The BritMeds 2007 (25)

Lean Health Care.

A man with a beard and funny teeth explains how to make the NHS quicker and cheaper





The one-stop quacktitioner service. Of course it’s cheaper.

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Chariots of Fire

Clearly, the Health and Safety Gestapo has gained a foothold in Hope hospital, and I fully expect to hear more of their lunacy in due course. I'll keep you informed!

The World’s gone mad.


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Dumb me down porridge

The following email has been sent to GPs by an Out Of Hours service:

"Dear Doctor

Further to a recent feedback meeting with our ECPs I am writing to advise you that at this early stage we would normally expect an ECP to be asked to accompany you on a visit to the prisons, rather than them being sent on their own.

This is because they need some further supervision and experience….

In the nick

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Oh dear

Wise words from Random Acts

Tom Reynolds


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Terror Tales

The wonderful Hospital at Night team have brought us yet more cost cutting dumbing down in the form of 'Safer Care Safer Training' and the 'developing of the role of nurse coordinator'. It really must be seen to be believed. There is an extensive 56 page document that outlines the so called 'competency framework' of these nurse coordinators. 'Competency' is really such a great way of introducing this marvellously termed 'safer care safer training' agenda, I wonder if the lambs skipping through the green pastures come as a free bonus item?

The Ferret

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The DK is having a bad hair day

Fucking statist doctor bastards with their fucking statist mindsets and their fucking illiberal views: listen to me very carefully (I would like to say this only once, but I've already said it many, many times).

SHUT THE FUCK UP. WE WILL DO AS WE PLEASE, YOU SHITE-BUCKETS, AND YOU WILL DO THE JOB THAT YOU ARE PAID FOR: PATCHING US UP.

FUCK. OFF.

We should ban doctors from speaking

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Bugger Off M'am

Dr Sally Winning, a psychiatrist and chairman of the BMA Scottish staff and associate specialists committee, said: "We don't want youngsters drinking on street corners."

There's a strand of social thought up there amongst the kilt-eaters and haggis wearers that is still very Puritan. That dreadful affliction caused by the fear that someone, somewhere, might be having fun.

Tim

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In the news

Perhaps the most important health news we have come across today is that the vaccine for the human papillomavirus (HPV) that causes cervical cancer has been approved for use in the U.K.

Life with leukaemia


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MASTURBATION

Temporary sexual pleasure with many dangers

says Tim

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There are idiots at all levels in the NHS

Another thoughtful post from Tom Reynolds

Random Acts of Reality

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Private sector quacktitioners

So, nurse specialists for the NHS, doctors for the private sector. It’s great rhetoric, but is it actually true? Let’s get the bourbon biscuits out and have a look at the claim. As a bit of lazy research, I’ve picked up a copy of this week’s Nursing Standard and flicked to the jobs pages. So let’s see who’s recruiting nurse specialists and nurse practitioners. Well…....

Mental Nurse still does not understandthat private patients are referred to and seen by consultants and that NHS patients take pot luck. Look at the Lean Health video at the top.

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Getting asthma right

An estimated 1 in 6 New Zealanders has a diagnosis of asthma. For some time there have been concerns that asthma is misdiagnosed and over-diagnosed..

Breath Spa for Kids

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Bowel Whispering

Bowel-whisperer Patrick Holford has some disturbing ideas about vaccination. If you pay a subscription to him, you can consult his special online reports on a number of topics. One of these reports is about vaccination. I'm accustomed to anti-vax denialism and general crankery but reading this report was like allowing my eyes to turn into two fists and pummel my brain.

BSK

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LEPERS AND WHISTLEBLOWERS - THE UNTOUCHABLES

Rita is on the war path again

The Whistleblower Diaries

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Nursing Research – the candy man cometh

I’ve never even heard of a “Penguin”, let alone a chocolate one. These are from the United Kingdom, and they used to have a bad joke on each wrapper!

Baffled American Nurse

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Work experience or more dumbing down?

"The 15-year-old son of two doctors performed a Caesarean section in an apparent bid to enter the Guinness Book of Records as the youngest surgeon.

Obesity and the Salt Connection

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Some must-read advice for everyone

If you are suffering from some serious illness like Hypertension ( Blood Pressure ), Diabetes or Chronic Kidney Disease, heart Diesease then keep yourself away from Ayurvedic, Homeopathic and Unani system of medicines. They are meant for small term illness and are not well in curing critical and long term diseases. You may fall into serious trouble if you skip this advice…

Aditya speaks

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AMERICAN DOCTORS DON’T LIKE YOU MUCH

Lawyers are making a mint in the USA at the expense of the medical profession due to allegations of malpractice. Doctors in the USA have had enough. They are looking elsewhere. Europe is the place! Now, we in the UK speak the same language as in the USA. Well nearly. So you would think these doctors would be swarming to the UK.

