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Found 498 results
  1. News Article
    Leading doctors say they have concerns about the NHS reducing mentions of the word "women" in ovarian cancer guidance. They say "it may cause confusion" and create barriers to care. But NHS Digital, which writes the online advice, said they wanted to make it relevant for everyone who needs it. The updated guidance now says that people with ovaries, such as trans men, can also be affected. Until February, the NHS guidance began by explaining ovarian cancer was "one of the most common types of cancer for women". Now, the only specific mention of women comes on the third page with the explanation that ovarian cancer can affect "women, trans men, non-binary people and intersex people with ovaries". NHS Digital said the changes were introduced to make the advice more relevant and inclusive. The Royal College of Obstetricians and Gynaecologists, which represents thousands of women's health specialists and pregnancy doctors, said the language used "does need to be appropriate, inclusive and sensitive to the needs of individuals whose gender identity does not align with the sex they were assigned at birth". But it added: "Limiting the term 'woman' to one mention may cause confusion and create further barriers for some women and people trying to make an informed choice about their care. "We would therefore support the use of the word 'woman' alongside inclusive language." Read full story Source: BBC News, 8 June 2022
  2. Content Article
    BMJ opinion piece from BMJ Chair Richard Smith.
  3. News Article
    Regulators have raised serious concerns over trainee doctors within the maternity department at one of the largest trusts in the country. The NHS’ training regulator said it had concerns over the treatment of trainee doctors within the obstetric and gynaecology department at University Hospitals Birmingham Foundation Trust, while some medics report being in ‘meltdown’. Reviewers raised an incident where a consultant had refused to respond to an obstetric emergency in A&E which had been requested by a junior doctor. “The panel unanimously agreed that Consultant presence was required without delay,” the report added. The latest review follows concerns in November 2020 and June 2021 when patient safety issues were also identified. It warned there was a “real risk” trainees would soon become “hesitant and reluctant” to call for consultant support when need. Read full story Source: The Independent, 5 June 2022
  4. News Article
    A retired consultant gastroenterologist has been struck off the UK medical register for “wide ranging failings” in treating young transgender patients and in prescribing testosterone for men. Michael Webberley, who was charged with failing to provide good care to 24 patients, acted outside the limits of his expertise, a medical practitioners tribunal concluded. Through the private online clinic GenderGP, which he ran with his wife Helen, a GP, Webberley prescribed puberty blockers to a child of nine and cross sex hormones to a teenager who died by suicide a few months later. He faced charges over his care of seven transgender patients, and the tribunal found that he had provided treatment that was not clinically indicated or that had been prescribed without adequate tests, assessments, or examinations. Read full story (paywalled) Source: BMJ, 30 May 2022
  5. Content Article
    Clinicians play an essential role in implementing infection prevention policy, but little is known about how infection control policy is implemented at an organisational level or what factors influence this process. This study explores the policy implementation process used in the introduction of a national large-scale, government-directed infection prevention policy in Australia.
  6. Content Article
    In this article for The BMJ, Matthew Limb looks at the findings of the British Medical Association's (BMA's) review of the UK's management of the pandemic. The review found that many doctors had traumatic experiences during the pandemic, and highlights the following areas where the government could have better supported doctors: Preparedness including chronic underfunding of the NHS Personal protective equipment (PPE) shortages Inadequate infection prevention and control guidance Testing failures Lack of risk assessment and failure to protect vulnerable staff Deaths Long Covid Exhaustion Mental health and emotional wellbeing Anxiety and moral injury Isolation Lack of support Career prospects The review did also highlight the vaccination campaign and rollout as a notable success in the government's response to the pandemic.
  7. Content Article
    This opinion piece in The BMJ looks at the importance of doctors being honest in all settings. Daniel Sokol, medical ethicist and barrister, uses the behaviour of the character Adam in the BBC series 'This is Going to Hurt' to look at why it is so important that doctors are honest. In one episode, Adam pretends not to be a doctor in order to avoid intervening when someone needs medical attention in the community. Daniel discusses the ethical and legal issues associated with this kind of behaviour, highlighting that it could lead to suspension or removal from the GMC register. He discusses how dishonesty undermines public trust, and the fact that dishonesty in any area of life can have professional consequences for doctors.
