GMC

Action Planned (AI summary) The General Medical Council (GMC) plans to launch a targeted awareness campaign in the new year, using its communication channels, to promote its existing guidance on assessing patients' fitness to drive. The GMC is also exploring opportunities for joint working with the General Optical Council. The General Optical Council will include information in its next registrant newsletter highlighting responsibilities regarding drivers' fitness to drive and explore using its annual survey to gather evidence on barriers preventing referrals. It also awaits the Government's strategy on this issue and will then work with stakeholders. The Department for Transport is considering evidence gathered during the 2023 call for evidence and findings from recent inquests, giving consideration to the process of self-declaration. The department has also developed a new Road Safety Strategy.

Action Planned (AI summary) The GMC is bringing Physician Associates (PAs) into regulation in December. They will write to the NCA to request sight of the local trust framework and seek assurances around clinical governance at the ROH. The Royal College of Physicians (RCP) is calling for a limit to the pace and scale of the roll-out of PAs and has set up an oversight group for PA-related activity. It is working with the RCP Patient Safety Committee to consider what more can be done to improve patient safety regarding PAs. The Faculty of Physician Associates (FPA) acknowledges the lack of regulation and is working towards it. They will review the DOPS (Direct Observation of Procedural Skills) form to see whether it can be enhanced. The DHSC is working with NHS England and the GMC to ensure safe practice of Physician Associates (PAs), including work around regulation, training, supervision and competency. NHS Supply Chain is considering a nationally standardised approach to uniforms.

Action Planned (AI summary) DEFRA, DFT, and DHSC will continue to work to improve public awareness of air pollution, including a pilot project with GPs providing air quality advice and information to a range of vulnerable groups. They will also make expertise available to relevant professional organisations. The Mayor of London has implemented measures such as the Ultra Low Emission Zone (ULEZ) and is expanding the monitoring network. They are also supporting health and care system support for vital structural changes. NICE amended its asthma guideline (NG80) in March 2021 to clarify the link between air pollution and asthma and added links to NICE guidelines on air pollution: outdoor air quality and health and indoor air quality at home. The RCGP is in the process of producing a planetary health element of the curriculum that all new GPs will be assessed against and are also planning a high-profile webinar incorporating elements regarding pollution. The RCP will work with specialist societies to raise the profile of air pollution's impacts, review the internal medicine curriculum, increase knowledge among physicians, produce resources for professionals to discuss air pollution with patients, improve incentives for conversations, and urge government to tighten regulations. The NMC will consider the concerns in their evaluation of pre-registration standards, focusing on communication with families, and identify further activity to ensure professionals understand their obligations to communicate clearly with patients about evidence related to managing and preventing ill-health. The BTS intends to build upon work undertaken to date by raising awareness of the effects of poor air quality, producing an updated Position Statement on air quality and lung health, and adding the health care profession voice to the debate on climate change and air pollution through membership of the UK Health Alliance on Climate Change and involvement in the Taskforce for Lung Health. The RCPCH curriculum includes a domain on health promotion, and they are working with NHS England/Improvement and Health Education England to develop asthma competencies for child health professionals and carers. They also declared a climate emergency and published a report on tackling climate change. HEE will write to the relevant medical Royal Colleges, GMC and NMC to highlight that improving awareness of the impact of air pollution on health should be considered when developing curricula. The GMC will review standards for medical education to consider how environmental issues are covered, encourage medical schools to address air pollution in curricula, and promote inclusion of environmental impacts in postgraduate training curricula. HEE will add the theme of environmental impacts to the list of potentially important areas to consider as they progress the credentialing agenda. UKHACC delivered a pilot project with Global Action Plan, funded by Defra and the Clean Air Fund, to educate paediatricians and respiratory health professionals on air pollution advice for patients. The London Borough of Lewisham has expanded monitoring capacity, taken part in the Breathe London project, and refreshed the Joint Strategic Needs Assessment for Air Quality. They also promote air quality monitoring tools via social media and local advertising, and ensure information is positioned on relevant websites and newsletters.

Action Planned (AI summary) The Department of Health has been in contact with multiple organisations including medical schools who have agreed that medical students will cease undertaking blood sampling from a central line under direct supervision, with a more detailed response indicating further actions to follow.

Action Planned (AI summary) The GMC has opened an investigation in relation to Dr. A and will require an expert report to comment on the care provided. The outcome of the investigation may result in the doctor being given advice, issued a warning, agreeing to undertakings, or referral to the Medical Practitioners Tribunal Service.

Action Planned (AI summary) The Trust has amended Appendix 1 of the Confidentiality Code of Conduct policy to enable staff to leave telephone messages for patients in urgent and emergency situations, has disseminated the learning from this case throughout Cardiology services, and will report to the next Patient Safety and Quality Committee meeting. The GMC is considering how best to use communication channels to remind doctors of their duty to take prompt action if they think that a patient's safety, dignity or comfort may be seriously compromised, will alert the Information Governance Alliance to the absence of guidance for NHS staff on the use of voicemail, and is working on extra resources to expand its ethical guidance hub.

Action Planned (AI summary) The Royal College of Radiologists will make its Fellows and members aware of the British Thoracic Society Pleural Disease Guidelines 2010. Following concerns about admitting acutely unwell patients without HDU/ITU facilities, BMI Mount Alvernia Hospital updated its admission policy to ensure all patients meet admission criteria. They also introduced mandatory training details for consultants and conduct monthly audits of consultant input into medical records.

Action Planned (AI summary) • Leeds City Council has been working to design a scheme which provides safe pedestrian assisted facilities across the Ring Road at this location and the neighbouring Coal Road junction. • Design considerations have been concluded and a final layout has been confirmed, which will be compatible with proposed future improvements planned at the Coal Road/ Ring Road junction and also longer term aspirations along this strategic corridor. • A Highways Board report is to be presented to the Chief Officer (Highways and Transportation) early in the New Year to seek formal funding approval to progress the junction improvement measures at the Ramshead Approach/ Ring Road junction.