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Found 496 results
  1. News Article
    Thousands of doctors feel under pressure from their employers to work extra shifts, often unpaid, to help tackle the backlog of care caused by the covid pandemic, the BMA has warned. The warning came after results from the BMA’s latest tracker survey showed that more than half its respondents (58%, 2834 of 4876) had worked extra hours in the previous month as part of the response to the pandemic. Almost a third (29%, 1387) said they were not paid for the additional time they worked. More than two fifths (44%) of respondents (2086 of 4719) said they felt under pressure from their employer to do extra hours in the last month. And more than a third (36%, 1759) had either skipped taking full breaks altogether or taken them on rare occasions in the past fortnight. Nearly six in 10 doctors who responded (57%, 2889 of 5059) reported a higher than normal level of fatigue or exhaustion because of working or studying during the pandemic. Chaand Nagpaul, the BMA’s chair of council, said, “To learn that an already depleted and now exhausted workforce feels forced into doing more and more hours, with many reporting higher levels of fatigue than ever, is extremely worrying. It is putting them and their patients at risk. Working ‘flat out’ without a change to rest and recuperate is simply unsustainable and unsafe." Read full story Source: BMJ, 10 May 2021
  2. News Article
    Ten junior doctors have been removed from a struggling hospital over concerns they were being left without adequate supervision on understaffed wards. Health Education England (HEE) removed the 10 foundation year one doctors, all on a general medicine rota, from Weston General Hospital last month. The General Medical Council said the trust’s previous efforts to address the issues “have not been sufficient or sustainable”. University Hospitals Bristol and Weston Foundation Trust did not say which services HEE had removed the juniors from or what mitigations had been put in place. However, the trust told HSJ none of the positions concerned were from the hospital’s emergency department, where the GMC has already imposed conditions on juniors’ training. HEE very rarely uses its power to withdraw trusts’ trainees. HSJ reported last June the regulator had only removed two posts at trusts under enhanced monitoring since the start of 2019. William Oldfield, University Hospitals Bristol and Weston FT medical director, said in a statement to HSJ: “We recognise the seriousness of the step taken by HEE to temporarily suspend the training programme for a small number of junior doctors at Weston General Hospital. ”We are working to provide the assurance HEE require to allow this training to recommence, and in the meantime we have appropriately mitigated the impact on services at Weston.” Read full story (paywalled) Source: HSJ, 10 May 2021
  3. News Article
    Thousands of UK doctors are planning to quit the NHS after the Covid pandemic because they are exhausted by their workloads and worried about their mental health, a survey has revealed. Almost one in three may retire early while a quarter are considering taking a career break and a fifth are weighing up quitting the health service to do something else. Long hours, high demand for care, the impact of the pandemic and unpleasant working environments are taking their toll on medics, the British Medical Association findings show. Dr Chaand Nagpaul, the leader of the BMA, said the high numbers of disillusioned doctors could worsen the NHS’s staffing problems and leave patients waiting longer for treatment. “It’s deeply worrying that more and more doctors are considering leaving the NHS because of the pressures of the pandemic – talented, experienced professionals who the NHS needs more than ever to pull this country out of a once-in-a-generation health crisis,” Nagpaul said. Read full story Source: The Guardian, 2 May 2021
  4. News Article
    Almost 20% of patients seen by neurology consultant Dr Michael Watt were given a wrong diagnosis, a report has found. A review of 927 of Dr Watt's high-risk patients found 181 people received a diagnosis described as "not secure", Health Minister Robin Swann said. He was speaking as the Belfast Trust announced the recall of a further 209 neurology patients seen and discharged by Dr Watt between 1996 and 2012. This is the third such recall. Dr Watt was at the centre of Northern Ireland's biggest patient recall linked to his work at Belfast's Royal Victoria Hospital. Mr Swann said he had met patients and families affected by the recall in October last year. "While this report is statistical in nature, it deals with individuals, their families and their experiences," he said. "I know that many will have had their confidence in our health service shaken and I remain committed to helping restore it." Read full story Source: BBC News, 20 April 2021
  5. News Article
    Nearly 90% of organisations representing doctors agree that the UK should have a mandatory and public register of doctors’ interests, a survey by The BMJ has found. Last year the Independent Medicines and Medical Devices Safety Review, chaired by Julia Cumberlege, called for the General Medical Council (GMC) to expand its register to include a list of financial and non-pecuniary interests for all doctors. That review investigated harmful side effects caused by the hormone pregnancy test Primodos, the anti-epileptic drug sodium valproate, and surgical mesh. One of its key conclusions was that patients had a right to know if their doctor had financial or other links with pharmaceutical or medical device companies. The BMJ wrote to six faculties, 14 royal medical colleges, and the Academy of Medical Royal Colleges about such a register. It received responses from two faculties, 12 colleges, and the academy, a 71% response rate. Of the organisations that responded, 13 (87%) agreed that there should be a mandatory and public register of doctors’ interests in the UK. Read full story Source: BMJ. 8 April 2021