  8. Content Article
    Doctors are unhappy. They are not all unhappy all the time, but when doctors gather, their conversation turns to misery and talk of early retirement. The unhappiness has been illustrated in a plethora of surveys and manifests itself in talk of a mass resignation by general practitioners from the NHS. The British government is rattled by the unhappiness of doctors, recognising that a health service staffed by demoralised doctors cannot flourish. It has responded by trying to hand more control of the service to frontline staff. But is this the right treatment, asks the BMJ's Editor Richard Smith.
  9. Content Article
    This US study in BMJ Quality & Safety aimed to assess whether limiting the hours worked by first-year resident doctors' had an impact on patient safety. In 2011, The Accreditation Council for Graduate Medical Education (ACGME) enacted a policy that restricted first-year resident doctors in the USA to working no more than 16 consecutive hours. This policy was rescinded in 2017, and this study assessed the impact of the policy change by comparing the number of medical errors reported by first-year doctors in the five years before the ACGME was enacted (2002/2007) and in the three years following its implementation. The authors found that the 2011 work-hour policy was associated with a: 32% reduced risk of resident physician-reported significant medical errors 34% reduced risk of reported preventable adverse events 63% reduced risk of reported medical errors resulting in patient death They conclude that rescinding the policy in 2017 may be exposing patients to preventable harm.
  10. Event
    until
    This Masterclass is aimed at consultants and will be led by Dr Marcy Rosenbaum, Professor of Family Medicine and Faculty Development Consultant, Office of Consultation and Research in Medical Education, University of Iowa. Marcy is an expert in the skills that make difficult healthcare conversations easier, has published widely on the topic and is world renowned in training clinicians to use these skills effectively. The Masterclass will involve skills rehearsal with simulated patients and families. It provides consultants with an opportunity to refresh their expertise an to learn about the specific skills being taught to their trainees and NCHSs in the Human Factors in Patient Safety programmes. Register for the Masterclass
  11. News Article
    New responsibilities for doctors regarding their use of social media and tackling toxic workplace behaviours and sexual harassment are among key proposals in the General Medical Council’s (GMC) planned update to its core ethical guidance. The regulator has launched a 12-week consultation on the draft new content of 'Good medical practice', which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. This represents the first major update of the guidance since it first came into effect in April 2013, with the review process launched last year. The GMC said the draft new update follows months of working with doctor, employer, and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces. Included for the first time in the draft new guidance is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment, or discrimination, as well as zero tolerance of sexual harassment. For the first time, the GMC's ethical guidance proposes 12 commitments, including: Make the care of patients my first concern. Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive, and fair. Provide a good standard of practice and care, and be honest and open when things go wrong. Ensure my conduct justifies my patients’ trust in me and the public's trust in my profession. Read full story Source: Medscape, 27 April 2022
  12. Content Article
    Nearly half of all adults and approximately 8% of children (aged 5-17) worldwide have a chronic condition. Yet, studies have consistently shown that adherence to medication is poor; estimates range from under 80% to under 50%, with an average of 50%. There could be a considerable improvement in health outcomes (and consequently longevity), not only by developing new drugs, but by helping people adhere to existing treatment regimens that have already been researched, tested and prescribed for them. But adherence isn’t usually prioritised by governments, health providers or healthcare professionals (HCPs). Adherence isn’t measured at a national level for any disease, apart from in Sweden where hypertension is recorded. And as governments don’t prioritise adherence, health providers aren’t measured or incentivised for improving it, meaning HCPs may not have the time and resources (or reminders) to focus on it during consultations.  This report from the International Longevity Centre-UK (ILC) makes a series of recommendations.
