Follow the CEM President on Twitter @CEMPresident
Updated CEM/NPIS Antodote Availability Guidance - This guideline updates the previous 2008 version and provides guidance on the stocking of antidotes in Emergency Departments in the UK.
'A better A&E' - design solutions to reduce violence and aggression - A design solution to reduce levels of violence and aggression in Accident & Emergency (A&E) departments created by PearsonLloyd and commissioned by the Department of Health and Design Council, has found significant improvements in overall patient experience, a reduction in levels of frustration hostility, and cost saving benefits.
New Carbon Monoxide poisoning diagnosis algorithm - Donwload the latest algorithm from Public Health England
IFEM Newsletter - November 2013 - Find out the latest news from the International Federation for Emergency Medicine
Guidance for doctors looking to work in the UK - The College has published a basic guide to working in Emergency Medicine for the NHS in the UK to help doctors familiarise themselves with the structure and terminology.
Latest version of Unified Diagnostic DAtaset released - The Unified Diagnostic DAtaset (UDDA) integrates ICD10, SNOMED, CDS and ‘real world’ descriptions of disease. The aim is to enable consistent coding in Emergency Departments, in a way that is easy for IT systems providers to implement. Download the latest version and release notes here
Commissioning the delivery of high quality care in the Integrated Emergency Department: Guidance for Commissioners, clinicians and managers - This position papers provides guidance on commissioning an integrated emergency care system and provides ten key recommendations which should always be considered when the configuration of locals EDs are made. Download this guide here.
Press statement: New contractual arrangements for GPs - The College of Emergency Medicine welcomes the news this morning that an agreement has been reached on new contractual arrangements for General Practitioners. The GP community is an important part of the answer to the challenges faced by Emergency Departments as we cope with rising patient numbers.
Press statement: Review of Urgent and Emergency Care by NHS England - The College of Emergency Medicine welcomes the review announcement made today (13th November 2013). However, this review is very much future focussed and the crisis is here with us now. For further information about this review please see this link: http://bit.ly/18qvXTO
10 priorities for resolving the A&E crisis - The College has published ’10 priorities for resolving the crisis in Emergency Departments’ which clearly sets out what action needs to be taken to address the current crisis in A&E. The College through its Members is playing its part and we are working in 5 key areas. However, this crisis cannot be solved by us alone, we need urgent action by all stakeholders to work with us to provide a stable long term future for A&E services whilst tackling the short term immediate pressures. This is why we have identified 5 priorities for us and 5 for the Government and NHS leadership to grasp to address this crisis. Our proposals are the collective view of practicing Emergency Physicians; they represent cost-effective solutions to ensure we can deliver safe patient care.
MHRA recall - certain batches of Novomix 30 Insulin: See full details here
Support the 8th National Carbon Monoxide Awareness Week: 18 –24 November 2013 - CO Awareness and the College are keen for all to support the 8th national carbon monoxide awareness week by raising awareness of the dangers from carbon monoxide poisoning, how to avoid it and supporting victims of CO poisoning. A variety of posters and information leaflets for display in your ED are available from http://www.covictim.org/file3 and from the College's guidelines page.
Follow the work of CO Awareness on Twitter https://twitter.com/coaware
Integration of Safety Checklist – How well is safety integrated into your ED? The Safer Care Committee has developed a safety checklist. This allows you to assess how well you integrate and consider safety in your departmental activities and makes suggestions for which staff need to be involved.
Press release - GMC report: The state of medical education and practice in the UK The College of Emergency Medicine welcomes this report from the General Medical Council (GMC) which identifies the important issues relating to the medical workforce in Emergency Departments.
CEM Patient Safety Award 2013 - The Patient Safety Award is awarded annually to an individual or hospital team that can demonstrate evidence of improved patient safety as a direct result of an innovation within their emergency department. The inaugural prize was awarded to Imperial College Healthcare NHS Trust for ‘Project to improve accurate identification of emergency patients’ at the 2013 CEM Scientific Conference at Twickenham. Read more about this here.
Never Events - Could they occur in your Emergency Department? - Never Events are incidents which are considered unacceptable and eminently preventable. The Safer Care Committee has prepared a guide which higlights Never Events that could occur within your Emergency Department and how to mitigate their risks. Download this guide here.
Stretched to the limit - A survey of Emergency Medicine consultants in the UK - This report, the first of its kind, describes the working practixes of consultants and other senior decision makers in the Emergency Department, the pressures they face and the impact on their working lives. It shows that overall 62% regard the job they are doing running the Emergency Medicine service as unsustainable in its current form and 94% of respondents tell us that they regularly work in excess of their normal planned hours to help deliver the service. The College calls for change to address this. Download the report and press statement here.
Creating satisfaction and maintaining wellbeing in Emergency Medicine - The College has published a series of documents to provide better guidance for doctors, employers and commissioners on ways in which to protect the senior medical workforce in Emergency Medicine (EM) in their present working practices. This is vital not only to retain safe, sustainable working but also to create careers that are attractive to our future trainees and satisfying for our present colleagues. The documents are out for consultation and we want to hear your views on how to develop this work.
Survey on Psychological Health in Emergency Medicine Consultants - Please complete this online survey from the University of Exeter which investigates Emergency Department (ED) consultants' perceptions of their psychological health and wellbeing. http://survey.ex.ac.uk/index.php?sid=62142&lang=en
Revalidation guide for Emergency Medicine - The Revalidation Guide for Emergency Medicine brings together key information regarding current revalidation requirements and processes in all four countries of the United Kingdom. It has been developed as a web-resource for Emergency Medicine (EM) doctors who may have queries about their revalidation. The guide advises on the requirements of revalidation which are current at the time of publication.
New GEMNet guideline - Suspected Scaphoid Fractures This document has been developed in response to a perceived need to improve and standardise clinical care in patients with a suspected fracture of the scaphoid bone. The intention is to distil the best available evidence into practical advice for clinicians working in the Emergency Department. The information is presented in the form of clinical decision support guidelines, readily available for use in the ED.
* Please note: There is an event in London in Sept 2014 entitled 'ICEM 2014', organised by the World Academy of Science, Engineering and Technology. This event is for scientists and is not related to the College or the International Federation for Emergency Medicine.
Press statement: Time to act. Severe sepsis: rapid diagnosis and treatment saves lives Sepsis is a significant cause of death and disability in the UK. The College welcomes the first clinical report from the Health Ombudsman that highlights the death of patients in the NHS after failure to diagnose and rapidly treat severe sepsis. It focuses on ten cases investigated where patients did not receive the treatment they urgently needed. In every case, tragically, the patient died.
Press statement: Future Hospital Commission The College welcomes the report Future hospital: caring for medical patients, which sets out the Commission’s vision for hospital services structured around the needs of patients, now and future. The Commission’s recommendations are drawn from the very best of our hospital services, taking examples of existing innovative, patient-centred services to develop a comprehensive model of hospital care that meets the needs of patients, now and in the future.
Thromboprophylaxis in ambulatory trauma patients requiring temporary limb immobilisation - This GEMNet guideline has been rebised prior to publication in the EMJ.
CEM submission to review of Urgent and Emergency Care in England - The College of Emergency Medicine has provided direct input into the Review of Urgent and Emergency Care being led by Sir Bruce Keogh.
A promise to learn – a commitment to act: improving the safety of patients in England - Read the report from Prof Don Berwick that highlights the main problems affecting patient safety in the NHS and makes recommendations to address them, stating that the health system must:
- recognise with clarity and courage the need for wide systemic change
- abandon blame as a tool and trust the goodwill and good intentions of the staff
- reassert the primacy of working with patients and carers to achieve health care goals
- use quantitative targets with caution - they should never displace the primary goal of better care
- recognise that transparency is essential and expect and insist on it
- ensure that responsibility for functions related to safety and improvement are established clearly and simply
- give NHS staff career-long help to learn, master and apply modern methods for quality control, quality improvement and quality planning
- make sure pride and joy in work, not fear, infuse the NHS
Press statement - £500 million to relieve pressures on A&E departments in England - The College welcomes the government announcement of additional funding but calls for long term solutions.
Continuing Professional Development Guidance - The College has revised and updated our guidance for doctors undertaking CPD. The guidance describes how to plan, undertake and record effective CPD that enables doctors to maintain their fitness to practice.
Standards for the clinical structure and content of patient records - The standards for the clinical structure and content of patient records were published in July 2013 by the Academy of Medical Royal Colleges. They were developed through extensive consultation to ensure that they address the requirements of clinicians, patients, carers and health information technology professionals.
The CEM best practice guidance has been revised following the recent recommendations from the MHRA restricting the use of codeine in those less than 12 years old, following a review of safety.
