Medicine

Planning e-learning for medical education – June 2010

Posted on July 2, 2010. Filed under: Clinical Education, Educ for Hlth Professions, Medicine | Tags: |

Planning e-learning for medical education – June 2010 – The British Journal of Healthcare Computing and Information Management

“A relatively new strategy within clinical education, e-learning is becoming an increasingly utilised way of teaching new clinical techniques. However, the marriage of education and technology can be difficult to get right. Dr Nicholas Blackwell of the University of Leicester Medical School gives advice for those in the medical profession who are considering using e-learning as a teaching tool.

Both education and technology have experienced a period of major change over the past two decades, with the latter becoming an increasingly important tool in teaching and learning. To be effective, clinicians need to stay abreast of new initiatives, techniques and treatments within their profession, whilst the text books and printed materials that learners use can sometimes be out of date by the time they are published.

E-learning is one way that the speed of change currently taking place in clinical technology can be incorporated into education, so it is logical that many medical educators regard online learning as the way forward. However, e-learning is more than posting material on the web — if it is to be used effectively as a teaching resource, the materials used need to be devised by people with the appropriate skills and experience — which means the marriage of technology and clinical knowledge. So, if you have the responsibility for devising an online learning project, where do you start?”

…continues

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Credentialling Framework for New Zealand Health Professionals – July 2010

Posted on July 2, 2010. Filed under: Allied Health, Medicine, Nursing, Workforce | Tags: |

Ministry of Health 2010. The Credentialling Framework for New Zealand Health Professionals. Wellington: Ministry of Health

“Summary of publication

The Ministry of Health published the first national credentialling document in 2001. Its focus was on the credentialling of senior medical practitioners in secondary and tertiary services within a single service or facility.

This updated framework has a wider application. The credentialling process it details applies not only to medical practitioners but to all health professionals in all New Zealand health and disability services, both public and private.

ISBN numbers: 978-0-478-35939-8 (print) 978-0-478-35940-4 (online)

HP number: 5072

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Future physician: Changing doctors in changing times – Royal College of Physicians – May 2010

Posted on June 2, 2010. Filed under: Medicine, Workforce | Tags: |

Future physician: Changing doctors in changing times – Royal College of Physicians – May 2010

Report of a Working Party
ISBN: 9781860163784

“Summary
The Royal College of Physicians 2005 report Doctors in society: medical professionalism in a changing world set out a definition and wider description of medical professionalism. The report’s pivotal role in raising the profile of medical professionalism provides a background to this new report, which looks at:

the likely context in which healthcare will be provided 15 to 20 years hence
the roles and responsibilities of doctors in this future context
the anticipated challenges
the steps needed to make the most of the opportunities ahead.

This report is a charter for change and should be read by doctors, patients and the public, healthcare organisations, employers of doctors, and those involved in medical education and training.”

…continues on the site

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Medical Chief Executives in the NHS: Facilitators and Barriers to Their Career Progress – NHS Institute for Innovation and Improvement – April 2010

Posted on May 6, 2010. Filed under: Health Mgmt Policy Planning, Medicine | Tags: |

Medical Chief Executives in the NHS: Facilitators and Barriers to Their Career Progress – NHS Institute for Innovation and Improvement – April 2010
Chris Ham, John Clark, Peter Spurgeon, Helen Dickinson, Kirsten Armit
NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges 2010
ISBN 978-1-907045-89-9

“This paper reports on the experience of 22 medical chief executives in England (around 5 per cent of the total chief executive community).

The career paths of medical chief executives are highly variable with some becoming chief executives relatively early in their careers and others being appointed much later.”   …continues

More on enhancing engagement in medical leadership

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Beyond the Basics: The Importance of Patient-Provider Interactions in Chronic Illness Care – April 2010 – Health Council of Canada

Posted on April 30, 2010. Filed under: Chronic Disease Mgmt, Medicine | Tags: |

Beyond the Basics: The Importance of Patient-Provider Interactions in Chronic Illness Care – April 2010 – Health Council of Canada

Canadian health care matters  bulletin 3

“For Canadians with chronic illness, the quality of interaction with their family doctor makes a difference not only in primary care, but in other settings as well. Canadians in poorer health who have a regular doctor or place of care – where their medical history is known and care is coordinated with specialists – report that their health care is safer, more supportive, more appropriate and better quality, compared to similar patients whose regular doctor does not provide one or both of those basic elements of good primary care.”

