British doctors dubious about new treatment protocols

Nurses doing surgery?? I think I'd be dubious too

The minister in charge of a review of the NHS has accused some doctors of being “laggards” for obstructing the introduction of new treatments. Lord Darzi, who continues to work as a surgeon, says some senior medical staff are so determined to protect “professional boundaries” that, 14 years after his own practice began using nurses to do minor surgery, others have yet to follow.

He said: “In all areas of healthcare you have innovators, people who really want to change things for the better, and you also have, in other areas of the healthcare system, people who are lagging behind and need to catch up. “They will eventually catch up once they know that, if you start thinking about what really matters to patients, how you can improve the care you provide, you get over all these different obstacles.”

Darzi, who has been in bitter conflict with doctors over the introduction of polyclinics, is backed by Sir Liam Donaldson, the chief medical officer. This weekend, Donaldson accused some surgeons of obstructing changes that would make operations safer because they objected to their “professional autonomy” being eroded. He said: “The culture of medicine has been one of clinical autonomy. Doctors are trained to take decisions, to feel they are in charge, to lead teams. They want to do what they feel is best and anything that suggests that they should standardise their practice in any way is sometimes seen as degrading of their professional ethos.”

Donaldson, who as chairman of the World Health Organisation world alliance for patient safety will this week launch an airline-style danger checklist for surgeons, added that one British doctor told him such checks would reduce consultants to “factory workers”. Donaldson said: “I was talking about a way in which standard operating procedures are used in the airline industry and he said: ‘Well, if you bring that into medicine, we might as well go and work in factories.’ “I think it is a new idea for some traditional people holding traditional attitudes in medicine and I think we need to break those down and get people thinking and learning from other industries.”

Darzi, who will publish his review on the NHS at the end of this month, also says doctors and nurses must treat patients as customers. He says that if patients don’t like the quality of care they are receiving they should go elsewhere. His report will include proposals to routinely invite patients to grade the quality of nursing care they receive during their hospital stay, including how comfortable they were made to feel on the ward and if they were treated in a kind and compassionate manner. Results of these questionnaires will be published so that patients can shop around for the hospital with the most compassionate nursing care.

Darzi, who still practises his keyhole surgery specialism two days a week at St Mary’s Hospital in London, said he recently had a patient who requested a referral to his unit from outside its catchment area. He said more details of the most advanced surgery will be made available to patients as part of his review. This will make it easier for patients to find out where the latest technology is used.

Darzi said: “Have patients been treated as customers? When you go to a restaurant you look at a website and find out exactly what people said about that restaurant. In future I want to show which hospitals, doctors and nurses are actually bringing innovation into their healthcare.” Darzi is to set up a new website featuring all the latest innovations in medicine to encourage hospitals to adopt new treatments more quickly.

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Not again! Another government computer system fails

And a dangerous one: The system for an Australian ambulance service. My local Yellow cabs and Pizza Hut have great computer systems for managing customers and Bill Gates sells programs that are a thousand times more elaborate. What's wrong with the bureaucratic boneheads? Nobody gives a damn. That's what's wrong. The system was "innovative", of course. Governments should only buy tried and tested systems. They bungle anything else

A $6 MILLION computer system crashed within hours of being turned on last week, leaving Emergency Services staff using pen and paper to dispatch ambulances and fire engines. The Queensland Ambulance Service computer-aided dispatch system, known as VisiCAD, went down for six hours on Wednesday and communications centre staff said patient lives were put at risk across the state.

"Once the crash occurred the computers froze . . . Many other dangerous technical difficulties then occurred," a QAS employee told The Sunday Mail yesterday. The informant said that in the chaos and confusion, two patients with non-life-threatening conditions who had requested ambulances were overlooked. "No one died, but it definitely put lives in danger," the employee said.

He said the Queensland Fire and Rescue ESCAD system crashed for 2® hours at the same time. Queensland's Emergency Services has spent millions of dollars in the past decade trying to find a suitable computer-aided dispatch system. Sources said the new model was rushed in without being properly road-tested.

A QAS spokesman played down the system crash. "The Department of Emergency Services is currently implementing one of the nation's most innovative dispatch systems, called VisiCAD," he said. "The new system will link all QFRS and QAS communications centres with a single state-of-the-art computer-aided system." He said the cause of the "outage" of about 90 minutes late on Wednesday was related to a maintenance issue ["maintenance"? How do you maintain a computer program? Do you oil it?], not the system. "There have been no reports of any significant impact on service delivery." The spokesman said senior management was unaware of any evidence to indicate lives were put at risk.

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