scholarly journals Partners in Progress: Patient Safety in the UK

2021 ◽  
pp. 203-213
Author(s):  
Lucian L. Leape

AbstractIn 1997, Britons were shocked by a report from the General Medical Council (GMC) of a series of deaths from bungled surgery at the Bristol Royal Infirmary. In response to parents’ complaints, the GMC had launched an investigation into the high mortality of cardiac surgery of children at the Infirmary. It found that of 53 children who were operated on, 29 had died and 4 suffered severe brain damage. Three surgeons were found guilty of serious professional misconduct, and two were stricken from the medical register [1].

2016 ◽  
Vol 98 (1) ◽  
pp. 1-5 ◽  
Author(s):  
PJ Benson

'Oh what a tangled web we weave, When first we practise to deceive.’ Sir Walter Scott (Marmion, 1808) Think of scientific misconduct in the UK and Malcolm Pearce – one of the most high-profile cases – comes immediately to mind. Malcolm Pearce was an assistant editor of the British Journal of Obstetrics and Gynaecology, and a senior lecturer at St George's Medical School, when two fraudulent papers were published in the journal. A whistleblower at the hospital was the catalyst for an investigation that led to Pearce being fired, found guilty of serious professional misconduct by the General Medical Council, and struck off.1 The professor of the department, Geoffrey Chamberlain, who was also President of the Royal College of Obstetricians and Gynaecologists and Editor of the journal, resigned from both positions as he was named as an author on one of the fraudulent papers. He reportedly did not know that his name was on the manuscript and, in his defence, it was not unusual at the time for Heads of Department to have ‘gift’ authorship on the department’s publications, despite not making any contribution. Regardless, both were disgraced. Scientific misconduct has many faces and its true prevalence is unknown, although many agree that it is increasing. Is it because researchers are committing more publication crimes, or are we just better at discovering them? In the race to find a home for articles, are authors getting lazy, sloppy and making more mistakes? In the era of online publications reaching wider audiences, mistakes are easier to detect and report, and beware if Clare Francis stumbles across such misdemeanours… Since 2010 an individual (or perhaps even a group) whose gender, identity and occupation are unknown, but who operate under the name ‘Clare Francis’, has upped the ante and flagged hundreds of suspected cases of potential fraud across the globe. Notorious among journal editors as a relentless whistleblower and crusader against text and image fraud, some of Francis’ tips have resulted in corrections and retractions. For example, a 2006 paper in the Journal of Cell Biology was retracted after Francis raised concerns years after publication about image manipulation, which were validated by the publisher. .2 But why does it happen? Why not? Researchers are human and subject to the same frailties as in other walks of life. If a measure of a good academic is solely the number of articles they have published, then – when quantity is rewarded over quality – scientific misconduct may reveal a glimpse of the pressure researchers are under. It is worth remembering that, despite the stress of the ‘publish or perish’ culture, scientific misconduct is unacceptable in any guise and likely to be discovered, with embarrassing if not downright career- and reputation-destroying consequences. Good publishing etiquette is ultimately down to the integrity and moral sensibilities of researchers and authors. In this excellent article about some of the ‘sins’ of publishing, Philippa Benson, who has kindly written for this series before, provides a thought-provoking insight into scientific misconduct. Jyoti Shah Commissioning Editor References Lock S. Lessons from the Pearce affair: handling scientific fraud. BMJ 1995; 310: 1,547. Retraction notice. J Cell Biol 2013; 200: 359. doi:10.1083/jcb.2005070832003r.


2018 ◽  
Vol 23 (2) ◽  
pp. 66-70
Author(s):  
Damian Lake

It is estimated that over 40 million people have had laser vision correction worldwide since 1991. Laser-assisted subepithelial keratomileusis is commonplace in the UK in high street chains and from more bespoke suppliers. The standards around this treatment have always been regulated by the General Medical Council (GMC), but litigation cases have been common. The recent GMC guidance for cosmetic procedures and subsequent guidelines by the Royal College of Ophthalmologists cover advertising, facility regulations, equipment, consent and surgeon training which should improve industry practices and deliver improved patient safety standards.


