Training Blog

Homeopathy is a type of therapy based on the idea that disease can be treated with minute doses of drugs that are thought to be capable of producing the same symptoms in healthy people as the disease itself. It was invented by German physician, Samuel Hahnemann during the late 18th and early 19th centuries. It became both refined and popularized courtesy of James Tyler Kent, an American physician .

Homeopathy is based on the idea that every naturally occurring element, plant, and mineral compound, when ingested or applied, will result in certain symptoms. Hahnemann believed that diluting the substances in a standardized manner, it was possible to reach the true essence of the substance. He described the process of dilution as “potentizing” the substance. The diluted amounts could then be used to treat the very symptoms they were known to produce.

Hahnemann and his students approached the treatment in a holistic way, in other words the whole of the body and spirit is dealt with, not just the localised disease. Hahnemann spent extensive periods of time with his patients, asking them questions that dealt with their particular symptoms or illness, aswell as questions about their daily lives. It is thought that homeopathy is a response to the violent forms of medicine used at the time.

Homeopathy teaches that symptoms are to be encouraged, by prescribing a “remedy” in minuscule doses that in large doses would produce the same symptoms seen in the patient this is because homeopathy is based on the idea that the symptoms are the body’s way of fighting disease, it is believed that the treatment is designed to simply stimulate the immune system to help cure the disease.

However there are those who think that homeopathy is useless and suggest that it is a load of nonsense, these views are quite clearly expressed in “Needed – irresponsible idiots to work with aids in Botswana”. This article is particularly good as it shows a case which homeopathy does seem rather ridiculous rather than just simply dismissing it they use the case study to support their argument. Further support that homeopathy is not a cure was recently in the news, Homeopathy not a cure.

So it would seem that there is alot of evidence to support the argument that it is useless. Some people use it as an alternative to conventional medicine while others use it as a last resort. The question is the people who claim it works is it simply psychological? The same could be argued for any form of treatment could all forms of treatment simply be placebos used to trick the brain into fighting diseases? Whatever your take on this these questions must crop up and there is no consistent answer it depends on the individual, although you will find that the vast majority will dismiss the idea that all forms of treatment are placebos purely on the basis that people who receive treatment don’t want to believe that the treatment is essentially useless.

For those of you who don’t know the term clinical director can be divided into the categories lab director, medical director, chief of service, etc. Essentially it just means that they are Top Dog of a department in terms of the medical side of things. For those of you who are familiar with the TV Show “House” the title character Gregory House is a clinical director as are Cameron and Wilson.

National clinical directors and advisors who are sometimes called Tsars are experts that supervise the implementation of a national service framework (NSF) or major clinical or service strategy. Tsars are acting advocates for the NSF or strategies within the NHS. They work with policy and delivery teams to achieve joined up action.

As national clinical directors the role also involves:

• visiting health and social care practitioners
• chairing task forces with health and social care professionals and health service managers
• working with the Royal Colleges to ensure that changes in health and social services are reflected in training and education
• chairing task forces to develop national service frameworks that bring together health professionals, service users and carers, health service managers, partner agencies, and other advocates.

Despite being at the top of the employment ladder there is still plenty of room for learning and as a result there are plenty of courses for Clinical Directors. A particularly good one is Core Skills in Finance & Business Planning for Consultants & Clinical Leaders, provided by Medicology.

Statistics show that more than £600 million is the cost to the NHS for patients failing to keep hospital appointments. That’s enough to run two medium-size hospitals! The figures show that between 2007 and 2008 6.5 million patients missed appointments which cost hospitals £100 per patient in revenue. In order to compensate for this some places are overbooking to compensate for people not attending, however there are drawbacks with this idea such as disadvantaging patients if 100% attendance occurs. Young males appear to make up the biggest portion of those that don’t attend appointments. At the opposite end of the scale people aged between 70 and 74 were the most conscientious in terms of attending appointments. However it isn’t all doom and gloom, over the past few years the attendance figures have improved slightly in England, Northern Ireland and Wales. Unfortunately the same can’t be said about Scotland where figures have increased.