The College has revised and republished this best practice guidance to include children and adolescents and the legal distinctions in Scotland.
*IMPORTANT: We recommend Fellows and Members in Scotland refer to the Mental Welfare Commission for Scotland publication Right to treat: http://www.mwcscot.org.uk/media/51822/Right%20to%20Treat.pdf
Supporting medical students with mental health conditions - New guidance from the GMC and Medical Schools Council that includes suggesting preventative measures that may help to reduce mental health problems in their students, the use of occupational health and how to handle students with mental health conditions in relation to fitness to practise. It is also relevant to people and organisations involved in postgraduate medical education and training. http://www.gmc-uk.org/education/undergraduate/23289.asp
FASSGEM conference 12-15 November 2013- View the provisional programme for this exciting event. Registration is now open via booking form.
Press release: CEM welcomes the House of Commons Health Committee Second Report on Urgent and Emergency Services (24 July 2013) - The College welcomes the report and calls for immediate action to reform urgent care and make careers in Emergency Medicine sustainable.
NHS Institute resources for Paediatric EM - Following the closure of the NHS Institute for Innovation and Improvement, a variety of resources for Paediatric EM can now be found on the College website, including assessment tools, pathways, management plans, patient advice leaflets for specific conditions. www.collemergencymed.ac.uk/Shop-Floor/Clinical Guidelines/External Guidelines/Paediatric EM guidance (NHS Institute)
The Francis report has many recommendations for organisations as a result of the enquiry. The College has developed this checklist for Clinical Directors of the Emergency Department – taking the most relevant recommendations and identifying key actions for clinical leaders of emergency departments. While the list is not exhaustive it is meant as a handy guide to action that might usefully be taken in the first instance
Urgent and emergency care: a prescription for the future (18 July 2013)
The Royal College of Physicians, NHS Confederation, the Society of Acute Medicine and the College of Emergency Medicine have set out ten priorities for action to address the challenges faced by urgent and emergency care services. These challenges include:
- Rising demand and the changing needs of an ageing population
- Lack of comprehensive, effective alternatives to hospital admission across seven-days
- Complex discharge issues
- Handover and flow
- Recruitment into emergency and acute medicine
Second victims are health care providers who are involved in an unanticipated adverse patient event, in a medical error and/or become victims in the sense that they are traumatised by the event. The Safer Care SubCommittee has prepared a guidance document for supporting Emergency Department colleagues who experience such events. This guide advocates key recommendations for individuals and the senior team within the Emergency Department.
CEM response to GMC report 'Medical Education's Frontline' - The College welcomes the GMC report and recommends that safe and sustainable working patterns for trainees and consultants must be found to be able to provide clinical care and time for supervision that reflects that intensity of work.
Care delivered in the urgent and emergency setting in England is increasingly important, and complex. Funding mechanisms need to be re-evaluated. Existing systems fail to adequately fund current care, and are not driving improvements in care. A fundamental change is needed so that resources are allocated to produce the most cost-effective outcomes.
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Recommendations for Safe Trainee Changeover - Doctors in training in the UK have historically started new six-monthly rotations in February and August, with the majority of junior doctors rotating to new training programmes during the first week of August. There is an increasing body of evidence to suggest that simultaneous trainee changeover is associated with higher mortality, reduced efficiency and lower satisfaction. The Academy of Medical Royal Colleges (AoMRC) and NHS Employers have worked with partner organisations to develop simple, practical recommendations that can help mitigate these problems.
The four key recommendations are recognised as best practice and could be implemented within the current arrangements:
1. Consultants must be appropriately available
2. Flexible and intelligent rota design
3. High quality clinical induction at all units
4. Reduction of elective work at changeover times
Improving Efficiency, Interoperability and Resilience of our Blue Light Services Report - A report from Parliament - author Tobias Ellwood MP and Mark Philips. - In the aftermath of the London Olympics, which exposed gaps in overall response and recovery capability, resulting in bespoke, but temporary, resilience procedures. This paper considers the significant financial and operational efficiencies to be gained with simpler and strongerministerial leadership, streamlining of government policy formulation and unambiguous inter-agency operational command at both national and local levels.
Message from the President - An update on College activities from the new President Dr Cliff Mann
NHS England consultation - Urgent and Emergency Care Review In January 2013 Professor Sir Bruce Keogh announced a review into the way the NHS in England responds to and receives emergency patients, called the Urgent and Emergency Care Review.
The Review has developed an evidence base for change, emerging principles on how a future system might be shaped, objectives which the new system would seek to achieve, and possible implementation options.
(Evidence base: http://www.england.nhs.uk/wp-content/uploads/2013/06/urg-emerg-care-ev-bse.pdf Emerging Principles: http://www.england.nhs.uk/wp-content/uploads/2013/06/uec-emerg-princ.pdf)
NHS England are conducting a survey seeking thoughts on the work so far, and suggestions which will help to strengthen this work and the evidence base.
The College is seeking the views of Fellows and Members in order to submit a response that represents the majority of member's views. I would be grateful if you could take a few minutes to share your views here: https://www.surveymonkey.com/s/UECReview
Fellows and Members are also encouraged to submit individual responses to the NHS England survey: https://www.engage.england.nhs.uk/survey/urgent-emerging-care
Many thanks in advance for your assistance.
Position statement: Hydroxyethyl starch products The European Medicines Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) has recommended the suspension of hydroxyethyl starch (HES) products. The Faculty of Intensive Care Medicine, the Royal College of Anaesthetists, the Intensive Care Society and the College of Emergency Medicine have published a statement in response supporting international recommendations to use crystalloid solutions for fluid resuscitation. Albumin may be used in patients with severe sepsis who require large volumes of crystalloid. Read the full statement from FICS, RCoA, ICS and CEM
Dr Cliff Mann is the new President of the College of Emergency Medicine. Cliff was the only nomination Council received for the role and under the bye laws Council exercised its powers to confirm him in post with immediate effect on Thursday 20th June.
Cliff will be writing to all Fellows and Members shortly. The College wishes Cliff every success in taking over the helm at a challenging time for the specialty.
A survey about the care of older people in emergency departments throughout England and Wales - As many of you will be only all too well aware, there are a growing number of older people attending emergency departments throughout the country.
The College of Emergency Medicine has recently participated in several pieces of work addressing the needs of older people in the Emergency Department (e.g. Silver Book, Acute Care Toolkit). A collaboration between Sheffield and Leicester is now looking into older peoples’ care in the ED in more detail, with a view to formally evaluating the role of dedicated services for older people embedded within the ED over the coming years. In order to help get the research underway, we would be very grateful if you could spare a few minutes to answer this online survey. Please follow this link
https://www.surveymonkey.com/s/P35RMTM Thank you for your support.
What do you think of NICE? The National Institute for Health and Care Excellence (NICE) are asking for feedback from staff in a range of disciplines to help shape the development and growth of NICE’s work. Please take part by completing this survey. It will take about 10 minutes to finish.
"We are always striving to understand the impact and effectiveness of what we do. This is more important than ever as our role evolves to fit in with the new health and social care landscape. By sharing your views, you will be helping us to disseminate and implement our work and improve treatments and delivery across the NHS, social care services and beyond."
Please click here to take part.
For a hard copy of the survey or for more information, email email@example.com or call 0161 219 3756.
The King's Fund Quarterly Report - A&E Findings - The report finds that for the final quarter of 2012/13, nearly 6 per cent of patients waited four hours or longer in A&E, the highest level since 2004.
The College of Emergency Medicine welcomes this report from the Foundation Trust Network which adds to the body of evidence describing the increasingly critical situation facing Emergency Departments (A&E): http://www.foundationtrustnetwork.org/resource-library/emergency-care-and-emergency-services-2013/
Press release: Emergency Departments and Ambulance Diversions - Released 30 May 2013
Important information regarding defibrillation of patients with implanted neurostimulators - The MHRA has published guidance on good practice when performing external defibrillation on patients with active non-cardiac implanted devices such as neurostimulators. The guidance can be found at http://www.mhra.gov.uk/Publications/Safetyguidance/Otherdevicesafetyguidance/CON266121
Please ensure that clinical staff, especially paramedics and Emergency Department staff, are made aware of this guidance.
New CO Awareness posters - download new posters that can be displayed in your ED to raise awareness about the dangers of carbon monoxide. With thanks to the Carbon Monoxide Awareness charity.
Feverish Children in Illness (May 2013) - Revised guideline published by NICE (replaces older guidance CG47)
New CEM Best Practice guidance - the patient who absconds - download this guideline that has been developed to assist Emergency Physicians and healthcare managers in the management of patients who abscond from the Emergency Department (ED).
NHS support plan launched to help hospital and A&E departments keep waiting times in check - NHS England has announced plans to to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures.
