Monday, June 18, 2018

Campus To Clinic Community Vists, and Community Consultations.

I've just completed giving feedback to the first and second year medical students on their group reports on community visits (in groups of four) to voluntary groups in North and West Yorkshire whilst at Primary Care. The standard again has been very good and the students visited 126 diverse community organisation plus the variety of the visits never ceases to impress me. I also recently attended a couple of consultations meetings in Leeds and the first was on 'Charging Overseas Visitors for Health Services.' This was hosted by Leeds City Council (Public Health) and the NHS and whilst no-one would perhaps disagree that wealthy overseas visitors should pay for health services, it does seem that the Government is taking a sledgehammer to crack a nut. Evidence seems to suggest that the way the policy is being implemented is impacting upon poorer migrants, refugees and asylum seekers and as one front line refugee and asylum seeker worker said: "It is hard to do a bad policy compassionately." The second consultation was run by Leeds and York Partnership NHS Foundation Trust and was on 'Changes to Mental Health Services.' These proposed changes will hopefully improve services by focussing on two different age groups separately, 16-65, and 65+. A lot of good comments were made by the service users, ex-service users, and voluntary sector representatives present. A point was made that 20% of all NHS letters received are not understood and we should perhaps make the language simpler, avoid jargon, perhaps be briefer, and use pictures where possible? It was also felt that we needed to cater for those "Who wanted somewhere to go." One presenter made the good point that we needed to counter loneliness in society and also we needed to have a "Need led service." In supporting older people in Care Homes and those with dementia in written feedback I suggested we could possibly explore the use of virtual reality (and this is being trialled around the country by organisations such as VR Doctors). The feeling of those present was that we also needed to keep individual care plans as everyone is unique but it was mentioned that we further needed effective partnerships with voluntary groups and we should not expect the third sector to take on additional roles without proper resources; we would then follow a holistic approach. One final point was that where possible people preferred face-to-face conversations rather than by telephone. SO WHAT'S IN THE BMJ THIS WEEK? . Swiss doctors object to new suicide guidance. . Scotland identifies public health priorities. . NHS must work harder to retain clinical workforce, says NHS Confederation Chief. . Cities with devolved powers can improve public health, finds Kings Fund. . Home Office scraps cap on doctors' visas. . Social media should take more responsibility for children's mental health, says NHS boss. . Online opioid distributors must cease trading, US drug regulator warns. . NHS leaders pledge to cut delayed discharges by 25%. . Creating a debate on air pollution. . US suicide rate is climbing steadily with highest prevalence in sparsely populated western states. . GMC stripped of right to appeal against tribunal decisions. READ ALL ABOUT IT! With best wishes, Barry

Monday, May 21, 2018

Leeds Food Aid and the Need to Change the Welfare Narrative

I attended a wonderful meeting of Leeds Food Aid Network (LFAN) on the 10th of May and they organise food collections from the public and supermarkets etc. and via Food Banks give out food parcels to citizens in the city. Their research showed that demand for food bank parcels had grown by 3% in a year and this was up from 26,831 parcels in 2016 to 27,873 in 2017 with the main Tressell Trust being responsible for 67% of food banks parcels. I learnt a lot at this meeting and for example people are only entitled (after being referred) to 3 parcels every 6 months. Benefit cuts was given as the main reason for food poverty by the respondents and I argued that tragically there was significant public support for benefit cuts and we perhaps needed to change the narrative on welfare. There seems to be two welfare states in the UK, one for ordinary people which is meagre, is often associated with stigma and shame and another for the wealthy with over 1,000 tax reliefs, £93b in corporate tax cuts and tax subsidies (the equivalent of £3,500 per household) and tax avoidance by the wealthy of £120b a year. As a civilised society perhaps we need to change the narrative that seems to blame the poor to one of decent benefits for all (and we may need one day), hopefully then there would be no need for food banks although we should still continue to make better use of food which is currently wasted. LFAN found 50% of referrals to food banks were for single people (up from 45% last year) and 17% were from single parents, 16% were from dual parents and 3% put their need down to benefit delays; low income was given by 24.5%) and 18% blamed benefit changes and 9% pointed to debt. For a fairer, better, more equal society we perhaps need decent welfare for all which treats citizens with dignity. SO WHAT'S IN THE BMJ THIS WEEK? . Assisted dying: Guernsey rejects proposal to move forward legislation. . Promises to treat more people at home fails to materialise as community services report cuts. . BMA reopening negotiations over imposed junior doctor contracts. . FDA names and shames branded pharma companies that obstruct generics development. . New guidance on reflective practice to be published in wake of Bawa-Garba case. . Capping entry visas is creating "massive longstanding" problems says head of NHS trust. . Junior doctor wins legal protection for all trainees who report safety concerns. . UK is taken to court for failing to tackle air pollution. . Experimental vaccine ready for use in Congo's Ebola outbreak. . Fall in GP numbers "extremely concerning" says BMA. . Accountable care organisations: campaigners lose first legal fight over NHS rollout. Read all about it! With best wishes, Barry

Monday, April 30, 2018

Outreach, Inreach and Prepariing for the Future.

