Acute and General Medicine Pre-Show Newspaper

Nine out of ten NHS trusts say that a hospital merger, closure or changing the way services are provided will be necessary in their area in the next two years.

The survey by the Foundation Trust Network also reveals that eight in ten trusts feel that a reconfiguration in their area would improve or at least maintain patient outcomes.

But objections by local councillors and other NHS trusts are considered to be the biggest barriers to service change followed by MPs.

A separate survey of the public shows that the public is more open to discussion about changing services than the NHS thinks. When asked to rank the importance of having services close to home versus accessing specialist care when being treated for a serious condition, over half of respondents said that it would be more important to be treated in a unit that specialised in their treatment area.

The Diabetesbible, an online guide which supports health professionals in diagnosing and managing diabetes has been commended at the Quality in Care awards in the Best Early Detection and Prevention Initiative category. Written by Dr Jeremy Turner, consultant endocrinologist and honorary senior lecturer in diabetes, endocrinology and general medicine, at the Norfolk and Norwich University Hospitals NHS Foundation Trust, the Diabetesbible adopts an innovative and clinically orientated interactive approach. Unlike a traditional textbook where people look things up, the tool is broken down into four headings: history, examinations, investigations and management, and each contains information in short, accessible chunks. Diabetesbible prompts doctors to ask the right questions when considering any given diabetes diagnosis; it outlines the features to look for when examining the patient; and it helps doctors decide which investigations are appropriate for an individual case. It includes an up-to-date list of protocols for performing common investigations and its information is consistent with current NICE and SIGN guidelines.

How does your team feel about revalidation? AGM Conference Highlights: Page 10 Update on chronic stable angina: Page 11Alere Breakfast Symposium: Page 12

Issue 3 | www.agmconference.co.uk

Revalidation: are you ready for change?

Major change in service is necessary

Innovative diabetes tool wins commendation at Quality in Care awards

With the launch of revalidation less than a month away the GMC is ramping up its publicity campaign to assure doctors that they have nothing to fear from the new regulatory system. Current concerns about revalidation include: appraisal rates are still too low in many NHS trusts; secondary care doctors will not have enough professional time and resources to complete revalidation at a time when they are already under pressure to deliver a more efficient service; the whole process will be onerous and bureaucratic and the needs of locums have not been addressed. GMC chair, Professor Sir Peter Rubin, is confident that most of these problems can be overcome. He says that revalidation is ready to start - the latest Department of Health figures show that over 80% of NHS locations are prepared and have enough trained appraisers. Revalidation for most doctor does not start until April 2013 and then only 20 per cent of doctors will be revalidated in that first year so there is still plenty of time for those trusts that are not ready, to catch up. Regarding consultants concerns about employers not providing them with enough SPA (supporting professional activity) time for revalidation Professor Rubin says they are aware of these worries, although he points out that they did not arise during pilots they carried out. The GMC has recruited employment liaison advisers to work in every region whose job will be to maintain close contact with responsible officers and troubleshoot any workplace problems early on. A key issue raised by doctors during the pilots was that the new system should be simplified and streamlined. Professor Rubin says lessons learned from consultations and pilots have ensured that the process is as good as it can be when it starts. Issues with revalidating locums still have to be resolved, admits Professor Rubin. The locum agencies are the designated bodies so they will be required to confirm that all doctors on their books are up to date and fit to practice. However we do know that in order to fulfil some of the requirements for their appraisals locums will need information which is not always easy to access. Both the GMC and the Department of Health are aware of the problem and it is being actively worked on. Junior doctors are concerned that the requirement to reflect

Professor Sir Peter Rubin

Main Sponsors:

Continued on page 2

Continued on page 6

Dr. Jeremy Turner

on Serious Untoward Incidents (SUIs) and Significant Event (SE) information as part of their specialty training could create a significant administrative burden and result in cases of double jeopardy. Professor Rubin says the system of juniors reflecting on their work when things have gone wrong is required for mistakes to be learned from in an NHS with an open culture. It will not change the threshold where their fitness to practise is called into question. Professor Rubin has been touring the country for the last three years talking to doctors about revalidation. All doctors have already been written to and in the next two or three months will be contacted with information about their date for revalidation. I really do think that a few years down the road when revalidation has become part of the normal landscape people will wonder what was all the fuss about, he says.

Connect with delegates, book your free lunch and download your own programme at www.agmconference.co.uk/connect

Page 5

The Medical Leaders SymposiumThe Future of Postgraduate Medical Education Get your questions answered at The Medical Leaders Symposium at AGM on 21 Novemeber at 6pm. Join the lively debate chaired by Peter Sharp, chief executive of the Centre for Workforce Intelligence and keynote by Professor Sir Peter Rubin. Shape the way forward and voice your opinions to the expert panel including Dr Tom Dolphin, former chair of the BMAs Junior Doctor Committee, Christine Outram, former managing director of Medical Education England, Professor Wendy Reid, vice president for education of the Royal College of Obstetricians and Gynaecologists.

Join the debate by booking your place at the leaders symposium by accessing My Seminars via www.agmconference.co.uk/connect

AGM Newspaper - November 09.indd 1 08/11/2012 12:36

Conference programme

21 November 2012Theatre 1 Theatre 2 Theatre 3 Theatre 4

9.00 Registration Registration

9.15Gastroenterology Dr Kieran Moriarty

Abdominal pain: medical or surgical?

Endocrinology Dr Francesca Swords

Endocrine emergencies

Cardiology Prof Adam Timmis

Acute Coronary Syndrome

Neurology Dr Fayyaz Ahmed

Epilepsy

9.55Gastroenterology Prof Terence WardleUpper GI Bleed

Diabetes Dr Mark Savage

Diabetic emergencies

Cardiology Prof Richard Schilling

Life threatening arrhythmias

Neurology Prof Neil Scolding

When is a stroke a stroke?

10.35Gastroenterology

Dr Will Bernal Acute liver failure

Diabetes Professor David Kerr

The Challenge of Glycaemic Control in Insulin-Dependent Diabetes:

Can Technology Provide the Solution? Sponsored by Abbott

Cardiology workshop in association with BayerProf Richard Hobbs

Anticoagulation in non-valvular Atrial Fibrillation: An Update

Neurology workshop

11.15 Morning Break Morning Break

11.45Gastroenterology Dr Chris Roseveare

Managing acute diarrhoea

Diabetes Dr Jeremy Turner

New therapeutics T2DM

Cardiology Dr Suzanna HardmanHospital Admissions for heart failure kill or cure

Neurology Dr Paul Davies

Acute headaches

12.25

Gastroenterology workshop sponsored by Abbott

Prof Terence StephensonManagement of paediatric patients presenting

acutely with diarrhoea and vomiting

Endocrinology Dr Maralyn Druce

Challenging thyroids

Cardiology Prof Andrew Clark

Advanced heart failure all the tricks of the trade

Neurology Dr Richard Davenport Acute leg weakness

13.05 Lunch Lunch

14.05Gastroenterology Prof Terence Wardle Upper GI bleed

Cardiology Prof Adam Timmis

Acute Coronary Syndrome

Neurology Dr Fayyaz Ahmed

Epilepsy

Endocrinology Dr Maralyn Druce

Challenging thyroids

14.45Gastroenterology

Dr Will Bernal Acute liver failure

Cardiology workshop sponsored by MenaraniProf Peter Collins

Challenges in chronic angina management, updates and case histories

Neurology Prof Neil Scolding

When is a stroke a stroke

Diabetes Dr Jeremy Turner

New therapeutics T2DM

15.25Complications of Cirrhosis session

sponsored by NorgineProf Andrew Burroughs

Cardiology Dr Suzanna HardmanHospital Admissions for heart failure kill or cure

Neurology workshop in association with BayerPanjak Sharma

Anticoagulation in non-valvular Atrial Fibrillation: Post Stroke

Diabetes session sponsored by Novo NordiskMichael D Feher

Hypoglycaemia- the challenge in diabetes therapy

16.05 Afternoon break Afternoon break

16.35Gastroenterology Dr Kieran Moriarty

Abdominal pain: medical or surgical?

