Digest News


Emergency cancer patients not seen by GP


A NEW study funded by Cancer Research UK has found that a third of cancer patients (34 per cent) diagnosed as an emergency in England had not consulted their GP beforehand. The research published in the British


Journal of General Practice used data from more than 4,600 cancer patients with 18 different types of cancer to determine how many times they had visited their GP before their disease was diagnosed in an emergency setting. Cancers diagnosed as emergencies are more likely to lead to poorer outcomes in patients, as these are usually at a late stage.


Among the cancer patients presenting as an emergency with no prior GP visits, most were men, the elderly and those from more deprived backgrounds. The researchers point to a range of practical, emotional and health barriers that can make these groups less likely to seek help promptly from their GP. Dr Georgios Lyratzopoulos, one of the


lead researchers based at University College London, said: “These findings tell us that some patients diagnosed as an emergency might not be acting on ‘red flag’ symptoms which could have prompted them to visit their GP. This highlights the need to explore all the reasons why cancers are diagnosed late, including what happens outside GP surgeries.”


Call to improve dentistry for homeless


NEW research has shown that 15 per cent of homeless people have resorted to pulling out their own teeth. The study by homelessness charity


Groundswell asked 260 homeless people in London about dental care and found 70 per cent reported having lost teeth since they had been homeless. Just over a third (35 per cent) said they had teeth removed by a healthcare


professional, 17 per cent lost teeth following acts of violence, and seven per cent had no teeth at all. The BDA’s chair of England Community Dental Services Michael Cranfield said: “The failure to invest in community dentistry is hurting patients who can’t always be cared for in traditional settings. This research should force government and health commissioners to reassess their priorities.”


GMC guidance on DVLA disclosures


REVISED GMC guidance on confidentiality came into effect in April of this year and includes key ethical duties and obligations of doctors in relation to fitness to drive issues. The strengthened guidance clarifies the need for doctors to disclose information to the appropriate authorities in situations where a patient ignores advice to stop driving and is potentially putting others at risk. MDDUS medical adviser Dr Barry Parker said: “We have encountered cases where patients disagree with the advice of their doctor and consider that they are still competent to drive, or they may seek to cope with the condition by offering to restrict driving in some way. “No doctor wants to find themselves in the position of having to act against their patient’s wishes and breach their confidentiality. After all, doctors are accustomed to acting as patient advocates and confidentiality lies


NHS cyber-attack: future planning


DOCTORS dealing with future ransomware attacks similar to the one recently affecting NHS IT systems are advised to apply common sense principles when treating patients without access to computerised or other medical records. Doctors are advised to revert to time-honoured methods of noting a detailed history by making hand-written records, ensuring they are accurate, legible, contemporaneous, timed and dated. Once IT systems have been restored, the hand-written note should be recorded within the patient’s electronic records, including the time and date of the original note, as well as when it is uploaded. We would also advise that the paper records be retained and scanned to the electronic record. Given the absence of past medical history, doctors should take


extra care to double check any relevant medical information with their patients and document these discussions. Doctors should prescribe for the minimum period necessary unless they are able to verify sufficiently the drug history. Other forms of communication such as telephone can be used to contact labs etc. if results are not available online. Finally, doctors are reminded to act within the limits of their


expertise and if in doubt, seek advice from a senior colleague or their medical defence organisation. Dr John Holden is joint head of medical division at MDDUS


6 / MDDUS INSIGHT / Q2 2017 at MDDUS


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