I recently helped on a stall at the Boyz2Men Men's Health Fair Event on the 28th of March at the West Indian Centre in Leeds LS7. It seemed to go pretty well and I even leafleted on the high street for a while to try to get more local people in. At the event I also attended a Question and Answer session with local men and a local male GP and this was absolutely brilliant! After 18 years in my post I will be retiring in October this year and I had a good meeting with senior managers in my School to discuss continuing this post and the recruitment process for a new person. In the School I have also continued to contribute to working groups such as one on staff equality issues - Athena Swann including attending a focus group on Flexible Working and I also attended The Transitions Team (which looks at student retention). For this group I wrote up a case study on my Inclusion Health - Valuing Diversity workshop on 'Working Class Doctors' plus I summarised two pieces of research on Widening Participation and it was great to hear that a fourth year medical student wants to make a video on her experiences coming to medical school and perhaps we need to collect more and diverse student stories to share with the early year students. I continue giving my time back to the community by being on the management committee of The Jigsaw Visitor's Centre (Leeds Prison), Leeds Men's Health & Wellbeing Network, Leeds BME Hub, and The City of Sanctuary Health Network. In Campus to Clinic 1/2 I have given feedback on 50 of the student brief community visit reports (one side of A4) and only have 70 more to do by the 29th of May but another enjoyable and rewarding few months working with students and community organisations. SO WHAT'S IN THE BMJ THIS WEEK? . Alfie Evans case: Proposed law aims to prevent conflicts between parents and doctors. . Indian paediatrician arrested over deaths of dozens of children gets bail after campaign to free him. . Junior doctor whistle blowers need protection they can trust, says Robert Francis. . Government is slow to act on NHS sustainability recommendations, says peers. . UK will explore net zero carbon emissions policy by 2050. . UK needs over 700 paediatric consultants, says Royal College. . NHS hospital drug costs are set to surpass spending in primary care. . Illicit drug use should not be a crime, says Royal College of Physicians. . NHS accountable care organisations would be unlawful campaigners tell high court. READ ALL ABOUT IT! With best wishes, Barry

Monday, March 26, 2018

Continuing Community Commitment

I have recently been helping to plan a Men's Health Fair with the Boyz2Men Project for diverse men in Leeds LS7/LS8 as their 12 month Clinical Commissioning Group funding comes to an end. I hope the fair on the 28th of March goes well and I will also be helping on Leeds Men's Health and Wellbeing stall at the event. We will then possibly be looking for some new funding to continue this valuable work in the future. I continue to attend our School's Transitions Team (to aid student retention) and I wrote a small piece for them on the School's Widening Participation work plus on my IDEALS 2 Inclusion Health - Valuing Diversity workshop on Working Class Doctors. I gave a brief talk to the BME Hub at Leeds Civic Hall in March on the work of Leeds Men's Health & Wellbeing Network (with Claude Hendrickson our Chair) and we think that this stimulated a very useful discussion. The University and College trade union (UCU) recently put on some really innovative Teach Out talks in the local community and I attended a few which I think were excellent. One was on an early 19th Century Black Chartist Leader in England (William Cuffay) and some argue that often Black people (like the working class in general) may often be written out of history. The other was on 'The 1938 Jamaican Labour Rebellion' and perhaps it could be argued that perhaps we can learn much from history. Finally I am currently marking the first and second years' Campus to Clinic brief reports (one side of A4) on their community visits whilst at Primary Care and hopefully these experiences will help the students to think more holistically about healthcare. As future doctors they may also then be able to signpost some patients to voluntary groups for additional support. I have marked 45 so far out of the 120 and they have until the end of May 2018 to do this. The student reports never fail to pleasantly surprise me particularly concerning the diversity of the organisations that they have visited. SO WHAT'S IN THE BMJ THIS WEEK? * Questions of research conduct follow Trump's pick for CDC (Centres for Disease Control and Prevention) director. * Doctors can take blood from Skripals for chemical weapons testing, rules judge. * BMA and government reach agreement on doctors' bonus scheme. * Call for new impetus to tackle TB across Europe. * Vote on legalising assisted dying in Guernsey is due in months. * Five medical schools are created in England in a bid to increase home grown doctors. * Brexit negotiators must seek "closer possible regulatory alignment" to protect patients and industry. * Britons in last year of life had 1.6 million emergency admissions. * Child health crisis calls for urgent action must not go unheeded. READ ALL ABOUT IT! With best wishes, Barry

