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Found 499 results
  1. 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.
  2. Content Article
    This study in the Journal of Patient Safety aimed to assess the impact of a pro forma that standardises medical record-keeping on ward rounds. The pro forma was developed by analysing notes entered in patient charts and comparing them with standards set out by the Royal College of Surgeons of Ireland and England, as well as Medical Council guidelines from the two countries. The authors found that the pro forma improved compliance of ward round notes when compared with internationally recognised guidelines, with no additional time required during ward rounds.
  3. News Article
    Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
  4. News Article
    A doctor who has suffered violent shakes and hallucinations during her ongoing 15-month battle with long COVID has criticised the government's plan to "live with the virus". Dr Kelly Fearnley told Sky News she contemplated ending her own life due to the debilitating long-term effects of coronavirus, which she caught while working on a COVID ward in November 2020. The 35-year-old from Leeds, who was previously fit and healthy, initially had flu-like symptoms before she suffered shortness of breath and painful rashes over her body, as well as swelling around her eye. More than a year later, she is still unable to return to work due to the effects of long COVID, which have included violent shakes lasting up to 14 hours at a time, hallucinations, night terrors, severe pins and needles in her arms and legs, and a resting heart rate of 140 beats per minute. With Prime Minister Boris Johnson set to unveil his "living with COVID" plan on Monday, Dr Fearnley branded it a "strategy of denial, driven by the need to cut costs" and she felt "angry and let down". Read full story Source: Sky News, 20 February 2022
  5. Content Article
    Early-years, primary and secondary education services have been severely affected by the global Covid-19 pandemic. As a result, school healthcare services have also been affected in terms of accessibility and the flow of services. In this blog, Dr Ahmed Khalafalla looks at the effects of this disruption to education-based health services.
  6. News Article
    Nearly 150 doctors have been disciplined for sexual misconduct in the last five years, as surgeons call for action on the “systemic” and “cultural” problem of sexual assault within healthcare, The Independent can reveal. Doctors campaigning for the UK’s healthcare services to address widespread problems with sexual harassment and assault in medicine have warned that people do not feel safe to come forward with allegations amid deep-seated “hierarchies” within healthcare. The Royal College of Surgeons’ Women in Surgery chair has said the issues are “widespread” across the health services and improvements to protecting whistleblowers needed to be made nationally. Last year, surgeons Becky Fisher and Simon Fleming wrote an academic paper exposing the problem of sexual assault, harassment and rape in surgery and surgical training. In interviews with The Independent, both have warned the “institutional” problem goes beyond surgery and across all of the healthcare services. Mr Fleming said the figures from the GMC were the “the very tip of the iceberg” in terms of actual levels of sexual assault within healthcare. Talking about the role of the GMC, Mr Fleming said he’d been told “by more than one person” that when they’ve reached out to the GMC over sexual assault or misconduct they were “failed” by the regulator and were “either not helped, abandoned or told to deal with it locally”. Read full story Source: The Independent, 15 February 2022
  7. News Article
