Issue 22 by CloserStill Media

Meet the 2019 speakers

Traditional acute medical care not suitable for all patients

How Croydon achieved a 30% reduction in inpatient falls

Expert tips for treating heart failure

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SEE PAGE 5

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NEW FOR 2019! Incorporating:

12-13 NOVEMBER 2019, EXCEL LONDON

www.agmconference.co.uk • www.hospitaldr.co.uk

February 2019 • Issue 22

New approach to Medical Registrar training in order to alleviate staff shortages Last month, a new flexible portfolio training (FPT) pilot scheme was launched with the aim of attracting doctors into hard to recruit posts. The pilot scheme, developed by the Royal College of Physicians and Health Education England, is aimed at juniors who will train in general internal medicine alongside their chosen specialty, such as acute medicine or geriatrics. Being a Medical Registrar is a demanding role, with responsibility for managing acutely ill patients – often out-of-hours. The FPT pilot is intended to offer more work-life balance to Med Regs, by allowing them to spend one day a week in a non-clinical setting.

GUEST EDITOR

This day a week can be spent in four different ways – medical education, quality improvement, research or clinical informatics. Continued on page 10 

More General Medicine on the agenda with launch of IMT programme

EARLY BIRD READER EXTENSION: 8TH MARCH We have given you an extra week to secure your early bird pass to Acute & General Medicine for just £199+VAT before rate increase to £249+VAT after 8th March. Book you and your colleague’s ticket today: Go online and use discount code EBNEWS: www.agmconference.co.uk/FEB Call our dedicated delegate relationship manager, Marlon on 0207 348 1851 For group bookings there are further discounts, please email training@closerstillmedia.com

2019 is a significant year for Advanced Internal Medicine in the NHS. This year sees the introduction of Internal Medicine Training (IMT) programme for juniors. In response to the recommendations set out in the Shape of Training Report, and the realisation that the NHS needs more generalists to deal with the growing demographic pressures, a new model for future physician training has been developed. Internal Medicine Training (IMT) will form the first three years of post-foundation training and, for the main specialties

supporting acute hospital care, an indicative 12 months of further internal medicine training will be integrated flexibly with specialty training in a dual programme. It replaces the two-year Core Medical Training (CMT) programme from August 2019. Continued on page 2 

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Contents Meet the 2019 speakers

The new conference for anaesthetists and intensivists

Traditional acute medical care not suitable for all patients

How Croydon achieved a 30% reduction in inpatient falls

Expert tips for treating heart failure

Sponsorship Statement AGM is for healthcare professionals only. The seminars at AGM have been brought to you by CloserStill Media in association with our partners and sponsors. The views and opinions of the speakers are not necessarily those of Closer2Medical or of our partners and sponsors.AGM’s association partners have helped develop the programme. Sponsors have not had any input into the programme except where an individual session states it is sponsored. The session topic and speaker have been developed by each sponsoring company.

EARLY BIRD READER EXTENSION: 8TH MARCH We have given you an extra week to secure your early bird pass to Acute & General Medicine for just £199+VAT before rate increase to £249+VAT after 8th March using discount code EBNEWS. To book or join the conference programme waiting list email: training@closerstillmedia.com or call 0207 348 1851.

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More General Medicine on the agenda with launch of IMT programme  Continued from page 1 The Joint Royal Colleges of Physicians Training Board, which has developed the IMT programme, says this will ensure that CCT holders are competent to practise independently at consultant level in both their specialty and advanced internal medicine.

There are specialties that will only require 2 years of IMT before progression. These include: • Allergy • Audio-vestibular Medicine

This model will enhance the training in internal medicine and will prepare doctors for the management of the acutely unwell patient, with an increased focus on chronic disease management, comorbidity and complexity. The JRCPT says generic professional capabilities as set out in the GMC's framework will be embedded in all curricula to emphasise the importance of these professional qualities as well as helping to promote flexibility in postgraduate training.

Experience in intensive care medicine, geriatric medicine and outpatients will be mandated and trainees will receive simulation training throughout the programme. Holistic decisions on progress will be made for the fourteen high level capabilities in practice (CiPs) using the professional judgement of appropriately trained, expert assessors. This represents a significant move away from the much criticised ‘tick box’ approach of previous curricula, says the JRCPT. •

Why not invite your juniors to attend Acute & General Medicine Conference 2019? There’s no better training event in the calendar to prepare them for their new IMT programme and working as a Med Reg.

