“Developing Themes in Clinical Practice”
- a meeting for consultants.

was held on
Wednesday 29th October 2008
at The King's Fund

This meeting provided some various topics which promoted some active participation from the audience. Mr. Michael Green, Chief Executive from Trust Health Ltd. spoke about the contracting opportunities for groups of consultants to carry out NHS contract work. The potential impact on the independent sector was noted. There are considerable complexities of coding which are slowly being improved.

Dr. Gerard Panting, Director of TWG consulting and FIPO Board member described the various government papers and responses to the Shipman enquiry which resulted in the Chief Medical Officer’s proposals on affiliates and responsible officers. Although scaled down from the original proposals there appears to be a desire to press ahead with the responsible officer role and there are two pilot schemes currently in place in north London and Yorkshire. The audience rapidly identified the considerable difficulties that would arise from this system if imposed nationally, not least of which would be the need for every doctor to identify a responsible officer, the overlap between various areas of work. The funding of the programme and indemnification were two other issues as yet unresolved.

Mr. Rodney Laing, Consultant Neurosurgeon from Addenbrooke’s Hospital, described eloquently the various political moves to engage the views of patients and described a number of validated techniques such as SF36 to obtain patient opinions. His own studies of SF36 in spinal surgery had shown good correlation between outcomes and patient scores but under questioning Mr. Laing agreed that there were many clinical scenarios in which such scores would not work. However, the drive for PROMS (patient recorded outcome measures) was inexorable and driven by political rather than academic source.

Mr. Simeon Maskrey QC gave an animated review of the legal aspects of medical negligence. Through a number of pithy examples he demonstrated that clinicians were, in fact, largely protected by the law although some cases had modified the legal position. He defined duty of care; breech of duty and causation but throughout he stressed the absolute need to maintain clear contemporaneous notes. Under questioning about guidelines Mr. Maskrey felt that these were not sacrosanct and could be breached provided a clear and logical statement was made at the time by the doctor to explain his actions.

Original agenda

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