Commissioning surgical services

2009 ◽  
Vol 91 (5) ◽  
pp. 162-163
Author(s):  
Paul Abrams
Keyword(s):  
Primary Care ◽  
Evidence Base ◽  
Collaborative Approach ◽  
The West ◽  
Surgical Services ◽  
Recent Meeting ◽  
South West ◽  
Health Authorities ◽  
West Midlands

The College has been working with the strategic health authorities (SHAs) in the West Midlands and the South West to foster a collaborative approach to commissioning and improving the quality of local surgical services. This is being driven by the new College directors for professional affairs (DPAs) who are actively engaging with primary care trusts (PCTs) and commissioners by hosting strategic joint College–SHA meetings to present the evidence base for reconfiguring local surgical services. This report describes a recent meeting in Taunton.

scholarly journals How do the general population behave with facemasks to prevent COVID-19 in the community?

2020 ◽  
Author(s):  
Colin DESCHANVRES ◽  
Thomas HAUDEBOURG ◽  
Nathan PEIFFER-SMADJA ◽  
Karine BLANCKAERT ◽  
David BOUTOILLE ◽  
...  
Keyword(s):  
Demographic Data ◽  
Female Gender ◽  
The West ◽  
Information Campaigns ◽  
Factors Associated ◽  
Health Authorities ◽  
Rural And Urban ◽  
General Populations ◽  
Indoor And Outdoor

IMPORTANCE The appropriate use of facemasks, recommended or mandated by authorities, is critical to protect the community and prevent the spread of COVID-19. OBJECTIVE To evaluate the frequency and quality of facemask use in general populations of different socio-spatial backgrounds. DESIGN A multi-site observational study carried out from 25 June 2020 to 21 July 2020. SETTING The observations were carried out in 43 different locations in a region in the west of France, representing various areas: rural and urban, indoor and outdoor, and in areas where masks were mandated or not. An observer was positioned at a predetermined place, facing a landmark, and collected information about the use of facemasks and socio-demographic data. PARTICIPANTS All individual passing between the observer and the landmark were included. EXPOSURE The observer collected information on whether a mask was worn, the type of mask used, the quality of the positioning, gender, and the age category of each individual. MAIN OUTCOMES AND MEASURES The main outcomes were the use of a facemask and the quality of the positioning. Factors associated with these outcomes were identified. RESULTS A total of 3354 observations were recorded. A facemask was worn by 56.4% (n=1892) of individuals, varying from 49% (n=1359) in non-mandatory areas and 91.7% (n=533) in mandatory areas, including surgical facemasks (56.8%, n=1075) and cloth masks (43.2%, n=817). The facemask was correctly positioned in 75.2% (n=1422) of cases. The factors independently associated with wearing a facemask were being indoors (adjusted odds ratio [aOR], 0.37; 95% confidence interval [CI], 0.31-0.44), being in a mandatory area (aOR, 0.14; 95%CI, 0.10-0.20), female gender (aOR, 0.57; 95%CI, 0.49-0.66), and age >40 years (aOR, 0.54; 95%CI, 0.46-0.63). The factors independently associated with correct mask position were rural location (aOR, 0.76; 95%CI, 0.97-0.98), being in an indoor area (aOR, 0.49; 95%CI, 0.38-0.65), use of a cloth mask (aOR, 0.65; 95%CI, 0.52-0.81), and age >40 years (aOR, 0.61; 95%CI 0.49-0.76). CONCLUSIONS AND RELEVANCE Information campaigns should promote the use of cloth masks. Young people in general and men in particular are the priority targets. Simplifying the rules to require universal mandatory masking seems to be the best approach for health authorities.