The drive for quality - How to achieve safe, sustainable care in our Emergency Departments Emergency care systems in the UK & Ireland are facing their biggest challenge in well over a decade as they aim to cope with unsustainable workloads and a lack of sufficient numbers of middle grade doctors and Consultants in Emergency Medicine to deliver consistent quality care. In this report, the first of its kind, The College calls for fundamental change in the way we design, fund and run our emergency care systems. Download the report and press statement here
NHS 111 - Press Release (2 May 2013)
The College of Emergency Medicine notes the very serious concerns being expressed about the efficiency and effectiveness of NHS 111 around the country at present. We have prepared a press release on NHS 111 which can be downloaded here.
Accident & emergency departments - planning and design guidance (30 April 2013)
The Department of Health has launched guidance aimed at the multidisciplinary team including clinicians, design teams, estates planners and managers involved in the strategic and operational planning of an accident and emergency service and built space. It sets out the strategic background, uncertainties and evidence base for key decisions that need to be made in the design and planning of a new or refurbished emergency departments.
Press release: the challenges facing Emergency Departments (26 April 2013)
Applications are invited for the post of EDITOR: Emergency Medicine Journal Closing date 30th June 2013
Revised Good Medical Practice (April 2013) - The GMC revised guidance was formally launched on 23 April 2013. Eight pieces of explanatory guidance have also been published, along with updated online learning materials linked to the guidance. http://www.gmc-uk.org/guidance/index.asp?WT.mc_id=EMSR130422
CEM response to the Francis Inquiry report - The College has prepared a statement for Fellows and Members on the Francis Inquiry Report outlining what the report is and why it is important for Emergency Medicine. This document also acts a guide to challenging occurrences of poor care.
Applications sought for College Professor - We are seeking to recruit a College of Emergency Medicine Professor in 2013. This post is for 4 years and is awarded in recognition of sustained and continued excellence in academic emergency medicine. This appointment is intended to promote the profile of the recipient, their work and their academic profile along with that of the College of Emergency Medicine.
For further information on the role, please download the job description
Applications in writing are to be submitted to Professor Suzanne Mason, Chair, Research and Publications Committee, c/o College of Emergency Medicine (firstname.lastname@example.org). Please include a CV and covering letter. Shortlisted candidates will be invited for interview at the College of Emergency Medicine Headquarters. Applications should be submitted by FRIDAY 3rd MAY 2013 with interviews planned for June or July.
Payment by Results arrangements for 2013-14 - Confirmation of the arrangements for Payment by Results (PbR) in 2013-14 is now available on the DH website at: https://www.gov.uk/government/organisations/department-of-health/series/payment-by-results-2013-14
Consent, Capacity and Restraint of Adults in Emergency Departments - Patients requiring care at the Emergency Department present particular challenges to ensure valid consent. Patients often attend in a crisis; have their capacity impaired by therapeutic or recreational drugs. These patients are attended to by clinicians who may have to make time critical decisions based on incomplete information. The Emergency Department can be a disorientating and frightening environment for patients. A patient is often anxious, afraid and in pain and this can impair their ability to make reasoned and rational choices about their care. Good consent also forms a medico legal defence for the treating clinician in the event of adverse outcome or complaint. The College has published a guideline designed to augment the guidance offered by the General Medical Council and the Department of Health as the College of Emergency Medicine has identified where further guidance is required.
Mental Health in Emergency Departments - A toolkit for improving care: Service provision for patients with mental health issues can be very challenging to resolve. Frequently ED and mental health are provided by discrete organisations, and offering a seamless service to the patient can seem impossible. Much of the commissioning structure for mental health is based around different geographical and logistical domains when compared to acute services. This often results in suboptimal or absent services to patients attending the ED with mental health needs.
The toolkit provides several resources that EDs can use to develop and improve the care provided to patients with mental health issues. Resources include guidelines, example assessment aids, example business cases and standards for EDs.
NHS Change Day 13th March 2013 - Is one day during which the collective energy, creativity and ideas of thousands of NHS staff, and those who support the NHS, in all areas of work and right across the country, will demonstrate how one simple action or new idea can make a difference and improve care for patients, their families and their carers. It will be the single largest improvement event in the NHS to date.
Anyone can take part, not just those involved in healthcare. Patients , carers, families, schools and charities are welcome to join us. Change Day is open to everyone who cares about the NHS.
The idea came out of a conversation with young leaders in the NHS, the next generation: ‘If we are the ones who are doing the work, then we are the people who can change the way we do it - for the better.’
Change can begin with very simple ideas. One innovative suggestion can lead to a new way of thinking which could transform the way we work.
The idea of NHS Change Day is create a mass movement of people working in the NHS and outside of it demonstrating the difference they can make, to mobilise 65,000 NHS staff - 1,000 for each year since the NHS was first established – to take action voluntarily on 13 March 2013, to demonstrate their commitment to improving patient care and create a movement which could lead to more NHS Change Days.
Find out more here and pledge to change the NHS: http://www.changemodel.nhs.uk/pg/groups/33183/NHS+Change+Day/48567?community=NHS+Change+Day
Needlesticks - ED care of patients who have been potentially exposed to blood borne viruses (Feb 2013) - Download the latest position statement from the CEC Best Practice subcommittee
Recognition of EPLS - The CEM curriculum requires trainees to have completed a paediatric life support course and recognises the course is an appropriate proxy for workplace based assessments in the major paediatric presentations. The College curriculum refers only to APLS but trainers and trainees can be reassured that the EPLS is the equivalent of the APLS and is acceptable as evidence of these competences.
Initial assessment tools - The ED team at QMC Nottingham have kindly shared a range of initial assessment tools designed to be used by nurses for others to adapt and use in their departments.
Press release here (31st January 2013) Challenges facing Emergency Departments
The College has released this press statement today on challenges faciling Emergency Departments.
IFEM Framework for Quality and Safety in the ED (2012) - IFEM has developed a framework for quality and safety that is applicable across the globe. The framework:
- Summarises what patients should expect from an ED.
- Examines how the ED differs from other healthcare settings.
- Presents a theoretical framework for the domains of quality and safety.
- Identifies the enablers and barriers to quality care in the ED.
- Suggests areas where the measurement of indicators may prove valuable
Sir Bruce Keogh to lead to review of urgent and emergency services in England - The NHS Commissioning Board today (Friday, 18th January 2013) announces that it is to review the model of urgent and emergency services in England. Details here.
Job Description - National Clinical Director for Urgent Care - The NHS Commissioning Board are recruiting to this role which will provide national clinical commissioning leadership and focus on out-of-hours primary care, rapid response community services, prehospital and ambulance services, urgent care facilities and Emergency Departments.
The appointment is offered on secondment on a part time basis, 0.5 WTE for a period of up to three years with an annual review of progress.
Apply via www.jobs.nhs.uk/ The deadline for applications is 9th January 2013
EMTA Christmas newsletter - catch up on the latest news for trainees
Christmas message from the President - Dr Mike Clancy reviews a hectic year and the year ahead; and on behalf of everyone at the College wishes you all a Merry Christmas and a Happy New Year.
Service Delivery and Workforce 2013: Tools to help address service and workforce pressures - EDs across the UK are facing considerable service pressures relating to workforce and activity. The College has published a toolkit with the aim of providing assistance to Emergency Medicine clinicians and Departments by listing in one place existing resources together with a description of new developments that we hope will help to address these pressures. It also provides an update on College work to support Emergency Departments and focus attention on finding solutions to the workforce challenges.
This is not a complete resource – where there are blanks the College is working hard to identify or develop resources/guidance, and we are grateful for all the suggestions and good practice examples provided by Fellows and Members to date. If you are aware of existing resources or new initiatives that could appear in this document please contact Gordon Miles (email@example.com). The document will be updated and re-issued throughout the next year
National Commissioning Board seeks National Clinical Directors - We have been given notice of some important posts that are being advertised.
The NHS Commissioning Board will be taking over the day-to-day running of the NHS from April 2013 and is now seeking National Clinical Directors to drive this transformation.
The 24 National Clinical Directors will focus on improving outcomes for patients in line with the NHS Outcomes Framework and the priorities of the NHS Mandate. Key to the post is developing the interventions that, embedded as commissioning instruments, will overcome the barriers to best care.