• For more on IMT visit the JRCPTB website www.jrcptb. org.uk/imt

• Nuclear Medicine

• Aviation & Space Medicine

• Paediatric Cardiology

• Clinical Genetics

• Pharmaceutical Medicine

• Clinical Neurophysiology • Dermatology • Immunology

IMT will be a three-year programme which will prepare doctors to become a medical registrar and provide them with the skills needed to manage patients presenting with a wide range of general medical symptoms and conditions.

• Medical Ophthalmology

•

Infectious Diseases (when dual with Medical Microbiology or Virology)

• Rehabilitation Medicine • Sport and Exercise Medicine

How will IMT differ from CMT? • IMT will deliver a training programme which enhances morale, values doctors in training and is ultimately better for patients • The 3 years of IMT is intended to equip doctors to lead with confidence the care of general ward and acute take patients • The length of the programme will better prepare trainees, providing supported progression for the medical registrar role • This is not just CMT plus one year. This is a completely reformed programme and represents a new era in physician training • It is hoped that more people training in Internal Medicine and the physician specialties will reduce rota gaps

The following specialties will require completion of a full 3-year IMT for juniors to progress:

• There will be wider exposure to medical specialties including dedicated experience in ICU

• Acute Internal Medicine

• It will provide improved access to outpatient experience

• Cardiology • Clinical Pharmacology and Therapeutics • Endocrinology and Diabetes Mellitus

• Infectious Diseases (except when dual with Medical Microbiology or Virology) • Neurology • Palliative Medicine • Renal Medicine

• Geriatric Medicine

• Respiratory Medicine

• Gastroenterology

• Rheumatology

• Genitourinary Medicine

• Trainees will be supported though a three-year programme as they progress through the MRCP Exam • There will be graded and supported increase in responsibility across the 3 years of the programme •

The JRCPTB will ensure that Educational Supervisors have access to a training package that will enable them to successfully provide strengthened and focused support alongside the assessment of the new Generic Professional Capabilities

•

A new assessment system will be in place to ensure that IMT trainees are assessed in both formative and summative ways, reducing the concerns about tick-box assessments

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Meet some of the expert Acute & General Medicine speakers:

Dr Simon Fynn Consultant Cardiologist Papworth Hospital

Prof Adam Timmis Professor of Clinical Cardiology The William Harvey Research Institute, Barts and The London NHS Trust

Dr Jonathan Behar Post CCT fellow in Cardiac Electrophysiology and Complex Devices Barts Health NHS Trust

Dr Sophie Farooque Consultant in Allergy Imperial College Healthcare NHS Trust

Dr Jon Wort Consultant in Pulmonary Hypertension and Intensive Care Medicine Royal Brompton and Harefield NHS Foundation Trust

Prof Morris Brown Professor of Endocrine Hypertension The William Harvey Research Institute, Barts and The London NHS Trust

Prof Emma Baker Professor of Clinical Pharmacology St George’s Hospital

Prof Andrew Menzies-Gow Consultant in respiratory medicine, director of the lung division Royal Brompton Hospital

Dr Resham Baruah Consultant cardiologist Chelsea and Westminster and the Royal Brompton and Harefield NHS Trusts

Dr Manjit Matharu Consultant Neurologist The National Hospital for Neurology and Neurosurgery and is Clinical Lead of the Heacache Group

Dr Sean Preston Consultant Gastroenterologist, Director of Endoscopy Barts and The London NHS Trust

THE FULL SPEAKER LINE-UP WILL BE REVEALED SOON!

NEW 2019 SPEAKERS INCLUDE: Dr Daniel Burrage; ST7 and Honorary Senior Lecturer in Clinical Pharmacology; St George’s Hospital

Dr Chris Laing; Consultant Nephrologist; UCL Hospitals

Dr Nik Sabarwal; Consultant Cardiologist; Oxford University Hospitals NHS Foundation Trust

Prof Tahir Masud; Consultant Physician; Nottingham University Hospitals NHS Trust, and President of the British Geriatrics Association

Dr Diego Kaski; Consultant Neurologist; The University College London Hospital and the National Hospital for Neurology and Neurosurgery

