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ID Medical celebrates 10th Birthday at AGM

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Revalidation goes live - Page 8

Over 3000 attend AGM & HD launch

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Main Sponsor:

Spot yourself in the crowd - Page 5

Acute & General Medicine 2013 27th & 28th November 2013, Olympia London

Issue 4 – Conference round-up edition

www.agmconference.co.uk

www.hospitaldirections.co.uk

Fiona Moss, Tom Dolphin, Sir Prof Peter Rubin and Peter Sharp debating at the Medical Leader’s Symposium

GMC chair calls for more flexible medical training The head of the GMC has called for more flexibility to be built in to medical training to enable trainees to switch between specialties before achieving their certificate of completion of training (CCT). At AGM 2012 debate on the future of postgraduate medical education, GMC chair Professor Sir Peter Rubin said developments in medicine were moving rapidly and the need for different specialties was changing. This meant some juniors wanted to learn new skills and switch specialties during their training but this was currently very difficult to do.

AGM video presentations now live

He said he had failed to introduce more flexibility into training in his former role as chair of the now defunct Postgraduate Medical Education and Training Board. The time had now come for specialty associations and the medical royal colleges to discuss aspects of their curricula that they had in common rather than thinking that their curricula were special only to them. “We have got to be able to identify the transferable skills that are needed to make it far more possible than it currently is for highly competent doctors undergoing their postgraduate medical education to change from specialty A to specialty B. I just can’t believe it’s that difficult.

Professor Sir Peter Rubin addresses delegates at the Medical Leaders Symposium These are key issues for the future,” he said. Another issue that urgently needed to be addressed was ensuring that trainees gained more generalist skills. Currently the majority of patients in secondary care needed the skills of generalists rather than super specialists. ‘If we are going to retain smaller district general hospitals (DGHs) in often remote and rural areas then they are going to have to be staffed by people who are very experienced... Continued on page 2

Bad hospitals could get worse under NHS Reforms Hospital services are not used as well as they could be and in some extreme cases are probably unsafe, Mike Farrar, chief executive of the NHS confederation warned in a talk in the Efficiencies stream of the Hospital Directions show. Rising emergency admissions for the frail elderly were putting a strain on hospital resources yet 30% of these patients would not need a hospital bed if there were alternative facilities for them in the community.

AGM delegates are now able to catch-up with all the highlights from the conference. With so much going on throughout the two days, delegates now have the unique chance to watch missed sessions or re-cap on seminars they attended. Visit www.agmconference.co.uk/connect to access video footage and presentation slides, including Dr Sarah Burnett’s presentation on chest x-rays, Professor Andrew Clarke’s presentation on heart failure and if you didn’t catch the keynote session with the GMC’s chair – Professor Sir Peter Rubin debating the future of postgraduate medical education, they’re all now available to watch.

Hospitals had never stood still and the current pattern of provision had been arrived at by accident and currently did not correlate to need or advances in medical knowledge and practice. Mr Farrar said he was profoundly worried by changes being driven by competition in the market, encouraged by the NHS reforms, because this allowed the best hospitals to get better but risked the worst deteriorating. A case had to be made for change. The three dynamics needed to drive change were having... Continued on page 2

Mike Farrar, chief executive of the NHS confederation

Follow us on Twitter: @AGMConfUK @HDShowUK


Acute & General Medicine 2013

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Main sponsor

Sophie Holt - Marketing and PR manager s.holt@closerstillmedia.com

AGM is organised by Closer2 Medical Ltd, part of the CloserStill family. Unit 17, Exhibition House, Addison Bridge Place, London W14 8XP www.agmconference.co.uk Tel: 0207 348 5250 Paul Shelley - Show director p.shelley@closerstillmedia.com Mike Broad – Programme director m.broad@closerstillmedia.com Liz Sanders – Business development manager l.sanders@closerstillmedia.com Yemi Ibidunni - Event executive y.ibidunni@closerstillmedia.com Delegate team training@closerstillmedia.com

Sarah Bray – Marketing Assistant s.bray@closerstillmedia.com Julia Danmeri - Head of operations j.danmeri@closerstillmedia.com Kate Jackson – Conference and speaker manager kate.jackson@closerstillmedia.com Daphne Perez – Event Coordinator daphne.perez@closerstillmedia.com Andy Center - Chief Executive a.center@closerstillmedia.com Michael Westcott - Business Development Director m.westcott@closerstillmedia.com Phil Nelson - Commercial Director p.nelson@closerstillmedia.com Jonathan Wood - Director of Finance j.wood@closerstillmedia.com Phil Soar – Chairman

