Friday, 29 August 2014

The Problem with a growing Complaints System

http://m.bbc.co.uk/news/health-28965026



The fact that the number of complaints in the English National Health Service has risen sharply should not surprise anyone. After years of terrible headline stories about Midstaffs, and other institutions followed by the Francis report and Keogh reviews, anything else but a massive increase in complaints would have been an abnormal response from users of the National Health Service. There are many, including victims and relatives of victims of poor practice, who feel that what the NHS needs to get it back on the straight and narrow is such an increase and more.
This rapid increase cannot however be sustained .
Increased complaints and an undoubted  increase in funding for the NHS by whoever is elected next year makes my heart sink.
The expected response from a service that is hooked on process will I fear produce a megamonster  that will eventually strangle its parent and make efficient working increasingly difficult.  This is clearly self defeating and will threaten to produce a service that is less and not more safe.
I am not advocating that complaints should be discouraged or ignored but that the response of the NHS should be smarter. There surely must be good examples out there in the world outside the NHS bubble from whom lessons could be learnt.

Saturday, 7 June 2014

Medical Super Specialisation is good AND bad for patients!

  • This is an interesting article suggesting that if a surgeon specialises in one type of operation and therefore carries out a large number of them per year, his patients are less likely to suffer complications. 
  • In an age when patient outcomes are important, this strengthens the case for further specialisation in different disciplines of surgery. In my specialty, cardiac surgery for example, there are moves now for surgeons just to specialise in surgery of the mitral valve or surgery of the aorta. If I was a patient with mitral valve disease, I know who I would want to operate on my mitral valve . 
  • There are however tensions and problems associated with increasing specialisation.

Saturday, 17 May 2014

When Modern Tech Makes it all Worthwhile.

I was listening recently to 8tracks online radio in my car.  It is one of the better online radio stations because it is intuitive to use and allows you to create libraries of tracks you like and are able to share with others. If you love music, online streaming stations, which include Bloom FM and others are must have apps on your smartphone.  The combination of these apps on your phone, a unlimited data contract with your mobile phone provider and the ability to link via bluetooth with your in-car audio is one of modern life's great treats
During a recent drive home, I heard a beautiful piano tune called I Giorni by Ludovico Einaudi. It seemed immediately familiar to me. Mr. Google subsequently informed me that it has been used by the BBC for one of their own ads to highlight Arts programmes. It has also been used in a television ad in India for Airtel, a mobile comms company.

Anyway, enjoy.

Friday, 16 May 2014

Is this a Wonder Prosthesis?




Reduced anticoagulation after mechanical aortic valve replacement: Interim results from the Prospective Randomized On-X Valve Anticoagulation Clinical Trial randomized Food and Drug Administration investigational device exemption trial

Cardiac surgeons, industry and increasingly patients with heart valve disease, are always on the lookout for the perfect  heart valve prosthesis.
There are 2 main types of prostheses that are used to replace diseased valves, mechanical and biological.

Opening the Doors on Animal Testing

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I am so pleased that we are where we are in the UK with animal testing.  I used to get depressed and angry in equal measures at the frequent stories of harassment and violence by anti-vivisection demonstrators 20 or so years ago.
It is to the credit of Tony Blair and Sheffield's David Blunkett (home secretary at the time), who changed the law making such violence a very serious offence, that we are in the happier position we are in today. Openness is good and will only strengthen the backing of the public for sensible animal testing. This is crucial if the wish of successive governments that Britain must remain at the forefront of biomedical research is to be realised. 

Friday, 25 April 2014

The Land of Opportunity ?

The nomination by the president Obama of Vivek Hallegere Murthy as America's surgeon general ( Public Health top doc) just further illustrates to me the heights professionals of the Indian diaspora are able to scale in the United States. See here , here , here and here
It is difficult to state such a fact without sounding unpleasantly condescending - that is not my  intention. The reason for my observation is that India has a far greater historical connection with the United Kingdom. Nonetheless it is in the United States, the land of opportunity that people of Indian origin have really shined and made a global impact. This is not to say that there is no racism or discrimination in the US. Like everything else in life, the boundaries that exist in the US are far greater, there is both more discrimination AND more opportunity - stifling poverty with no health cover (until now that is) for many African Americans as well as the position of Commander - in - Chief.

ps The blocking of the nomination of Dr. Murthy by the NRA is quite extraordinary. Not only do they want guns promoted, they want a top doc who agrees with them!!!