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Last Build Date: Tue, 24 Apr 2018 12:49:25 GMT

 



Two week wait referrals

Tue, 24 Apr 2018 11:30:26 GMT

← Older revision Revision as of 11:30, 24 April 2018 (3 intermediate revisions not shown)Line 4: Line 4: Any doctor who thinks a patient meets the criteria for an NHS two week wait referral can make the referral. This includes accident and emergency department doctors, and doctors working in private hospitals or clinics.   Any doctor who thinks a patient meets the criteria for an NHS two week wait referral can make the referral. This includes accident and emergency department doctors, and doctors working in private hospitals or clinics.   -It is inappropriate to, for example, refer the back to the GP for the GP to make the referral: this introduces a risk of delays and miscommunication.+It is inappropriate to, for example, refer the back to the GP for the GP to make the referral: this introduces an unacceptable risk of delays and miscommunication.  +   +:"Where a patient has been referred to one service within a provider by the GP, or has presented as an emergency, the contract allows the provider clinician to make an onward outpatient referral to any other service, without the need for referral back to the GP, where:  +   +:*either the onward referral is directly related to the condition for which the original referral was made or which caused the emergency presentation (unless there is a specific local CCG policy in place requiring a specific approach for a particular care pathway);  +:*or the patient has an immediate need for investigation or treatment (suspected cancer, for instance)." [https://www.england.nhs.uk/publication/the-interface-between-primary-and-secondary-care-key-messages-for-nhs-clinicians-and-managers/ NHS England. The interface between primary and secondary care: Key messages for NHS clinicians and managers. 2017.][https://www.england.nhs.uk/publication/the-interface-between-primary-and-secondary-care-key-messages-for-nhs-clinicians-and-managers/ NHS England. The interface between primary and secondary care: Key messages for NHS clinicians and managers: NHS England, 2017(04 July);  (https://www.england.nhs.uk/publication/the-interface-between-primary-and-secondary-care-key-messages-for-nhs-clinicians-and-managers/).]  +   +There is a duty on all NHS Trusts in England to facilitate urgent referrals, directly to the appropriate specialist. There are stories that some - perhaps many - actively prevent doctors from doing this, requiring them instead to ask the patient's GP to make the necessary referral. Others - Arrowe Park, for example - are models of good practice, with referral forms being made easily available to all doctors via their intranet.[https://m.facebook.com/groups/412825109160614?view=permalink&id=458683587908099 Thread on DAUK Facebook forum by a doctor who was prevented from referring appropriately, and a discussion of the issue 2018 (22 Apr)] (closed group, members only). ==External links== ==External links== [...]



Cord colitis syndrome

Mon, 23 Apr 2018 21:19:48 GMT

starter

New page

Cord colitis syndrome (CCS) is a form of colopathy, typically associated with diarrhoeal symptoms, occurring after haematopoietic stem cell transplantation using umbilical cord stem cells. The pathogenesis is not entirely clear. Bradyrhizobium bacteria have been implicated,ERROR: Download of reference details rejected. Click on the link - [https://www.ncbi.nlm.nih.gov/pubmed/?term=23924002 PMID:23924002] but this may represent contamination. The symptoms may be indistinguishable from [[graft-versus-host disease]] (GvHD). Distinguishing between the two entities is important because CCS is treated with antibiotics, while GvHD is treated with increased immunosuppression.

[[Category: Haematology]]
[[Category: Gastroenterology]]



Cord colitis

Mon, 23 Apr 2018 21:13:40 GMT

redirect

New page

#REDIRECT[[Cord colitis syndrome]]



Two week wait referrals

Mon, 23 Apr 2018 16:21:08 GMT

Created page with "{{stub}} In England, patients suspected to have cancer are supposed to be referred and seen within two weeks of referral. Any doctor who thinks a patient meets the criteria for..."

New page

{{stub}}
In England, patients suspected to have cancer are supposed to be referred and seen within two weeks of referral.

Any doctor who thinks a patient meets the criteria for an NHS two week wait referral can make the referral. This includes accident and emergency department doctors, and doctors working in private hospitals or clinics.

It is inappropriate to, for example, refer the back to the GP for the GP to make the referral: this introduces a risk of delays and miscommunication.

==External links==
*[http://www.cancerresearchuk.org/cancer-symptoms/what-is-an-urgent-referral ''"Your urgent referral?"''] from [[Cancer Research UK]]
*[https://improvement.nhs.uk/resources/two-week-wait-cancer-capacity-and-demand-tool/ Two week wait cancer capacity and demand tool] from NHS Improvement
*[https://www.england.nhs.uk/wp-content/uploads/2015/03/delivering-cancer-wait-times.pdf ''Delivering cancer waiting times''] from NHS Interim Management and Support - Intensive Support Team (Cancer).

{{Refsec}}



Cancer Research UK

Mon, 23 Apr 2018 16:20:54 GMT

Created page with "{{stub}} Cancer research charity. [https://www.cancerresearchuk.org/ Home page]."

New page

{{stub}}
Cancer research charity. [https://www.cancerresearchuk.org/ Home page].



The Bawa Garba case

Mon, 23 Apr 2018 11:39:13 GMT

David Nicholl, a consultant neurologist's blogs etc: ← Older revision Revision as of 11:39, 23 April 2018 Line 284: Line 284: *[http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ From blame culture to just culture.][http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ Nicholl D. David Nicholl: Bawa-Garba—From blame culture to just culture. thebmjopinion, 2018; Updated 06 Apr 2018; Accessed: 2018 (06 Apr): (http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/).] *[http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ From blame culture to just culture.][http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ Nicholl D. David Nicholl: Bawa-Garba—From blame culture to just culture. thebmjopinion, 2018; Updated 06 Apr 2018; Accessed: 2018 (06 Apr): (http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/).] -*[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b ''Black box thinking in the NHS - can we safely learn from our mistakes?'']. Slides from a presentation given by Dr Nicholl at a [[British Association of Physicians of Indian Origin (BAPIO)|BAPIO]] meeting on 21 April [[2018]], comparing and contrasting the approach to accidents in the airline industry - which are used to learn to prevent future accidents - with those in the NHS where a scapegoat is found and blamed.[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b Nicholl D. Black box thinking in the NHS - can we safely learn from our mistakes?: British Association of Physicians of Indian Origin (BAPIO), 2018(21 Apr 2018);  (https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b).]+*[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b ''Black box thinking in the NHS - can we safely learn from our mistakes?'']. Slides from a presentation given by Dr Nicholl at a [[British Association of Physicians of Indian Origin (BAPIO)|BAPIO]] meeting on 21 April [[2018]], comparing and contrasting the approach to accidents in the airline industry - which are used to learn to prevent future accidents - with those in the NHS where a [[scapegoat]] is found and blamed.[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b Nicholl D. Black box thinking in the NHS - can we safely learn from our mistakes?: British Association of Physicians of Indian Origin (BAPIO), 2018(21 Apr 2018);  (https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b).] ===== David Oliver, geriatrician and columnist ===== ===== David Oliver, geriatrician and columnist ===== [...]



