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GMC updates pandemic guidance


he GMC has updated its guidance for doctors working in a pandemic this month. ‘Good Medical Practice, responsibilities of doctors in a national pandemic’ outlines the standards of practice expected of doctors if their work is affected by an outbreak. The guidance recognises that a pandemic can break out regionally and allows those most affected to work flexibly to provide assistance where it is most needed. Key adjustments include: • An allowance for doctors to work outside their normal field of practice so long as they are able to do so safely. • Doctors running research programmes are asked to consider whether to interrupt them during a pandemic. • Patient care prioritisation will be based on clinical need and on the pa-

tient’s likely capacity to benefit. For example, young people should not be given automatic priority over adults. • No formal duty to report concerns about resources, equipment or insufficient patient services, other than in exceptional circumstances. “Should a complaint be made against a doctor working under the strain of a pandemic, the GMC will take into account the circumstances under which they were working,” said Jane O’Brien, GMC Head of Standards and Ethics. “However, it is important to note that all doctors should be ready to explain how and why they altered their practice if called upon to do so.”


Patients In US 5 Times More Likely To Spend Last Days In ICU Than Patients In England


atients who die in hospital in the United States are almost five times as likely to have spent part of their last hospital stay in the ICU than patients in England, according to research from Columbia University. The study, which compared the two countries’ use of intensive care services, also found that of all hospital discharges only 2.2 percent in England had received intensive care, compared to 19.3 percent in the U.S. “In England, there is universal health care through the NHS, and there is also much lower per-capita expenditure on intensive care services when compared to the U.S.,” said Dr. Hannah Wunsch, assistant professor of anesthesiology and critical care medicine at Columbia University and lead author of the study. “The use of intensive care in England is limited by supply to a greater degree than it is in the U.S., and there are consequently implicit and explicit decisions regarding who gets those limited services. We wished to examine what different decisions are made.”



60 percent of US medical schools have reported having to deal with unprofessional content posted by their medical students online, according to research published in JAMA. Incidents ranged from profanities about the course and staff, to frank breaches of patient confidentiality on social networking sites and blogs. Most were given an informal warning but three medical schools reported dismissing students after they had posted unprofessional material.

Health gets scarier Eight out of ten (84%) doctors believe the public has become more susceptible to health scares, according to a poll published in BMA News. Examples given included a London specialist registrar in anaesthesia who said pop star Michael Jackson’s death had led to patients expressing concern about the use of the anaesthetic drug propofol. 80 per cent of doctors did not believe the government was doing enough to rebut scare stories.

Errors in elderly treatment Seven out of 10 care home residents are subject to drug errors, suggests research published in Quality and Safety in Health Care. The study of 55 care homes located in West Yorkshire, Cambridgeshire and central London found that drug errors were made in seven out of 10 cases, with the average number of mistakes just under two for each resident. Contributory factors included doctors who did not know the residents, or had insufficient background information.

Standardise to stop resistance England currently has one-sixth the number of intensive care beds available per capita that are available in the U.S. The study, published in the American Journal of Respiratory and Critical Care Medicine, also noted that medical decisions in England are generally considered to be the direct responsibility of the physician, rather than that of the patient or the patient’s surrogate decision-makers as it is in the U.S.

Antibiotic prescribing for respiratory illness should be standardised across Europe to help reduce resistance, say experts in the largest study of its kind published in the BMJ. The EU funded Network of Excellence GRACE project found that antibiotic prescribing for LRTI ranged from 21% to nearly 90% across the EU. There were also marked differences in the choice of antibiotic. Amoxicillin ranged from 3% of prescriptions in Norway to 83% in England.

Junior DR #15  
Junior DR #15  

Junior DR magazine design and layout. Issue 15.