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Tuesday, 22 June 2010

BMA Cymru backs new GMC guidance on end of life care

New guidance for doctors, “Treatment and care towards the end of life: good practice in decision making” has been published by the GMC.

The BMA has been involved with the development of this guidance and we support it. How best to care for individuals at the end of life is one of the most complex areas in medicine and it is essential that clear guidance is in place to assist doctors to act in the best interests of their patients.

The emphasis on advance care planning discussions with patients is to be welcomed, taking onboard their wishes and preferences and subsequently delivering quality care partnered with these choices.

The guidance highlights the importance of good communication, and is clear about the need to work with the patient or where appropriate their relatives or advocate to ensure that they are treated fairly, with dignity and without prejudice.

It will also be invaluable for patients and their relatives who need the reassurance of readily accessible information about what to expect in the very anxious period at the end of a person's life.

The guidance and supporting materials are available on the GMC website here.

Monday, 21 June 2010

All Wales telephone advice, information and support service on alcohol and drug abuse

The Primary Care Support Service has launched a range of services for those with alcohol or substance use concerns. This includes on-line screening tools as well as a confidential telephone information, advice support service.

View the services online here

This new Pilot project has been developed in response to primary care professionals’ concerns about their alcohol and substance use. It will run until March 31st 2011 and is subject to on-going evaluation. A Motivational Interviewing approach is used.

Drinking and Cooking related fires a burning issue for the fire and rescue service

This week the North Wales Fire and Rescue Service are guest blogging as part of our ongoing campaign to tackle alcohol abuse. This article by Richard Fairhead, Senior Fire Safety Manager highlights another dimension to the discussion.

North Wales Fire and Rescue Service has recently launched another campaign focussing on drinking and cooking, this time to coincide with the World Cup football tournament.

This initiative is the latest effort in the region to discourage residents from attempting to cook after drinking alcohol.

Statistics across the U.K. show that one in every three fire deaths is drink related, and the majority of accidental domestic fires begin in the kitchen.

In 2007, Sean Bowers, 24, from Penyffordd and Andrew Roberts, 39, from Ruthin, both died following separate fires in their homes both caused by chip pans. Both had been drinking, and had arrived home to cook themselves something to eat. Andrew had finished cooking and had fallen asleep on the couch but failed to turn off the gas. Sean also fell asleep with the chip pan left on the stove. The chip pans overheated and caught fire - Sean and Andrew never woke up.

Leaving cooking unattended is often a recipe for disaster and if you've been drinking you're even more vulnerable as you're at high risk of being distracted of falling asleep. Drink affects people mentally and physically, increasing their likelihood of having a fire and slowing their reaction times when one breaks out.

If you're asleep and a fire breaks out, you're in serious trouble. Just a couple of breaths of fire smoke can be enough to knock you completely unconscious. The smell of smoke doesn't wake up you up - the poisonous gases produced by a fire numb the senses and put you into a deeper sleep. This is why it is essential to have working smoke alarms in your home. Frighteningly, you are also putting the lives of your whole family at risk - a child can die from smoke inhalation in under a minute.

Despite the old proverb 'a watched pot never boils', keeping a close eye on your cooking really will save your life. Whether you've had a few drinks or not, our advice to cooks is quite simply to stand by your pan and get working smoke alarms.

Avoid your lives going up in smoke by following the tips listed below.

- Never cook after drinking - prepare a sandwich or get a takeaway instead.
- Don't leave cooking unattended -a small fire can quickly turn into a life threatening one. A household fire doubles in size every thirty seconds.
- Ensure you have a working smoke alarm in your home, and test them once a week.
- Formulate a fire escape plan to ensure that you and your family know how to escape safely in the event of a fire.

All three fire and rescue services in Wales fit alarms free of charge, and will give fire safety hints and tips as well as helping you design a fire escape plan for your home.

To take advantage of their friendly and informal home visits, residents can book a free Home Safety Check by calling the 24 hour hotline on 0800 1691234 or texting 88365, ensuring they prefix the message with the word HFSC.

Friday, 18 June 2010

Letter from the Minister - Vaccination uptake in 2009-10

I have received a letter from the Health Minister Edwina Hart regarding vaccination uptake in 09-10.

The Minister asks for her message of personal thanks to be shared with everyone involved in delivering vaccination services, and I would like to share her comments on this blog.