Scapegoat

Mon, 23 Apr 2018 11:38:16 GMT

Created page with "{{stub}} Category:Bawa-Garba According to Wikipedia, a scapegoat was described in the old testament of the bible, and it describes ''"is an animal whi..."

New page

{{stub}}
[[Category:Bawa-Garba]]
According to [[Wikipedia:Scapegoat|Wikipedia]], a scapegoat was described in the old testament of the bible, and it describes ''"is an animal which is ritually burdened with the sins of others then driven away"''.

It has been claimed that the NHS in particular, and the UK public sector in general, has a habit, when something goes wrong, of identifying a scapegoat - an individual to blame for whatever went wrong - in order to absolve all others of any blame. (There are many references that could be used here; here's one to start with.[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b Nicholl D. ''Black box thinking in the NHS - can we safely learn from our mistakes?'': British Association of Physicians of Indian Origin (BAPIO), 2018(21 Apr 2018); (https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b).])

{{Refsec}}



The Bawa Garba case

Mon, 23 Apr 2018 11:31:59 GMT

David Nicholl, a consultant neurologist's blogs etc: ← Older revision Revision as of 11:31, 23 April 2018 (One intermediate revision not shown)Line 283: Line 283: *[http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ From blame culture to just culture.][http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ Nicholl D. David Nicholl: Bawa-Garba—From blame culture to just culture. thebmjopinion, 2018; Updated 06 Apr 2018; Accessed: 2018 (06 Apr): (http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/).] *[http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ From blame culture to just culture.][http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/ Nicholl D. David Nicholl: Bawa-Garba—From blame culture to just culture. thebmjopinion, 2018; Updated 06 Apr 2018; Accessed: 2018 (06 Apr): (http://blogs.bmj.com/bmj/2018/04/06/david-nicholl-bawa-garba-from-blame-culture-to-just-culture/).]  +  +*[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b ''Black box thinking in the NHS - can we safely learn from our mistakes?'']. Slides from a presentation given by Dr Nicholl at a [[British Association of Physicians of Indian Origin (BAPIO)|BAPIO]] meeting on 21 April [[2018]], comparing and contrasting the approach to accidents in the airline industry - which are used to learn to prevent future accidents - with those in the NHS where a scapegoat is found and blamed.[https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b Nicholl D. Black box thinking in the NHS - can we safely learn from our mistakes?: British Association of Physicians of Indian Origin (BAPIO), 2018(21 Apr 2018);  (https://ngewktts.tkhcloudstorage.com/item/3878d8e33dd94763ac5adc80765fd44b).] ===== David Oliver, geriatrician and columnist ===== ===== David Oliver, geriatrician and columnist ===== [...]



Manslaughter

Mon, 23 Apr 2018 09:05:41 GMT

Professor Sir Norman Williams Review of gross negligence manslaughter: ← Older revision Revision as of 09:05, 23 April 2018 Line 27: Line 27: The Williams review has a very short deadline (''"The Review will aim to report in Spring 2018"''[https://www.gov.uk/government/groups/professor-sir-norman-williams-review Department of Health. Williams Review into Gross Negligence Manslaughter in Healthcare: Terms of Reference. London: Department of Health, 2018(March); 1-2 (https://www.gov.uk/government/groups/professor-sir-norman-williams-review).]). It has been reported that it will confine its deliberations to level of knowledge among clinicians about ''“where and how the line is drawn between gross negligence manslaughter and negligence”''; and to ''“lessons that need to be learned by the GMC and other regulators in how they deal with professionals following a criminal process for gross negligence manslaughter.”''   The Williams review has a very short deadline (''"The Review will aim to report in Spring 2018"''[https://www.gov.uk/government/groups/professor-sir-norman-williams-review Department of Health. Williams Review into Gross Negligence Manslaughter in Healthcare: Terms of Reference. London: Department of Health, 2018(March); 1-2 (https://www.gov.uk/government/groups/professor-sir-norman-williams-review).]). It has been reported that it will confine its deliberations to level of knowledge among clinicians about ''“where and how the line is drawn between gross negligence manslaughter and negligence”''; and to ''“lessons that need to be learned by the GMC and other regulators in how they deal with professionals following a criminal process for gross negligence manslaughter.”''    +  +The very narrow terms of the Williams review have been criticised:  +  +  +:"From construction to aviation, safety conscious industries have tried to move away from a culture of blame, in which sanctioning individuals is, wrongly, seen as a useful deterrent, and towards a “just culture,” in which only reckless behaviour and wilful rule violations are punished.  +  +:"Many law and ethics scholars have argued that the law of gross negligence manslaughter, or the way in which it is used, is in need of an update to reflect this. But the terms of reference2 of the Williams review indicate that it will examine neither the law itself nor its use by the crown prosecution service and the courts. Instead it will consider only how government can make sure healthcare professionals know about the law, how (if at all) openness and transparency can be preserved in the current climate, and how professional regulators should act after a conviction.  +  +:"Why these narrow terms have been adopted is not clear. The department of justice has likely interfered to close down the health secretary’s broader ambitions.  +  +:"Missing the opportunity to review the law around gross negligence manslaughter is a great shame. Anyone with an interest in promoting patient safety should press the government to broaden the terms of the review to encompass the real issues."[https://www.bmj.com/content/361/bmj.k1721 Reynolds T. Narrow terms of reference mean that Jeremy Hunt’s review of gross negligence manslaughter will miss the point. BMJ 2018;361, DOI: 10.1136/bmj.k1721  (https://www.bmj.com/content/361/bmj.k1721).] or [https://www.bmj.com/content/360/bmj.k592/rr-1 full rapid response]. ==== Submissions to the Williams review ==== ==== Submissions to the Williams review ==== [...]