GMC chair calls for more flexible medical training Continued from page 1

and very competent generalists who know when to get the helicopter out to send patients to the super specialists. “My personal view is that we do need to reinvent general medicine and general surgery, which can be very enjoyable, fulfilling specialties. There is some urgency in moving along that road.” A consultant in a small DGH complained that they struggled to provide quality education to trainees. Professional activities (PAs) were being squeezed out of job plans, consultants were doing two or three ward rounds a day and often there were no juniors accompanying them because they were either away on a teaching course or on holiday. Also frequent changes in the e-portfolio system meant trainers were faced with a lot of new tick boxes and assessments and juniors spent all their time filling in their e-portfolios instead of seeing patients. Tom Dolphin, former chair of the BMA’s Junior Doctors Committee, said most juniors were absent from ward rounds because they had probably been on nights or were resting. “All we ever seem to do is be on call or do nights or weekends and we never actually get to see the boss. It reflects the fact that a lot of employers don’t really value education and training at the moment,” he said.

The future of hospital services in the modern NHS Continued from page 1

an evidence base to argue the case for modernising healthcare, overcoming emotional barriers to change and addressing the practical issues in order to move forward. A conversation about fairness needed to be had with the public. Data should be published to help people to understand how fair or equitable their hospital services were and how performance varied across the NHS. “We started this system in 1948 when the NHS inherited a whole set of organisations and hospitals that had come about for a whole variety of reasons, some through philanthropy, some through doctors who worked together and made decisions hundreds of years ago. Now it needs to have a bigger emphasis on the rational if we are to make services more efficient,” said Mr Farrar. If he was starting from scratch, Mr Farrar said he would start by spending money on earlier diagnosis in primary care and providing a care bed service for people coming out of hospital. One solution for the future was for hospitals to work collaboratively. Another hope was that incentives in the new health and social care legislation would encourage clinical commissioners to provide more integrated care that included GPs. It was also important to enable more patients to be able to access specialist opinion in community settings. “I’m hopeful that clinical commissioning groups working in a different way will get over this nonsense that nothing in hospitals can be altered,” he said.

Sponsorship statement AGM is for healthcare professionals only. The seminars at AGM have been brought to you by Closer2 Medical in association with our partners and sponsors. The views and opinions of the speakers are not necessarily those of Closer2 Medical 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.


Acute & General Medicine 2013 Main sponsor

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Over 3,000 attend launch of AGM 2012 and Hospital Directions show Doctors, managers, and key NHS decision-makers came together to learn, network and gain inspiration at the inaugural Acute and General Medicine conference and Hospital Directions show at Olympia, London. The launch event attracted over 3000 attendees and more than 100 exhibitors for two packed days of clinical training, hands-on sessions and networking. High profile speakers offered practical, interactive clinical presentations on the latest thinking and practice on clinical topics ranging from complications of cirrhosis and managing advanced heart failure to emergency care for older people, demystifying difficult ECGs and pulmonary embolus.  With over 80 talks and a skills lab, medics were able to tailor their own programme of learning according to their own training needs earning Royal College of Physicians accredited CPD points for revalidation. The Hospital Directions show, running alongside AGM, offered senior care managers best practice advice across eight key areas: patient services, HR, leadership, estate management, outsourcing, technology, information management and infection control. At the end of the first day a medical leaders symposium with Professor Sir Peter Rubin, chair of the GMC, Dr Tom Dolphin, former chair of the Junior Doctors Committee and Dr Fiona Moss, director of medical and dental education at the London Deanery, debated the future of postgraduate medical education. Bayer sponsored three events: a symposium on the changing treatment paradigm in deep vein thrombosis plus two cardiology and neurology workshops. Paul Wright, senior brand manager at Bayer, said:  “Our events have been really well attended and we have had a lot of people visiting our stand.  With revalidation starting attendees have been very interested in the clinical areas we have sponsored. This has been a great opportunity for us to reach out to doctors working in acute and emergency medicine.”

Ashley Brook, customer relationship manager at TPP, the company whose SystmOne clinical software enables clinicians to access patient records in any care setting, said attendees visiting their stand showed a lot of interest in their acute module.   TPP recently signed a three year agreement with Airedale NHS Foundation Trust to implement a full hospital system that will connect local clinicians with 1.1 million electronic patient records.   “We were able to show people what our hospital system can do in areas such as bed management and e-prescribing. Visitors to our stand were very interested in our Clinical Record Viewer which allows clinicians in emergency care to view patient records (with their consent) and see their entire clinical history without having to chase up the GP.” Patrick Gray, head of healthcare at Experian, said a lot of footfall had been directed their way from the stands of pharmaceutical companies co-located nearby. Practitioners had been keen to discuss service design and efficiency. Experian specialises in providing their own and publicly available data from primary and secondary care and combining it with that of their clients and third parties. This data helps clinicians and managers to make informed decisions about issues such as patient pathways and patient eligibility for treatment from both an efficiency and risk perspective.