The letter reads:

I was very pleased to see the Public Health Wales annual report on the routine childhood vaccination programme. I noted particularly that, national uptake of all vaccinations by one year old is at the 95% target. Also that uptake of both MMR doses continues to increase towards target. This is all very good news.

There is still some way to go to reach target in the pneumococcal and Hib/MenC levels and uptake in the teenage booster is worryingly low. I am expecting to see improvements in these programmes during this year.

Vaccination is the best way of protecting children – and the wider community – against potentially very serious illnesses. We will achieve high uptake levels in all childhood programmes only through the efforts of local health professionals who support parents in making informed decisions about vaccination. I therefore want to thank everyone involved for their hard work last year when considerable challenges were faced during the swine flu pandemic.

I would appreciate this message of personal thanks being shared with everyone involved in delivering vaccination services.

Wednesday, 16 June 2010

BMA Cymru welcomes call to lower drink-drive limit

BMA Cymru Wales is very pleased that the North Review is calling for a reduction in the drink drive limit and we urge the UK government to act on the review’s findings.

We have lobbied for a reduction in the drink drive limit for over twenty years, and contributed to the North Review. We believe that such a move will help prevent deaths and reduce the number of lives ruined by drink-driving.

Scientific evidence from around the world has agreed that once a person’s alcohol level goes over 50mg their driving becomes impaired.

A reduction in the limit would also bring the UK in line with most other European countries, and would be in agreement with the best available evidence on the effects of alcohol on driving.

The introduction of the current limit, backed up by police enforcement and TV and media education campaigns, led to a dramatic fall in the number of deaths on the road, but the position has been stagnant since 1993. We need a new impetus to reduce the toll of injury and death.

The BMA is not suggesting a zero limit because there will be cases where an individual would register slightly above zero, even when they had not been drinking (diabetes and the use of mouthwash can both cause an above-zero level). The BMA doubts whether an absolute zero would be enforceable and acceptable to the public but argues that a 50mg level, would be effective and beneficial.

Scientific evidence from around the world has agreed that once a person’s alcohol level goes over 50mg their driving becomes impaired.

We would also like to see roadside random breath tests carried out. This measure is a vital element in deterring people from drinking and driving.

As a road accident doctor and a member of the British Association of Immediate Care (BASICS), I go to road accidents to provide advanced medical care with the emergency services, and I have seen at first hand the awful and devastating consequences of drink driving.

Monday, 14 June 2010

Why Wales has to attract the best medical talent


Our Public Affairs Officer Carla Mahoney has written a column for the Western Mail today. It looks at the inadequate staffing levels in the NHS in Wales.

Take a look here and leave a comment on this blog if you have something to share on this topic.

Diabetes Week 2010

This week is Diabetes week, an annual nationwide awareness week organised by Diabetes UK with the aim of raising awareness about diabetes and the issues people living with the condition face.

Diabetes Cymru UK are raising awareness this week about the key myths about diabetes, and have asked me to share some key facts and statistics with readers of this blog.

Diabetes costs the NHS in Wales £500m a year and is increasing rapidly.

According to the latest QOF statistics, released in September 2009, more than 146,000people in Wales – almost one in 20 people – have been diagnosed with diabetes. This figure had risen by more than 7,000 compared to the previous year’s statistics. The Welsh Assembly Government estimates that a further 50,000 people in Wales have undiagnosed diabetes.

Around 90 per cent of people diagnosed with diabetes have Type 2 diabetes. Usually diagnosed over the age of 40, the condition happens when the body stops making enough insulin or when it cannot use the insulin it produces. Eighty per cent of cases of the condition are associated with being overweight, but other risk factors for the condition are having a large waist and having a close family history of the condition. Being from a black or South Asian background makes people more likely to develop the condition and people from these communities are at risk of the condition from the age of 25. Type 2 diabetes can be treated with diet and exercise, tablets or insulin injections (30 per cent of people with the condition are treated with insulin injections). Many people with Type 2 diabetes assume that it is not as serious as Type 1. In fact, both conditions are serious.

Around 10 per cent of people diagnosed with diabetes have Type 1 diabetes. This condition happens when the body stops producing any insulin and is usually diagnosed in childhood and under the age of 40. It is not associated with lifestyle and cannot be prevented. Type 1 diabetes is always treated with insulin injections or an insulin pump, a device which constantly infuses fast-acting insulin into the body.