Cardiology Prof Andrew Clark

Advanced heart failure all the tricks of the trade

Neurology Dr Paul Davies

Acute headaches

Endocrinology Dr Francesca Swords

Endocrine emergencies

17.15 Gastroenterology Dr Chris Roseveare

Managing acute diarrhoea

Neurology Dr Richard Davenport Acute leg weakness

Diabetes Dr Mark Savage

Diabetic emergencies

18.00Medical Leaders Symposium: The Future of

Postgraduate Medical EducationClose Close

22 November 2012

Breakfast symposiaSponsored by GMC

Registration Registration

Breakfast symposia sponsored by AlereHow biomarkers can aid rapid patient assessment

in Acute and General Medicine9.00

Hot topics Dr Sarah Burnett

Chest X-rays radiology for the general physician

Respiratory Medicine Prof Emma Baker

Understanding COPD

9.15Rheumatology Prof John Isaacs

Update on rheumatoid arthritis

Hot topics Dr Simon Fynn

Demystifying difficult ECGs

Respiratory Medicine Dr Sam Janes

Pulmonary embolus

Nephrology Dr Peter TophamSodium disorders

9.55Rheumatology

Prof Raashid LuqmaniVasculitis and inflammation diseases

General workshop

Respiratory in association with BayerDr Raj Patel

The changing treatment paradigm in deep vein thrombosis (DVT)

Nephrology Prof Sunil BhandariPotassium disorders

10.35 Morning Break Morning Break

11.15Hot topics

Dr Simon Conroy & Dr Ben TeasdaleEmergency care for older people

Hot topics Dr Stephen Waring

Poisoning and overdose

Respiratory Medicine Dr Andrew Menzies-GowAcute severe asthma

Rheumatology Prof John Isaacs

Update on rheumatoid arthritis

11.45Hot topics

Dr Simon Conroy & Dr Ben TeasdaleEmergency care for older people

Hot topics Dr Richard Beale

Sepsis

Respiratory Medicine Dr Nick Maskell

Pleural effusions pneumothorax

Rheumatology Prof Raashid Luqmani

Vasculitis and inflammation diseases

12.25 Lunch Lunch

13.05Nephrology Dr Mark ThomasAcute kidney injury

Respiratory Medicine Dr Andrew Menzies-Gow Acute severe asthma

Hot topics Dr Stephen Waring

Poisoning and overdose

Hot topics Dr Simon Conroy & Dr Ben TeasdaleEmergency care for older people

14.05Nephrology Dr John Firth

Chronic Kidney Disease whats the fuss about?

Respiratory Medicine Dr Nick Maskell

Pleural effusions pneumothorax

Hot topics Dr Richard Beale

Sepsis

Hot topics Dr Simon Conroy & Dr Ben TeasdaleEmergency care for older people

14.45 Nephrology WorkshopRespiratory medicine workshop

sponsored by Chiesi Dr Omar Usmani - Targeting small airways disease

Hot topics Dr Rayaz Malik

Vitamin D: Beyond Bones

Prostrakan sessionDebate on managing change for

Osteoporosis Patients

15.25 Afternoon break Afternoon break

16.05Nephrology

Prof Sunil BhandariPotassium disorders

Respiratory Medicine Dr Sam Janes

Pulmonary embolus

Hot topics Dr Ross Welch

Managing the pregnant patient

Nephrology Dr Mark ThomasAcute kidney injury

16.35Nephrology Dr Peter Topham Sodium disorders

Respiratory Medicine Prof Emma Baker

Understanding COPD

Hot topics Dr Paul Gill

Psychiatry for general physicians

Nephrology Dr John Firth

Chronic Kidney Disease whats the fuss about?

17.15 Close Close

Wednesday 21st November

Thursday 22nd November

Main sponsor:

Main sponsor:

- Acute Medicine - General

- Acute Medicine - General

Conference Speakers

Dr Sam JanesDr Peter Topham Dr Andrew Menzies-GowDr Nick Maskell

Dr Fayyaz AhmedDr Simon Fynn Prof Neil Scolding Dr Richard Davenport

Dr Mark ThomasProf Peter Collins Dr John FirthProf Sunil Bhandari

Dr Mark Savage Dr David KerrDr Jeremy Turner Dr Francesca Swords

Prof Andrew Clark Prof Richard Schilling Dr Suzanna HardmanDr Paul Davies

Dr Simon Conroy Dr Ross WelchDr Stephen Waring Dr Sarah Burnett

Dr Richard Beale Dr Paul GillProf John Isaacs Prof Raashid Luqmani

11 CPD points accredited by the RCP

Prof Terence StephensonDr Kieran Moriarty Dr Chris Roseveare Dr Will Bernal

AGM is organised by Closer2 Medical Ltd, part of the CloserStill family.

Unit 17, Exhibition House, Addison Bridge Place, London W14 8XP

www.agmconference.co.uk Tel: 0207 348 5250

Paul Shelley - Show director [email protected]

Mike Broad Programme director [email protected]

Liz Sanders Business development manager [email protected]

Yemi Ibidunni - Event executive [email protected]

Delegate team [email protected]

Sophie Holt - Marketing and PR manager [email protected]

Sarah Bray Marketing Assistant [email protected]

Julia Danmeri - Head of operations [email protected]

Kate Jackson Conference and speaker manager [email protected]

Daphne Perez Event Coordinator [email protected]

Andy Center - Chief Executive [email protected]

Michael Westcott - Business Development Director [email protected]

Phil Nelson - Commercial Director [email protected]

Jonathan Wood - Director of Finance [email protected]

Phil Soar Chairman

Our high profile speakers will offer practical, interactive presentations that will help delegates transfer the latest thinking and practices from the auditorium to the clinic room and ward. With over 80 talks, and a skills lab, medics will be able to tailor their own programme of learning according to their own training needs. After attending our conference, doctors will be ready for anything when on-call or dealing with general medical intakes!

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Adverse events should also be reported to Bayer plc. Tel.: 01635 563500, Fax.: 01635 563703,

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Xarelto 15 and 20mg lm-coated tablets (rivaroxaban) Prescribing Information (Refer to full Summary of Product Characteristics (SmPC) before prescribing) Presentation: 15mg/20mg rivaroxaban tablet. Indication(s): Prevention of stroke & systemic embolism in adult patients with non-valvular atrial brillation with one or more risk factors such as congestive heart failure, hypertension, age 75, diabetes mellitus, prior stroke or transient ischaemic attack. Posology & method of administration: Dosage 20 mg orally once daily with food. Continue therapy long term provided bene t of prevention of stroke & systemic embolism outweighs risk of bleeding. Refer to SmPC for information on converting to/from Vitamin K antagonists (VKA) or parenteral anticoagulants. Renal impairment: mild (creatinine clearance 50-80 ml/min) - no dose adjustment necessary; moderate (creatinine clearance 30-49 ml/min) & severe (creatinine clearance 15-29 ml/min; limited data indicates rivaroxaban plasma concentrations are signi cantly increased, use with caution) reduce dose to 15mg o.d.; patients with creatinine clearance

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Dont face the future alone go to bma.org.uk/join or call 0300 123 1233.

Join the BMA today for access to employmentadvice and representation, as well as all our other member benefits, including:

Local and national representation Contract checking service BMA Careers Employer Advisory Service Ethics advice and expertise

HAVE YOU GOTTHE SUPPORTOF YOUR TRADEUNION IN YOURWORKPLACE?

PEACE OF MIND SHOULD BE A NO-BRAINER!

Connect with delegates at Acute and General MedicineThe Acute and General Medicine Connect platform is live for AGM delegates to use. The Connect platform makes the AGM conference experience unique, by allowing delegates to set their own agenda for the show and network with other attendees.

With so much going on over the two days, the Connect site will ensure delegates dont miss out on seminars and workshops, by creating their own bespoke programme, as well as 1-2-1 meetings.

Connect will also bring social networking to the show, allowing delegates to share opinions through Twitter, Facebook and LinkedIn.

Delegates can also book their free lunch using Connect.

Find out more at www.agmconference.co.uk

A&E departments are seeing more patients but losing moneySeven out of ten NHS trusts lose money treating A&E patients because of the way emergency admissions are funded reveals a study by the Foundation Trust Network (FTN).

The FTN is calling on the Department of Health to re-examine its policy of paying for some emergency admissions at 30% of the standard tariff because it fails to incentivise primary care providers to avoid sending patients to A&E.

