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  1. Talks calls after strikes abandoned

    The decision to abandon sustained junior doctors' strikes won mixed reactions from doctors, senior and junior, yesterday.

    The BMA says it is still considering industrial action over the imposition of the rejected junior doctor contract.

    Its junior doctors committee said it had abandoned a programme of five-day strikes because of concern about patient safety and because of feedback from doctors, patients and the public.

    The decision sparked threats of mass resignations from the BMA.

    But it was welcomed by the General Medical Council.

    Its chair Professor Terence Stephenson said it was "good news and the right decision."

    He added: "Escalated and prolonged action would have harmed patients and that is the last thing doctors in training would have wanted to do."

    And Michael Lavelle-Jones, president of the Royal College of Surgeons, gave the news a "warm welcome".

    He added: "We now ask the government to follow the lead of the BMA and Junior Doctors by calling off the imposition of the contract and resuming negotiations."

    Professor Neena Modi, president of the Royal College of Paediatrics and Child Health, said: "The country can be proud of the junior doctors' mature, compassionate and principled determination during this damaging dispute."

    A spokesman for the Royal College of Psychiatrists said it "accepted" the decision, adding: "Now the way is clear for all of us who work in and care about the NHS to address head on the causes of low morale and disaffection among junior doctors."

    A Department of Health spokesman called for industrial action "to be permanently called off."

    But Professor David Oliver, a clinical vice-president of the Royal College of Physicians, tweeted: "Department of Health 'victory' over junior doctor contract may prove hollow if highly trained clinicians take marketable skills out of NHS forever and seven-day empty promise."

    [Earlier report on this on news]

  2. Thousands warned of medical data leak

    Some 700,000 patients had personal health data wrongly shared as part of the failed project, it has been revealed.

    And some organisations that purchased the data have failed to respond to requests to delete the information.

    A series of problems and blunders have led to NHS Digital - the organisation now responsible for data projects - being ordered to alert patients to the leak of data. was abandoned amid controversy about the extent to which information supplied to commercial companies was being anonymised. Critics said postcode information could lead to individuals being identified.

    During the roll-out of the project at least 700,000 responded to practice letters asking to opt out. Some 51 practices have never supplied details of those who wanted to opt out, according to the Health Service Journal.

    The Health and Social Care Information Centre, now NHS Digital, then failed to implement any of the opt-outs, citing "legal and technical" problems, the journal reports. This was a breach of the data protection act, the office of the Information Commissioner reported.

    NHS Digital then wrote to its customers asking them to destroy the illegal datasets - but about one third, 56 out of 151, have failed to respond, it was reported.

    Now it has been ordered to write to the 700,000 affected people by 19 October to warn them that their personal data may have been shared with third parties "against their wishes."

    The information comes from board papers published by NHS Digital. It says it is now able to "clean" data files of opt outs and is improving the proportion of GP practices reporting on opt out wishes to more than 99%.

  3. Challenge on GP retirement

    The growing age of Britain's GPs is a major risk to primary care, a senior doctor has warned.

    The Royal College of GPs has called for new measures to persuade doctors to stay in general practice.

    Its latest analysis suggests that 467 practices in England have GPs who are mostly over the age of 55. Across the UK the number is 594, the college said, warning that this placed the practices at risk of closure.

    Its concerns reflect the difficulty in recruiting young GPs, especially those willing to buy into partnership agreement.

    The college has proposed a five-point plan to retain GPs past pensionable age.

    This would include bursaries for continued professional development together with support for indemnity fees - enabling GPs to work flexibly.

    The college says there should be a review of pensions to ensure that doctors do not suffer financial loss by continuing to work.

    There could also be a mentoring and job-sharing scheme to match older doctors with those returning to work after having children, it says. This would allow retiring doctors to phase out of practice - and returning doctors to phase themselves in.

    College chair Dr Maureen Baker said: “Older GPs have so much to give to their patients, their colleagues and the wider NHS, yet we are at risk of ‘brain drain’ on a massive scale. Even with the significant levels of investment promised in NHS England’s GP Forward View, this cannot be replaced overnight, if ever.

    “Many GPs approaching retirement want to keep on practising but also want to develop other interests, medical and otherwise. But there are currently very few opportunities for them to do this, without leaving the profession altogether."

    She added: “In the most extreme cases, practices could close, forcing patients to travel long distances to other practices, or being left with no GP at all.

    "Our recent research suggests that nearly 600 practices across the UK are at risk of closure because the majority of GPs that run and work in them are at or approaching retirement age."

  4. Call to reform vegetative state law

    Britain should reform the lengthy legal procedures needed to allow withdrawal of life support from patients in a persistent vegetative state, two experts have said.

    The procedures are both expensive and distressing, according to Professor Jenny Kitzinger, from Cardiff University, and Professor Celia Kitzinger, from York University.

    The professors say it is time the law was reformed to allow withdrawal of life support where there is "general agreement" among doctors and family that it would be in the patient's best interests.

    Writing in the Journal of Medical Ethics, they report on a case which took four years to settle.

    The patient lost consciousness in 2012 after suffering a catastrophic brain injury and never recovered, they report.

    In 2015 they were contacted by the family, who were struggling to get the case to court to get permission for withdrawal of life support.

    They say the annual cost of supporting a patient in persistent vegetative state is about £90,000 a year.

    They write: “The length of time this case took to be resolved is sadly rather typical of many cases that go through the courts.

    “The costs of continuing to give treatment that is not in the patient’s best interests (and which the family believes the patient would not want) are huge, both financially and ethically."

    Causes and consequences of delays in treatment withdrawal from PVS patients: a case study of Cumbria NHS Clinical Commissioning Group v Miss S and Ors [2016] EWCOP 32 Journal of Medical Ethics 23 September 2016; doi 10.1136/medethics-2016-103853 [abstract]


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