Challenge them to do what? Recruit more staff Find better leaders Find better managers Find the magic money tree Creat a national procurement system 'Change the culture' Change the training schemes Find more time for staff to talk with patients & carers
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YES! But how do we balance the reality of austerity, population based decision making, evidence based healthcare and a person's desires. It is the stuff of a philosopher's career.
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That's a lot of variables! The only one which might remotely interfere with the patient's autonomy for me though would be austerity. I accept that finances have to have limits and that some treatments may be unaffordable/poor value. Heartbreaking though that is.
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The CCGs are making those decisions on a daily basis: - who to fund, who not to fund? Who do we want to make those decisions? The government, local politicians, the CCG board, the ICS leaders?
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I'd love to pretend to know something about that, but I'm afraid I don't Bill. It's not an area I've had time to research. Doesn't sound like an ideal scenario, but not sure of the right alternative. Something that includes patients/clinicians ideally.
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Hey, we cant expect you to know everything. It is amazing what you do comment on. The trouble is it is at the heart of what we are talking about. In reality they are not just decision on who gets treatment but also about the quality of care we receive.
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Haha! Guess I'm not shy in poking my nose in, am I?! Fair enough. This one's beyond my understanding at this stage I'm afraid, but interesting to hear that. Thanks for the heads up. :)
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always 'follow the money'

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Finally, something I DO know something about without having to research it first. :)
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I've been wondering how Montgomery sits with the Access to Health Records Act 1990 (& GDPR, which I'm told is the same). It seems to me that the law is now contradicting itself. GDPR: Doctor decides what info the patient is given. Montgomery: Patient decides.
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I'm no expert, but I think the two things operate at different ends of the process? Montgomery determines what risks must be disclosed (and recorded in medical records as such) at consultation, whereas GDPR governs what info is shared when requesting medical records. Any help?
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Yes, I was thinking about that, but it seems that's playing with the letter of the law rather than the spirit. What's good for one should be good for the other, and besides records from the past my inform the risks for the future.
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That's an interesting take. I think the other aspect here is that Montgomery is limited to info that is relevant for securing consent only, whereas GDPR relates to all patient data. Truth is, we know they weed/seed medical records. Not sure GDPR will likely change that much, tbh.
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Particularly relevant in my case. In the absence of any alternative explanations, they appear to have been deliberately malicious, and that bears directly on the risk of all future treatment.
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I'm told that GDPR isn't any different to the old 1990 Act in that records can be withheld on the grounds that it's against the patient's interest to see them.
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Exactly. And once you allow that ability to exclude, it begs for cover up. Health service - the only place I know of where you have to convince the accused to hand you the evidence with which to prosecute them. And they get to decide what you see. But I'm sure it's fine...
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The 1990 act allows for applying to the court for records, but if you can't see and then challenge the reasons NHS give the judge it's just a waste of legal fees.
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