Audio-recording your consultations with NHS doctors

[nolegion]

Here’s another piece of research along the lines recently brought here by My Turn - from a BMJ publication back in 1992:-

 

“Research Article.

 

Should audio recordings of outpatient consultations be presented to patients?

 

1. G Rylance

+ Author Affiliations

1. Children's Hospital, Birmingham.Abstract

 

Three hundred and four new and return paediatric outpatient consultations were tape recorded. Questionnaires (and tapes) relating to the experience were returned from 286 families. They showed that tapes had been helpful to more than 99% of parents and grandparents. The main benefits were in refreshing the memories of those who attended the consultation and in helping the understanding of those unable to attend. More than 70% of tapes were listened to more than once and a third of families made a copy. Most parents considered that all consultations should be taped.”

( see http://adc.bmj.com/content/67/5/622.abstract )

 

 

Yet, 10 years later, when the Bristol Royal Infirmary Inquiry into neonatal surgery mortalities specifically recommended the provision of recording facilities, the Department of Health refused, point blank.

Edited September 29, 2010 by nolegion

[nolegion]

Now here’s a fine quango:-

 

Advisory Committee on Clinical Excellence Awards (ACCEA)

 

The Advisory Committee on Clinical Excellence Awards (ACCEA) is an independent, advisory NDPB and succeeded the Advisory Committee on Distinction Awards (ACDA).

The NHS Consultants' Awards Scheme

 

 

 

Clinical Excellence awards are given to recognise and reward the exceptional contribution of NHS consultants, over and above that normally expected in a job, to the values and goals of the NHS and to patient care. ACCEA will operate the arrangements which replaced discretionary points and distinction awards with a single, more graduated scheme comprising both local and national elements known as the Clinical Excellence Awards Scheme. The scheme operates under:

• fair and uniform criteria
  
• transparent and equitable processes and
  
• clear operational frameworks
  

The 2011 National Award Round

 

 

 

 

The 2011 Round is now open. Please click on the link below to access the online system

 

 

Please note: The closing date will be 17pm on Friday 10 December 2010.

 

No applications will be accepted after this time under any circumstances.

Please see the note below from the Chair and Medical Director on the 2011 round.

 

 

 

 

 

(Ex: http://www.dh.gov.uk/ab/ACCEA/index.htm )

 

If you hurry up with organising the nomination of your buddies (who will doubtless do the same for you one day soon) you could get one or more of them a ’clinical excellence award’. And just look at the august company then entered into:-

 

The following consultants were awarded a Platinum Award in 2005

 

REGION SURNAME INITIALS GMC SPECIALTY

 

CHES&MER JOHNSON JN 1461219 General Surgery

EAST ENG MAHER EJ 2300472 Clinical Oncology

O'RAHILLY SP 2573872 Endocrinology & Diabetes M

EAST MID JOHNSON IR 1647963 Obs. & Gynaecology

WALLACE WA 1332474 Trauma & Ortho Surgery

LON NE DARBYSHIRE JH 1468072 Genito-Urinary Medicine

GRIFFITHS PD 2402477 Med Microbiology & Virology

LUXON LM 1570610 Audiological Medicine

MCKENNA WJ 3040685 Cardiology

LON NW NORTHOVER JMA 1448803 General Surgery

PUSEY CD 1523797 Renal Medicine

ROBINSON EAE 0629355 Blood Transfusion

WEBER JN 2488792 Genito-Urinary Medicine

LON STH ADAM AN 2371726 Clinical Radiology

HUGHES RAC 0376107 General Medicine

LEE TH 2238997 Clinical Immun. & Allergy

MUFTI GJ 2560243 Haematology

SMITH IE 1327623 Medical Oncology

NTH EAST ALLEN ED 1547348 Ophthalmology

NTH WEST MCCOLLUM CN 1548909 General Surgery

SOUTH GOODWIN GM 2447793 General Psychiatry

HIGGS DR 1726404 Haematology

(Page 1)

 

Yup, you could be right up there with James Johnson (1461219), the surgeon now before the GMC as mentioned a little earlier in this thread.