The complications of diabetes are heart disease, strokes, kidney disease, visual problems that can lead to blindness, and amputation. People with diabetes can reduce their risk of developing these complications by eating a healthy, balanced diet, maintaining a healthy weight, keeping active, taking their prescribed medications and keeping their blood glucose levels within the recommended levels.

People can live with diabetes for up to 10 years before it is diagnosed, which means half of these people already have developed the complications of diabetes. Many people can miss the symptoms of diabetes as they can often be mistaken for getting older and being stressed. The key symptoms of diabetes are going to the toilet more often to pass water (particularly at night), extreme tiredness, blurred vision, genital itching, regular episodes of thrush and slow-healing wounds.

People from deprived communities are up to twice as likely to develop diabetes. In Wales, there is a big variation of the percentage of the population diagnosed with the condition in different areas. According to the latest QOF statistics, Blaenau Gwent has the highest percentage of the population diagnosed with diabetes at 5.8 per cent. This is significantly higher than the area with the lowest percentage, Cardiff, which has 3.6 per cent of the population diagnosed with diabetes.

Diabetes UK Cymru provides advice, support and information for people with diabetes and their families and funds research into diabetes. The charity also does a series of talks for GPs every year and organises an annual conference for healthcare professionals in Wales.

For more information, contact 029 2066 8276, email wales@diabetes.org.uk or visit www.diabetes.org.uk/wales. The charity can also be found on Facebook and Twitter at http://twitter.com/DiabetesUKCymru.

I wish them the best of luck with raising awareness this week!

Wednesday, 2 June 2010

Time to tackle the affordability of alcohol

NICE have today published guidelines to tackle alcohol misuse.

BMA Cymru have been saying for some time that tough action is needed to tackle this issue. We are pleased that NICE is joining our call for a ban on alcohol advertising and the introduction of a minimum price per unit of alcohol.

Critics of minimum pricing should read the research by Dr Robin Purshouse on alcohol pricing - it makes for interesting reading. He estimates that a minimum price on every unit of 40 pence would result in about 1,000 fewer premature deaths a year, around 40,000 fewer hospital admissions a year, and about 10,000 fewer violent crimes and criminal damage incidents per year. Read his report here.

We are convinced that in order to tackle alcohol misuse a whole raft of measures is required, which include reducing availability, increasing taxes on drinks with the highest alcohol concentration, reducing the drink-driving limit and tackling advertising and minimum pricing.

We are not opposed to people drinking alcohol in moderation - what we want is to help people avoid using alcohol at levels which endanger their lives and those of others.

A few weeks ago we held a seminar on tackling alcohol abuse: an integrated approach forward. Watch it here.

What do you think about the recommendations from NICE?

Tuesday, 1 June 2010

Why Wales has to persuade doctors to come home


I was pleased to read this article in the Western Mail yesterday written by Conservative Assembly Member Andrew RT Davies, endorsing our We'll Keep A Welcome campaign.

BMA Cymru have consistently highlighted the problem of the shortage of doctors in Wales, which could lead to the NHS becoming unsafe for both staff and patients.

This campaign is the latest move by BMA Cymru to promote Wales as a desirable place to live and work.

We have contacted all schools in Wales to reach out to prospective medical students before they leave for university.

All students have been sent packs which include letters from me, as well as from Welsh postgraduate dean Derek Gallen, along with information about training in Wales and posters to put up in medical schools.

Whilst we are happy to initiate grass roots action here in Wales, the Government has a responsibility to ensure that safety standards in Wales are maintained, and that the citizens of Wales receive the quality healthcare they deserve.

Follow our campaign by joining our facebook group here to keep up-to-date with the latest developments.

Tell us why you think Wales is a great place to live and work.....

Thursday, 27 May 2010

BMA Wales Social Media

BMA Cymru Wales is embracing new media! We communicate with members and non members via a number of channels listed below.

Take a look and keep up-to-date with the latest news and developments.

Follow us on Twitter here

Join our Students Facebook group here

Join our Junior Doctors Facebook group here

Join our We'll Keep a Welcome Campaign Facebook group here

And finally watch our clips on YouTube here

The Welsh Health Survey

The new Welsh Health survey data makes for worrying reading. There has been a rise in the number of children classified as overweight or obese.

