The Sugar Tax positives (3)and negative (3)
:)
- Fall in amount of surgary drinks purchased - health
- Revenue used for research, treatments, subsidies
- Global support - other countries introduce it
:(
- recent figures Mexico showed rebound
- ETHICS: Some families prevented from buying product- autonomy. Soft paternalism? So government educates instead of telling
- Eg. Type 1 diabetic relying on sugary drinks for hypoglycaemic episodes
JDC: positives and negatives
.
JDC: should they strike?
YES: patient at risk
non-emergency practises- inconvenience
other public sector jobs can strike
NO: patient at risk if A&E
public regard doctors as high paid job- striking my seem un-professional and lose trust
Problems of NHS
- ageing and growing population
- increase of obesity and diabetes
- medical advancements- high costs
- increase reliance of private areas
- closure of local services like A&E due to centralisation
Should it be privatised?
NO: NHS values, justice, money motivation, more difficult to record practises, postcode lottery (varying standard care),
YES: efficient, increase in competition, save money NHS
Principles of NHS (7)
- SERVICE AVAILABLE TO ALL
- ACCESS BASED ON CLINICAL NEEDS, not ability to pay
- ASPIRES TO HIGHEST STANDARDS OF EXCELLENCE AND PROFESSIONALISM
- PATIENT AT HEART
- Works across organisational boundaries and in partnership w other organisations in INTEREST OF PATIENT
- BEST VALUE for taxypayer’s money
- ACCOUNTABLE-system of responsibility,
Harold Shipman: case and consequences
Blackouts- addicted to opiate (e.g. Morphine), barred from jobs access drugs
GP convicted of murder 15 and forgery will
GMC did not strike off from Medical Register
Set up own GP
Lots of elderly deaths after seeing him
~200 deaths associated
- Less Single- handed GP practices
- Tighter regulations on use of controlled drugs
- Tighter regulation of death certification- cremated patients require 2 signatures
- Review of revalidation process
Issue: MMR vaccine 2013 measles epidemic
- against research (5)
- result of investigation (4)
Wakefield published research paper linking MMR vaccine and autism+ bowel disease
But:
- No researches able to confirm
- Reporter produced evidence that he applied for a patent on single- Jab measles before campaign, planned for new medical tests for profit- autistic entercolitis
- Student testified wake ignored conflicting data
- Research based on 12 cases- 5 of which pre existing developmental concerns
- Some children reported symptoms days after but actually months
GMC investigated:
- Paid conduct study solicitors of children believed to be harmed
- Ordered investigations without approval of departments ethic board
- Dishonest- bought blood samples for £5 from sons bday party
- Study not approved by ethics committee
2013: measles epidemic
Revalidation (4)
2012:
1. Licensed doctors link to responsible officer
2. Participate annual appraisal based on portfolio (info, continuous professional development record, review and feedback own practice)
3. Responsible officer recommend to GMC about doctor every 5 years
4. GMC to revalidation a licensed doctor informed by Responsible Officer recommendation
Revalidation pros (2) cons (4)
pro:
Formalises practices that could be ad hoc basis previously
Compliance with basic requirements- focus on appraisal process
Cons:
Will not stop another shipman
May not ensure proper management of individuals at other times of the year
May be too late (appraisal points once a year)
May require info that trusts to do not hold
Clinical governance (5)
- Practice compliant with latest evidence- up to date, adjust, audit
- Safe care, no risk, owe mistake
- recognise limitations
- Constantly Develop skills train and educate others
- Attentive to patient- feedback
Audit process
What is it
How it works (7) audit cycle
Importance (4)
•assess performance against standards
- Choose topic for audit
- Define standard to be achieved
- Collect data
- Compare results of analysis against standard
- Identify changes
- Implement changes
- Re-audit months later
- Identify weaknesses in practice increase quality
- Identify inefficiencies- better use of resources
- Provide info on quality of care to outside agencies
- Opportunities train and education
