Clare Gerada: influence on UK medical practice and ME/CFS management

One feels obliged to enquire whether the terms of reference will extend to complaints brought against doctors, possibly frivolously, by their colleagues.

I remembered that the term to describe Gerarda's position is "parti pris".

EDIT. OK, I know its about gross negligence, and not professional sensibilities.
 
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Luther Blissett said:
There are big risks to complaining.

  • Future discrimination
  • Psychological results if a just complaint is rejected unjustly
  • Psychological results of powerful people treating a factual recounting as fantasy
  • Allegations of being a serial complainer
  • Use of past allegations used against complainer
  • Psychological results of complaint(s) being used to try to discredit complainer as pathological
  • etc
I'll re-frame her comment in a different context. Imagine a complaint of sexual harassment at work against a manager.

"It’s easy to complain. No risk to complainant . Sadly they kill managers"

If that were still her view then I won't say what I think of her.
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exactly LB and the same applies to a complaint of child abuse for example - would she propose dealing with children as she sees as appropriate for patients
 
large donner said:
I don't know about the case that lead to this but her hastag "complaints kill" is just bizarre. Who died and why?
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I'm guessing some doctors subject to complaints have committed suicide, which is tragic, but not a reason to stop patients being able to complain. It may be a good reason to provide more support to doctors going through the complaints procedure, and speeding it up.
 
large donner said:
I don't know about the case that lead to this but her hastag "complaints kill" is just bizarre. Who died and why?
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Judging by her tone, it seems every doctor, everywhere, who has ever had a complaint made against them, has died, as a direct result of the complaint.

This strikes me as a little unlikely, but in the event it is not, do we really want such unstable people in healthcare?
 
Invisible Woman said:
I understand doctors are human and make mistakes. If they were more open and honest with patients and had a more equal relationship they would probably find patients don't want doctors scapegoated or punished unfairly.
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Quite so....I remember many years ago an interview on the radio with a top US heart surgeon and he said he'd avoided lots of litigation by being honest and up front when he, or a member of his team were in error.

If anything went wrong, they'd right away admit it and explain why eg complications that were unforeseen or human error which should have been avoided etc and by so doing they found that issues could be dealt with quickly and in a fair and decent manner for all concerned.
 
Daisybell said:
Doctors kill far more patients than the other way around - and I’m sure that is true if one crunched the numbers to get to be able to make a direct comparison.... obviously it’s just that doctors are more important than patients.
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Exactly, just how many ME patients have committed suicide or died after brutal incompetent treatment from doctors and the DWP etc.
 
Two well-known healthcare figures have been hired as co-chairs of a new “NHS assembly”, whose role is to “advise the joint boards of NHS England and NHS Improvement on delivery of the NHS long-term plan”.

The co-chairs are Clare Gerada, the prominent GP and one of the earliest and most vociferous critics of the Lansley NHS reforms of 2010-13, and Sir Chris Ham, who stepped down as King’s Fund chief executive at the beginning of the year and was one of the first champions of developing integrated care over competition in the NHS.

Sir Chris said: “I’m delighted to be working with Clare Gerada in chairing the assembly which will have a key role in implementing the long-term plan. We will support and challenge national bodies, the NHS and its partners to ensure the plan delivers improvements in health and care.”
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https://www.hsj.co.uk/policy-and-re...-england/7024527.article#.XHftPEE0WFw.twitter
 
The live link I was watching said that Clair was looking forward to working closely with patients. At which point I spat out my coffee and still have not recovered. Chris is part of the Kings Fund I think they said he was giving up his chair to be part of this :coffee::coffee::coffee::coffee:
 
And the Kings Fund have decided MUS is a top 10 priority for integrating mental and physical health:

https://www.kingsfund.org.uk/publications/physical-and-mental-health/priorities-for-integrating

Priority 3: Improving management of medically unexplained symptoms in primary care
The problem
Medically unexplained symptoms are physical symptoms that lack an identifiable organic cause. They can include musculoskeletal pain, persistent headache, chronic tiredness, chest pain, heart palpitations and gastric symptoms. These symptoms are highly common and have a major impact both on the people experiencing them and on the health system. There is often no clear referral pathway for medically unexplained symptoms, and as a result patients are repeatedly investigated, which can cause significant harm and contribute to excess health care costs. Patients with medically unexplained symptoms are particularly common in primary care, yet most GPs receive no specific training in managing these symptoms and may lack confidence in exploring the psychological issues potentially involved. Identifying and managing medically unexplained symptoms can be highly challenging, not least because failing to identify a condition that has a straightforward medical cause can also have serious consequences.

Impact on people
Poor management of medically unexplained symptoms can have a profound effect on quality of life. People with such symptoms often experience high levels of psychological distress as well as co-morbid mental health problems, which can further exacerbate their medical symptoms. More than 40 per cent of outpatients with medically unexplained symptoms also have an anxiety or depressive disorder. Chronic pain can worsen depressive symptoms and is a risk factor for suicide in people who are depressed. Impact on the health system Patients with medically unexplained symptoms account for an estimated 15 to 30 per cent of all primary care consultations and GPs report that these can be among the most challenging consultations they provide. Medically unexplained symptoms also account for a significant proportion of outpatient appointments – in one study, accounting for more than 20 per cent of all outpatient activity among frequent attenders. In primary care, some of the biggest challenges are related to patients with a mixture of medically unexplained symptoms and poor adjustment to a long-term physical health condition, leading to disproportionate symptoms and medication use for the long-term condition. The annual health care costs of medically unexplained symptoms in England were estimated to be £3 billion in 2008/9, with total societal costs of around £18 billion.

What would a more integrated approach look like?
The needs of people with medically unexplained symptoms vary enormously, and evidence suggests that biopsychosocial management delivered within a stepped care framework can be an effective approach for some people. GPs have an important role to play in this, identifying people affected, exploring relevant psychosocial factors, and doing so in a way that acknowledges physical symptoms as real. Where symptoms are mild, sensitive handling and watchful waiting by the GP may be sufficient. People with moderate needs would receive appropriate psychological interventions and other support as necessary. Those with the most complex needs would be considered for referral to a dedicated service for medically unexplained symptoms with specialist mental health input using a collaborative care approach including joint case management with GPs. Where a referral for psychological intervention is made, GPs need to be able to discuss this with patients in a way that avoids implying that their symptoms are ‘all in the mind’.
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