The full list of the available positions is on the NHS Jobs website: http://www.jobs.nhs.uk/index.html - search under 'National Clinical Director'
New version of Unified Diagnostic DAtaset published - At the moment emergency and urgent care diagnoses are coded in different ways by different organisations. The UDDA is a translation table between SNOMED and ICD10 covering approximately 600 of the most common Emergency Care diagnoses. To help utilise the UDDA effectively we have also published a wallchart and FAQs guide. Download from:
New version of CEM Minimum Dataset published - Download the latest verison of the minimum dataset. THis has been updated to assist EDs with:
- communicating more timely and better quality clinical information with GPs and other clinicians through the Summary Care Record initiative of CfH to reduce risk
- collect better quality data about Emergency Department activity to improve standard of care and give commissioners of acute healthcare accurate and consistent information
- appropriately funding demand and strategic changes in casemix through the HRG/Payment by Results reimbursement mechanism
- supporting audit and service improvement initiatives
- monitoring patterns of patient conditions – 'syndromic surveillance’ of Emergency Departments that has been identified as key priority for the monitoring of the impact of major public health incidents e.g. pandemic influenza
- collecting standardised information about causes of injury to ensure that public health policy such as injury prevention initiatives are informed by accurate data
- balancing the desire of external organisations to collect information with the realities of clinical Emergency Medicine practice
- facilitating the design and local procurement decisions for Emergency Department information systems by a clear coordinated college approved standard of data.
CO charity will close unless a good fairy appears with funding support - A charity dedicated to supporting victims of carbon monoxide (CO) poisoning faces closure within weeks as the country’s desperate economic plight continues to force public and private sector organisations to curb charitable donations, funding and support. Unless a fairy godmother appears, Carbon Monoxide Awareness will close its doors for the last time on 31 December after seven years dedicated to raising awareness of carbon monoxide and providing a counselling and support service for victims of CO poisoning.
December 2012 CEM e-Newsletter Catch up on all the latest news from the College
Accident and Emergency Patient Survey 2012 - read the key findings from the fourth national survey of patients who attended an Emergency Department (A&E) in January, February or March 2012. Almost 46,000 patients aged 16 or older from 147 NHS Trusts in England
completed questionnaires, yielding a response rate of 38%.
Emergency Medicine Taskforce - Interim Report - In recent years, the poor recruitment at ST4 in Emergency Medicine (EM) has raised concerns within the specialty and the medical profession. The specialty in 2011 and 2012 has achieved a lower than 50% fill rate into higher training. Fewer trainees are opting to choose EM for higher specialty training due to concerns over the intensity and nature of the work, unsociable hours, working conditions and the sustainability of such a career to the age of 68.
The Emergency Medicine Taskforce was established by the Department of Health in September 2011. This is its interim report. The Taskforce in fulfilling its Terms of Reference has explored many aspects of medical education and training, which may be contributing to the problems that the specialty is currently facing.
Fill rates, trainee numbers and deanery data has been collected, expert evidence and opinion has been sought to establish the key factors effecting Emergency Medicine. Using this data and evidence the Taskforce has developed a number of recommendations focusing on medical education, training and service provision in order to improve the recruitment and retention in the specialty.
Driving Improvements in A&E Services - The Foundation Trust Network ahve published a briefing document summarising the results of their A&E 2012 benchmarking study. Key messages include:
- The majority of trusts are losing money on their A&E services. Trusts are continuing toimprove their efficiency, but fundamental problems remain on the funding of A&E and emergency services
- The Department of Health should re-examine the policy of paying for some emergency admissions at 30% of the standard tariff
- Risks and responsibility for avoiding emergency admissions should bemore fairly shared between acute trusts and primary and community care
- Trusts with primary care or urgent care centres within their A&E departments have faster average treatment times. 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(75yrs+) end in admission. Multidisciplinary teams in A&E reduce admissions of elderlypatients, who receive nursing, occupational therapy and physio services in A&E before being discharged home rather than having an overnight stay.
- Trusts have reduced reattendance 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 reduce frequent A&E attendances
Revalidation of licensed doctors begins Monday 3 December 2012 - It is expected that the majority of licensed Emergency Medicine doctors in the UK will have been revalidated by 2016. Revalidation aims to give patients and the public, as well as employers and other healthcare professionals, extra confidence that doctors are up to date and fit to practice. All licensed doctors will need to revalidate on a regular basis (usually every five years) in order to keep their licence to practise.
The College is working hard to provide members with information to assist Emergency Doctors in revalidation. We are in the final stages of testing a Revalidation Portfolio which will allow Members and Fellows to store information required by their Responsible Officer to make a revalidation recommendation to the GMC , as well as providing help and information. This resource will be available early in 2013.
To use the portfolio, all Members and Fellows must ensure that their personal information is correct on the CEM website. If it is not, they will not be able to register. Please login (bottom of the screen) and check or change your personal details, such as your employer, email or postal address.
A Revalidation Helpdesk is now available at the College. If you have any questions about revalidation please email them to firstname.lastname@example.org. A team of Specialty Advisers is on hand to answer non-standard queries, or provide tailored advice and information about revalidation in Emergency Medicine that may not be easily accessible elsewhere.
For general information about revalidation please go to the GMC website: http://www.gmc-uk.org/doctors/revalidation.asp
For specialty specific informaiton please visit the Revalidation section of the CEM website
Download a poster listing the events taking place next week to raise awareness of carbon monoxide poisoning
For other carbon monoxide awareness resources visit the external guidelines page
Details about support for victims of CO poisoning can be found at: http://www.covictim.org/
Winterwatch 2012 - Winterwatch brings you regular updates about: how the NHS is coping with the increased demands of the cold winter months, levels of flu-like illness and uptake of flu vaccination: http://winterwatch.dh.gov.uk/
Major trauma and the use of tranexamic acid in children - An evidence statement from the RCPCH states:
- Tranexamic acid reduces mortality in adult trauma
- Early administration is vital for efficacy
- Due to the lack of published data on the use of tranexamic acid in paediatric patients who have undergone major trauma there is no evidence for a specific dose in this situation
- The RCPCH and NPPG Medicines Committee recommend a pragmatic dosage schedule – 15mg/kg tranexamic acid loading dose (max 1g) over 10 minutes followed by 2mg/kg per hour
Acute Bronchitis/ Bronchiolitis – Early Warning - The EDSSS, a joint public health surveillance project between CEM and the HPA has picked up that attendances for Acute Bronchitis/Bronchiolitis are currently increasing and if they haven't hit your department, they may do soon!These increases are
particularly noted in the 0-4 years age group. This EDSSS aims to provide early warning of large increases of transmissible disease through monitoring daily ED attendances across a range of syndromic indicators. This information may help front line clinicians with service planning.
Please send any feedback to email@example.com
Safe Sedation of Adults in the Emergency Department - This document has been produced as a good practice document on sedation in the Emergency Department. The document was produced by a working party which included members from the Royal College of Anaesthetists, the College of Emergency Medicine and other stakeholder groups.
Sedation is a continuum, and it is not always possible to maintain patients at a pre-determined sedation depth. This document recognises a clear distinction between lighter levels of sedation (minimal and moderate, or conscious, sedation) and deeper levels (including the dissociative state caused by ketamine). Deeper levels of sedation are indistinguishable from general anaesthesia, and should be treated as such. This is reflected in a series of recommendations for staff numbers and competencies,
alongside the required environment and equipment, which are required for each target sedation depth.
Example proformas for paracetamol poisoning - paediatric and adult proformas have been kindly shared by Leicester Royal Infirmary. The proformas follow the new MHRA guidelines. Download from http://secure.collemergencymed.ac.uk/Shop-Floor/Clinical%20Guidelines/Clinical%20Guidelines/Paracetamol%20Overdose
Trust Special Administrator at South London Healthcare NHS Trust publishes draft report - Read the TSA report which makes recommendations for the future of South London, including the future configuration of urgent and emergency care. A public consultation about the report will open between 2 November 2012 and 13 December 2012: http://www.tsa.nhs.uk/document-downloads
Updated never events policy framework and data published - The never events policy framework has been reviewed and updated in order to address areas of uncertainty and provide greater clarity about never events and the recommended response to them following feedback from stakeholders. It offers a useful reference for boards, clinicians, other staff and patients.
The document also contains data on the number and types of never event reported in 2011/12 and 2010/11, revealing 326 never events were reported to strategic health authorities in 2011/12.