 

Of course, you would primarily be interested in the recognition of services to the NHS. The fact that the awards carry potentially tens of thousands of pounds additional annual salary is just a happy (pensionable) bonus for those thus distinguished.

[nolegion]

If you complain to a PCT or Foundation Trust you will encounter their “complaints procedure”.

 

Behind the scenes, as issued to administrative staff, is the PCT’s\Trust's ‘policy’ for dealing with complaints. These policies are usually based on DoH\NHS models\templates often with little to no departure from the original.

 

If you are deemed ‘vexatious’ you will merit especially dsimissive behaviour from the Chief Executive of the institution.

 

Here are the relevant model clauses:--

 

"Complainants (and/or anyone acting on their behalf) may be deemed to be vexatious or habitual complainants where previous or current contact with them shows that they meet one or more of the following criteria:-

 

…“Are unwilling to accept documented evidence of treatment given as being factual, e.g. drug records, medical records or computer records, nursing records, psychology and therapy records…”

 

[and/or]

 

“….are known to have recorded meetings or face-to-face / telephone conversations without the prior knowledge and consent of other parties.”

 

Who said 1984 was yesterday?

[nolegion]

It may be of passing interest to note that the template ‘classify-you-as-vexatious’ Complaints Policy clauses (see previous post) still contain, in many cases, the ‘conviction of conspiracy theory’ excuse.

 

 

So the delusional like the Bristol Royal Infirmary Inquiry and ‘The NHS-is- spending- millions-gagging-disaffected-employees’ crew know where they stand. See eg:-

 

http://www.independent.co.uk/life-style/health-and-families/health-news/millions-spent-on-doctor-gagging-orders-by-nhs-investigation-finds-2041209.html

 

 

(And, purely as one illustration, see 2nd page, Appendix D of http://www.haltonandsthelenspct.nhs.uk/library/documents/agendaitem080910iappendix1complaintspolicyjune2008.pdf )

 

 

IIn all fairness, I should perhaps add that this particular ’classification’, in my experience with complainants so far at least, is not something that I have ever seen, 'overtly' wheeled out of the locker-room by an NHS body. Others may well know better. And it is of course something that can be ’applied’ to the complaints process ‘behind the scenes’ without its ever being acknowledged. (How’s that for a conspiracy theory?)

 

It remains a pernicious concept, though - akin to a doctor’s saying, ‘The fact that you are complaining about me just demonstrates how mentally ill you are…’

 

The only way out of this potentially grotesque ‘syndrome’ is for all formal complaints to be investigated by the truly independent from the outset.

[nolegion]

From the blog of a former chairman of a PCT:-

 

“I subsequently found out, accidentally and independently, that there was another very serious complaint running in the local system, which I was unaware of while in post. This case involved prolonged and systematic breaches of professional conduct and probity. The complainant was falsely accused of mental illness when in fact medical data had indeed been misused, and this was readily verifiable. The matter was eventually resolved, but following terrible cost to the complainant. Had I been aware I would have intervened.”…

 

“…There are plenty of issues concerning the complaints system, but two which need addressing with urgency. The fact even these have not been satisfactorily addressed, in the entire history of the NHS, speaks volumes.

 

1. The deliberate falsification of personal medical and related records by omission and commission, usually by medical professionals, as well as in some cases by managers,is endemic, and requires a change in legislation to make theact a crime, as it is in the USA. It is an abuse of power, often with far reaching and severe, perhaps unforseen, or delayed consequences, is a form of rape, a psychological betrayal, and should be treated as such…”

 

2 “…. Lack of an appropriate complaints mechanism. There is no agency in this country which regards it as within its remit to act independently and appropriately in cases of systematic falsification of medical records, dishonesty, intimidation, and permitting or causing deliberate harm….”

