Training Blog

Health Secretary Andy Burnham announced that the days of NHS junior doctors working 80 hour weeks have gone for good and that the “overwhelming majority” of junior doctor rotas will comply with the European working time directive by 1 August.

Due to the fact that the NHS is seriously understaffed it means that junior hospital doctors are working an 80-hour week often unsupervised. It is believed that scrapping this system will be a long-awaited boost to their morale. One reason that the system was reviewed was because of the number of reports of serious, potentially fatal, mistakes or near-misses, made while coping alone and exhausted on a ward late at night and their consultant bosses were tucked up in bed.

This is made worse when junior doctors complain to their consultants about the excruciatingly long hours, the clerical work, the endless list of minor tasks are still told: ‘We did it, so can you.’ Do consultants not realise that things are changing all the time? The number of staff has decreased due to the economic climate meaning that jobs have been cut and the amount of paperwork has increased due to various policies put in place by those higher up the ladder, some are a result of Government policy and others are a result of media coverage of errors in practice.

The number of NHS trusts who claim that they are following the child protection guidelines has declined. According to the Care Quality Commission (CQC) there has been a 3.1% decline in reporting compliance, but the vast majority of those were meeting these and many other standards. The Care Quality Commission (CQC) found a 3.1% decline in those reporting compliance, but the vast majority were meeting these and many other standards. Half of all trusts report that they are meeting all measures concerning issues ranging from hygiene to patient confidentiality. In the period 2005-2006 only 1 in 3 trusts were meeting the the measures.

The child protection guidance includes making sure staff are trained in recognising children who may be at risk, those who fail to meet these standards could lose their licence.

Those who defend the NHS argue that “The NHS has delivered steady improvements in compliance and that should be commended. But it remains concerning that all trusts aren’t meeting core standards on safety and quality, five years after they were introduced. They also argue that anyone reading all of the report cannot fail to come to the conclusion that there is a great deal that is improving in the NHS. However there is still considerable room for improvement and the service recognises that.”

There has been a greater focus in recent years on the areas of child protection and employment checks. Statistics show that standards in these areas are not improving but it should be emphasised that in these cases trusts are both being expected to deliver more and are asking more of themselves.

The painkiller co-proxamol has been gradually phased out after its licence was removed in 2007, since then there have been 350 fewer suicides and accidental deaths. The reason the drug was banned was due to the fact that studies such as that done by Professor Keith Hawton of Oxford University showed that co-proxamol was responsible for one fifth of drug related suicides.

Co-proxamol is a mixture of paracetamol and an opiod drug called dextropropoxyphene. It was used to manage the pain in conditions such as arthritis. Co-proxamol is extremely dangerous as even a slight overdose can be fatal as it takes effect very quickly so death occurs before medical attention can be sought.

Since the licence was removed there is a system in place where doctors could prescribe the drug on a named patient basis. This is for patients who are unable to manage their pain using alternatives, although they do so at there own risk because it is an unlicensed drug.

It seems that with any drug there is the risk of an overdose just so happens that the media found out about this one and created alot of hype otherwise known as a moral panic which then caused the regulators to remove it. If that’s the case then why not move drugs such as aspirin, that are readily available because if somebody decides that they want to commit suicide then they will do so using any means at their disposal, so are the regulators going to slowly ban every drug and put it on a named patient only system. This will not only cause problems for people who wish to gain access to analgesia or other fairly routine medication such as hayfever remedies, also it will cause the pharmaceutical companies to lose billions as the number of their product sold will decrease.

Scientists have found that the anti-cancer properties of carrots are more potent if they are not cut up before cooking. It is estimated that carrots that are boiled before they are cut contain approximately 25% more falcarinol, which is and anti-cancer compound. Dr Kirsten Brandt, from Newcastle University claims that: “Chopping up your carrots increases the surface area so more of the nutrients leach out into the water while they are cooked. By keeping them whole and chopping them up afterwards you are locking in nutrients and the taste, so the carrot is better for you all round.” The latest findings indicate that when carrots are heated the cells lose the ability to hold water inside them thus increasing the falcarinol concentration.

Studies show that in blind taste studies the whole carrots also tasted much better, eight of ten people favoured the whole vegetables over those that were pre-chopped. The reason for this is because the naturally occurring sugars which are responsible for giving the carrot its distinctive flavour were found in higher concentrations in the carrot that had been cooked whole.

Dr Kat Arney, from Cancer Research UK, remains unconvinced that keeping carrots whole would have any impact on cancer risk arguing that: “When it comes to eating, we know that a healthy balanced diet – rich in a range of fruit and vegetables – plays an important part in reducing the risk of many types of cancer, rather than any one specific food.”