    Health officials have “paid lip service” to racism in the NHS for years, leading black, Asian and minority ethnic doctors have warned as they called for “concrete” action to tackle inequalities exposed by a landmark review. The damning study – the largest of its kind – had found “vast” and “widespread” inequity in every aspect of healthcare it reviewed, and warned that this was harming the health of minority ethnic patients in England. In response, an NHS spokesperson said the health service was “already taking action” to improve the experiences of patients and access to services and was working “to drive forward” the recommendations made in the report. However, Dr JS Bamrah, a consultant psychiatrist in Greater Manchester and national chairman of the British Association of Physicians of Indian Origin, said he was unsatisfied with the response. “This 166-page review … is a terrible indictment of the current state of the NHS,” he told the Guardian. “As many of us have often said and reported, we don’t need any further reports. It’s action we need, as there are scores of patients who are not getting optimal treatment, and many are being neglected. “It really isn’t good enough for NHS bosses to say that action is being taken and it’s even more disappointing to then not see any concrete proposals on dealing with glaring disparities despite all that we have learnt during the pandemic.” Dr Rajesh Mohan, presidential lead for race and equality at the Royal College of Psychiatrists, said it was “time for warm words to end” as he urged NHS leaders to “do everything they can to ensure patients from ethnic minority backgrounds get the care they need”. Read full story Source: The Guardian, 15 February 2022
  8. News Article
    Two NHS hospital trusts are working with police after a doctor was arrested on suspicion of sexual assault. Staffordshire Police has launched a major incident review of the doctor's work at hospitals in Dudley, West Midlands, and Stoke-on-Trent, The Sunday Times reported. The force said the 34-year-old man from the West Midlands was arrested in December and released on bail. It is reviewing an investigation into the same suspect it undertook in 2018. The doctor was suspended from seeing patients at the Royal Stoke University Hospital in Staffordshire when the parents of a vulnerable female raised concerns about his examination of her, the Sunday Times reported. The case was referred to police in 2018 who said there was "insufficient evidence to take further action" at the time. The Staffordshire force has now reported itself to the Independent Office for Police Conduct. University Hospitals of North Midlands NHS Trust, which runs the Royal Stoke, said it was working with police and had set up a helpline for any patient and guardian who may have concerns. Read full story Source: BBC News, 13 February 2022
  9. Content Article
    This study in Patient Education and Counseling aimed to systematically review parental perceptions of shared decision-making (SDM) in neonatology, and identify barriers and facilitators to implementing SDM. The study identified the following key barriers to SDM: Emotional crises experienced in the NICU setting Lack of medical information provided to parents to inform decision-making Inadequate communication of information Poor relationships with caregivers Lack of continuity in care Perceived power imbalances between HCPs and parents. It also identified the following key facilitators for SDM: Clear, honest and compassionate communication of medical information Caring and empathetic caregivers Continuity in care Tailored approaches that reflected parent’s desired level of involvement.
  10. Content Article
    An article* from Ehi Iden, hub topic leader, discussing the Nigerian healthcare workforce crisis.
  11. Content Article
    Medical expertise is fundamental to the practice of medicine. But other skills and knowledge are important too. Doctor Informed gives the inside story on the evidence about giving the best care and having positive relationships with patients and colleagues.
  12. Content Article
    In 2015, the ruling of the UK Supreme Court in Scotland in the case of Montgomery v Lanarkshire Health Board fundamentally changed the practice of consent. According to the Judges in this case, doctors are no longer the sole arbiter of determining what risks are material to their patients. They should not make assumptions about the information a patient might want or need but they must take reasonable steps to ensure that patients are aware of all risks that are material to them. The Royal College of Surgeons has developed guidance on consent that sets out the principles for working with patients through a process of supported decision-making, and a series of podcasts that illustrate those principles in practice.