 

 

…”…It is dangerous to make assumptions about what strategic manoeuvres, motivations, and methods might be employed. Doctors are intelligent, flexible, and creative. They also close ranks. In addition the intent may not be murder, but if it is an unfortunate by product of covering up, or serving vested interests, with undesired but predicable consequences it amounts to the same thing. If records are falsified, the sky is the limit, literally. Adverse consequences may be due to, as just some examples, wrong treatment, reluctance to access medical services, inability to access appropriate medical services, missing diagnostic tests, misdiagnosis, unrecorded risk factors/drug allergies, excessive or inappropriately used drugs. Another avenue is the misdiagnosis of mental illness, deliberately or avoidably causing mental illness such as PTSD, or depression, or "paranoia", falsely ascribing legitimate and readily verifiable physical illnesses to mental illness, ascribing genuine complaints concerning the medical system to mental illness, taken to extreme this could include section on false grounds,ECT,and community treatment orders on long term and disabling drugs. This approach, Soviet style, has the advantage of short circuiting the criminal justice system, and avoids the potential inconvenience of a dead body. This is a horrifying prospect, but unfortunately is one I have seen hard evidence for. Finally, covering up serious side-effects by omission or commission, or misrepresenting or misattributing any benefit of interventions when writing and processing medical records may not only harm the patient, but also others offered treatments on the back of such evidence.”

 

Scorching , knowledgeable and very genuinely meant, I would say: see

 

http://www.wrightingtonwiganandleighexposed.co.uk/NHS-Corrupt-Complaints-System/B23.htm

[nolegion]

This thread is about recording doctors etc in the context of the NHS - and the many reasons why patients and\or their carers might want so to record.

 

Strictly speaking, the question of claimants wishing to have a recording of the ‘medicals’ to which they are summoned, in order for the state to determine any entitlements to benefits, is not ‘on all fours’ with this, though there are many cognate aspects. (I have got ‘roped’ into trying to catch up on the law and practice relating to some of this for a couple of claimants, partly, at least, because of the drum I have been banging concerning the rights of NHS patients, for instance.)

 

I am delighted to see that, this very morning, a significant breakthrough for claimants has been announced. The full details are for subscribed members of the site concerned and I would not wish to disappoint their confidentiality expectations. In short, though, a claimant’s dogged persistence made the DWP|Atos back down in an individual case, and the matter’s current (and likely continuing) profile on the net will make it very difficult for the same not to apply in other cases.

 

You can get more than just a flavour of the turn of events from the relevant thread in the public forum there today:

 

{just edited out my own link! Sorry about that all round. Apparently the £subscribe means I shoudn't put it here even though you can see the forum bits for free. As has been said elsewhere, it's a well known site.}

Edited October 2, 2010 by nolegion
see text above

[My Turn]

This thread is about recording doctors etc in the context of the NHS - and the many reasons why patients and\or their carers might want so to record.

 

Strictly speaking, the question of claimants wishing to have a recording of the ‘medicals’ to which they are summoned, in order for the state to determine any entitlements to benefits, is not ‘on all fours’ with this, though there are many cognate aspects. (I have got ‘roped’ into trying to catch up on the law and practice relating to some of this for a couple of claimants, partly, at least, because of the drum I have been banging concerning the rights of NHS patients, for instance.)

 

I am delighted to see that, this very morning, a significant breakthrough for claimants has been announced. The full details are for subscribed members of the site concerned and I would not wish to disappoint their confidentiality expectations. In short, though, a claimant’s dogged persistence made the DWP|Atos back down in an individual case, and the matter’s current (and likely continuing) profile on the net will make it very difficult for the same not to apply in other cases.

