A costometer in overdrive

Hole Ousia

In the last 3 years the National Clinical Director for NHS Scotland has been representing NHS Scotland in the following countries (in date order):

London, Hong Hong, Florida, Gothenberg, Brisbane, Singapore, Mexico City, London, Denmark, Florida, Massachusetts, Kuwait, London, Qatar, Dublin, Kuala Lumpar, Belfast, London, Denmark, Stormont, Amsterdam and the Faroe Islands.

In between all this, the National Clinical Director for NHS Scotland has presented at TEDx 2017 and hosted TEDx 2018.

The following is a list of some of the events that the National Clinical Director for NHS Scotland has attended.

[if there are any errors in this list please let me know and I will amend for the record]
  • April 2015, London IHI Forum, Joint chair of seminar panel.
  • September 2015, Hong Kong, IHI Forum. Speaker together with IHI Derek Feeley: “Person Centred Health Care.”
  • December 2015, USA Florida, IHI Forum, Speaker
  • April 2016, Gothenburg, IHI Forum…

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Frailty and “common misunderstandings”

Hole Ousia

I recently submitted a response to a Healthcare Improvement Scotland blog titled “the right words are crucial to empower patients and the public”. Dr Graham Ellis, National Clinical Lead for Older People, Safety and Improvement, has since replied:

Dear Dr Gordon,
Thank you for your comment.

I think there are several important things to say here and a common misunderstanding.

Firstly, the misunderstanding is that frailty is seen as a label. It is not a label but a diagnosis and precision around this is vital. We have had a similar fight to get the language right for delirium and are now seeing the benefits.

Frailty represents a risk of acute dependence or death in the context of an acute illness. It therefore represents an opportunity to intervene and prevent harms.

Getting the diagnosis correct for frailty is important. A recent trial showed that if GPs were given a…

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Special partnerships

Hole Ousia

A friend of mine recently told me that the road signs used throughout Great Britain were devised by a partnership between Richard Kinneir and Margaret Calvert. Their system has become a model for modern road signage. This led me on to think of other great partnerships such as husband and wife, Steven and Hilary Rose. Steven Rose is a neuroscientist and biologist and Hilary Rose, a sociologist. Their writings have had significant influence on me.

Another married couple, who individually and together have had an influence on me, are Prof Sir Simon Wessely, former President of the Royal College of Psychiatrists, and his wife Dr Clare Gerada, former President of the Royal College of General Practitioners.

Yesterday, Dr Gerada was one of the guests on radio 4, where she was debating with Professor John Read on the subject of antidepressants. This follows a recent meta-analysis on antidepressants

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“Sink”

Hole Ousia

In a previous post I have written about the decision by NICE to re-consult on depression guidelines. This late stage development followed on from a briefing from a group of experts who felt the draft guidelines were “not fit for purpose”. This group of experts were “extremely concerned about significant flaws in methodology, lack of transparency and inconsistencies in the document.”

NICE have since confirmed that a meeting took place on the 27th April 2018 with the authors of the expert briefing and that this “was not minuted or otherwise recorded.” Given the call for transparency by this expert group I considered this most disappointing.

This is the backdrop to me writing to one of the signatories of this expert briefing, Professor Sir Simon Wessely, explaining that I was interested only in the transparency of the process and not the persons involved.

I have shared Professor Sir Simon Wessely’s initial replies to…

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The development of healthcare Guidelines should be fully open

Hole Ousia

In a recent post I wrote about the decision by NICE to re-consult on depression guidelines. This late stage development followed on from a briefing from a group of experts who felt the draft guidelines were “not fit for purpose”. This group of experts were “extremely concerned about significant flaws in methodology, lack of transparency and inconsistencies in the document.”

Expert Group that brought sabout a second consultation to NICE guideline on treating depression

Seeking further clarifications on this development I wrote to NICE and received this response: “NICE decided to offer a meeting to the authors of the 17th November letter to discuss their concerns with them. The meeting took place on 27th April. Afterwards, NICE decided to run a second consultation.”

I wrote again to NICE to ask for details of this meeting of the 27th April 2018 with the authors of the “expert briefing” and I was informed by NICE that “the meeting on 27th April was not minuted or otherwise…

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