Delegates get hands-on at the Simulation Lab

Mr Gray said they were also able to explain how Experian can map and predict any likely future demand for services and help senior level clinicians and mangers to re-engineer their services by for example showing how changes might impact on the community. Colin Cram, a public sector consultant specialising in procurement, who chaired the Efficiencies stream of the Hospital Directions show, said they covered a whole range of issues from how to make better use of the estate and data to improving skills deployment and achieving effective outsourcing. “The people who came to these talks were very attentive and were taking everything on board,” he said.

Delegates network with clinical suppliers on the exhibition floor

Delegates flock in their thousands to the first morning at AGM


Acute & General Medicine 2013

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Main sponsor

New gynaecological training tool attracts the crowds at AGM 2012 The ground-breaking GST100 gynaecological skills training model was a major draw on the Pharmabotics stand at AGM. The model, which has a central core hand-crafted using a unique tactile elastomeric polymer, is believed to be the first of its kind. Pioneered by award winning consultant obstetrician and gynaecologist Mr Barry Whitlow of Colchester Hospital University NHS Foundation Trust, and three years in the making, the model enables high quality simulation training for gynaecologists.

Pharmabotics GST100 gynaecological skills training model

It allows over 15 procedures to be performed ranging from salpingectomy, ovarian cystectomy and oophorectomy to repair of the rectum, episiotomy repair to vaginal or abdominal hysterectomy. Core skills such as suturing and knot tying at depth can also be practised in a realistic, safe and low pressure environment.

This gives trainees access to high quality training at a time when the number of gynaecological operations performed by registrars has significantly reduced.

The GST100 gynaecological skills training model made its premiere at AGM 2012 Sara Rollason, managing director of Pharmabotics Ltd, said: “Our model generated a huge amount of interest at AGM 2012 and we were very pleased with the number of inquiries we received.” The trainer will be launched next year at the new Iceni Centre in Colchester, a state-of-the-art training and research and development centre for laparoscopic surgery.

Transforming care in Ealing

FreeStyle InsuLinx. In sync with your patients. Informative for you.

When Ealing Hospital NHS Trust took on responsibility for managing the community services of the London boroughs of Brent, Ealing and Harrow it was at first a hard job to sell the deal to the local community. In a talk on how the district general hospital moved to become an integrated care organisation (ICO), Julie Lowe, the trust’s chief executive, said the community which had raised money for the hospital was disappointed. She had to explain to them that an application to become a foundation trust would not have succeeded because the strategic plan for London had designated Ealing to be a local hospital sending their plans to become a big provider of acute care out of the window. But once they had picked themselves up off the floor and got over thinking it was unfair they realised that their hospital did not offer enough specialist services and was being propped up financially by 100,000 A&E attendances, which were acting as a poor substitute for good primary care. Within the new ICO acute and community services were joined together as equal partners within a single directorate and three community services directorates were set up, one for each borough. Some services such as specialist community nursing and dietetics are now provided across three boroughs. A new provider, Care UK, is now running an urgent care centre, helping to keep patients out of A&E.

FreeStyle InsuLinx translates blood glucose and individual patient data into accurately calculated insulin dosing suggestions*

GPs complained about losing their primary care teams with district nurses and midwives based in the practice so they ended up backtracking to some degree and giving them back some locally based services. “We had forgotten just how much GPs look after patients most of the time and that at its best primary care offers holistic care that hospitals can only dream of,” said Ms Lowe.

For In Vitro Diagnostic Use Only. * Data on file, Abbott Diabetes Care 2012

There were also cultural barriers to overcome - secondary care doctors assumed they were leaders of any team going whereas in primary care the culture is of multidisciplinary teams that might be led by a nurse or a therapist.

Ask your Abbott Diabetes Care representative about FreeStyle InsuLinx or for further information please visit Blood Glucose Monitoring System

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Community staff who joined the ICO who were used to smaller organisations and being involved in decisions had to start following the processes and structures of a very large organisation covering three boroughs.