  6. News Article
    Doctors in pain management have raised concerns about the National Institute of Health and Care Excellence’s guidance on treating chronic primary pain, which they said do not reflect clinical practice or current evidence. Patients could be left in “despair,” said the British Pain Society, because of the recommendation that the only drugs that doctors should prescribe are certain antidepressants. Commonly prescribed drugs, including paracetamol, non-steroidal anti-inflammatory drugs, benzodiazepines, and opioids, should not be used to treat chronic primary pain, said NICE. Instead patients should be offered exercise programmes, therapy, and acupuncture. Read full story (paywalled) Source: BMJ, 9 April 2021
  7. News Article
    Many doctors from black, Asian and minority ethnic backgrounds say key risk assessments have still not taken place, or have not been acted on. About 40% of UK doctors in the UK are from BAME backgrounds, yet 95% of the medics who have died from coronavirus were from minority backgrounds. The NHS said last June that its trusts should offer risk assessments to staff, but hundreds told a poll for BBC News that they were still awaiting assessments or action. Of 2,000 doctors who responded, 328 said their risks hadn't been assessed at all, while 519 said they had had a risk assessment but no action had been taken. Another 658 said some action had been taken, with just 383 reporting their risks had been considered in detail and action put into place to mitigate them. One of those who responded was Dr Temi Olonisakin, a junior doctor in London who has Type 1 diabetes. She had her risk assessment early on in the pandemic. "It was as comprehensive as a side A4 paper can be," she says. "I think for a lot of people it felt more like a tick-box exercise, and one that could be used to say: 'We've done what we need to do to make people feel safe' - but I'm not sure in reality that's how people felt." Read full story Source: BBC News, 26 March 2021
  8. News Article
    Doctors are being issued with new guidance for cases where children are repeatedly brought in when there is nothing wrong. The Royal College of Paediatrics and Child Health (RCPCH) says cases where parents know there's nothing wrong are rare. Instead genuine, if misplaced, health anxieties are more common. They advise referring to "perplexing symptoms" instead of "fabricated or induced illness". Paediatricians say there has been a rise in cases where children are repeatedly brought in, despite nothing being found to be wrong. The unexplained symptoms could be because a genuine condition has not yet been diagnosed. But there are cases where a parent or carer might make up or cause illness in their children - a rare form of abuse which used to be known as Munchausen's By Proxy Syndrome. But often, doctors say, it is genuine concerns - and they believe the rise may be fuelled by bad information online. Read full story Source: BBC News, 2 March 2021
  9. News Article
    Guidance from NHS England that doctors may lawfully use video assessments during the pandemic to decide whether patients should be detained in hospital under the Mental Health Act was wrong, two High Court judges have ruled. The act makes it a legal requirement that doctors must “personally examine” a patient before recommending detention. A code of practice requires “direct personal examination of the patient and their mental state.” But guidance from NHS England just after the start of the first lockdown last March said that “temporary departures from the code of practice may be justified in the interests of minimising risk to patients, staff, and the public.” Revised guidance in May 2020 included a section drafted jointly by NHS England and the Department of Health and Social Care for England (DHSC) “for use in the pandemic only.” This stated, “It is the opinion of NHS England and NHS Improvement and the DHSC that developments in digital technology are now such that staff may be satisfied, on the basis of video assessments, that they have personally seen or examined a person ‘in a suitable manner.’ ” The guidance added, “While NHS England and NHS Improvement and the DHSC are satisfied that the provisions of the Mental Health Act do allow for video assessments to occur, providers should be aware that only courts can provide a definitive interpretation of the law.” It went on, “Even during the COVID-19 pandemic it is always preferable to carry out a Mental Health Act assessment in person. Decisions should be made on a case-by-case basis and processes must ensure that a high quality assessment occurs.” Read full story Source: BMJ, 25 January 2021
  10. News Article
    Emergency legislation is needed to protect doctors and nurses from “inappropriate” legal action over critical Covid treatment decisions made amid the pressures of the pandemic, health organisations have argued. A coalition of health bodies has written to Matt Hancock, the health secretary, calling for the law to be updated so medical workers do not feel “vulnerable to the risk of prosecution for unlawful killing” when treating coronavirus patients “in circumstances beyond their control”. The letter, coordinated by the Medical Protection Society (MPS), states there are no legal safeguards for coronavirus-related issues such as when there are “surges in demand for resources that temporarily exceed supply”. The coalition, which includes the British Medical Association and Doctors’ Association UK, wrote: “With the chief medical officers now determining that there is a material risk of the NHS being overwhelmed within weeks, our members are worried that not only do they face being put in this position but also that they could subsequently be vulnerable to a criminal investigation by the police. “There is no national guidance, backed up by a clear statement of law, on when life-sustaining treatment can be lawfully withheld or withdrawn from a patient in order for it to benefit a different patient, and if so under what conditions. The first concern of a doctor is their patients and providing the highest standard of care at all times.” Read full story Source: The Guardian, 16 January 2021
