advice. Initiatives to diagnose diabetes and cardiovascular disease, as well as other conditions such as child obesity and eating disorders, should engage dentists and other oral health professionals, and the links between oral health and general health should be part of all healthcare training and continuing professional development. Figures from NHS Digital indicate that over


half (50.4 per cent) of adults in England were seen by an NHS dentist in the 24 months to 31 December 2018, suggesting that dentists and oral health professionals are well placed to play a broader role in supporting patients’ general health.


RCGP offers vision for the future


EXTENDED GP consultations and continuity of care delivered via ‘micro-teams’ are key elements in a vision for the future of general practice. The Royal College of General Practitioners has set out this vision in an extended report – Fit for Future. It states that by 2030, face- to-face GP consultations will be at least 15 minutes, or longer for patients with more complex needs. Research showed that the UK offers some of the shortest GP consultations amongst economically-advanced nations at 9.2 minutes. Professor Helen Stokes-Lampard, chair


of the RCGP, said: “It is abundantly clear that the standard 10-minute appointment is unfit for purpose. It’s increasingly rare for a patient to present with just a single health condition, and we cannot deal with this adequately in 10 minutes.” The report


also predicts that continuity of care will be delivered via ‘micro-teams’ with a named GP and other members of a multi-disciplinary team, including nurses, pharmacists, physiotherapists, occupational therapists, link workers, dieticians and health coaches. Vital health information will be available via personalised patient ‘data dashboards’, accessible by healthcare professionals across the NHS, drawing on data from the patient’s genomic profile and wearable monitoring devices. A greater use of AI will include improved triage systems that assess the severity of a patient’s health needs, enhance diagnosis, flag ‘at risk’ patients, and safely identify the most appropriate care pathway.


The report also predicts that GPs will no longer work in isolation – practices will operate in networks or clusters, allowing them to pool resources and people, but facilitating smaller practices to retain their independence and patient lists. Professor Stokes-Lampard added: “Ours is an ambitious vision but it is not a pipe dream. Realising it will depend on having a sufficiently resourced service to keep people well and provide them with the care they need around the clock.” The full report can be found at bit.ly/2wedYEQ


RCS looks to guide surgical innovation


NEW guidance to avoid a “maverick” approach to surgical innovation has been published by the Royal College of Surgeons. The RCS cites “exciting” developments, such as three-dimensional printing, artificial intelligence, robotics, nanotechnology and regenerative medicine, but identifies significant risks in allowing innovation to occur in the “absence of a clear guiding principle”. Mr Peter Lamont, who helped develop the new guidance and is a Royal College of Surgeons Council Member, said: “Surgery is set to be transformed for millions of patients by a new wave of technologies…. Historically though, the development of new surgical techniques have often taken place in the absence of the rigour associated with the development of new medicines or devices. “It is absolutely vital that surgical innovation places both patient safety and the best interests of the patients at the core. The


introduction of new technologies or techniques in surgery has no place for the maverick surgeon who


proceeds without appropriate


peer review or training.” The guidance sets out the clinical


governance and oversight needed to introduce innovations. It also covers patient consent requirements, managing potential conflicts of interest, how new techniques should be translated into wider practice (with requisite training and mentors) and the need to measure long-term outcomes. Access the guidance at tinyurl.com/


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q FALL IN POST- SURGICAL DEATHS DEATHS following surgery have been reduced by more than a third in Scotland since the implementation of a safety checklist as part of the Scottish Patient Safety Programme. A study published in the British Journal of Surgery found a 36.6 per cent reduction in mortality since the World Health Organization (WHO) Surgical Safety Checklist was introduced in 2008. An analysis of 6.8 million operations performed between 2000 and 2014 saw rates fall to 0.46 deaths per 100 procedures.


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NEW INVESTMENT IN REST FACILITIES THE Department for Health and Social Care has announced it will invest £10m in improving doctors’ rest facilities. Ninety-two trusts in England will receive £30,000 in 2019-20 to help improve facilities, with a further 122 trusts defined as having greater need and each receiving £60,833. Health Education England has welcomed the initiative to improve the working lives of NHS doctors and trainees.


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MEDICAL REGISTER HITS 300,000 The UK medical register reached a major milestone this year, welcoming its 300,000th doctor – up by a third from the year 2000. The GMC reports that 95,850 are on the specialist register and 70,154 are on the GP register. The number of female doctors has more than doubled over the past two decades, accounting now for 46 per cent of registered UK doctors.


MDDUS INSIGHT / 7


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