© 2012 Abbott Not real patient, photos for illustrative purposes only. FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. ADCMDP120003

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At the end of the day the integrated care agenda was all about improving care for patients and providing care closer to people’s homes and in community settings. “We tried to keep hold of that,” said Ms Lowe. 12/09/2012 10:55


Acute & General Medicine 2013 Main sponsor

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Can you spot yourself in the crowd? Take a look at all the photos from AGM & Hospital Directions by visiting www.agmconference.co.uk or www.hospitaldirections.co.uk

Private sector will partner with NHS to deliver acute services The private sector will increasingly work in a partnership role with the NHS predicts John Myatt, strategic development director at Serco, a British company which operates globally helping public services to be more efficient and productive. Working in partnership rather than replacing or privatising services was more palatable to the public he explained in a Serco-sponsored Hospital Directions talk on the role of the private sector in delivering acute services. A second key approach was now to put patients at the heart of healthcare and to focus on improving outcomes. “One of the biggest trends I have observed in my travels around different markets is that over the next 20 to 30 years we can anticipate different business models that are actually built around the patient,” he said. Private sector partnerships could introduce commercial

acumen, a new perspective on a problem, a customer service mindset or help a trust achieve sustainable growth. A private company’s experience of working with healthcare organisations in other countries could also introduce innovative ideas.

One of the biggest things people say to me when I talk to them about partnerships is – will you share some of the risks with me? “I’ve got a lot of challenges – maybe I need to take over a neighbouring hospital or I’m looking to grow but I don’t want to do that on my own. “Do you just want to pay someone to do something and hope they will deliver or do you want someone to share those benefits with you - that’s where we are seeing a trend towards more outcomes based contracting for NHS organisations.”

Mr Myatt outlined examples of ways that Serco has helped NHS organisations to become more productive. In Suffolk where Serco is running community services efficiency had been improved by providing the mobile workforce with electronic devices which enabled staff to capture information and work in a smarter way as they visited patients in the community. At a new hospital in Scotland’s Forth Valley Serco has helped to introduce an automated mail room and minimise infection control by introducing separate walking facilities for staff and patients and introduce robots to deliver equipment and meals. In a joint venture with Guys and St Thomas’ Hospital in London Serco has helped to improve pathology services by looking at the challenge of building a hub around pathology rather than having separate spokes.


Acute & General Medicine 2013

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Main sponsor

2013 Floorplan

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Acute & General Medicine 2013

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Main sponsor

Where did delegates come from?

Exhibitor spotlight 2012 East Anglia East Midlands London Midlands North West North Northern Ireland Scotland South East

NHS Professionals is the leading provider of managed flexible workforce services to the NHS with approximately 40,000 doctors, general and specialist nurses, midwives, administrative and other healthcare staff signed to its bank. It helps its 66 NHS Trust clients improve workforce efficiency and productivity as part of an overall workforce strategy. http://www.nhsprofessionals.nhs.uk/

South West Wales Yorkshire

GE Healthcare provides transformational medical technologies and services are shaping a new age of patient care. Our expertise in medical imaging; information technologies, medical diagnostics, patient monitoring systems, is helping clinicians around the world re-imagine new ways to predict, and monitor disease, so patients can live their lives to the fullest. http://www3.gehealthcare.com/en/Global_Gateway

Delegates by specialty Acute Medicine Cardiology Diabetes & Endocrinology Emergency Medicine Gastroenterology General Practice General Internal Medicine

CRG Locums are a supplier of Doctors across all grades and specialities including A&E, Medicine, Surgery, Paediatrics & Psychiatry, to both the Public Sector ( NHS, MoD & HMPS) & private sector. CRG Locums has an experienced team in place that are available 24/7 to help with any locum needs. http://www.castlerockrg.com/

Geriatric Medicine Haematology Infectious Diseases Intensive / Critical Care Nephrology Neurology Palliative Medicine Respiratory Medicine Rheumatology Other

“AGM has been a different type of show compared to other conferences; it has provided a broader range of delegates. The response from delegates has been very positive with lots of people interested in purchasing products. We’ve gained several dozen strong leads and we’ve booked a bigger stand for next year.”

“AGM has been a new experience for us; the calibre of delegates has been brilliant. We’ve met senior consultants, professors and researchers who have all seen the benefit of our service, which has been very encouraging. AGM has provided us with the chance to network with key influencers in purchasing who have shown nothing but pure interest in our product. We’ll come away of AGM with some serious leads.”

Rob Pike, Pulmolink David Hutchinson, Tanita

Skills for Health felt the themes covered at the Hospital Directions conference would provide delegates with useful insights into workforce planning and service delivery. We are pleased to have been invited to speak about workforce and skills development and the impact this has on improving productivity, efficiency and quality of care in the health sector. http://www.apetito.co.uk/

“Hospital Directions has provided a different level of delegate and better contacts compared to other medical conferences we take part it in. We target senior level decision makers which is what Hospital Directions has delivered.” Susan Siegal, 360 CRM


Acute & General Medicine 2013

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Main sponsor

Regular checks on doctors begin The UK’s 230,000 doctors are now legally required to show they are keeping up to date and are fit to practise following the launch of revalidation on December 3. The new system, which is being overseen by the General Medical Council (GMC), is based on an annual appraisal and the information doctors will collect about their practice, including feedback from patients, doctors, nurses and other colleagues.

confident that over time revalidation will make a significant contribution to the quality of care that patients receive and should give them increased confidence that the doctors who treat them are up to date.’ Chair of BMA Council, Dr Mark Porter, said: “Although the system is a considerable improvement on the plans that were first proposed, there is still some work to do to ensure it is workable.

