NEWS DIGEST “Over the past decade many efforts


have been made to find solutions to try and provide alternative services to help patients whose conditions could be treated outside of the Emergency Department. Our experience is that most of these have been unsuccessful. Almost all were implemented without effective testing or piloting.” The College has published its own


“pragmatic solutions, deliverable in a short time scale.” To access these go to the RCEM website or www.tinyurl.com/ lh3jqht.


areas. These include providing better support for people to self-care, thus avoiding the need to see a doctor and also helping people with urgent care needs to get the right advice and ongoing support via the NHS 111 service. The report also calls for “highly


responsive urgent care services outside of hospital so people no longer choose to queue in A&E”. This would mean “consistent same-day, every-day access” to primary care and community services and developing the 999 ambulance service into a mobile urgent treatment service capable of treating more patients at the scene to avoid the need for hospital.


In dealing with patients with serious or


life-threatening emergencies it calls for the development of two types of hospital emergency departments: emergency centres and major emergency centres. Emergency centres will be capable of assessing and initiating treatment for all patients and safely transferring them when necessary. Major emergency centres will be much larger units, capable of not just assessing and initiating treatment for all patients but providing a range of highly specialist services. The NHS envisages around 40-70 major emergency centres across the country. The Royal College of Emergency Medicine welcomed the review but pointed out that it is very much future focussed, saying “the crisis is here with us now”.


● UPDATED SCOPE OF PRACTICE GUIDANCE NOW ONLINE Recent changes reflecting the new direct access agreement for dental care professionals have been incorporated in the GDC’s revised Scope of Practice guidance which is


WINTER 2014


Call for clarification on direct access


FURTHER clarification is needed from the GDC on the new arrangements for direct access to dental care professionals, according to a group of dental stakeholders who recently met at the BDA.


“Gaps remain in dental professionals’


understanding of the complexities surrounding direct access”, said the group in a statement.


Members include the British


Association of Dental Nurses, the British Association of Dental Therapists, the British Association of Clinical Dental Technology, the British Dental Association, the British Society of Dental Hygiene and Therapy and the Faculty of General Dental Practice. Among the areas they believe still


require further guidance are: • NHS regulations and the variations in legislation between the devolved nations


• prescribing and reporting on radiographs


• consent and referrals within the dental team to ensure efficient and safe care for patients. Many of the stakeholders reported uncertainty about how the new arrangements can be implemented efficiently, with patients fully understanding the different roles among dental professionals. The members agreed to work together in future to resolve these uncertainties.


now available to download. The guidance reminds registrants that they must only undertake a task or type of treatment or make decisions about a patient’s care if they are sure they have the necessary skills and are appropriately


trained and indemnified. ● COMPLAINTS HIGHER THAN REPORTED Complaints against NHS doctors and dentists in Scotland increased by 36 per cent last year, according to revised government figures. The original report from


information unit ISD Scotland in September indicated complaints had dropped by 15 per cent between 2011/12 and 2012/13. However, these figures were later found to be inaccurate and the result of a “formula error”.


7


Doctors may face criminal charges for neglect


DOCTORS accused of “wilful neglect” in the care of patients in England and Wales could face criminal charges, according to proposals set out in the Government’s recent full response to the Francis inquiry. The offence would be modelled on one punishable by up to five years in prison under the Mental Capacity Act. A consultation on what scale of sentence should be applied to the extended law will be carried out over the next few months. The recommendation stems from a


report on patient safety led by Professor Don Berwick, commissioned by the Government in response to the Francis inquiry. It called for new criminal offences to be created for “recklessness or wilful neglect or mistreatment by organisations or individuals and for healthcare organisations which withhold or obstruct relevant information”. But the report emphasised that the use of such sanctions should be extremely rare and unintended errors must not be criminalised. Both the RCGP and the BMA are not supportive of the proposal. Dr Mark Porter, Chair of BMA Council, said: “While extending wilful neglect as a criminal offence may go some way towards reassuring the public, it is unlikely to bring around the change in culture we need, and how this will work in practice is something that we will continue to discuss with the Government as there are already criminal sanctions in place in order to hold healthcare workers, including doctors, to account.”


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