Notes from RCGP council 23/2/18

This is a note of what I said. Of course there are many other things I could have said – but there is little point in doing so if someone else has just made the point – it wastes time.

Minutes from last time:  Babylon – ‘while undoubtedly a quick convenient way ‘ for some people
please remove undoubtedly – agreed.

Other papers:

sponsorship:
c43
sounds to me as though a lot easier to have no sponsorship

sponsorship – charities should be included esp single issue charities

– lack inclusion other organisations who have no sponsorship in the list of ‘how else it could be done’

– recent study showing association with attendance at sponsored meeting and prescribing branded products

– would you like the OD group to do an evidence review about effect of sponsorship to be included in the pack for consultations – not quite sure if this offer was accepted but we should do it anyway

 

John Cosgrove made excellent point –  agree with him that if a sponsor wants to change clinical practice, does this align with RCGP policy?

c46 ‘three before GP’ campaign

I think this is very poor – there was no  evidence testing or ascertainment of harm
I’m worried about how college develops campaigns like this in terms of oversight
There are far better ways to reduce demand i.e. address the system issues e.g. NHS 111 that produce it

GMC discussion paper

I was accused of being inaccurate in my BMJ column, and I don’t believe I have been.

Bawa Garba hand wrote notes on a trainee encounter form mainly completed by her supervisor

she did not sign this as she disagreed with the contents

this was seen by the prosecution who cross examined her.
We require to be absolutely candid about this and the issues it creates.

 

The bottom line is that the current system of investigating errors and doctors does not have the confidence of many patients families or professionals and fundamentally allows the same mistakes to keep repeating themselves. Putting the blame on individuals while ignoring system errors is disastrous.

I had hoped there would be consideration of a vote of no confidence in the GMC. This time, there wasn’t.
c47 AI paper

Google deep mind was a worrying project because of the way the law and ethics were disregarded. and clinically  AKI was looking for patterns data but not for necessarily for sense

said could detect AKI early BUT overdiagnoss of AKI and profit for deep mind with
lots of data but not necessarily sense – who profits from the data the NHS gathers?

when we put this under the banner of innovation rather than research we lose sight of ethical frameworks and evidence based medicine
WHY ARE WE NOT sorting out far more basis problems but investing in this without adequate testing
SAFETY and feedback loops

chat bot – binary questions not a true chatbot

 

c48 on the interface between online GP companies and the NHS
Q FOR PATIENTS babylon have changed T+C – what is reasonable need – to note

2)
q for patient – will this treatment be available in the NHS also issues of cross over care – e.g. push doctor – gabapentin – started rx – do patients need to know that NHS gps may not agree with private sector? inter professional conflict

3) arguable that the CQC are capable of telling what is effective and safe – seem to be a real gap regarding evidence base of decisions – praise meeting of demand not whether inducing demand reasonable – I am writing to the CQC again about this

4) Q FOR DOCTORS – will I be serving need rather than demand

c58 – EVIDENCE was not prospectively gathered and was only examined too late
huge harms
4) q for doctors : will I be serving need rather than demand?

Paper on declaring intérêsts was agreed and a short life working group will examine the issues – but principle of more transparency was accepted.

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