The UK is the first country in the world to introduce such a scheme across its whole healthcare system, covering GPs, hospital doctors, locums and those working in the independent sector.

“The BMA will be monitoring its implementation to ensure the process is fair and consistent across the UK, and to make sure those doctors who need support receive it as soon as possible.

The GMC expects to revalidate the majority of licensed doctors by March 2016, with medical leaders and Responsible Officers expected to go first.

“While revalidation will strengthen current assessments, it is important to remember that doctors are already providing a very high quality service.”

Professor Sir Peter Rubin, Chair of the GMC, said: ‘We are

Health Minister Dr Dan Poulter said: “Doctors save lives every

Because it’s not always that simple.

day and making sure they are up to speed with the latest treatments and technologies will help them save even more. This is why a proper system of revalidation is so important.” Dr Tony Falconer, the Academy of Medical Royal College’s revalidation lead and president of the Royal College of Obstetricians and Gynaecologists said: “I am pleased that the process of revalidation has finally started and like the majority of doctors, I hope that this process will improve the quality of medical care for patients and look forward to seeing the evidence of such progress.”

Doctors could be made redundant if they don’t accept cuts warns pay cartel Up to 6000 doctors and other healthcare staff could lose their jobs in the south west if they do not sign up to a regional deal that will reduce their pay terms and conditions. The warning comes from the so-called ‘pay cartel’ a consortium of 19 NHS trusts, formed to look into introducing regional pay in the South West. Chris Bown, chief executive at Poole Hospital NHS Foundation Trust and chair of the consortium, told AGM attendees that NHS trusts faced unprecedented financial and workforce challenges and the time had come for them to tackle the pay bill which consumed 70% of their spending. Costs could no longer be cut by the efficiency approaches such as improving productivity or changing skill mix that had been used over the last few years. “The real drive behind the work of the pay consortium has been about sustainability of organisations, clinical services and employment,” he said. But he admitted that trusts would struggle to find 6000 people who were ‘not making a contribution’ and that if staff were axed the quality of clinical services would suffer. Their aim of the cartel was to establish a set of pay and conditions which rewarded performance and changed behaviour. For staff it would mean increased job security, he said. But Dr Nick Jenkins, a consultant in emergency medicine at Poole Hospital NHS Foundation Trust, asked: “Even if you pay people less how does that guarantee job security?”

Sometimes you need more than a plaster. The Royal Medical Benevolent Fund is the leading UK charity for doctors, medical students and their families. We provide financial support, money advice and information when it is most needed due to illness, age, bereavement or disability.

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Mr Bown replied: “I don’t think we can guarantee job security but what we can do is increase the prospect of improved job security. It’s a balancing act that we need to achieve and discuss with staff.” He said the time had come for trusts to use affordability as a justification for examining pay terms and conditions. David Amos, a healthcare human resources and public services management consultant and KPMG associate, who is advising the consortium, said this was the first time trusts had got together to discuss pay, terms and conditions and there was a lot of interest in what they were doing from other trusts around the country. A recent survey by the Foundation Trust Network revealed that 70% of its members had an appetite for introducing more flexible regional pay terms and conditions. A couple of trusts had already gone out on their own in a minor way, he said.


Acute & General Medicine 2013

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Main sponsor

Birthday celebrations for ID Medical ID Medical celebrated its 10th birthday at the forefront of medical recruitment with balloons and a drinks party on its stand at AGM 2012. As part of its celebrations ID Medical has rebranded and launched a new website Visitors to the stand received a free light pen, a box of popcorn and the chance to win a new Kindle Fire. Established in 2002, ID Medical is a key provider of locum doctors, nurses and allied health professionals. It supplied over 1.2million hours to the NHS in 2011 with preferred supplier contracts in over 80% of UK hospitals. ID Medical’s Head of Marketing, Caryn Cooper, said: “ID Medical found the AGM 2012 exhibition and conference to be one of the most successful events of the year and would like to thank its current and new customers for joining in with its 10 year birthday celebrations. “It was amazing to see so many medical professionals in the one location and we welcomed the opportunity to educate our locum doctors on the importance of revalidation and invite them to join our nationwide revalidation events.  We look forward to extending our involvement at the AGM event in 2013.”