Forest Dialect

English Today ◽  
2020 ◽  
Vol 36 (3) ◽  
pp. 70-76
Author(s):  
Michelle Straw
Keyword(s):  
Identity Construction ◽  
Nation State ◽  
The South ◽  
The West ◽  
South West ◽  
Special Place ◽  
West Midlands ◽  
National Borders

The Forest of Dean (henceforth Forest) is one of the lesser known English Royal Forests. The area is considered locally to be a special place with a distinctive dialect. The Forest lies at the intersection of three regions: South East Wales, West Country, also known as the South West, and the West Midlands. The Forest is situated between two rivers: the River Severn to the East separates it from the rest of Gloucestershire; the River Wye to the West separates it from Wales. National borders and physical boundaries seem to play an important role in identity construction. ‘Identities matter most’ (Llamas & Watt, 2010: 17) to those communities ‘at the physical margins of the nation state’ (Llamas, 2010: 225). Such communities may engage in practices that differentiate their dialect and situate it at the centre of their own region.

scholarly journals Validation of the acute cholecystectomy rate as a quality indicator for emergency general surgery using the SWORD database

2019 ◽  
Vol 101 (6) ◽  
pp. 422-427 ◽  
Author(s):  
TR Palser ◽  
AP Navarro ◽  
S Swift ◽  
IJ Beckingham
Keyword(s):  
Gallbladder Disease ◽  
Evidence Base ◽  
Biliary Colic ◽  
Annual Number ◽  
Research Database ◽  
Biliary Disease ◽  
Emergency General Surgery ◽  
Process Indicator ◽  
Surgical Services

Introduction Despite an increasing emphasis on data-driven quality improvement, few validated quality indicators for emergency surgical services have been published. The aims of this study therefore were: 1) to investigate whether the acute cholecystectomy rate is a valid process indicator; and 2) to use this rate to examine variation in the provision of acute cholecystectomy in England. Materials and methods The Surgical Workload and Outcomes Research Database (SWORD), derived from the Hospital Episode Statistics database, was interrogated for the 2012–2017 financial years. All adult patients admitted with acute biliary pancreatitis, cholecystitis or biliary colic to hospitals in England were included and the acute cholecystectomy rate in each one examined. Results A total of 328,789 patients were included, of whom 42,642 (12.9%) underwent an acute cholecystectomy. The acute cholecystectomy rate varied significantly between hospitals, with the overall rate ranging from 1.2% to 36.5%. This variation was consistent across all disease groupings and time periods, and was independent of the annual number of procedures performed by each NHS trust. In 41 (29.9%) trusts, fewer than one in ten patients with acute gallbladder disease underwent cholecystectomy within two weeks. Conclusions The acute cholecystectomy rate is easily measurable using routine administrative datasets, modifiable by local services and has a strong evidence base linking it to patient outcomes. We therefore advocate that it is an ideal process indicator that should be used in quality monitoring and improvement. Using it, we identified significant variation in the quality of care for acute biliary disease in England.

scholarly journals Poorly performing supervisors and trainers of trainee doctors

2007 ◽  
Vol 31 (4) ◽  
pp. 148-152 ◽  
Author(s):  
Rafey A. Faruqui ◽  
George Ikkos
Keyword(s):  
Medical Staff ◽  
Recent Survey ◽  
Previous Survey ◽  
Training Experience ◽  
The West ◽  
Medical Trainees ◽  
West Midlands ◽  
Trainee Satisfaction ◽  
North London

Paice & Ginsburg (2003) surveyed postgraduate medical trainees in London and found that most considered their training as satisfactory and the proportion that evaluated their training as poor had fallen compared with a previous survey. They also reported, however, that the training experience for some trainees remains unsatisfactory and that the single most important factor in determining trainee satisfaction is the quality of supervision provided by the consultant trainer. In the light of this it is alarming that in a recent survey of psychiatric trainees in the West Midlands, 47% had experienced bullying and in 27% of cases of alleged bullying the perpetrators were senior medical staff (Hoosen & Callaghan, 2004). Paice et al (2004) reported consultants as the source of bullying in 27% of cases in a survey of bullying among doctors in training in north London.