Conjugate vaccines

Mon, 23 Apr 2018 08:56:57 GMT

← Older revision Revision as of 08:56, 23 April 2018 Line 1: Line 1: -[[Category:Infectious diseases]] [[Category:Vaccination]] {{stub}}+[[Category:Infectious diseases]]  +[[Category:Vaccination]]  +{{stub}} ==What are conjugate vaccines?== ==What are conjugate vaccines?== Many bacteria are surrounded by a polysaccharide capsule, which both provides the [[Antigens|antigens]] against which antibodies can act, the molecules that largely determine how [[virulent]] and [[pathogenic]] the organism and protects the main bacterial cell from the bodies defense systems. Many bacteria are surrounded by a polysaccharide capsule, which both provides the [[Antigens|antigens]] against which antibodies can act, the molecules that largely determine how [[virulent]] and [[pathogenic]] the organism and protects the main bacterial cell from the bodies defense systems. Line 9: Line 11: If the molecules are bound to larger, more immunogenic molecules - typically [[tetanus]] or [[diphtheria]] toxoids - the combination becomes far more antigenic. Conjugate vaccines are effective in infants, and give long-lasting immunity, with [[immune memory]]. (If there is immune memory, on subsequent challenge the body very rapidly responds by producing antibodies.) If the molecules are bound to larger, more immunogenic molecules - typically [[tetanus]] or [[diphtheria]] toxoids - the combination becomes far more antigenic. Conjugate vaccines are effective in infants, and give long-lasting immunity, with [[immune memory]]. (If there is immune memory, on subsequent challenge the body very rapidly responds by producing antibodies.)  +  +Early conjugate vaccines used a convenient antigenic molecule (diphtheria or tetanus toxoids) because they were effective, but without the particular intention of inducing or boosting immunity to those antigens. More recent conjugate vaccines have introduced antigens to which immunity might be beneficial. Examples include:  +  +*[https://www.medicines.org.uk/emc/product/463/smpc ''Synflorix''] 10-valent pneumococcal conjugate vaccine (PCV-10), which uses non-typable [[Haemophilus influenzae|''Haemophilus influenzae'']] as the conjugate molecule. Non-typable ''H influenzae'' can cause otitis media in children, and the use of this vaccine is consequently claimed to reduce otitis media rates. (This licensed vaccine is not part of the routine vaccination programme in the UK - PCV-13 is preferred.)  +*Other conjugate vaccines have not yet been licensed but are in trials. One, for example, uses the Vi polysaccharide of [[Salmonella typhi|''Salmonella typhi'']] conjugated with a [[malaria]] transmission blocking vaccine antigen, to create a bivalent vaccine which, researchers hope, will be effective in preventing both [[malaria]] and [[typhoid fever]].[https://www.sciencedirect.com/science/article/pii/S0264410X18305188 An SJ, Scaria PV, Chen B, Barnafo E, Muratova O, Anderson C, et al. Development of a bivalent conjugate vaccine candidate against malaria transmission and typhoid fever. Vaccine, DOI: https://doi.org/10.1016/j.vaccine.2018.04.035 (https://www.sciencedirect.com/science/article/pii/S0264410X18305188).] ==Examples of conjugate vaccines== ==Examples of conjugate vaccines== [...]



Pneumococcal vaccine

Mon, 23 Apr 2018 08:46:48 GMT

Pneumococcal conjugate vaccines: ← Older revision Revision as of 08:46, 23 April 2018 Line 18: Line 18: See [[pneumococcal polyaccharide conjugate vaccine]]. See [[pneumococcal polyaccharide conjugate vaccine]]. -Like other [[conjugate vaccines]], these give long-lasting protection, even in infants. The polysaccharide is conjugated to a carrier protein eg tetanus toxoid, which enhances immune response.  [[Prevnar]] as used formally in the UK contains 7 serotypes, which are responsible for about 85% of invasive disease in the UK and most of the world apart from Russia and Africa.  These are also the serotypes most associated with penicillin resistance, although rare in the UK. +Like other [[conjugate vaccines]], these give long-lasting protection, even in infants. The polysaccharide is conjugated to a carrier protein eg tetanus toxoid, which enhances immune response.  [https://www1.pfizerpro.com/product/prevnar-13/adult/risk-factors Prevnar] as previously used in the UK contains 7 serotypes, which are responsible for about 85% of invasive disease in the UK and most of the world apart from Russia and Africa.  These are also the serotypes most associated with penicillin resistance, although rare in the UK. (NB - the UK has been using 13-valent Pneumococcal conjugate vaccine (PCV-13) since [[2010]].) There is always the possibility that the serotypes covered by the conjugate vaccine will simply be replaced by others.  This has been seen in a few studies eg nasal carriage in Alaskan children, however most areas have reported a sustained overall reduction in pneumococcal carriage and cases, even if non-vaccine serotypes make up a higher proportion than before. There is always the possibility that the serotypes covered by the conjugate vaccine will simply be replaced by others.  This has been seen in a few studies eg nasal carriage in Alaskan children, however most areas have reported a sustained overall reduction in pneumococcal carriage and cases, even if non-vaccine serotypes make up a higher proportion than before. [...]



Pneumococcal polyaccharide conjugate vaccine

Mon, 23 Apr 2018 08:41:48 GMT

← Older revision Revision as of 08:41, 23 April 2018
Line 2: Line 2:
[[Pneumococcal polyaccharide conjugate vaccine]] is product specific in its indications and used to:
[[Pneumococcal polyaccharide conjugate vaccine]] is product specific in its indications and used to:
*Prevent community acquired pneumonia in those 65 or over (Prevenar 13®)
*Prevent community acquired pneumonia in those 65 or over (Prevenar 13®)
-
*Prevention in children and infants including [[otitus media]] (between 6weeks to 5 years Synflorix®)
+
*Prevention in children and infants including [[otitis media]] (between 6 weeks to 5 years Synflorix®)
*Prevention in those aged 6-49 years(Prevenar 13®)  
*Prevention in those aged 6-49 years(Prevenar 13®)  



