Medico Legal

Researchers from the Musculoskeletal Research Unit at the University of Bristol have found that eight out of 10 total knee replacements and six out of 10 total hip replacements will still be in place after 25 years. The research, funded by the National Joint Registry and the National Institute for Health Research was published in The Lancet in February.

After reviewing thousands of case studies going back 25 years across six countries, generalisable survival data is now available for the first time to estimate how long hip and knee replacements are likely to last.

Health Secretary Jeremy Hunt has accepted the findings of Professor Sir Norman Williams’s review of the use of manslaughter gross negligence charges against doctors. The review was commissioned by Mr Hunt in February, prompted by the conviction of Dr Hadiza Bawa-Garba following the death in 2011 of a six-year-old boy in Leicester.

The conviction caused an international furore, with the president of the Australian Medical Association in New South Wales commenting: “How on earth was the doctor convicted of manslaughter? We don’t understand it.”

Doctors are increasingly expected to provide patient care in unsafe environments, where a persistent culture of blame stifles learning and discourages innovation. That is the conclusion drawn from a BMA survey: part of an ambitious project aiming to find solutions to the challenges faced by the NHS.
The project – Caring, Supportive, Collaborative – has seen almost 8,000 doctors provide accounts of their working lives across the NHS. It will go on to look at how working life can be improved.

BMA council chair Chaand Nagpaul said: “It is vital that the government and policymakers heed the views of all doctors who provide care at the coalface; they are in the best place to know the problems the NHS faces on a daily, hourly basis.

“They know the scale of impoverishment in the NHS is staggering and they are working in a culture which has improved little since the publication of the Francis and Berwick reports following the tragedies in Mid-Staffordshire five years ago.”

Confirmation that Health Secretary Jeremy Hunt is to launch an initiative to reduce prescribing and medication errors in the NHS was met with a mixed response from bodies representing the pharmacy sector.

The move was confirmed by Pharmacy Minister Steve Brine MP in his speech to the Royal Pharmaceutical Society’s annual conference in September. Mr Brine said that studies currently indicate that up to 8% of prescriptions have a mistake in dosage level, course length or medication type.

He said: “Patient education and safe management of information will be at the heart of our efforts to tackle this serious issue. For example, we will need to improve how we use electronic prescribing, as well as how we transfer information about medicines between care settings, where there is significant scope for errors.”