These soaring rates in obesity over recent years has lead to an increase in childhood type II diabetes and will lead to more future cases of heart disease, osteoarthritis and some cancers.

If current trends continue, the cost to the health service is likely to increase unless measures are put in place to halt this growing problem.

We need to prevent children from becoming overweight in the first place, and parents, schools, health professionals, the media, food manufacturers and the government all have an important role to play in this.

The other item which stood out from the data was the increase in smoking amongst men in Wales.

Although smoke-free legislation is making a huge difference to the health of patients, these figures reveal the serious reality of Wales’ smoking problem.

The damage caused by smoking is cumulative. Most people know that smoking causes heart disease and stroke. But they may not realise that if men smoke heavily during their teens and twenties, they risk developing erectile dysfunction in their thirties and forties.

There is no doubt that giving up smoking can be extremely difficult – like any addiction, kicking the habit is no easy task. When smokers decide to quit they are often advised to set a date, bin the cigarettes and then just do it. Support from a doctor or health professional during this time can be invaluable, and I would advise anyone thinking about quitting to contact their GP for advice and support.

What do you make of the data?

Tuesday, 25 May 2010

Survey on alcohol policy issues

Alcohol Concern Cymru are conducting a survey to gauge the views of those working in primary care on current alcohol policy issues in Wales.

45% of adults in Wales admit to drinking more than the recommended daily amount on at least one day in the past week, including 28% regularly binge drinking (drinking more than double the recommended daily amount over a short period). Alcohol now accounts for over 1,000 deaths in Wales each year.

If you are working in primary care take a minute to fill out this 7 question survey by clicking here.

Tuesday, 18 May 2010

Alcohol Abuse: An Integrated Approach Forward


Last week we brought together leading UK experts to speak at our seminar on alcohol abuse, and to debate an integrated approach forward in tackling Wales' growing drink problem.

Speakers included: myself; Dr Zul Mirza, President of the Emergency Medicine Section, Royal Society of Medicine; Simon O’Brien, Deputy Inspector of policing for Ireland; Professor Eileen Kaner, Chair, Alcohol Programme Development Group NICE; Wynford Ellis Owen, Chief Executive of The Welsh Council on Alcohol and other Drugs; Andy Tighe, Director, Brewing, Beer and the Pub Association.

You can watch the seminar here.

We know that Health Minister Edwina Hart would like to see action on alcohol pricing from her statement in Plenary last month, and we are urging the Minister to act sooner rather than later in seeking further powers to tackle alcohol abuse, to help improve the health of the people of Wales.

Recent years have seen an increase in the levels of alcohol misuse in Wales, and in particular the pattern of binge drinking and heavy drinking.

Alcohol consumption is associated with a wide range of medical conditions and is a significant cause of morbidity and premature death. It contributes to a range of acute and chronic health consequences, from alcohol poisoning and injuries resulting from traffic crashes to cancer and cardiovascular disease. The more an individual consumes, the greater the risk of harm.

Alcohol misuse is associated with crime, violence and anti-social behaviour, and can impact significantly on family and community life.

Below are our recommendations to tackle alcohol abuse which we intend to send to the Health Minister:

• Taxation on all alcoholic beverages should be increased at higher than inflation rates and this increase should be proportionate to the amount of alcohol in the product.

• Legislation should be introduced to:
-prohibit irresponsible promotional activities in licensed premises and by off-licenses
- set minimum price levels for the sale of alcoholic beverages

• It should be a legal requirement for alcohol labeling to include the following information:
- alcohol content in units
- recommended daily UK guidelines for alcohol consumption
- a warning message advising that exceeding these guidelines may cause the individual and others harm

• Licensing legislation should be strictly enforced, including the use of penalties for breach of license, suspension or removal of licenses, the use of test purchases to monitor underage sales, and restrictions on individuals with a history of alcohol-related crime or disorder. There should be adequate funding for enforcement agencies, with consideration given to the establishment of a dedicated alcohol licensing and inspection service.

• A statutory code of practice on the marketing of alcoholic beverages should be introduced and rigorously enforced. This should include a ban on:
-marketing of alcoholic soft drinks to young people
-alcohol industry sponsorship of sporting, music and other entertainment events aimed mainly at young people
-broadcasting of alcohol advertising at any time that is likely to be viewed by young people

• The legal limit for the level of alcohol permitted while driving should be reduced from 80mg/100ml to 50mg/100ml throughout the UK.

