GPs' reactions to "internet-informed" patients

Don’t dismiss ‘cyberchondriacs’

Dr Anthea Martin
Dr Anthea Martin
Senior Medical Adviser with Medical and Dental Defence Union of Scotland

Searching the web

Many people now search the web for health information

As the internet becomes more and more easily accessible it is perhaps inevitable that patients should try to self-diagnose.

In this week’s health opinion column Scrubbing Up, medical law expert Dr Anthea Martin warns doctors against dismissing all web-wise patients as ‘cyberchondriacs’.

Picture the scene. A man walks into a GP’s consultation room and the doctor’s eye is immediately drawn to a 10-page print-out in his hand.

The GP suspects the patient has spent hours researching all of his symptoms on the internet before arriving at the appointment, armed with his dossier of medical information.

Some GPs said they were frightened of losing control of the consultation and of the prospect of having to admit to their patient that they have read something they don’t understand

It’s possible he has diagnosed himself with anything ranging from a simple cold or flu to some exotic disease such as dengue fever.

So, what would be the GP’s initial reaction? Does she welcome the chance to discuss her patient’s health, or does a look of panic cross her face while she gazes anxiously at the clock wondering how long the consultation will take?

click the link to read more about GPs’ reactions to “internet-informed” patients

Rise in "bed-blocking" in Scotland's hospitals

Rise in delayed discharges from hospital

  • Many patients staying too long in hospital
    Many patients staying too long in hospital

herardscotland staff

Published on 23 Feb 2010

The number of patients waiting in Scottish hospitals beyond the end of treatment has increased in the past year.

There were 606 delayed discharges in January, an increase from 492 in the same month last year, according to NHS statisticians at ISD Scotland.

Of those, 83 patients waited more than six weeks to leave, up from 79 in January 2009.

The problem arises when patients have to wait for necessary care, support and accommodation arrangements to be put in place.

Although up over the past year, the recent figures showed a fall from a peak in October.

Click link to read more about delayed discharges

Read ISD’s latest update about delayed discharges

London hospital tests handheld ultrasound scanner

Vscan handheld ultrasound scanner launched

By Fergus Walsh
Medical correspondent, BBC News

An ultrasound scanner the size of a large mobile phone has been launched in Europe and North America.

The Vscan can be used to image the heart and other organs.

Developer GE Healthcare says the portable device, priced at about £5,000 in the UK, is not designed to replace existing machines.

But it may offer rapid early diagnosis to triage patients in hospitals and the community who would then be referred for more specialist examination.

‘Not sci-fi’

It looks like a cross between a flip-top phone and the medical scanner used by Dr McCoy in the TV series Star Trek.

The Vscan is not science fiction but a hand-held ultrasound machine with a scanning wand attached, which has been approved for use in Europe and North America.

The device is being used in the cardiac investigation unit at St George’s Hospital in south London.

The moving colour images show blood flow around the heart and by switching to black and white you can see heart valves opening and closing.

Click the link to find out more about the handheld ultrasound scanner

Burnham to stress need for more NHS care at home

Health Secretary Andy Burnham

Mr Burnham said more treatments must be offered outside hospitals

There must be a “decisive shift” in the NHS to provide more care in people’s homes, the health secretary is to say.

Andy Burnham will stress on Thursday that the health service must be more “confident” in being able to offer services outside hospitals.

This could improve patient experiences as well as save billions, he will add.

The Tories have pledged to put patients in the “driving seat”, with people able to receive treatment for more minor ailments in their local communities.

‘Patient convenience’

The Lib Dems say high-street pharmacists and the voluntary sector should play a role in supporting patients with long-term conditions and those with one-off medical queries or issues.

In a speech, Mr Burnham will call on the NHS to reach out more to patients, arguing that it makes sound clinical and financial sense.

“The time has come for the NHS to make a decisive shift in providing more care out of hospitals and in the patient’s community and home,” he will say.

Integrating health services into the local community could save the NHS £2.7bn a year, he will argue.

click the link to read more about “decisive shift” in the NHS to provide more care in people’s homes

More patients may be treated at home by paramedics

Published Date: 18 February 2010

By Lyndsay Moss

Health Correspondent

MORE patients calling an ambulance in Scotland could be treated at home by paramedics rather than going to hospital, a report on the future for the service reveals.