…continues

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Unmet Needs: Teaching Physicians to Provide Safe Patient Care – National Patient Safety Foundation [US] – 10 March 2010

Posted on March 18, 2010. Filed under: Clinical Education, Educ for Hlth Professions, Health Professions, Medicine, Patient Safety | Tags: , |

Unmet Needs: Teaching Physicians to Provide Safe Patient Care – National Patient Safety Foundation [US] – 10 March 2010

“Ten years after the Institute of Medicine’s landmark 1999 report To Err Is Human, the Lucian Leape Institute at the National Patient Safety Foundation has released a white paper finding that US medical schools are not doing an adequate job of facilitating student understanding of basic knowledge and the development of skills required for the provision of safe patient care.

Unmet Needs: Teaching Physicians to Provide Safe Patient Care is the culmination of three LLI Roundtable discussions and makes key recommendations for reforming medical education in order to improve patient safety. The paper is the first in a planned series of such reports on issues that the Lucian Leape Institute has identified as top priorities in ongoing efforts to improve patient safety.”

Download the full report (pdf) here

More on the Lucian Leape Institute

Read the media release here

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Reducing Costs Through the Appropriate Use of Specialty Services. IHI Innovation Series white paper – 2010

Posted on March 18, 2010. Filed under: Health Systems Improvement, Medicine | Tags: , , |

Baker N, Whittington JW, Resar RK, Griffin FA, Nolan KM. Reducing Costs Through the Appropriate Use of Specialty Services. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2010.
[Free] login required to download the white paper.

“This white paper describes efforts by the Institute for Healthcare Improvement (IHI) to find ways to reduce overuse, with a focus on specialty services, by identifying the most promising change ideas from case examples and the literature, and by incorporating improvement methodology to implement these changes. The resulting framework is a theory of the elements needed to reduce costs through the appropriate use of specialty services, focused primarily on changing professional practice culture by engaging physicians in developing and implementing practice standards that will work best in local circumstances.”

…continues

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The Bologna Process: will it affect UK biomedicine and clinical science: symposium report – Academy of Medical Sciences – February 2010

Posted on March 3, 2010. Filed under: Educ for Hlth Professions, Medicine | Tags: , , |

The Bologna Process: will it affect UK biomedicine and clinical science: symposium report – Academy of Medical Sciences – February 2010
ISBN No: 978-1-903401-27-9

Publication Details:
Report of a symposium held in March 2009 on the Bologna Process. The symposium aimed to raise awareness and provide information about how the Bologna Process will affect higher education qualifications and ensure the views of the biomedical and clinical academic community were represented in the decision-making processes.

Publication Downloads:
The Bologna Process: will it affect UK biomedicine and clinical science [280.69k]

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The Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education – The Association of Faculties of Medicine of Canada (AFMC) – 28 January 2010

Posted on January 29, 2010. Filed under: Educ for Hlth Professions, Health Professions, Medicine |

The Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education – The Association of Faculties of Medicine of Canada (AFMC) – 28 January 2010

“Just as Abraham Flexner’s report did 100 years ago, The Future of Medical Education in Canada (FMEC) project looks at how the education programs leading to the medical doctor (MD) degree in Canada can best respond to society’s evolving needs. In turn, the FMEC project is rooted in the Association of Faculties of Medicine of Canada’s (AFMC’s) articulated social accountability mission for medical schools.

Health care has become increasingly complex and faces enormous challenges in providing quality care to diverse populations. An important need has developed for a cohesive and collective vision for the future of medical education in Canada. While Canada’s Faculties of Medicine are leaders in medical education, continually adapting to changing expectations and requirements, the physician of the future requires skills that will involve further adaptations and reforms to our medical education system.