The report argues that the risks and responsibility for avoiding emergency admissions should be more fairly shared between acute trusts and primary and community care.

It says the pressures on A&E departments are compounded by rising numbers of elderly patients and a lack of primary and community services for the elderly that operate around the clock. This means that some patients have to be admitted when it is not strictly clinically necessary. A&E attendances are currently growing at 3% a year. Solutions that some trusts have developed to overcome these challenges include Chelsea and Westminsters Rapid

Assessment team, Nottingham University Hospitals programme to avoid unnecessary testing and South Warwickshires work with GPs to manage the peaks in admissions. Chris Hopson, FTN chief executive, said their benchmarking data showed that trusts were dealing with increasing numbers of patients and improving their performance by reorganising the way that their A&E departments worked. Many were refining the separation of patients with major and minor conditions and providing more specialist care for frail elderly patients in A&E. But the amount that NHS trusts were paid for doing this work was being trimmed by a policy designed to keep people out of hospital.

There is only so much that hospital-based services can do to change patterns of care. What is needed is a whole system approach with a real commitment to keeping patients out of A&E in the first place. In the meantime trusts should not be financially penalised by fines for rising numbers of patients

coming into hospital via A&E, he said.

Key findings from data obtained from 11 trusts were:

Individual trusts receive an average of between 79 and 123 for every patient seen in A&E, yet the cost of treating these patients is between 69 and 129 per patient. Only a minority of the trusts in the study broke even on their A&E work.

Trusts with primary care or urgent care centres within their A&E departments have faster treatment times for patients with minor injuries with the average time spent in A&E nearly an hour shorter. Patients with major problems are also treated faster.

Trusts that use senior clinicians as part of a rapid assessment team have faster initial assessments for the most acute A&E patients.

There is no one-size-fits all approach to staffing an effective A&E service; trusts can use their freedoms to innovate and develop different service models that meet local health needs.

Nearly half of all A&E attendances for older patients (75 yrs +) end in admission, compared with 16% for younger patients. Multidisciplinary teams in A&E reduce admissions of elderly patients, who receive nursing, occupational therapy and physio services in A&E before being discharged home rather than having an overnight stay.

Trusts have reduced re-attendance rates by providing comprehensive information and follow-up advice when patients leave A&E.

More available out-of-hours primary and community services particularly those covering mental health and addiction would help reduce frequent A&E attendances and provide more effective support for these patients.

Junior doctors are concerned that the requirement for them to reflect on Serious Untoward Incidents (SUIs) and Significant Event (SE) information as part of their specialty training could result in cases of double jeopardy when they are revalidated.

They also fear that the revalidation process will create an overly complex and administrative burden.

Dr Tom Dolphin, former chair of the BMAs Junior Doctors Committee, says they are worried about the doctors who have been involved in an SUI or SE but have not been found guilty of any medical malpractice, who may have their fitness to practise called into question.

He also points out that if a doctor has been involved in an SUI and it has been investigated then any issues should be picked up and dealt with at that point. So why should those issues then be gone over again when that doctor has their ARCP (annual review of competence progression) - whats the purpose? he asks.

The answer we have been given is that it will flag up patterns of behaviour, especially if a doctor has been involved in an SUI in every hospital they have worked in. This means that virtually everybody linked to SUI is going to have to be exception reported, he says.

Another concern of juniors is that the process of collecting information about disciplinary issues and clinical governance will be overly complicated and will create a lot of paperwork. They are also worried about who will control the data, and how secure it will be, especially as juniors move around different hospitals.

In theory it should be relatively easy to make the data secure but in practice people share passwords and stuff gets left lying around on desks in HR departments. Somebodys personal data could be leaked and then their life could become very uncomfortable if everyone in their hospital knows they have a problem with their health or they were involved with a patient that died.

Aside from these concerns Dr Dolphin believes that revalidation for junior doctors should be relatively easy because much of it will be based on the regular performance assessment that juniors undergo all the time.

In theory we should just plug in to the ARCP we have every year with a bit of extra data to make sure we have not been involved in any disciplinary processes the deanery didnt know about. It should be quite easy for trainees in that respect - we just hope that the whole process does not become overly complicated, he says.

Dr Dolphin is speaking at the Acute and General Medicine debate on revalidation and its impact on postgraduate medical education.

Juniors fear revalidation burden

Dr. Tom Dolphin

Integrated care would cut hospital admissionsUnnecessary hospital admissions have grown over the last 10 years because financial incentives fail to encourage GPs and consultants to work together in the best interests of the patient, claims the Policy Exchange think tank.

The report argues that fewer people would need to go to hospital if consultants and GPs worked together to provide integrated care which enables more people to be treated in the community.

The way GPs and consultants are incentivised must be radically reformed, the think tank says. At the moment, GPs are paid thousands of pounds on top of their basic salaries to carry out basic administrative tasks such as arranging blood tests and updating disease registers.

Meanwhile acute hospitals are encouraged to admit patients to service high fixed costs for staff and property instead of trying to treat patients at a community level or in the home.

The report says this system has arisen over the past 20 years because successive governments have divided the NHS into ever smaller and more divided parts. This has created a multi-tiered and un-coordinated system of separate organisations, each setting their own legal identity, culture and bonus scheme and leads to unnecessary and costly admissions to hospital for patients with long term conditions.

The reports author Henry Featherstone says: Most patients dont want to be stuck in a hospital ward when they could be treated in expanded GP surgeries closer to home or better still in their own homes. But, perversely, the present system of organisational and individual incentives actually encourages admissions to hospital. This is expensive for the NHS and bad for patient care.

The report calls for a full-scale integrated care model to be piloted alongside the new clinical commissioning groups. It argues this model would drive up standards in a competitive environment.

Page 4 Page 5Main sponsor Main sponsor

AGM Newspaper - November 09.indd 4-5 08/11/2012 12:36

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Build your management and leadership skills at AGMThis session will cover how the application of lean as an organisational philosophy of continuous quality improvement can be a key driver for transformational and cultural change. The focus will be on how a systematic approach to understanding systems and services, standard work and the discipline of daily review engenders clinical ownership and significant redesign of pathways. It will also review how using lean metrics enables reduction in harm, waste, increased productivity and quality whilst enabling financial benefits realisation. Learning points for delegates include: Understanding lean principles in healthcare Applying lean principles in the real world Role of the daily review in management

The future of hospital services in the modern NHS

22 November 9.15, Efficiencies Stream

New structures and organisations are being created in the NHS and its vital that they work towards the same goals, make policy compliance easy and avoid partisanship. Success will depend on local leaders being empowered to do the right thing for their patients. The pressures of transition will be intense but everyone must focus on the big, strategic issues facing the NHS - the need to radically reshape models of care to improve services and get the NHS on a financially stable footing.

There is a series of questions which need answering however: Can we have sustainable acute services in each locality? Does the economic business model for local hospitals get in the way of high quality care? Can we re-organise hospital services without disrupting community primary care services?

Getting to grips with Hospital Standardised Morality Ratios

22 November 14.35, Innovation Stream

Mortality data in the NHS is becoming a significant indicator of quality, and being used to pinpoint problem trusts. This session will look at the importance of understanding mortality data and its role as a driver for improved clinical care. To make progress clinical teams need to Implement weekly deaths reviews, and outcomes need to be shared widely if behaviours are to be altered. In this session delegates will learn about: the skills needed for studying mortality data providing productive feedback to clinicians about clinical

outcomes Bringing about important changes from clinical consensus

Acute and General Medicine delegates will have the exclusive opportunity to access the great programme running alongside AGM at Hospital Directions at no extra cost.

Hospital Directions - the co-located conference at Olympia will provide delegates with a variety of comprehensive speaker streams on Innovation, Efficiency and Leadership, bringing hospital managers together and helping doctors gain a range of new skills for best practice. Weve picked a few seminar highlights that shouldnt be missed:

How the NHS Leadership Academy will support service transformation

21 November 10.05, Innovation Stream

Developing Outstanding LeadershipThe challenges faced are unprecedented and the NHS Leadership Academy is designed to support leaders across the system, so that they can develop their skills and behaviour to deliver better patient outcomes and experiences. This session will outline how the NHS Leadership Academy will take forward its strategy.