Delegates flock to ID Medical’s stand to celebrate their 10th Birthday

Lack of seven day working in primary care increases pressure on acute services The failure of primary care health professionals to work seven days a week is contributing to the pressures piling up on acute care in hospitals, Mark Temple, the Royal College of Physicians’ acute care lead, told the Hospital Directions show.

The report says the past decade has seen a 37% increase in emergency admissions yet there are a third fewer general and acute beds now than there were 25 years ago.

A lack of social care funding is also preventing medical fit patients from being moved out of hospital for care in the community.

Dr Temple said the frustration for secondary care physicians was that hospital doors were open 24/7 to accept patients but the pathways out of hospitals were often built on a five day working pattern.

“These are the elephants in the room that we have tended to tiptoe around in the past when discussing these huge issues,” he said.

The problem was patient care was often built around the staffing and service needs of the NHS and not necessarily around patients’ needs seven days a week.

Dr Temple, a consultant physician at the Heart of England Foundation Trust, was giving a presentation on a report called ‘Hospitals on the Edge’ published by the RCP in September, which revealed that demand on clinical services is increasing to the point where acute care cannot keep pace in its current form.

“One of things that is extraordinary in all the discussions about seven day working is that they are pretty well confined to what we do in secondary care and there isn’t really any currency around seven day working in the community. That’s a huge failing. We’re going to have to address that if we are going to

SAVE THE DATE Acute & General Medicine and Hospital Directions returns on the 27th & 28th November 2013

Acute & General Medicine

deliver the care our patients need seven days a days a week.

Patients need support in primary care from GPs specialist nurses and community matrons seven days a week but the NHS is not set up like that. “Hospital care is moving reasonably smartly towards seven day working a number of areas but there’s very little noise within the community conducive to good patient care.” Dr Temple said the problem with the acute medical take was that there were few safe alternatives for managing patients out of hours in the community. Ambulatory care was a big potential growth area but needed primary care services working seamlessly with acute care for it to become universal.


Acute & General Medicine 2013

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Main sponsor

Integrated care project in Greenwich cuts admissions Emergency admissions have been reduced and money has been saved by introducing a more collaborative and proactive approach to managing older people with urgent health and social care needs in Greenwich. This integration project between Greenwich Community Health Services, Oxleas NHS Foundation Trust and Royal Borough of Greenwich, Social Care began three years ago. The objectives were to create a more accessible, responsive and flexible service, enabling fair access to services via a single point of entry and seamless, well-coordinated and holistic health and social care at the right place at the right time, explained Jane Wells, Service Director, Oxleas Foundation Trust in a talk in the Innovation stream of the Hospital Directions show. Three community assessment and rehabilitation teams consisting of therapists, social workers and nurses were set up around the borough. A joint emergency team with the same mix of staff was established to deal with all

emergencies both in health and social care and an integrated hospital team of nurses and social workers dealt with discharges. The changes have positively impacted on staff motivation to maximise quality outcomes and efficiency. The right referrals now go to the right team at the right time and the shared outcomes have enabled an increased number of people to live at home, with a reduction in emergency hospital admissions, and long-term care placements. It has also reduced the size or need for social care packages. Ms Wells said a crucial factor in the success of the project was to ensure that they engaged staff and trust boards in the shared values, beliefs and culture change: “Before we started designing a new way of working we were very conscious about the organisational development and cultural changes that we wanted to foster in our workforce that we were bringing together so we worked with them to get all their fears and anxieties on the table early on. We didn’t want to create a new model or way of working that

Apto Revalidation   Manager  

Apto Solutions   created  the  MAG   Form  with  the     NHS  Revalidation   Support  Team  

The Model  Appraisal  Guide  Form   Apto  worked  with  the  Revalidation  Support  Team  through  2011  and  early  2012  to  build   the  Model  Appraisal  Guide  Form.    This  is  the  Adobe  PDF  Form  that  has  become  the   standard  document  to  help  Doctors  with  their  revalidation  appraisals.    Together  with   the  rest  of  the  resources  the  RST  has  assembled,  a  clear  approach  to  the  Appraisal   itself  is  defined.  

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The concept is to have a totally integrated model so that people will be able to travel through different systems in a smooth pathway and will receive the services they need said Jay Stickland, assistant director of Greenwich Social Services.

Royal colleges push for seven day consultant care The report by the Academy of Medical Royal Colleges (AMRC) also stresses the need to provide seven day access to appropriate investigations and treatments and emphasises the crucial role provided by support services both in hospital and in the community. The document recognises that implementing this change will take time and that the costs will be substantial and unlikely to be afforded within existing NHS funding. It also says achieving the new standards will require changes in the working patterns of consultants and other staff and hospital reconfiguration into fewer sites. However the benefits for patients are likely to be substantial as there is now clear evidence that mortality and complication rates are significantly higher for patients admitted as emergencies at the weekend. The AMRC calls for seven day consultant present care to be resourced and implemented across the UK.

