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Found 498 results
  1. Content Article
    Transformative reflection is based on the idea is that people's perspectives on the world around them change when they reflect on new experiences that challenge their world view. NHS England (NHSE) says that reflection can be hugely valuable for patient care, staff morale and for doctors themselves. In this interview, Dr Alison Sheppard, a national clinical fellow who contributed a new NHSE guide on transformative reflection, talks about what transformative reflection is and how it can be helpful for doctors.
  2. Content Article
    In this BMJ article, consultant in geriatrics and acute medicine David Oliver describes his experience of being an inpatient in the hospital he works in. He talks about how his three-day admission with respiratory syncytial virus and pneumococcus has given him a better understanding of what patients experience in hospital. He describes how lack of privacy, poor quality food and noise affected him during his stay as an inpatient. He also highlights that although all staff were professional and kind, they were clearly overworked and unable to focus on more 'minor' concerns that patients have.
  3. Content Article
    In this blog, Jennifer Nelson investigates why doctors have one of the highest suicide rates of any profession. She speaks to experts including health psychologist Jodie Eckleberry-Hunt, who highlights that doctors tend to have a lower level of cognitive flexibility, which may affect their ability to cope when things don't go to plan. Psychotherapist Brad Fern goes on to describe the complex range of reasons that doctors may take their own lives, and describes the importance of tackling silence and isolation among doctors. The blog concludes by addressing the need to separate suicide from other wellbeing issues doctors might face, and by looking at how the system itself contributes to high suicide rates.
  4. News Article
    Junior doctors are to stage a four-day walkout in April in their fight to get a 35% pay rise in England. Members of the British Medical Association (BMA) will take strike action from 11 April to 15 April. Last week's walkout led to the cancellation of 175,000 treatments and appointments, with consultants brought in to provide cover in emergency care. Hospitals bosses said the fallout from the strike would last weeks given the huge number of bookings that have to be rescheduled. The new walkout of both planned and emergency care comes directly after the Easter weekend, which tends to be a busy period for the NHS. Saffron Cordery, of NHS Providers, the membership organisation for NHS trusts in England, said demand would have built up over the bank holiday weekend. "This threatens the biggest disruption from NHS walkouts so far," she said, adding: "There should be no doubt about the scale of the impact on patients, staff and the NHS." Read full story Source: BBC News, 23 April 2023
  5. Content Article
    GPs in the UK are under extreme strain and public satisfaction with general practice has plummeted. Pressures on general practice are not unique to the UK and GPs around the world are contending with the impact of the pandemic on their patients and working lives. The 2022 Commonwealth Fund survey compares perspectives from GPs across 10 high‑income countries. The survey asked GPs’ views about their working lives and wellbeing, quality of care and how services are delivered. The Health Foundation analysed the survey data to understand the experiences of GPs in the UK and how they compare to other countries.
  6. News Article
    More than 175,000 patient appointments and surgeries were postponed this week during the three-day junior doctor walk-out, it has emerged. NHS leaders have warned the strikes were the most disruptive yet with more appointments cancelled across three days than across any of the previous nurse strikes. Data published by the NHS showed in total 181,049 patients had their care postponed, this included more than 5,000 mental health and hundreds of community health appointments. The news comes after nursing and ambulance unions accepted a pay offer from the government, for a 5.3 per cent increase in 2023-24, which their members will now vote on. Read full story Source: The Independent, 18 March 2023
  7. News Article
    A woman was denied the chance to have children with her husband after a contraceptive coil was accidentally left in place for 29 years. Jayne Huddleston, from Crewe, had eight rounds of fertility treatment she did not need because the correct checks were not carried out by her doctor. She said the mistake happened in 1990. "The GP said it couldn't be seen, so I was sent for a scan and the scan didn't pick anything up, the GP recommended another coil was fitted," she told the BBC. She was told the coil she had fitted around a year earlier had probably fallen out. When she and her husband, David, then decided they wanted to have a child, the second coil was removed, but the first coil, which had gone undetected, remained inside her. They tried for years to have a baby, with no success, including IVF treatment which cost them thousands of pounds. The mistake was only discovered when she went for an X-ray in 2019 after complaining of back pain and the original coil was revealed. Mr and Mrs Huddleston were awarded a six-figure out of court settlement after taking their case to Irwin Mitchell solicitors. Read full story Source: BBC News, 16 March 2023