It is recommended that all NHS boards consider this refreshed framework and that medical and nursing directors ensure that work is taken forward to improve patient safety and eradicate these never events from health care. http://www.dh.gov.uk/health/2012/10/never-events/
Cold Weather Plan for England 2012 published - The Cold Weather Plan aims to prepare for the effects of winter weather on people’s health. It provides advice for individuals, communities and agencies on how to prepare for and respond to severe cold weather. And it is supported by a Met Office cold weather alert service that starts on 1 November and runs until the end of March 2013: http://www.dh.gov.uk/health/2012/10/cwp-2012/
Survey published on public perceptions of the NHS - 78% of recent ED patients were satisfied with their most recent visit. View the full report at: http://www.dh.gov.uk/health/2012/10/survey-public-perceptions/
RCPCH - Epilepsy 12 Audit - Epilepsy 12 is a national three-year audit to help improve patient outcomes and the quality of care and service provided being run by the RCPCH. For complete details of the project including a report on the findings so far, go to: www.rcpch.ac.uk/epilepsy12
New tool for measuring children’s experiences in emergency settings launches - A new tool to measure the patient’s reported experience, designed ‘by children, for children’, will capture the views of young patients to help Emergency Departments, GP surgeries, Walk-in/Urgent Care Centres and the Ambulance Service identify what’s working well and areas for improvement. Developed by the Royal College of Paediatrics and Child Health (RCPCH) with the Picker Institute Europe, the new patient measure tool will ask children about their waiting times, how well doctors explained what was happening, how they were looked after by staff and whether there were age-appropriate facilities available.
Ambulatory emergency care statement (Oct 2012) - the College has published a statement highlighting the benefits of ambulatory care based on clearly designed and safe pathways. Download the full statement
Shaping a healthier future – North West London consultation. The College’s response (Oct 2012) - The College is grateful for the opportunity to comment on the consultation for North West London (NWL) reconfiguration plans. We have reviewed both the consultation document and elements of the evidence provided in the outline business case. The priority is to ensure that the proposed changes maintain a high quality and safe service for the people of NWL. Our comments are based around this important premise.
NHS Employers: Guidance on the appointment and employment of NHS locum doctors - A quick summary (Oct 2012) - Read the College's quick summary highlighting the key information you need to know about employing and appointing locums. Full guidance is on the NHS Employers website: http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/Latest-news/Pages/Guidanceonlocumdoctors.aspx
Join us on Wednesday 28 November to learn more about commissioining - what it means for you and what you need to do to.
Held here at the College offices in London, this day is open to ED clinicians, directors and managers.
The day will explore:
- Overview of the CEM strategy on commissioning
- Configuration of EM services – how should we guide commissioners to spend wisely?
- Commissioning a sustainable, cost effective workforce for emergency care
- A commissioner's viewpoint - what clinicians need to be able to say
- Examples of practices in the regions : Commissioning the integrated ED
- Measuring Success: The Importance of Informatics
- Next steps – Developing guidance to support Commissioners of emergency care.
Find out more details and how to register on the CEM Study Days
GEMNet thromboprophylaxis guidance - revised flowchart published (19 Oct 2012) - Many thanks to those of you who spotted omissions to the originally published flowchart. This has now been amended and the updated version can be downloaded via link above.
Academy supports staff who voice concerns (19 Oct 2012) The Academy has signed up to the speaking up charter. Launched today by the NHS Employers this is the first charter outlining a commitment from employers, regulators, health unions, professional associations and bodies to work together to support staff when raising a safety concern or issue at work.
The charter, signed up to by 28 organisations, outlines a commitment to work more effectively together to create a just culture which is open and transparent. A just culture ensures individuals are fully supported to report concerns and safety issues, and are treated fairly, with empathy and consideration, when they have been involved in an incident or have raised a concern.
The Academy and those signed up have committed to:
- Work in partnership with other organisations to develop a positive culture by promoting openness, transparency, fairness, reporting and learning as an important and integral part of providing safer patient and public care
- Adhere to the principles of this charter to foster a culture of openness which supports staff to raise concerns
- Share expertise to create effective ways of breaking down barriers to reporting incidents and concerns early on
- Exchange information, where it is appropriate and lawful to do so, in the interest of patient and public safety
- Signpost individuals to support and guidance to ensure that they are fully aware of and understand their protected rights under the Public Interest Disclosure Act 1998 (PIDA)
- Seek to highlight issues where current law or regulations may restrict those who wish to raise a concern about a human error.
The Charter and further details can be found on the NHS employers website
Are you ready for Revalidation? (18 Oct 2012) We would be extremely grateful if you could answer this very short survey (just 4 multi-choice questions) to give us an idea of how prepared you are for revalidation. This will help us to satsify any of the training or information needs that may be identified. Please respond by Friday 26 October 2012
APEM Annual Conference - Bristol - 5th & 6th December 2012 We hope to see you at this year’s APEM Annual Conference in Engineer’s House, Bristol. The two day program contains a number of exciting keynote lectures, with updates from leaders in the field of Paediatric Emergency Medicine. In addition, the latest developments in PEM research will be showcased through oral and poster presentations, culminating in the awarding of the Liz Molyneaux prize. Thursday afternoon will see the second meeting of the PEM research group, with all welcome to attend.
**Abstract submission has been extended – closing date 26th October 2012**
Abstracts are invited for oral and poster presentations. Research should be relevant to PEM, and abstracts should be no longer than 300 words (suggested format of Background, Methods, Results, Conclusions). Submitted abstracts should be sent by email to firstname.lastname@example.org.
To register for this event, please complete the registration form or go to www.apem.me.uk for further details. Costs are £150 for Consultants and £100 for doctors in training. Enquiries to Kath Berry (email@example.com). Venue information and directions
HIV Testing in the Emergency Department (16 Oct 2012) - revised best practice position statement produced in consultation with British Association for Sexual Health and HIV (BASHH) and British HIV Association (BHIVA). The guidance has been developed to assist Emergency Physicians and healthcare managers in the establishment of human immunodeficiency virus (HIV) testing in Emergency Departments. The guideline offers recommendations regarding the principles and safeguards required for the implementation of HIV testing in the Emergency Department setting. Go to Clinical Guidelines
New GEMNet guideline for the use of thromboprophylaxis in ambulatory trauma patients requiring temporary limb immobilisation (16 Oct 2012) - The College's Guidelines in Emergency Medicine Network (GEMNet) exists to promote best medical practice in a range of conditions presenting to Emergency Departments (EDs) in the UK. This guideline presents a summary of the best available evidence to guide the use of thromboprophylaxis in adult ambulatory outpatients who present to the ED following acute limb trauma and require temporary immobilisation. The document has been developed following discussion amongst Emergency Physicians and collegiate fellows to decide which topics would benefit from the development of clinical guidelines. Go to Clinical Guidelines
William Rutherford International Award 2013 - Call for Nominations (15 Oct 2013) - This award made by the College of Emergency Medicine recognizes the inspiring work of one of the specialty’s ‘founding fathers’, William Rutherford. Potential recipients can be nominated by Fellows or Members of the College of Emergency Medicine although the nominee need not be formally affiliated with the College. The recipient will be invited to present at the 2013 autumn national conference. The deadline for nominations is 30 November 2012. Examples of the type of work suitable for consideration for this award would include the following: disaster relief, refugee assistance, establishing new public service health/emergency care facilities, epidemic or disease control operations, and diplomatic efforts connected with peace programmes. Further information about nominations
Election of College Treasurer - Call for Nominations (15 Oct 2012) - Nominations are sought for a Fellow to serve as Treasurer of the College of Emergency Medicine. The nomination paper, together with the candidate’s signed agreement to stand for election, must be received at the College office by Wednesday 31 October 2012. A ballot of Council members will be conducted if more than one nomination is received.