Thursday, February 01, 2018

Our Community Based Medical Education Continues

We have just finished marking the December RESS Year 2/3 Student Selected Project reflective diaries and from our moderation meeting you get to see the fantastic range of SSP choices on offer to the medical students such as one on Music and Arts in Medical Education. The 31 Community Options that I marked were generally of a very good standard and feedback from all of the parties involved was very positive. Our IDEALS 2 Inclusion Health - Valuing Diversity workshops in January also went really well and I passed on the students' ideas from a case study in my Working Class Doctors workshop to our Widening Participation Team for consideration and action! I was very proud that our School hosted the January national meeting of the Diversity in Medicine and Health (DIMAH) group and the session went really well plus people were able to get away before the snow arrived! It could be a very exciting new year for DIMAH as they elect a new Chair with a new vision and I think we should all acknowledge the excellent and pioneering work carried out by the retiring Chair, Professor Nisha Dogra, over many years. Our School is a member of DIMAH and we will continue to support this valuable work with our involvement and see their website at: www.dimah.co.uk/ I am also giving Year 1 & 2 students feedback on their small group community visits whilst at Primary Care (as part of Campus to Clinic) and it is wonderful to read about their diverse range of community visits which will hopefully help the medical students to think more holistically about healthcare. SO WHAT'S IN THE BMJ THIS WEEK? . . Former USA Gymnastics team doctor sentenced for abusing hundreds of girl athletes. . Use paracetamol for most acute sore throats, says NICE. . Government postpones first Accountable Care Organisations (ACOs) to allow further consultation. . Alcohol labels should include information on calorie content, public health doctors say. . "No deal" Brexit would threaten access to new drugs, Hunt warns. . NHS care has worsened over the past decade, doctors warn. . Drug shortages derail CCGs budgets. . Government is not doing enough to improve children's health, paediatricians warn. . NHS England faces legal challenge over proposed changes to services. . Money to transform NHS services is diverted to reducing deficits, watchdog finds. . Public will have to pay £220b for PFI until 2040 NAO calculates. READ ALL ABOUT IT! With best wishes, Barry

Thursday, January 04, 2018

Marking and a New Term Begins!

Over the next two weeks I will be marking the 31 student reflective diaries and community newsletter pieces from our recent RESS Pre-Xmas Student Selected Projects placements (Community) with community organisations in Leeds. I am also regularly checking Minerva (our virtual learning environment) for small group short student reports on their community visits to local community organisations whilst at Primary Care which is part of Campus to Clinic Years 1 & 2, and I offer students feedback on these. The 15th of January will see our second set of IDEALS 2 Inclusion Health - Valuing Diversity workshops in the School and I will be running my usual workshop on 'Working Class Doctors'. I will then get back to attending a range of meetings at community organisations in the city. I am really proud that our School will be hosting the next national meeting of Diversity in Health and Medicine (DIMAH) on the 16th of January and we are members of this network - check out their website at www.dimah.co.uk/ I will also be attending a very interesting sounding lecture in our School at the end of the month by Professor Hilary Becker on 'Making Decisions Better Together' which I believe includes involving patients. Our medical students return next week and the new term then begins! SO WHAT'S IN THE BMJ THIS WEEK? . Indian government promises independent review of medical regulation reform bill. . "Drunk Tanks" are studied over festive period to see if they ease pressure on emergency departments. . Trump says tax bill "essentially repealed Obamacare". . NHS consults public on plans to restrict access to over-the-counter drugs. . Drug shortages cost NHS £38m in November. . Seven in 10 complaints reviewed under new GMC scheme thrown out. . UK is less attractive place to work, GMC warns, as reliance on overseas doctors increases. . Darzi to lead new independent review of the NHS and social care. . NHS publishes estimates of avoidable deaths in hospitals. . NHS will need 190,000 more clinicians unless productivity improves, workforce plan warns. . GMC cuts junior doctors registration fees. READ ALL ABOUT IT! With best wishes, Barry

Monday, December 11, 2017

End of Term and Happy Holiday!

We currently have 32 year 2/3 medical students out with community organisations in Leeds on placement as part of the RESS Pre-Xmas Student Selected Projects (Community) Programme. I have a feedback meeting with the students on Friday the 14th of December after the placements finish and I will then hear if the placements went well or if anything could have been done differently. I mark the students reflective diaries and community newsletter articles from these in January and they are usually really enjoyable to read. I am also currently getting some of the short reports (one side of A4) on student community visits whilst at Primary Care as part of Year 2 Campus to Clinic and I offer brief feedback to the students on these. The first years do Campus to Clinic from January next year and again in small groups of four they also have to carry out community visits and it is always interesting to read about the diverse range of community organisations that the students have visited. SO WHAT'S IN THE BMJ THIS WEEK? . . Judge grants anonymity to hospital treating brain damaged baby to protect staff. . NHS pays £45,000 to family of woman who was kept alive against her will. . Make detaining patients who can't pay their medical bills illegal. . Leading doctors back legal action to force UK government to act on carbon emissions. . Brexit could mean delays for cancer treatments and less safe medicines. . Personalised diet advice could tackle obesity, report advises. . NHS England and government are on collision course over funding. . Welsh opt-out law fails to increase organ donations. . US tax bill could destroy central pillar of Obamacare. . Four week target for children to access mental health services proposed. READ ALL ABOUT IT! A Happy Christmas, A Happy Holiday, and A Happy New Year to All! With best wishes, Barry