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.

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.

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.

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.