 

You can get more than just a flavour of the turn of events from the relevant thread in the public forum there today:

 

{just edited out my own link! Sorry about that all round. Apparently the £subscribe means I shoudn't put it here even though you can see the forum bits for free. As has been said elsewhere, it's a well known site.}

 

Its great to hear the news that someone has got the DWP/ATOS to permit recording of their medical assessment! I can only hope the Department of Health notices that decision and will itself issue good practice guidelines which encourage the recording of consultations.

 

However we also need a fairer complaints procedure in the NHS which is actually prepared to listen to recordings instead of expending its energy on unfairly labelling people who record as "vexatious complainants".

 

My Turn

[My Turn]

From the blog of a former chairman of a PCT:-

......

Scorching , knowledgeable and very genuinely meant, I would say

 

 

What an amazing article. Straight from the horse's mouth of a PCT chairman.

 

There are some excellent observations about how difficult it is to raise an NHS problem in a report (dated June 2009) about patient safety by the Parliamentary Health Select Committee. The report is quite readable and condenses some very authoritative evidence heard by the committee. As a starting point, one could glance at the section about dealing with complaints from page 29 onwards.

 

(This CAG forum doesn't permit me to post the link but a quick Google for "pdf health select committee patient safety" will allow you to locate it.)

 

My Turn

[My Turn]

There was an interesting article called For The Record by the Medical Protection Society (casebook vol 15, no 3, Sept 2007). I probably don't need to tell you that the MPS is an insurance company for doctors which represents members in disputes. There is a section in that article which starts "But what happens if it is a patient who does the recording?"

 

I suspect I am not able to post a link here in C.A.G. but a search for MPSsep07 pp12-14 On The Record will let you read the PDF for yourself. Below is a brief extract.

 

Turning The Tables

 

But what happens if it is a patient who does the recording? Because of the prevalence of third generation mobile phones and other devices, it has never been easier for a patient to record conversations surreptitiously. Whether such recordings are admissible in subsequent court or disciplinary proceedings is another matter, but recent cases suggest that they are being accepted as evidence more frequently.

 

In 2006, a Sunday Times journalist, armed with a recording device, entered two doctors’ surgeries posing as a patient to obtain sickness certificates to which she wasn’t entitled. The journalist recorded the consultations without either doctor’s consent and then passed the recordings to the GMC.

 

The Society of Editors’ Code of Practice, which is enforced by the Press Complaints Commission, says that journalists “must not seek to obtain material acquired by using clandestine listening devices.” However, the GMC admitted the evidence. One of the doctors was suspended and the other was reprimanded. A person can covertly record a telephone conversation solely for their own use, but if they intend making the recording available to a third party (eg to a solicitor for the purposes of pursuing a claim), then the person receiving the call must be told that the call is being recorded. If consent to recording is not obtained in these circumstances, this could give rise to criminal and civil liability.

 

“Unless it’s over the telephone, the recording of doctors without their permission is certainly underhand, but it is not illegal,” explains Dr Dempster. “The advice to doctors should be to assume you are being recorded, because you shouldn’t be saying anything that you aren’t professionally happy with.”

 

One way of tackling patients you suspect may be recording you is to be frank about it. Ask the patient politely if they are recording the consultation, and if so, say that you are happy to be recorded, but that you want to be told it is happening.

 

“However, just because a patient records a doctor does not mean that they are going to use it as a weapon,” says Dr Mastihi. She adds: “I don’t think it is the recording itself which is the problem; it is more the idea that it is being used as a threat to catch doctors out. As long as doctors behave professionally they should not encounter any problems.”

 

One solution would be to make consultation recordings more commonplace by making recording devices available to patients, so that doctors and patients would begin to trust them as a valuable way of documenting discussions. This was envisaged by the 2001 Bristol Royal Infirmary Inquiry into children’s heart surgery, which recommended that patients should be invited to make tape recordings of a discussion with a healthcare professional when a diagnosis, course of treatment or prognosis is being discussed.