Not so.

Find out where they are going here

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Accomplia

But on Thursday, a committee advising the U.S. Food and Drug Administration voted to ban the pill after concerns about its psychiatric side-effects. The 14-member-panel heard testimony that Acomplia increases the risk of suicidal thoughts even in patients without a history of depression.

It is still being prescribed in the UK

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How much did the NHS supercomputer REALLY cost? Take a guess.

With the NHS "supercomputer" about to plunge into the crevasse, I've taken another look at the costings. How can it possibly be that they've been so hard to pin down?

The answer is here

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It’s those bloody NHS consultants again…

The relationship between the NHS and its consultants has always been poisonous. Bevan hated them and reckoned he only got them to go along with the NHS by stuffing their mouths with gold; Babs Castle hated them and tried to bludgeon them into giving up their private work; doubtless the 10 (yes 10!) Health Secretaries we've had since 1985 have all hated them. And we may be assured the feeling is entirely mutual….

Spanish Practices

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Find a utility bill or go away and die

Now I am on horrible tablets that I can't drink on, have constant headaches, can't walk very far unaided and might possibly have to wait weeks to see the neurologist. And Aunty Pat thinks the NHS is in a good state? I waited so long at A&E in a hospital gown with no pillow, no water even though I was thirsty, no pain killers and no chance of seeing a doctor that eventually I discharged myself on the grounds that I would me more comfortable and a lot warmer in my own bed. A health service which is the envy of the world? I don't think so.

I haven't even been able to register with my local GP since I moved house because I don't have a utility bill with my name and address on, since I share a flat, so have to go back to old house when I want to see a doctor.

Trixie

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Not all Nurse Practitioners are Bad

We’ve had nurse practitioners for seven years now, we had night nurse practitioners when they were just another word for night sisters. They may have started off by trying to prove that they could do a better job than doctors, but after seven years of being bleeped every time the on-call house officer was to do they are now firmly on the Doctors side. We usually have a coffee break together where we complain about the ward nurses.

Our NPs aren’t the sort that try and be Doctors, they haven’t replaced the Doctor at night. They’re not the sort that see patients or make diagnosis or management plans, some of them prescribe - but only really re-writting drug charts. If they find someone sick they will get an ECG, do an ABG and take bloods and most importantly get a Doctor. When I get there I have to assess the patient and make a management plan - the actual work of being a Doctor.

FtM Doctor

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Read the label

Here’s a reminder that one should read instructions and treat all medicines, including non-prescription ones, with respect. A 17-year-old athlete has died folllowing excessive use of an over-the-counter topical anti-inflammatory sports rub…

Black Triangle

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The beautiful game

Today I saw one of my favourite patients. We have known each other for many years and for some reason I always feel more cheerful after she has been to see me.

A fortunate man

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Lyme disease diagnosis

The Medical Defence Union (MDU) has told its members to remain vigilant for possible cases of Lyme disease. Lyme disease, caused by the bacterium Borrelia burgdorferi and transmitted to humans by the bite of infected ticks, can be hard to spot…..

Microbiology Bytes

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Does it make any difference?

Let those who claim that all political parties are the same and it makes no difference who we vote for make an appointment with their local GP and ask what they think.

The difference

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What hope is there?

My post yesterday concentrated on the petty attack by one blogger (doctor) against the grammar and punctuation of another (nurse) when the real fight was going on over on the other side of the Atlantic……

Life in the NHS

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The return of HJ

Dear old HJ used to be a regular commentator on NHS BLOG DOCTOR but then one day he disappeared. But he is alive and well, and commenting just round the corner (? bend) on anaesthetists

“Incidentally, your comment about 'consultant anaesthetists' made me laugh. Let's face it - for the vast majority of procedures, the anaesthetists job is that of a skilled technician, no more. It could be done by a well trained nurse. It's in their interest to make out that it needs a 'consultant' to do it.

HJ

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I am a big fan of using well trained specialist nurses. Often, they can do things as well or better than medics because they specialise in a technical task.

I recently received excellent treatment from a Nurse Practitioner. I was subsequently checked by a doctor who was much less informative. Whilst I am confident that the doctor was competent, he did make a minor criticism of the NP - a criticism I later discovered was clinically incorrect (albeit his error was minor).

HJ

Quite right too. Who needs a Gas Man? Please sent letters of support to HJ here


UPDATE UPDATE UPDATE UPDATE

Please be gentle with HJ. He tells me that "in fact, I have several friends who are doctors." Phew, that is all right then. But, however many medical friends HJ may have, not all comments are supportive of his views and he is getting angry:

HypoCrippen,

Don't go anywhere near your hypocritical, self serving, blog any more, you mean? A surgeon friend of mine reckons that for most purposes about 12 months of training is sufficient for most anaesthetic tasks. But then, what would he know compared to you? By no sensible measure should it take 12 years to train an anaesthetist for any task. Only someone oozing the worst pomposity and self importance of the medical profession - like you - would claim this.