A Practice Review of Technology Management

1996 ◽  
Vol 11 (3) ◽  
pp. 237-247
Author(s):  
Barbara Tilson
Keyword(s):  
Local Economy ◽  
The West ◽  
Public And Private ◽  
South West ◽  
Defence Industry ◽  
West Midlands ◽  
Practice Review ◽  
Primary Focus ◽  
Public And Private Sector ◽  
Operational Issues

Defence industry cutbacks impact at national and local economy levels by triggering business deaths and job cuts, leading to lost workforce and production skills and a contracting manufacturing and technology base. Diversification is a key responsive mechanism to defence industry contraction, but how this can be funded and managed is a major issue. One route is to provide the structure and mechanisms for technology transfer. The 1980s and 1990s have seen a number of initiatives established which prioritised this route and some have received European funding under KONVER I support for defence diversification. These constituted the primary focus of research for this paper and form a practice review of diversification experiences between 1993 and 1995 through selected case studies from Lancashire, the West Midlands, the South West and Hertfordshire. Discussion of the mechanisms, structures and operational issues is contexualised by outlining public and private sector strategies and support.

scholarly journals Barriers to mental healthcare for psychiatrists

2006 ◽  
Vol 30 (10) ◽  
pp. 382-384 ◽  
Author(s):  
Alfred White ◽  
Purushottam Shiralkar ◽  
Tariq Hassan ◽  
Niall Galbraith ◽  
Rhiannon Callaghan
Keyword(s):  
Mental Illness ◽  
Mental Healthcare ◽  
Postal Survey ◽  
Clinical Implications ◽  
Vulnerable Group ◽  
The West ◽  
Adequate Treatment ◽  
West Midlands ◽  
Psychiatric Profession

Aims and MethodTo determine the opinions of psychiatrists on mental illness among themselves and their colleagues a postal survey was conducted across the West Midlands.ResultsMost psychiatrists (319/370, 86.2%) would be reluctant to disclose mental illness to colleagues or professional organisations (323/370, 87.3%). Their choices regarding disclosure and treatment would be influenced by issues of confidentiality (n=245, 66%), stigma (n=83, 22%) and career implications (n=128, 35%) rather than quality of care (n=60, 16%).Clinical ImplicationsThe stigma associated with mental illness remains prevalent among the psychiatric profession and may prevent those affected from seeking adequate treatment and support. Appropriate, confidential specialist psychiatric services should be provided for this vulnerable group, and for doctors as a whole, to ensure that their needs, and by extension those of their patients, are met.

Quality of Written Reports Provided by Consultants in Restorative Dentistry to Referring General Dental Practitioners in the West Midlands

2006 ◽  
Vol os13 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Shuva Saha ◽  
Anthony J Summerwill
Keyword(s):  
Postal Questionnaire ◽  
Primary Objective ◽  
The West ◽  
Standard Format ◽  
Dental Practitioners ◽  
West Midlands ◽  
Dental Hospital ◽  
Bullet Point ◽  
Referral Letters

Objectives The primary objective of this study was to assess the views of general dental practitioners (GDPs) on the content, style, and readability of written reports provided by restorative consultants at a dental hospital in response to referral letters from the GDPs. The secondary objective was to determine the style of the written consultant report preferred by GDPs. Setting Referral letters received and replied to by four consultants in the restorative department at Birmingham Dental Hospital. Method The quality of written reports sent by the four consultants to 100 referring GDPs in the West Midlands area was evaluated using a postal questionnaire, which assessed 100 GDPs’ satisfaction with the content, style, and readability of the reports. To assess which format they favoured a second questionnaire was subsequently sent to the same GDPs with three versions of the original report in: (a) a standard format, (b) a summary format, and (c) a bullet point format. Results The results of the initial questionnaire revealed that 79 (96%) of practitioners were satisfied with the existing style of the reports. Following a second questionnaire in which GDPs were asked to choose which format they preferred, 61 (81%) expressed a preference for a bullet point or summary style report. Conclusion The GDPs who responded to the questionnaires felt that a bullet point format or summary style report from the consultants concerned would summarise cases more clearly and concisely than the conventional standard format letters which they had previously received. Opportunities may exist for improving the quality of consultant reply letters through the use of structured templates and/or a summary or bullet point format.

