Checks and Balances? Has the Introduction into the UK of the Freedom of Information (FOI) Act 2000 Impacted upon the Ministry of Defence’s Operational Efficiency?

Introduction Antimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. The aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011. Methods Two questionnaires (one in 2008 and one in 2011) were sent to all National Health Service trusts in the UK using the Freedom of Information Act. Results In total, 87% of trusts that perform orthopaedic surgery responded. The use of cefuroxime more than halved between 2005 and 2011 from 80% to 36% and 78% to 26% in elective surgery and trauma surgery respectively. Combination therapy with flucloxacillin and gentamicin rose from 1% to 32% in elective and 1% to 34% in trauma surgery. Other increasingly popular regimes include teicoplanin and gentamicin (1% to 10% in elective, 1% to 6% in trauma) and co-amoxiclav (3% to 8% in elective, 4% to 14% in trauma). The majority of changes occurred between 2008 and 2010. Over half (56%) of the trusts stated that Clostridium difficile was the main reason for changing regimes. Conclusions In 2008 a systematic review involving 11,343 participants failed to show a difference in surgical site infections when comparing different antimicrobial prophylaxis regimes in orthopaedic surgery. Concerns over C difficile and methicillin resistant Staphylococcus aureus have influenced antimicrobial regimes in both trauma and elective surgery. Teicoplanin would be an appropriate choice for antimicrobial prophylaxis in both trauma and elective units but this is not reflected in its current level of popularity.

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A cross-sectional study of all clinicians’ conflict of interest disclosures to NHS hospital employers in England 2015-2016

BMJ Open ◽

10.1136/bmjopen-2017-019952 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019952 ◽

Cited By ~ 4

Author(s):

Harriet Ruth Feldman ◽

Nicholas J DeVito ◽

Jonathan Mendel ◽

David E Carroll ◽

Ben Goldacre

Keyword(s):

Conflict Of Interest ◽

Conflicts Of Interest ◽

Current System ◽

Tertiary Care ◽

Cross Sectional Study ◽

Freedom Of Information ◽

Sectional Study ◽

Cross Sectional ◽

The Gift ◽

The Uk

ObjectiveWe set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.DesignCross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.SettingNHS Trusts (secondary/tertiary care organisations) in England.Participants236 Trusts were contacted, of which 217 responded.Main outcome measuresWe assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.ConclusionOverall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US ‘Sunshine Act’.

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Searching for the true attrition rate of UK paediatric trainees

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-321415 ◽

2021 ◽

pp. archdischild-2020-321415

Author(s):

Melody Grace Redman ◽

Davide Carzedda ◽

Nicola Jay ◽

Simon J Clark ◽

Marie Rogers

Keyword(s):

Geographical Area ◽

Workforce Planning ◽

Training Programme ◽

Attrition Rate ◽

Freedom Of Information ◽

Evidence Based ◽

Record Keeping ◽

Retrospective Data Analysis ◽

Level Of Training ◽

The Uk

ObjectiveTo quantitatively analyse the number of doctors leaving the paediatric specialty training (ST) programme in the UK, to assist with evidence-based workforce planning.DesignData were sought on those leaving the UK paediatrics training programme between 2014 and 2019 from Heads of Schools of Paediatrics and Freedom of Information Act requests.SettingRetrospective data analysis.Outcome measuresOverall attrition rate, attrition rate across level of training, attrition rate across geographical area, recorded reason for leaving.ResultsAll results must be interpreted with caution due to limitations in record keeping and analysis. The annual attrition rate across all ST levels between 2014 and 2019 is estimated at 3.7%–4.2% (ie, 749–845 trainees may have left the paediatric training programme over 2014–2019). No reason for leaving was recorded for three-quarters of individuals, around 630 doctors. Of those leaving paediatrics, significantly more (χ², p=0.015) did so at ST3 (20.3%) versus the next highest training year, ST2 (13.6%).ConclusionsThis project seems to demonstrate worryingly poor record-keeping of the true attrition rate of paediatric trainees by organisations responsible for workforce planning, including Health Education England, the Royal College of Paediatrics and Child Health and individual paediatric schools across the UK. To allow evidence-based workforce planning for the benefit of UK children, it is vital that accurate records on trainees who leave the training programme are kept and shared across the UK.