2020 ◽  
Vol 20 (1) ◽  
pp. 58-72
Author(s):  
Paula Case ◽  
Gunjan Sharma

In a 2015 prosecution which divided public opinion, Dr Bawa-Garba was convicted of gross negligence manslaughter and sentenced to 2-years’ imprisonment, suspended for 2 years. The post-conviction litigation which sought to determine whether and when Dr Bawa-Garba could return to clinical practice threatened to destabilise the already fragile relationship between the medical profession and its regulator, the General Medical Council. At the heart of this litigation lay the regulator’s quest to maintain and promote public confidence in the profession, in a case where the doctor concerned was not regarded as posing a future risk to patient safety. Using the Bawa-Garba litigation, this commentary examines the position and use of the nebulous concept of ‘public confidence’ within the fitness to practise framework for doctors. Although the authors’ observations arise specifically from a case decided in the UK, ‘public confidence’ is a touchstone concept in professional regulation regimes around the world and so these observations have relevance beyond this jurisdiction. The authors argue that, for too long, use of the rhetoric of public confidence in the regulation of the medical profession has been characterised by an unsatisfactory lack of transparency, excessive deference by the courts to regulatory tribunals and that research is increasingly signalling that instinctual ‘expert’ judgements on the issue of ‘what the public think’ may be unreliable.


2019 ◽  
Author(s):  
Sneha Barai

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Alice Malpass ◽  
Kate Binnie ◽  
Lauren Robson

Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an “allowed vulnerability.”


2016 ◽  
Vol 40 (2) ◽  
pp. 87-88 ◽  
Author(s):  
Derek Summerfield

SummaryThis is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.


2012 ◽  
Vol 94 (2) ◽  
pp. 90-93 ◽  
Author(s):  
G Kirby ◽  
K Kapoor ◽  
P Das-Purkayastha ◽  
M Harries

INTRODUCTION The General Medical Council states ‘a surgeon must not work when their health state is adversely influenced by fatigue, disease, drugs or alcohol’. However, there are no defined criteria for acceptable blood alcohol levels when operating. The aim of this study was to measure the effect of varying amounts of alcohol on surgical dexterity, cognitive abilities and the social interactions required to ensure patient safety during a routine ear, nose and throat (ENT) operation. METHODS ENT surgeons were asked to perform a microlaryngoscopy with excision of a predetermined glottic lesion on a validated laryngeal model. The procedure was repeated four times over a period of four hours with varying doses of alcohol (no alcohol control, one glass, three glasses and six glasses of wine). The parameters recorded included theatre etiquette, surgical time, operative skills and patient safety. Scores were adjudicated by two independent observers. RESULTS The more glasses of wine consumed, the more detrimental the effect was on the surgical performance of all participants. There was a global reduction in ability of 7.25% after three glasses and 19.25% after six glasses of alcohol. No domain showed an improvement following sequential increase in blood alcohol concentration. CONCLUSIONS This study suggests that there are no deleterious effects on surgical performance following the consumption of one glass of wine 45 minutes prior to microlaryngoscopy among ENT surgeons of varying experience. However, there is clear evidence that with three or more glasses of wine there is an adverse effect on performance, with decreased surgical dexterity, cognition functions and professionalism.


2019 ◽  
Vol 8 (1) ◽  
pp. e000548 ◽  
Author(s):  
Adam Backhouse ◽  
Myra Malik

BackgroundPatient safety is at the core of the General Medical Council (GMC) standards for undergraduate medical education. It is recognised that patient safety and human factors’ education is necessary for doctors to practice safely. Teaching patient safety to medical students is difficult. Institutions must develop expertise and build curricula while students must also be able to see the subject as relevant to future practice. Consequently graduates may lack confidence in this area.MethodWe used gamification (the application of game design principles to education) to create a patient safety simulation for medical students using game elements. Gamification builds motivation and engagement, whilst developing teamwork and communication. We designed an escape room—a team-based game where learners solve a series of clinical and communication-based tasks in order to treat a fictional patient while avoiding ‘clinician error’. This is followed up with an after action review where students reflect on their experience and identify learning points.OutcomeStudents praised the session’s interactivity and rated it highly for gaining new knowledge and skills and for increasing confidence to apply patient safety concepts to future work.ConclusionOur findings are in line with existing evidence demonstrating the success of experiential learning interventions for teaching patient safety to medical students. Where the escape room has potential to add value is the use of game elements to engage learners with the experience being recreated despite its simplicity as a simulation. More thorough evaluation of larger pilots is recommended to continue exploring the effectiveness of escape rooms as a teaching method.


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