  13. News Article
    In an unprecedented murder case in the United States about end-of-life care, a physician accused of killing 14 critically ill patients with opioid overdoses in a Columbus, Ohio hospital ICU over a period of 4 years was found not guilty by a jury Wednesday. The jury, after a 7-week trial featuring more than 50 witnesses in the Franklin County Court of Common Pleas, declared William Huse not guilty on 14 counts of murder and attempted murder. In a news conference after the verdict was announced, lead defense attorney Jose Baez said Husel, whom he called a "great doctor," hopes to practice medicine again in the future. The verdict, he argued, offers an encouraging sign that physicians and other providers won't face prosecution for providing "comfort care" to patients suffering pain. "They don't need to be looking over their shoulders worrying about whether they'll get charged with crimes," he said. The trial raised the specific issue of what constitutes a medically justifiable dose of opioid painkillers during the end-of-life procedure known as palliative extubation, in which critically ill patients are withdrawn from the ventilator when they are expected to die. Under medicine's so-called double-effect principle, physicians must weigh the benefits and risks of ordering potentially lethal doses of painkillers and sedatives to provide comfort care for critically ill patients. To many observers, however, the case really centered on the largely hidden debate over whether it's acceptable to hasten the deaths of dying patients who haven't chosen that path. That's called euthanasia, which is illegal in the United States. In contrast, 10 states plus the District of Columbia allow physicians to prescribe lethal drugs to terminally ill, mentally competent adults who can self-administer them. That's called medical aid in dying, or physician-assisted dying or suicide. Read full story Source: Medscape, 27 April 2022
  14. Content Article
    The first wave of the pandemic necessitated a large scale shift to greater digital engagement with patients, yet progress has not been uniform. While virtual consultations have become increasingly commonplace, communication outside of those appointments is still often analogue and generally sporadic. Cancelling an appointment – or indicating in advance that a specific day or time doesn’t work – remains a complicated, non-digital experience for many patients. With millions now on waiting lists for treatment, and a significant minority having already waited two years, this sort of communication gap becomes more challenging. As such there are arguments that it’s now time for the digital acceleration seen during the pandemic to extend to this area too.
  15. Content Article
    Dr Katherine Henderson is a senior A&E consultant in London and the president of the Royal College of Emergency Medicine. In this article for The Guardian, she describes the deep crisis facing urgent and emergency care in the UK. She describes hospital warnings of dangerous delays that have seen vulnerable patients waiting hours to be seen and admitted to hospital. This is dangerous, frustrating and undignified for patients, but also distressing for staff, who are finding themselves unable to offer the quality of care they want to deliver. Dr Henderson attributes the issues to shortfalls in healthcare staff and hospital beds, but also a lack of capacity in community care that is delaying patients being discharged from hospital. The situation is exacerbated by staff absence due to Covid-19. To tackle the crisis, she calls for clear plan to increase bed capacity and a robust, fully funded long-term workforce plan.
  16. Content Article
    In August 2021, University Hospitals North Midlands Trust (UHNM) commissioned brap and Roger Kline to conduct a review of bullying and harassing behaviours across the Trust. The purpose of the review was to understand: the nature of bullying/harassment within the Trust (what types of behaviour are staff being subject to?) the basis of bullying/harassment (is poor treatment linked to people’s protected characteristics or other aspects of identity (such as language spoken) the scope of bullying behaviour (how frequently are staff subject to bullying behaviours and are they concentrated in particular sites, job roles, or bands? Are staff subject to bullying from patients/visitors or primarily from colleagues?) the response to any unprofessional behaviours (do people feel confident reporting or challenging poor behaviour? If not, why?) the conditions that allow bullying behaviours to continue (what aspects of organisational culture may be contributing to the persistence of bullying? Are stress, workloads, or poor management practice roots causes?) The review was prompted by anecdotal claims of inappropriate behaviour within some parts of the Trust. (The Trust has a range of mechanisms to monitor levels of bullying and harassment, including national and local surveys, reports from the Freedom to Speak Up Guardians, Dignity at Work reports, and staff listening events.) In addition, a survey conducted by BAPIO/LNC raised concerns about the treatment of doctors and how this intersected with issues around race. As such, this review sought to explore whether the treatment of Black and minority ethnic (BME) people was different to that of White British staff. 
