USPFA appear to be a pilots' organisation. Is this a typo? If so, what organisation do you mean?
How can this have got ethical approval??
I always understood that, due to issues around consent, no DNA test would be offered in childhood for diseases that only present in adulthood.
HS-L: "...it’s important that regular reviews are undertaken..."
But if the problem is that primary care time is being wasted on poor-value interventions, regular reviews will only worsen the situation.
I don't recall completing these forms - is it a common thing?
@11:23 I was under the impression that NEWS2 hasn't been validated in primary care settings, and that there was little evidence available in such settings.
EG: "there isn’t much clear evidence to support their use" - from researchers at:
It's a nonsense to arbitrarily deem X to be responsible for Y when there exists a massive body of medicolegal case law establishing who is - in legal fact - responsible for what.
I do not, in legal fact, have any extra responsibility for Mrs Smith's care just because my name appears in her notes as her named GP.
This sounds like an unusually complex situation: how often do we have to deal with a patient jumping in front of a train who happens to have had an unrelated cardiac arrest the previous month and who also happens to have an unrelated terminal illness and an unrelated degenerative disease?
There is a danger that if we alter systems to better cope with this type of very rare case, the result will be increased bureaucracy when dealing with simple cases. And this increased bureaucracy will itself put other lives at risk by taking up more clinician time.
Good point. When I was at school a billion meant a million million, and this gives a figure of 0.007%. But now the US meaning of a thousand million is normal, giving 7%.
Interesing discussion above.
Improving health doesn't guarantee a reduction in healthcare demand / social costs, which may paradoxically rise.
EG fewer premature cardiac deaths means more people surviving to old age with concomitant risk of dementia, care needs etc
It may be a fact that inhalers are being over-prescribed in chest infections.
But even if so, that doesn't necessarily make it a problem.
I think the problem is more subtle: what proportion leads to action that is almost certainly pointless?
(Vitamin D, I'm looking at you... marginally raised TSH, I'm looking at you... eGFR of 54, I'm looking at you... hba1c of 42...)
Actually I don't want my guidelines nuanced. I want them to be simple enough to memorize...
...or, if not memorable, at least comprehensible at a glance on a single page / screen.
But I agree having a link to more detailed info would be nice.
There was a BMJ review saying the same in 2012
Since then I don't really use them except to diagnose PMR and inflammatory arthritis, and I gently discourage my trainees from using them.
I have not so far had a complaint / medicolegal issue arising. If one arises I feel I have the evidence to justify my decision.
(Unfortunately they still form part of various referral pathways in our CCG including memory clinic!)
The Doctors Association spokesman seems to have missed the point.
A higher PROPORTION of received complaints are investigated against BME doctors.
Dr Vaughan implies that this is the result of trusts making higher NUMBERS of complaints against these doctors.
But clearly a higher number of complaints doesn't explain a higher proportion investigated.
Computer prompts! Yay!
I was just thinking I could do with more of them.
Only true if they died in the UK I presume
Indeeed. And on a local level it should be a QOF requirement for each practice should keep a register of all the registers it keeps.
Will be interesting to see what happens.
There seems to be a contradiction between two of the NHSE's aspirations for GP at the moment:
to make access more convenient by directly booking GP appointments
to direct pts to non-GP clinicians where possible, which requires triage (IE requires that GP appointments are not directly booked)
I don't know if this contradiction has been explicitly acknowledged - perhaps it has...
It is hard to see how this "responsibility" could work in practice, given Copernicus's point that we are not generally notified of admissions.
I suppose it is relevant on the occasions that a GP is making the admission.