scholarly journals An audit of consent for allograft use in elective orthopaedic surgery

2016 ◽  
Vol 98 (04) ◽  
pp. 254-257 ◽  
Author(s):  
CJ Mullan ◽  
R Pagoti ◽  
H Davison ◽  
MG McAlinden
Keyword(s):  
Informed Consent ◽  
Disease Transmission ◽  
Orthopaedic Surgery ◽  
High Volume ◽  
General Medical Council ◽  
Adverse Outcomes ◽  
Audit And Feedback ◽  
Medical Council ◽  
Patient Consent ◽  
Arthroplasty Surgery

Introduction Patients receiving musculoskeletal allografts may be at risk of postoperative infection. The General Medical Council guidelines on consent highlight the importance of providing patients with the information they want or need on any proposed investigation or treatment, including any potential adverse outcomes. With the increased cost of defending medicolegal claims, it is paramount that adequate, clear informed patient consent be documented. Methods We retrospectively examined the patterns of informed consent for allograft bone use during elective orthopaedic procedures in a large unit with an onsite bone bank. The initial audit included patients operated over the course of 1 year. Following a feedback session, a re-audit was performed to identify improvements in practice. Results The case mix of both studies was very similar. Revision hip arthroplasty surgery constituted the major subgroup requiring allograft (48%), followed by foot and ankle surgery (16.3%) and revision knee arthroplasty surgery (11.4%) .On the initial audit, 17/45 cases (38%) had either adequate preoperative documentation of the outpatient discussion or an appropriately completed consent form on the planned use of allograft. On the re-audit, 44/78 cases (56%) had adequate pre-operative documentation. There was little correlation between how frequently a surgeon used allograft and the adequacy of consent (Correlation coefficient -0.12). Conclusions Although the risk of disease transmission with allograft may be variable, informed consent for allograft should be a routine part of preoperative discussions in elective orthopaedic surgery. Regular audit and feedback sessions may further improve consent documentation, alongside the targeting of high volume/low compliance surgeons.

Informed consent in orthopaedics

2018 ◽  
Vol 100-B (9) ◽  
pp. 1253-1259 ◽  
Author(s):  
S. Seewoonarain ◽  
A. A. Johnson ◽  
M. Barrett
Keyword(s):  
United Kingdom ◽  
Informed Consent ◽  
Reading Ability ◽  
General Medical Council ◽  
Medical Council ◽  
Written Information ◽  
The United Kingdom ◽  
Patient Consent ◽  
Improve Compliance ◽  
The Mean

Aims Informed patient consent is a legal prerequisite endorsed by multiple regulatory institutions including the Royal College of Surgeons and the General Medical Council. It is also recommended that the provision of written information is available and may take the form of a Patient Information Leaflet (PIL) with multiple PILs available from leading orthopaedic institutions. PILs may empower the patient, improve compliance, and improve the patient experience. The national reading age in the United Kingdom is less than 12 years and therefore PILs should be written at a readability level not exceeding 12 years old. We aim to assess the readability of PILs currently provided by United Kingdom orthopaedic institutions. Patients and Methods The readability of PILs on 58 common conditions provided by seven leading orthopaedic associations in January 2017, including the British Orthopaedic Association, British Hip Society, and the British Association of Spinal Surgeons, was assessed. All text in each PIL was analyzed using readability scores including the Flesch–Kincaid Grade Level (FKGL) and the Simple Measure of Gobbledygook (SMOG) test. Results The mean FKGL was 10.4 (6.7 to 17.0), indicating a mean reading age of 15 years. The mean SMOG score was 12.8 (9.7 to 17.9) indicating a mean reading age of 17 years. Conclusion Orthopaedic-related PILs do not comply with the recommended reading age, with some requiring graduate-level reading ability. Patients do not have access to appropriate orthopaedic-related PILs. Current publicly available PILs require further review to promote patient education and informed consent. Cite this article: Bone Joint J 2018;100-B:1253–9.

Confidentiality and Release of Medical Information

2018 ◽  
pp. 25-37
Author(s):  
Rebekah Ley ◽  
Natalie Hayes
Keyword(s):  
Medical Information ◽  
Common Law ◽  
General Medical Council ◽  
Tort Law ◽  
European Convention ◽  
Regulatory Body ◽  
Medical Council ◽  
Patient Consent ◽  
Practice Of Medicine ◽  
Professional Guidance

The duty of confidentiality that a doctor owes to a patient is probably as old as the practice of medicine and is essential for trust between doctors and their patients. However, it is not an absolute duty and there are instances when a doctor is entitled, and in certain circumstances obliged, to disclose confidential information without patient consent to do so. This chapter is concerned with doctor–patient confidentiality and when medical information can reasonably be released. Confidentiality is covered by a mixture of UK statute, common law, tort law, and the European Convention on Human Rights. It is also a core component of the professional guidance given to doctors by the profession’s regulatory body, the General Medical Council, to which all doctors registered with it are expected to adhere.