Schemes such as sending text message reminders are being rolled out by the Department of Health. Whilst some say that missing appointments is unforgivable Unison is saying that the patients are not to blame when appointments are arranged months in advance. Other initiatives such as the choose and book scheme have also been introduced in order to reduce the number of missed appointments.

It is common courtesy to inform the doctor that you won’t be able to make the appointment or that you no longer require their services. Obviously this can’t be done if you forget but simply not attending is just rude and also selfish as not only is it wasting health professionals’ time and money but it is also impacting on others such as those who are on waiting lists or need to make an appointment but are unable to get one because the doctors are fully booked.

If their mothers are obese the statistics show that the daughters are 10 times more likely to be overweight; with sons the chance is 6 times more likely that they will be overweight if their father is overweight.

These results came from a study into whether childhood obesity was linked to environmental influences instead of genetic ones. The study involved looking at BMI’s for 226 five-year-olds and their parents. The researchers noted a relationship between the BMI of the children and the same sex parent. However no link was found between the children and the parent of the opposite sex. This suggests that the link is environmental as if it was genetic it would be unlikely to be gender selective.

These findings are not really surprising as it is a logical step that the parents eating habits and lifestyle would influence the child but what is surprising is that it seems to be gender specific. One possible explanation for the relationship between children and same sex parents is that the children use their parents as role models and so model their behaviour on the parent of the same sex.

If this is the case you would have thought that the parents would ensure that they are a positive role model for their children. Also they should take into consideration that the “fat kids” are usually singled out by bullies and are more prone to health problems such as diabetes and heart problems, add into the mix the psychological problems such as low self esteem. It is also worth pointing out that your eating habits can be passed down through the generations so not only are your children affected but your grandkids and great….grandkids.

We all know that good communication is key but it is not always practised as the coroners reports are showing, there seems to be a high number of deaths which could have been avoided. Since the rules were changed last year, coroners have been able to write detailed reports following inquests that highlighted a risk of more deaths occurring. Coroners reported that better communication could reduce the number of deaths occurring in hospital.

Out 207 reports between July 2008 and March 2009, 58 arose from hospital deaths, 19 were classed as mental health related, 19 were associated with community healthcare and emergency services and 11 were linked to drugs and medication.

So what is good communication?
Good communication is sharing information is a clear and concise manner with everyone who is involved in the care of the patient, it is also ensuring that the patient fully understands what is going; obviously in emergency situations this is not always possible at the time but after the emergency has passed they need to be told what is going on. This will minimise the chance of the patient possibly taking the wrong medication or committing suicide because they become depressed.

There are a number of courses available which are designed to help improve communication skills. One particularly good one is done by Medicology, Communication Skills for Doctors.

The government is planning to ban all private transplants of organs from dead donors in the UK. The ban comes as a result of media reports of patients from countries such as Greece and Italy paying to get on waiting lists for organs from British people, so due to the fact that organs are scarce the general consensus is that to ensure NHS patients don’t miss out no one should be allowed to pay for transplants. At present the ban is only been approved in England but is expected to come into place across the rest of the UK by October.

An enquiry carried out revealed that over 700 transplants, most of which were liver transplants, had been carried out on non-UK patients over the past 10 years. Of the 700 transplants 631 of those transplants used organs from dead donors and, of those, 314 were from outside the EU. It is worth pointing out that the enquiry uncovered no evidence of wrongdoing with regards to the allocation of the organs but came to the conclusion that no one should be able to pay for such operations. According EU law, some patients can receive treatment in other countries, if approved by their healthcare system, which then foots the bill, however the NHS should be more cautious when assessing patients’ eligibility as it is possible that some patients are receiving treatment when they should be refused. Some say that the NHS should work with other EU countries to help develop their own transplant scheme.

The ban only applies to transplants from dead donors private transplants can still be carried out using organs from living donors. Critics of the ban claim that the only reason people pay for transplants is the NHS takes so long that you will probably be dead before you get it. They also point out that it is illegal to sell your organs so why should hospitals be allowed to sell organs to the highest bidder, especially when there are not enough organs available for citizens of the UK. The organs should be allocated on the basis of who is in the greatest need instead of who can afford to pay.