The 10 FMEC recommendations for MD education (also known as undergraduate medical education) are grounded in evidence and emerge from a broad and rigorous consultative process. They are as follows:

1. Address Individual and Community Needs
2. Enhance Admissions Processes
3. Build on the Scientific Basis of Medicine
4. Promote Prevention and Public Health
5. Address the Hidden Curriculum
6. Diversify Learning Contexts
7. Value Generalism
8. Advance Inter- and Intra-Professional Practice
9. Adopt a Competency-Based and Flexible Approach
10. Foster Medical Leadership

They are accompanied by five enabling recommendations that will facilitate the implementation of the FMEC recommendations:

A. Realign Accreditation Standards
B. Build Capacity for Change
C. Increase National Collaboration
D. Improve the Use of Technology
E. Enhance Faculty Development”

…continues in the document

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Myth: Most physicians prefer fee-for-service payments – Canadian Health Services Research Foundation – January 2010

Posted on January 27, 2010. Filed under: Health Economics, Medicine | Tags: , |

Myth: Most physicians prefer fee-for-service payments – Canadian Health Services Research Foundation – January 2010
Myth busted January 2010

“Since the introduction of Medicare in 1966, physicians in Canada have operated as independent, self-employed entrepreneurs, billing their provincial ministries of health and other payers for each insured service they provide. This payment method – commonly called fee-for-service – reimburses doctors for each of their clinical activities, based on a set of billing codes established by the payer.

Fee-for-service is believed to be the payment model most trusted by physicians, possibly because it reflects their desire for professional autonomy.[i] However, some doctors may also prefer this form of payment because it enables them to use fee-for-service billing to generate more revenue. This tactic arguably drives the “one problem per visit” policies adopted by a number  of family doctors.[ii]
 
Recent decades have seen the introduction of alternative payment plans such as salary, capitation (under which doctors receive a yearly fee for each patient on their roster) and blended models (which combine multiple payment schemes). More recently, some payers have introduced new payment plans as part of a primary healthcare reform agenda that promotes interdisciplinary team-based care, with the goal of improving accessibility and comprehensiveness of care.[iii] It is generally understood, however, that any shift in the way doctors are reimbursed requires their voluntary buy-in; accordingly, some payment plans offer financial incentives to further entice physicians to make the switch.

New physicians, new preferences”

…continues on the website

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Enhancing Engagement in Medical Leadership – NHS

Posted on January 14, 2010. Filed under: Leadership, Medicine | Tags: |

Enhancing Engagement in Medical Leadership – from the NHS Institute for Innovation and Improvement

“The Enhancing Engagement in Medical Leadership project is a jointly led by the Academy of Medical Royal Colleges (AoMRC) and the NHS Institute. This UK-wide project aims to promote medical leadership and help create organisational cultures where doctors seek to be more engaged in management and leadership of health services and non-medical leaders genuinely seek their involvement to improve services for patients across the UK. The project team has been working closely with the medical professional, regulatory and education bodies and health service organisations in promoting these goals.”

As part of the project we have developed:

A Medical Leadership Competency Framework which describes the leadership competences doctors need in order to become more actively involved in the planning, delivery and transformation of health services. We are working with the General Medical Council (GMC), Postgraduate Medical Education and Training Board (PMETB), Medical Schools, Medical Royal Colleges and Postgraduate Deaneries to embed these competences in undergraduate and postgraduate training. We are also working with health care organisations across the UK to encourage the use of these competences in the health service for development, recruitment and appraisal. A Medical Leadership Curriculum has been developed for the postgraduate phase of training, it can be downloaded here.

A Medical Engagement Scale which enables NHS trusts a greater insight to the level of engagement of doctors in their organisation and ways in which this engagement might be improved.

We have also undertaken several research projects including exploring the link between medical engagement and organisational performance, an international study of how doctors are prepared for leadership roles in other countries and how they are engaged in the management and leadership of the health service. We are currently undertaking a Medical Chief Executive study to better understand the factors that influence doctors to assume Chief Executive roles and identify how more doctors may be encourage to apply for these positions.

Further information about these various aspects of the project are available through the links on the right-hand side of the page. You can also download our latest project update here.”

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Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes – US GAO – January 2010

Posted on January 7, 2010. Filed under: Medicine | Tags: |

Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes – US GAO – January 2010   –  United States Government Accountability Office

GAO Highlights

“Why GAO Did This Study

VA has policies to ensure that physicians have appropriate qualifications and clinical abilities through the processes of credentialing, privileging, and continuous monitoring of performance. Results of a VA investigatory report in 2008 cited deficiencies in the Marion, Illinois, VA medical center’s (VAMC) credentialing and privileging processes and oversight of its surgical program. This report examines VA’s policies and guidance to help ensure that information about physician qualifications and performance is accurate and complete, VAMCs’ compliance with selected VA credentialing and privileging policies, and their implementation of VA policies to continuously monitor performance. GAO reviewed VA’s policies, interviewed VA officials, and reviewed a judgmental sample of 30 credentialing and privileging files at each of six VAMCs that GAO visited. GAO selected the files to ensure inclusion of highly paid specialties, newly hired physicians, and other physician characteristics. GAO selected the judgmental sample of six VAMCs based on geographic balance and other factors.