  8. News Article
    The disruption caused by the junior doctors' strike in England could take weeks to resolve, health bosses say. Tens of thousands of appointments and treatments, including cancer care, had to be cancelled during the three-day walkout. Patients with appointments coming up may see them cancelled to make room for high-priority cases hit by the strike. Hospitals are also reporting problems discharging patients from wards, as consultants were sent to cover A&E. Saffron Cordery, of NHS Providers, which represents NHS trusts, said the scale and length of the walkout, coupled with the fact it started on a Monday - traditionally the busiest day of the week - had made it more difficult than previous strikes by nurses and ambulance staff. "It will take weeks to recover - just rebooking patients who have treatments and appointments cancelled is a big job," she said. "Patients have to be individually prioritised - it may mean some patients with bookings in the coming weeks being pushed further back." Read full story Source: BBC News, 16 March 2023
  9. Content Article
    This practical advice and guidance from the Association of Anaesthetists aims to help anaesthetists and other healthcare staff to look after their mental wellbeing. It covers the following topics: Achieving a work/life balance Using mindfulness Managing stress Coping with death Dealing with bullying Guidelines to help anaesthetists at risk of suicide
  10. News Article
    The patient lay slumped next to a pile of pills and a personally signed note reading: 'do not resuscitate me'. His breathing was agonal, his skin mottled, his pupils fixed, no pulse discernible. The attending doctor, in agreement with both paramedics and family member, decided to respect his wishes. Yet, this GP was placed under investigation for gross negligence manslaughter by the Crown Prosecution Service (CPS) for not resuscitating the patient, setting in motion a sequence of investigations, including by the coroner and the General Medical Council (GMC), that were triggered by the statement of one policeman at the scene. All investigations and allegations were eventually dismissed but not until the GP had been through years of significant physical and mental stress. Still today, questions remain unanswered – in particular, concerning the actions of the police and the CPS. Speaking under the condition of anonymity, the GP spoke to Medscape News UK, and said that now, over 7 years after that fateful home visit, she remained resolute that she made the correct clinical decisions at the time. "It has all been very stressful for me. What was behind this case? What was driving this potential prosecution? And throughout, the patient, the family and their concerns were completely forgotten in the pursuit of so-called justice," she pointed out. Read full story Source: Medscape News, 9 March 2023
  11. News Article
    Ministers and NHS England have not sufficiently warned the public of the risk to patient harm posed by next week’s junior doctors strike, some of the NHS’s most senior trust chief executives have warned. The senior leaders contacted HSJ with their concerns after a group call between trust leaders and NHSE bosses on Thursday. The chief executives and medical directors, who spoke to HSJ on condition of anonymity, made a series of robust criticisms which focussed on the lack of awareness of danger presented by the junior doctor’s industrial action, a lack of thorough communication of that to the public, and the insistence that trusts negotiate strike agreement with the British Medical Association at a local level. One comment on the chat function stated: ”Public awareness of the impact of this strike seems far lower than for e.g. the ambulance strike, but from a an acute trust perspective this will have a much bigger impact on patient care and safety. Junior doctors’ are not newly qualified students - they are the backbone of day to day medical management in our services. I am concerned we might be giving false assurance about the quality of service we can offer next week.” Read full story (paywalled) Source: HSJ, 10 March 2023
  12. News Article