Dr Robin Fackrell; Consultant Physician & Specialist in Parkinson’s Disease and Related Disorders; Royal United Hospitals’ Bath NHS Foundation Trust

Prof Tim Briggs; Consultant Orthopaedic Surgeon & Director of Strategy and External Affairs; Royal National Orthopaedic Hospital NHS Trust, and Chair of GIRFT

Dr Rachel Limbrey; Consultant in respiratory medicine; University Hospital Southampton NHS Foundation Trust

Prof Opinder Sahota; Professor in Orthogeriatric Medicine & Consultant Physician; QMC Nottingham University Hospitals NHS Trust

Dr Pasupathy Sivasothy; Consultant in Respiratory Vasculitis and Acute Medicine; Addenbrooke’s Hospital Dr Linda Dykes; GPwER in Ambulatory Care & Consultant in Emergency Medicine; Ysbyty Gwynedd

EARLY BIRD READER EXTENSION: 8TH MARCH. We have given you an extra week to secure your early bird pass to Acute & General Medicine for just £199+VAT before rate increase to £249+VAT after 8th March using discount code EBNEWS. To book or join the conference programme waiting list email: training@closerstillmedia.com or call 0207 348 1851.

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THE NEW CONFERENCE FOR ANAESTHETISTS AND INTENSIVISTS

Share me with your anaesthetic department

The Anaesthesia & Critical Care conference is a new two-day conference dedicated to the vital role Anaesthetist and Critical care consultants perform as the perioperative physician to the surgical patient.

Created to provide the specialty with a high quality education accredited for 12 CPD points by the RCoA* over two days, the event is the most cost-effective conference of its kind. This conference is aimed at consultants, senior trainees and staff grades General Anaesthesia and Critical Care.

Please note: If you wish to access the Acute & General conference you will need to purchase a ticket for that conference which will also give you access to the Anaesthesia & Critical Care conference. Delegates can combine both seminar-based learning with hands-on training across a range of practical workshops. Anaesthesia & Critical Care conference will include hands on training focussed on: ltrasound for regional anaesthesia U peripheral nerve blocks and increasingly for spinals/epidurals in the obese Rapid Ultrasound for Shock and Hypotension

irway workshops - fibre optic intubation, A the use for high flow nasal oxygen therapy for supporting difficult intubation, airway exchange catheters, US for emergency front of neck access Individualised lung ventilation

Monitoring the critically ill patient Non Invasive Ventilation Temperature Management Tracheostomy Management Inotropes and Vasopressors

Preview of the Anaesthetist side of the conference programme:

Preview of the Critical Care side of the conference programme

Peri-operative medicine:

Challenging presentations:

Cardiopulmonary exercise testing and pre-habilitation

Early identification of the deteriorating patient

Principles of enhanced recovery pathways

Sepsis: the latest

Peri-operative management of diabetes

Heart Failure in ICU

Management of anaemia/patient blood management

Head Injury in ICU / Neurological Emergencies

Assessment and impact of frailty

Kidney Injury in ICU / Acute Renal Failure

Risk stratification

Optimising Care for the High Risk Surgical Patient

Sub-specialty updates Paediatrics Obstetrics

Paediatric issues for adult intensivists Acute Respiratory Distress Syndrome (ARDS): an update

Managing ICU

ICM

What is ‘critically ill’? Who should be on ICU?

Vascular

Effective discharge

Management of the head injured patient

Human factors

Hot topics: Acute pain and opioids – are opioids friend or foe?

Leadership and communication Lessons from ICNARC

Trauma management – lessons from the military Regional anaesthesia update Managing Anaphylaxis

Co-located with

Organised by

*CPD applied for.

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PLANNING A RENUNION? Doctors attend Acute & General Medicine in their thousands not only for the world-class training but to meet up with colleagues and peers old and new. Make Acute & General Medicine even more memorable this year by planning a reunion with old colleagues or university medical peers. How can we help? We can arrange group discounts for six more doctors who would like to plan a reunion and attend Acute & General Medicine. Our Delegate Relationship Manager can help you find discounted accommodation and take the stress away from coordinating your reunion.

Group bookings of ten of more will receive a £200* tab at a restaurant or bar near the ExCeL to help you kick start your reunion in the best way!

