GMC BME Doctors’ Forum Meeting:
The next meeting of GMC BME Doctors’ Forum will take place in London on Thursday 18 May. Dr Abdul Hafeez, Prof Amir Nisar and Dr Ayaz Abbasi will represent APPS UK at this event.
The aim of APPS UK Junior Doctors’ Wing is to support medical students both in the UK and in Pakistan. Please become part of a dynamic, productive and supportive environment to advance lives and healthcare.
Medical Education: As British junior doctors, we have a great privilege of being taught by people at the forefront of their profession. The curriculum and teaching we get equips us with the relevant skills knowledge and attributes as defined in the charter of “tomorrows doctors”. As such we are expected to be leaders of the medical profession in the future. We strongly desire to bring together medics of Pakistani origin and exchange our experience and understanding of Medicine. Students from different backgrounds bring a unique diversity and flair when united under one flag for common purpose.
Career development: The post graduate training has been evolving continuously for the past few years and we aim to keep our peers updated with the developments to include the requirements of the foundation training programme, core run through surgical and medical training.
Research and Collaboration: We hope to be able to organise national medical conferences where we can present our research in the form of audits, clinical case reports or laboratory based projects. This would allow exchange of knowledge within a wider community of Pakistani Medical students from across the country.
Promoting education and development in local communities: We represent not only a great profession, but also our identity as a Pakistani as well a role model for wider Pakistani communities in the country. We aim to educate the people on the themes of Healthy living, Risk factors of common diseases of prevalent in particular areas, mental health, Sexual health, Domestic violence and Woman’s health.
Development and promotion of health in Pakistan: We aim to set up a platform where medical students can come together and organise charity fundraisers, awareness sessions and social events. We believe such work is a very rewarding experience for the volunteers and the outcomes can have lasting impact on bringing a change in the society. With the help of APPS UK networking between Pakistani and UK hospitals can be a wonderful opportunity for students to isolate an area of problem, undertake research and produce well informed findings which can be used to improve the healthcare.
In Conclusion: The aim of APPS UK is to promote quality, virtue and excellence in healthcare, society and advancing lives. This has to be based on highest levels of professional demeanour without any discrimination on grounds of race, culture or religion. As junior doctors we have enthusiasm, drive and ability to contribute and the best thing the youth can offer is their time and dedication. We believe we as the youth represent not only the medical profession but the wider society we are part of. With dedication and determination we can develop the most appropriate skills, knowledge and personal attributes and materialise high quality of healthcare delivery.
APPS UK is as part of General Medical Council’s BME Doctor’s Forum. In these meetings we have opportunities to raise any concerns directly with their top management.
Here is summary report of our last meeting that took place in November 2018:
The Chief Executive of General Medical Council, Charlie Massey, is aware of the enormous challenges faced by the medical profession in the UK:
A BME doctor may be earning up to £5K less than their counterpart whilst doing the same job.
33% of doctors in the NHS want to reduce their working hours and nearly half of 45-55 years olds plan to retire early.
A female BME doctor is twice as likely to be referred to the GMC.
Doctors are human beings and human beings make mistakes. The general public expectations from the NHS are too high who want every doctor to be 100% perfect.
Though GMC does not use reflective notes against any doctor in their investigations but as per Medical Act of 1983 any doctor can be compelled to disclose their reflections by a court, in case of an investigation, which may be used against them.
There is an urgent need to develop a culture of learn not blame:
> There should be higher bar for prosecution of gross negligence manslaughter. ?Reckless or wilful.
> Human factor training for all investigators
> Forma appraisal of all expert witnesses
GMC should take serious steps to ensure well being of doctors who are subject to investigations as suicide rates are very high in this group.
MPTS: There are 297 tribunal members: 157 lay (including legally qualified) and 140 medical tribunal members. 48% of tribunal members are females and 20% BME. GMC is planning further appointments during next year.
An audit of the fairness of GMC FtP decision making will be conducted during next year.
Barriers to reporting serious incidents:
> Blame culture
> Being new to the team
> Fear of implications (e.g. trainees educational progression)
> Workload Pressures
> Lack of feedback
There have been 18 recorded cases of Gross Negligence Manslaughter in last 20 years.
One of our main objectives is to raise health awareness amongst the communities in the UK as well as Pakistan.
Prevention is better than cure!! We believe it is a doctor’s responsibility to educate the public about health issues. This is the only way we can alter pubic health-seeking behaviors and break the stigma’s attached to the health in our community.