What GAO Recommends

GAO recommends that VA develop a formal mechanism to systematically review VAMC credentialing and privileging files and performance monitoring for compliance with VA policies. VA agreed with GAO’s findings and recommendations.”

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AMC endorses Good Medical Practice: A Code of Conduct for Doctors in Australia – 10 August 2009

Posted on August 10, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Medicine | Tags: , , |

AMC Directors Endorse Code of Conduct

The Australian Medical Council (AMC) Directors have endorsed a code of conduct that defines clear, nationally consistent standards of medical practice.
The AMC developed the Code – Good Medical Practice: A Code of Conduct for Doctors in Australia – on behalf of all state and territory medical registration boards.

Full text of the Code

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Treating People Well: Report of the Director-General of Health’s Commission on the Resident Medical Officer Workforce – NZ – August 2009

Posted on August 6, 2009. Filed under: Health Professions, Medicine, Workforce | Tags: , |

Treating People Well: Report of the Director-General of Health’s Commission on the Resident Medical Officer Workforce

Date of publication (online): August 2009    ISBN number: 978-0-478-31965-1 (Online)

Summary of publication

“The RMO Commission was established to investigate the issues facing the resident doctor workforce and make recommendations on the medical workforce needed to deliver services now and into the future. The Commission supports the establishment of a single agency with the capacity to coordinate medical education and training across the entire continuim of learning. The Commission also recommends the establishment of a stand-alone body responsible for the employment of resident medical officers.”

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A review of how the training of the New Zealand health workforce is planned and funded – August 2009

Posted on August 6, 2009. Filed under: Allied Health, Clinical Education, Educ for Hlth Professions, Medicine, Nursing, Workforce |

A review of how the training of the New Zealand health workforce is planned and funded: a proposal for a reconfiguration of the Clinical Training Agency
Ministerial Task Group on Postgraduate Training and Education
Date of publication (online): August 2009

Executive summary

“New Zealand has significant problems in recruiting, training and retaining adequate numbers of appropriate health and disability services workers. This is most likely to worsen.

The planning and funding of the training of the New Zealand health and disability services workforce is iterative, ad hoc and poorly coordinated.

A single agency, which has a whole of health and disability services workforce and a whole of educational continuum responsibility, is needed if New Zealand is to have an affordable and fit-for-purpose health and disability services workforce.

It is recommended that the Clinical Training Agency be substantially reconfigured so that the Agency can plan and either fund or direct the funding of the training of the New Zealand health and disability services workforce.

Disclaimer

This report was prepared for the Minister of Health. The views of the author do not necessarily represent the views or policy of the New Zealand Ministry of Health. The Ministry makes no warranty, express or implied, nor assumes any liability or responsibility for the accuracy, use or reliance on the contents of this report.”

…continues on the website

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Health and Disability Workforce Reports – NZ Ministry of Health – August 2009

Posted on August 6, 2009. Filed under: Allied Health, Clinical Education, Educ for Hlth Professions, Medicine, Nursing, Workforce |

Health and Disability Workforce Reports – NZ Ministry of Health – August 2009

“The following five reports on the health and disability workforce all broadly agree on the need to:

* enable greater leadership for improvements in national and regional co-ordination to reduce the current duplication in workforce activities across the health and disability sector
* strengthen health and disability workforce planning that is aligned to service delivery
* balance long-term responses to workforce supply issues with the pragmatic tactics used by district health boards to meet their unique short-term workforce needs.

The Medical Training Board, the SMO Commission and the RMO Commission were asked to focus on the medical workforce, although the Medical Training Board report does make provision for the inclusion of other professions within its proposed structure. The Nursing Committee was asked to evaluate the merits of a nursing education and training board. The CTA Review group was asked to look at the wider health and disability workforce.