COPD care pathways - case study of hospital efficiency


COPD accounts for 10% of all medical admissions to acute trusts, suffers with a large proportion of undiagnosed and poorly diagnosed patients and is destined to be the worlds 3rd largest killer by 2030. The talk will cover the national COPD picture and agenda. We will discuss the project led by UHS to fully integrate primary and secondary care services to improve disease diagnostics and reduce admissions in the background of an increasingly volotile political arena. We will show that medical intelligemnce to first understand the local picture eventually led to an intervention that improved diagnostics by 50% and reduced admissions by 19%. Delegates will learn:1. Understanding of the national COPD situation2. How medical intelligence can be used in a clinical setting3. How vertical integration can be used as a model for long

term conditions

Application of lean principles to improve performance, productivity and quality in an integrated organisation



Innovative diabetes tool wins commendation at Quality in Care awards

The management advice is geared towards helping the doctor or nurse to deal with the patient sitting in front of them. Diabetesbible is aimed at GPs, consultants outside of the endocrine/diabetes world, junior doctors, practice nurses, diabetes specialist nurses and medical students. Over 3,000 health professionals visit the site each month from all around the world and the audience continues to grow. Diabetesbible has been endorsed by bodies such as Diabetes UK, NHS Diabetes and the Young Diabetologists Foundation and the commendation from the QIC awards is a further admiration of the resources credibility, says Dr Turner. I have a strong interest in medical education and writing Diabetesbible was a remarkably good bit of professional development for myself and required a lot of intellectual and academic discipline. It took me a year walking around with a laptop working in the evenings, on train journeys and using spare half hours between meetings. Feedback has been extremely good and I seriously hope that people will be able to use Diabetesbible to keep themselves up to date. The Diabetesbible can be accessed at www.diabetesbible.com. Dr Turner will be giving two talks on Wednesday, November 21 at AGM designed to update non-specialists on the new therapeutics available for the treatment type 2 diabetes.

Continued from page 1

Department of Health is failing to plan for NHS trust bankruptciesA number of NHS trusts are in serious financial trouble but the Department of Health (DH) has no plan for dealing with any that might go bankrupt, MPs on the Public Accounts Committee (PAC) warn.

An investigation by the committee into the financial sustainability of the NHS reveals that in the last financial year 10 NHS trusts, 21 NHS foundation trusts and three primary care trusts reported a combined deficit of 356 million.

Eleven NHS foundation trusts would not have made foundation trust status today given their financial performance, and there is a real concern that some organisations will fail, says the report.

The very difficult financial situation of some NHS bodies is particularly marked in London, where two trusts reported a combined deficit of 115 million. The DH placed one of these, South London Healthcare NHS Trust, in special administration in July 2012.

PAC chair, Margaret Hodge MP, said the Department of Health could not explain to the committee how it would deal with an NHS trust that went bankrupt and what might trigger a trusts failure.

We do not know whether a bankrupt trust would be allowed to fail or how and when ministers would intervene. And it is not clear how the Department would ensure that essential services are protected if a trust fails. She said the committee found that the overall surplus of 2.1 billion across all NHS bodies in 2011-12 masked the fact that a significant minority are in financial difficulty.

Up to now financial problems have often been hidden, with struggling trusts being bailed out through additional financial support from the NHS and the Department.

But Ms Hodge said the incentives for clinical commissioning groups to work collaboratively within regional health economies were unclear. Given the scale of the challenge, it is alarming that there is a lack of comparative data that could inform a debate on reconfiguration of services particularly because the Department expects that every trust will need to reconfigure services, she said.

Planning the future shape of the medical workforceMore effective workforce planning is now essential if patient outcomes are to be improved. Identifying, analysing and interpreting potential future challenges and opportunities that are likely to have an impact on the health and social care workforce is the remit of the Centre for Workforce Intelligence (CFWI).

The organisation was set up five years ago after a Health Select Committee report slammed catastrophic failing is workforce planning.

The CFWI is currently conducting a review of the workforce needs of general internal medicine and acute medicine to determine how the growth in the numbers of the frail elderly and people with long term conditions will impact on the specialty.

A previous review, which reported in August last year, recommended that no change was needed to the number of training posts or their geographical location in acute medicine. But it warned that activity was increasing in the specialty and an increase in the numbers of trainees may be required to meet future demand.

It also noted that there was a need to consider the future impact of the care closer to home and the Quality, Innovation, Productivity and Prevention (QIPP) policies which focus on reducing unplanned admissions in addition to the demands of elderly care medicine.

In February the CFWI produced a report called the Shape of the Medical Workforce which warned that consultant numbers are set to increase by 60 percent by 2020 if policy makers continue to recruit and train doctors at the current rates.

But it calculated that if services shift to being consultant-delivered, there may be about the right number of trainees currently coming through the training pipeline - but they are unlikely to be training in the right specialty areas.

Stakeholders including the medical profession and employers are now looking to see what is now happening in terms of recruitment at trust level. They are also working with Local Education and Training Boards to work out the training and development needs of doctors.

In the next few weeks a CFWI report commissioned by the Health National Strategic Exchange Group will make recommendations on the number of medical and dental students that will be needed in the future.

CFWI chief executive Peter Sharp says the work they are now doing enables them to plan and predict up to 30 years ahead for the medical workforce needs of the 62 medical specialties in the NHS.

Recently the CFWI launched a new horizon scanning portal to help forecast future health workforce needs. This is a system which allows everybody in health and social care to contribute to the agenda about what is actually happening and what they think will happen. Horizon scanning isnt about predicting the future it is about estimating probable futures and developing quantitative provocations to the system, explains Mr Sharp.

Visit www.hospitaldirections.co.uk to see the full programme.

Peter Sharp is chairing The Medical Leaders Symposium: The Future of Postgraduate Medical Education on 21 November at 6pm. Book your place by visiting My Seminars via www.agmconference.co.uk/connect


MPS

MPS is the worlds leading medical defence organisation, putting members first by providing professional support and expert advice throughout their careers. Our whole ethos is focused on what members need and doing our best to help them in whatever way we can.

Medical Defence Union

Established in 1885, the MDU was the first medical defence organisation and has led the way ever since. Members have access to the largest team of medico-legal experts 24 hours a day. Our sole purpose is to serve members and we pride ourselves on providing the best possible service.

Mount International Ultrasound Services

Mount International Ultrasound Services Ltd offer tailored for you ultrasound scanner packages from basic black and white systems through to gold standard colour doppler systems. We also offer a wide range of value for money service contract options for your existing systems; see how much MIUS could save you.

Medical Money Management

For over 40 years, Medical Money Management has provided independent financial planning advice to healthcare professionals. We care for our clients throughout their careers and beyond. With our leading reputation, theres no better way to ensure your finances are fit to meet your needs, both now and in the future.

National Locums

National Locums are fast becoming the agency to work for in the UK. Our National Framework status and multi award winning team will deliver a myriad of locum roles, with excellent hourly rates, across the UK and Northern Ireland. Look to National Locums for a progressive and profitable locum career.

NHS Diabetes and Kidney Care

Our objective is high quality cost effective care for every person with diabetes or kidney disease. We produce evidence, case studies and guidance to inform local decision-making. Our networks regional representatives support frontline NHS staff to drive quality and efficiency, tackle health inequalities and improve outcomes for patients.

NHS End of Life Care Programme

Over half of all deaths take place in hospital, despite the majority of people not wanting this. The estimated total cost of acute admissions ending in death in 2010-11 was over 520m. The National End of Life Care Programme has made significant progress working with health and social care staff, providers, commissioners and third sector organisations across England to improve end of life care for adults.

NHS Improvement

NHS Improvements strength and expertise lies in practical service improvement. It has over twelve years of experience in clinical patient pathway redesign and demonstrates some of the most leading edge improvement work in England. Over the past year we have tested, implemented, sustained and spread quantified improvements with over 250 sites across the country.

NHS Institute

The NHS Change Model - a dynamic framework that draws together everything we know about delivering successful improvement in the NHS - its about improving improvement. Created by a wide range of people from across the service, including clinicians, the Change Model supports a proactive, pragmatic and partnership approach to leading change and transformation.

NHS Professionals

NHS Professionals is the leading provider of managed flexible workforce services to the NHS with approximately 40,000 doctors, general and specialist nurses, midwives, administrative and other healthcare staff signed to its bank. It helps its 66 NHS Trust clients improve workforce efficiency and productivity as part of an overall workforce strategy.