We produce leaflets, organise regular talks, set-up stalls and conduct heath awareness campaigns in Pakistan as well as at asian melas, schools and universities in the UK to provide health checks and health related information to the public.
The aim of this project is to provide state of the art primary care facilities to the remote rural communities in Pakistan.
Our mobile health units will be fully equipped with medical equipment required by a family physician.
It will be manned by a driver and a fully qualified doctor. APPS UK will provide initial training, guidelines, pathways and back-up support to this doctor so he / she can discuss any complex cases with a doctor in the UK at any time.
We will recruit 2 doctors for each of the units who will work part-time and will be paid on a pro- rata basis with big incentives.
The mobile unit will work for 6 days a week visiting 2 villages every day for about 2-4 hours each (depending upon the population) hence catering for 12 villages in a week serving a total population of around 25,000.
All villages in the cluster will be made aware of the rota so if need arises an acutely unwell patient can be sent to the neighbouring village where the clinic is due to be held.
The consultations will take place within the mobile health unit ensuring dignity and privacy of the patients. We will also consider the feasibility of using any basic health unit facilities that may already exist in some villages.
Each consultation will be charged at a nominal fee of Rs 20 (less than 1.5 pence) plus cost of the medicines; however the most deserving poor families in the village will be issued with an identity card exempting them from all charges (consultation and medicine). The card will be issued to these families based upon the recommendation of the village head.
There will be a designated co-ordinator in each village who will act as our liaison officer and will be responsible for keeping records of the patients attending and cash generated. This named person (or his named representative) will stay with the mobile unit throughout the duration of the visit (once a week for that village).
The co-ordinator will identify and register each patient and take cash from them before they are seen by the doctor. Our driver will keep his own record of all consultations and submit this record at the end of the day including mileage done on that day. Any significant incidents will also be logged and reported to the Chief Operating Officer in Pakistan on a daily basis.
Detailed records of all activities will be kept for monitoring and auditing purposes. This will help us identify any issues and help improve the service on an ongoing basis.
We will issue medicine for acute medical problems for a maximum of 5 days and patients are expected to buy ongoing treatment as and if required.
A prescription will be issued for medicines required to manage chronic medical problems (for example high blood pressure, diabetes etc).
We will record all medical consultations in a file issued to the patient who will be advised to keep their file safe and bring for each consultation. An entry will be made by the doctors in these files at each consultation detailing clinical observations, diagnosis and treatment recommended.
The doctor will be trained to briefly explain the medical condition diagnosed and the treatment proposed. This will help improve patients understanding of their medical condition.
Any acutely unwell patient will be signposted to the nearby tertiary care facility.
We will collect regular patient feedback and conduct spot checks to prevent abuse of the service and ensure consistent high standards of care.
A complaints number will be displayed on the clinic so anyone can report any issue or log any complaints directly with the Chief Operating Officer or his named assistant in Pakistan.
We will conduct comprehensive reviews of the project at 6 and 12 months before extending it further.
PHASES OF IMPLEMENTATION:
The project will be implemented in 4 phases as below. It is expected that each transitional phase will be completed in 3-6 months:
In the first phase the above service will run during day hours and provide medical treatment.
In the second phase the mobile clinic will also be used as a patient transporter during night time to transfer acutely unwell patients from any of the villages in the cluster to the nearby city hospital.
We may need to recruit a separate night time on-call driver for this purpose.
In the third phase we will recruit a nurse or lady health visitor to accompany the doctor as a champion of ladies and children’s health. The nurse will conduct antenatal checks, run health awareness and health promotion campaigns from time to time e.g. general hygiene, breastfeeding, stop smoking, contraception, vaccination etc. She will also help break the communication barriers between the doctor and female patients when a male doctor is on duty.
In the last phase we will introduce electronic medical records. We will bring in tough book that is connected to the internet via a satellite. Software will be designed to enter medical records on the system which will be saved on a database and accessible to us in the UK.
This will help us monitor the running of the project, the quality of care provided as well as analyse patient data so we can modify the service based upon population needs.
LIST OF MEDICINES AVAILABLE IN THE CLINIC:
Gentisone ear drops
Our members conduct free clinics in Pakistan whilst on holidays. Members of APPS Executive Council in Pakistan facilitate this process by making all the arrangements on the ground.
If you would like to run a clinic while visiting Pakistan, please contact us via email: email@example.com