 

Conclusion:...The rapid development of technology raises important considerations for doctors, and brings a number of new issues which need to be considered when dealing with patients. But the benefits of improved communication with patients appear to outweigh the possible downsides. The key is to maintain your professionalism at all times, and be alert to the advantages – and pitfalls – which go hand in hand with technological advances.

 

My Turn

[nolegion]

In my view, the article you cite contains much legal and practical sense, My Turn. It’s a shame that something published in September 2007, should be taking so long to ‘catch on’ amongst the wrong sort of medic - and I guess your own experiences, quite apart from any I have managed to cite, are more than sufficient testimony to that.

 

Nevertheless, there is hope in the attitude of the MPS. They insure a large part of the country’s medics and it was their director of medical services who went on record with the heathcarerepublic people this year, saying that dotors would have to get used to it and look on the positive side.

 

I have said before that, in my view, any GP who seeks to threaten a patient with ‘ban’ solely on the ground that they insist on recording, is acting illegally - and I know some legal guns more active than I will ever be again just itching to have a shot at the next one seen to try. Something tells me the MPS know about that at least as well as I do, and probably a lot better.

 

I am currently short of recent reports of the experiences of anyone overtly recording (or trying to) in a ’hospital consultant’ setting, however. Don’t suppose there is anyone out there…?

 

(BTW - I record hospital consultants overtly, have done so many times, and make them write into their notes that I do. But then I am old, practised an immensely ugly.)

[nolegion]

Meant to add to previous post, but will do just as well if not better in this: Re: ‘Patient Safety’, last year -

 

As picked up by My Turn, the very sensible Select Committee analysis:-

 

http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/151/151i.pdf

 

The disgraceful, gloss-over, Governmental response:-

 

http://www.official-documents.gov.uk/document/cm77/7709/7709.pdf

 

Not up to me to interpret ‘site’ link rules (especially since I have so recently, quite accidentally, put my foot in in myself!), but you would have to be a bribable member of the House of Lords to identify a commercial interest in reports of parliamentary committee business.

 

The thing that really gets my goat (so it does) is the loss of any notion of a genuinely independent complaints … (fume, grumble, mutter,…another post….)

[nolegion]

If you use the word ‘tort’ (= ‘actionable civil wrong’) in a UK conversation you sometimes get a raised-eyebrow response. In the US it’s common parlance, because there it (usually) equates to ‘negilgence’and we all know what that means.

 

Which may or may not be of assistance in unravelling this post by ‘MiniTruth’ who declares himself\herself to be a (clearly US) lawyer-

 

“Sep 20, 2010

1:09 am EDT

Open recording of healthcare providers will result in one thing. Worse health care that is more expensive.

You are going to have doctors who are going to go by the book on everything. Only going to give you the FDA, standard treatment. Start low, go slow etc etc and order every freaking test known to man “just to be on the safe side ma’am.”

Whoever said there is no tort reform needed is crazy. Lawyers run this country. I am a malpractice lawyer and life is good. The public is stupid and easily fooled. Now that I am ready to retire, I am completely behind tort reform because otherwise this country will collapse under the weight of healthcare costs. Or you are going to see the best doctors only treat the richest…see concierge care.

Posted by MiniTruth”

 

This has been appended, somewhat late it the day one might say, to the commentary on a reuters article I have mentioned before (http://blogs.reuters.com/great-debate/2010/03/15/iphone-app-makes-doctors-irate/#comments ).

 

If your attention can survive natural revulsion arising from the blind smugness of someone celebrating personal propserity derived from a sytem the change of which is apparently being advocated at least partly because the arguer will shortly be milking it no longer…

 

…you are left with an argument, I think, that being able to prove how you have been advised\treated leads to what, in the UK at least, is sometimes termed ‘defensive medicine’ - a stance which falls over as soon as you blow on it.

 

Well, healthcare truly is very different in America, but I do not think patients are that ’stupid and that easily fooled,’ here.

[nolegion]

So what happens when you complain? And why not try a more conciliatory approach e.g. through ‘PALS’ (Patient ‘Advice and Liaison’ Services)?