Contact us today for more information by emailing training@closerstillmedia.com and we can work with you to make it a reunion to remember! Events is our thing! Did you know we can also help you organise larger Alumni events too – call 0207 348 5271 to find out more.

*This is a limited opportunity and will be granted on a first come first serve basis.

Many acutely ill patients are better served with ambulatory care rather than being admitted to hospital, Dr Clarissa Murdoch, Consultant in Care of Older People and Acute Medicine, told AGM 2018.

Talking about why she set up an ambulatory care unit six years ago at the Whittington Health NHS Trust, she said. “I recognised that a lot of harm that was being done to our patients and on a humanitarian basis a lot of my patients generally would prefer to be at home. Traditional acute medical care doesn’t necessarily suit everyone,” she said.

Dr Murdoch’s unit sees an average of 65 new patients with a full range of medical conditions a week. Patients are also looked after in their own homes with a virtual ward team. Dr Murdoch’s top tips for running an ambulatory care unit: • Understand and address risk – you need to be able to talk about it in a more dedicated way than on the acute medicine unit or a geriatric ward.

@AGMConfUK /AGMConference Acute & General Medicine

•

Senior gatekeeping – Dr Murdoch spends most of the day on the phone in the ambulatory care unit talking to GPs or face-to-face with the emergency department and is bleeped constantly by specialist colleagues. From time to time the team stops to take stock of what is happening with the caseload. This enables Dr Murdoch to supervise the patients that are going through the unit. “This is a very efficient service with patients receiving consultant supervised care regularly during the day,” she said.

• Good relationships with specialty teams are key. •

Celebrate the unique training environment – training junior doctors in ambulatory care enables them to understand risk in a different way and appreciate that some patients will get better in their own bed and which is what most people want

• Build a bespoke unit that is well designed and a pleasure to work in. •

Work in an integrated care organisation - the benefits of knowing healthcare professionals in the community respiratory team, the palliative care team and the district nurse leads on first name terms is really important and means you can discharge people with much more security.

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European Acute Care Conference held for the first time at Acute & General Medicine The European Acute Care Conference (EACC) was held for the first time at AGM 2018 attracting international delegates from around the world. The EACC talks covered both acute medicine topics such as haematological emergencies, difficult ECGs in the emergency department and management of pneumothorax and surgical subjects such as surgical management of inflammatory bowel disease complications.

“The conference programme focused on physicians and surgeons working collaboratively in the acute setting. It is very important for them to work together on the front line so they have a better understanding of how to diagnose something in an accurate and timely manner and then refer to the appropriate specialist. It is important to empower staff in the acute hospital to work more holistically and in a more effective way to give patients high quality and safe care,” said conference organiser Dr Evangelos Vasileiades, Consultant Stroke Lead, Assistant Clinical Director Non-acute Medicine Hillingdon Hospital NHS Foundation Trust.

“Our aim is to offer condensed and compact talks which give delegates tips and personal experience from experienced speakers on how to be more vigilant and how to identify problems they possibly they weren’t aware of before,” says Dr Vasileiades. The EACC conference is relevant for doctors from all countries and offers them a great opportunity to not

only keep up to date in a short time frame but also to network with international colleagues.

“We will return at AGM 2019. We have partnered with AGM because they provide a great venue in London with excellent catering, offer high quality medical talks and are very supportive.”

Co-organiser Dr Cristiana Coneru, Emergency Medicine Physician, Northwick Park Hospital, said: “The EACC talks are all based on the latest research data and are pitched just above the generalist level. So each year if we repeat a topic it will be from a different perspective and it will bring something new so that delegates are learning something rather than simply refreshing their knowledge.”

How Croydon achieved a 30% reduction in inpatient falls Changing the culture and behaviour of nursing and medical staff to reduce inpatient falls takes time but is achievable, Dr Wallace Tan, Consultant Geriatrician and Chair of the Falls Group at Croydon University Hospital NHS Trust, told AGM 2018. In Croydon a 30% reduction in falls was achieved in three years, reversing a falls rate that had been going up over the previous ten years. Falls are the most commonly reported adverse event in hospital costing £15m per year, 2500 hip fractures and causing a loss of confidence and general function in the patient. Dr Tan said in-depth investigation and root cause analysis of falls provided considerable insight into how falls could be prevented. This showed that recurrent falls did not necessarily indicate a lack of care. But it flagged up that the dementia care plan was not integrated into the falls care plan and there was often a delay in diagnosing neck of femur fractures. Falls champions such as healthcare assistants, physiotherapists and housekeepers were appointed to take the lead on raising awareness in the ward, identify high risk fallers and conduct daily inspections of walking aids and call bells. “Falls champions are very helpful, they spend time with the patients help us

