Junior Doctors Prepare For First Full Walk-Out

[TheDaddy]

Originally Posted by nomadking

Those pilot studies are examples of where 7-day is happening right now.

Let's hope those figures are correct then

Originally Posted by martyh

I can't see where Hunt has BS'd anyone unless i'm missing something ,he has cut the hours in the new contract ,he has given a pay rise in the new contract and he has put safeguards in place to prevent overwork all in the new contract ,so since the doctors have yet to adopt the new contract how can anyone say that Hunt has lied and BS'd everyone ,maybe i'm missing something

Passing opinion pieces of as studies isn't bs, passing studies of as legit that haven't been peer reviewed isn't bs, claiming to have three independent reports without mentioning they use the same study data isn't bs and telling blatent lies about mortality rates, dead babies and strokes isn't bs, no wonder he has been doing everything he can to avoid his day in court.

Originally Posted by TheDaddy

Let's hope those figures are correct then



Passing opinion pieces of as studies isn't bs, passing studies of as legit that haven't been peer reviewed isn't bs, claiming to have three independent reports without mentioning they use the same study data isn't bs and telling blatent lies about mortality rates, dead babies and strokes isn't bs, no wonder he has been doing everything he can to avoid his day in court.

But what has any of that got to do with the new contract and the strikes .Whatever you think of the data that Hunt has used and the way he presented it ,it doesn't detract from the fact we still need a 7 day NHS and that the doctors have got what they asked for ,in some cases more.

[nomadking]

Originally Posted by TheDaddy

Let's hope those figures are correct then

Passing opinion pieces of as studies isn't bs, passing studies of as legit that haven't been peer reviewed isn't bs, claiming to have three independent reports without mentioning they use the same study data isn't bs and telling blatent lies about mortality rates, dead babies and strokes isn't bs, no wonder he has been doing everything he can to avoid his day in court.

The figures from the pilot studies are actual real figures.

The British Medical Journal wouldn't be publishing non-peer reviewed work. There are too many studies in the UK and from around for the world for it not to be an issue. Even if it isn't an issue, so what.

These concerns have led to calls for better service models in hospitals at the weekend from Health Education England, the Academy of Medical Royal Colleges, the Royal College of Physicians, and the Royal College of Surgeons with the aim of not only improving patient outcomes but also to enrich the training of the next generation of NHS doctors.

Are they all wrong?

The compassionate argument: patients should be entitled to receive the same standard of care regardless of the day of the week. Furthermore patients should be able to access care over the weekend if they need it regardless of whether it is an emergency. The potential benefits are a reduction in suffering and/or the provision of peace of mind.

Anything wrong with that sentiment?

Salford Royal found that the introduction of the emergency village saved significant acute ward bed days by preventing admissions beyond the front door into acute ward beds. These savings largely paid for the additional investment in clinical and other staff in the emergency village.

In at least some trusts with actual experience, the costs of seven day services at the front-end of the hospital can pay for themselves by reducing bed usage: partly reducing unnecessary admissions through better initial assessment and partly reducing length of stay by putting patients onto the right clinical pathway as soon as possible.

[Arthurgray50@blu]

The biggest trouble with the NHS. Is that there is NOT enough being umped into it. And the Tories hate spending the Money into it, as they are not getting anything from it.

I was reading recently where, patients are being sent miles from home for treatment as there are no beds. In the region where they live.

We have elderly being kept in hospital as there is a shortage of care in the home. There fore they are taking up beds. Which can be used for Urgent care patients.

My neighbour has been moved SIX times to separate wards. As they needed the bed in the acute care dept. where he is. And he has been there one week tomorrow. And he cannot come home. As he has gone yellow. And been told that he has cancer. Lymphoma - I think that's what they call it. A large lump on his neck

Jeremy Hunt isn't a Dr. So is going on info from NHS England.

What the Government has to do is sit round a table and sort this mess out.

I strongly believe that Drs and Nurses should get the high wage deserve. And you cannot have SEVEN DAY service, unless you pay for it. If you were working Five days, and they wanted yu to work extra hours for nothing. Would you do it. I wouldn't do it.

[nomadking]

OK, so where's this utter garbage(and that's putting very politely) about working extra hours and no extra money coming from?

Maximum average 48 hour working week (reduced from 56) with doctors who opt out of the WTR capped at maximum average of 56 working hours per week.
Maximum 72 hours’ work in any seven day period (reduced from 91).Maximum shift length of 13 hours (reduced from 14 hours).
Maximum of five consecutive long (>10 hours) shifts (reduced from seven) with minimum 48 hours rest after a run of five consecutive long shifts (up from 11 hours rest).
Maximum of four consecutive night shifts (reduced from seven) with minimum 46 hours rest after a run of either three or four consecutive night shifts (up from 11 hours rest).
Maximum of four consecutive long, late evening shifts (>10 hours finishing after 11pm) with minimum 48 hours rest after four consecutive long, late evening shifts (up from 11 hours rest).
No doctor should be rostered to work more frequently than one weekend in two (a slightly different definition of weekends applies to F2 doctors for one rotation only).
Maximum eight consecutive shifts with 48 hours’ rest after eight consecutive shifts (reduced from 12 consecutive shifts), apart from low-intensity non-resident on-call rotas, for which a 12-day maximum applies.
No more than three rostered on-calls in seven days except by agreement, with guaranteed rest arrangements where overnight rest is disturbed.
Maximum 24-hour period for on call which cannot be worked consecutively except at weekends or by agreement that it is safe to do so.
Work rostered following on-call cannot exceed 10 hours, or 5 hours if rest provisions are expected to be breached.