HOW? For   the   Appraisee   and   Appraiser,   this   means   giving   them   simple   tools   with   which   to   schedule   and   complete  the  Appraisal.     For  the  Responsible  Officer,  this  means  giving  them  confidence  in  the  information  they  are  getting  from   the  Appraisal  outputs  and  making  it  easy  for  them  to  report  on  the  progress  of  Revalidation  Appraisals.     For   the   Organisation,   this  means   achieving   the   above  without  having   to   occupy   administrators   to  do   what  can  easily  be  an  error  prone  and  time  consuming  set  of  tasks,    

She said they will now be looking for wider integration across the entire health and social care system, bringing in GPs and links to long term conditions teams and occupational therapists.

Patients in all specialties should be reviewed by a consultant at least once every 24 hours throughout their stay recommends a new report which is set to reshape the future of hospital care.

 

was only paying lip service to integration.”

Professor Norman Williams, steering group chair and president of the Royal College of Surgeons of England, said: ‘Clinical staff and managers must work together to re-shape hospital services in a way that strengthens the quality of care given to patients regardless of the time of day they are admitted. Similar arrangements will be necessary to support patients in the community when discharged at weekends. ‘Ensuring that key staff are available to provide this support will come at a cost. However this is crucial for the full benefit of seven day consultant-led care to be realised.’ Dr Chris Roseveare, president of the Society for Acute Medicine and co-chair of the Academy’s seven-day working sub-group, said publication of the report, which was supported by all the medical royal colleges, demonstrated the commitment of hospital specialists to seven day consultant present care.

The  solution  is   designed  to  be   simple  in  use  for   the  clinicians  and   highly  productive   for  the  back   office  

‘Delivering these standards will be an enormous challenge for the Health Service, particularly for medical specialties which care for large numbers of patients in hospital. It is vital that a high quality weekday service is also maintained, which inevitably will require an expansion of the numbers of consultants in many areas.’

See how   simple   apto   revalidation   manager   is   to   use.   To   arrange   an   online   demo.       Contact  us  at  Apto  Solutions  Ltd,  enquiries@aptosolution.co.uk,  0845  226  3351,   www.aptosolutions.co.uk  

Follow us on Twitter: @AGMConference UK @HDShowUK


Acute & General Medicine 2013

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Main sponsor

What did our delegates think of AGM & Hospital Directions? Take a look at what some of our visitors thought of their first AGM & HD conference experience… Katherine Lindsay

Nahla Awad

Teaching & Research Fellow, Sherwood Forest Hospital Trust

Consultant Anaesthetist, United Lincoln Hospital

“Overall AGM has been very useful, the range of topics have been excellent. Being able to tailor-make your own bespoke programme flexibly has been great. The variety of educational sessions available has been invaluable and it’s so important to have revalidation addressed at the same time.”

Michael Tan

“The variety of topics AGM has provided has been excellent and I’ll definitely attend next year. The presenters have given delegates the most up-to-date education and it’s been very helpful to have someone explain about revalidation. It’s the biggest scale conference in terms of content I’ve attended in England and also very affordable.”

A&E Consultant, Royal Blackburn Hospital

“Getting to meet drug companies has been very useful as it’s usually very difficult to meet on an every-day basis. The seminars I’ve attended have been very valuable and I’ve picked up some really interesting learning points which will help my clinical practice. AGM has been a very cost-effective conference and obtaining CPD points at the same time is a big plus.”

Ike Ugboma Consultant Geriatrician, Portsmouth Hospitals NHS Trust

“There were many interesting sponsors and exhibitors. I was particularly keen on the software in health stands.”

What did our exhibitors think? Kim Beaumont

Fiona Ritchie

Medical Protection Society (MPS)

RIS Products

“AGM is a huge event and a great opportunity for us. We’ve had a lot of people show interest and it’s one of the only event where you can target most specialties in one place, making it very costeffective.”

Amy Parmer A . Menarini

“AGM has attracted the right people with the right level of curiosity for us. AGM has been useful for us to spread awareness and delegates have been very responsive, we’ve gained 20 strong leads.”

Jon Knappett Your World

“We’ve gained a number of useful contacts and it’s been a good chance to gather information by talking directly with the consultants who are usually very difficult to talk to.”

Heather Barratt Team 24

“AGM has provided the perfect set of doctors we need to target and we’ve come away with lots of leads.”

AGM & Hospital Directions: The nitty gritty • 86% delegates rated the quality and range of the seminar programme as excellent or very good. • 85% of delegates welcomed the support of the pharmaceutical industry at AGM. • 85% delegates took time to speak to three or more exhibitors. • Two-thirds of delegates are considering changing their prescribing practices based on conversations they had at the show. • 75% of delegates who paid for their ticket rated the event as good or excellent value for money.