 

No doubt there may be accounts of patients who have found themselves helped (or at least appeased) by these patronisingly-named quasi-departments of PCTs\HospitalTrusts which I yet to read, and my experience of them is not very extensive, but:-

 

1. On the primary care side, the instance which stays in my mind (courtesy of ‘forcible’ disclosure) is a GP’s note of a telephone call he had received from the purported ‘head’ of one of the local PCT’s ‘PALS’. The note failed to record any details of the serious matters raised by the complainant but itemised, in celebratory and vulgar terms, the advice received from PALs as to how to set about getting rid of the patient.

 

2. On the ‘hospital Trust side’, here is a manouevre as recorded in the annual report [2007\2008] of one of them:-

 

“ 5.7 Third and Final Stage Health Service Ombudsman

There are no cases under investigation with the Health Service Ombudsman. This has

been consistent for the past three years.

 

5.8 Local Campaign Group

Following a comlaint raised in December 2007 a local campaign group has been

established. The Group have protested about the care that was delivered at the Trust.

The Trust has tried to meet many times with the leaders of the Group however, they

have declined.

 

5.9 Developments throughout the year

The complaints and PALS departments were merged in January 2008 to provide a ‘one

stop’ customer focused service .”

 

 

So what, you might say (or even, as an acerbic commentator of my aquaintance did say of such ‘mergers’,”Just stops the lipstick denying it’s pasted to a pig,”), but the annual-report extract is from that of a well-known mid-StaffordshireTrust as in eg.

 

http://www.telegraph.co.uk/health/healthnews/5008935/NHS-targets-may-have-led-to-1200-deaths-in-Mid-Staffordshire.html

 

and, indeed, the public Inquiry at last under way.

 

( http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_116650.)

 

If you record, you have evidence, and that is a form evidence preferable to a staggeringly high mortality rate, I would suggest.

[nolegion]

It’s sometimes difficult to believe that some of the medical profession has any idea of how what they say will be perceived by others.

 

'Hot off the press':-

 

“Advice on raising concerns about NHS care

 

By Dr Tom Dolphin, co-chair of the BMA’s junior doctors committee - 7th October 2010 5:07 pm

 

I had a long chat with a journalist this week who was very keen to find a junior doctor who would carry a hidden camera to do some covert filming at work to highlight patient safety concerns...

 

...After about half an hour, he gradually started to agree with me that this might have some negative effects on a junior doctor’s career…

 

 

…Dramatic media exposés of errors in hospitals are generally a bad idea for all involved.

 

 

…Last year one of my friends was trying to raise concerns within the hospital where he worked, about the poor standard of anaesthetic care he witnessed. He was met by a brick wall internally, and was cornered for ‘chats’ in the corridors by the medical director and so on…”

 

Extracts from:

http://www.hospitaldr.co.uk/blogs/bma/advice-on-raising-concerns-about-nhs-care

[My Turn]

“Advice on raising concerns about NHS care

 

By Dr Tom Dolphin, co-chair of the BMA’s junior doctors committee - 7th October 2010 5:07 pm

 

I had a long chat with a journalist this week who was very keen to find a junior doctor who would carry a hidden camera to do some covert filming at work to highlight patient safety concerns...

 

...After about half an hour, he gradually started to agree with me that this might have some negative effects on a junior doctor’s career…

 

…Dramatic media exposés of errors in hospitals are generally a bad idea for all involved.

 

…Last year one of my friends was trying to raise concerns within the hospital where he worked, about the poor standard of anaesthetic care he witnessed. He was met by a brick wall internally, and was cornered for ‘chats’ in the corridors by the medical director and so on…”

 

I recall how the nurse Margaret Haywood secretly recorded videos about how elderly patients were being mistreated. When the videos were shown on Panorama in 2009, she got struck off by her regulatory organisation. Luckily for her the public outcry forced the Nursing Council to reinstate her.