to identify problems and that lot of them take these roles very seriously,” he said. Bi-weekly multidisciplinary team falls ward rounds were able to identify patients on the Datix system over seven days and were able to put in place action plans for individual patients which were re-checked every few days. To help with mapping of when patients fell the Datix forms were redesigned with additional questions added to provide useful data and analysis. Other successful initiatives included the introduction of a Baywatch card to prevent falls adopted by all staff visiting the ward including the Chief Executive and cleaning staff and changes to the layout of the ward to fit in with patients’ homes. The most innovative idea was asking patients on admission which side of the bed they get in and out of at home so that all equipment including walking aids, bedside tables and chairs could then be placed on that side.

Dr Wallace Tan, Chair of Falls Group; Consultant Geriatrician, Croydon University Hospital NHS Trust

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Expert tips for treating heart failure Organisation of care of acute heart failure is hugely important to ensure that patients do not keep returning to hospital, Professor Andrew Clark, told AGM 2018. Chair of Clinical Cardiology and Honorary Consultant Cardiologist at Castle Hill Hospital, University of Hull, Professor Clark, said it was important that patients being admitted with suspected heart failure were treated by a specialist team. But he said NICE guidance which recommends that a follow up assessment should be undertaken by a

member of the specialist heart failure team within two weeks of the patient being discharged from hospital, was unachievable. “There is no way on earth on earth that I can manage this so it’s going to take a radical reappraisal of how we manage heart failure to achieve these sorts of targets,” he said.

Key points for treating heart failure: •

The reason for most admissions for heart failure is fluid retention, it is more common than pulmonary oedema. The more fluid retention a patient has at the time of the admission, the worse their prognosis.

•

Treat the patient in front of you not the blood test result. Don’t worry about the kidneys, if the patient has gross fluid retention, you need to treat the fluid retention. In the congested patient, congestion is the problem.

•

Low doses of frusemide given by mouth don’t work. Start with 10 mg an hour intravenous infusion to induce a large diuresis. You can reduce the dose if the patient responds quickly.

• Don’t worry about restricting dietary salt when the patient has fluid retention, it makes no difference and only makes the patient unhappy •

Once a patient has had an admission for heart failure their prognosis is gloomy - at least 10% of patients die during their acute admission and 25% will die in the first year after an admission.

•

When a patient is admitted for acute heart failure, think about your links to palliative and community care. You need to have frank discussions with the patient about what the consequences of an admission with acute heart failure might be and you need to start planning for the future.

Prof Andrew Clark, Chair of Clinical Cardiology and Honorary Consultant Cardiologist at Castle Hill Hospital

How to improve quality in difficult times Think about quality in terms of the whole pathway of patient care rather than compartmentalising it within organisations, Professor Stephen Powis, Medical Director, NHS England, told Acute and General Medicine 2018. “The NHS Long Term Plan sets out a direction of travel of moving towards integrated care systems and collaboration. So for the future we will be moving away from competition between organisations and much more towards working together in the interests of our local population,” he said. Speaking in a debate on improving quality in the NHS, he explained that this meant that the quality of care in A&E and acute medicine would be dependent on what happens in social care and the 111 service. Prof Emma Baker, Professor of Clinical Pharmacology, St George’s, University of London, who chaired the debate, said: “It is very important as we enter this new difficult time with the NHS £1 billion in deficit, rota gaps and understaffing that we look at the quality agenda and don’t let Mid Staffs happen again.”

Professor Powis said quality improved when there was a culture of clinicians and managers working together in the best interests of patients by for example learning from the deaths and serious incidents that occurred in hospitals. Prof Ted Baker, Chief Inspector of Hospitals at the Care Quality Commission, said trusts improved when they faced up to their problems, had a values driven and collaborative leadership that engaged with staff and drove cultural change and continuous quality improvement.