Norgine

Based in Amsterdam, the Netherlands, Norgine is a long-established specialty pharmaceutical company with an extensive presence throughout Europe. Since its foundation in 1906, Norgine has been committed to the development and marketing of high quality, innovative and ethical products for the benefit of both patients and physicians. Specialising in the areas of gastroenterology, hepatology and supportive care, Norgine is dedicated to addressing unmet clinical need, not only for effective treatment of life-threatening conditions, but also, importantly, to improve the quality of life for patients with a range of acute and chronic illnesses. In recent years, Norgine has focused on expanding its pan-European infrastructure. The company now has affiliates in all major European countries and has centralised and strengthened its research and development activities. Norgines success is based not only on its strong portfolio and robust development programme, but also on a long-standing tradition of building strong and meaningful relationships with patients, physicians, employees, partners and other key stakeholders.

Novo Nordisk

Headquartered in Denmark, Novo Nordisk is a global healthcare company with 89 years of innovation and leadership in diabetes care. The company also has leading positions within haemophilia care, growth hormone therapy and hormone replacement therapy.

Parkinsons UK

We bring people with Parkinsons, their carers and families together via a network of local groups, our website and free confidential helpline 0808 800 0303. Specialist nurses and staff provide information and training on every aspects of Parkinsons. Help us to find a cure and improve life for everyone affected by Parkinsons. www.parkinsons.org.uk

PCTI

PCTI provide advanced electronic document management, workflow, collaboration and transfer solutions for 5,500 primary care organisations and over 70 secondary care organisations. Kings College NHS deployed Docman Referral Management System (RMS) as complete electronic document management and workflow solution for managing all referral documentation from external and internal sources.

Pharmabotics

Pharmabotics Ltd is a medical model making company, established to research and develop new and innovative training aids. Doctors and surgeons liaise to produce models that enhance medical education. Pharmabotics specialise in the manufacture of soft tactile tissue, making probably the best gel suture pads on the market.

Phoenix Healthcare Distribution Limited

PHOENIX Healthcare Distribution Limited provides distribution of pharmaceutical products and added value services to Hospital Pharmacies throughout the United Kingdom. Gail Daines, Head of Hospital Services and Steve Charnock, Pharmacy Solutions Manager welcome you to visit us on stand 233.

Podiacare Healthcare

Podiacare Healthcare are a leading supplier of healthcare products to a range of medical professionals. Our range of products are suitable for all walks of medical and

pharmaceutical applications. Specialising in podiatry and foot healthcare products, we also supply medical and surgical disposables, surgery uniforms and footwear.

Premium Medical Protection

Offering a new approach to calculating medical professional indemnity insurance premiums. We assess you as an individual providing a bespoke quote to meet your needs. Whatever your requirements, come and talk to us to learn about the key features of our policies and see if we can save you money.

ProStrakan

ProStrakan is engaged in prescription medicines for the treatment of unmet therapeutic needs. A member of Kyowa Hakko Kirin, ProStrakan is headquartered in Scotland. The companys development capabilities are centred on Scotland and US. Sales of ProStrakans portfolio of products are handled by subsidiaries in the UK, US, and EU.

Pulmonary Hypertension Association UK

The Pulmonary Hypertension Association (PHA UK) is the only charity in the UK especially for people with pulmonary hypertension (PH). Our main objectives are to advance the education & awareness of the general public and medical professionals whilst helping improve the lives of people with PH, and supporting the PH community in the UK. We do this by funding research into PH, raising awareness of the condition, and helping people in their day-to-day lives. The PHA UK was started in 2000 with only 6 members. We now have approximately 4000 members and over 10 years experience of supporting people affected by PH. If you would like to know more about PH or the PHA UK, please visit www.phassociation.uk.com or contact the office on 01709 761 450.

Pulmolink

For over 2 decades, Pulmolink has dedicated itself to providing high quality respiratory testing and monitoring products at affordable prices. An independent, British company offering healthcare professionals and their patients specialist knowledge in and a wide choice of Pulse Oximeters; either as standalone devices or combined with Spirometry or Capnography.

Pulse

For over 20 years, PULSE has been supplying Multi-disciplinary Mental Health staff and Acute Doctors to the NHS and Private Organisations. We have recently expanded our bespoke services across the UK with the launch of 2 additional branches, staffed by experienced teams and serviced by an efficient out of hours resource to ensure that the service you receive is nothing short of excellent.

RIS Products

For more than 38 years we have provided a key service link between our worldwide manufacturing partners and consumers of pharmaceuticals in the UK and Ireland. Our increasing product range, knowledge of the pharmaceutical market-place, and our strength in warehousing & logistics make RIS Products your ideal pharmaceutical supply partner.

Roche

Visit the Roche Diagnostics stand (C46) to hear how a simple test can identify myocardial infarction pre-hospital, enabling patients to be redirected to the appropriate department, freeing up A&E beds and time.

Royal Air Force Careers

The RAF provides protection of the UK and its dependent territories, ensures against major external threats and promotes the UKs security. Working for the RAF is very different

to working for a civilian employer. We offer opportunities few companies can match and challenge you in ways you wont find anywhere else.

The Royal Medical Benevolent Fund

The Royal Medical Benevolent Fund is the leading UK charity for doctors, medical students and their families. We provide financial support, money advice and information when it is most needed due to age, ill health, disability and bereavement.

Royal Society of Medicine

The Royal Society of Medicine is one of the largest providers of continuing medical education in the UK, organising over 400 CPD accredited conferences each year. Supporting 56 medical specialties, including cardiology, respiratory medicine and endocrinology, these meetings offer doctors professional development opportunities throughout their careers. For more information about the benefits of RSM membership visit: www.rsm.ac.uk/join

Seca

Where BMI ends, seca mBCA begins the unique diagnostic instrument for hospitals and medical practices. A single measurement can be taken in 17 seconds to determine fat mass, extracellular/intracellular water, and skeletal muscle mass - the only measurement that has been clinically validated against the scientific gold standard.

Skills for Health

Skills for Health, the Sector Skills Council for the health sector, works with employers to develop a skilled, flexible and productive workforce. We offer a range of tools and solutions including rostering systems, e-learning and compliance reporting tools that offer tangible benefits including improved productivity, quality and efficiency.

Strimar

Look out for your free Strimar seawater nasal spray sample, plus a handy recommender pad, within your exhibition goody bag. You can also learn more about Strimar and access specialist CPD modules on nasal conditions for free on our website.

Swisslogs Healthcare Solutions

Swisslogs Healthcare Solutions division is a world leader in logistics automation solutions for healthcare facilities. Giving you a complete supply chain management approach to the logistics challenges of your hospital and to substantially improve efficiency, financial performance, and patient safety. Swisslog provides logistics solutions that save time, money and lives.

TAG Medical

TAG Medical is a leading medical equipment testing and calibration company, covering everything from blood pressure monitors to ECG machines. As part of the dbg group, TAG customers can also access the latest information on CQC compliance and CPD training.

TANITA

TANITA is a global leader in precision weighing and body composition analysis. With a wide range of weighing scales, pediatric scales and BIA Body Composition Analysers, Tanita offers the highest clinical accuracy and reliability on the market today. Our body composition equipment is rapidly growing in the field of weight management by successfully monitoring patients progress and providing key educational and motivational platforms that weight alone or BMI are not able to provide. For more information visit our stand, go to www.tanita.eu or contact [email protected]

Team 24

Team24 supply experienced GPs and highly skilled hospital doctors covering all grades and specialities, operating 24hour service 365 days a year. Were able to react quickly

to your needs; ensuring continuity of care is maintained and delivered in line with patients needs. Our doctors offer excellent patient care and professionalism.

Templars

Templars Medical has been supplying doctors to the NHS, Ministry of Defence and private sector since 1998. Templars is on all UK frameworks for the supply of locum doctors. Additionally, there are opportunities to work in the Isle of Man, Guernsey, Falkland Islands, Cayman Islands and New Zealand.

The Kingsway Group

The Kingsway Group manufactures a specialist range of products for challenging healthcare environments. As a group we design and manufacture anti-ligature ironmongery and specialist privacy vision panels and supply complete doorset solutions with all components pre fitted. As a group our brands include Visilux, Duralux, Pyrolux, Logica and Hunter Doorsets.