 

Sadly this shows the attitude of bodies like the Nursing Council to recordings of patient abuse.

 

My Turn

[nolegion]

Fine example. There is a lot that could - and probably should going on being - said about the admirable Margaret Haywood, in my view. I think that when someone like Dr Tom Dolphin say media exposure of calamitous care is ‘generally a bad idea for all involved’ he must be ‘mentally exempting’ eg. those admitted to the relevant hospital’s acute wards subsequent to the media spotlight - or, dare I say it, using ‘all’ to mean ‘all those involved in the NHS’ and not thinking of patients at all.

 

The notion of anyone - patient or professional - taking any form of recording of abysmal care or malpractice is of course anathema to the NHS.

 

The ‘court of patient opinion’ thinks otherwise:-

 

http://www.nursingtimes.net/whats-new-in-nursing/news-topics/whistleblowing/whistleblowing-nurse-margaret-haywood-wins-patient-award/5008374.article

Edited October 9, 2010 by nolegion
accuracy

[nolegion]

I have been asked (‘off-line’) whether I think the stuff I pitched in a little earlier about ‘vexatious-complainant’ policies could mean that a hospital Trust or PCT dealing with a complaint could properly refuse to consider a ‘covert recording’.

 

In my opinion for whatever it may be worth, the answer to that is emphatically, ’No, they cannot.’

 

In a case in which it was alleged a covert recording of an appointment with a GP indicated ‘sick notes’ were for sale, that dear protector and upholder of medical standards and probity, the General Medical Council, tried ‘not to listen’: i.e to stop the hearing, as a species of ‘abuse of process’. The High Court told it (in my words) to grow up, get real and hear the evidence.

 

For a summary see e.g.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1647341

 

 

(For the insomniac, try:-

 

http://www.chre.org.uk/_img/pics/library/061110_Saluja_Judgment.pdf )

[nolegion]

Like most of us, I trust, I try to pracitse what I preach. In the case of this thread, however, I also hope I have sufficiently acknowledged my own departure from that. I record, ‘insistently’, overtly and have been so doing for quite a few years now.

 

It has not always been easy.

 

Very clearly, to date, you are better off recording ‘covertly’ than overtly - and the former is what I advocate unless you are truly prepared to challenge the hostility you are likely to encounter.

 

But, ‘as discussed’, maybe, just maybe, all that is now beginning to change.

 

I have given examples, so far as confidentiality permits, of cases within my own experience as professional\family member\friend\ adviser of patients. I am also very grateful to others who have shared their experiences with me.

 

Next week - having put it off for quite a long time - I intend to change GPs’ practice to one of the two within whose catchment area I now live.

 

Let’s see how much has changed.

 

I’m seldom lost for words, and will report should you be interested.

[nolegion]

Re: Ubani

 

Just how much can the NHS fail to respond to evidence of gross incompetence?

 

Extracts from’ Pulse Today’ - today-

 

 

“ Exclusive: Fewer than a quarter of EU doctors from outside the UK registered to work in this country as GPs have been tested for their language skills and clinical competence, Pulse can reveal.

 

PCT records show hundreds of foreign doctors are included on primary-care performers lists without having been formerly checked, exposing a shocking lack of action in the wake of the Daniel Ubani case.

………………………….

 

Remarkably, these included NHS Cambridgeshire, the trust in which Mr Gray was killed, which has 29 non-UK EU doctors on its performers list, but has only tested 10.”

 

Full story, see:-

http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4127353&cid=eu_doctors_131010&sp_rid=NTE2NjQzMDk2MgS2&sp_mid=35878174

 

Beggars belief.

[honeybee13]

Very worrying, I agree. Don't they ever learn?

 

My best, HB

[nolegion]

Worrying is indeed the word, HB.