“In our CQC inspections we see more and more examples of trusts making quality improvements. I’m an optimist about the future but to achieve improvement we’ve got to start from the position of honesty about what the problems are.” Katherine Henderson Clinical Lead, Emergency Department, St Thomas’ Hospital and Chair of the Royal College of Emergency Medicine Regional Board, said

Prof Stephen Powis, Medical Director, NHS England emergency care had been transformed in the last 20 years through investment in A&E departments and staffing. But she said the ever increasing volume and complexity of patients coming through the door was a concern. “In the next couple of years we need to make sure that we can provide the right care for those patients rather than feeling that we are always on a treadmill just trying to get these people through the system,” she warned.

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AGM CONFE “It’s my second time at AGM; I came back for the broad spectrum of sessions, there have been some eye-opening talks this year. The speakers have been fantastic and very interactive with the audience. There’s an excellent range of exhibitors which I enjoy seeing and are very interesting. I always recommend AGM to my colleagues and I will be back next year.” Dr Tunde Nejo, Physiatrist Consultant, Locum

“The talks have been interesting and I will be looking forward to seeing the presentations and slides online after the conference. It has also been useful for me to visit the advanced life skills area for hands on training – I haven’t done that sort of thing for such a long time. It will help me to explain to my patients what’s happening to them.” Dr Werner Hiersche

“I am a junior trainee in an acute hospital, and to be able to get two days of study leave to come to the AGM conference and get updates in a broad range of acute specialties from speakers who are at the top of their field has been really useful.” Alex Stilwell, SHO, Conquest Hospital Hastings

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ERENCE 2018 “I enjoyed my time at AGM 2013. It was very informative, educational and provided a platform to interact with other physicians. The venue was very easily accessible and convenient. I also attended a few sessions in Hospital Directions and they were very interesting. Overall it was very good experience and value for money. I would recommend this to all my junior colleagues.” Dr Srujan Ardhalapudi, Consultant Physician

“One thing I really like is the ability to create your own programme – to be able to pick and choose which seminars to attend. Also the exhibition has a much broader range of stands to most medical conferences. The cost per CPD point is probably one of the cheapest in the country.” Dr Gavin Francis, Arrowe Park Hospital

“Getting a good update on a lot of common acute problems. The timing is good, 35 minutes helps the speakers be pithy and concise. At other events they can lack focus. I have picked up something useful from each of the sessions I’ve been to – this has been a good investment of my time and very worthwhile.” Dr Carl Brooks, Hampshire NHS

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Critical UK healthcare topics of 2018 – Doctors’ viewpoints In this summary, we have collated the insights into our members’ views on the most important events and issues throughout 2018.

Doctors.net.uk has over 230,000 GMC registered members, and is the largest online doctor community in the UK. Our website is independent and closed to members, so doctors can express their views on issues and events that are important to them. In 2018 65 polls were sent to our members. Some of these results have been collated into Critical UK healthcare topics of 2018 – Doctors’ viewpoints. Here is an overview of what was most discussed last year.

to be at busting point. Elective surgeries were cancelled and medical students asked to volunteer to help ease the pressure. The number of vacant posts in the NHS also increased, in September 87% of members agreed that the number of posts in the NHS was a national emergency.

Dr Bawa-Garba and the GMC: what have we learned? We asked if our members thought the case of Dr Bawa-Garba would be likely to make them less open when reviewing mistakes made during their clinical practice.

92%

YES

40%

AGREE

50%

DISAGREE

The number of vacant posts in the NHS is a national emergency.

10%

UNSURE

87%

AGREE DISAGREE

13% n=607

n=590

Are you aware of the warning signs of burnout in colleagues? agues?

(n=370)

Over 82% said Yes (n=370)

40% of responden respondents

said they wouldn’t recognise sig signs of burnout in colleagues. (n=296)

We asked members if their work environment encouraged meaningful learning from clinical errors and near misses?

Doctors’ working environments – what is it really like?

27%

YES

The case of Dr Hadiza Bawa-Garba has resonated with our members. The intricate details of the case, the proceedings and finally the court hearing, were all discussed within our news stories and forum. 92% of members said the case would be likely to make them less open when reviewing mistakes during their clinical practice.

As the key clinical decision makers in healthcare delivery, doctors are frequently faced with dilemmas and challenges which test their professionalism to the limit. Our collection of themes from 2018 provides a glimpse of the passion and pace of debate across a range of topical issues.

