MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'dumbing down'. Sat, 03 Sep 2011 02:29:32 +0100 http://www.medworm.com/index.php?rid=3790704&cid=t_116218_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-dumbing-down-of-nursing-academics%2F2010.07.26 I’m embarrassed to say this, but the nursing profession is making a mockery of healthcare education by downgrading the post-graduate degree process. The nursing education requirements in the advertisement seen here are an embarrassment to the nursing profession. Mrs. Happy pointed out an advertisement from her nursing magazine offering advanced nursing education opportunities. This advertisement for the doctor nurse practitioner (DNP) training track at Creighton University is a mockery of the rigorous educational requirements necessary to care for patients independently. Check out the nursing education requirements on their advertisement: No entrance exam required?  No clinical experience?  No thesis required?  What has this world come to? These are professionals who are going to... Better Health blogs http://www.medworm.com/rss/comments.php?id=3790704 Mon, 26 Jul 2010 16:00:00 +0100 3790704 http://www.medworm.com/index.php?rid=3448860&cid=t_116218_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2010%2F04%2Fanother-one-bites-dust.html (Source: The KnifeMan) The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=3448860 Thu, 01 Apr 2010 09:00:00 +0100 3448860 http://www.medworm.com/index.php?rid=3326943&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2010%2F03%2Fend-of-nursing-rise-of-doctorlite.html For Dawn Chapman, going back to school opened new doors in her nursing career: “I’ve had the most exciting last few years as a result of choosing, in my fifties, to get a degree.”After completing her State Registered Nurse (SRN) training in 1971, Dawn went to work and by the 1990s was a ward sister managing a 66-bed unit. At the end of the decade, she changed her job and became a Nurse Practitioner at Cambridge’s Addenbrookes Hospital’s breast unit, training under two consultants and examining symptomatic patients. Her expertise in breast examination was put to good use in reducing waiting times. In preparation for the new role, Dawn attended an A11 breast examination course at London’s City University and this experience, along with the Project 2000 initiative, prompted her to... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=3326943 Wed, 03 Mar 2010 11:41:00 +0100 3326943 http://www.medworm.com/index.php?rid=3269667&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2010%2F02%2Fproviders-of-care-in-nursing-fashion.html The Conservative Party has incorporated the dumbing down of health care into their election manifesto.The Conservatives have confirmed their support of graduate level entry for registered nurses and clarified their definition of “nursing” to include HCAs.The party was under growing pressure to clarify its position after shadow health secretary Andrew Lansley told Nursing Times that degrees should not be “an entry requirement to the profession.”Shadow health minister Anne Milton then appeared to contradict Mr Lansley’s announcement by telling Nursing Times there was “no doubt” that registered nurses needed degrees.This week the Tories said Mr Lansley’s definition of “nursing profession” included healthcare assistants.A spokesman said: �... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=3269667 Sat, 13 Feb 2010 11:44:00 +0100 3269667 http://www.medworm.com/index.php?rid=3017032&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F11%2Fwhy-nhs-is-failing.html Any more good ideas?My drug-sodden old friend Wat Tyler at Burning our Money has just explained in a few hundred words how NHS resources are being squandered. ReadEarning your pharmacist an honest crustTyler may not know, but will not be surprised to hear,  that these pharmacist "reviews" are laboriously transcribed onto paper and then sent to the family doctors who put them, unread, into the bin. (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=3017032 Sun, 22 Nov 2009 10:16:00 +0100 3017032 http://www.medworm.com/index.php?rid=2634383&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F07%2Fswine-flu-news-7-fuckwittery-takes-its.html This story will be the first of many. A teenager, on Tamiflu, begging for medical help and finally having to invent a different medical history to get herself taken seriously.A teenager whose meningitis was misdiagnosed as swine flu had to pretend she had taken an overdose of pills so that emergency services would take her to hospital. Even then, 17-year-old Gemma Drury, from Brimington, Chesterfield, was discharged from hospital after another misdiagnosis and told to go home to bed. After her illness worsened she was rushed back to hospital where the life-threatening meningitis was finally discovered.Sky NewsI am grateful to an NHS BLOG DOCTOR reader who is himself a retired doctor for drawing my attention to this story. He says: .hmmessage P { margin:0px; padding:0px } body.hmmessage { f... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2634383 Thu, 23 Jul 2009 15:13:00 +0100 2634383 http://www.medworm.com/index.php?rid=2630117&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F07%2Fswine-flu-news-6-rise-of-fuckwit.html I hear there is to be a dedicated "swine flu line". The layman who answers has been "empowered" both to diagnose swine flu and to prescribe Tamiflu. I wish someone would likewise "empower" me. I don't know how to diagnose swine flu. I can prescribe Tamiflu, though as yet I have not. I would not take it, and I would not give it to my family, so why would I prescribe it for patients? What this means is that anyone with any vaguely viral symptom is going to get "treatment" for a condtion they probably do not have with a drug that is next to useless and may have hitherto unexpected side effects. Great! It is going to be worse than resisting the demands for inappropriate antibiotics.I'd rather speak with the patients myself. I know, it is going to be a lot of work, but it is important, and I do... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2630117 Thu, 23 Jul 2009 10:06:00 +0100 2630117 http://www.medworm.com/index.php?rid=2572918&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F07%2Fgoodbye-mr-chips.html Just returned from an unexpected few days away in North Wales, hence the lack of posts. Mrs Crippen's sister and brother-in-law, both teachers in the state sector, both heads of respective departments and both in their early fifties, were with us. There is little that doctors can tell teachers about government interference in professional life or about top-down micromanagement. Over a glass of three of wine the conversation turned to retirement and, in particular, to early retirement.It is not acceptable to be "ageist". Indeed, our government has legislated to make it unacceptable. And it is good to see that Tesco and Sainsburys, for example, are employing people who are well into their eighth decade. These people still have a lot to offer.All is not well in the state education system. Mr ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2572918 Sun, 05 Jul 2009 19:52:00 +0100 2572918 http://www.medworm.com/index.php?rid=2441312&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Fdiversity-in-medicine.html From its earliest days, NHS BLOG DOCTOR has railed against the dumbing down of health care in the NHS. The process has been so well handled by the government PR spinmeisters that nowadays it is politically incorrect to say that a health care professional who has not been to university may have neither the training nor the intellectual capacity to do the same job as a doctor. How dare you even suggest that?The process continues.It is now recognised that it is intellectual discrimination to insist that only qualified doctors should be allowed to apply for jobs as doctors. It is essential to get people from a broader intellectual base into medicine. From 1st August 2010 the computerised MTAS system, which matches applicants for junior hospital doctor jobs, will be using the new Mandelson-Hewi... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2441312 Sun, 24 May 2009 10:15:00 +0100 2441312 http://www.medworm.com/index.php?rid=2398646&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Fdr-crippen-is-ashamed.html Doctor’s receptionist awarded honorary medical degreeMrs James was given the award after demonstrating an extraordinary ability to diagnose patient’s illnesses within seconds of meeting them. Almost without exception she was able to deduce that the patients were nowhere near as ill as they thought they were and so did not need to see the doctor. ‘It seems insane that the Health Service spends so much on blood tests, x-rays, explorative surgery or whatever when Mrs James could just give them a quick once over and tell them they’ve probably just got a cold.’ NewsbiscuitA patient emails NHS BLOG DOCTOR :Last week, in the morning for no apparent reason, my heart started to beat at a pace of around 200-250 and it lasted for about 10 minutes. It started in a heartbeat and stopped in a ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2398646 Fri, 08 May 2009 13:14:00 +0100 2398646 http://www.medworm.com/index.php?rid=2398647&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Fcaring-for-children-of-mentally-ill.html Mental health nurse “child risk”Children may be being put at risk because nurses carrying out assessments on mothers with mental illnesses do not have enough training, an expert says.Mental health nurses are often asked to assess the parenting capabilities of mothers with serious conditions such as schizophrenia and bipolar disorder. But Sarah Rutherford, from Manchester Metropolitan University, said they did not get enough guidance or training.She called for a thorough review of practices across the UK.BBCNHS BLOG DOCTOR readers are only too well aware of the deficiencies of modern NHS mental health care.  Patients who cannot afford to pay to see a psychiatrist are dealt with by the CMHT, a pot pourri of poorly paid HCPs with no real psychiatric training. They do not diagnose, they d... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2398647 Fri, 08 May 2009 11:47:00 +0100 2398647 http://www.medworm.com/index.php?rid=2398648&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Fvulgarity-at-local-chemists-shop.html “Oh! Oh! Oh! To touch and feel a girl’s vagina and hymen”Well, that’s got the post of to a cracking start! Don’t worry, Dr Crippen has not had a rush of blood to the head. It’s a mnemonic. But be warned that the next time you visit your local chemist, you may hear the pharmacist repeating it over and over again.The mnemonic is a medical student favourite and is an aide memoir to remind him of the twelve cranial nerves.The cranial nervesOf course, ultimately, all nerves originate from and report back to the brain, but the cranial nerves are special. They make their way, often tortuously, from the brain through various holes in the skull to various parts of the head and neck and even to the shoulders and gut. Learning their anatomy is challenging. The tenth cranial nerve, the vag... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2398648 Thu, 07 May 2009 14:11:00 +0100 2398648 http://www.medworm.com/index.php?rid=2389738&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Ffy1s-tale-choosing-between-experience.html Remedy UKNHS BLOG DOCTOR has received a long email from "Joanne", an FY1 doctor in a famous London Teaching hospital. As always, I print it verbatim. A word of explanation about "banded" and "unbanded" jobs. This refers to the availability of overtime. An unbanded job, with no overtime, after deductions barely pays a living wage. Sadly, as the NHS dumbs down, more are more protocols appear. It no longer matters what you have done. It no longer matters what real experience you have. What matters is which boxes are ticked in your glossy work "portfolio".The FY1's taleI am currently an FY1 at a major teaching hospital. Both of my jobs this year have been incredibly busy and have had a huge on-call commitment - for example, in my surgical job I worked every other weekend. The result is I've ha... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2389738 Wed, 06 May 2009 08:35:00 +0100 2389738 http://www.medworm.com/index.php?rid=2386859&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F05%2Fclinical-dashboards-empowering-monkeys.html The rise of the CliniciansAs doctors gradually disappear from the NHS their roles are taken over by HCPs who are often beguilingly now called "clinicians". It's a useful word. Redolent of "doctor" all it really means is "the person who happens to be at the bedside". If the bedside monkey is to perform, he needs simple instructions. NHS BLOG DOCTOR readers know that paediatricians have been replaced by traffic lights. Now please welcome the "clinicians". They will be empowered by a "clinical dashboard"Delivering High Quality of Care for AllClinical Dashboards are a toolset being developed to provide clinicians with the relevant, and timely, information they need to inform daily decisions** that improve the quality of patient care.Frontline staff of three NHS organisations are working with N... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2386859 Sun, 03 May 2009 10:56:00 +0100 2386859 http://www.medworm.com/index.php?rid=2364991&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Falastair-campbell-on-mental-health.html Bendy girl, who writes Benefit Scrounging Scum, draws my attention to an odd outburst from Alastair Campbell. Campbell is well known as Tony Blair's PR man and, despite previous differences, is close to Gordon Brown. He has a personal history of alcohol abuse, now under control, and of a severe depressive illness.Whilst the other Alastair was delivering the worst and most dishonest budget in living memory, Alastair Campbell was speaking at an event organised by MIND. One of the other speakers was Henck van Bilsen [who] is a consultant cognitive behaviour therapist who also leads a degree programme in CBT at the University of Hertfordshire. Alaistar Campbell says:[Henck van Bilson] spoke of a 'revolution' taking place in mental health services in Britain. He said the government had taken a... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2364991 Thu, 23 Apr 2009 14:51:00 +0100 2364991 http://www.medworm.com/index.php?rid=2347978&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fshould-this-hcp-have-been-sacked-for.html Going off pisteA fascinating story from Paul Marchant, a highly experienced anaesthetic practitioner.Paul decided to insert an arterial line into a patient who was seriously ill and awaiting emergency surgery for a life threatening condition. Urgent calls had gone out for an anaesthetist who had not yet arrived. He carried out the procedure but without medical supervision. He decided not to ask the surgeon who was present to help for he took the view that the surgeon would not have the skills to do the job.The arterial line was inserted efficiently and without problem. The patient survived the operation. There were no complaints at the time. However, word of Paul’s action reached the hospital management. There was a disciplinary hearing and he was sacked.Paul Marchant's quandary is a c... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2347978 Sun, 12 Apr 2009 21:32:00 +0100 2347978 http://www.medworm.com/index.php?rid=2347983&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fwho-dares-blow-whistle-who-dares-loses.html Let us not forget that, as health care in the UK crumbles, we are not the only country that has problems. NHS BLOG DOCTOR gets a lot of comments from the USA, usually extolling their medical system and condemning the concept of “socialized (with a “z”) medicine” as the Americans call it.One of the greatest problems we face in the UK is getting people to realise that their attachment to the NHS is emotional rather than rational. Criticisms of British health care are usually met with disbelief and incredulity. I get emails and comments saying that the picture I paint of the NHS is unnecessarily gloomy. Then the writers of these comments are admitted to hospital or, more likely, their elderly grandmothers are admitted, and I get an email saying, “I had not realised…”.The governm... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2347983 Fri, 10 Apr 2009 09:29:00 +0100 2347983 http://www.medworm.com/index.php?rid=2307011&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fdr-crippen-is-losing-will-to-live.html The nurse-specialists are going to fall over laughing as Dr Crippen, relentlessly seeking out all examples of dumbing down in the NHS, is painfully hoisted by his own petard.Medical students are now being taught some of their clinical patient skills by playing Second Life. No, I am not joking. This is happening at Imperial College, which is (used to be) one of the leading medical schools in the world.At Imperial College London, medical students navigate a full-service hospital where they see patients, order X-rays, consult with colleagues and make diagnoses.It's an interactive, hands-on learning experience -- and none of it is real.These prospective doctors are treating virtual patients in Second Life, the Internet world where users interact through online alter egos called avatars. The th... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307011 Sun, 05 Apr 2009 22:44:00 +0100 2307011 http://www.medworm.com/index.php?rid=2307012&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fnurses-husbands-tale.html A letter arrives from the husband of a senior nurse. An ex-nurse, I should say. It is a reminder of a bygone age. I have many friends who are trained and experienced nurses and who now, as their children are older, would love to go back to nursing. Sadly, the door has been closed.I have spent many a happy, though more often than not, frustrating, hours reading your wonderful expose of the sham that is now the NHS. Forgive any incorrect usage of medical terms – that is not my discipline.My wife is what you and I would call a ‘proper’ nurse. She followed the traditional route into nursing. Having waited and waited for an opportunity, she applied, underwent a strict interview, then completed her RGN training. This included time spent on wards managed by a single ‘Sister’ in charge. ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307012 Sat, 04 Apr 2009 11:00:00 +0100 2307012 http://www.medworm.com/index.php?rid=2307015&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fletter-from-surgeon-please-sign-ewtd.html British orthopaedic surgery training post EWTDAnything coming out of “Europe”, by which I mean the EC, tends to induce immediate somnolence. If there is one thing worse than bureaucracy, it’s French bureaucracy. And who cares about the EWTD? Most of you have never heard of it. It’s the European Working Time Directive. Yawn. Nearly as boring as straight bananas and the definition of “chocolate”.But, before you fall asleep, I want you to imagine this. Your mother is about to have a knee replacement. A challenging operation. There is a choice. Mother can have the operation done by that charming consultant orthopaedic surgeon, Mr Green. Or she can have it done by that charming consultant orthopaedic surgeon, Mr Grey. They are both new, young, keen, experienced surgeons. There is on... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307015 Fri, 03 Apr 2009 13:05:00 +0100 2307015 http://www.medworm.com/index.php?rid=2307020&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F04%2Fthrowing-junior-doctor-to-lions.html Remember “Watership Down”? Gosh, that was a while ago, wasn’t it? When rabbits ran across a road and were caught in car headlights, they used to freeze in terror. Richard Adams called this going “tharn.”As a junior hospital doctor, I never did a formal anaesthetics (anaesthesiology for those in the colonies) job. Never fancied it. 98% boredom, 2% abject panic for the whole of your working life. But I did a lot of paediatrics and was, for a year, on-call for the labour ward. So I did my fair share of intubating and, after about three months, was not too troubled by it. I stand to be corrected by a real anaesthetist but I reckon the easiest mistake to make when you are inexperienced is putting a tube into the oesophagus rather than into the trachea. Anyone who says they have not do... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307020 Wed, 01 Apr 2009 23:11:00 +0100 2307020 http://www.medworm.com/index.php?rid=2307028&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Fdumbing-down-twelve-years-of-labour.html No, it is not a joke from a Christmas Cracker. It is a question from an Edexcel GCSE physics paper. There are further examples of this dumbing down in an excellent article from Amused Cynicism. It is particularly depressing that, despite all the dumbing down, the education achievements of are children are still poor.At GCSE 54% still fail to gain 5 A-C grades including both English and MathsChris WoodheadIt is going to get worse for, as Wat Tyler describes this morning, it is proposed to: ...scrap the teaching of history in primary schools in favour of lessons in Twittering. According to the Guardian:"Children will no longer have to study the Victorians or the second world war under proposals to overhaul the primary school curriculum. However, the draft plans will require children to maste... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307028 Sat, 28 Mar 2009 10:06:00 +0100 2307028 http://www.medworm.com/index.php?rid=2307039&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Fgladiators.html The comments under the recent post about Natasha Richardson and Medical technology were diverted/hijacked/subverted (you chose) by yet another spat about hierarchies within the NHS. The A & E Charge nurse (and others) were upset (again) and there were some vitriolic ripostes. All good stuff. I suggested that someone might like to put a few words together to vent their spleen, and here it is:WASN'T IT GEORGE BERNARD SHAW who said the biggest problem with communication is the illusion that it has taken place? Take Dr Crippen’s recent item on the untimely death of Natasha Richardson, a piece ostensibly lamenting the loss of hard earned medical skills. I was reminded of Del Boy’s phrase ‘he who dares wins’. In my mind, the post contained a sort of longing, or even a veiled hint tha... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2307039 Wed, 25 Mar 2009 17:15:00 +0100 2307039 http://www.medworm.com/index.php?rid=2284470&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Ftales-from-chmt-more-journeys.html Many years ago, when the NHS psychiatric services were still working, it was easy for a GP to get help from secondary care.To over-simplify, patients with mental health problems saw their GP. If he could not deal with them, he referred them to his medically trained colleague, the Consultant Psychiatrist. The Psychiatrist carried out an assessment, and formulated a plan. He might admit the patient. He might suggest that the GP put the patient on different medication. He might suggest that the patient was followed up by secondary psychiatric care services and, when that happened, might enlist the help of CPNs.Nowadays, in many areas, and certainly where I work, there is no direct access to psychiatrists. They do not even read our referral letters. The letters all go to the CMHT, the communit... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2284470 Thu, 19 Mar 2009 21:42:00 +0100 2284470 http://www.medworm.com/index.php?rid=2284471&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Fquacktitioner-alerts-2009.html Andrea Street, 34, and Jennifer Ansell, 39, told a mother it was not necessary to feed her baby boy vital medication, the Nursing and Midwifery Council heard   Source++++++++++Another sad but classical example of the results of dumbing down health care. A doctor prescribes antibiotics for a new born baby for sound clinical reasons. The midwives do not understand those reason. Well, not their fault. They have not been to medical school, so why should they understand? They don’t know what they don’t know. But what is their fault is their arrogance in not following the instructions of someone who is superior to them, and does know what he is doing.Arrogant midwives have always been a nightmare, particuarly when they go "independent" but they do not have a monopoly of stupidity. This so... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2284471 Thu, 19 Mar 2009 19:56:00 +0100 2284471 http://www.medworm.com/index.php?rid=2284478&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Fit-couldnt-happen-in-britain.html This report highlights the work that the Trust and its dedicated staff have contributed to transforming Stafford Hospital from one that was failing to one that is already significantly better in many areas and continuing to improve in the key areas highlighted by the Healthcare Commission.“The report has highlighted instances where care standards fell below those that our patients had a right to expect of their hospital and we regret this. We would like to take this opportunity to offer our very sincere apology. We would like to reassure the local community that our focus is, and will remain, on providing high quality, efficient and safe health care for the people of Staffordshire.Comrade Eric Morton : Mid-Staffordshire NHS Foundation TrustBe under no illusion. What went in Staffordshire... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2284478 Tue, 17 Mar 2009 15:45:00 +0100 2284478 http://www.medworm.com/index.php?rid=2232493&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F03%2Fcaring-for-mentally-ill-you-get-what.html His desperate plea for help was ignored : click to enlargeSad news today about Daniel Gonzales. Daniel suffered from schizophrenia. Unlike most schizophrenics, he was violent and dangerous. I want to stress that last point. Most schizophrenics are sad, isolated, friendless people who are incapable of violence. Most schizophrenics are like my friend Emily. I still miss her. I still feel angry about the appalling lack of psychiatric care she received from the NHS.So what happened to Daniel Gonzales? Four murders, two attempted murders and then, alone in his room in Broadmoor, he committed suicide. How could this happen? It seems he begged for help but was ignored. Why was he not sectioned and removed to a place of safety earlier? And what sort of complacent, indolent incompetence allowed thi... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2232493 Wed, 04 Mar 2009 10:22:00 +0100 2232493 http://www.medworm.com/index.php?rid=2086878&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2009%2F01%2Fdestruction-of-nhs-government-plans.html There is going to be bloodshed at the Department of Health when Alan Johnson finds out who leaked the goverment's confidential plans for the further "development" of the NHS. Full details of the leak here. (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2086878 Wed, 07 Jan 2009 13:30:00 +0100 2086878 http://www.medworm.com/index.php?rid=2026894&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F12%2Fcrossing-over-to-dark-side-nurse-goes.html Nurse turns into doctorCrossing over to the Darkside is written by a nurse with a degree in nursing who has decided to study medicine. Real medicine. She has just started at medical school and, in her most recent post, "It's hard work", she writes (my hightlights)…to the few nurses there are in existence that think "nurses should be given credit to jump to second year of medicine" or "Making you start in first year is the two fingered salute to nurses isn't it?" (Both comments I have heard from different colleagues) You are utterly wrong.Nursing education is so poor that the whistlestop tour of anatomy you get in 2nd year is merely a drop in the ocean compared to the stuff we have been doing since the start of the semester.So, you nurses who have major attitude problems on wards to FY1s,... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=2026894 Tue, 09 Dec 2008 14:52:00 +0100 2026894 http://www.medworm.com/index.php?rid=1938991&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F11%2Fdaft-doctors-and-silly-nurses.html A characteristically excellent post from Tom Reynolds at Random Acts which had me giggling at the delicious absurdity of New Labour’s NHS. I giggled so much that I can even forgive Tom for taking a pot shot at a hopelessly inexperienced junior hospital doctor called to (probably his first) cardiac arrest. I have been that doctor. It’s exciting being a member of the on-call crash team for the first time. When the crash bleep went off, you ran like hell, feeling grand and important (isn’t this why we all went into medicine?) ostentatiously charging through the hospital on your way to save a life. Dream on. Unlike on the telly, (ER has much to answer for) very few patients survive real cardiac arrests. The art of the exercise, as Tom points out, is to make sure that it is a real cardiac... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1938991 Thu, 06 Nov 2008 17:01:00 +0100 1938991 http://www.medworm.com/index.php?rid=1637709&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F07%2Fdumbing-down-in-usa.html As so often, I am grateful to KevinMD for pointing me towards a "dumbing down" tale from the USA. I take little comfort from the fact that this is not just happening in the UK.Nobody dies of appendicitis these days. Don't you believe it. But they are very unlikely to die if they are managed by someone who knows what they are doing. Someone with surgical expertise; someone able to exercise discretion. A "health care professional" implementing a protocol is the antithesis of discretion.Imagine your small daughter has peritonitis from a ruptured gangrenous appendix. She is being managed by a consultant surgeon but, when his back is turned, a "health care professional" with a cost-cutting protocol intervenes.I operated on a little girl the other night for a perforated, gangrenous appendicitis.... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1637709 Fri, 18 Jul 2008 13:44:00 +0100 1637709 http://www.medworm.com/index.php?rid=1531138&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F06%2Flooking-after-patients-with-dementia-4.html The Visual Dictionary of the Human Body, Dorling Kindersley, 1991Carrying on about the dementia saga, the plot thickens. I see that the government’s “new” dementia strategy includes plans to assign every patient with dementia a ‘dementia care advisor' who can be their single contact throughout diagnosis and treatment.The care advisor could bea GP a nurse or even a charity worker.Healthcare RepublicWide range of skills there. This is an incredible attack on the role of the family doctor who has hitherto fulfilled that role for all his patients. I can’t wait for the phone calls from the “concerned” charity worker who, having just read the Dorling Kindersley "PoP Up Book of Dements", wants to suggest a change in medication.Health minister Ivan Lewis said that the strategy woul... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1531138 Fri, 20 Jun 2008 18:45:00 +0100 1531138 http://www.medworm.com/index.php?rid=1531141&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F06%2Fdr-frankenstein-no-dr-nurse.html As so often, via Kevin MD, I have just discovered the Covert Rationing Blog in the USA. How did I miss it? This excellent site is, not surprisingly, dedicated to monitoring the covert rationing of medical care in the USA. There is no better and more successful form of covert rationing than dumbing down. I note with a cross between horror and amusement that a new medical Frankenstein has appeared in the USA. The Doctor-Nurse.The June 16 issue of AMANews reports that the National Board of Medical Examiners will begin offering a certification examination this fall for graduates of “doctor of nursing practice” programs. Revealingly, the test will be based on Step 3 of the U.S. Medical Licensing Exam. Doctor-nurses will soon be Board Certified, just like, uh, doctor-doctors. Mary Mundinger,... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1531141 Thu, 19 Jun 2008 13:27:00 +0100 1531141 http://www.medworm.com/index.php?rid=1497396&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F06%2Fdumbing-down-in-courts.html Inevitably enough, I suppose, with my vestigial interest in law, I am a frequent visitor to The Law West of Ealing Broadway which is without doubt the best blogging insight into the day to day work of the English legal system. I take a strange comfort from the fact that the government is not just dumbing down the NHS. It is happening to the legal system as well:We then dealt with a few committals to the Crown Court, that were put before us because we had a proper Crown Prosecutor, rather than the Designated Case Worker who was in the Remand Court. DCWs can't do committals, at least not yet, but as the system continues to dumb down and take the cheap option I expect that these 'Lawyer-Lite' types (soon to be renamed 'Associate Prosecutors') will end up doing everything that qualified lawyer... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1497396 Thu, 05 Jun 2008 19:10:00 +0100 1497396 http://www.medworm.com/index.php?rid=1492002&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F06%2Fronald-mcdonald-to-take-over-uk.html Leader of the Community Mental Health TeamA fascinating and well written post on Doctors and Nurses from Seaneen, who is 22, from Ireland, living in London and suffering from what she describes as “classic manic depression”. She lists amongst her idols Viv Stanshall, Peter Cook and the Bonzo Dog Doo Dah Band. I feel in tune with her already.The interface between doctors and nurses is a frequent source of controversy, classically summed up in that hackneyed old phrase “doctors cure, nurses care” and Seaneen’s experiences in psychiatric services suggest she has seen a lot of that precise dichotomy.She is gently critical of my continuing fight against the dumbing down of the health service because she sees it, as do many others, as a tirade against nurse specialists. It is nothing o... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1492002 Wed, 04 Jun 2008 10:45:00 +0100 1492002 http://www.medworm.com/index.php?rid=1463712&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Fdestroying-english-legal-system.html Crown Prosecution ServiceRegular readers will be in doubt as to Dr Crippen's determination to expose the Government's policy of dumbing down professional services. Everywhere you look there are "health care professionals", teaching assistants, and pretend policemen.Do you remember those two amateur policemen who would not pull a drowning child out of a pond?Jordon Lyon leapt into the water in Wigan, Greater Manchester, after his eight-year-old stepsister Bethany got into difficulties on 3 May. Two anglers jumped in and saved Bethany but Jordon became submerged. The inquest into his death heard the PCSOs did not rescue him as they were not trained to deal with the incident. (BBC)What a pair of prats. They would not go into the pool because they had not got their swimming badge. I bet they a... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1463712 Thu, 22 May 2008 15:55:00 +0100 1463712 http://www.medworm.com/index.php?rid=1445979&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Fkings-college-medical-school-dumbs-down.html King's College Medical School, LondonThe Times has today picked up on the BMJ report from King’s College, London on “Widening participation in medicine” or, to give it its correct name, the “Extended Medical Degree Programme” (EMDP)(EMDP) aimed to attract bright students from state schools in inner London who had A-level results that were far too poor to gain entry to medical school and show that, with the right help, they could succeed. Students would normally require two As and a B at A level, but the scheme, called the Extended Medical Degree Programme, accepted those who had managed no better than three Cs. (The Times) This is a warm, cuddly Shawshank Redemption sort of story. Select a small number of students from sink comprehensives, measure their IQs and, if they are high ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1445979 Fri, 16 May 2008 12:55:00 +0100 1445979 http://www.medworm.com/index.php?rid=1442756&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Fcambridge-university-dumbs-down.html Our door is open to allThe University of Cambridge is to drop its requirement that prospective students should have a foreign language at GCSE. Hitherto, the following GCSEs were required:EnglishA foreign languageMaths or scienceTwo other subjectsThe move comes amid concerns over a huge drop in numbers studying French, German and Spanish in the state sector. Last summer, fewer than 50 per cent of teenagers took a foreign language GCSE compared to 80 per cent in 2000. It is hoped the reforms will make Cambridge more accessible to pupils from comprehensives following claims of elitism and bias towards fee-paying schools. (Daily Telegraph)Language teaching in the UK has never been good. Compare the number of English teenagers who can manage a conversation in French (or German, or Spanish, or ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1442756 Wed, 14 May 2008 10:50:00 +0100 1442756 http://www.medworm.com/index.php?rid=1439504&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Fmotoring-offences-upside-of-dumbing.html Freddie FlintoffYou may think it is easy to prosecute someone for speeding. Anyone can do it. You may think it is easy to deliver a baby. Anyone can do that do. Sadly, "anyone" was recently delivering a baby at home, in Suffolk, and a young mother died. Total, gobstopping incompetence - but pay peanuts, get monkeys.Back to speeding. If you are going to prosecute someone for motoring offences you need professional skills. You need a lawyer. Nowadays, you don't get real lawyers. You get lawyer-lite from the CPS or, even worse, Dixon. We all loved George, but George did not pretend to be a lawyer. It's not like that anymore. No one knows their place.A man who knew his placeA cricketer has escaped from an allegation of driving much faster than the speed limit. His solicitor glories in the so... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1439504 Tue, 13 May 2008 22:18:00 +0100 1439504 http://www.medworm.com/index.php?rid=1436798&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Ffor-lovers-of-dr-rant.html The Rant Foundation has been exploring the outer limits of Anglo-Saxon of late, and very entertainingly too. Over in the colonies, of course, our American cousins are of too delicate a disposition to understand the humour. Or I thought they were until I discovered that Dr Rant's brother is a family doctor in the USA:"I may be going the way of the dinosaur, but I'm not dead yet" He is as passionate as Dr Crippen about dumbing down health care. A local pharmacist told one of his patients to stop taking his statins. For Crippen strained through Rant, read:Attention, Pharmacists.I'm going to appoint him the NHS BLOG DOCTOR American correspondent and surely he deserves to be an honorary vice-president of the Rant Foundation. (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1436798 Mon, 12 May 2008 17:26:00 +0100 1436798 http://www.medworm.com/index.php?rid=1423121&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F05%2Fdumbing-down-professions-lawyer-lite.html The government's continuing attack on the professions has two purposes. First of all, it serves their need for centralised, top-down micro-management. Secondly, it saves money. It takes many years to train a barrister or doctor. Both command high salaries and both insist on working with professional independence.  The Americans talk about paraprofessionals. Teaching assistants, paramedics, health care professionals. Give them all a government sanctioned protocol to follow and Gordon Brown would have you believe that you get the job done just as well and much more cheaply. It has happened to the teachers and the doctors, and now the government is trying to do it to the lawyers. Yet another example appears in today's newspapers.A convicted drugs offender has escaped a confiscation order for... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1423121 Tue, 06 May 2008 13:00:00 +0100 1423121 http://www.medworm.com/index.php?rid=1388929&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Ffraudulent-qualifications.html If it were announced tomorrow that 18% of doctors had fraudulently misrepresented their qualifications, there would be a national outcry. The Health Care Republic reveals today that:18% of nurses using the Nurse Practitioner title do not have the qualificationAsk yourself carefully why no one is bothered.The Health Care Republic also reveals that13 per cent of nurses who are prescribing do not have the prescribing qualification.It is scary enough when they do have the "qualification". It's all about professional standards, I suppose. Real professional standards. How many of these nurses will be struck off? Don't hold your breath.  (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1388929 Mon, 21 Apr 2008 22:11:00 +0100 1388929 http://www.medworm.com/index.php?rid=1388931&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fpolyclinics.html Pretty Polly ClinicsIt is not easy at the moment to say anything positive about family doctors. Any suggestion that they may be providing a valuable service is nowadays met with a tirade of jealousy from nurses, particularly the oxymoronic “consultant nurses”, who cannot get through the day without asserting that they can do any job a doctor can do, and probably do it better. Then the right-wing Taxpayers’ Alliance wades in with one of their tabloid headline grabbing ad hominen attacks on public sector salaries.This is a perfect starting point for the government to introduce the polyclinics. They sound wonderful, don’t they?(....continued here) (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1388931 Mon, 21 Apr 2008 14:08:00 +0100 1388931 http://www.medworm.com/index.php?rid=1375055&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fdumbing-down-out-of-hours-service.html New Labour out of hours HCPOver ten years ago I was heavily involved in setting up a GP co-operative to rationalise and manage the out of hours on call committment. We had active support from the government including access to and meetings with both Norman Lamont and Virginia Bottomley. The co-operatives were a cost efficient method of ensuring that patients received quality out of hours care form local experienced family doctors.We started our co-operative from nothing. I remember when I and one other colleague opened the first bank account with a float of a couple of thousand pounds raised by approaching other local GPs. We drew up a business plan and approached the bank manager for help. We needed to rent premises, buy or rent half a dozen cars, purchase expensive radio equipment and ab... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1375055 Wed, 16 Apr 2008 08:27:00 +0100 1375055 http://www.medworm.com/index.php?rid=1370716&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fwat-has-trouble-in-trouser-department.html Following on from yesterday's post about the Observer and the suggestion that pharmacists should have a diagnostic role in the treatment of sick patients I was about to put pen to paper, so to speak, when I came across a post by Wat Tyler from last week. Somehow, I had missed it.Please raise your 125ml glass to Wat as, in "Jade will see you when she has finished her pie", he tells the sorry story of trying to get the pharmacist to discuss his sore willy.What more is there to say? (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1370716 Mon, 14 Apr 2008 13:12:00 +0100 1370716 http://www.medworm.com/index.php?rid=1369088&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fobserver-lynches-incompetent-gps.html Alan Johnson and Gordon Brown at the Royal Marsden Hospital, London, pitching for the cancer voteA reader has just told me about a lead story in this morning’s Observer.  I wish he had not. It has spoilt my morning. It will spoil my day. The head line is particularly difficult to deal with. In transactional, “parent-child” terms, it portrays GPs as naughty children who need a “warning”, a rap over the knuckles. The story is based on an interview with Mike Richards, one of the government's cancer czars, or whatever it is we are now supposed to call them. I actually know Mike Richards, though he does not know I know him, and so I will suppress the temptation to call him an egregious little prick, because he is not. He is a nice guy. He is well meaning. Bumbling professor type. He... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1369088 Sun, 13 Apr 2008 10:04:00 +0100 1369088 http://www.medworm.com/index.php?rid=1356041&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fdestroying-independence-of-english.html Nigel Rumfitt QCSuccessive Labour governments have destroyed the English secondary education system. They are in the process of destroying the university education system by compelling the universities to admit under qualified students from sink comprehensives. They are destroying the NHS by undermining the medical profession so that they can be replaced with poorly trained but cheaper HCPs. It is only right and fair, therefore, that they should also destroy the English legal system. And when you see what a thorn in the side of government an independent lawyer can be, is it any wonder that Gordon Brown wants to bring these turbulent professionals to heel?The government has made a start by trying to impose a contract on barristers who work in the legal aid system. So far the barristers ar... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1356041 Mon, 07 Apr 2008 18:41:00 +0100 1356041 http://www.medworm.com/index.php?rid=1347315&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fany-old-fool-can-be-doctor.html High street pharmacistPharmacists must be the most overqualified and under-utilised professionals in the country. The days of the apothecary using his pestle and mortar have long gone. The modern pharmacist’s job is mind numbing. Counting tablets, checking prescriptions and sticking on labels. It is no wonder these highly intelligent, university graduates are looking for more challenging work.It is well recognised that barristers are far too expensive a resource to be funded by the legal aid system to defend common folk who cannot afford to pay themselves. The Government believes that as pharmacists are such a vastly under-used resource, they could be better employed providing assessment of legal problems. The government therefore wants them to provide legal advice for those charged with... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1347315 Thu, 03 Apr 2008 15:32:00 +0100 1347315 http://www.medworm.com/index.php?rid=1346126&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F04%2Fair-hostesses-more-popular-than-pilots.html A fascinating post (Unskilled and unaware of it?) from Mental Nurse on professional perception of personal boundaries of knowledge. Mental nurse comes from the old school of metaphysical analysis. He believes that Dean Swift really did want the Irish to eat their children. He has also been taken in by some beguiling research from men with beards - or possibly from our dear friend Fradd the Destroyer - which shows that airline passengers find the trolley-dollies more approachable and user friendly than those grumpy old pilots.Much more interestingly, he quotes some  analysis of the perception of professional boundaries:The tendency to overestimate our ability in a profession is most noticeable when the profession relies on a degree of expert knowledge. In such professions (such as medicine... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1346126 Wed, 02 Apr 2008 15:55:00 +0100 1346126 http://www.medworm.com/index.php?rid=1337920&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F03%2Ffat-lazy-male-nurse.html There is a relatively new blog on the block, which is well worth a visit for the best picture of Hillary Clinton I have seen this year. But apart from that...oh dear.The blog is written by the self-deprecatingly named “fat lazy male nurse”, so he obviously has a sense of humour, which always helps. In more detail, he describes himself in the following way:12 years nursing in A&E, being forced to be polite to the kind of people I wouldn't share a life raft with if I was on the Titanic. Now working in Unscheduled Care and realising that the grass really isn't any greener!Obviously a sympathetic sort of chap. And in the profile, he styles himself as an Advanced Nurse Practitioner. Advanced, eh? That sounds good. I wonder what it means? What ever it means, fatman has not taken his medi... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1337920 Sun, 30 Mar 2008 23:25:00 +0100 1337920 http://www.medworm.com/index.php?rid=1297720&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F03%2Fas-regular-readers-know-only-too-well.html As regular readers know only too well, one of the prime objectives of NHS BLOG DOCTOR is to publicise the widespread dumbing down of health care that is insidiously, gradually but relentlessly destroying the NHS. Of course, when you keep banging a drum, people stop listening after a while and you become a voice in the wilderness. Yesterday, I highlighted the dumbing down of cardiology in the community. Once again, I said that a nurse is no subsitutue for a doctor. The usual vitriolic comments came in from the blinkered, egalitarian fantasists who lack insight into their own ignorance.I think you need to put the rose-tinted glassess that you use when looking back "at the way things were", as it simply NOT the case that things are always getting worse. It must be the distorted view form yo... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1297720 Wed, 12 Mar 2008 10:22:00 +0100 1297720 http://www.medworm.com/index.php?rid=1296034&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F03%2Fdeath-on-maternity-ward-collapse-of-nhs.html Earlier today (in the post below) a commentator said:...it (is) simply NOT the case that things are always getting worse. It must be the distorted view from your insular little GP goldfish bowl.I replied:Generally I just feel sad and at times ashamed for what the NHS has become. I particularly hate the two tier medicine which fobs off the “free at the point of entry" people with a second rate service, and only provides decent medical care for those with private health insurance.And then Arf, a regular visitor from America, asks me to explain what this case is about:Mother left cradling stillborn baby after midwife failed to notice the child was deadLast updated at 14:52pm on 11.03.08A mother was handed her baby to cradle by a midwife who hadn't noticed that the infant was dead. Elizabeth... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1296034 Tue, 11 Mar 2008 20:44:00 +0100 1296034 http://www.medworm.com/index.php?rid=1283406&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F03%2Fproms-please-god-dont-dumb-down-proms.html Someone just pointed me at the government’s latest kultural outburst. Margaret Hodge, the Secretary of State for Heritage and Arts wants to dumb down the proms.Mrs Hodge said a "shared sense of common cultural identity" was a key part of social integration and cohesion. She said she wanted to "challenge our sectors square on"."The audiences for some of many of our greatest cultural events - I'm thinking particularly of the Proms - is still a long way from demonstrating that people from different backgrounds feel at ease in being part of this," she added.In her speech, Mrs Hodge praised other institutions for "creating the icons of a common culture that everybody can feel a part of" - such as the Angel of the North, the British Museum and the Eden project as well as TV and radio shows "fr... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1283406 Thu, 06 Mar 2008 16:59:00 +0100 1283406 http://www.medworm.com/index.php?rid=1252411&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fadvances-in-cardiology.html A consultant cardiologistYou might be forgiven for thinking that the above is a hospital bed. You are wrong. It is indeed a consultant cardiologist. It joins our friend, the consultant paediatrician, who is often mistaken for a traffic light. Government dumbing down of the health service continues apace. Anything, yes anything, to keep the NHS patient out of hospital.There are around 63,500 new cases of heart failure each year in the UK and many of them require hospitalisation which puts an expensive burden on the NHS.Serious heart problems putting a burden on the NHS? What is the frigging NHS for?A bed packed with sensors could keep a close watch on the health of heart failure patients, it has been claimed. It is hoped the system, alongside similar devices built into clothing, could help ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1252411 Sat, 23 Feb 2008 20:50:00 +0100 1252411 http://www.medworm.com/index.php?rid=1251730&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fpolyclinics-dont-get-fooled-again.html The objective of “polyclinics” is not to improve primary health care. It is to make it cheaper. Beneath the flashing “24/7” sign the polyclinics will have a cornucopia of medical expertise on their headed notepaper; surgeons, physicians, psychiatrists, rheumatologists, and general practitioners. But do not for one moment think that this medical expertise will be available 24/7. It will not. It will probably be less available than it is now. Polyclinics will be run by HCPs. We looked at one of these embryonic polyclinics a few weeks ago in the Future of British Family Medicine.The Melbourne Grove Medical Practice say:You don’t need to wait to see a doctor.“Our prescribing Nurse Practitioners are highly trained and are able to deal with the vast majority of medical issues that yo... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1251730 Sat, 23 Feb 2008 14:22:00 +0100 1251730 http://www.medworm.com/index.php?rid=1245027&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fcrown-prosecution-service-legal.html Crown Prosecution ServiceThe beleaguered Crown Prosecution Service (CPS) has become the public embodiment of the disasters inherent in dumbing down. In medicine we often say that there is no such thing as minor surgery, only minor surgeons. The drafting of legal charges, the decisions as to who or who not to prosecute and the conduct of the prosecution may seem minor matters. They are not. All these tasks need the skills of trained lawyers.You do not find Russell group university law graduates beating a path to the CPS. The CPS is not the place for high fliers.Dumbing down the prosecution service and handing it over to a salaried state enterprise means means that independent barristers are often not involved until it is too late. And now, it seems, for many cases they will not be involved ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1245027 Wed, 20 Feb 2008 17:57:00 +0100 1245027 http://www.medworm.com/index.php?rid=1215238&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fquack-quack-youre-nicked.html Well, at least this government is consistent about dumbing down. This is an excerpt from today's statement from Sir Ronnie Flanagan's "vision".Why do you need a highly-trained police sergeant to act as a jailer in a custody suite? When 80 per cent of crime is low level, why should sworn officers need to take written statements when a civilian clerk could do so? Why do you need a police officer manning the reception desk at the police station? A lot of backroom police work could be better done by a civilian professional with a specific competency, he says - why have a police constable analysing the books in a complex fraud case when a forensic accountant would do a better job? And so it goes on. (Source: NHS Blog Doctor) NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1215238 Thu, 07 Feb 2008 17:28:00 +0100 1215238 http://www.medworm.com/index.php?rid=1212027&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Frichard-and-judy-dumbing-down-levels.html It is not just the NHS that is being dumbed down. GCSEs and “A” levels are increasingly discredited and, with this government, is it any wonder? The possibility of anyone failing such exams has long gone. Now the content of the exams is to be destroyed as well.“...one of the country’s most respected examination boards is hoping to capture a little of their literary magic by encouraging teachers to select any title from the Richard & Judy Book Club list for A-level study alongside the classics.” (The Times)Richard and Judy to set “A” levels? Richard and Judy??What’s it to be then, guys? “Pride and Prejudice” or “Sharon Osbourne’s Autobiography?”Who do you want to see if you are ill? A doctor or a “health care practitioner”?Oh dear God. (Source: NHS Blog Doc... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1212027 Wed, 06 Feb 2008 09:18:00 +0100 1212027 http://www.medworm.com/index.php?rid=1207274&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fhow-do-you-turn-psychiatric-nurse-into.html You probably will not believe this. Even cynical Dr Crippen was taken aback. It was sent to me today by a Consultant Psychiatrist in a well known London Teaching Hospital. He sounds close to despair. Dr Crippen has told you about the CMHT, those well meaning but unqualified amateurs armed with their protocols and the Dorling Kindersly "Pop-up book of lunatics". And I have told you about Hospital at Night, where Sue and Dave are "team building".The most dangerous place in the UK to get a physical illness used to be in a psychiatric ward. Worry no more. You can be mad and ill in safety. There may be no psychiatrists there. There may be no doctors there. But who needs them? The mental health nurses have been"upskilled". They have been on a course. They are doctors now. The CMHT has amalgamate... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1207274 Tue, 05 Feb 2008 23:11:00 +0100 1207274 http://www.medworm.com/index.php?rid=1204628&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Ffuture-of-british-family-medicine.html This evening I received a glimpse of the future. The future is not orange. The future is Melbourne Grove Medical Practice.Plausible touchy-feely website. Trendy corporate name - Concordia Health – and lots of nurse practitioners. This is the beginning of the end of the family medicine for which I trained. And why not? The dinosaurs had to go and perhaps the British family doctor is a dinosaur and an expensive one at that.Elsewhere, in a larger forum, I have written today about how I feel. Read it if you want, but my views are well known to regular readers of NHS BLOG DOCTOR.The Melbourne Grove Medical Practice say:You don’t need to wait to see a doctor. “Our prescribing Nurse Practitioners are highly trained and are able to deal with the vast majority of medical issues that you prese... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1204628 Mon, 04 Feb 2008 21:45:00 +0100 1204628 http://www.medworm.com/index.php?rid=1194732&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F02%2Fqucktitioner-goes-to-war.html At least the government is consistent. It is now going to "save" a little money by dumbing down the army. Why should the army be spared? They have done it to the doctors, the teachers and the lawyers. It's all in The Times:Nearly 1,000 new army recruits face having their combat training cut by half so that they can be rushed to the battlefields of Afghanistan. The “exceptional” measure is being proposed by senior officers to meet a serious shortage in manpower, The Times has learnt. It would affect those infantry battalions being earmarked to fight in the country next year. One senior defence source admitted that the new recruits would not be properly qualified to fight since they would receive only 50 per cent of the basic training usually given to qualified combat infantrymen. “I w... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1194732 Fri, 01 Feb 2008 13:29:00 +0100 1194732 http://www.medworm.com/index.php?rid=1166341&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2008%2F01%2Fpay-peanuts-get-monkeys.html Dumbing down health care is slowly destroying the NHS.Nurse specialists, EMTs and the whole collection of “health care professionals” who front end the “free” at the point of entry NHS continue to play “doctor”, the ludicrous GPwSIs continue to play consultant, and the consultants? There are not enough of them. It takes twelve years or more to train a consultant and it is an expensive business. Cheaper to employ a monkey.GPs are, by definition, "generalists". That is what they are trained to do. A Consultant in any speciality trying to do GP surgeries would be a disaster. A GP trying to be a consultant is, well, laughable. GPwSIs are a strange bunch. Some are skiving off the job for which they trained, leaving their patients in the hands of a quacktitioner. Others have inferio... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=1166341 Mon, 21 Jan 2008 13:28:00 +0100 1166341 http://www.medworm.com/index.php?rid=821657&cid=t_116218_109_f&fid=35677&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FBrainBasedBusiness%2F%7E3%2F147929026%2F10_surefire_ways_to_dumb_down.html People increasingly claim we blow out candles daily - while biotech and research oriented nations leave us in the dark lately. Hopefully it's not so. I say it's more about dumbing down a  workplace. What do you say? Here are 10 Surefire Ways I see to Dumb Down any American Workplace … 1. Ignore future directions the winning workforces take and stick to practices that worked well when you were hired.2. Criticize a person who spells poorly  … far more than you value the fact that same person can rebuild your entire computer system in a day.3. Impress younger workers with your generation’s wizardry and wisdom … but don’t listen to stories about how they are smarter in unique contemporary ways.4. Present your... BrainBasedBusiness blogs http://www.medworm.com/rss/comments.php?id=821657 Sat, 25 Aug 2007 02:10:22 +0100 821657 http://www.medworm.com/index.php?rid=695196&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F06%2Fdebate-doctors-for-rich-nurse.html If NHS BLOG DOCTOR has one mission statement above all others, it is to fight against the dumbing down of the NHS. This dumbing down most frequently involves the over-promotion of nurses into roles for which they are ill equipped. Roles that used to be filled by doctors.In many fields of medicine the only way to be sure of seeing a qualified doctor is to go privately. Take yourself to the “free” at the point of entry NHS and most likely you will find yourself managed by some sort of “Health Care Professional” (HCP = there is no doctor available today).This is two-tier medicine. Only the wealthy and the “great and the good” see doctors. The riff-raff get the cheapo-cheapo productions HCP.The nurse-specialists usually counter this argument by saying that “we are just as good as... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=695196 Mon, 25 Jun 2007 21:53:00 +0100 695196 http://www.medworm.com/index.php?rid=682442&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F06%2Fyou-wouldnt-treat-dog-like-this.html Physicians do not know much about surgery, haematologists do not know much about cardiology, psychiatrists do not know much about orthopaedics and GPs, well, they do not know much about anything. And yet, we all went to medical school and so, before we became specialists, we were doctors. We had learnt how to analyse problems and how to know our boundaries. Those five years were not wasted.Another email arrives, this time from a Consultant Psychiatrist somewhere in the West Country. Her teenage daughter, who is herself about to go to medical school, fell off a horse last week and hurt her shoulder.I had a look, and although I am but a humble psychiatrist, I knew it was a bust clavicle. Palpable lump, point tenderness, severe pain. Pretty obvious diagnosis. Sling and rest is all that is req... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=682442 Mon, 18 Jun 2007 14:29:00 +0100 682442 http://www.medworm.com/index.php?rid=644696&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F05%2Fwho-needs-midwives-anyone-can-deliver.html Tip of the IcebergRegular NHS BLOG DOCTOR readers will not have been surprised by the headlines in today’s newspapers complaining that untrained “health care professionals” have been working as midwives.It is happening throughout the NHS, in all specialties. The midwifery scandal is but the tip of a large iceberg.The NHS is being deliberately dumbed down by a government intent on saving money on the wage bill. The monkey is always cheaper than the organ-grinder. The nurse is cheaper than the doctor. The auxiliary is cheaper than the nurse. The cleaner is cheaper than the auxiliary.A culture is now developing that makes the use of the word “doctor” old-fashioned, elitist and politically incorrect. Soon words like “nurse” and “midwife” will disappear as well, to be replaced... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=644696 Tue, 29 May 2007 14:20:00 +0100 644696 http://www.medworm.com/index.php?rid=637747&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F05%2Fquacktitioner-alert-14.html First, some definitions:Atavistic: relating to or displaying the kind of behaviour that seems to be a product of impulses long since suppressed by society’s rulesHealth Care Professional: I am sorry, there is no doctor available.HCP: Have you Considered Private healthcare?+++++++++++Dr Crippen firmly believes that we are witnessing the destruction of the National Health Service.My use of the term “NHS” is atavistic. I am referring to the system that existed when I trained. A system in which people who were ill, or thought they might be ill, had this impulse to see a doctor. That system has long since been suppressed by NHS rules. The doctors have all gone. The government will not admit that though. They have invented a new and better professional. The "health care" professional. Anyo... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=637747 Thu, 24 May 2007 09:44:00 +0100 637747 http://www.medworm.com/index.php?rid=623210&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F05%2Fdumbing-down-nursing-profession.html Nurses are to be replaced by robots. No, really, it is not April Fool’s Day. It is going to happen in a hospital near you. Soon.Nurses, those caring people who have pulled many a patient back from the brink with their expertise, brow-wiping and tender words, are likely to be replaced soon by yards of wiring, transistors, hydraulics, a motherboard and light-emitting diodes. Enter the Robo-nurse. (Independent)As we report today, a medication-dispensing machine is coming soon to a ward near you. Robot nurses to take your temperature and blood pressure cannot be far behind. Makes sense, though, does it not? (Leader in Independent)And the girls and boys at Dr Crippen's favourite website, the wonderful Center for Nurse Advocacy are going to love this one. In the USA they have flirtatious robo-... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=623210 Sun, 20 May 2007 10:59:00 +0100 623210 http://www.medworm.com/index.php?rid=582667&cid=t_116218_87_f&fid=34595&url=http%3A%2F%2Fnhsblogdoc.blogspot.com%2F2007%2F05%2Fcrippen-diaries-2007-week-18.html Not quite Emergency Ward 10Monday 30thAprilEric is 79. He is a widower. He lives alone. His daughter, who is married with two children, lives nearby. They are close.Eric has had osteoarthritis of his knees for many years. He also has dry macular degeneration and is registered as partially sighted. Finally, this year, the arthritis of his right knee became so intolerable that he had a knee replacement. The operation went well. He was discharged from hospital after a few days. He was more or less pain free within a few days and, all things considered, fairly mobile.So far so good.He presented last month with an irritating cough, which was causing sharp chest pain. He was a little short of breath, not dramatic, but enough to notice it when he walked upstairs. There was nothing to find in his ... NHS Blog Doctor blogs http://www.medworm.com/rss/comments.php?id=582667 Tue, 01 May 2007 14:00:00 +0100 582667