• Public and school-based alcohol educational programmes should only be used as part of a wider alcohol-related harm reduction strategy to support policies that have been shown to be effective at altering drinking behaviour, to raise awareness of the adverse effects of alcohol misuse, and to promote public support for comprehensive alcohol control measures.

• The detection and management of alcohol misuse should be an adequately funded and resourced component of primary and secondary care to include:
- formal screening for alcohol misuse
- referral for brief interventions and specialist alcohol treatment services as appropriate
- follow-up care and assessment at regular intervals

Monday, 10 May 2010

Welsh Cancer Standards

The Western Mail today reports on Wales falling short on meeting national cancer standards.

Health professionals throughout Wales are committed to providing the best possible services to patients, and welcome the Welsh Assembly Governments ambition to achieve 100 per cent compliance across this set of standards - unfortunately the reality falls woefully short of the ambition as this report highlights.

While acknowledging that much work has been done, this report highlights how much more there is to do.

Additional resources will be required to meet these standards - and even in these tight financial times, cancer services will remain a priority to doctors and patients in Wales.

The report highlights a shortage of specialists throughout multidisciplinary clinical teams. BMA Cymru have warned the Welsh Assembly Government repeatedly over the shortage of doctors in Wales, and this data adds wait to our argument.

The high level of middle grade and junior doctor vacancies means that consultants are left picking up the pieces where there are gaps in rotas.

This is compromising consultants’ ability to deliver routine daily work, and there is no evidence that hospitals are adjusting services to take these shortfalls into account.

While BMA Cymru has been working with WAG and employing Local Health Boards around doctor shortages - many of our suggestions on how to address the current crisis we are facing have yet to be taken up.

Without doubt, the rates of work being undertaken cannot be sustained with the current levels of staffing.

The Welsh Assembly Government must ensure that training programmes are in place to provide future specialists.

Although the waiting times for radiotherapy have not improved, it is pleasing that the WAG identified the need for more resources in this area to ensure improvements were made. The recent investment into extended working hours and a national procurement programme for linear accelerators is to be welcomed.

The WAG must now ensure that sufficient resources are available in other areas to enable workers to implement recommendations.

Doctors are eager to drive forward efforts to improve the care cancer patients receive and are usually at the forefront of leading improvements and new initiatives; but sustainable solutions are needed to address the problems raised in this report if NHS Wales is to deliver and maintain the quality and capacity of cancer services that the people of Wales deserve.

Tuesday, 27 April 2010

Alcohol Pricing

This afternoon in Plenary Health Minister Edwina Hart AM set out the Welsh Assembly Government’s position on alcohol pricing.

I’m pleased that the Welsh Assembly Government are taking the issue of alcohol abuse seriously.

In recent years, the affordability of alcohol in the UK has been increasing, and this has played a significant role in the rise in alcohol consumption.

There is strong and consistent evidence that alcohol consumption and rates of alcohol-related problems are responsive to price.

It is clear that the relationship between the affordability of alcohol and the level of consumption provides an effective tool for controlling levels of consumption and reducing levels of alcohol related harm.

We believe it is essential that there is an increase in the level of excise paid on alcohol in the UK, and this should be relative to the number of units of alcohol. This increased taxation would not only reduce alcohol consumption and its related harms, but would also contribute to providing the necessary funding to meet the social and economic costs of these harms like police enforcement measures, healthcare service costs and treatment services.

We at BMA Cymru urge the Minister to act sooner rather than later in seeking further powers to tackle alcohol abuse, to help improve the health of the people of Wales.

Monday, 26 April 2010

WalesOnline - News - Health News - What do the big three political parties have to say about health in Wales?

BMA Members Jonathan Osborne, Sharon Blackford and Stefan Coghlan have been telling the Western Mail what they believe the priorities for the next government should be. Take a look here on page 3 and 4 of the article on health in Wales:

WalesOnline - News - Health News - What do the big three political parties have to say about health in Wales?

Do you agree with their opinions?

Friday, 23 April 2010

Mae hen wlad fy nhadau yn annwyl i mi


A line from the song which arouses passion in all who sing it. Hen Wlad Fy Nhadau, our national anthem.