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.

We’ve all heard about the growing rates of obesity in Britain and the USA. With the increasing number of bizarre diets and diet pills it was only a matter of time before somebody invented a pill that could apparently cure obesity. The company that invented the drug called Lorcaserin saw a 20% decline in shares after it announced that the 2 year trial period on 3,000 patients at over 100 sites throughout the US had fallen short of the benchmark sought by the US Food and Drug Administration (FDA).

The results of the trial were:

• 47.5% of Lorcaserin patients lost 5% or more of their body weight, compared to 20.3% in the placebo group in 12 month.
• In the first 12 months the Lorcaserin group lost on average 5.8% of body weight (12.7 pounds), compared to 2.2% (4.7 pounds) in the placebo group.
• In total 22.6% of Lorcaserin patients lost 10% or more of their body weight compared to 7.7 % in the placebo group.

It seems that there are also reports the results are more than good enough to meet the FDA requirement for approval, the Arena claims that the drug has met all its primary endpoints, and shows significantly greater weight loss compared to placebo.

It is already accepted that obesity is a widespread disease, so having an effective therapy that can be used by the majority of patients who need to reduce their weight that could also be beneficial for conditions, such as diabetes, lipid disorders, and cardiovascular disease, Lorcaserin is the first in a new class of selective serotonin 2C receptor agonists; the serotonin 2C receptor is in the hypothalamus and other parts of the brain and helps to control of appetite and metabolism. This could potentially save the NHS millions of pounds as instead of paying for patients to have procedures such as stomach stapling and liposuction, a simple course of tablets can be just as effective.

One idea that seems to be frequently cropping up especially with the current economic climate is that dentists should have a limit on the amount of private work they can do. This is due to the privatisation of alot of dental clinics; it is argued that the limit on the amount of private work they can do was justified as it cost the NHS £175,000 to train a dentist.

However there was opposition from dental leaders who said that they were against the idea of quotas, pointing out that there were dentists who wanted to do more NHS work but could not. Since the privatisation of many dental practices patients continue to struggle to find NHS practices with capacity to take them. The figures show that there are one million fewer patients actually using NHS services now, compared with when the arrangement started. The opposition pointed out that the majority of dentists’ income is evenly split between private and public patients, but there are signs that younger dentists are more likely to turn their backs on the health service.

Some people argue that it is the credit crunch that is to blame for dentists going private as on average private patients pay more for treatments whereas the NHS allocate a fixed amount of money to each practice which you would of thought would be better for dentists as it is a guaranteed amount, also the NHS pays for their training but it would seem that there must be a reason that they choose to stay private.

According to Action for Blind People more people could end up going blind as they avoid getting their eyes tested. This is because the majority of people have to pay to get their eyes tested so when money becomes tight people are reluctant to pay for things like that instead they focus on ensuring that they keep up with the payment of bills and mortgages instead. Other things that have seen a decline is people taking time off work to have treatments such as those to remove cataracts; it is assumed that the reason for this is that during times when businesses are making cut backs of staff people are becoming scared to take time off for whatever reason as they feel that when deciding who to “get rid of” any time off will count against them.

Dental care has also seen a decline in the number of people getting regular check ups and then the subsequent treatment that may follow. It would seem that treatments that are not deemed to be essential are being ignored by people as they worry about the cost and the issues previously mentioned about having time off.

The number of people purchasing condoms has declined as people are trying to save money which is ultimately resulting in more people putting themselves at risk. One particular clinic noted an increase on the number of patients presenting at the clinic with severe cases of various STIs as people aren’t taking precautions and then ignore the problem until it becomes a severe problem.
It may be worth reminding people that condoms are free from family planning clinics and your GP. Also if you end up pregnant as a result of not using a condom it will ultimately cost you more and may go against you when employers are making staff cut backs.

In summary whilst I can appreciate that money is tight at the moment the cost of the basic check ups and contraceptives it is worth it because it detects problems earlier on therefore means less time off work and treatment may be cheaper and to some extent cheaper.