  11. News Article
    Guy’s and St Thomas’ NHS Foundation Trust will work with Omnicell to develop a European technology-enabled inventory optimisation and intelligence service which will be initially implemented across South East London Integrated Care System (ICS). This partnership will encompass all six acute hospital sites within the South East London ICS, including Guy’s & St Thomas’, Kings College Hospital NHS Foundation Trust and Lewisham & Greenwich NHS Trust. The project will have the following goals: Develop analytics and reporting tools with a goal of improving patient safety, achieving increased operational efficiency and cost efficiencies Utilize the analytics and reporting tools with a goal of achieving agreed efficiencies and cost reductions Demonstrate the impact of managing clinical supplies and medicine spend together at scale Build a service model for the ICS which can be scaled up and adopted by other hospital groups in the UK Read the full article here
  12. News Article
    Consultants at a major tertiary centre have written to their chief executive, warning services are in ‘an extremely unsafe situation’ and calling for elective work to be diverted elsewhere. Surgeons and anaesthetists at the former Brighton and Sussex University Hospitals Trust — now part of University Hospitals Sussex Foundation Trust — said: “We are devastated to report that the care we aspire to is not being provided at UHS… we are forced to contemplate that it is not safe to be open as a trauma tertiary centre and we feel elective activity must be proactively diverted elsewhere.” The letter from BSUH’s anaesthetist and surgical consultant body is dated yesterday and was sent to UHSussex chief executive Dame Marianne Griffiths. The Royal Sussex County Hospital in Brighton — part of the trust — is the major trauma centre for the South East coast, from Chichester to parts of Kent. In the letter, seen by HSJ, the consultants claimed a shortage of theatre staff is leading to “clinical safety issues, gross operational inefficiencies and burnout within our remaining depleted staff groups”. Read full story (paywalled) Source: HSJ, 21 September 2021
  13. News Article
    The NHS may be unable to cope this winter because of a “frightening” shortfall of more than 50,000 doctors, the head of the British Medical Association has warned. The number of medics in England has fallen further behind comparable European countries over the summer, ahead of what is predicted to be one of the worst winters in the 73-year history of the health service, Dr Chaand Nagpaul said. “Winter is an incredibly difficult time for the health service,” he said. “With flu season on the horizon and even fewer staff this time round, it’s a total unknown as to how well our services will cope – if they even cope at all.” With more GPs and hospital doctors quitting over the summer, the shortage has risen to 50,191, according to the BMA. This reflects a loss of 919 doctors in primary care and 110 in secondary care over the last two months. Yet more doctors are actively considering quitting in the coming months due to burnout and excessive workloads. “Alarm bells” should be ringing, Dr Nagpaul said. The workforce crisis means staff are working longer hours to keep up with patient demand. Some feel they have no choice but to hand in their notice to get the respite they need. This piles pressure on those that remain, Dr Nagpaul said. Last week, Prof Martin Marshall, the chair of the Royal College of General Practitioners, told the Guardian that GPs in England are “finding it increasingly hard to guarantee safe care” for millions of patients, because the shortage of medics means they are unable to cope with soaring demand." Read full story Source: The Guardian, 13 September 2021
  14. News Article
    The family of a senior medic and lifelong NHS campaigner have called for an investigation into his death as it took paramedics more than half an hour to arrive at his home after operators were told he was suffering a cardiac arrest. Professor Kailash Chand, a former British Medical Association deputy chair, had complained of chest pains before one of his neighbours, a consultant anaesthetist at Manchester Royal Infirmary, called 111 for help before telling the call handler within three minutes that he believed his friend was having a cardiac arrest. “I was answering their questions when Kailash’s eyes began rolling and he slipped into unconsciousness. That’s when I said ‘this looks like a cardiac arrest’ and to upgrade the call. They kept asking questions as I started CPR and asked for an urgent ambulance. That was two or two and a half minutes into the call." Evidence seen by i News shows that it took another 30 minutes after the neighbour told the operator about the cardiac arrest for the paramedics to arrive at Professor Chand’s flat in Didsbury, Greater Manchester. National standards for ambulance trusts show that ambulance trusts must respond to category 1 calls – those that are classified as life-threatening and needing immediate intervention and/or resuscitation, such as cardiac or respiratory arrest – in 7 minutes on average, and respond to 90% of Category 1 calls in 15 minutes. Read full story Source: iNews, 3 September 2021