  13. News Article
    One in four doctors in the NHS are so tired that their ability to treat patients has become impaired, according to the first survey to reveal the impact of sleep deprivation on medics during the coronavirus pandemic. Growing workloads, longer hours and widespread staff shortages are causing extreme tiredness among medics, leading to memory problems and difficulty concentrating, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, nurses, dentists and other healthcare workers. The survey of more than 500 doctors across the UK, carried out within the past month and seen by the Guardian, uncovered almost 40 near misses as a direct result of exhaustion. In at least seven cases, patients actually sustained harm. Despite encouraging signs the Omicron wave may be fading, doctors admitted the constant pressure of the past 22 months spent fighting coronavirus on the frontline was taking a toll on their technical skills and even their ability to make what should be straightforward medical decisions. Medics admitted for the first time sleep deprivation was causing real harm to patients in the NHS. Almost six in 10 doctors (59%) reported their sleep patterns had worsened during the pandemic. More than a quarter (26%) of medics admitted being so tired that their ability to treat patients was “impaired”. Of these, one in six (18%) said a patient was harmed or a near miss occurred as a result. Read full story Source: The Guardian, 17 January 2022 Read MDU press release
  14. News Article
    Over a third of doctors say they feel sleep deprived on at least a weekly basis and over a quarter have been in a position where tiredness has impacted their ability to treat patients, a new survey by the Medical Defence Union (MDU) has found. The UK's leading medical defence organisation carried out the survey among its doctor members. Of 532 respondents one in four doctors (26%) said tiredness had affected their ability to safely care for patients, including almost 40 near misses and seven cases in which a patient actually sustained harm. In addition, six in ten respondents said their sleep patterns had worsened slightly or significantly during the pandemic. Dr Matthew Lee, MDU chief executive, said: "Doctors and their healthcare colleagues are running on empty. Our members have come through a period of immense pressure caused by the pandemic and it is affecting all aspects of their life, including sleep patterns. Previous studies have shown that fatigue can increase the risk of medical error and affect doctors' health and wellbeing. In our survey, side effects doctors reported due to sleep deprivation included poor concentration (64%), decision making difficulties (40%), mood swings, (37%) and mental health problems (30%). "Taking regular breaks is vital in the interests of doctors and their patients yet in our survey, three in ten doctors got no breaks at all during the working day despite many working long shifts. In addition, 21% didn't have anywhere to go such as a staff room, or quiet area, to take a break. "Pressures on frontline healthcare workers are likely to get worse for doctors in the coming weeks. At a time of considerable staff absence in the NHS it is more important than ever that those staff who are fit to work are properly supported so they can care for patients safely." Read full story Source: MDU, 17 January 2022
  15. News Article
    Thousands of overseas-qualified doctors wanting to work in the UK will be delayed after the General Medical Council cancelled exams due to the surge in Covid cases. The regulator said its decision to pause professional and linguistic assessment board tests, scheduled for January and February, was made “in direct response” to the current omicron wave. Up to 54 doctors would have been needed each per day as examiners, it said, alongside a “large number of role players and staff”. It comes as overseas recruitment is seen by government and national officials as a crucial way to boost NHS staffing, including GPs. Director of registration Una Lane said: “We are deeply disappointed to have to cancel exams at this time, but given the pressures on the NHS and the impact on examiner availability, it was the only viable option.” Read full story (paywalled) Source: HSJ, 6 January 2022
  16. Content Article
    This article in The BMJ discusses the consequences for practising doctors of the 2015 Montgomery v Lanarkshire Case. The case was brought by Nadine Montgomery, a woman with diabetes and of small stature, after she delivered her son vaginally and experienced complications during the birth which resulted in her son having cerebal palsy. Her obstetrician had not disclosed the increased risk of this complication in vaginal delivery, despite Montgomery asking if the baby’s size was a potential problem. The Supreme Court ruling in her favour established that a patient should be told whatever they want to know, not what the doctor thinks they should be told.
  17. Content Article
    How often do we visit our doctor for guidance on our health, however, who asks after the doctor's health? When faced with life or death situations on a daily basis, that demands scrupulous attention to detail, across unsocial shift patterns; the option of ‘normal’ life seems unimaginable. In the last decade alone we have seen a rise in mental health issues for those working in healthcare. A recent study by the British Medical Association identified that almost 80% of all doctors are at high risk of burnout. An issue that used to arrive at the maturity of one's career, is now common in its nascency and is equating to growing rates of suicide. With a growing crisis around a serious issue, there is an urgent need to tackle the cultural taboos, training and opinions that are associated with mental health in our industry. 'You ok doc' is committed to not only supporting doctors' mental health through services like 'The Huddle', but also empowering doctors' wellbeing through bespoke mental and emotional health aids.
  18. Content Article
    When COVID-19 struck, many doctors helped out by willingly changing the way they worked. The BMJ hears some of their stories, including from Michael Farquhar, Paediatric sleep consultant at the Evelina London Children’s Hospital, and Alice Findlay, Retired former emergency medicine consultant at Dartford and Gravesham NHS Trust.