Talk:Main Page

Sun, 22 Apr 2018 21:26:51 GMT

comment

← Older revision Revision as of 21:26, 22 April 2018
Line 226: Line 226:
:: The end of the financial year is probably a good time for such things. [[User:Midgley|Midgley]] 12:58, 13 April 2018 (BST)
:: The end of the financial year is probably a good time for such things. [[User:Midgley|Midgley]] 12:58, 13 April 2018 (BST)
::: I have a contact who can haul down a backup for reinstallation, set up a new server, play this back on to it and host for less than the current hosting.  I'm inclined to just go ahead with that - there might be a short gap, and if this carries on during it updates wuold not make it into the new installation. [[User:Midgley|Midgley]] 10:32, 22 April 2018 (BST)
::: I have a contact who can haul down a backup for reinstallation, set up a new server, play this back on to it and host for less than the current hosting.  I'm inclined to just go ahead with that - there might be a short gap, and if this carries on during it updates wuold not make it into the new installation. [[User:Midgley|Midgley]] 10:32, 22 April 2018 (BST)
 +
::::Good. I have no definite time to commit for at least 6 months. Rupert did volunteer to try to get a new server going but the key issue is successful migration from the old and time for administration when holding down a job in medicine. Happy to help within my limited skill base but the administration involved in a server transition would be a minefield for the likes of me I suspect [[User:Mlj|Mlj]] 22:26, 22 April 2018 (BST)
== Registration ==
== Registration ==



Talk:Prescribing

Sun, 22 Apr 2018 19:38:02 GMT

Dysfunctional stories abound ← Older revision Revision as of 19:38, 22 April 2018 Line 14: Line 14: *[https://www.rcn.org.uk/clinical-topics/medicines-optimisation/specialist-areas/prescribing-in-pregnancy https://www.rcn.org.uk/clinical-topics/medicines-optimisation/specialist-areas/prescribing-in-pregnancy] *[https://www.rcn.org.uk/clinical-topics/medicines-optimisation/specialist-areas/prescribing-in-pregnancy https://www.rcn.org.uk/clinical-topics/medicines-optimisation/specialist-areas/prescribing-in-pregnancy] *[http://www.nipec.hscni.net/MidwivesandMedicines/NIMidwives&Medicines.pdf http://www.nipec.hscni.net/MidwivesandMedicines/NIMidwives&Medicines.pdf re Northern Ireland] *[http://www.nipec.hscni.net/MidwivesandMedicines/NIMidwives&Medicines.pdf http://www.nipec.hscni.net/MidwivesandMedicines/NIMidwives&Medicines.pdf re Northern Ireland] - +==Dysfunctional NHS==  +*While lots of examples of Health Trusts in England not accepting each other's paperwork this usually does not happen for too long where there is a functional APC and the two providers are not direct competitors.  +*Now Tertiary care interface to local community/secondary care/primary care is another matter.  Biggest issue locally is London Tertiary centres as they have of course no common paper work with the commuting counties, get the money to sort out tertiary prescribing but of course use it for other purposes and can not set up agreements with third parties to sort out network prescribing and access issues  as NHS England now will not pay a bill more than a month in arrears and NHS billing is barely that efficient. Cheers [[User:Mlj|Mlj]] 20:38, 22 April 2018 (BST) --[[User:Penglish|Penglish]] 16:07, 23 August 2017 (BST) --[[User:Penglish|Penglish]] 16:07, 23 August 2017 (BST) :OK Peter - since I am paid extra by NHS to include this in as an area of expertise so I will drag the details out of my files sometime . Midwifes have always been able to prescribe from a limited list. As to your other questions we do have some comment in GANFYD on who can prescribe since I had to get interested in this issue about 1996 or so but its not been brought together. Will have to look up dentists/speak to social acquaintances,  as I had assumed they can prescribe within their competencies and this included all those medicines open to medical practitioners. I love Vets who have access to all sorts of medicines we can't give humans [[User:Mlj|Mlj]] 20:58, 24 August 2017 (BST) :OK Peter - since I am paid extra by NHS to include this in as an area of expertise so I will drag the details out of my files sometime . Midwifes have always been able to prescribe from a limited list. As to your other questions we do have some comment in GANFYD on who can prescribe since I had to get interested in this issue about 1996 or so but its not been brought together. Will have to look up dentists/speak to social acquaintances,  as I had assumed they can prescribe within their competencies and this included all those medicines open to medical practitioners. I love Vets who have access to all sorts of medicines we can't give humans [[User:Mlj|Mlj]] 20:58, 24 August 2017 (BST) [...]



Prescribing

Sun, 22 Apr 2018 09:36:35 GMT

England: this is not, of course, a theoretical supposition ← Older revision Revision as of 09:36, 22 April 2018 Line 44: Line 44: Thus certain health professionals such as nurses and pharmacists might therefore be able to prescribe PoMs within their professional competence and under appropriate governance frameworks. Sometimes they might be more familiar with some rare drugs than doctor prescribers. However they are likely to have more restrictions on [[Off-label or unlicensed use of medicines|unlicensed medication]] prescribing than doctors}} Thus certain health professionals such as nurses and pharmacists might therefore be able to prescribe PoMs within their professional competence and under appropriate governance frameworks. Sometimes they might be more familiar with some rare drugs than doctor prescribers. However they are likely to have more restrictions on [[Off-label or unlicensed use of medicines|unlicensed medication]] prescribing than doctors}}  +  +  +==== Dysfunctional Health Trusts====  +Can play political games, wasting effort and disadvantaging patients, by refusing to accept each other's identical paperwork - thus discharge prescriptions and medication administration documents prepared in hospital as part of a properly managed and safe discharge to community nursing care may be refused and the opportunity to make mistakes working from inadequate information in a hurry pressed upon GPs.  +  +For the two Trusts involved to not talk and resolve the argument suggests that management changes should take place. ====Classification of medicines==== ====Classification of medicines==== [...]