  15. News Article
    The Modality Partnership, one of England's biggest general practice groups told HSJ that its GPs are regularly seeing more patients each day than is safe, after the number of people going to see their GP surged in the wake of Covid-19. Data has shown the provider’s GPs had an average of 20 patient contacts per day during April 2020, which has now risen to to an average of nearly 50 patient contacts per day. Modality, which had drawn up a report on the situation were quoted as saying, "There is just so much to cover – I am worried about missing something.” One partner at Modality who is also quoted in the report said: “An increasing number of patients I see are broken, often in tears, and seeking help to cope with the new stresses of life.” Read full story (paywalled). Source: HSJ, 31 August 2021
  16. News Article
    England's senior doctors may take industrial action if the offer of 1% pay rise is not improved. Paid and unpaid overtime may be stopped if the figure is not increased to at least 4% says the British Medical Association. The BMA have also said industrial action may impact patient clinics and attempts to shorten waiting lists if it goes ahead. The Department of Health has said the government was committed to a wage rise for NHS staff, including consultants. Read full story. Source: BBC, 2 July 2021
  17. News Article
    Almost 7,000 junior doctors who treated patients during the Covid pandemic are at risk of falling behind with their training, potentially causing staffing shortages and costing taxpayers a potential £260m. The worst-case scenario estimate of the impact of the pandemic on frontline medics has prompted ministers to inject an extra £30m to try to help doctors finish training so they can progress their careers. Ensuring medics progress into their next roles is viewed as crucial to ensuring the health service has the doctors it needs to try and reduce the massive waiting list for operations caused by the pandemic. Read full story Source: The Independent, 20 May 2021
  18. 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
  19. Content Article
    After 12 years of brutal service, Neil Barnard, an NHS emergency medicine consultant, is leaving his NHS post to work abroad. His decision to leave is driven by financial and personal reasons. More than anything, he says he's tired and has little more left to give to the NHS. 
  20. Content Article
    Most doctors enter their training with a desire to help people. When a patient asks us for assistance, and what is requested is within our power, we generally say yes. If what they want is not safe or evidence based—another home detox from alcohol, or a drug that is blacklisted in our formulary—we have good reasons for declining. When the main reason for saying no is that we are just too busy, however, it is far harder. Our ability to say no raises questions of equity and patient safety; as there are not enough GPs to cope with patients’ demands, we need to be careful how we spend our time. If we want to continue to look after our patients safely, we must also start learning to say no in other spheres, politely pushing back against the transfer of work from hospitals to general practice.
  21. Content Article
    Junior doctors can struggle with decision-making in emergency departments because they worry about “looking silly” in front of senior colleagues, a study has found. A team from the Healthcare Safety Investigation Branch (HSIB) looked at missed or delayed diagnosis of conditions in A&E. They specifically examined cases of pulmonary embolism and focused on diagnostic decision-making using applied cognitive task analysis. Interviews with medical staff found a number of factors which were common among expert level doctors. These included being aware of life-threatening conditions and seeking to rule them out, being comfortable in expressing doubt and seeking out peers to challenge their diagnosis. Junior staff on the other hand often tried to fit symptoms to specific conditions and had a fear of making wrong a diagnosis. Some said they were afraid of “looking silly in front of a senior”. The study, presented at an online session at the Ergonomics & Human Factors 2022 conference, suggested looking at how younger staff can be supported in improving their decision-making. HSIB investigator Nick Woodier, who presented the study, said: “Decision-making is a skill, commonly developed in healthcare through experience without formal training or opportunities to practise it.” You can view the presentation from the link below.
  22. Content Article
    This report presents the findings of the British Medical Association (BMA) racism in medicine survey, which ran from October to December 2021. The survey sought to gather evidence of the racism experienced by doctors and medical students working in the NHS, and the impact of these experiences on their working lives and their career opportunities. All doctors and medical students in the UK, from all ethnic backgrounds, were invited to participate. The survey received 2030 responses in total, making it one of the largest of its kind. It found a concerning level of racism in the medical profession, stemming from fellow doctors, other NHS staff, and patients. These experiences of racism present in a variety of forms in the institutions and structures of the medical profession
  23. Content Article
    BMJ opinion piece from BMJ Chair Richard Smith.
  24. 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.
  25. 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.
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