scholarly journals A survey of communication skills teaching at medical school

2006 ◽  
Vol 88 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Andrew Raftery ◽  
Particia Scowen
Keyword(s):  
Informed Consent ◽  
Medical Students ◽  
Medical School ◽  
Communication Skills ◽  
Undergraduate Education ◽  
General Medical Council ◽  
Skills Assessment ◽  
Medical Council ◽  
Surgical Practice ◽  
Essential Component

Communication is an essential component of surgical practice. Awareness of its importance is increasing among surgeons due to both the association between litigation and poor communication and recent requirements for obtaining informed consent. The General Medical Council has stated that medical students should have acquired and demonstrated their proficiency in communication by the end of their undergraduate education. Furthermore, communication skills assessment is now a pass/fail component of the intercollegiate MRCS examination of the surgical royal colleges.

Changes in surgical consent practices for common otolaryngology procedures: impact of Modernising Medical Careers

2010 ◽  
Vol 124 (8) ◽  
pp. 899-904 ◽  
Author(s):  
P Puwanarajah ◽  
S E McDonald
Keyword(s):  
National Health Service ◽  
Telephone Survey ◽  
Elective Surgery ◽  
General Medical Council ◽  
Medical Council ◽  
Consent Forms ◽  
Department Of Health ◽  
Medical Careers ◽  
Patient Consent ◽  
Selection Of

AbstractObjectives:To assess elective surgery consent practices amongst senior house officers from a selection of UK ENT departments, and to compare results with similar surveys in 2002 and 2005.Methods:A telephone survey of senior house officers in 40 UK ENT departments was conducted to assess departmental consent policies and knowledge of complications of common ENT operations.Results:A total of 77.5 per cent of responding senior house officers were responsible for consenting, reduced from 92.5 per cent in 2002 (p = 0.06). There had been a significant improvement in the use of patient information sheets, from 25 per cent of departments in 2002 to 65 per cent in 2008 (p = 0.0002). There had been no improvement in training or in the use of standard National Health Service consent forms, and the senior house officers' knowledge of specific complications remained poor. Of the senior house officers surveyed, 37.5 per cent were foundation trainees.Conclusions:There has been some improvement in information delivery to patients during the consent process, in accordance with General Medical Council, Department of Health and Modernising Medical Careers guidelines. However, most senior house officers are still required to obtain patient consent without appropriate training.

scholarly journals The far-reaching implications of Montgomery for risk disclosure in practice

2018 ◽  
Vol 24 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Sarah Devaney ◽  
Craig Purshouse ◽  
Emma Cave ◽  
Rob Heywood ◽  
José Miola ◽  
...  
Keyword(s):  
Informed Consent ◽  
Patient Autonomy ◽  
Service Providers ◽  
General Medical Council ◽  
Medical Council ◽  
Court Decisions ◽  
Risk Disclosure ◽  
Risks And Benefits ◽  
Uk Supreme Court ◽  
The Uk

The UK Supreme Court held in Montgomery v Lanarkshire HB (2015) that practitioners must take reasonable care to ensure patients are aware of any material risks involved in treatment. We reviewed all court decisions since Montgomery which deal with the case, to establish how this judgment is being interpreted by the courts and the implications of this for risk disclosure in practice. We found that Montgomery’s application has been expanded in a number of ways: information about reasonable alternatives includes the provision of information about their risks and benefits; Montgomery applies to post- as well as pre-operative disclosure; and the timing of discussion with patients about risks is important. Conversely, there is evidence that the parameters of Montgomery are being curtailed, giving rise to questions about judicial commitment to patient autonomy. In some cases there is focus on the objective risks of procedures as opposed to patients’ subjective concerns; in others, causation of injury is sometimes a factor that will defeat claims. There are also further questions about whether patients now should accept more responsibility for the outcome of decisions they make. We conclude that practitioners engaged in discussions about the risks of proposed treatments and their alternatives have been left in a position of uncertainty by the courts in relation to the obtaining of informed consent in practice. It is now critical that updated guidance is provided by the UK General Medical Council to give practitioners and service providers confidence that they are adhering to the law.