The Prime Minister has announced details of a new, voluntary contract for GPs to deliver 7-day care for all patients by 2020. He has also unveiled proposals to deliver 7-day hospital services across half the country by 2018. These are the next steps in making England the first country in the world to provide a truly 7-day health service, underpinned by a strong economy and £10 billion of investment in the NHS.

So less hours and £10billion. Does that sound like longer hours and no money?

[TheDaddy]

Originally Posted by martyh

But what has any of that got to do with the new contract and the strikes .Whatever you think of the data that Hunt has used and the way he presented it ,it doesn't detract from the fact we still need a 7 day NHS and that the doctors have got what they asked for ,in some cases more.

If the rationales used to justify the 7 day service are false then perhaps we don't need as 7 day nhs after all.

---------- Post added at 22:52 ---------- Previous post was at 22:49 ----------

Originally Posted by nomadking

The figures from the pilot studies are actual real figures.

The British Medical Journal wouldn't be publishing non-peer reviewed work. There are too many studies in the UK and from around for the world for it not to be an issue. Even if it isn't an issue, so what.

Are they all wrong?

Anything wrong with that sentiment?

If they came out of hunts mouth I wouldn't trust them and the validity of all claims is soon to be tested.

[nomadking]

Originally Posted by TheDaddy

If the rationales used to justify the 7 day service are false then perhaps we don't need as 7 day nhs after all.

---------- Post added at 22:52 ---------- Previous post was at 22:49 ----------
If they came out of hunts mouth I wouldn't trust them and the validity of all claims is soon to be tested.

Still absolutely nothing to do with the new contract and the strike.

How many studies do you need from around the world that have all firmly established the "weekend effect". It is the medical profession doing the studies.

[TheDaddy]

Originally Posted by nomadking

Still absolutely nothing to do with the new contract and the strike.

How many studies do you need from around the world that have all firmly established the "weekend effect". It is the medical profession doing the studies.

I'd like to see independent British ones that aren't relying on using the same data and therefore aren't independent and this weekend effect is it like when hunt claimed more babies die at weekends when the truth is Thursdays are the worst day.

[nomadking]

Overall, that amounts to an extra 11,000 deaths a year among those admitted between Fridays and Mondays.
Prof Sir Bruce Keogh, NHS medical director, one of the authors of the landmark study, said it revealed an “inconvenient truth” which could no longer be ignored, and required an overhaul in the way services are run.
The research by University Hospital Birmingham NHS Foundation Trusts and University College London, examined the effect of hospital admission day on death rates across NHS England hospitals for 2013-201

A British study of more than 25,000 patients found those who took ill at the start of the weekend have death rates one fifth higher than those admitted during regular working hours.
...
Researcher Dr Rahul Potluri, from Aston University, which led the ACALM study, said the differences were "extremely stark".

There will be more neonatal deaths on a Thursday simply because of their being more births that day of the week, It is about the proportions.

The most common day for giving birth was Thursday (15%; 206 732 births and 205 632 maternities), and the least common was Sunday (12%; 167 159 births and 159 132 maternities).

Published in British Medical Journal.

William L Palmer, honorary research fellow
A Bottle, senior lecturer
P Aylin, professor of epidemiology and public health
This study provides an evaluation of the “weekend effect” in obstetric care, covering a range of outcomes. The results would suggest approximately 770 perinatal deaths and 470 maternal infections per year above what might be expected if performance was consistent across women admitted, and babies born, on different days of the week.
...
MacFarlane published a paper in 1978 that showed a seven day cycle in birth numbers across England (and Wales) and that perinatal mortality was higher among babies born at weekends.Similar studies in the 1970s found similar phenomena in other developed countries.The delivery of obstetric care has changed dramatically since that time; however, where the weekend effect has been evaluated, this has predominantly been based on mortality. In setting out key challenges in obstetric care—albeit in a broader, global context—a paper from the World Health Organization highlighted ineffective referral to, and inadequate availability of, 24 hour quality services to emergency obstetric care services
...
Performance across four of the seven measures was significantly worse for women admitted, and babies born, at weekends. In particular, the perinatal mortality rate was 7.3 per 1000 babies delivered at weekends, 0.9 per 1000 higher than for weekdays (adjusted odds ratio 1.07, 95% confidence interval 1.02 to 1.13).

Dharmintra Pasupathy, MRC/RCOG clinical research fellow
Angela M Wood, lecturer
Jill P Pell, Henry Mechan professor of public health
Michael Fleming, statistician
Gordon C S Smith, professor of obstetrics and gynaecology
Objective To determine the effect of time and day of birth on the risk of neonatal death at term.Design Population based retrospective cohort study.
Setting Data from the linked Scottish morbidity records, Stillbirth and Infant Death Survey, and birth certificate database of live births in Scotland, 1985-2004.
...
Conclusions Delivering an infant outside the normal working week was associated with an increased risk of neonatal death at term ascribed to intrapartum anoxia.