Talk:Main Page

Sun, 22 Apr 2018 09:32:25 GMT

Succession: rebuild, rehost

← Older revision Revision as of 09:32, 22 April 2018
Line 225: Line 225:
::It is greatly appreciated.  I'm now out of Medicine, and embarking on a building project and need to hand the whole thing over.  If the team will put up with it I'd like to remain a member/user and do sub-editing and so on. [[User:Midgley|Midgley]] 12:56, 13 April 2018 (BST)
::It is greatly appreciated.  I'm now out of Medicine, and embarking on a building project and need to hand the whole thing over.  If the team will put up with it I'd like to remain a member/user and do sub-editing and so on. [[User:Midgley|Midgley]] 12:56, 13 April 2018 (BST)
:: The end of the financial year is probably a good time for such things. [[User:Midgley|Midgley]] 12:58, 13 April 2018 (BST)
:: The end of the financial year is probably a good time for such things. [[User:Midgley|Midgley]] 12:58, 13 April 2018 (BST)
 +
::: I have a contact who can haul down a backup for reinstallation, set up a new server, play this back on to it and host for less than the current hosting.  I'm inclined to just go ahead with that - there might be a short gap, and if this carries on during it updates wuold not make it into the new installation. [[User:Midgley|Midgley]] 10:32, 22 April 2018 (BST)
== Registration ==
== Registration ==



Abbreviations

Fri, 20 Apr 2018 09:57:02 GMT

L:

← Older revision Revision as of 09:57, 20 April 2018
Line 467: Line 467:
*LGV - [[Lymphogranuloma venereum|LymphoGranuloma Venereum]]
*LGV - [[Lymphogranuloma venereum|LymphoGranuloma Venereum]]
*LMC - [[Local medical committee]]
*LMC - [[Local medical committee]]
 +
*LMIC - Low and Middle Income Countries - an abbreviation used in some medical research papers, for example some relating to global health and immunisation.
*LMWH - [[Heparin|Low Molecular Weight Heparin]]
*LMWH - [[Heparin|Low Molecular Weight Heparin]]
*LMS - left main stem (coronary artery)
*LMS - left main stem (coronary artery)



The Bawa Garba case

Fri, 20 Apr 2018 09:38:08 GMT

← Older revision Revision as of 09:38, 20 April 2018 (One intermediate revision not shown)Line 9: Line 9: An account of the events: [http://54000doctors.org/blogs/an-account-by-concerned-uk-paediatric-consultants-of-the-tragic-events-surrounding-the-gmc-action-against-dr-bawa-garba.html ''"An account by concerned UK paediatric consultants of the tragic events surrounding the GMC action against Dr Bawa-Garba"''.] There is another detailed account of the events in the GMC's response to [[Manslaughter#Professor Sir Norman Williams Review of gross negligence manslaughter|the Williams review]].[https://www.gmc-uk.org/news/news-archive/doctors-reflections-should-be-legally-protected General Medical Council (GMC). ''Williams Review into Gross Negligence Manslaughter in healthcare – GMC written submission'': General Medical Council (GMC), 2018;  (https://www.gmc-uk.org/news/news-archive/doctors-reflections-should-be-legally-protected).] An account of the events: [http://54000doctors.org/blogs/an-account-by-concerned-uk-paediatric-consultants-of-the-tragic-events-surrounding-the-gmc-action-against-dr-bawa-garba.html ''"An account by concerned UK paediatric consultants of the tragic events surrounding the GMC action against Dr Bawa-Garba"''.] There is another detailed account of the events in the GMC's response to [[Manslaughter#Professor Sir Norman Williams Review of gross negligence manslaughter|the Williams review]].[https://www.gmc-uk.org/news/news-archive/doctors-reflections-should-be-legally-protected General Medical Council (GMC). ''Williams Review into Gross Negligence Manslaughter in healthcare – GMC written submission'': General Medical Council (GMC), 2018;  (https://www.gmc-uk.org/news/news-archive/doctors-reflections-should-be-legally-protected).] -{{QuotationBox|“'''We need to rethink the role of the criminal law and medical manslaughter. Does it have any place in how we deal with things going wrong . . . because medical manslaughter means that you can pick someone, blame them, and imagine that you’ve solved the problem. And what you have actually done is exacerbated it…''' If there is a barrier to doctors doing what they signed up to do and then dealing with things going wrong, it is the intrusion of the criminal law and [ [[The Bawa Garba case|Bawa Garba]] ] is a good example of that… Because she could be picked out, she could be prosecuted for medical manslaughter, and no one was concerned that she was looking after six wards in a new hospital without any induction, the IT system was down, and several doctors were on leave. In terms of human factors, she was walking into a disaster zone. But a [child] died and someone had to go—and that, in my view, suggests we should first ‘kill all the lawyers’.” … He said that the GMC’s work looking into wider issues around medical manslaughter “should consist entirely of ‘lets get rid of it’," and that it was “madness” to sue doctors when things went wrong. “There is another way… We should not sue doctors because that persuades them not to confess their mistakes—understandably so—because their career is about to be at risk… If we want to learn from errors then we have to expose them… Suing doctors confuses the need for compensation for a patient who has been harmed with culpability. We need to separate those two things.”|Prof [[Wikipedia:Ian Kennedy (legal scholar)|Ian Kennedy QC.]][https://www.b[...]