It is precisely this type of gusto that BMA Cymru Wales would like to invoke in Welsh medical students currently studying elsewhere in the UK.

Our campaign “We’ll keep We'll Keep a Welcome / Pleidiol wyf i'm gwlad, intends to attract medical students back to Wales to train, and work as a doctor.

I’d like to thank all four Assembly Members who have contributed to my blog over the last two weeks in support of our campaign.

We really believe that Wales has it all. The standards of clinical training and career development opportunity are as good as can be found anywhere, with the added bonus of working in attractive surroundings offering excellent facilities and professional support.

With the added benefits of a quality lifestyle - reasonably priced housing, good schools and access to beautiful countryside - Wales is a clear winner when it comes to aligning career development with work-life balance.

Wednesday, 21 April 2010

“Wales has a tremendous amount to offer” - Shadow Minister for Health and Social Services, Andrew R.T. Davies A.M.


I am pleased to be given the opportunity to endorse the BMA Cymru campaign “We’ll keep a welcome”.

I have lived and worked in Wales all my life – I live with my family near Cowbridge in South Wales, situated in the rural Vale of Glamorgan but close to the Nation’s Capital City, Cardiff and we can therefore enjoy the best of both worlds – the beauty of the Welsh countryside and all that a bustling first city can offer.

We are never short of places to take our visitors - whatever their interests; the strikingly beautiful Welsh countryside boasts three National Parks and five regions designated as being of “Outstanding National Beauty”.

Wales has over 1200 Kilometres of coastline so you are never too far from the sea and the range of leisure activities that it provides, including surfing, sailing, fishing and swimming from some of the best beaches in the U.K. The temperate Welsh climate means that you can access the countryside throughout the year so if climbing the mountains of North Wales or the Beacons in the south are your bag or if you are into walking the coastal pathways or the picturesque valleys you will never be far from these areas.

Neither will you ever be far from civilisation – the cities and towns of Wales offer World – class theatres, museums and galleries – all evidence of the strong appreciation of music, literature and the Arts shared by Welsh people. Famous sons (and daughters) of Wales include Dylan Thomas, Richard Burton, Tom Jones and Shirley Bassey and throughout history many famous Welshmen and Welshwomen have helped shape the development of the Americas and emerging countries.

The Urban areas also have busy shopping centres that cater for all tastes and pockets and the night life – whether in the vast choice of restaurants of all culinary styles or in the friendly village pubs is there for all to enjoy and relax in.

In Wales we are also proud of the education that we provide for our children. We have a strong ethos of Life-long Learning and share our education facilities with many over-seas students. Our Universities are at the cutting edge of Research and Development, particularly in the Sciences and especially in Medicine.

Wales has its own unique culture and Celtic language, which although only spoken by 20% of the population, is enjoying a steady growth and is evident throughout Wales in the bi-lingual road signs and literature. This strong sense of culture helps the Welsh people to empathise with the cultures of other nations – illustrated by the International Eisteddfod held annually at Llangollen in North Wales since the Second World War to celebrate and promote understanding between nations of the World. Our Cities (Cardiff in particular) have a strong cosmopolitan flavour and are home to a myriad of ethnic cultures.

Did I mention Sport? The Welsh are renowned for their love of Rugby – but soccer also enjoys a wide following in Wales with highly enthusiastic teams representing their cities, towns, villages and schools. In fact, whatever your sporting interests you will not find it difficult to follow them in Wales.

Perhaps the thing that I love most about Wales is the people – the community spirit, the strong work ethic and the sense of “chwarae teg” (fair play) that is inherent in our culture makes me realise how lucky that I am to live and work in Wales, with the people’s sense of humour, willingness to communicate and their need to work as part of a cohesive team – working in Wales has much to recommend it – indeed, there has been an increasing inward trend for workers from outside Wales since the 1970s.

As a place to live and work I believe that Wales has a tremendous amount to offer – the beauty of its landscape, the entertainment in the towns and cities, the education and training opportunities available, the fascinating culture and history of the country and the warmth of its people make it a place that many want to come to but few want to leave.

Wales has a lot to offer everyone.

Monday, 19 April 2010

1,000 Lives Campaign

This week, the 1,000 Lives Campaign which was designed to improve patient saftey in the NHS in Wales comes to an end. Here is an article which I wrote for the Western Mail about the campaign.