Manchester ED doctor leads trial of new ‘heart attack detection’ system (15 Oct 2012) - A doctor from Central Manchester University Hospitals NHS Foundation Trust, who developed a new method for assessing whether patients arriving at Emergency Departments with chest pain have in fact suffered a heart attack has been awarded a £467,000 National Institute for Health Research (NIHR) Postdoctoral Fellowship to test the method at two local hospitals. Read the press release for more information
Management and Transfer of Patients with a diagnosis of Ruptured Abdominal Aortic Aneurysm to a specialist Vascular Centre (Oct 2012) - Endorsed jointly by the Vascular Society, the Royal College of Radiologists and CEM, this guideline aims to ensure patients with a clinical diagnosis of rAAA equity of access to a specialist vascular centre for expert assessment and intervention. If not already present, emergency physicians and vascular surgeons should work collaboratively to develop region-wide protocols to facilitate access to this standard of care. Simultaneously this guideline should assist the emergency physician in the assessment, resuscitation and timely preparation for transfer of the patient with a clinical diagnosis of ruptured abdominal aortic aneurysm, if this diagnosis is made in a hospital without suitable vascular facilities. http://www.collemergencymed.ac.uk/Shop-Floor/Clinical Guidelines/Clinical Guidelines
Guidance published on sharing information to tackle violence (9 Oct 2012) - This Guidance highlights how Community Safety Partnerships (CSPs) made up of local authorities, the Police and other local agencies can reduce violence in their community by encouraging EDs to collect and share information on time, type and location of assault. http://www.dh.gov.uk/health/2012/09/information-sharing/
The health and care system in England from April 2013 (17 Sept 2012) - The Department of Health has published a diagram giving an overview of the new health and care system from April 2013: http://healthandcare.dh.gov.uk/system-overview-diagram/
CEM Press Statement - re: 'RCP Report - Hospitals on the edge' (13 Sept 2012) - The College of Emergency Medicine welcomes the publication of the Royal College of Physicians (RCP) report 'Hospitals on the edge? The time for action'. Download the statement
U Can Cope coalition and campaign (4 Sept 2012) - The U Can Cope coalition now consists of over 100 organisations and exists to spread the message that it is possible to overcome suicidal thoughts and feelings and that there are many resources available to help those who are struggling to cope. You can get involved or follow the campaign in various ways:
- Via Twitter @ UcanCope or @AlysColeKing
- Follow the blog: there is an email sign up on the home page. http://ucancope.org
- Read the helpful resources on http://www.connectingwithpeople.org
The RCPsych has also developed a new resource particularly aimed towards young people to build their ability to cope with life’s difficulties and build their resilience (also called U can Cope). http://www.rcpsych.ac.uk/mentalhealthinfo/youngpeople/ucancope.aspx
World Suicide Prevention Day - Monday 10th September 2012 - is an opportunity for all sectors of the community - the public, charitable organizations, communities, researchers, clinicians, practitioners, politicians and policy makers, volunteers, those bereaved by suicide, other interested groups and individuals - to join with the International Association for Suicide Prevention and the WHO to focus public attention on the unacceptable burden and costs of suicidal behaviours with diverse activities to promote understanding about suicide and highlight effective prevention activities.
Find out more about how you can support WSPD at http://www.iasp.info/wspd/
Warning! Scam e-mail re: 'ICEM 2013' (3 Sept 2012) - an email is circulating regarding a supposed ‘ICEM 2013’ being held in Paris in June 2013. The email refers to ‘ICEM 2013 : International Conference on Emergency Medicine’ Paris, France June 2013 and provides a link to a website under the banner of ‘World Academy of Science Engineering and Technology’ or WASET. This Organisation is not known to IFEM and we advise you delete the e-mail without opening it.
Paracetamol overdose: new guidance on the use of intravenous acetylcysteine (3 Sept 2012) - The Medicines & Healthcare Products Regulatory Agency (MHRA) in collaboration with the College has published new guidance following a review by the Commission on Human Medicines of the treatment of paracetamol poisoning. Professor Simon Thomas chaired the implementation group, with input from the National Poisons Information Service (NPIS). The key changes from previous guidance are:
- A single treatment line regardless of hepatotoxicity risk (see Annex I, via link below).
- The duration of administration of the first dose of intravenous acetylcysteine is increased from 15 minutes to 1 hour.
- Removal of hypersensitivity as a contraindication to treatment with acetylcysteine.
- Provision of weight-based dosing tables for adults and children.
- A Technical Information Leaflet (TIL) which gives more detailed instructions on the preparation of acetylcysteine infusions (see Annex II, via link below).
These changes are intended to simplify treatment decisions, minimise allergic reactions and reduce prescribing errors. They reflect the findings of the Commission on Human Medicines that risk factor assessment was difficult and inconsistently applied in clinical practice. There have also been many reports of prescribing and administration errors. This new guidance will be published in the next edition of the British National Formulary (BNF). We would therefore recommend that you introduce these changes as soon as possible, and cascade this information to all clinical staff in your Emergency Department.
CEM e-Newsletter - September 2012 edition (31 Aug 2012)
World Sepsis Day - The first World Sepsis Day, 13th September 2012, aims to increase awareness and recognition of Sepsis and the need to diagnose and treat the illness early and to win health hospitals, departments, individual physicians and health care workers as supporters of the WSD. It is the goal of the WSD coalition to get at least 1000 institutions registered until September 13th 2012.
New and revised clinical standards (24 Aug 2012) - Following a comprehensive review over the last year, new and revised clinical standards have been published by the Standards and Audit subcommittee.
Job vacancy - Conference and Events Organiser (24 Aug 2012)
Poster: Top tips for patient safety in your ED (13 Aug 2012) - The CEM Safer Care committee has produced a poster that lists simple steps that eveyone can take to improve patient safety and raise awareness of patient safety. Please download and display in your ED. http://secure.collemergencymed.ac.uk/code/document.asp?ID=6531
Clinical Excellence Awards 2012 NEWS FLASH (9 August 2012): – if you would like to request a citation from the College your CVQ MUST be received no later than 5.00pm on Friday 10th August. Please send your CVQ as an attachment on email to Gerardine Beckett (Gerardine.firstname.lastname@example.org) – no CVQs can be accepted after that time. See more about CEAs
Preventing and detecting acute kidney injury (3 Aug 2012) - Donal O'Donoghue (National Clinical Director for Kidney Services) and Matthew Cooke (National Clinical Director Urgent and Emergency Care) call upon EDs and AMUs to consider their clinical contribution in preventing and detecting acute kidney injury in light of the potential shortage of devices for haemofiltration caused by the earthquake damage to a factory in northern Italy.
Exam Notices (30 July 2012) - Please note the following if applying for MCEM or FCEM:
- MCEM Part A Eligibility -There has been a change in the eligibility criteria for the Part A examination. Part A may be taken in the first year of medical practice. In the UK this will be the first Foundation year or equivalent.
- New MCEM International Exams section - All you need to know about sitting MCEM in India or Singapore
- Revised fees for MCEM and FCEM
Latest Medical Device Alerts relevant to EM (25 July 2012)
National Recruitment to Higher Specialty Training - The second round of recruitment to Emergency Medicine ST4 posts will open for applications on 31 August 2012 with a closing date of 28 September 2012. Short listing, if required, will be on 8 October 2012 and interviews on 6 November 2012 (in Sheffield). For further information please contact email@example.com
Could your patient have carbon monoxide poisoning? (24 July 2012)
CO Awareness and the Katie Haines Memorial Trust have produced a poster, supported by the College, which is aimed directly at medical and nursing staff in Emergency Departments. Copies are being posted today to the lead consultant in every ED in the UK. Please take a few minutes to read the poster and display them prominently in an appropriate location in your department.
HPA asks emergency medicine doctors for early warning of Olympic public health threats (20 July 2012) - The College and the Health Protection Agency (HPA) are asking emergency medicine doctors to report potential links between patients and the Olympics or Paralympics when reporting notifiable diseases, chemical exposures and other threats to public health between July and September 2012. This enables control measures to be implemented as early as possible, which it is hoped will prevent illness spoiling anyone’s enjoyment of the Games and avert serious harm to health. See here for full details of how to report
Latest Syndromic Surveillance Report (Week 28) - Asthma and difficulty breathing indicators continue to increase over a number of syndromic systems. Current levels are slightly higher than those expected for the time of year. Lower and upper respiratory tract infection rates also continue to remain slightly higher compared to recent years. Read the full report here
Survey of the provision of analgesia and anaesthesia for the reduction of wrist fractures (17 July 2012) - Please take a minute of your time to complete this survey: https://docs.google.com/a/sheffield.ac.uk/spreadsheet/viewform?formkey=dFlLQklfOHpwSjNhUWVRZ0hlOTQxTHc6MQ
Protecting children and young people: the responsibilities of all doctors (16 July 2012) - The GMC has issued new guidance to every doctor in the UK to help them protect children from abuse or neglect. The guidance underlines the duty on doctors to act if they are concerned that a child or young person is at risk. It provides detailed advice for doctors on information sharing, working in partnership with other agencies, consent for child protection examinations, acting as a witness in court, and where to turn for support.
The guidance will come into effect on 3 September 2012. It can be found at www.gmc-uk.org/childprotection, along with learning materials, including case studies, and a decision-making flowchart.