Prescribing

Fri, 20 Apr 2018 08:17:10 GMT

Interface prescribing between primary and secondary care: ← Older revision Revision as of 08:17, 20 April 2018 Line 27: Line 27: ===Interface prescribing between primary and secondary care=== ===Interface prescribing between primary and secondary care=== {{:Interface between primary and secondary care}} {{:Interface between primary and secondary care}}  +{{England|There is [https://www.england.nhs.uk/publication/responsibility-for-prescribing-between-primary-and-secondary-tertiary-care/ clear guidance on this from NHS England], published in [[2018]].[https://www.england.nhs.uk/publication/responsibility-for-prescribing-between-primary-and-secondary-tertiary-care/ NHS England Direct Commissioning Change Projects. Responsibility for prescribing between Primary & Secondary/Tertiary Care. Leeds: Produced in partnership with BMA, RCGP, NAPP, RCN, and NHS Clinical Commissioners, 2018(January (online 13 March)); (https://www.england.nhs.uk/publication/responsibility-for-prescribing-between-primary-and-secondary-tertiary-care/).] ([https://www.england.nhs.uk/wp-content/uploads/2018/03/responsibility-prescribing-between-primary-secondary-care-v2.pdf direct link to pdf].)}}  + ===Non-Medical prescribing=== ===Non-Medical prescribing=== Before prescribing became regulated everyone could do it. Even with regulation often nurses working in institutions were up to the 1980s able to order laxatives and simple remedies. This did not apply to independent community practice which drove clarification. The Cumberlege Report from the DHSS in [[1986]] recommended ""''The DHSS should agree a limited list of items and simple agents which may be prescribed by nurses as part of a nursing care programme, and issue guidelines to enable nurses to control drug dosage in well defined circumstances.''". While the enabling primary legislation was the ''Medicinal Products: Prescription by Nurses Act 1992'' other necessary secondary legislation did not get passed until [[1994]]. In [[1996]] the ''Nurse Prescribers’ Formulary for District nurses and Health Visitors'' was created, which since [[2005]] has been known as ''The Nurse Prescribers’ Formulary for Community Practitioners''. In 1997 Dr June Crown was appointed by the government to a ''Review of Prescribing, Supply and Administration of Medicines'' and the second report in [[1999]] of this group recommended extension of prescribing to further healthcare professionals. By 2000 first-level registered nurse or registered midwives after training as EINPs could prescribe from the Nurse Prescribers' Extended Formulary (NPEF) which contained all General Sales List (GSL) and Pharmacy (P) medicines prescribable by GPs, together with almost 180 specified Prescription Only Medicines (POMs), including some opioids. In April [[2003]] it became possible for nurses and pharmacists to train to become supplementary prescribers. Now nurses, pharmacists, physiotherapists, radiographers, podiatrists and optometrists can prescribe in partnership with a doctor (or dentist). Nurse and pharmacist supplementary prescribers are able to prescribe any medicine including controlled drugs and [[Off-label or unlicensed use of medicines|unlicensed medicines]] that are listed in an agreed clinical management plans (CMP). All supplementary prescribers may prescribe for any medical condition, provided they do so under an agreed, patient-specific CMP. Legislation from 31st May 2006 enabled all qualified Extended Independent Nurse Prescribers (now known as Nurse In[...]



Mortality rate

Thu, 19 Apr 2018 22:51:21 GMT

English mortality rate up yet again

← Older revision Revision as of 22:51, 19 April 2018
Line 3: Line 3:
[[category:epidemiology]]
[[category:epidemiology]]
The crude [[mortality]] rate in a population is usually corrected to the [[age specific mortality rate]] in epidemiological studies of an illness. The [[mortality rate]] in a given population is a direct [[:category:metrics|metric]] that is often used in the most convincing studies of a treatment to show success for that treatment relative to base line or other interventions.
The crude [[mortality]] rate in a population is usually corrected to the [[age specific mortality rate]] in epidemiological studies of an illness. The [[mortality rate]] in a given population is a direct [[:category:metrics|metric]] that is often used in the most convincing studies of a treatment to show success for that treatment relative to base line or other interventions.
-
 
+
{{UK|Such data can have political implications when mortality rate goes up in one devolved country more than others. See  http://researchbriefings.files.parliament.uk/documents/CBP-8281/CBP-8281.pdf }}
[[Category:Metrics]]
[[Category:Metrics]]
==External links==
==External links==
*[http://www.euromomo.eu/ European weekly crude mortality rate]
*[http://www.euromomo.eu/ European weekly crude mortality rate]



Whistleblowing

Thu, 19 Apr 2018 16:24:01 GMT

External links:

← Older revision Revision as of 16:24, 19 April 2018
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*[https://minhalexander.com/ Alexander's Excavations] the blogsite of campaigning whistleblower Minh Alexander. (There are other useful whistleblowing links at this site.)
*[https://minhalexander.com/ Alexander's Excavations] the blogsite of campaigning whistleblower Minh Alexander. (There are other useful whistleblowing links at this site.)
*[https://sharmilachowdhury.com/ The website of Sharmila Chowdhury], a radiologist turned NHS whistleblower.
*[https://sharmilachowdhury.com/ The website of Sharmila Chowdhury], a radiologist turned NHS whistleblower.
 +
*[https://www.greens-efa.eu/en/article/news/time-for-the-eu-to-protect-whistleblowers/ EU Green Party calls for protection for whistleblowers]



Manslaughter

Thu, 19 Apr 2018 13:21:19 GMT

Dame Clare Marx Review of gross negligence manslaughter: ← Older revision Revision as of 13:21, 19 April 2018 Line 37: Line 37: === Dame Clare Marx Review of gross negligence manslaughter === === Dame Clare Marx Review of gross negligence manslaughter === -The Marx report will use the Williams review's findings, and will be much broader, comparing the English and Welsh law with the Scottish law. ''"the lack of corporate manslaughter prosecutions against healthcare organisations as compared to individual healthcare professionals within organisations facing gross negligence manslaughter prosecution… Doctors are often working in an immensely pressurised system where mistakes can happen. This review aims to encourage a renewed focus on a just culture, reflective practice and individual and systemic learning."'' It will also investigate equality and diversity issues and the suggestions that overseas doctors face an increased risk of facing serious charges.[https://news.doctors.net.uk/news/27947 Anon. GMC to consider corporate manslaughter in Bawa-Garba inquiry. doctors.net.uk, 2018; Updated 19 Mar 2018; Accessed: 2018 (19 Mar): (https://news.doctors.net.uk/news/27947).]+The Marx review, commissioned by the [[General Medical Council|GMC]] ([https://www.gmc-uk.org/-/media/documents/terms-of-reference-for-gnm-review-_pdf-73991039.pdf terms of reference]),[https://www.gmc-uk.org/news/news-archive/responding-to-the-case-of-dr-bawa-garba GMC. Terms of reference: Review of gross negligence manslaughter and culpable homicide. 2018 (??19 April - undated) GMC, London] or [https://www.gmc-uk.org/-/media/documents/terms-of-reference-for-gnm-review-_pdf-73991039.pdf direct link to pdf] will use the Williams review's findings, and will be much broader, comparing the English and Welsh law with the Scottish law. ''"the lack of corporate manslaughter prosecutions against healthcare organisations as compared to individual healthcare professionals within organisations facing gross negligence manslaughter prosecution… Doctors are often working in an immensely pressurised system where mistakes can happen. This review aims to encourage a renewed focus on a just culture, reflective practice and individual and systemic learning."'' It will also investigate equality and diversity issues and the suggestions that overseas doctors face an increased risk of facing serious charges.[https://news.doctors.net.uk/news/27947 Anon. GMC to consider corporate manslaughter in Bawa-Garba inquiry. doctors.net.uk, 2018; Updated 19 Mar 2018; Accessed: 2018 (19 Mar): (https://news.doctors.net.uk/news/27947).] == Healthcare workers convicted of gross negligence manslaughter == == Healthcare workers convicted of gross negligence manslaughter == [...]



