The Medical Officer of Health and his town

Keyword(s):  
1987 ◽  
Vol 33 ◽  
pp. 537-571 ◽  

Owain Westmacott Richards was born on 31 December 1901 in Croydon, the second son of Harold Meredith Richards, M.D., and Mary Cecilia Richards ( née Todd). At the time H. M. Richards was Medical Officer of Health for Croydon, a post he held until 1912 when he returned to the town of his birth, Cardiff, as Deputy Chairman of the newly formed Welsh Insurance Commission, the forerunner of the Welsh Board of Health. Owain Richards’s grandfather had a hatter’s business in Cardiff, which had been established by his father, who had migrated to Cardiff from Llanstephan in Carmarthenshire (now Dyfed). This great-grandfather was probably the last Welsh-speaking member of the family; his son discouraged the use of Welsh as ‘unprogressive’ and married a non-Welsh speaking girl from Haverfordwest. Harold Richards, being the youngest son, did not inherit the family business. On leaving school he worked for some years in a shipping firm belonging to a relative. He found this uncongenial and in his late twenties, having decided to become a doctor, he attended classes at the newly founded University College at Cardiff. Passing the Intermediate Examination he entered University College London, qualifying in 1891, taking his M.D. and gaining gold medals in 1892 and 1893. He was elected a Fellow of University College London in 1898. As medical practices had, at that time, either to be purchased or inherited, Harold Richards took a salaried post as Medical Officer of Health for Chesterfield and Dronfield (Derbyshire), soon moving to Croydon. After his work at Cardiff, he transferred, in 1920, to the Ministry of Health in London, responsible for the medical and hospital aspects of the Local Government Act, 1929 (Anon. 1943 a, b ). He retired in 1930 and died in 1943. His obituaries recorded that he was ‘excessively shy and modest’, that he always ‘overworked’ and had markedly high standards (Anon. 1943 a, b ). Such comments would be equally true of Owain.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S191-S192
Author(s):  
Nupur Gupta ◽  
Adit B Sanghvi ◽  
John Mellors ◽  
Rima Abdel-Massih

Abstract Background Telemedicine (TM) has emerged as a viable solution to extend infectious disease (ID) expertise to communities without access to this specialty.1 TM allows clinicians in rural settings to connect with specialists at distant sites and provide the best care for their patients, often eliminating the need for hospital transfers. Here, we describe the experience from one of the longest standing inpatient Tele-ID consult services using live audio-video (AV) visits with the assistance of a telepresenter. Methods Longitudinal data were collected from a 126-bed rural hospital in Pennsylvania that had no access to ID consultation before 2014. Live AV consults during business hours began in 2014 and telephonic physician to physician consults were made available 24/7. All ID consult data were extracted from the hospital electronic health record between 2014 to 2019. Key outcomes assessed included the number of consult encounters, total hospital length of stay (LOS), discharges to home, transfer to tertiary care centers, and readmission rates at 30 days. Results Most consulted patients were Caucasians, and females with an average age of 64.7 years (Table 1). The number of unique consult encounters increased annually from 111 in 2014 to 469 in 2019 (Table 1). The Charlson Comorbidity Score and Elixhauser Comorbidity Index also increased each year beginning in 2016 (Table 1). By contrast, LOS decreased each year as did the 30-day readmission rate (Table 2). Most patients were not transferred (average 89.4% over 6 years) to tertiary care centers and more than half were discharged to home each year (Table 2). Conclusion This longitudinal 6-year observation study of an inpatient TM ID service at a rural hospital showed remarkable annual growth in consult encounters (total growth >400%). Despite increasing patient acuity, overall hospital LOS decreased over time (10.2 to 8.2 days). Patient transfers to tertiary care centers remained low (average 10.5% over 6 years) as did 30-day readmissions (average 16.3% over 6 years). The majority of patients were discharged to home (average 61.3% over 6 years). These findings show that a rural inpatient TM ID consult service can expand over time and is an effective alternative for hospitals without access to ID expertise. Disclosures John Mellors, MD, Abound Bio (Shareholder)Accelevir Diagnostics (Consultant)Co-Crystal Pharmaceuticals (Shareholder)Gilead (Consultant, Grant/Research Support)Merck (Consultant) Rima Abdel-Massih, MD, Infectious Disease Connect (Shareholder, Other Financial or Material Support, Chief Medical Officer)


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Cylie M. Williams ◽  
Anna Couch ◽  
Terry Haines ◽  
Hylton B. Menz

Abstract Background On the 19th of January, 2020, the Chief Medical Officer of Australia issued a statement about a novel coronavirus, or SARS-CoV-2. Since this date, there have been variable jurisdictional responses, including lockdowns, and restrictions on podiatry practice. This study aimed to describe impacts of the SARS-CoV-2 pandemic on the podiatry profession in Australia. Methods This was a cross sectional study of Australian podiatrists using demographic data collected between 2017 and 2020, and pandemic-related question responses collected between 30th March and 31st August, 2020. Data were collected online and participants described their work settings, patient funding types, business decisions and impacts, and information sources used to guide practice decisions during this time-period. Inductive thematic analysis was used to analyse open-ended questions about their practice impact of SARS-CoV-2. Results There were 732 survey responses, with 465 Australian podiatrists or podiatric surgeons providing responses describing pandemic impact. From these responses, 223 (49% of 453) podiatrists reported no supply issues, or having adequate supplies for the foreseeable future with personal protective equipment (PPE) or consumables to support effective infection prevention and control. The most frequent responses about employment, or hours of work, impact were reported in the various categories of “business as usual” (n = 312, 67%). Participants described most frequently using the local state and territory Department of Health websites (n = 347, 75%), and the Australian Podiatry Association (n = 334, 72%) to make decisions about their business. Overarching themes which resounded through open-ended comments was that working through the pandemic was likened to a marathon, and not a sprint. Themes were: (i) commitment to do this, (ii) it’s all in the plan, but not everything goes to plan, (iii) my support team must be part of getting through it, (iv) road blocks happen, and (v) nothing is easy, what’s next? Conclusion Podiatrists in Australia reported variable pandemic impact on their business decisions, PPE stores, and their valued sources of information. Podiatrists also described their “marathon” journey through the pandemic to date, with quotes describing their challenges and highlights. Describing these experiences should provide key learnings for future workforce challenges, should further restrictions come into place.


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