All five reports recommend a separate national entity to respond to the complexities of health and disability workforce training issues. The RMO Commission report also recommends the establishment of a separate single employer for RMOs.”

…continues on the website

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Foundations of Excellence: Building Infrastructure for Medical Education and Training: Report of the Medical Training Board – NZ Ministry of Health – August 2009

Posted on August 6, 2009. Filed under: Clinical Education, Educ for Hlth Professions, Medicine, Workforce |

Foundations of Excellence: Building Infrastructure for Medical Education and Training: Report of the Medical Training Board – NZ Ministry of Health – August 2009

Date of publication (online): August 2009

Summary of publication

“In September 2008 the Medical Training Board (MTB) released a series of documents on the medical workforce and on the need to achieve integration and coordination in medical education and training. This report takes into account the feedback received on these documents and progresses the work to the next level. It focuses on what change is needed and how it could occur, and proposes a framework for the structure and governance of an integrated medical training system that builds on current arrangements.

In consultation, there was considerable support from the sector for an integrated education and training framework. The need for a smooth medical training continuum was recognised, especially covering the period between graduating from medical school and entering vocational training. As a result, although this report focuses primarily on the prevocational period, it also addresses ways to improve the coordination of education and training across the whole continuum.

The MTB makes the following recommendation:

* that a new body is established with the capacity to coordinate medical education and training across the entire continuum of learning and govern the transition from the current system. The new body would be called Medical Education and Training New Zealand (METNZ) and would replace the MTB.”

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NHS Medical Education England (MEE) website

Posted on July 17, 2009. Filed under: Clinical Education, Educ for Hlth Professions, Medicine, Pharmacy, Workforce |

NHS Medical Education England (MEE), the body that provides independent expert advice on training, education and workforce planning for pharmacists, dentists, doctors and healthcare scientists, now has a website available. The new site provides information about MEE’s governance, structure and core functions as well as its membership, role and an indication of the areas of work it is likely to be involved in.

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Medical practitioners: education and training in Australia – Parliamentary Paper – 15 July 2009

Posted on July 17, 2009. Filed under: Medicine, Workforce | Tags: |

Medical practitioners: education and training in Australia – Parliamentary Paper – 15 July 2009

This background note summarises that process, elaborating upon the roles played by the major providers of medical education in Australia and the pathways taken by students to qualify as medical practitioners.

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A guide to finance for hospital doctors (UK) – 9 July 2009

Posted on July 9, 2009. Filed under: Health Economics, Medicine | Tags: , |

A guide to finance for hospital doctors (UK)  Released  09 July 2009

Summary

“The Audit Commission and the Academy of Medical Royal Colleges have jointly published a short, practical manual that aims to help hospital doctors to get to grips with the way the money works in the health service. By understanding how the money flows and some of the principles of financial management in the NHS, hospital doctors will be well equipped to deliver better patient care.

The guide is aimed at medical students and doctors in the early stages of their training.

The guide was produced following the Audit Commission report, A prescription for partnership, published in December 2007, which clearly illustrated the benefits to patients, clinicians and the NHS as a whole when doctors are fully engaged in the finances of the hospitals in which they work.

A joint statement on clinicians and finance was also published in February 2009 by the Audit Commission and the Academy of Medical Royal Colleges, along with the Royal College of Nursing, the NHS Institute for Improvement and Innovation, the Healthcare Financial Management Association and the Department of Health.

You can watch a video of Andy McKeon, the Audit Commission’s Managing Director for Health, and Professor Dame Carol Black discussing the guide and the importance of clinical engagement in financial management.”

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Senior doctors in New Zealand: securing the future – report – July 2009

Posted on July 3, 2009. Filed under: Medicine, Workforce | Tags: |

Senior Doctors in New Zealand: Securing the Future
Date of publication (online): July 2009

Summary of publication

“The Director-General of Health’s Commission on senior medical and dental officers employed by district health boards was set up in 2008 to investigate a sustainable and competitive workforce strategy for senior doctors.

The Commission’s report provides a comprehensive summary and analysis of the senior medical and dental workforce, and the Ministry has accepted and begun implementing all 13 of the Commission’s recommendations. The Commission’s report includes its Terms of Reference and recommendations.”