  17. News Article
    Doctors at an acute trust believe their clinical leaders have failed to tackle the ‘big personalities’ accused of being aggressive bullies, a review has found. The probe at University Hospitals of North Midlands Trust was prompted by a survey carried out last year by the British Associations of Physicians of Indian Origin, after concerns were raised by its members. The review was undertaken by Birmingham-based equalities charity Brap, and Roger Kline, a research fellow at Middlesex University Business School. It found the trust was not an outlier in statistical measures of bullying and harassment, but suggested the situation was still worse than leaders would wish. They said: “The most common reason people cited for bullying/harassment they experienced was the personality, attitude, and disposition of their managers and colleagues… it is felt senior clinical leaders have, in the past, failed to tackle these ‘big personalities’. “It is worth noting feedback from interviews suggesting many doctors feel they have endured poor behaviour – talking over people during meetings, criticising work in public, aggressive questioning – for years, and have simply become inured to it. The reviewers found that as a consequence, certain people within the organisation were perceived to be “bullet proof”, and added: “We would suggest the trust needs a big, long-term plan to ‘rehumanise’ the organisation. “The trust’s existing culture has permitted, and continues to permit infringements in behaviour… While this is not condoned by senior leaders in the trust, the lack of a plan to proactively tackle a legacy of overlooking poor behaviours has allowed them to persist.” Read full story (paywalled) Source: HSJ, 6 April 2022
  18. News Article
    Doctors too often "ignore" women's pain, Sajid Javid said as he called for change in the wake of the Shrewsbury maternity scandal. Writing for The Telegraph, the Health Secretary said the wider NHS needed to do much more to listen to women, adding that too many are left in pain and ignored by clinicians. On Wednesday, the Ockenden report revealed that the deaths of 201 babies and nine mothers at Shrewsbury and Telford NHS Trust could have been avoided, citing a failure to listen to women. Mr Javid wrote: "This week we have seen the tragic reality of what can happen when women's voices are not listened to when it comes to their care. "Donna Ockenden's report into maternity failings at Shrewsbury and Telford Hospitals raises specific concerns for maternity services, but more widely we must address issues across the whole of the health and care system when it comes to listening to women's concerns and recognising their pain." In the joint piece with Maria Caulfield, the minister for women’s health, Mr Javid welcomed a "shift in the way we talk about women's health", with more open discussions about areas once seen as taboo. But the pair said more needed to be done – specifically to improve the treatment of endometriosis, an extremely painful gynaecological condition. "We must ensure all women feel confident in going to their GP when they experience symptoms of endometriosis and, when they do, that they are listened to," they said. Too many were "spending too long in pain waiting for a diagnosis, often feeling ignored by clinicians", they warned. Later this year the Government will publish a women's health strategy, which will examine issues including fertility, menopause, and prevention and treatment of diseases. Read full story (paywalled) Source: The Telegraph, 31 March 2022
  19. News Article
    A doctor's bid to be voluntarily removed from the medical register on health grounds has been rejected. It means Dr Heather Steen, who is accused of failings following the death of Claire Roberts in 1996, will still face a fitness to practice tribunal. The tribunal would have been halted if she had been removed from the register, as she would no longer have been a doctor. Claire Roberts died at the Royal Belfast Hospital for Sick Children, where Dr Steen worked, in October 1996. The nine-year-old's death was examined as part of the hyponatraemia inquiry. Her father Alan said his family welcomed the decision to refuse the paediatrician's application. He said the tribunal hearing was "in the public interest" and should proceed "to maintain public confidence in the medical profession, the regulatory process and to ensure that professional standards are upheld". Read full story Source: BBC News, 28 March 2022
  20. Content Article
    Healthcare professionals have a duty to be open and honest with patients and people in their care when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress. This is know as the professional duty of candour. This joint guidance from the General Medical Council and Nursing & Midwifery Council provides detailed guidance for healthcare professionals on: being open and honest with patients in your care, and those close to them, when things go wrong. encouraging a learning culture by reporting errors.
