CONTENTS FROM THE EDITOR
THE transformation in dental health in the UK over the past 50 years is a remarkable success
story. Advances in preventative and restorative dentistry, health promotion and better nutrition have all played their part, but the improvements have not been achieved evenly across society and this remains a concern. The Childsmile initiative in Scotland, focusing on prevention and early intervention, has produced encouraging results and reason for optimism. On page 18 of this issue of Summons, Dr Colwyn Jones describes the approach that has been adopted and results to date. The proposed new NHS dental contract in England also changes the focus from treatment to prevention. Professor Jimmy Steele led the 2009 review of NHS dental services in England and in our Q&A on page 10 he provides a personal
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perspective on the progress made during the pilot phase of the new contract.
Our clinical risk article (page 16) focuses on cauda equina
syndrome, a condition that continues to result in claims for clinical negligence, often of high value in view of the severe and long-term consequences for patients. Robert McFarlane’s update offers helpful guidance on diagnosis and management of this uncommon but important condition, and there is also a case study on the same topic (page 21). In the course of assisting our members with GMC complaints, it is clear that these can be extremely stressful. Only a minority, however, will progress to any form of sanction, as highlighted in the most recent GMC fitness to practise statistics in 2014. On page 12, Mary Peddie describes how at MDDUS we approach GMC complaint handling, and she offers practical guidance on dealing with them when they arise. Dr Barry Parker
MAKING PREVENTION PAY Q&A with Professor Jimmy
Steele on progress towards a new NHS dental contract in England
LETTER FROM THE GMC Medical adviser Mary Peddie
explains why receiving notification of a GMC complaint need not be a cause for panic
DRUGS THAT WILL TAKE LITTLE LIVES
Allan Gaw recounts how a 1937 medical tragedy contributed to our modern approach to the approval of new drugs
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Cover image: ‘Stillness’ (detail) Pauline Jacobsen. Woodcut, 1992.
Pauline Jacobsen studied at Ealing Technical College & School of Art (1949). She lived most of her life in Scotland and had five children. Her wood engravings are known for
her use of the natural grain in the wood which she used to beautiful effect to make her prints, which often have a spiritual theme.
Art in Healthcare (formerly Paintings in Hospitals Scotland) works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit
www.artinhealthcare.
org.uk Scottish Charity No SC 036222.
AUTUMN 2015
CLINICAL RISK REDUCTION Robert Macfarlane highlights
the need for early diagnosis to avoid irreversible nerve damage in cauda equina syndrome
Editor:
Dr Barry Parker Managing editor: Jim Killgore Associate editor: Joanne Curran Editorial departments: MEDICAL Dr Richard Brittain DENTAL Mr Aubrey Craig LEGAL
Simon Dinnick REGULARS
4 Notice Board 6 News Digest 8 Risk: A tailored process of consent 9 Ethics: The moral of the tail 20 Case studies: Shooting pains, Long-term neglect? 22 Addenda: Radioactive soda water, Book review – On the move, Crossword and Vignette – Dorothy Stuart Russell, Pioneering pathologist
Please address correspondence to:
Summons Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA
jkillgore@mddus.com
Summons is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208
Email: General:
info@mddus.com • Membership services:
membership@mddus.com • Marketing:
marketing@mddus.com • Website:
www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Articles of Association.
The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily reflect the opinions or policies of The Medical and Dental Defence Union of Scotland.
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Design and production: Connect Communications 0131 561 0020
18
KEEPING KIDS OUT OF THE DENTAL CHAIR
Colwyn Jones looks at the success behind the much-lauded Childsmile programme in Scotland
Printing and distribution: L&S Litho
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