Interesting that you don't actually challenge anything I say with any evidence - because you haven't any. It scares me that thanks to the NHS someone might actually have to put up with you as their GP. Scary.

I do miss HJ. I wish he would start commenting on NHS BLOG DOCTOR again, rather than hiding elsewhere! Or maybe he should try his luck at the Dr Rant Foundation.

Go on, HJ, I dare you. Have a go at Dr Rant.

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From large bin to small bucket

When our old Victorian asylum was starting to wind down, many people were full of optimism, looking forward to waving goodbye to the long, dim, corridors with high ceilings. Farewell to the stains, the smells and the memories of a dubious history. They envisaged a brave new world of shiny purpose built units. These new state of the art environments would benefit and uplift all of us, reducing stress and promoting well being. Oh, everything was going to be so much better….

Mental Nurse

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Darkness and silence

It seems counterintuitive that I should be happy when I’m starting my 4th go of chemo next week and have nearly exhausted the available cytotoxics, but I am, mostly, and when I’m not there is nearly always an obvious physical cause. There is no merit in this; I was born with a default state of happiness, I think.

Metastases in Auspicious Dragon

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We Do Not Have Adequate Provision of Allergy Services in the UK

There are so few clinical allergists in the UK and such a surge in need for them that it is hardly surprising that Jo Revill has a dramatic headline for her story: NHS Swamped by an Epidemic of Allergies. There are the equivalent of 26 fulltime posts in clinical allergy in the UK. I don't fully agree with her overview of the situation but you can understand the scale of the mismatched resources

Breath Spa for Kids

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Why I want "suspendeds"

My recent entry about seeing my first ’suspended’ - or, to be more accurate, my first dead body - prompted a bit of a discussion in the comments section. It’s been pointed out that some people, probably including myself, come across as far too eager to experience a ‘juicy’ job such as a resus or serious trauma. To some, it appears that we are almost willing people to die in order to give us the job we want. We are only happy when someone else is suffering…

Nee Naw

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Here we go round the mulberry bush

Yesterday, in agony, having not been able to sleep for several days, she took herself off to A&E. She had tried to get a GP appointment and was told there were none for two weeks. She then went to the walk-in centre, who told her to go straight to A&E. She saw a doctor, who told her the likely problem, and told her she'd need an X-ray. I happen to know that the X-ray department is in A&E Majors. What was she told? "Go to your GP and tell him to send you for an X-ray."

She can't get a GP appointment for two weeks.

This is crap, we all know it, and it goes on every day.

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Tweety Pie

Hewitt is living in a fantasy land if she thinks that she has 'reversed the decline'. New Labour have frittered away billions on grandiose schemes which provide bugger all benefit to anyone except to the brain dead bureaucrats who are employed to shuffle the glossy bog roll around. Productivity and efficiency have been on the decline for years, despite endless meaningless statistics manufactured by the government that prove just how much better everything is.

Dr De’ath and the DK

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Kids today are fat.

There are apparently many things to blame for the fat kid crisis. Things like computer games, television adverts for fast food, and the fact that most of them are utter lazy c…

I am livid

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Nurse blogging at your own risk

For some reason Dr C has it in for nurses in a big way and sadly, if he can’t get you on content he will now resort to your spelling and punctuation inadequacies. No doubt he would have a field day with me, because though I am better educated than most, for some strange reason I am kind of grammar blind! I am not sure that my inadequacies with the comma and semi colon would ever have kept me out of medical school or indeed stopped me from becoming a doctor.

Julie @ Life in the NHS

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MTAS and MMC

Dumbing down the doctors

At the moment most paediatric wards have up to seven specialist paediatric senior house officers (SHOs) - doctors with up to four years' experience. Most could be replaced under Modernising Medical Careers. In future, trainee doctors with one or two years' experience will spend four months in paediatrics before moving on to another specialism, and would not necessarily have any interest in that area of medicine.

Socialist Courier

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Shuffling the deck chairs

So, MTAS is heading towards August 1st and across the UK there are about 15000 junior doctors who have no idea what job they will be doing, nor in which speciality, in which hospital, or even which region they will be doing it. The better qualified they are the less likely they are to have been offered a job.

Dr Rant

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There’s no business like SHO business

Since the recent conclusion of 'Britain's Got Talent', 'Any Dream Will Do' and 'The X Factor', the interminable boredom of Big Brother has prompted the executive team at the Dr Rant Foundation to devise a new prime-time television extravaganza. It will hopefully also help to solve some of the heartache caused by the MTAS junior doctor jobs fuckwittery that has recently caught our attention.

Simon Cowell has already given his backing to our new show that will be open to the 10,000 experienced junior doctors who will be jobless in August.

Dr Rant

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