The “strategic vision” for the Scottish Ambulance Service (SAS) over the next five years suggests more conditions could be treated without going to hospital, reducing trips to busy A&E departments.

At present, conditions that can be dealt with by paramedics at home under so-called “see and treat” guidelines are panic attacks, fainting, minor head injuries, fitting and epilepsy, diabetes and asthma. The report also said the service would work with “vulnerable” rural communities to improve the services they received, including more home care.

The SAS said it would develop a new system with NHS 24 and local out-of-hours providers to make sure patients got through to the right service they needed, after its consultation suggested widespread public confusion.

It comes after The Scotsman revealed last week that doctors were increasingly concerned the NHS will not be able to cope with rising demand for emergency out-of-hours services.

The report, which follows a lengthy public consultation, looks at plans to improve the care given to patients from 2010 to 2015.

Demand for ambulances is growing every year. Between 2003-4 and 2008-9, call-outs went up 35 per cent, with a 41 per cent rise out of hours. At the same time, more patients are being treated in Scottish A&Es. This year, it is expected they will deal with more than 1.6 million patients.

Click the link to read more about The “strategic vision” for the Scottish Ambulance Service (SAS)

Survey finds Scots to be the UK's second-fattest people.


The BMI map, issued by Slimming World, the UK’s leading weight loss organisation, puts people in the East Midlands at greatest risk with around 7 out of 10 adults in cities like Leicester, Derby and Nottingham now approaching the borderline between overweight and obesity. The map shows an average BMI of 28.9kg/m². The higher a person’s BMI, the greater the risk of developing life-threatening conditions such as diabetes, heart disease and stroke.

The trend is much the same across most of the UK, with increasing numbers of people in Scotland, the West Midlands, the North West and Wales presenting a BMI that is closer to being obese than it is to a healthy weight. In light of the statistics, Slimming World launches a “Let’s Beat It Together” community weight loss campaign on 22 February to get together with people in communities all over the country to help turn the rising tide of obesity together.

The data comes from a national survey by Slimming World and YouGov which also reveals that while one in three very overweight people believe there is a genetic explanation for their size, a significant 73% feel that the environment around them is the cause of their condition.

Average BMI breakdown by region

REGION Average BMI (kg/m²)
  1. East Midlands
  1. Scotland
  1. West Midlands
  1. North West
  1. Wales
  1. East of England
  1. South West
  1. Northern Ireland
  1. Yorkshire and The Humber
  1. South East
  1. North East
  1. London


Healthy BMI = 18.5 to 24.9 kg/m²

Overweight BMI = 25 to 29.9 kg/m²

Obese BMI = 30 to 39.9 kg/m²

Morbidly obese BMI = more than 40 kg/m²

Click the link to read the full article about BMI

Don't be tomorrow's Headline – ICO Announces £500k fines as of April 2010

£500k data loss fine could hit from April

As reported recently online by Nick Heath and others Companies that lose individuals’ sensitive personal data will face a fine of up to £500,000 under powers expected to come into force from April.

The powers will allow the UK’s privacy watchdog, the Information Commissioner’s Office, to fine private and public sector organisations that commit a serious breach of the Data Protection Act.

Justice minister Michael Wills laid a statutory instrument before Parliament on Tuesday, setting the maximum fine at £500,000. The instrument will become law by default on 6 April this year, unless Parliament objects.

Follow the link to read more on this security article

Follow this link to find out more about the Scotland IS security meeting

GP appointment system in Scotland frustrating

Generic GP writing prescription

The report found frustration with the appointment system

The current GP appointment system is a “frustration” for doctors and patients, a report for the British Medical Association (BMA) in Scotland has said.

Doctors, charities and the public said a more flexible approach to appointments should be a top priority for the service in future.

Patients have also called for better access to GPs via e-mail and telephone.

The BMA said research was needed to understand why demand for frontline health services was rising.

The report said: “Demand across all services, NHS 24, A&E and Scottish Ambulance Service is increasing. This continued rise in demand must be addressed.

Going back to old styles of working with GPs controlling other members of the healthcare team is not an option
Theresa Fyffe
Royal College of Nursing in Scotland

“In order to do so, it is important to understand why patients are seeking more support out-of-hours and the decision-making process they undertake when contacting an out-of-hours service.”

The report points to 1.55 million A&E visits in 2006/07, up 50,000 on the previous year.