 

A recent report [ www.ic.nhs.uk/pubs/nhscomplaints0910] …

… has shown that between 2008/09 and 2009/10 the number of complaints rose from 89,139 to 101,077, a 13.4 per cent rise and the largest year-on-year increase since… Data on Written Complaints in the NHS, was first published annually in 1997/98.

… The report is mandatory for all NHS hospital and community services apart from NHS foundation trusts, for which it is voluntary; 18 foundation trusts did not supply any data.

 

Katherine Murphy, Chief Executive of The Patients Association said:

 

“The rise in complaints is very worrying and is reflected in an increase in the number of people contacting our helpline to tell us of problems they are having with NHS services… On our Helpline we hear absolutely appalling stories of neglect, misdiagnosis and a distinct lack of care and compassion… Keep in mind many people want to complain but don't and these figures will certainly massively underestimate the number of people that actually want to complain… We need a fundamental review of the complaints process…. At a time when the NHS is facing budget constraints, we want to make sure that the quality of care patients’ receive is not compromised and that staff and management become more open and more accepting of complaints and respond constructively when something goes wrong.

 

It is absolutely outrageous that 18 Foundation Trusts did not participate in the report… They should be forced to share their data."

 

Emphasis mine, but otherwise these informed and wise words are extracted from:-

 

http://www.patients-association.org.uk/Press/383

 

And obviously I think that any ‘fundamental review of the complaints process’ should include the welcoming of recording by patients.

[nolegion]

On the score of complaints, the following - to my mind quite staggering - dimness is lifted from the blog of a GP ‘complaining about having been formally complained about’:-

 

“…And today I get an email from a patient from years ago, saying I was the only doctor she met who had treated her as a human being.

 

That should be enough to offset 1,000 complaints, whether justified or not…

 

…Complaints cause untold suffering to doctors [!!], and arguably make matters worse by demoralising doctors to a dangerous level…”

 

 

Some medics really cannot think outside the boundaries of their own unmerited vanity. I hope I’m usually fair, even assiduous, as regards acknowledging, sources, links etc when posting here, but this particular prize of a doctor really doesn’t need the oxygen of further publicity…or even, as the old joke has it, of oxygen.

[nolegion]

From an editorial which appeared in the Journal of the Royal College of General Practitioners (1975, 25, 705-707.706) entitled “Tape Recording Consutations”.

 

“….

 

Telling the patient

 

There are, however, different ways of arranging for tape recordings to be made. Sometimes the recording machine is displayed on the desk, sometimes the microphone is placed in front of the patient, or sometimes a light signal or switch is placed in position for the patient. Doctors who use these methods normally ask for consent to record the consultation immediately, and some record the consent itself.

 

Not telling the patient

 

There are, however, some general-practitioner teachers who do not ask for consent and who do not even tell the patient that the consultation is being recorded. These doctors, who include some of the leading authorities in the country, argue that the record of such a consultation is no more the patient's property than is the medical record.

 

It is, therefore, now appropriate to consider whether this practice raises ethical, educational, and service problems…”

 

Is there life on Mars?

 

(ref:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2157837/pdf/jroyalcgprac00298-0006.pdf)

Edited October 16, 2010 by nolegion

[My Turn]

From an editorial which appeared in the Journal of the Royal College of General Practitioners (1975, 25, 705-707.706) entitled “Tape Recording Consutations”. ........ These doctors, who include some of the leading authorities in the country, argue that the record of such a consultation is no more the patient's property than is the medical record.

Doctors who write in that way about a patient's medical records are displaying breathtaking arrogance. The article you quoted may have been published many years ago but the paternalistic attitude it demonstrates is still too commonplace in the NHS.

 

Sadly, many patients never get to see what is in their medical records and this web page shows just how adverse some of the comments can be. http://www.cfoi.org.uk/mymedrecds.html

[nolegion]

Those really are some staggeringly clear, and horrible, examples of their kind, My Turn. I confess I had to read them just a couple at a time and ‘do something else’ in between. Gotta watch one’s blood pressure, these days.