Consultant Physician
Midlands
Consultant Physician who is passionate about good patient care
Recent activity
Comments (12)
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Comment on: Hunt: Unsafe staffing 'totally unacceptable'
Exactly! Can he perhaps define "unsafe staffing"...and if we can all have more staff if we fit this criteria?
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Comment on: Chief executives not confident on out-of-hours safety
Interesting that the smaller the hospital , the more confidence there is in the safety of patients seen out of hours? Perhaps there is a critical size, beyond which amalgamation may not be helpful....a J shaped curve of cost vs safety .... There has to be enough wards/ beds in big hospitals to deal with the extra capacity required in these amalgamated superhospitals?
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Comment on: What's the alternative?
So the death rates in Elder Care are much higher ( almost doubled)....its not always easy for families/even some patients to accept death without hospital assesment/treatment ( which may prolong life for a little longer....dubious about the full benefit of such prolongation )....nonetheless...the much higher death rate does raise the possibility of treartment/investigation being witheld in view of age/fraility.... LCP in hospital has become a great ethical debate...I anticipate that it will only be be a matter of time before similar debates about witholding investigation or treatment in the community to enable a peaceful death is also highlighted by the press? There are members of the public who might see it as compassionate "euthanasia" for the frail elderly?
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Comment on: Performance of individual surgeons to be published by next summer
Surgical outcomes also depend on Anaesthetic performance, nursing care, medical support, ITU beds post op etc....a bit unfair to simply blame the surgeon? I guess , there will be less surgery for the older patient under the circumstances.....
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Comment on: We must beat our hospital addiction
There appears to be a belief that most elderly patients with multiple comorbidities and acute exacerbations do not need admission to hospital? Would the public buy seeing their loved one cared for in the community without quick investigations and appropriate treatment which defines acute care?Ethical issues to sort out - are the elderly now a second class citizen that will not have access to hospital assesment and treament plans when they fall ill? ( would this amount to some form of "euthanasia"?)What is desperately neeeded is the ability to discharge patients quickly and safely once diagnosis and treatment has been started. Every integrated care pilot that integrated with social care but not acute care has yet to show these major savings and reduction in admissions expected.A significant rising part of NHS activity/expenditure now revolves around the frail elderly falling ill....and having centralised big super specialised hospitals will not mean better treatment for this group!the evidence base to support such a move is not there apart for a tiny number of specific conditions (like stroke ,aneurysms, ST segment heart attacks) - whilst common garden conditions such as pneumoniae and sepsis( serious infections) depend on how quickly patients can get to hospital for treatment( which does not require super specialists).