    In posts on two Facebook forums, GP Survival and Resilient GP, family doctors write anonymously, revealing their concerns about how hard they sometimes find it to get an ambulance to attend to a sick patient – and the risks that can pose. “I ended up in the back of a police car with sirens going with a stranger who’d had a probable stroke on the street. Category 2 ambulance hadn’t come after 45 minutes so flagged down a cop car. They bundled us in. “Emergency department full of waiting ambulances unable to unload and I eventually left him in the very capable hands of the stroke team. Terrifying how broken our system is and how many people had likely just walked past him before I spotted him from my car." “Our emergency care practitioner called an ambulance at 6pm on Wednesday 6 July. Very elderly gentleman. Off legs, urinary symptoms, not eating/drinking. Guess when crew arrived? This morning, Friday 8 July, around 10am – 40 hours [later]. And the ECP had to wait 35 minutes just for 999 call to be answered!” “I recently complained [to the local ambulance service] for first time ever when ambulance refused to take a very sick patient of mine into hospital that I’d assessed over the phone because ‘her obs are normal’. They weren’t but even if they had been the reliance on these alone, ignoring the medical background, the family history and my history was just wrong. “I then had to go out and see her, re-call 999 (with many hours additional delay) and she died after a few days in hospital.” Read full story Source: The Guardian, 9 March 2023
  13. News Article
    More than three years into the Covid pandemic, there are a host of important unanswered questions about Long Covid, which significantly limit healthcare providers’ ability to treat patients with the condition, according to US physicians and scientists. That vacuum of information remains as much of the US has moved on from the pandemic, while Covid long-haulers continue to face stigma and questions over whether their symptoms are real, providers say. “We don’t quite have our finger on the pulse of what’s wrong, what biologically is causing it, and that’s a big problem,” said Dr Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center. “It’s hard to direct drugs or treatments without having the biological underpinnings for why someone is feeling so fatigued with exercise.” In addition to the ambiguity around the root causes of Long Covid, there are also challenges in research because of how Covid can produce so many different symptoms. The Centers for Disease Control and Prevention list includes fatigue, respiratory issues and difficulty thinking or concentrating but also states that “post-Covid conditions may not affect everyone the same way”. “Everyone has a different constellation of symptoms,” said Dr Steven Deeks, an infectious disease specialist at the University of California, San Francisco. “Some people get better over time, some people wax and wane, some people get worse,” and so it is difficult for researchers to determine when a study should end and compare a drug versus a placebo. Read full story Source: The Guardian, 6 March 2023
  14. Content Article
    Patients with Long Covid—defined by the National Institute for Health and Care Excellence (NICE) as signs and symptoms that persist for more than four weeks following acute Covid-19—may present in primary care with symptoms of palpitations (tachycardia) triggered by standing or minimal exertion. These may be accompanied by dizziness, breathlessness, chest pain, sweating, bloating, fatigue and other symptoms which may be caused by a dysfunction of the autonomic nervous system (dysautonomia). This practice pointer in the BMJ outlines: how tachycardia present in patients with Long Covid. what clinical assessment should involve. how to test for postural orthostatic tachycardia syndrome in primary care. drug and non-drug treatments that are available. what patients can do for themselves. when patients should be referred to a specialist.
  15. News Article
    A consultant has said that doctors were put under pressure by hospital management not to make a fuss when they raised concerns about nurse Lucy Letby. Dr Ravi Jayaram said his team first raised concerns about unusual episodes involving babies in October 2015 but nothing was done Ms Letby, 33, is accused of murdering seven babies and attempting to murder 10 others at the Countess of Chester Hospital between 2015 and 2016. He told the court the matter was raised again in February 2016 and the hospital's medical director was told at this point. The consultants asked for a meeting but did not hear back for another three months, the court heard. Ms Letby was not removed from front-line nursing until summer 2016. Dr Jayaram told jurors that he wished he had bypassed hospital management and gone to the police. He said: "We were getting a reasonable amount of pressure from senior management at the hospital not to make a fuss." Read full story Source: BBC News, 28 February 2023
  16. Content Article
    This guide by the National Patient Safety Agency offers guidance for junior doctors on what to do if they are involved in a patient safety incident. It includes case studies on: medication error competence communication patient identification reporting It also includes guidance on how to deal with a complaint.