Collaborative research: a case example of dissemination of CBT in primary care

2013 ◽  
Vol 6 ◽  
Author(s):  
Fiona Mathieson ◽  
Sunny Collings ◽  
Anthony Dowell ◽  
Felicity Goodyear-Smith ◽  
James Stanley ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Real World ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Family Doctor ◽  
Evidence Base ◽  
Collaborative Approach ◽  
Behaviour Therapy ◽  
Cognitive Behaviour

AbstractWhile we now have a strong evidence base for cognitive behaviour therapy in managing mental health problems, the challenge is to disseminate it into real-world settings. Two dissemination approaches exist: the dominant ‘research to practice’ model, a linear sequence, taking interventions from the research laboratory and overcoming barriers so as to apply them in the real world and a more collaborative approach, in which researchers work together with clinicians and patients to adapt existing treatments for real-world settings. This article provides a detailed example of a collaborative approach to adapting cognitive behaviour therapy, by developing a very brief mental health intervention for patients in a primary-care (family doctor) setting.

scholarly journals New Ways not working? Psychiatrists' attitudes

2009 ◽  
Vol 33 (6) ◽  
pp. 204-207 ◽  
Author(s):  
Jenny Dale ◽  
Gabrielle Milner
Keyword(s):  
Response Rate ◽  
Quality Of Work Life ◽  
Clinical Implications ◽  
Direct Experience ◽  
The West ◽  
Quality Of Work ◽  
New Ways Of Working ◽  
West Midlands

Aims and MethodA questionnaire survey of general adult psychiatric consultants and specialist registrars in the West Midlands was conducted to examine attitudes towards New Ways of Working (NWW) for psychiatrists; these were measured using a 5-point Likert scale. Participants were also asked about their own experiences of NWW. the data were analysed using Mann–Whitney U-test.ResultsThe response rate was 31.2%. Attitudes were generally negative, particularly regarding the effect on patient care, the erosion of the professional role of the consultant and effect on quality of work life. the attitudes of those who did not have any direct experience of working to the NWW models were more negative than those who had direct experience of NWW.Clinical ImplicationsThere are significant concerns about NWW among consultants and specialist registrars. There is a need for further debate and research with regard to the proposals.

Mental Impairment in the West Midlands: 10 Years on

2002 ◽  
Vol 42 (4) ◽  
pp. 325-333 ◽  
Author(s):  
David William Perry ◽  
Carl Benton ◽  
Martin Walsh ◽  
David Martin ◽  
John Corbett
Keyword(s):  
Mental Health ◽  
Sexual Offending ◽  
Learning Disabled ◽  
Service Development ◽  
The West ◽  
Data Set ◽  
Mental Health Act ◽  
Health Authorities ◽  
West Midlands ◽  
Mentally Impaired

In 1989, a survey was undertaken to describe the learning disabled population, originating from the West Midlands, classified as mentally impaired or severely mentally impaired under the Mental Health Act 1983. The results obtained were then used to help guide future service development within the region. Given the marked changes in service provision over the subsequent decade, the study was repeated in 1998–1999, looking at the same population on 1st December 1997 (prior to the Bournewood Ruling). Attempts were made to identify all people residing within the West Midlands region, or originating from it, and classified as mentally impaired or severely mentally impaired under the Mental Health Act (1983). This was achieved by contacting medical records departments, learning disability consultants and Health Authorities. The same data set as the original study was then collected from case notes to allow comparison. The current study however, collected extra information, relating to diagnosis, treatment and outcome. Ninety-three people were identified for the study. Over the 10 years, there has been approximately a 100% increase in the numbers of people detained under these categories of the Mental Health Act (1983). There has been a marked increase in the use of the private sector, as well as out-of-region placements. Sexual offending seemed a common reason for detention. The authors attempt to explain this phenomenon. They also highlight the need for future developments and greater systematic data collection.

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