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Insight-Secondary-Q2-2020.Pdf Featuring: Raising concerns amidst COVID-19 / Remote consulting in the coronavirus outbreak / Dealing with racism / Making SEA work for you Peak performance Emergency medicine doctor Stephen Hearns on performing under pressure Welcome Dr Greg Dollman Editor WELCOME to the first issue of Insight Secondary Care – one of three new quarterly magazines we are launching at MDDUS to broaden the scope of content we produce for all our medical and dental members. I am excited to take on the role of editor and hope you find this inaugural issue both interesting and useful. All comments and suggestions are most welcome. Coronavirus is presenting an enormous challenge for the health service, so in this issue we feature relevant, practical advice for clinicians. On page 4 risk adviser Kay Louise Grant highlights key points when raising safety concerns in times of crisis. Remote consulting has become a crucial part of coronavirus care. On page 5 risk adviser Alan Frame explores how to minimise risk in treating patients online or via telephone or video. If anyone knows how to perform under pressure it’s emergency medicine MEDICATION physician and helicopter rescue medic Dr Stephen Hearns. He talks fighting fatigue and avoiding “frazzle” on page 8. HIV treatment roll-out Significant event analysis is not easy to get right and many of the SEAs we see at MDDUS are more description THE preventative HIV treatment PrEP is to be rolled out across than analysis. On page 10, Liz Price offers tips on making England thanks to a £16 million funding boost. them more than just box-ticking exercises. Over the next year, local authorities will receive the cash to On page 6 we look at what to do when confronted with make the drug available in sexual health clinics for anyone who racist patient behaviour – challenge it or simply “turn the is at a high risk of contracting HIV. other cheek”? The move is part of the government’s aim to end HIV Professor Deborah Bowman offers a personal perspective transmission by 2030. (page 13) on how even “small things” can reflect ethical Studies have shown that, taken daily, PrEP reduces the risk of choices when it comes to dealing sensitively with patients. getting the virus from sex by about 99 per cent. Our case study on page 12 highlights issues around It is currently available in England through the three-year PrEP consent in a patient diagnosed with an inguinal hernia. impact trial which has recruited more than 20,000 participants. Addenda on page 14 includes some curious cardiac The new funding boost will ensure those taking part in the trial imaging, reviews of Bill Bryson’s brilliant new book The can continue to take the drug once the trial ends. Body and the corporate crime film thriller Dark Water, The move comes almost three years after the Scottish along with a vignette of Dr Margaret Fairlie – pioneering Government made PrEP freely available in July 2017 to obstetrician and gynaecologist, and the first professorial individuals across Scotland at highest risk of HIV. chair in Scotland. Health and social care secretary Matt Hancock said: “This will benefit tens of thousands of people’s lives.” Dr Greg Dollman Editor DATA PROTECTION EDITOR EDITORIAL DEPARTMENTS Greg Dollman Medical: Dr Richard Brittain Legal: Joanna Jervis Information sharing MANAGING EDITOR Joanne Curran MDDUS NHSX in England has said that in the current circumstances ASSOCIATE EDITOR Mackintosh House with COVID-19 it could be more harmful not to share health and Jim Killgore 120 Blythswood Street care information than to share it. Glasgow G2 4EA The organisation has had assurances from the Information DESIGN Connect Communications t: 0333 043 4444 Commissioner that she “cannot envisage a situation where she 0131 561 0020 e: [email protected] would take action against a health and care professional clearly www.connectmedia.cc w: www.mddus.com trying to deliver care”. NHSX states: “We will need to work in different ways from Insight – Secondary Care is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, usual and the focus should be what information you share and 120 Blythswood Street, Glasgow G2 4EA. Tel: 0333 043 4444 Fax: 0141 228 1208 who you share it with, rather than how you share it.” Email: General: [email protected] Membership services: membership@mddus. Find out more at tinyurl.com/twabbcl com Marketing: [email protected] Website: www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Articles of Association. The opinions, beliefs and viewpoints expressed by the various authors in Insight – Secondary Care are those of the authors alone and do not necessarily reflect COVER PHOTOGRAPH: ANDREW CAWLEY/DCT MEDIA CAWLEY/DCT ANDREW PHOTOGRAPH: COVER the opinions or policies of MDDUS. Fees waived STUDENTS starting their