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01/22/2020 - 10:25pm

by Steven H Miles, MD

The Nazi Doctors at Nuremberg in 1945 brought enormous attention on medical war crimes. The unearthing of complicity of United States physicians and psychologists with interrogational torture during the war on terror of  at the beginning of the 21st century reignited attention to participation of physicians in human rights crimes. In retrospect, two aspects of that renewed attention deserved more scrutiny. There was a lack of attention to international context for the United States experience and, against this background, the fact that no US physicians were held accountable for complicity with torture was as noteworthy as their collaboration with that practice.…

01/22/2020 - 11:17am

By John Tingle

History has not served the NHS (National Health Service) complaints system well

History has not served the NHS complaints system well. There have been many reports about NHS complaints going back well over two and a half decades, saying the same or similar things about the system. Many have argued and continue to argue that the NHS complaints system needs to be much more responsive, simpler in operation and less defensive. It is fair comment to argue today that the NHS complaints system is still plagued with endemic and systemic problems. The NHS has never been able to gets its health care complaints system right.

Two contemporary reports, one published in 2018 and the other in 2020, give support to the view that the NHS needs to do much more to improve how patient complaints are handled.

NHS Resolution: BIT (Behavioural Insights Team)

The Behavioural Insights Team in association with NHS Resolution found in a complaints survey conducted for the report:

  • The majority (69-75%) rated the response to their complaint as ‘poor or very poor’ in terms of: – Accuracy – Empathy – Speed of the response – Level of detail of the response” (p 25).

The report also highlighted research interview findings:

  • Overall, complainants were not satisfied by the complaints handling process.
  • Interviewees described poor communication: the complaints process was opaque, impersonal and lacked compassion for some.
  • Interviewees reported lacking confidence that their complaints resulted in any meaningful outcomes. (p27)

Healthwatch

Healthwatch is the independent national consumer champion for people who use health and social care services in England. They also provide a leadership and support role for the local Healthwatch network. Healthwatch recently identified some major problems with NHS hospital complaint handling in a report and made several key recommendations for change.

Research

For the report, Healthwatch searched the websites of 149 NHS acute hospital trusts in England and looked for substantive reporting on complaints. They also looked for reporting of data on informal complaints and concerns handled by the hospital’s Patient Advice and Liaison Service (PALS) team. A 0-3 rating was then given to each trust for the level of transparency shown in their reporting and the quality of learning that they have evidenced from the documentation shown. The report made some key findings which include the following.

-Local reporting on complaints is inconsistent and inaccessible.

-Staff are not empowered to communicate with the public on complaints.

-Reporting focuses on counting complaints, not demonstrating learning.

Healthwatch found:

  • “Only 38% of trusts make public any information on the changes they’ve made in response to complaints.”
  • “Much of this reporting is still only high-level, telling us little detail about what has changed and only stating that ‘improvements were made'” (p5).

Not all doom and gloom

The report did highlight some positive examples of hospital trusts demonstrating learning taking place. The report is however not all doom and gloom, but it is clear hospital trusts should be doing much more to build public confidence in the complaints system. If NHS hospitals don’t publish the changes that they have made in the light of complaints being made, then the public will reasonably assume that complaining and giving feedback makes no difference.

The main hospital trust approach adopted to annual reports seems very perfunctory and generally not much is given away. It seems to me as if the complaints are treated as an embarrassment and the least said on them the better. I would agree with this statement in the report’s recommendation section:

  • “Feedback from patients should be seen as an opportunity to learn and demonstrate improvement rather than an adversarial process to be managed and minimised” (p15).

The post Improving the Mindset on NHS Complaint Handling appeared first on Bill of Health.

01/22/2020 - 10:53am

A welcome back to Kirk Nahra, a partner at and co-chair of the Cybersecurity and Privacy Practice at WilmerHale in DC. A leader in the privacy bar, Mr. Nahra has been involved in developing the privacy legal field for 20 years. As a founding member and longtime board member of the International Association of Privacy Professionals, he helped establish the organization’s Privacy Bar Section. He has taught privacy issues at several law schools, including serving as an adjunct professor at the Washington College of Law at American University and at Case Western Reserve University. In addition, he currently serves as a fellow with the Cordell Institute for Policy in Medicine & Law at Washington University in St. Louis and as a fellow with the Institute for Critical Infrastructure Technology. We have a broad-ranging discussion about the last year in HIPAA enforcement, HHS-OCR’s apparent interest in access rights likely influenced by a highly publicized Ciitizen study, the HIPAA RFI, and the health privacy implications of California’s Consumer Privacy Act (or CCPA).

The Week in Health Law Podcast from Nicolas Terry is a commuting-length discussion about some of the more thorny issues in health law and policy. Subscribe at Apple Podcasts or Google Play, listen at Stitcher Radio, SpotifyTunein or Podbean.

Show notes and more are at TWIHL.com. If you have comments, an idea for a show or a topic to discuss you can find me on Twitter @nicolasterry or @WeekInHealthLaw.

The post New TWIHL with Kirk Nahra appeared first on Bill of Health.

01/22/2020 - 8:28am

Announcement: Brian Earp and Julian Savulescu’s new book ‘Love Drugs: The Chemical Future of Relationships‘, published by (Stanford University Press) is now available. Is there a pill for love? What about an “anti-love drug”, to help us get over an ex? This book argues that certain psychoactive substances, including MDMA—the active ingredient in Ecstasy—may help ordinary couples […]

01/22/2020 - 4:36am

Written by Stephen Rainey In the midst of global climate change set to devastate entire ways of life, and ultimately on track to render the biosphere uninhabitable for all but the most adaptable organisms, it seems timely to question how political legitimacy relates to matters of scientific fact. While it seems mostly desirable that groups […]

01/22/2020 - 2:00am

The Annual Bioethics Conference at Harvard Medical School is world class programming for only $50. 

1. The potential of biotechnology to drive and shape the future of clinical care and research...

01/22/2020 - 11:04pm

I learned about him when the police arrested me for the murder of his mistress. We look very much alike, and police facial recognition doesn’t work very well on Hispanics in the dark.

I don’t belong in jail, Your Honor....

01/21/2020 - 9:59am

The US isn’t the only country struggling with the high price of prescription drugs. A decade ago, Germany was facing rapidly rising medication prices. In 2011, it struck back, with a law regulating the price of new medications. Here’s how that law works, and what it has meant for whether Germans have access to new […]

The post Pharma Says Price Regulation Will Take Life-Saving Drugs Away From Us. Here’s The Truth. appeared first on Peter Ubel.

01/21/2020 - 4:27am

A recent Perspective in The NEJM by Dr. Amy Caruso Brown discussed the ethics consultation involved in treating addiction as a terminal disease. Since the article is behind a subscription firewall, I will briefly summarize the case and some of the ethical problems outlined by Dr. Brown. The focus of this blog is to ask …

Continue reading "Autonomy of Access vs. Autonomy of Decision Making in Opioid Addiction"

01/21/2020 - 4:24am

by Roger Crisp In a recent work-in-progress seminar at the Oxford Uehiro Centre, Xavier Symons, from the University of Notre Dame Australia, gave a fascinating and suggestive presentation based on some collaborative work he has been doing with Reginald Chua OP, from the Catholic Theological College, on institutional conscientious objection. Conscientious objection is usually discussed […]