  21. News Article
    A Derby doctor who has been the subject of eight tribunals in less than nine years has been sanctioned for a further four months. Dr Anatta Nergui was originally found guilty of misconduct in 2014 and has been found to have not fully reflected on the severity of his offending in six different hearings since. The psychiatrist was suspended by the Medical Practitioner Tribunal Service (MPTS) in 2014 for running a website and blog which offered incorrect medical advice to those who got in contact with him. In 20 of 22 cases, he was found to have failed to recommend that the patient saw a doctor or psychiatrist, and failed to recommend a counselling or psychotherapy course in 30 cases, among other complaints, which put patients at "significant risk of harm". The latest tribunal aimed at assessing his fitness to practice, held in March 2022, has imposed a further four months of conditions on him, after the MPTS found that "despite there being a low risk of repetition, the remediation had not yet been completed", according to the chair of the tribunal, Jetinder Shergill. In the MPTS determination, released on Thursday (March 17), Mr Shergill said: "While the tribunal was satisfied that there is sufficient evidence Dr Nergui is a competent and safe doctor, there remains a lingering concern that he did not appreciate the findings made against him from the patient’s perspective and/or did not express this in a clear, cogent manner. The tribunal considered that Dr Nergui might have benefitted from seeking feedback from a trusted colleague or mentor, reflecting on what went wrong and setting out his thought processes on avoiding similar risk. "In short, the self-reflection has led Dr Nergui down a restricted path of understanding, leading him to focus on the legal aspects of the process and semantics rather than the primary issue which was one of patient safety. If he had sought the input of a third party, it may have led to him developing an alternative view rather than the binary approach that he has adopted. This left the tribunal with the view that whilst there has been some insight, remediation is not yet complete." Read full story Source: Derbyshire Live, 18 March 2022
  22. News Article
    A paediatrician who was at the centre of one of Northern Ireland's longest running public inquiries will appear before a professional misconduct panel. Dr Heather Steen is accused of several failings following the death of Claire Roberts at the Royal Belfast Hospital for Sick Children in October 1996. The nine-year-old's death was examined by the hyponatraemia inquiry, which lasted 14 years. It examined the role of several doctors. Among his findings, the inquiry's chairman Mr Justice O'Hara said there had been a "cover-up" to "avoid scrutiny." Monday's tribunal will inquire into allegations that, between 23 October 1996 and 4 May 2006, Dr Steen "knowingly and dishonestly carried out several actions to conceal the true circumstances" of the child's death. Also that the doctor provided inappropriate, incomplete and inaccurate information to the child's parents and GP regarding the treatment, diagnosis, clinical management and cause of her death. The tribunal website adds: "It is also alleged that Dr Steen inappropriately recommended a brain-only post-mortem for Patient A (Claire Roberts) when a full post-mortem was necessary. "In addition, it is alleged that Dr Steen failed to refer Patient A's death to the coroner, inappropriately completed the medical certificate of cause of death and inaccurately completed the autopsy request form for Patient A. "Furthermore, it is alleged that during a review of Patient A's notes, Dr Steen failed to consult with the necessary colleagues and medical teams and provided a statement and gave evidence to the coroner's inquest into Patient A's death which omitted key information." Read full story Source: BBC News, 21 March 2022
  23. Content Article
    “Hi, I’m the doctor. First I need to apologise for how long you’ve been waiting.” An apology is now the default way I introduce myself to patients in the busy emergency department where I work, writes an emergency medicine consultant in an article for the Independent newspaper. An apology for the shortage of beds, an apology for the shortage of staff and most importantly for the person in front of him, an apology for how long they’ve waited, in pain and distress, to be seen.
  24. Content Article
    People like being treated well. A civil approach to relationships in the healthcare workplace – any workplace – has merit, but there are many questions to explore. While most doctors interact with others in a civil manner most of the time, anyone can experience lapses occasionally. When the many dimensions of civility are considered more closely, it appears that there is much that can be learned about the causes of incivility and the strategies that can be adopted to foster civil behaviour, even at times of risk. Physician Health Programme offers a series of articles below as Five Fundamentals of Civility for Physicians.
  25. Content Article
    Employers have a duty of care to support doctors when they are faced with an abusive patient or their guardians/relatives. This guidance from the British Medical Association (BMA) gives background information and steps that all employers and healthcare workers should take when discrimination against a healthcare worker occurs.
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