“We’re thrilled with the amount of relevant contacts we’ve met at AGM. We didn’t expect such a flurry of people at the conference and we’ve had some incredibly good meetings with consultants who might have not necessarily had an interest in the product we supply. There will be no doubt that we will exhibit at next year’s show. AGM as an idea is perfect and we will certainly gain business from our time here.”

Paul Wright Bayer

“Our events have been really well attended and we have had a lot of people visiting our stand. With revalidation starting attendees have been very interested in the clinical areas we have sponsored. This has been a great opportunity for us to reach out to doctors working in acute and emergency medicine.”

Rebecca Brown Clarity Informatics

“We really enjoyed the show, met the right people for both our product. It was our first experience targeting secondary care end users and it was really successful, we will definitely be looking to do it again next year.”

First Medical Defence Organisation to introduce a 24-hour advisory helpline. For almost 30 years our members have enjoyed the benefits of our freephone 24-hour helpline. MDU doctors are on hand with expert guidance any time of the day or night, so when urgent medico-legal advice is needed, no-one is more accessible or experienced. It’s exactly the standard of excellence you would expect from the world’s first medical defence organisation. 24-hour freephone advisory helpline 0800 716 646 For more information or to join the MDU visit themdu.com or call our freephone membership helpline on 0800 716 376 MDU Services Limited (MDUSL) is authorised and regulated by the Financial Services Authority in respect of insurance mediation activities only. MDUSL is an agent for The Medical Defence Union Limited (the MDU). The MDU is not an insurance company. The benefits of membership of the MDU are all discretionary and are subject to the Memorandum and Articles of Association. MDU Services Limited is registered in England 3957086. Registered Office: 230 Blackfriars Road London SE1 8PJ. © MDU Services Limited 2012 GN/097x/1112-e


Acute & General Medicine 2013 Main sponsor

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Hospitals in North West England saved lives using Clarity Informatics’ Quality Improvement Service Figures published in the New England Journal of Medicine by a team from the Universities of Manchester, Nottingham, Birmingham and Cambridge, show significant drops in mortality after using Clarity Informatics’ Quality Improvement Service (QIS) in the North West of England.

Mike Farrar, Chief Executive of the NHS Confederation, who originally worked on the QIS project, said: “My only regret is that this programme did not become national.” To view the report and for more information, please visit www.clarity.co.uk

The results show that this programme was associated with a reduction in mortality of 1.3%, equating to a reduction of 890 deaths in this population of patients. Clarity Informatics can confirm that the proven trend of quality improvements, cost savings, reduced bed days and lives saved continues from the end of their evaluation period to the current date. Clarity has supporting evidence and data proving significant financial savings from this programme. QIS is an end to end solution for secondary care which reviews clinical topics and combines proven clinical best practice, data collection, software, analytics and workshops to improve quality of care and clinical outcomes. Introduced to the UK by Advancing Quality and developed further by Clarity from 2010, the solution has been used for over four years in the North West and independent evaluation up to 2010 by the University of Manchester has demonstrated tangible benefits in terms of lives saved. QIS was developed out of a pilot designed to improve outcomes in secondary care for specific disease areas in NW England, where mortality relating to myocardial infarction and heart failure was observed to be higher than the national average for England. Since the project started, the clinical focus has expanded from five to ten patient pathways and new developments have included using NHS SuS linked data sets.

Pre-hospital ECG diagnosis reducing A&E admissions

Identifying Acute Myocardial Infarction in the Ambulance and redirecting patients to the appropriate treatment centre will avoid unnecessary admissions to A&E Introduction of pre-hospital ECG diagnosis has improved triage and outcomes in patients with acute STEMI. However pre-hospital ECG diagnosis is difficult when presented with an equivocal ECG pattern. A study presented at the American Heart Association Scientific Sessions 2012 detailed how a Point of Care Troponin test from Roche Diagnostics enables identification of 40% of AMI patients pre-hospital.

Together with TroponinT, the same technology can test for D-dimer and NT-proBNP and is widely used in both primary and secondary care, streamlining chest pain, DVT, PE and heart failure care pathways helping to speed up turnaround times and reduce unnecessary hospital admissions. For further information please contact Roche by email: burgesshill.cardiacpoc@roche.com or phone 01444 256000 and ask for ‘Point of Care’.

Main sponsor:

Patients identified early can be triaged for example to the catheterization laboratory for primary percutaneous coronary intervention, bypassing the Emergency Department.

AGM & Hospital Directions Post Show Newspaper  

Read a round-up from the Acute and General Medicine and Hospital Directions Conference

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