Total Assist

Total Assist has been operating in the healthcare sector for over 10 years in the supply of Locum Doctors and Healthcare Staff and has built its reputation on delivering outstanding services to clients and candidates. An approved supplier for Medical Locums and recently awarded as the Winning bidder for HTE.

TPP

TPP has been delivering clinical systems for over a decade. In 1997, we developed an IT system to link a GP practice and a diabetes service; SystmOne was born. Now SystmOne is used by more than 120,000 NHS staff, connecting electronic records across primary, secondary and social care.

Triple West Medical

Triple West Medical offers a complete range of Medical staffing solutions; from Contract to Permanent, from UK doctors to Specialized Medical Professionals from overseas. Our modus operandi is to offer the best staffing solution through in-depth understanding of our client objectives; adapt to the ever changing culture of the healthcare industry and match the career aspirations of our candidates to offer them progression and satisfaction.

Vaxaid

New, unique hydro-vacuum techniques for aiding Erectile Dysfunction, now used in the NHS and available on the drug tariff from 1st December this year, along with new non-invasive vacuum/pressure technology for increasing blood flow to the extremities is the theme of the VaxAid Ltd stand.

Vocera

Vocera helps nurses and doctors save time, improve patient safety and satisfaction, and increase hospital efficiency through our Voice, Messaging, and Care Transition solutions. Using Vocera, nurses typically save over 30 minutes per shift, banning page and wait of traditional bleeps. Vocera solutions are installed in over 800 hospitals worldwide.

Wesleyan Medical Sickness

Wesleyan Medical Sickness have been providing financial advice to doctors for over 120 years and look after the financial needs of over 90,000 medical professionals across the UK. We provide tailored advice for doctors on a broad range of products and services, including pensions, investments, mortgages and income protection.

Your World Healthcare

Your World Healthcare is a leading healthcare recruitment agency. Specialising in all areas of Doctors as well as medical staffing and administration, we deliver a truly personal service. We offer jobs specific to your individual needs, offering you short term, on-going and ad-hoc jobs in line with your availability.

360CRM

360CRM currently helps over 40 Acute Trusts throughout the UK to reduce DNAs and generate substantial savings through innovative, flexible, and user-friendly services utilising an effective blend of messaging methods. We are the market leader in appointment reminder services, and provide a range of other efficient, time saving communications services.

Abbot Healthcare Products

Abbott Healthcare Products Ltd is committed to optimising patient care through innovative treatments and education. These include therapies for post myocardial infraction, lipid regulation and hypertension. Towards the end of 2012, Abbott will launch a first in class antisecretory for treating acute diarrhoea for all ages from 3 months.

Abbott Diabetes Care

Abbott Diabetes Care are proud to lead the way in improving diabetes management for people dependent on insulin. Abbott introduce the FreeStyle InsuLinx System, which removes the guesswork of insulin calculation by translating glucose and individual patient data into insulin dose suggestions, giving patients confidence to manage their diabetes effectively.

AFL Architects

AFL Architects have established a reputation for the delivery of inspiring design solutions that combine striking aesthetics and high quality functionality with a sound commercial focus. We are committed to the delivery of high quality, elegant architecture, in the knowledge that excellence in design influences a positive quality of life.

Alere

Alere is a global diagnostics company employing more than 11,000 people worldwide. Our rapid tests provide on-the-spot results that support immediate treatment decisions, improve outcomes and enhance the patient experience. We bring together diagnostic products and health screening services to enable healthcare providers to perform diagnostic testing in the clinic, community, hospital or home.

Allocate Solutions

The leading supplier of workforce optimisation and corporate governance solutions for healthcare organisations. Allocate solutions deploy the right people with the right skills, to the right place at the right time, allowing them to match operational demands with workforce supply ensuring efficiency, safety and compliance whilst reducing costs.

Army Medical Services - Territorial Army

AMS-TA is looking for trained clinical professionals who wish to serve in the Armed Forces in a part time capacity. If you seek a challenge and rewarding experience outside of normal working hours then please visit our stand for more information.

A-Team Health Recruitment

A-Team Health Recruitment place doctors from throughout Europe into positions within the UK and Ireland. They specialise in permanent rather than temporary staffing solutions for both public hospitals and private sector clients. Extensive professional, language and clinical screening ensures the provision of some of Europes best doctors from all specialties.

Athona

Athona Doctor Recruitment specialises in placing Medicine hospital doctors into some of the UKs most sought after jobs. We have a dedicated team of consultants who work exclusively in the Medicine sector, so we are able to tell you about the range of opportunities immediately across all grades and sub-specialties.

Bayer HealthCare

Bayer HealthCare In the UK/Ireland, Bayer

HealthCare Pharmaceuticals is comprised of Specialty Medicine (consisting of Haematology, Neurology, Oncology and Ophthalmology) and General Medicine (including Womens Health). We aim to discover and manufacture innovative products that will improve patients lives. Bayers products enhance wellbeing and quality of life by diagnosing, preventing and treating a number of different conditions.

British Association for the Study of Headaches

BASH is a national membership society for healthcare professionals with interest in headache. We are a group of both primary and secondary care doctors, nurses and therapists working with headache patients. Through our work we are committed to promoting headache education among healthcare professionals and the general public.

BCM Specials

BCM Specials is at the forefront of the unlicensed medicines market. Based in MHRA approved facilities, we manufacture sterile and non-sterile specials and also offer a wide range of manufacturing services: clinical trials and contract supply. Our ethos is about being ethical, improving patient care and exceeding our customer expectations.

Biosense

Guided by the needs of Electrophysiologists and Cardiologists, Biosense Webster has pioneered innovative technological advancements for more than 30 years. From the first deflectable tip catheter to todays most sophisticated 3-D cardiac mapping and navigation system Carto3, our products and services continue to help Electrophysiologists expand the boundaries of their field.

BK Medical

BK Medical is a leading provider of premium performance ultrasound. Our systems deliver superior image quality with superb contrast resolution and penetration, and up to 4 hours of plug-free imaging giving excellent mobility to the point of care. For over 30 years we have pioneered innovation in ultrasound.

BMA Services

As a medical professional much of your time and energy goes into caring for others, so finding the time to ensure your financial needs are being addressed is challenging. Thats where we can help. Independent financial advice is provided by AWD Chase de Vere, one of the UKs leading independent financial advisers.

BMJ Group

BMJ Group is a global provider of trusted independent medical information and services for healthcare professionals. Evidence-based clinical decision support tools for the point-of-care. Assessment, learning, CPD resources. Over 40 world-leading medical journals including the BMJ and our recently launched BMJ Open Editions free content covering six specialty areas dermatology, HIV/AIDS, infectious diseases, neurology, obstetrics & gynaecology and oncology.

Chiesi

Chiesi Limited is a research focused, international company, developing innovative pharmaceutical solutions which aim to relieve symptoms and improve the quality of human life. Chiesi is established in the areas of respiratory, cardiovascular and musculoskeletal medicine, with a research pipeline focused in the treatment of respiratory diseases.

Clarity Informatics

Clarity Informatics offer a wide range innovative products and services including our Appraisal Toolkit revalidation ready and fully compliant with latest MAG, RST and GMC guidance, Multi-Source Feedback, and our Quality Improvement Service. For more information, visit us on stand D25 or call us on 0845 113 1000.

Cleankeys

Cleankeys is a world leader dedicated to providing technology based infection prevention and infection control solutions

to the healthcare industry. These solutions include commonly touched devices like computer keyboards that are easy to clean and disinfect whilst having in built software that ensures that the keyboards cleanliness is continuously monitored.

Crescendo

Crescendo offers the most advanced, flexible and feature rich digital dictation solutions. With the user experience being a key drive in our development focus. We ensure maximum functionality including HL7 Interfacing. Supporting Desktop, Telephone, Mobile, BlackBerry, Iphone and Windows 7 smartphone dictation.

CRG Locums

CRG Locums are a supplier of Doctors across all grades and specialities including A&E, Medicine, Surgery, Paediatrics & Psychiatry, to both the Public Sector ( NHS, MoD & HMPS) & private sector. CRG Locums has an experienced team in placethat are available 24/7 to help with any locum needs.