foundation year 1 post early to assist the COVID-19 response will have their MDDUS membership fees waived. To take advantage of this offer, email [email protected] ANNOUNCEMENT Message from CEO Chris Kenny on COVID-19 WE know that the practical, ethical Reporting a claim and ongoing cases • Third, we are giving the option to and legal challenges you face will only We must urge members to use email rather reduce subscriptions for doctors in increase in the coming weeks. than telephone communication wherever private practice facing reductions in their possible. Not only will this mean fewer income. We will continue to do our best to Continuity unavoidable delays to us assisting you, it provide the best value that we can as we Our full service will remain available to also means we will be able to help more consider future pricing. our members throughout the duration members, more efficiently. of this uncertain time. We will keep If you do need to call us, our number How we will keep you updated you informed of any changes we are remains 0333 043 0000. This service will We have developed a coronavirus required to make in response to new UK continue on a 24/7 basis, and as the information hub at www.mddus.com/ Government legislation. coronavirus situation develops we will coronavirus It features links to the We know that Government has invest in new lines to embed this service latest official advice as well as common confirmed it will provide indemnity for and ensure its sustainability. medicolegal queries and employment clinical negligence liabilities arising law Q&As. We will continue to refine and from NHS activities carried out in Membership update this information. relation to coronavirus where there is I want to give three clear messages about We will continue to support you with no existing indemnity arrangement in membership: risk management training material and place. • First, we are enabling the return of also communicate with you via our social The vast majority of MPTS hearings will recently retired members by automatically accounts, predominantly our Twitter be scaled back until 5 July. We’re pressing giving free non-claims indemnity to account @MDDUS_News regulators to respond pragmatically doctors returning to clinical practice who At this unprecedented time our entire across the board, being robust in triage retired up to six years ago, and who have effort is to support you, our members. of cases and getting certainty quickly, been granted temporary registration by If you have a concern, or are unsure who rather than cutting corners. the GMC. You do not need to contact us to to contact about a difficult decision, access this – we are writing to all members contact us. If you are worried about a Business continuity who fall into this category. colleague or your own capability, contact I have asked my entire team to work • Second, we know that counting hours and us. And if you need general advice about from home for the foreseeable future. sessions will be one of the last things on your membership or regarding work Our team is of sufficient size, diversity of your mind. So we will enable retrospective you are being called upon to deliver, skillset and flexibility that we believe we adjustments where you either cannot contact us. can maintain business as usual whilst sensibly forecast your workload or it varies working remotely from our two offices. suddenly and unexpectedly. MDDUS is here for you. Blood test holds promise A NEW blood test has the potential to from patients with cancer represented more detect more than 50 types of cancer as than 50 cancer types. well as their location within the body, say The researchers report that the test was researchers. over 99 per cent accurate in detecting that The test uses DNA sequencing to identify cancer was present and it correctly identified the presence of cell-free DNA from specific the organ or tissue where the cancer cancerous cells entering the bloodstream originated in more than 90 per cent of cases. upon cell death. In the study, investigators Dr Geoffrey Oxnard of the Dana-Faber analysed 6,689 blood samples, including 2,482 Cancer Institute, co-lead author of the study, from people diagnosed with cancer and 4,207 said: “The test can be an important part of from people without cancer. The samples clinical trials for early cancer detection.” MDDUS INSIGHT SECONDARY / 3 SAFETY RAISING CONCERNS AMIDST COVID-19 Kay Louise Grant Risk adviser at MDDUS EALTHCARE services are facing increasing pressure to cope with demand caused by the coronavirus outbreak – and some NHS staff are already working at capacity. Practising in this type of environment Hand treating patients under new protocols means that you may have concerns about the risks to patients, colleagues and yourself.
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