The Bawa Garba case

Thu, 19 Apr 2018 13:20:15 GMT

14 April 2018 The Lancet editorial calls for resignations at the GMC: ← Older revision Revision as of 13:20, 19 April 2018 Line 134: Line 134: :''The GMC's leadership has lost the trust of the profession and public. Empty apologies and further reviews are not enough. To rebuild confidence in the GMC, its Council Chair Terence Stephenson and Chief Executive Charlie Massey must resign.''[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30838-9/fulltext The Lancet. The General Medical Council has lost its way. Lancet 2018;391(10129):1456, DOI: 10.1016/S0140-6736(18)30838-9  (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30838-9/fulltext).] :''The GMC's leadership has lost the trust of the profession and public. Empty apologies and further reviews are not enough. To rebuild confidence in the GMC, its Council Chair Terence Stephenson and Chief Executive Charlie Massey must resign.''[http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30838-9/fulltext The Lancet. The General Medical Council has lost its way. Lancet 2018;391(10129):1456, DOI: 10.1016/S0140-6736(18)30838-9  (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30838-9/fulltext).]  +  +==== 19 April 2018 Marx Review Terms of Reference published ====  +The GMC's Marx Review of gross negligence manslaughter and culpable homicide (in Scotland) were published on 19 April [[2018]] (or possibly before that date - the document is undated), and the [https://www.gmc-uk.org/news/news-archive/responding-to-the-case-of-dr-bawa-garba page linking to it] gives no indication of when the TsoR were published).[https://www.gmc-uk.org/news/news-archive/responding-to-the-case-of-dr-bawa-garba GMC. Terms of reference: Review of gross negligence manslaughter and culpable homicide. 2018 (??19 April - undated) GMC, London] or [https://www.gmc-uk.org/-/media/documents/terms-of-reference-for-gnm-review-_pdf-73991039.pdf direct link to pdf]  +  +See [[Manslaughter#Dame Clare Marx Review of gross negligence manslaughter|Dame Clare Marx Review of gross negligence manslaughter section of manslaughter page]] for more information. ===Crowdfunding to fight this case=== ===Crowdfunding to fight this case=== [...]



Tetanus

Wed, 18 Apr 2018 20:34:17 GMT

update as yet another tetanus immunoglobulin shortage in UK ← Older revision Revision as of 20:34, 18 April 2018 Line 26: Line 26: ===Preventing Effects of Toxin=== ===Preventing Effects of Toxin=== -{{WarningBox|In the absence of prior immunisation, administration of [[:Category:Therapeutic_antibody#Tetanus|anti-tetanus serum]]. This is a form of [[immunity|passive immunity]], where [[antibody|antibodies]] produced by other humans are administered to neutralise the toxoid.}}+{{WarningBox|In the absence of prior immunisation, administration of [[:Category:Therapeutic_antibody#Tetanus|anti-tetanus serum (tetanus immunoglobulin)]] IM. This is a form of [[immunity|passive immunity]], where [[antibody|antibodies]] produced by other humans are administered to neutralise the toxoid.}}  +*If no prior immunisation IM Tetanus immunoglobulin. Some human normal immunoglobulin can be substituted[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/441355/IMW165.02_Tetanus_Immunoglobulin_Handbook_v1.4.pdf Tetanus treatment Public Health England 2015]. *Tetanus booster if not in date, i.e. no booster in last 10 years, and less than 5 injections during life time. *Tetanus booster if not in date, i.e. no booster in last 10 years, and less than 5 injections during life time. *In the UK, tetanus toxoid comes as the DTP combination ([[diphtheria]], tetanus and [[poliomyelitis]]). Unfortunately, if patients are fully up-to-date for diphtheria and poliomyelitis, there is no single tetanus toxoid injection (use the DTP combination Revaxis®). *In the UK, tetanus toxoid comes as the DTP combination ([[diphtheria]], tetanus and [[poliomyelitis]]). Unfortunately, if patients are fully up-to-date for diphtheria and poliomyelitis, there is no single tetanus toxoid injection (use the DTP combination Revaxis®). Line 33: Line 34: == Management of Tetanus == == Management of Tetanus == -Admit. Paralysis and ventilation may be required.+Admit. Paralysis and ventilation may be required. [[Intravenous immunogobulin]] is effective but the dose depends upon the anti tetanus toxin activity of the product[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/441355/IMW165.02_Tetanus_Immunoglobulin_Handbook_v1.4.pdf Tetanus treatment Public Health England 2015]. == External Links == == External Links == [...]



Hypertension

Wed, 18 Apr 2018 20:24:08 GMT

more epidemiology ← Older revision Revision as of 20:24, 18 April 2018 Line 15: Line 15: *alcohol intake *alcohol intake *psychological stress *psychological stress  +**Note "White coat hypertension" is significantly associated with mortality ===Secondary Hypertension=== ===Secondary Hypertension=== Line 38: Line 39: ==Clinical== ==Clinical== === End-organ Damage=== === End-organ Damage=== -The end-organs affected by hypertension include the arterial lining, the heart and kidney, the eye and the brain.+The end-organs affected by hypertension include the arterial lining, the heart and kidney, the eye and the brain. Twenty-four hour systolic BP is more strongly associated with mortality than one off clinic measurement. Interestingly masked hypertension in which clinic BPs are normal while 24 hour BPs are elevated is a stronger predictor of mortality than sustained hypertension (both clinic and 24 hour BP raised) or "white coat" (ie clinic only) hypertension. Blood pressures greater than 170/105 are those with a distinctly higher risk of five year death (over 40%). {{BiteBox|Evidence of end-organ damage is an indicator for treatment.}} {{BiteBox|Evidence of end-organ damage is an indicator for treatment.}} [...]



