Welcome to the Spring Bank Holiday Monday Message.

The round up of news this week includes the good news for First5 doctors about the teaming up of the MDDUS and the RCGP to offer savings of up to £3000 on the combined package of RCGP membership and MDDUS medical indemnity. If you want more information, have at either organisation’s web site.

I have posted a paper from David Sanbach – David used to be a Chief Executive at PRH and has been retired for a while, but he still seems to be clear thinking in his suggestions for improvement, even if his thoughts are not always well received.  I have published his paper on the Ophthalmology services as it puts Shropshire’s problems into context and shows that the only unit thriving is a Tertiary Referral Service in London (Moorfields). If anyone is interested in reading it and has any ideas, David would welcome your comments.  He has also prepared a response to the new proposals for acute services in SaTH which were published in the Shropshire Star – I am not sure if they were published.

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This month’s GP evening meeting in the North Locality in Shropshire (organised by Dr Deborah Shepherd) was on Sepsis and Antibiotic Use, with an additional presentation on Paediatric Sepsis. It was  fascinating, particularly to see how the airline pilot argument doesn’t quite hold up in clinical care when you do not engage your brain and use your clinical experience. The paediatricians use the Sepsis Screen in order to triage cases into urgency rather than to block referrals & they will always err on the side of caution with a worried GP, worried parents and a sick child, which is always good to know.  Have a look on the meetings tab to see the slides that the presenters shared with those at the meeting and that they are happy to disseminate.  The premise of Dr Harvey’s talk was challenging the incorrect assumptions about the costs of his service and reducing the threat to his budget and how investing in a new powerful analyser will reduce delays in obtaining diagnoses and sensitivities.   I think that the biggest shock to me was how little the prescribing of antibiotics has fallen nationally.  So much for conservation of resources.

The next meeting is on Monday 23rd May and Dr Moulik will be talking about Non-Diabetic Endocrinology. The meeting does attract drug company sponsorship but it is low key. If you would like to attend please let the organisers know by 15th May. Details are on the calendar.

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Elin Roddy has written a blog which has been published on the King’s Fund website prior to the publication of a report. It is called Accepting the Unacceptable: a Physician’s Perspective on Front Line Care and it will serve a useful reminder that frontline staff in hospital are walking a very fine line indeed.  Elin is not just a respiratory consultant but is also an interesting and prolific blogger with a young family. At the same time a Guardian newspaper article has been tweeted by a number of sites with medical interest.  This talks about the fall in pay in real terms for many of our colleagues and questions have been asked about nurses having to use food banks.  How has the balance of care in the world been so skewed?

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Diabetes and the Explosion with Obesity, or should that be Diabesity?  There is a new approach which is being supported by Diabetes.co.uk and is a 10 week Low Carb Programme with online support and talks. Have a look and recommend it to your patients if you think it might help them. I am not sure I could give up my flapjack, even if it is made with fruit and nut butters to reduce the GI score!

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Age UK have published an Index of Wellbeing in Later Life which is on my pile of things to read – if anyone gets there first, how about reviewing it for the Group?

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Confused about STPs (Sustainability and Transformation Plans)? Don’t know what they are? Don’t know how they will affect services in the local area?  This could be for you – www.england.nhs.uk/stps/about-stps  but if they want to make it easier to see a GP they will need to retain them – apparently the total number of GPs has fallen by 100 in the past month. I can’t find the link for that so don’t quote me! Simon Wright, the Chief Executive of SaTH has published his STP further in the document and the link for that is www.sath.nhs.uk/news/healthier-future-stp