Holyrood’s health and sport committee is investigating the availability of out-of-hours care in rural areas.

The report also said there was a “lack of awareness” that telephone helpline service NHS 24 is the “first point of contact” for non-urgent out-of-hours care.

“The Scottish government should commission research on the beliefs that underpin decisions to contact out-of-hours services and why demand is rising,” it said.

Follow this link to read more about the frustrating GP appointment system

Download the New BMA Policy document General Practice in Scotland: The Way Ahead

Doctors refused to see patients after computer KO


By Donna MacAllister

Published: 09/02/2010

Hundreds of people in Moray were unable to see their GPs after a computer system crashed, blocking access to medical records.

Patients were turned away from the Maryhill Practice at Elgin Health Centre after doctors decided it would be too dangerous to treat them without being able to check their medical history.

The centre stayed open for emergencies, but practice manager Eileen Rae said it was the first time in her 21 years in the role that patients could not be treated.

“It is very disappointing to say the least,” she said.

Mrs Rae said the situation came to a head when computers crashed last Tuesday.

Around 200 patients were affected and it had been distressing for medical centre staff who were forced to tell them they could not be seen by a doctor on that day.

Read more  about this computer outage

InterSystems TrakCare selected as the new national patient information system for Scotland

-Nurses and doctors set to benefit from easier and quicker access to patients’ records-

Eton, UK – 03 February 2010 – InterSystems has announced that it has signed a framework contract with NHS National Service Scotland to supply its InterSystems TrakCare™ connected health information system as the new national patient management system for Scotland.

The contract is a national framework in line with Scotland’s eHealth Strategy that will enable any Health Board access to the system and associated modules over the next four years.

The new system will help to speed and improve the effectiveness of patient care in Scotland by ensuring patient information will only need to be entered once to make it immediately accessible by authorised staff in other care settings. The TrakCare patient management system includes hospital and mental health patient administration, order communications, results reporting and clinical support tools. A number of optional modules are available for: accident and emergency; hospital electronic prescribing and medicines administration; pharmacy management; maternity; neonatal; and theatres.

Initially the five purchasing Consortium NHS Boards involved (Ayrshire & Arran, Borders, Grampian, Greater Glasgow & Clyde, and Lanarkshire) will take advantage of this national framework agreement. Together with NHS Lothian, an existing TrakCare customer, these five Boards provide care for 70% of the Scottish population.  The total value of the initial contract will be in excess of £44M.  Additional Health Boards are already in discussion about how this framework can benefit them.

Commenting on this development, Scottish Health Secretary, Nicola Sturgeon said, “This contract will enable Health Boards across Scotland to implement a single, nationally available patient management system that will play a major role in improving patient services. Clinicians and patients will both be winners from a system which will track patient journeys from referral to discharge. It means clinicians will have easier and quicker access to medical records and patients will benefit from having more time with healthcare professionals.”

Alan Lawrie, Programme Board Chairman said, “We believe that this solution will play an important role in streamlining patient services leading to faster diagnosis and treatment while enhancing patient safety. Not only will this give us a modern technical base but it has been chosen by the staff who will be using it.”

The contract award follows a rigorous 20-month Competitive Dialogue procurement process. In total, more than 160 front-line healthcare staff, including doctors, nurses and other health professionals, took part in the evaluation of the solutions being proposed.

This contract for InterSystems TrakCare follows other recent successes including: the States of Jersey and the States of Guernsey (Channel Islands); the Santiago Military Hospital (Chile) and the new Sharjah Teaching Hospital (United Arab Emirates).  Together, these underline the global recognition of TrakCare as a proven, internationally adaptable and versatile connected healthcare information system, suitable for a wide range of care delivery models in acute, community, mental health and polyclinic settings.

TrakCare puts the patient at the very centre of the system, which means a record only needs to be created once, upon first admission. All subsequent treatments, admissions and visits can then be added to the initial record. Furthermore, by creating one structure for a common, shared record, information is simultaneously available wherever it is needed, and accessible from within each TrakCare module.

Kerry Stratton, Healthcare Managing Director of InterSystems said; “The decision to use Health Board staff from many departments in the selection process has given us a clear understanding of NHS Scotland’s immediate requirements and long-term vision. We are now ready to focus on delivering TrakCare for the benefit of patients and staff across Scotland.”