Friday, 9 December 2011

Module 3

Module 3 is about helping people recover from illness and injury. Most of the specific objectives fall into the category of “Yes, we are doing it already”

.....3.1 Improving outcomes from joint replacement, hernial repair, and varicose veins.
These have been the subject of considerable investigation, improvement and advancement over many years. All done without higher directive. Don’t teach granny to suck eggs Lansley.

.....3.2 Preventing respiratory infections in children from becoming serious.
Again this has already been the preoccupation of paediatricians for many years. UK mortality has decreased steadily for 30 years and a guideline has been published and is regularly updated. What more is this objective likely to achieve?

.....3.3 Improving recovery from injury and trauma.
This is another one where “an indicator needs to be developed.” Bearing in mind the sheer diversity of trauma patients I think developing a single indicator is going to be impossible. And what precisely do they think trauma surgeons and their supporting teams are doing every day?

.....3.4 Improving recovery from stroke.
Again, no indicator, and again being done already.

.....3.5 Improving recovery from fragility fracture.
I think whoever wrote this has never seen the average patient with fracture of the neck of femur. A substantial proportion of these operations are done solely for reasons of palliation and pain relief, and the medical status of many of them is such that simply surviving the procedure itself represents as full a recovery as you can expect.

.....3.6 Helping older people recover independence after illness or injury.
This is about preventing readmission to hospital. The problem only arises because patients are often discharged earlier than the clinicians might deem appropriate, simply because of pressure to vacate beds. It is a problem that is insoluble as long as the powers that be continue in their obsession with keeping patients out of hospital at almost any cost, and as long as bed numbers continue to fall.

So my response to this section is, “Don’t tell us what to do, we know what needs doing, and given adequate resources we are already doing it”

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