Lean’ analysis to their clinical processes report that between 30 and 90 per cent of activities add no value to patients. Yet it is not all bad news. Across the NHS, we see an increasing number of teams using systematic redesign approaches to create lean, largely error free, processes that deliver consistent care and save money. For instance, teams that took part in a natural experiment to reduce variation in care processes achieved an average 25 per cent reduction in defect rates and an average saving of £65,000 per process.”

Note: “defect rates of 30 per cent” and “between 30 and 90 per cent of activities added no value to patients”.