55%

NO UNSURE

18% n=650

In September 2018, we asked about the impact of the number of vacant posts in the NHS.

Do you think there is a stigma a attached s seeking to healthcare professionals alth issues? treatment for mental health

Over 82% s said Yes

Dr Bawa-Garba and the GMC: what have we learned?

A winter crisis UK hospitals should routinely reduce the volume of elective work scheduled for January to enable them to accommodate the expected surge in emergency admissions.

Do you think pressure at work is affecting your health?

Stressful working environments, mental health support and financial hardship are all issues faced by UK doctors and are often communicated in our forum. Over 82% of our members think pressure at work is affecting their health.

n=977

At the start of 2018 the UK faced its toughest winter to date, during which pressure on the health service seemed to be at bursting point.

Doctors’ working environments what is it really like?

A winter crisis At the start of 2018 the UK faced its toughest winter to date, during which pressure on the health service seemed

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FOLLOW US New approach to Medical ON SOCIAL Registrar training in order MEDIA FOR to alleviate staff shortages THE LATEST UPDATES  Continued from page 1

The scheme is being offered for a range of medical specialties and areas that are currently struggling to recruit doctors.

The RCP analysed why certain regions and specialties struggled to fill vacancies, and the feedback focused on the pressure of being a medical registrar.

So, for example, in Yorkshire and Humberside 15 FPT posts are being offered in Endocrinology and Diabetes and Acute Medicine.

The scheme is supported by Health Education England, which has a programme of enhancing junior doctors’ lives. There will be between 65-70 FPT posts offered nationally around England.

In the South West, 8 trainee posts are available in Geriatrics, Respiratory, Endocrinology and Diabetes and Acute Medicine. Other shortage specialties in other regions include Clinical Pharmacology, Infectious Diseases, and Renal Medicine.

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Each post will operate as a normal national training number and trusts will not receive any additional funding for taking on FPT trainees.

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Clinical & Medical Affairs – EZ-IO ® & Airway Cadaver Procedural Laboratory Invitation

Arrow EZ-IO ® & Airway Cadaveric Procedural Lab Program Offered at different dedicated locations, the procedural lab program is designed to provide the unique opportunity for healthcare providers to understand and practice EZ-IO ® & airway procedures using cadaveric specimens in a safe & realistic environment.

These programs help overcome apprehension and build confidence, and can be incredibly impactful in changing practice. Attendees will enhance their understanding of EZIO ® & airway procedures and their associated risks, complications and benefits. Upon completion of this course, participants will demonstrate an understanding of anatomy, physiological process and clinical applications, including increased skill proficiency in EZ-IO ® & airway insertion and care management. The lab provides attendees with an interactive workshop designed to provide practitioners with the knowledge and skills to use the Arrow EZ-IO® Intraosseous system. Airway workshops cover basic & advanced airway skills including supraglottic airway devices, endotracheal intubation using direct & video laryngoscopy in line with difficult airway algorithms using simulated practical skills using cadaveric tissue. Ensure you select the correct lab track on booking.

Online booking is available approximately 4 months prior to event. 2019 dates include: West Midland Surgical Training Centre, University Hospital Coventry: • 26th & 27th February 2019 • 21st & 22nd May 2019 • 17th & 18th September 2019 • 12th & 13th November 2019 St Georges, University of London: • 1st & 2nd May 2019 • 4th & 5th September 2019

University of Manchester, Surgical Skills Centre: • 2nd & 3rd July 2019 • 21st & 22nd October 2019 Newcastle University Medical School: • 26th & 27th June 2019 Vesalius Clinical Training Centre, Bristol: • 10th & 11th June 2019 To book your free place: Go to our online booking system

www.teleflex.com/en/procedural-lab-registration/emea.html Questions? Please contact your Teleflex Sales Representative or Clinical Medical Affairs at clinical.affairs.uk@teleflex.com

This educational event is approved by the Royal College of Anaesthetists, Royal College of Nursing & the British Association of Critical Care Nurses for 3 CPD credits/hours.

Teleflex, the Teleflex logo and EZ-IO are trademarks or registered trademarks of Teleflex Incorporated or its affiliates, in the U.S. and/or other countries. All dates may be subject to change/cancellation. Teleflex will not be responsible for changes/cancellations. Please see online booking conditions and disclosure. © 2016 Teleflex Incorporated.