Changing practices in the consent process for nose and throat procedures: a three-year study

2008 ◽  
Vol 122 (10) ◽  
pp. 1105-1108 ◽  
Author(s):  
S E McDonald ◽  
N K Chadha ◽  
R S Mills
Keyword(s):  
Informed Consent ◽  
Elective Surgery ◽  
General Medical Council ◽  
Medical Council ◽  
Information Leaflets ◽  
Department Of Health ◽  
Similar Survey ◽  
Health Model ◽  
Changing Practices ◽  
Small Change

AbstractObjectives:To assess elective surgery consent practices amongst senior house officers from a selection of UK ENT departments, and to compare results with those obtained in a similar survey in 2002.Methods:A telephone survey of senior house officers in 40 UK ENT departments was carried out to assess departmental consent policies and knowledge of complications of common ENT operations.Results:Over 80 per cent of the senior house officers surveyed remained responsible for obtaining consent for routine surgery. Since 2002, there had been a significant increase in the proportion of departments which: used the Department of Health model consent form; provided patient information leaflets; and had an established informed consent protocol. Senior house officers' knowledge of specific complications remained poor.Conclusion:There has been a small change in the practice of obtaining informed consent, in accordance with General Medical Council guidelines. Many senior house officers continue to perform this duty, however, and the majority are poorly trained.

The effect of consent guidelines on a multiple sclerosis register

2006 ◽  
Vol 12 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Helen L Ford
Keyword(s):  
Multiple Sclerosis ◽  
Informed Consent ◽  
General Medical Council ◽  
Advisory Group ◽  
Medical Council ◽  
Community Based ◽  
Disease Characteristics ◽  
Significant Difference ◽  
Relapsing Remitting ◽  
Stroke Register

Background The 1998 Data Protection Act and guidelines from the General Medical Council on informed consent have caused concern for medical researchers and particularly those involved in the management of disease registers. Objective The aim of this study was to determine rates of consent for a multiple sclerosis (MS) community-based register and to investigate authorization bias by examining the characteristics of those refusing consent. Methods A consent letter was developed with the advice and support of an advisory group which included people with MS. All people with MS on the prevalent register (n=820) were informed about the register and its purposes and asked to indicate whether they would like their details to be removed from the register. Results Thirty-four (4.1%) people with MS asked for their details to be removed from the register. There was a significant difference in disease course in this group with more patients with benign relapsing-remitting disease compared to the prevalent population. There was no significant difference in age or sex distribution. The proportion of people not giving consent was similar to a local stroke register. Prospectively all new patients have given written informed consent. Conclusion Patients refusing consent may have different disease characteristics than those who consent. The potential for response bias needs to be considered in the development of a UK MS register.

scholarly journals 1492 The Age of Trainees When Joining the Specialist List – What Are the Differences Across Specialties?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Douglas ◽  
P Magennis ◽  
A Begley
Keyword(s):  
Orthopaedic Surgery ◽  
Maxillofacial Surgery ◽  
General Medical Council ◽  
Medical Council ◽  
The Creation ◽  
Age Of Entry ◽  
Second Degree

Abstract Introduction Those wishing to pursue a career in surgery will be aware of stereotypes that exist within each specialty, including how long it takes to attain a certificate of completion of training (CCT). These perceptions are often historic, and whilst may be based on elements of truth, are rarely backed by robust data. Oral & maxillofacial surgery (OMFS) for example is plagued by the stigma of necessitating a second degree which gives the assumption the age of being appointed a consultant is somewhat above average. We aim to dispel (or prove, depending on one’s predisposition) such myths by analysing the age of surgeons when appointed to the General Medical Council’s specialist list. Method Information on the age of entry onto the surgical specialist lists between 1997 and 2018 was obtained from the General Medical Council (GMC). Data was suitably statistically analysed. Results 19,135 surgeons joined surgical specialist lists during the study period. General and trauma and orthopaedic surgery accounted for 60% of all surgeons (n = 11,444). The age on joining surgical specialist lists ranged from 27–83 years, with a mean of 41.4 years. Neurosurgeons most frequently joined the specialist list in the youngest age bracket. OMF surgeons, along with their cardiothoracic and vascular colleagues, are joint eldest by 1.3 years. Conclusions Since the creation of the specialist list, training has seen several upheavals. This data shows that despite each specialty’s specific requirements and individuals’ varying paths, there is little difference in the age when the consultant destination is reached.

scholarly journals Unsuccessful Article 14 Submissions to the Specialist Register for Trauma and Orthopaedic Surgery

2009 ◽  
Vol 91 (5) ◽  
pp. 172-174
Author(s):  
J Gray ◽  
M Arnander ◽  
D Ricketts
Keyword(s):  
Medical Education ◽  
Orthopaedic Surgery ◽  
Postgraduate Medical Education ◽  
General Medical Council ◽  
Training Programme ◽  
Medical Council ◽  
Specialty Training ◽  
Legal Requirement ◽  
Medical Education And Training ◽  
And Training

It is a legal requirement that all NHS consultants have their names entered on the General Medical Council (GMC)'s specialist register. Entry to the register can be obtained by two routes. The first is to obtain a Certificate of Completion of Training (CCT) in a recognised specialty training programme approved by the Postgraduate Medical Education and Training Board (PMETB). The second is by obtaining a Certificate of Eligibility for Specialist Registration (CESR) by the article 14 process.

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