CRT

CRT specialises in the provision of real-time patient feedback solutions, known as ViewPoint. Weve helped over 120 NHS Trusts engage with their patients and achieve unparalleled insight into their experiences. Our user-friendly, customisable systems allow our healthcare partners to focus on what they do best delivering world-class patient care.

CSC

Eighty-five percent of NHS trusts use one or more CSC solution, making it the UKs principal IT provider. And with 13,000 customers in 42 countries, it also ranks among the worlds largest healthcare IT companies. Its software portfolio is extensive and covers every facet of healthcare delivery and planning. This includes interoperable e-health solutions that build on existing systems to maximise current investments, increase efficiency and transform patient care. Its MedChart solution supports all aspects of electronic prescribing and medicines administration and is shown to prevent drug-related mistakes. It improves the communication of medicines related information between medical, nursing and clinical pharmacy teams. Advanced drug formulary management, and clinical and workflow based decision support, provides a highly effective tool to help improve safety and clinical outcomes. CSC works with its NHS customers to develop solutions that meet a genuine need, deliver real benefits and make a lasting difference to clinical staff and patients alike.

Doctors.net

Doctors.net.uk is the largest and most active network of medical professionals in the UK, with a membership of over 190,000 doctors. 97% of members say that the network is their most trusted source of information to support them in making the best decisions for the care of their patients.

Elsevier

Elsevier is a leading publisher of health science information, helping to advance medicine by delivering superior education and reference information as well as decision support tools for students and health care professionals. At this years AGM conference, Elsevier is proud to announce the launch of ClinicalKey, the worlds first Clinical Insight Engine.

Esaote

Esaotes systems are designed for your needs and provide superior image quality and ease of use thus allowing you to concentrate on your patient. These systems will stun you with their image quality, ease of use and ergonomic platform.

eWin

eWIN is a website designed to support NHS organisations deliver the QIPP agenda by improving workforce quality and productivity. It gathers knowledge, including good practice case studies, and provides benchmarking/ predictive modelling tools. Launched in the North West initially it has been rolled out to Trusts across several other regions.

Experian

Experian helps maximise profits and drive efficiencies. Effective sales force planning. Identify demand levels for effective resource allocation. Informed customer engagement Successfully communicate in a multi-channel world. Meaningful NHS engagement Prioritise organisations with greatest potential. Market insight. Maximise existing and potential markets to increase competitive advantage.

Finegreen

Finegreen Associates are a market leading recruitment consultancy that focus on permanent, interim and fixed-term contract roles across the Healthcare Sector. Our highly specialist consultants have extensive experience within Clinical Services, dealing specifically with the recruitment/placement of Doctors, Nurses and Allied Health Professionals to healthcare providers in the UK and overseas.

Fortrus

Fortrus is a company focussed on applying user experience design to create software interfaces that end users find engaging and intuitive, enabling them to view greater and more complex information more readily than through any other means. Our approach provides an abstract layer built around the requirements of the user.

GE Healthcare

GE Healthcare provides transformational medical technologies and services are shaping a new age of patient care. Our expertise in medical imaging; information technologies, medical diagnostics, patient monitoring systems, is helping clinicians around the world re-imagine new ways to predict, and monitor disease, so patients can live their lives to the fullest.

General Medical Council

Revalidation for licensed doctors will start on 3 December 2012. A greater focus on professional standards, encouraging doctors to develop and reflect on the quality of their practice, and supporting better care for patients - this is what revalidation is all about. To find out how you can get ready for revalidation: Come to our breakfast session on Wednesday 22 November 09.00 - 09.55 visit us on Stand No. B94 or visit our website at www.gmc-uk.org/ revalidation

HCL Doctors

As one of the largest locum agencies in the UK, HCL Doctors has built a reputation based on our knowledge, experience and unparalleled customer service. With sole and preferred supplier contracts nationwide, we can guarantee some of the best job opportunities available. Visit our stand to find out more.

Head Medical

Head Medical is a UK based specialist in international medical recruitment, working with doctors across all levels and specialties. Head Medical recruit to amazing places throughout Australia, New Zealand and the Gulf, so if youre looking for a change in lifestyle come along to our stand for a chat.

Holt Doctors

We are an approved supplier of locum and permanent doctors to the NHS with a great choice of work. We hold numerous supplier contracts across the UK and with our specialist divisions and experienced teams, are often called first by Trusts for locum doctor provision.

Hospital Doctor

Hospitaldr.co.uk is an online magazine for NHS consultants and trainees. It covers all the latest developments in the NHS and how they effect doctors working lives. Known for its hard hitting coverage of medico-politics, the website also provides essential career advice and the latest job opportunities in secondary care. Visit www.hospitaldr.co.uk - as 35,000 other doctors do each month - to find out more.

ID Medical

ID Medical Group is a leading supplier of doctors, nurses, GPs and AHPs to the NHS and private sector. We hold supplier contracts with over 80% of NHS hospitals. With specialist teams dedicated to each of the primary specialties, you need look no further for your perfect medical position.

Interact Medical

Interact Medical are one of the leading providers of locum doctors to the NHS and private healthcare sectors. Our supply under the GPS National Framework has positioned us as a strategic partner to the NHS and as such is recognised as innovation in service delivery.

International Medical Information

IMI publishes a variety of E-journals to an EU audience of >360k HCPs. The major medical specialties are covered and content published online for doctors and patients. Education is at the core of our services and IMI have an expertise in creating, delivering and measuring successful educational projects.

Internis

Founded in 2010, Internis is a pharmaceutical company engaged in the development and commercialisation of highly effective and innovative new medicines aimed at the treatment and prevention of a range of common bone disorders, such as osteoporosis and vitamin D3 deficiency.

Kora Healthcare

Kora Healthcare aims to be to the leading company in the development and supply of quality specialist innovative products to niche hospital and healthcare markets Business Interests Kora Healthcare develops, manufactures and markets own label products and also acts as a distributor for several partners in the areas of: Infectious disease Womens health Clinical nutrition KoRa Healthcare is the hospital and retail pharmacy distribution division of the Immdal group. Within the Immdal group, KoRa develops and sources niche products for supply to hospitals and pharmacies. Kora outsources its products from GMP audited manufacturing companies for distribution in multiple markets Kora is licensed to batch release pharmaceuticals and investigational medicinal products into EU markets. Wholesaling Kora has appointed distribution agencies to supply wholesale, hospital and retail customers in Ireland and United Kingdom - Kora is also licensed to distribute prescription medicines in the EU.

Lexacom

Lexacoms secure, accurate and easy-to-use digital dictation system has been designed to help improve patient service. Lexacoms latest software, L3, provides secure mobile dictation, integration with leading clinical systems and reporting functions to monitor and manage

workload and referrals.

Limbs and Things

For over 20 years Limbs & Things has been designing, manufacturing and supplying quality medical training products for healthcare professionals. Our catalogue includes task trainers, synthetic soft tissue anatomical simulation models and demonstration models.

McGraw-Hill Education

McGraw-Hill Education is a global provider of educational materials, information and solutions. AccessMedicine from McGraw-Hill is an innovative online resource that provides students, residents, clinicians, researchers, and all health professionals with access to more than 65 medical titles from the best minds in medicine.

Exhibitor profiles


AGM is for healthcare professionals only. The seminars at AGM have been brought to you by Closer2 Medical in association with our partners and sponsors. The views and opinions of the speakers are not necessarily those of Closer2 Medical or of our partners and sponsors.

AGMs association partners have helped develop the programme. Sponsors have not had any input into the programme except where an individual session states it is sponsored. The session topic and speaker have been developed by each sponsoring company.