And there's plenty more where they came from.

[TheDaddy]

Originally Posted by nomadking

There will be more neonatal deaths on a Thursday simply because of their being more births that day of the week, It is about the proportions.

Published in British Medical Journal.

And there's plenty more where they came from.

That's not what hunt said, his claims about strokes were proven to be nonsense as well. I wonder if any of these reports you link make up any of the much vaunted eight studies hunts based all his claims on that have proved false

[nomadking]

Originally Posted by TheDaddy

That's not what hunt said, his claims about strokes were proven to be nonsense as well. I wonder if any of these reports you link make up any of the much vaunted eight studies hunts based all his claims on that have proved false

Proved false? Or just excuses based on conjecture?

In the summer, the BMA put a pay calculator on its website – so inaccurate it has since been removed – which told junior doctors their wages would be cut by 30-50 per cent.

Objective: We assessed in-hospital mortality and utilization of invasive procedures following ischemic stork admissions on the weekend versus weekdays in the United States.
,,,
Conclusion: For stroke patients, weekend admission is associated with higher mortality and lower utilization of invasive procedures, and those who did undergo these interventions had higher rates of mortality and complications than their weekday counterparts.

Plenty of other medical conditions to choose from and plenty of other reports from plenty of other countries, all saying the same thing.

Still nothing to do with the new contract and the strike.

[TheDaddy]

Originally Posted by nomadking

Proved false? Or just excuses based on conjecture?


Plenty of other medical conditions to choose from and plenty of other reports from plenty of other countries, all saying the same thing.

Still nothing to do with the new contract and the strike.

Yes proved false, as in he lied, you'd have thought he'd have saved himself the bother and used the plentiful supply of other countries research, perhaps he'll bring them to court

[nomadking]

Originally Posted by TheDaddy

Yes proved false, as in he lied, you'd have thought he'd have saved himself the bother and used the plentiful supply of other countries research, perhaps he'll bring them to court

Apart from anything else, if there was lying involved it would have been the DOCTORS doing the research. Any examples of this LYING?

Still nothing to do with the strike and the new contract. Nothing will ever change that fact.

Originally Posted by martyh

But what has any of that got to do with the new contract and the strikes .Whatever you think of the data that Hunt has used and the way he presented it ,it doesn't detract from the fact we still need a 7 day NHS and that the doctors have got what they asked for ,in some cases more.

I think the Junior Doctors suffered a set-back after the deal was accepted and then rejected. It's harder to see their justification now.

On the 7-day NHS though I do think the Goverment are trying to get it on the cheap. 2 extra days requires more funding surely? Substantially more funding. Maybe not 40% as I doubt their budgets scale like that but certainly a hefty increase. Then we also need more doctors. How is a 5 day week going to stretch to a 7 day week? You can adjust the timetables so the hospitals are staffed more on weekends but are we suggesting that the doctors sit around doing nothing during the week? If not then the coverage on weekdays will suffer. Spreading the same amount of butter on a large slice of toast will give you thinner..err..butterage.

Personally I would sooner seen the government abandon, for now, the plans for a 7 day NHS until such a time they have a clearer idea of how to fund it and how to staff it. If that requires reform into how we pay for the NHS (separate tax?) then so be it.

I also think any politician who says we can have better services at the same cost is a liar. We already don't push the boat out on spending compared to European countries. For whatever reforms we can introduce to help the solution to this problem is more money.

Originally Posted by Damien

I think the Junior Doctors suffered a set-back after the deal was accepted and then rejected. It's harder to see their justification now.

On the 7-day NHS though I do think the Goverment are trying to get it on the cheap. 2 extra days requires more funding surely? Substantially more funding. Maybe not 40% as I doubt their budgets scale like that but certainly a hefty increase. Then we also need more doctors. How is a 5 day week going to stretch to a 7 day week? You can adjust the timetables so the hospitals are staffed more on weekends but are we suggesting that the doctors sit around doing nothing during the week? If not then the coverage on weekdays will suffer. Spreading the same amount of butter on a large slice of toast will give you thinner..err..butterage.

Personally I would sooner seen the government abandon, for now, the plans for a 7 day NHS until such a time they have a clearer idea of how to fund it and how to staff it. If that requires reform into how we pay for the NHS (separate tax?) then so be it.

I also think any politician who says we can have better services at the same cost is a liar. We already don't push the boat out on spending compared to European countries. For whatever reforms we can introduce to help the solution to this problem is more money.

I always saw a 7 day NHS more of a load spreading exercise ,for example,if a hospital treats 100,000 in/out patients over 5 days surely it's better to treat the same 100,000 patients over 7 days ,less work load on the doctors and nurses.There will naturally have to be more doctors and nurses but the NHS is having a big recruitment drive anyway due to staff shortages .The main reason for a 7 day NHS is for out patients really imo