Patient safety is the highest priority for anyone working on the frontline in NHS Wales and it’s making a real difference in primary care.

That’s why the British Medical Association strongly supports the 1000 Lives Campaign and works hard to highlight those areas of patient safety and care that are important to our members.

For doctors, safety and quality go hand in hand, and the Campaign has created a focus around which those can be considered every day, in every patient contact, by health professionals and managers alike.

As we come to the final months of this two year campaign, we are pleased to see how much progress has been made across Wales.

When the initiative was launched in April 2008, it was the first time that primary care had been included in a similar patient safety campaign anywhere in the world.

Wales has led the way and our members have contributed in many of the Campaign’s areas, including improving leadership, medicines management and general medical care.

We have seen the impact made by establishing patient safety WalkRounds and culture surveys which have empowered our members to talk about their concerns and hopes for improvement.

Again Wales has led the way in this area, becoming the first country to arrange a safety culture survey for its general medical primary care services at a national level.

And the response from our members have been extremely positive with over 60 per cent of GP practices taking part.

The results have been helpful in identifying aspects of care working well, but also raised areas where there is scope for improvement.

BMA Cymru supports a healthcare service that listens to the concerns of doctors, acts on those concerns to improve safety and quality of care, and in which health professionals are not afraid to speak out.

Last year we published the ‘Speaking up for Patients’ report based on survey responses from 565 doctors working in England and Wales.

Almost three quarters (74%) said they had concerns about issues relating to patient safety over the course of their career.

Within in this group, 73% said their concerns related to standards of care.

Seven in ten doctors said they had raised their concerns but were not always satisfied with the response.

Often they were not asked for further information or made aware if any action was taken to improve the issue.

WalkRounds and culture surveys have the potential to examine and improve patient safety issues across the whole patient pathway.

Other areas that have helped to improve patient care are in medicines management and work to improve the quality of life for chronic heart failure patients.

More than 80 GP practices are working with Health Boards to reduce, where possible, the number of unnecessary hospital admissions for patients with chronic heart failure.

The promotion of evidence-based procedures such as timely and accurate diagnosis, medication therapy, and lifestyle advice could make a significant impact on the disease process.

GPs are also currently carrying out detailed work to improve the reliability of instructions given to patients about their medication.

We have already seen the difference this has made for patients who take Warfarin and we are looking at other areas including diabetes.

The development of the primary care trigger tool to measure improvements is also being embraced by members.

We know that all our GP practices are continually making changes to ensure the care they deliver to their patients is the best possible.

But now, thanks to the trigger tool they will be able to actually measure those improvements, see how they are working and if they are making a difference.

One of the fundamental features of the new tool is looking at harm caused by failure to recognise or adequately manage a new presentation of an acute illness.

If a patient’s problem does not respond to treatment or they develop an adverse reaction, they are likely to make another appointment.

It is these unscheduled reattendances that can act as triggers of possible harm.

We are proud to see the progress made through the 1000 Lives Campaign, and that doctors across Wales are playing their full part in it.

BMA Cymru will continue to support the Campaign and to highlight those areas of healthcare over which our members have concerns – so that patients can look forward to even safer services in Wales.

What are your views on the 1,000 Lives Campaign?

Wednesday, 14 April 2010

“Wales may be a small country but it has a lot going for it” – Christine Chapman AM


How we get the next generation of Doctors to train in Wales continues to be a major issue and one which is not new for the BMA.

Representing an area which has traditionally suffered from high levels of health inequalities, over the last ten years I do think that we can talk up the achievements that have been made in Cynon Valley. We’ve got more salaried GP’s than ever which has helped to solve the recruitment problem we once had, new, modernised surgeries are clearly visible and in Spring 2011 the new Community Hospital in Mountain Ash will open its doors.

Across Wales, there is a choice of high quality facilities which provide first class training and education. But while clinical experience is very important, so too is the life experience.

I do think that what is attractive to those who have studied in England, particularly in the big cities such as London, is the quality of life on offer in Wales. Whether you are looking to continue with the city life or a more rural environment, Wales has much to offer. Generally house prices are lower and everyday living costs are more reasonable. In my own area, the Valleys have great opportunities for outdoor recreation, cycle trails, quad biking, mountain climbing and also its close proximity to Cardiff. Wales may be a small country but it has a lot going for it.

Christine Chapman AM Cynon Valley
Labour