Medicines shortages

Wed, 18 Apr 2018 20:13:03 GMT

update ← Older revision Revision as of 20:13, 18 April 2018 Line 93: Line 93: *[https://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM372566.pdf Strategic Plan for Preventing and Mitigating Drug Shortages  Food and Drug Administration October 2013] *[https://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM372566.pdf Strategic Plan for Preventing and Mitigating Drug Shortages  Food and Drug Administration October 2013] *[https://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm349561.htm FDA current prescription drug shortages news]   *[https://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm349561.htm FDA current prescription drug shortages news]   -*Following Baxter’s Puerto Rico manufacturing plant being hit by Hurricane Maria in August [[2017]] a nationwide shortage of small volume normal saline for infusion resulted. It transpired there were only three manufacturers for the entire market. There had been similar shortages in 2007, that time due to manufacturing capacity not being sufficient to meet increased demand for a year, and since 2013 constant manufacturing issues for other types of medical saline products. Temporary licensing and imports from elsewhere then destabilised the wider international supply chain.+*Following Baxter’s Puerto Rico manufacturing plant which held 44% of market share, being hit by Hurricane Maria in August [[2017]] a nationwide shortage of normal saline for infusion resulted. It transpired there were only three manufacturers for the entire market. There had been similar shortages in 2007, that time due to manufacturing capacity not being sufficient to meet increased demand for a year, and since 2013 constant manufacturing issues for other types of medical saline products. Temporary licensing and imports from elsewhere then destabilised the wider international supply chain. }} }} {{refsec}} {{refsec}} [[Category:Politics]] [[Category:Politics]] [[Category:Pharmacology]] [[Category:Pharmacology]] [...]



Medical records

Wed, 18 Apr 2018 08:52:49 GMT

← Older revision Revision as of 08:52, 18 April 2018 Line 1: Line 1:  +[[Category:Clinical Governance]]  +[[Category:Communication]]  + Medical records are complex collections of data, commonly distributed, and serving many functions some of which conflict with each other. Medical records are complex collections of data, commonly distributed, and serving many functions some of which conflict with each other. -Records need to be structured to a degree, but also to present a narrative.+Records need to be structured to a degree, but also to present a narrative. [https://www.rcplondon.ac.uk/projects/outputs/standards-clinical-structure-and-content-patient-records Health and Social Care Information Centre, Academy of Medical Royal Colleges. ''Standards for the clinical structure and content of patient records.'' London: Health and Social Care Information Centre and Academy of Medical Royal Colleges, 2013(13 July); 1-73 (https://www.rcplondon.ac.uk/projects/outputs/standards-clinical-structure-and-content-patient-records).] ==Functions== ==Functions== Line 46: Line 49: ==External Links== ==External Links== *[http://www.medicalprotection.org/medical/united_kingdom/publications/booklets/default.aspx MPS publications on record keeping] *[http://www.medicalprotection.org/medical/united_kingdom/publications/booklets/default.aspx MPS publications on record keeping]  +*[https://www.rcplondon.ac.uk/projects/outputs/standards-clinical-structure-and-content-patient-records Health and Social Care Information Centre, Academy of Medical Royal Colleges. ''Standards for the clinical structure and content of patient records.'' 2013][https://www.rcplondon.ac.uk/projects/outputs/standards-clinical-structure-and-content-patient-records Health and Social Care Information Centre, Academy of Medical Royal Colleges. ''Standards for the clinical structure and content of patient records.'' London: Health and Social Care Information Centre and Academy of Medical Royal Colleges, 2013(13 July); 1-73 (https://www.rcplondon.ac.uk/projects/outputs/standards-clinical-structure-and-content-patient-records).] {{UK|There are NHS national standards endorsed by Connecting for Health}} {{UK|There are NHS national standards endorsed by Connecting for Health}} *[http://information.connectingforhealth.nhs.uk/default.aspx?Category=Digital%20Health%20Information%20Policy&SubCategory=Booklet link to purchase] ([http://www.rcplondon.ac.uk/clinical-standards/hiu/medical-records/Pages/clinicians-guides.aspx link to download unlikely to be available to most]) *[http://information.connectingforhealth.nhs.uk/default.aspx?Category=Digital%20Health%20Information%20Policy&SubCategory=Booklet link to purchase] ([http://www.rcplondon.ac.uk/clinical-standards/hiu/medical-records/Pages/clinicians-guides.aspx link to download unlikely to be available to most]) -[[Category:Clinical Governance]]+  -[[Category:Communication]]+{{Refsec}} [...]



Manslaughter

Tue, 17 Apr 2018 14:02:10 GMT

Submissions to the Williams review: ← Older revision Revision as of 14:02, 17 April 2018 (One intermediate revision not shown)Line 30: Line 30: ==== Submissions to the Williams review ==== ==== Submissions to the Williams review ==== Submissions to date include the following. Submissions to date include the following. -*[https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review Submission from the Medical Protection Society][*[https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review Bradshaw P, Hanington L, Reynolds T. Evidence to the Professor Sir Norman Williams Review: Medical Protection Society (MPS), 2018(13 March 2018);  (https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review)]+*[https://www.bma.org.uk/collective-voice/committees/medico-legal-committee/medical-manslaughter/bma-response-to-norman-williams-review BMA response] [https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/committees/medico%20legal/bma-response-sir-norman-williams-review-apr-2018.pdf (pdf)][https://www.bma.org.uk/collective-voice/committees/medico-legal-committee/medical-manslaughter/bma-response-to-norman-williams-review BMA. BMA response to Sir Norman Williams Review. London: BMA, 2018(17 Apr); 1-13 (https://www.bma.org.uk/collective-voice/committees/medico-legal-committee/medical-manslaughter/bma-response-to-norman-williams-review).] [https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/committees/medico%20legal/bma-response-sir-norman-williams-review-apr-2018.pdf (pdf)]  +*[https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review Submission from the Medical Protection Society][https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review Bradshaw P, Hanington L, Reynolds T. Evidence to the Professor Sir Norman Williams Review: Medical Protection Society (MPS), 2018(13 March 2018);  (https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review)] *[https://www.themdu.com/about-mdu/our-impact/our-impact-archive/mdu-urges-for-clearer-coroners-guidance-to-minimise-manslaughter-investigations Submission from the MDU][https://www.themdu.com/about-mdu/our-impact/our-impact-archive/mdu-urges-for-clearer-coroners-guidance-to-minimise-manslaughter-investigations Barker I. Professor Sir Norman Williams Review into gross negligence manslaughter in healthcare: Medical Defence Union submission: MDU, 2018(27 March);  (https://www.themdu.com/about-mdu/our-impact/our-impact-archive/mdu-urges-for-clearer-coroners-guidance-to-minimise-manslaughter-investigations).] *[https://www.themdu.com/about-mdu/our-impact/our-impact-archive/mdu-urges-for-clearer-coroners-guidance[...]