Sponsorship statement


Page 11

Team24 is a medical recruitment specialist which provides experienced GPs and highly skilled hospital doctors for a wide range of temporary and permanent placements covering all grades and specialities. Were able to react quickly to your needs; ensuring continuity of care is maintained and delivered in line with patients needs. Our doctors offer excellent patient care and professionalism. Whatever the need, be it ad hoc cover, contract work or long-term sabbatical cover we are here to help. We are also a specialist supplier to the NHS, private hospitals, out-of-hours organisations, HM Prison Service and Military establishments, as well as placing doctors in some of the more remote parts of the world. Specialist occupations include: associate specialists consultants general practitioners RMOs SHOs specialist registrars staff grade doctors Team 24 operate a 24hour service 365 days a year. Please call our medical division on 0845 370 2424 or e-mail: [email protected]

Acute & General Medicine Conference Highlights

Improving patient care through pioneering document management system

In addition to AGMs packed eight stream education programme, the two days will be filled with other must-do events to help you get up-to-date with the latest practices in an interactive and hands-on way. Take a look at what else we have in store for our delegates. E-prescribing clinic Date: 21 & 22 November Time: All day Location: CSC Stand C37

CSC will be running an e-prescribing clinic at AGM, where delegates can receive skilled advice from one of the experts on hand to demonstrate how new technology can improve efficiency, cut down on errors and significantly improve patient outcomes. Find out more: http://www.isofthealth.com/

Breakfast Symposium: How biomarkers can aid rapid patient assessment in Acute and General Medicine hosted by AlereDate: 21 November Time: 9.00 am Location: Theatre 4

The session will explore how rapid diagnostics can help remodel patient pathways within secondary care. Eminent

guest speakers will discuss the role of diagnostic testing within the risk assessment of patients requiring ICU admission and bundled care packages, along with a discussion on the complex interaction between cardiac and renal disease and the management challenges these linked conditions present.Find out more: www.alere.co.uk

Breakfast Symposium: Revalidation sponsored by GMCDate: 21 November Time: 9.15 am Location: Theatre 1

The GMC will be running a morning session where delegates can learn about the future of revalidation, the effects on the clinician and what the real benefits are.Find out more: http://www.gmc-uk.org/

Presentation Arena Date: 21 & 22 November Time: All day Location: Presentation Arena

21st November at 11.15 - 11.45 & 22nd November at 11.55 - 12.25 Dr Gerry Morrow: Quality Improvement Clarity SolutionImproving quality, saving lives and lowering costs.

BlueWare is dedicated to improving patient care through eliminating the stressors involved with paper and document management within the healthcare provider environment. With BlueWares BestBond Electronic Document Management EMR solution, acute trusts can access a complete view of a patients health. BlueWare has been in the EDM business for 20 years with success in both the United Kingdom and the United States with over 200 installations.

BlueWare has given me the confidence to be able to promise our clinicians that if a patient has been discharged, his records will be fully updated, signed and available online by the next day, and the next time they need to be available to a doctor, they can be recalled with a few clicks. Emmett Hennessey, CIO of Beacham Memorial Hospital, Magnolia, MS, USA.

Through a clinical portal designed with customizable workflows including Electronic Signature, clinicians are able to perform duties that are passed on to other users to complete the revenue cycle. BestBond also integrates clinical and legacy systems seamlessly through HL7 interfaces allowing users immediate access to information across the organisations facilities. With BestBonds Community Portal offering, healthcare providers can also access information from GP clinics and the community.

Please contact a BlueWare representative today to learn more about what BestBond can do for you and your organisation. Please e-mail our staff directly at [email protected] or go to our website at http://www.blueware.co.uk

For the past eighteen months Clarity Informatics has been running a quality improvement service in collaboration with two strategic health authority areas, in the South East Coast and in the North West of England. This service looks at clinical indicators of quality in the domains of; myocardial infarction, pneumonia, stroke, CABG, dementia, psychosis, heart failure and hip and knee replacement. The service has produced quantifiable progress in process measures which have translated into defined improvement in outcomes for patients across the project.

21st November at 14.35 - 15.05 & 22nd November at 11.15 - 11.45 Dr Philips Zack& Dr Manson: How to avoid getting sued for clinical negligence Medical Defence Union

Clinical negligence claims sometimes come out of the blue in situations which could not have been avoided. But many claims can be avoided, or at least made less likely, to be pursued. This presentation will show ways in which you can you minimize the risks in your practice.

21st November at 9.55 - 10.25 & 22nd November at 9.55 - 10.25 Ric Belcher: The NHS Pension Scheme Dispelling a few myths - Medical Money Management There has been much concern throughout the Healthcare profession about the forthcoming changes to the NHS Pension Scheme. Pay more in, get less out and work til you drop is a popular summary of the changes. Taking an in-depth look at the contribution rates, when you can retire, and what you might get out all without the spin from one side or the other. If you have any questions that you would like to have answered, please email in advance at [email protected]

Chronic stable angina pectoris affects over 2 million people in the UK and in most European countries 20,000 40,000 individuals/million suffer from angina. Despite many recent therapeutic advances, a growing number of patients experience persistent angina in spite of intervention and optimal medical treatment.

Current estimates suggest as many as ten percent of all patients diagnosed with CHD will develop angina which is difficult to control, highlighting an ever increasing population of patients. Routine tasks such as climbing a flight of stairs, walking short distances, or housework become impossible without patients experiencing chest pain. Many patients are left to suffer from their symptoms, restrict their activities chronically, and anticipate a reduced life expectancy.

The aim of the clinical management of patients with angina should be to relive symptoms, as well as improving quality of life and long-term outcomes. In the setting of chronic

stable angina, medical therapy represents the main stay of treatment.

Optimal antianginal therapy should always include medication for secondary cardiovascular protection including aspirin, statins and angiotensin-converting enzyme inhibition. Risk factors that increase cardiovascular events should also be optimally managed such as cigarette smoking, hypertension, diabetes, obesity and lack of exercise.

Traditional agents for the chronic management of stable angina include calcium-channel blockers, beta-blockers and long acting nitrates. These agents either reduce myocardial oxygen demand or increase myocardial oxygen supply through haemodynamic effects.

Challenges in chronic stable angina management, updates and case histories

The Medical leaders syMposiuM

The Medical Leaders Symposium: The future of Post Graduate Medical Education

Network with Medical Leaders; help shape the future of postgraduate medical education and listen

to a lively debate.

Professor Sir Peter Rubin, chair of the GMC will join Peter Sharp, chief executive for the Centre for Workforce Intelligence, at the Medical Leaders Symposium where

heads, deaneries and decision makers will find out whether the current training system is fit-for-purpose and whether the tensions between training and service needs

are sustainable in the NHS.

Book your place by visiting My Seminars on the Connect site:

www.agmconference.co.uk/connect

Peter Collins, Professor of Clinical Cardiology, Royal Brompton Hospital and Imperial College London.

Main sponsor Main sponsor

Visit the Connect site from www.agmconference.co.uk to book in to the presentation arena.

Listen to Professor Peter Collins seminar on the 21 November, Theatre 2 at 2.45pm.

Need accommodation in London for AGM?

There is plenty do and see in the Kensington area around your time at the conference, including the restaurants of Kensington and Notting Hill, Portobello Market and the world famous Science and Natural History Museums.Delegates for AGM can get preferential rates on local hotels through our accommodation partner, Event Express.

Visit the Attending page of our website for more information: www.agmconference.co.uk


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Bayer Healthcare BHP Simple, proven, predictable anticoagulation

L.GB.10.2012.0708c October 2012

1. National Institute for Health and Clinical Excellence. Technology appraisal guidance 261. July 2012.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Bayer plc. Tel.: 01635 563500, Fax.: 01635 563703,

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Xarelto 15 and 20mg lm-coated tablets (rivaroxaban) Prescribing Information (Refer to full Summary of Product Characteristics (SmPC) before prescribing) Presentation: 15mg/20mg rivaroxaban tablet. Indication(s): Treatment of deep vein thrombosis (DVT) & prevention of recurrent DVT & pulmonary embolism (PE) following an acute DVT in adults. Posology & method of administration: Dosage 15mg b.i.d. for 3 weeks followed by 20mg o.d. for continued treatment & prevention of recurrent DVT & PE; take with food. Refer to SmPC for information on duration of therapy & converting to/from Vitamin K antagonists (VKA) or parenteral anticoagulants. Renal impairment: mild (creatinine clearance 50-80 ml/min) no dose adjustment necessary; moderate (creatinine clearance 30-49 ml/min) & severe (creatinine clearance 15-29 ml/min: limited data indicates rivaroxaban plasma concentrations are signi cantly increased, use with caution) 15mg b.i.d for 3 weeks, reduce maintenance dose to 15mg o.d; patients with creatinine clearance

Acute and General Medicine Pre-Show Newspaper

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