  17. Content Article
    This presentation on fatigue and shift work is used as an induction session for doctors in training. It covers: Why are we talking about fatigue? What do you need to know? What can we do about fatigue? Improving sleep habits Working well at night How long to nap for Recovery after night shifts Driving tired Rest facilities Individual and organisational responsibilities and standards
  18. News Article
    Record levels of NHS staff are seeking mental health help as clinicians warn the “crisis” facing workers is “worse than the pandemic”. Hundreds of staff are being referred to the specialist mental health service, NHS Practitioner Health, with 842 workers referred in October 2022 – up from 534 in the same month the year before and 371 in 2020. Around 40% of the staff seeking the service are GPs and 50% are hospital doctors. The news comes as The Independent reported that the NHS and government are set to axe funding for 40 mental health hubs set up for health and social care workers following the pandemic. Amandip Sidhu, of Doctors in Distress, which offers workers mental health support, said: “Health workers believe that the crisis they are currently dealing with is worse than during the pandemic and exacerbated by the fact there is no end in sight, with little evidence that decision-makers are taking steps to improve the situation. “The fact that the public, their patients, lack sympathy or understanding is making many medics feel isolated and completely unappreciated.” Read full story Source: The Independent, 23 February 2023
  19. News Article
    A trust has admitted it ‘missed opportunities’ to identify that a locum doctor – who was arrested on hospital premises for two sexual offences — had already been cautioned for indecent exposure. Salman Siddiqi admitted two offences – attempting to engage in sexual communication with a child and attempting to arrange or facilitate a meeting with a child for sexual offences – last month. East Kent Hospitals University Foundation Trust, where he was working as a locum paediatric registrar at the time of the January offences, has now said there had been “missed opportunities” to identify his previous caution. Chief medical officer Rebecca Martin told HSJ the trust had taken steps to ensure that these missed opportunities could not happen again. She said in a statement: “This includes standardising DBS checks for temporary workers booked through an agency and escalating all DBS and General Medical Council checks that feature conditions, cautions or warnings.” Read full story (paywalled) Source: HSJ, 23 February 2023
  20. News Article
    Hundreds of thousands of operations and medical appointments will be cancelled in England next month and progress in tackling the huge care backlog will be derailed as the NHS prepares to face the most widespread industrial action in its history. Junior doctors are poised to join nurses and ambulance workers in mass continuous walkouts in March after members of the British Medical Association (BMA) voted overwhelmingly to take industrial action. In only the second such action in the 74-year-history of the NHS, junior doctors will walk out for 72 hours – continuously across three days, on dates yet to be confirmed – after 98% of those who voted favoured strike action. Amid an increasingly bitter row between health unions and the government, NHS leaders expressed alarm at the enormous disruption now expected next month. Read full story Source: The Guardian, 20 February 2023
  21. Content Article
    The Covid-19 pandemic has thrown a spotlight on the treatment of NHS staff and their perceived value to their employers.  An estimated two million people in the UK have Long Covid, including many thousands of NHS workers, so why do we hear so little about it? In this BMJ article, a doctor in the NHS who has Long Covid explains why he is disappointed by the collective silence and the lack of protections and support mechanisms in place.
  22. Content Article
    Dr Freya Smith, a Specialty Trainee in General Practice, reflects on the sinister and toxic side of medicine, using the recent Paterson and vaginal mesh scandals to demonstrate how patients have been let down by the system. In an honest and personal account, she shares with us the horror and sadness she felt at learning of these scandals and how she aspires to keep her future patients safe.
  23. Content Article
    Twenty-six doctors were referred to the General Medical Council by a single hospital trust - no further action taken. BBC Newsnight investigated.
  24. News Article
    Two health watchdogs have issued safety warnings after junior staff were left to work unsupervised on maternity wards previously criticised after a baby’s death. Training regulator, Health Education England (HEE), criticised the “unacceptable” behaviour of consultants who left junior doctors to work without any superiors at South Devon and Torbay Hospital Foundation Trust’s wards. The maternity safety watchdog Healthcare Safety Investigation Branch (HSIB) also raised “urgent concerns” over student midwives and “unregistered midwives” providing care without supervision. The latest criticism comes after the trust was condemned over the death of Arabella Sparkes, who lived just 17 days in May 2020 after she was starved of oxygen. According to a report from December 2022, seen by The Independent, the HEE was forced to review how trainees were working at the trust’s maternity department after concerns were raised to the regulator. It was the second visit carried out following concerns about the department, and reviewers found there had been “slow progress” against concerns raised a year earlier. Read full story Source: The Independent, 16 February 2023
  25. News Article
    The number of GPs seeing patients outside standard surgery hours in Scotland has dropped by almost a quarter in three years. Nurses and paramedics have had to fill in for doctors in the out-of-hours urgent care centres because GPs could not be found to cover the shifts. Some health boards have had to close their centres and send patients to overstretched A&Es instead because of the GP shortage. Dr Andrew Buist, chairman of the British Medical Association’s Scottish GP committee, said, “Patient demand is outstripping GP capacity across the whole service, including out-of-hours. We simply do not have enough GPs in Scotland. Those who are working in out-of-hours may be doing more hours now than they perhaps did in 2019 which comes as no surprise if there are fewer GPs to go around but it is unsustainable and puts those working in the service at risk of exhaustion and burnout.” Read full story (paywalled) Source: The Times, 15 February 2023
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