ISBN number: 978-0-478-31950-7 (Online)
HP Number: 4893

Citation: Commission on Competitive and Sustainable Terms and Conditions of Employment for Senior Medical and Dental Officers Employed by District Health Boards. 2009. Senior Doctors in New Zealand: Securing the future. Wellington: Ministry of Health.

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More acute consultants means shorter hospital stays – Royal College of Physicians – 18 June 2009

Posted on June 23, 2009. Filed under: Acute Care, Medicine, Workforce | Tags: |

More acute consultants means shorter hospital stays News : 18 June 2009

“New research published by the Royal College of Physicians shows that more consultants on Acute Medical Units (AMUs) can reduce hospital stays and prevent inappropriate admissions in the first place. AMUs are now found in hospitals all over the country, despite being a relatively new specialty. This is the first evidence to support arguments that they will bring benefits to patient care.”

Editors Notes

1. The full team involved in the study consisted of: Dr Nicola Trepte, consultant physician in acute medicine; Dr Gregor McNeill, specialist registrar in acute medicine; Dr Darshan Brahmbhatt, academic foundation house officer 2 in cardiothoracic surgery; and A Toby Provost, medical statistician.

2. The article What is the effect of a consultant presence in an acute medical unit is published in this month’s edition of Clinical Medicine journal [June 2009].

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Better, safer doctors: implementing medical revalidation – NHS Employers Briefing 62 – June 2009

Posted on June 19, 2009. Filed under: Medicine, Workforce |

Better, safer doctors: implementing medical revalidation – NHS Employers Briefing 62 – June 2009

From autumn 2009 all doctors who wish to practise medicine in the UK will require a Licence to Practise. This is the first step in introducing a system for regularly checking and assuring every doctor’s continued fitness to practise, known as revalidation. This briefing explains the key elements of the process, sets out the various roles and responsibilities, and discusses the areas that remain to be resolved as revalidation gets underway.

NHS Employers – publications

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General Medical Council affiliates pilots: mid-term report of the independent evaluation from KPMG 1 May 2009

Posted on May 4, 2009. Filed under: Medicine, Workforce |

GMC affiliates pilots: mid-term report of the independent evaluation from KPMG

Document type:      Report
Author:    KPMG
Published date:      1 May 2009
Pages:      32

In July 2008, the Department commissioned KPMG to undertake an independent evaluation of two pilots introducing a system of GMC Affiliates aimed at closing the regulatory gap between local workplace management of doctors and national professional regulation. The purpose of this evaluation is to produce feedback and provide an assessment of the feasibility, potential benefits, costs and wider impacts of the introduction of GMC Affiliates at a national level. This report marks the mid term point in the evaluation of the pilots.

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ACCC medical indemnity report issued April 2009

Posted on April 29, 2009. Filed under: Medicine | Tags: , |

ACCC medical indemnity report issued

“The Australian Government today issued the Australian Competition and Consumer Commission report monitoring medical indemnity insurance premiums, Medical indemnity insurance—sixth monitoring report—April 2009.

The report is produced after a Government request to monitor medical indemnity premiums to assess whether they are actuarially and commercially justified. It is the final ACCC medical indemnity insurance premium report.

The ACCC found that the premiums written in 2008–09 (2008 in the case of Avant Insurance Limited and QBE Insurance (Australia) Limited) were both actuarially and commercially justified for all five national medical indemnity providers.

The report also examined the actuarial and commercial justification of premiums within each State and Territory and found that, based on the information available, relativities were justified.

The ACCC’s monitoring focuses on how premiums were derived by the indemnity insurers that were operating as at 30 June 2008 from an actuarial and commercial perspective. The insurers are Avant Insurance Limited, MDA National Insurance Pty Ltd, Medical Insurance Australia Pty Ltd, MIPS Insurance Pty Ltd, and QBE Insurance (Australia) Limited.

The assessment of actuarial justification of premiums considers the technical actuarial aspects of pricing. It examines the process adopted by medical indemnity providers to derive premium rates, the approach taken to construct those premiums, the level of detail used to support pricing assumptions and the breadth of issues taken into consideration (such as recent medical indemnity and tort law reforms).

The commercial justification of premiums assessment considers the ability of medical indemnity providers to meet their commercial obligations to key stakeholders.  It examines the impact on premium rates of APRA’s minimum capital requirements that medical indemnity providers need to achieve to reach a fully capitalised position by 30 June 2008, as well as broader commercial obligations such as solvency targets and emerging surplus.