Seeking expressions of interest - Violence Reduction Nurse Programme 2012-13 (5 July 2012) - DH England is working with the College of Emergency Medicine to develop a working model in each region in England to support the Coalition Commitment on Information Sharing to tackle violence. 2012-13 is the last year before transition into the new health and social care system and we would like to invite consultants / senior nurses to register interest in working to support information sharing as detailed in the College of Emergency Medicine guideline. Read further information and how to apply
Sharing resources - discharge advice for patients (28 June 2012) - The ED team at Sunderland Royal Hospital has kindly shared a number of discharge advice leaflets for a variety of conditions. These are available for you to download and use in your own ED. Download from the local guidelines section: http://www.collemergencymed.ac.uk/Shop-Floor/Clinical Guidelines/Local Guidelines
Northern Ireland Emergency Medicine Quality Improvement Collaborative for Emergency Medicine (21 June 2012) - The Emergency Department (ED) quality improvement initiative was proposed in late 2010 by the Northern Ireland Trust Chief Executives Forum. Subsequently the Health
and Social Care Safety Forum was asked to act as a facilitator and has the engaged Trust ED teams. Together they have reached consensus on a number of internal professional standards that would act as regional quality indicators for emergency medicine. Download the first edition of the collaborative Newsletter
Best Practice Tariff for Same Day Emergency Care (20 June 2012) - Please take a few minutes to complete a short survey about ambulatory emergency care. We need to gather stakeholder's views to inform the Department of Health’s review of the Same Day Emergency Care Best Practice Tariffs (SDEC BPTs) introduced in 2012-13. Please complete the questionnaire by following this link. We would be grateful if you could complete the questionnaire by 3 July 2012 latest: http://www.snapsurveys.com/swh/surveylogin.asp?k=133967868234
The new Silver Book is launched: Quality Care for Older People with Urgent and Emergency Care Needs (20 June 2012) - The Silver Book provides necessary and important guidance to support all those involved in delivering emergency care to meet the needs of older patients and to promote continuous improvement in the standards of care.
- Download the silver book
- CEM Statement
- In the news - Daily Telegraph article
- In the news - Pulse Today article
- See statements from other organisations: BOAT & COT, BGS, CSP
NCEPOD Trustee vacancy (20 June 2012) - NCEPOD are currently recruiting for the vacancy of NCEPOD Trustee. For a role description and for further information please go to http://www.ncepod.org.uk/vacancies.htm Closing date for applications is 16 July 2012.
Latest CEM e-Newsletter (15 June 2012)
The new commissioning arrangements for the NHS in England - what do we know so far? (15 June 2012) - The BMA have produced a useful guide to the new commissioning arrnagements in the NHS. Download the full report from: http://bma.org/working-for-change/shaping-healthcare/commissioning/~/media/EF3FAF6B19B2448C9C7CDB34FF3798D3.ashx
CEM Annual Report 2012 (15 June 2012) - Download the report on the College's activities in the past year.
Reconfiguration of Emergency Care system services - 10 Key Principles (31May 2012) - This position statement by the College describes the principles that relevant stakeholders must consider when decisions regarding reconfiguration are being made. These will be especially relevant where stakeholders decide that part of reconfiguration will involve down grading or even closure of an Emergency Department.
Decreased Conscious Level for the management of children - RCPCH audit report (31 May 2012) - The RCPCH has published the findings from an 18-month multi-site clinical audit of the Management of a Child (aged 0-18 years) presenting with a decreased conscious level. Read the report here: http://www.rcpch.ac.uk/decon
Support for people who are distressed, are experiencing suicidal thoughts or who self-harm (29 May 2012) - The Royal College of Psychiatrists has produced an advice leaflet for patients presenting to EDs that are feeling suicidal or in distress. You can view the leaflet online and order copies from: http://www.rcpsych.ac.uk/mentalhealthinfo/problems/feelingontheedge.aspx
NHS Innovation Challenge Prizes (28 May 2012) - this award scheme recognises and rewards ideas that tackle some of the most challenging areas of healthcare. Prizes are awarded for
achievement of speciﬁc challenges, ranging from signiﬁcant improvements in delivery
through to major clinical breakthroughs. The rewards are substantial, including the added value in knowing that these innovations are making a real difference to patients and the NHS. Several of the challenges are relevant to Emergency Medicine - visit www.challengeprizes.institute.nhs.uk
Changes to ambulance response time categories (17 May 2012) - Changes to prioritise the most critically ill patients, increase the number of vehicles available to reach patients most in need and reduce the number of cancelled ambulances have been announced for England by the Department of Health: http://www.dh.gov.uk/health/2012/05/a8-measure/
Promoting the NHS Organ Donor Register with Facebook (16 May 2012) - Facebook has joined the drive for more organ donors by developing an initiative allowing users to state their intention to become an organ donor and share that choice with others via their profile timeline. NHS Blood and Transplant (NHSBT), the UK Organ Donation organisation is collaborating with Facebook UK so that in addition to allowing users to share their intentions with friends and family, those who have n ot yet officially joined the ODR can do so easily using NHSBTs Facebook registration page.
2012 CEM Research Grants (16 May 2012) - Applications are now invited for the 2012 CEM research grant application cycle. Consideration will be given to projects up to £10,000.00. Guidelines and application forms are available on the Research Grants page: http://www.collemergencymed.ac.uk/Shop-Floor/Research/Research Grants
Hard copy applications must be received before 17:00 on Friday 27 July 2012.
Applications will be reviewed at the October meeting of the College’s Research and Publications Committee.
New standards set for emergency care of children and young people (3 May 2012) - Developed by the Intercollegiate Committee for Standards for Children and Young People in Emergency Care Settings, the revised edition of Standards for Children and Young People in Emergency Care Settings provides healthcare professionals, providers and service planners with measurable and auditable standards of care applicable to all urgent and emergency care settings in the UK.
The 2012 edition reflects changes in the way care is delivered: there is a new chapter focusing on mental health and substance misuse and the document takes a 'pathway' approach to aid a multi-professional workforce. Most importantly, this edition shifts from making recommendations to setting standards, giving healthcare professionals the guidance they need to provide the best service for children and young people along the care pathway.
Launch of newsletter for EM trainees (30 Apr 2012) - EMTA has published the first of a hopefully quarterly newsletter aimed at keeping EM trainees updated on trainee related issues and the work of EMTA. See the EMTA news page
24/7 consultant-delivered care a ‘must’ for effective NHS, says new report from the RCPCH (30 April 2012) - Patients would receive far better care if they had access to a senior doctor (consultant) 24 hours a day, 7 days a week, says a report published by the Royal College of Paediatrics and Child Health.
The report, Consultant Delivered Care: An evaluation of new ways of working in paediatrics, shows that if consultant delivered care (CDC) models (face-to-face consultant-led care for children up to 24 hours a day requiring acute care) are implemented, it will improve quality of care, ensure good handovers and improve communication with patients and their families. http://www.rcpch.ac.uk/cdc
Information Sharing between EDs and CSPs to tackle violence (26 April 2012) - To determine the level of engagement in data sharing, the Department of Health is currently conducting an audit to see whether EDs are collecting and sharing data with local partners. Please help by completing this survey at: https://www.surveymonkey.com/s/dataevaluation2012nhs
The Combined Royal Colleges Medal 2012 - Call for nominations (20 April 2012) - the Combined Royal Colleges Medal is awarded for an outstanding contribution to photography and/or its application in the service of medicine and surgery. Any person of any nationality, whether a member of The Society or not, or organisation is entitled to submit work or to be nominated for the Award. The winner will be announced at an Awards ceremony to be held in London on 6 September 2012. See here for further details
HPA/CEM Emergency Department Syndromic Surveillance System - EDSSS (16 Apr 2012) - The Emergency Department Syndromic Surveillance System (EDSSS) is a new syndromic surveillance scheme which has been developed by the HPA in collaboration with the College of Emergency Medicine. This national sentinel surveillance system monitors daily emergency department (ED) attendances in England for key morbidities.
- See the latest bulletin here: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317133540747
- Visit the Informatics section for more information about the project and how you can get involved.
Launch of the CEM Quality in Emergency care Dashboard (QED) (11 Apr 2012) - The College's Quality in Emergency care Dashboard (QED) project is being launched on Thurs 12th April at midday on the ENLIGHTENme website at http://www.enlightenme.org/dashboard
This is an important strategic initiative for the College. The QED aims to collect data that is most relevant to the care we deliver in the ED so that it can be used for local benchmarking, appraisal (revalidation) and in discussions with commissioners. See here for more details
Essentials of Patient Safety (4 April 2011) - the second edition of Prof Charles Vincent's book Patient Safety was published in 2010. He has now adapted some material from the book to produce a short version which is free to use for any non-commercial purposes . We hope this may be helpful as an introduction for anyone interested in patient safety or for those teaching courses. http://www1.imperial.ac.uk/medicine/about/institutes/patientsafetyservicequality/cpssq_publications/
Academy survey on less than full time working (28 Mar 2012) - Please take a few minutes to complete this survey designed to identify whether consultants, SAS doctors and trainees working less than full time (LTFT) are experiencing difficulties in working LTFT: if so how frequent are these difficulties, what type of difficulties are commonly encountered, and how (or if) they are resolved. Many thanks https://www.rcpworkforce.com/se.ashx?s=253122AC3FC24E78
CEM Simulation Faculty Course, 9th July 2012, Bath - Are you delivering simulation training? Do you want to enhance the learning in your simulation sessions? Then this is the course for you. The focus is on maximising the education benefit of simulation training through effective debriefing. This course is principally run as small group workshops with loads of opportunities to practice debriefing. Download Flyer for details
Big variation in deaths and hospital admissions due to injury across England (26 Mar 2012) - The rates of people killed and admitted to hospital due to injury differs dramatically from one
local authority to another. These are the findings from the Injury Profiles, a new online data
tool launched today by the South West Public Health Observatory (SWPHO) on behalf of
Public Health Observatories in England. www.injuryprofiles.org.uk
Latest Newsletter from National End of Life Care Programme (26 Mar 2012) - This issue highlights acute care issues. Download this edition. To subscribe, visit http://www.endoflifecareforadults.nhs.uk/
CEM Corporate Plan 2012-2015 (26 Mar 2012) - The College has published a strategic plan outlining aims and objectives for 2012-2015. We have produced it to share our objectives with our stakeholders. For our Members and Fellows it shows where our main priorities lie. Our other stakeholders such as patients, the public, Departments of Health and NHS organisations will also be interested in our priorities.