  19. Content Article
    Lindsey's doctor was so focused on the 52 pounds she'd gained during her third trimester, she missed a pregnancy disorder that could have killed Lindsey and her unborn child. Watch Lindsey's video where she talks about her experience and why it is important to find a doctor who respects you and who you can trust.
  20. Content Article
    This guidance document for healthcare professionals highlights language that can discourage a person with type 1 diabetes, and what kind of language can motivate them. The project produced by The Diabesties Foundation and Diabetes India, and was adopted from the Language Matters guidance produced by NHS England. The guidance is available to download in English, Hindi and Tamil.
  21. News Article
    The NHS has a backlog of 5.8 million waiting for surgery and specialists are increasingly frustrated at how the unvaccinated have left them unable to tackle it. Doctors and nurses have told of their anger and frustration at not being able to treat seriously ill patients as new figures show that more than 90% of Covid sufferers requiring the most specialist care are unvaccinated. While the success of the vaccination rollout has reduced the overall impact of COVID-19 on hospitals, intensive care clinicians from across England have spoken out over the continuing pressure they are under. Between 20% and 30% of critical care beds in England are occupied by Covid patients and three-quarters of those have not been vaccinated, according to the latest data up to July this year. Read full story (paywalled) Source: The Times, 4 December 2021
  22. News Article
    Doctors' leaders have welcomed plans to allow GPs in England to defer some services to deliver Covid booster jabs instead. Practices can postpone minor surgery and routine health checks for over-75s and new patients until 31 March. All adults in England are expected to be offered boosters by the end of January in response to the emergence of the Omicron variant. A further 75 Omicron cases were confirmed in England on Friday. On Saturday the UK reported a further 42,848 cases of coronavirus and 127 deaths within 28 days of a positive Covid test while 372,557 booster jabs were administered on Friday. Dr Farah Jameel, the GP committee chair of the British Medical Association, said the new measures would release GPs from "filling out paperwork" and chasing unnecessary and often undeliverable targets. She told BBC Radio 4's Today programme: "We have been struggling with significant prevailing workforce pressures - backlog pressures, winter pressures, pandemic pressures. "Whilst these changes make a difference and start to create some time, I think every single practice will have to look at just how much time it does release." Read full story Source: BBC News, 5 December 2021
  23. News Article
    A lack of support for general practice is indirectly putting patient lives at risk, amid escalating abuse in GP practices, the England LMCs conference has heard. A debate around abuse saw 99% of conference delegates agree that ‘the abuse of primary care staff directly affects patient care and puts patient safety at risk’. And 98% agreed that ‘when Government and [NHS England] choose not to support NHS staff, they directly affect patient safety and knowingly put lives at risk’. The conference also voted to ‘demand that healthcare policy is decided based on high-quality evidence on population health, and not the whims of a handful of vitriolic media’, with the vote unanimous on the topic. Speaking in the debate, which focussed on GP abuse and wellbeing, Dr Abel Adegoke of Wirral LMC told delegates that the NHS "runs on the blood of GPs" He said: "About four weeks ago, my younger sister was being buried and I had to watch via Zoom because that was taking place in Nigeria – yet I was still seeing patients. That was the day I felt so sad about being a GP because despite that sacrifice, I was still abused by a patient who wanted to be seen urgently for an absolutely non-urgent condition." "We are being taken for granted." Read full story Source: Pulse, 30 November 2021
  24. Content Article
    This study in the journal Rheumatology looked at the experience and views of rheumatology patients and clinicians regarding telemedicine. The Covid-19 pandemic has forced a rapid transition towards telephone consultations, but there are still many research gaps in understanding the safety and acceptability of telemedicine.
  25. Content Article
    These free e-learning courses about communicating the potential harms and benefits of treatment to patients have been produced by the Winton Centre for Risk & Evidence Communication, the Academy of Medical Royal Colleges in the UK and the Australian Commission on Safety & Quality in Healthcare.
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