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.

Wednesday, 25 March 2015

Chestcracker's Dictum #1 Everyone takes a hit!

Heart surgery used to be a high stakes game for the patient.

It is now a high stakes game for the patient, the commissioner and the surgeon.

Long Live Equity.

Tuesday, 24 March 2015

The Human Cost of Scrutiny?

This story appears in the health section of BBC news online today.
The BBC are wee bit late onto this story. There was an excellent article on the subject of the mental health of NHS staff published 2 weeks ago in the Lancet.
The ever excellent and compassionate Claire Gerada makes some very important points on the need to look after NHS staff.
Maybe noone should be surprised at the findings of these surveys.

Life used to be like this - you are a nurse/doctor. You therefore must be compassionate. You have been trained well. Because of who you are you must be going your best - end of story.

It certainly is not like that anymore.

Monday, 23 March 2015

How to deal with immigration from the EU - make everyone pay - a lesson from the General Medical Council.

In 2008, a locum GP doctor injected David Gray, a patient with typical excruciatingly painful kidney stones, with a fatal (10 times normal) dose of morphine. This act was not intentional but a tragic mistake and it occurred because the doctor who was a German national and whose command of the English language was not good, for want of a better description, screwed up - badly.