Information standard to close the communication gaps in end of life care (22 Mar 2012) - The End of Life Care Co-Ordination: Core Content Information Standard sets out and describes a core dataset of key information which is required to support the provision of safe and high quality care. http://www.endoflifecareforadults.nhs.uk/strategy/strategy/coordination-of-care/end-of-life-care-information-standard
Ultrasound training (22 Mar 2012) - Contact your regional ultrasound training co-ordinator and find out more at http://www.collemergencymed.ac.uk/Training-Exams/Training/Ultrasound training
The route to success in end of life care - achieving quality in ambulance services (15 Mar 2012) - Ambulance services are a key player in end of life care team, NHS guide concludes
Ambulance services could support more people in achieving ‘a good death’ and reduce unnecessary or unwanted hospital admissions and treatment, according to the latest in a series of practical guides co-ordinated and published by the National End of Life Care Programme. The guides aim to improve care for people nearing the end of life in a variety of settings while making best use of available resources. http://www.endoflifecareforadults.nhs.uk/publications/rts-ambulance
EM Operational Handbook (Way Ahead) - Highlights (14 Mar 2012)
Latest CEM e-Newsletter (9 Mar 2012) - Please note log-in is required to download
National Review of Asthma Deaths (9 Mar 2012) - For a 12-month period from 1 February 2012, every death from asthma in the UK will be reviewed systematically and will be subject to an in-depth multidisciplinary confidential enquiry. Click on the link to the left for an update or visit the RCP website to learn how to get involved: http://www.rcplondon.ac.uk/projects/national-review-asthma-deaths
Get ready for Revalidation! (8 Mar 2012) - Revalidation is imminent; see our checklist of supporting information for apprasial and preparation so you can be ready.
Raising and acting on concerns about patient safety (8 Mar 2012) - New guidance from the GMC makes clear that doctors have a duty to act when they believe patient safety is at risk, or when a patient’s care or dignity is being compromised. The guidance explains when doctors need to raise concerns and advises on the help and support available to them, including how to tackle any barriers that they may face. http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp
Leadership and management for all doctors (8 Mar 2012) - New guidance from the GMC aimed at helping doctors understand their responsibilities in relation to employment issues; teaching and training; as well as planning, using and managing resources.
New website launched for doctors with health concerns (8 Mar 2012) - The General Medical Council is launching Your Health Matters, a new website for doctors who may be concerned about their own health or that of a colleague. The website provides case studies showing doctors with a range of health concerns, a testimonial from a doctor who has gone through fitness to practise procedures, and a range of advice on the process.
Your Health Matters also provides detailed information about what happens to doctors who are referred to the GMC where the concerns relate to their health.
For more information, go to www.gmc-uk.org/doctorshealth
The Benefits of Consultant Delivered Care (8 Mar 2012) - The most comprehensive and focused review into the benefits to patients of consultant delivered medical care has been published by the Academy of Medical Royal Colleges (AOMRC).
NHS Medical Director's Clinical Fellow Scheme (8 Mar 2012) - this scheme gives junior doctors the opportunity to spend time in a dedicated out-of-programme experience to develop their skills in leadership, management and health policy. Participating doctors work within a host organisation in roles that typically include policy work, analysis, strategy and project management. Applications for the 2012-13 intake are now open. Closing date for applications: 5pm, 22 March 2012. For more information and application packs go to: http://www.fmlm.ac.uk/clinical-fellow-scheme
NHS Innovation Challenge Prizes (6 Mar 2012) The latest round is now open for entries. The list of challenges includes:
• Emergency Care – right place, first time
• Reducing avoidable use of Primary Care
• Improved Diagnostic Investigation
• Reducing Falls and Falls Injuries
As you know the recent Chief Executive’s report ‘Innovation Health and Wealth’ – increased its commitment to the NHS Innovation Challenge Prizes as part of a wider effort to encourage better spread and diffusion of innovation and new ideas.
Applications will be received up until the 1st June and details can be found at: www.challengeprizes.institute.nhs.uk
Notice about College EGM to discuss the Health and Social Care Bill (5 March 2012) Login to view document
Crowding in the Emergency Department (2 Mar 2012) - The College has published this best practice guideline to assist managers and clinicians who are trying to reduce crowding in their hospital Emergency Departments. The guideline explains the causes and consequences of crowding. This guideline offers suggestions to reduce the effects of crowding and improve the safety of an Emergency Department. CEM clinical guidelines
Payments by Results 2012/13 (1 Mar 2012) - The final 2012-13 Payments by Results package has been published by the Department of Health in England. This comes into effect from 1st April 2012. There are five Emergency care tariffs for services delivered in EDs and minor injury units (MIUs), spread over 11 HRG classifications based on investigation and treatment. In addition, best practice tariffs have been introduced for a number of emergency clinical scenarios. The aim is to promote management of these scenarios on a same day basis in an ambulatory emergency care manner. See Casemix - how your ED is paid for a summary and link to full details
Job vacancy - Membership and Finance Administrator (G4) (29 Feb 2012)
Latest issue of NPSA Signals (28 Feb 2012) - Emerging issues from national review of serious patient safety incidents
Doctors needed! Help test assessment tools (27 Feb 2012) - The Academic Centre for Medical Education at UCL is working with the GMC to review Fitness to Practise procedures and update the assessments to ensure each assessment is fair to the doctor being assessed.
To do this, they are holding validation events for new assessment material and are looking for interested and fully registered doctors to participate. The day will involve taking a written test of knowledge and a 12 station OSCE and will last from 10:00am – 4:30pm at the Clinical Assessment Centre, Archway. To be eligible, you must be FY2 to Consultant level, and have worked in the specialty for at least four months within the last year. Volunteers can only take this test once for each specialty. Download the flyer to see dates
All volunteers will receive feedback about their own performance. The day provides valuable insight into how the GMC assesses referred doctors and is also excellent examination practice for those about to do postgraduate exams. Participants will receive an honorarium of £350 plus (standard class) travel expenses and lunch. https://www.ucl.ac.uk/dome/gmc/pilot_information
Opportunities with the Judicial Appointments Commission (8 Feb 2012) - In February, the commission will have some positions for medical members and are looking to recruit those who are medically qualified and registered with the GMC.
This is an opportunity to use their medical knowledge and experience to consider evidence and, together with the judge, decide appeals against decisions of the Department for Work and Pensions relating to Employment and Support Allowance and Disability Living Allowance. The role involves enabling all parties, some of whom are among the most vulnerable in society, to have a fair hearing. Visit http://jac.judiciary.gov.uk/selection-process/selection-exercises/forthcoming/1649.htm for more information.
BMA 2012 Research Grants (8 Feb 2012) - Applications are invited from medical practitioners and/or research scientists and are for either research in progress or prospective research.
The 2012 research grants are now to apply for online on the BMA website. The application deadline is 16 March 2012 at 5pm.
Subject specifications for each grant vary. For example, in 2012, research areas range from rheumatism and arthritis, cardiovascular disease and cancer to the uptake of preventative measures and the use of information and communication technologies in medicine.
For more information on the grants on offer in 2012 and details of how to apply, please see: www.bma.org.uk/researchgrants
Time for work for the benefit of the wider NHS (23 Jan 2012) - a copy of the letter to all NHS organisations from the four CMOs, Sir Bruce Keogh and the GMC asking employers to look favourably on requests from doctors for absence to undertake national work of benefit to healthcare systems across the UK.The letter helpfully specifically refers to work for Royal Colleges.
The complete archive for the EMJ is now available to members at the site below:
Previous College statements
Hot Topics in EM
- The Way Ahead 2008-2012
- Human H1N1and Seasonal Influenza
- Unscheduled Care Facilites
- Primary Care and Emergency Departments
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- CEM Manifesto
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