Thursday, 11 February 2016

WHAT AN UTTERLY HORRIBLE MESS !

Today I am depressed and sad &  I write this with a very heavy heart
I have resisted the urge to write or do anything about the Junior doctors' dispute apart from showing my support for the juniors in our department.
But after today's developments, I just cannot hold back any further.
The poor Syrian people and junior doctors in England have alot in common  -  let down by everyone around them,
a health secretary who is obsessed with a single issue and who seems to have lost the plot completely,
a trade union that since the days of Tony Blair has tried to convince everyone that the NHS is about to be sold off to big bad American Corporations and that this dispute is about privatisation and saving the NHS,
a trade union that has continued to argue for huge increases in the number of doctors paid at a premium rate at a time when the the country is indebted to the hilt
by Health Education England and their predecessors for not  developing the role of Physicians/Surgeons Assistants  or whatever they're called nowadays,  as a separate profession for school leavers (rather than raiding depleted stock of nurses and other healthcare workers).
By educationalists and royal colleges who insisted on removal of the apprenticeship model and  developing and formalising training for junior doctors ( a good thing in itself) without insisting on a decrease in the huge amount of service they were still providing  -
by senior healthcare managers and public health doctors who continue to argue for fewer hospital beds and seem to missed the fact that the population is ageing fast and that these elderly people require both increased social and healthcare services resulting in a unbearable burden that seems to fallen on, amongst others the shoulders of junior doctors,

and I could go on and on.
Something had to give and I fear we are all about to pay a very high price.

PS I gave a talk to 6th formers last week and the ones who plan to do medicine are applying to Scottish and Welsh medical schools because of the doctors' dispute.

I was speaking with junior German doctors last night and their jaws dropped when I told them that the UK government wanted to classify Saturday as a normal working day for doctors in training in England. 

Wednesday, 16 December 2015

Breaking the Enigma Code

Nice Animation telling the sad story of bravery which led to shortening of World War 2.

Friday, 13 November 2015

Hilarious Reactions to Virtual Reality

2016  will be VR year - Facebook (Oculus), Samsung, Sony and HTC will all releasing VR sets and scenes like these will I suspect become common place.
But for now let us enjoy watching fellow human beings look silly - next year it will probably be you! On the serious side, these devices could prove invaluable in simulated training of manual tasks such as surgery, which is why I am very interested in their development.

Thursday, 29 October 2015

Two reasons why Publication of Surgeon Specific Mortality Data is Anachronistic and just anti-NHS


Since writing the post on the latest edition of the Bulletin of the Royal College of Surgeons of England, I have thought, pondered and cogitated on the subject of  publication of surgeon specific mortality data (SSMD) - the theme of the above mentioned edition. (containing 2 articles which all surgeons must read, here and here). And the more I cogitate the more I realize that publication of SSMD is not 'modern' or essential as Professor Bridgewater suggests but flies contrary to the way the NHS and healthcare generally is developing. All healthcare is a team sport, and this includes Surgery . The days of conspicuous individualism, the Sir Lancelot Spratt era are thankfully long gone. Ironically, proponents of publication of SSMD will argue that one of the functions of such publication is to deter 'have a go' surgeons. It certainly is achieving that in spades in cardiac surgery where an increasingly large number of surgeons are 'not having a go' (even though they should be !) A phenomenon, increasingly occurring because of the need to adhere to waiting time targets is for patients to be seen and listed by one surgeon and to be operated on by another. So, which surgeon's SSMD should the patient look up before coming into hospital ?
This relatively recent change is emphasised in the consent form which patients are asked to sign and which contains the statement that 'The NHS Trust cannot guarantee the surgeon who will operate on you'.
In this age of Multi-Disciplinary Team Working where the decision to operate is taken by groups of individuals, publication of surgeon specific outcomes is just SO yesterday.
Patients want to and are entitled to know what the chances of a successful outcome after their surgery are. Publication of SSMDs is just NOT the way to do it. 

Saturday, 11 April 2015

The Stick and Bigger Stick Approach to Health Outcomes Publication


The Bulletin of the Annals of the Royal College of England (RCSEng)is this month dedicated to the thorny issue of surgical outcomes reporting. The editorial team should be commended for publishing 2 very opposing views of the reporting of surgeon specific mortality data.