The ACCC’s assessment of the actuarial and commercial justification of jurisdictional premium relativities involves an assessment of the extent and level of analysis undertaken to confirm or modify existing premium relativities. This also involves an assessment of the extent insurers took into account jurisdictional tort law reforms.”

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The effect of physician supply on health status as measured in the NPHS (Canadian National Population Health Survey)

Posted on April 16, 2009. Filed under: Medicine, Workforce |

The effect of physician supply on health status as measured in the NPHS (Canadian National Population Health Survey)

Emmanuelle Pi´erard,  Department of Economics, University of Waterloo

Abstract:

We use data from the Canadian National Population Health Survey and the Canadian Institute for Health Information to  estimate the relation-ship between per capita supply of physicians, both general practitioners and specialists, on health status. Measures of quality of life, self-assessed health status and the Health Utility Index are explored. The sample consists of all individuals who were age 18 or over at the beginning of the survey in 1994, and the sub-sample includes only individuals who were not diagnosed with a chronic condition for the first four years. Most previous studies of the effect of physician supply on health status used data only on individuals who had specific health problems, and many of them used outcomes related to the length of life of the patient. Random effects ordered probits are used to model self assessed health status and quantile regressions are used for the Health Utility Index. A higher supply of specialists is correlated with worse health outcomes, while a higher supply of general practitioners is correlated with better health outcomes as measured by both measures of health status.

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Physician supply forecast: better than peering in a crystal ball? – article from Human Resources for Health 2009

Posted on April 9, 2009. Filed under: Medicine, Workforce |

Physician supply forecast: better than peering in a crystal ball?
Dominique Roberfroid email, Christian Leonard email and Sabine Stordeur email
Human Resources for Health 2009, 7:10doi:10.1186/1478-4491-7-10
Published:     13 February 2009

Abstract

Background
Anticipating physician supply to tackle future health challenges is a crucial but complex task for policy planners. A number of forecasting tools are available, but the methods, advantages and shortcomings of such tools are not straightforward and not always well appraised. Therefore this paper had two objectives: to present a typology of existing forecasting approaches and to analyse the methodology-related issues.

Methods
A literature review was carried out in electronic databases Medline-Ovid, Embase and ERIC. Concrete examples of planning experiences in various countries were analysed.

Results
Four main forecasting approaches were identified. The supply projection approach defines the necessary inflow to maintain or to reach in the future an arbitrary predefined level of service offer. The demand-based approach estimates the quantity of health care services used by the population in the future to project physician requirements. The needs-based approach involves defining and predicting health care deficits so that they can be addressed by an adequate workforce. Benchmarking health systems with similar populations and health profiles is the last approach. These different methods can be combined to perform a gap analysis. The methodological challenges of such projections are numerous: most often static models are used and their uncertainty is not assessed; valid and comprehensive data to feed into the models are often lacking; and a rapidly evolving environment affects the likelihood of projection scenarios. As a result, the internal and external validity of the projections included in our review appeared limited.

Conclusions
There is no single accepted approach to forecasting physician requirements. The value of projections lies in their utility in identifying the current and emerging trends to which policy-makers need to respond. A genuine gap analysis, an effective monitoring of key parameters and comprehensive workforce planning are key elements to improving the usefulness of physician supply projections.

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Canadian Institute for Health Information Workforce Trend Reports 1 Dec 2008

Posted on March 25, 2009. Filed under: Allied Health, Medicine, Nursing, Workforce |

December 1, 2008
In a series of five new reports released today, the Canadian Institute for Health Information (CIHI) provides the latest available and most comprehensive data in Canada about the supply, distribution, migration, education, demographic trends and work patterns for seven major health professions. The reports highlight changes in workforce trends over several years for physicians, registered nurses, licensed practical nurses and registered psychiatric nurses, as well as recent data for occupational therapists, physiotherapists and pharmacists.

Reports-  Information about:

Supply, Distribution and Migration of Canadian Physicians, 2007
Workforce Trends of Occupational Therapists in Canada, 2007
Workforce Trends of Physiotherapists in Canada, 2007
Workforce Trends of Pharmacists for Selected Provinces and Territories in Canada, 2007
Regulated Nurses: Trends, 2003 to 2007

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