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Freedom of Information in Scotland and the UK: Time to Notice the Difference

Freedom of Information ◽

10.4324/9781315583150-12 ◽

2016 ◽

pp. 75-90

Keyword(s):

Freedom Of Information ◽

The Difference ◽

The Uk

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31. Parliament and Freedom of Information

Exploring Parliament ◽

10.1093/hepl/9780198788430.003.0031 ◽

2018 ◽

Author(s):

Ben Worthy

Keyword(s):

Freedom Of Information ◽

House Of Commons ◽

High Profile ◽

House Of Lords ◽

The Law ◽

The Uk ◽

The Impact

This chapter considers the impact of the Freedom of Information (FOI) Act 2000 on the UK Parliament. Since 2005, FOI 2000 has helped make both the House of Commons and the House of Lords more open and accountable. The most high-profile effect of the law came in 2009, when it played a part in exposing the abuse of the expense allowance system. Despite the scandal, it is not clear whether FOI has transformed the culture of the two Houses. Nevertheless, the law has indirectly sparked a series of other reforms, so that FOI now sits alongside a whole range of instruments intended to make Parliament more open and accessible. The chapter first provides an overview of what FOIs consist of, their application to legislatures and Westminster specifically, before analysing the extent of the impact of FOI 2000 on the UK Parliament.

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Cutting edge or ignored resource: assessing the uptake and content of the NHS e-Learning for healthcare on “identifying and supporting survivors of modern slavery”

Journal of Public Health ◽

10.1093/pubmed/fdz124 ◽

2019 ◽

Cited By ~ 1

Author(s):

Segan Helle ◽

Sarah Steele

Keyword(s):

International Law ◽

Healthcare Workers ◽

Local Level ◽

Freedom Of Information ◽

Modern Slavery ◽

The World ◽

E Learning ◽

Open Session ◽

The Uk ◽

Level Variable

Abstract Background Across the last decade, healthcare emerged as a critical space for combatting modern slavery. Accurate and informative training of healthcare professionals is, therefore, essential. In the UK, the National Health Service (NHS) plays a central role in the identification and care of survivors. With training at the local-level variable, an e-Learning programme was developed. We ask: has this programme reached NHS staff? Is it accurate? Should the e-Learning approach be replicated around the world? Method A Freedom of Information request has been sent to the NHS’s Health Education England for data held on registrations, sessions and completions since 2014. An open session was used to assess the content. Results Across the past 5 years, there have been 31 191 registrations (≈2% of the workforce) and 1763 completed sessions (≈0.12%). Uptake remains low. We also identify deficiencies in the ways the programme represents modern slavery, and how the program engages with the complexities of national and international law and UK policy, as well as reporting mechanisms. Conclusions e-Learning, while flexible and on-going, must be engaging and, we suggest, accompanied by in-person sessions. Materials should be co-produced with survivors and healthcare workers around the world to improve interest and relevance. Updating content regularly is critical.

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Rig integration and remote monitoring set new standards in offshore operations

The APPEA Journal ◽

10.1071/aj14088 ◽

2015 ◽

Vol 55 (2) ◽

pp. 453

Author(s):

Scott Sivewright ◽

Markus Hulke ◽

Goh Teck Hua

Keyword(s):

Remote Monitoring ◽

Cost Savings ◽

Operational Efficiency ◽

Safety Standards ◽

Wellbore Integrity ◽

High Profile ◽

The North ◽

The North Sea ◽

The Uk ◽

Productive Time

Heightened focus on wellbore integrity in the high-profile offshore arena has signaled the need for integrated solutions that deliver greater operational efficiency, safety, reliability and cost savings. Innovative systems that can interface with the existing rig package and facilitate mechanised processes are critical to operator needs to maximise safety and efficiency. A rig integration operation to run tubulars and make up connections for a multi-well project in the UK sector of the North Sea reduced overall operational costs without compromising performance. This operation combined remote-controlled mechanised power tongs (maximum 100,000 ft/lb) with a software package that recorded, analysed and evaluated critical torque-turn data in a real-time report, which could be viewed from multiple remote locations. This hands-off system ensured the integrity of the connections, eliminating the possibility of tubing damage and reducing tripping. The technology performed risky activities in a mechanised fashion, increased efficiency, reduced non-productive time and kept workers safer. This approach is particularly suited to the offshore sector, which is defined by high costs and risks, specifically the use of high-torque strings where casing-running operations present potential hazards. The North Sea’s stringent safety standards dictate the need for a totally integrated methodology that provides a control system, and handling and makeup tools that can easily interface with existing rig equipment. This extended abstract will review the evolution of connection integrity and remote monitoring to enhance safety and well integrity in offshore environments. It will also discuss the latest technologies and software in connection make up and their impact on improving operational efficiency.

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