Future healthcare journal最新文献

The 2024 Teale Essay Prize invited resident or specialty and associate specialist doctors to consider how climate change affects healthcare, and the role of the physician. This theme aligns with the Royal College of Physicians' commitment to sustainable healthcare. The link between climate and health is not new - Hippocrates described this relationship nearly 2,500 years ago. More recently, catastrophic events, including crop failures due to extreme weather and the spread of diseases, have been attributed to climate change. These events can impact health directly, eg through trauma and infections, and indirectly, through rising rates of cardiovascular, respiratory, and mental health illnesses and other long-term conditions. Here, I reflect on my winning essay, from the perspective of a trainee rheumatologist with an academic interest in social determinants of health. This article examines the global health challenges resulting from climate change, and considers how physicians can practice more sustainably.

This is a discussion on implementation of facemask sampling for the detection of infectious individuals with SARS-CoV-2 in high-stakes clinical examinations. Important concerns on diagnostic accuracy and reliability are raised.

'Failure to rescue' in patients with documented signs of deterioration results in an estimated five potentially avoidable deaths at each acute trust in England each month. One common cause is inattention to concerns of patients or their families about acute deterioration. Martha's Rule requires reliable methods for (1) patients or their families to escalate worries and concerns about deterioration and (2) to routinely input their understanding of their illness/wellness and trajectory into the health record. This paper sets out the rationale for these approaches. Following review with staff from the first wave of British units that have introduced Martha's Rule or similar systems, the authors suggest tested and evidence-based methods for implementation and describe gaps in current understanding of such systems. Importantly, the paper outlines answers to frequently voiced concerns about these sorts of methods and a set of suitable metrics for organisations to measure the impact of implementation on processes and outcomes in acute care.

Introduction: The growing utilisation of international medical graduate (IMG) doctors in the UK has uncovered a need for hospitals to establish induction programmes that harness supportive environments for these doctors to learn within the specific context of the NHS. Currently, IMGs are under-supported at local and national levels.

Method: The educational team within Withybush Hospital have designed and delivered a robust IMG induction programme. The aim was to improve IMG doctors' clinical confidence within this specific setting. Feedback generated from the induction was provided to educational supervisors (ES) on their tutees. This induction was evaluated by questionnaires for IMGs following the induction activities, and annually for educational supervisors to assess their views.

Outcome: Feedback was overwhelmingly positive with reported increased confidence post sessions. 100% of educational supervisors found the feedback provided to them very useful, allowing them to identify areas that the doctor needed support in, and aiding in the collaborative creation of development plans.

Conclusion: NHS hospital-specific induction programmes for IMG doctors help to improve their clinical confidence and support their integration into their new role and environment. Additionally, educational supervisors value early, highly specific feedback generated from induction activities on the doctors they are supervising.

In this article, we describe how the landscape of hospital pharmacy has changed over the last 20 years. As well as commenting on the impact of COVID-19 on services, we describe five major advancements namely: clinical pharmacy services, the development of multi-professional teams, policy changes, attitudes to using and producing evidence, advances in technology and workforce development. Finally, there is brief comment around the future challenges for hospital pharmacy in the UK.

This opinion piece explores the opportunities and challenges from increased utilisation of pharmacists and pharmacy technicians in delivery of the UK immunisation programme, within the recent legislative change enabling pharmacy technicians to administer Prescription Only Medicines (POMs) under Patient Group Directions (PGDs).

Pharmacist independent prescriber numbers continue to increase. In 2025/2026, independent prescribing will be integrated into the foundation year of pharmacy training, which will see a surge of pharmacists with the independent prescribing annotation on the General Pharmaceutical Council register. With increased responsibility and expectation from early careers pharmacists, the risk of burnout may be higher, and we could potentially see an increase in the number of individuals leaving the profession. In contrast, for those who remain in the pharmacy profession, there needs to be a fair evaluation of career progression, to ensure that they understand their skills are valued, and give them a reason to stay in the profession that they devoted years of their life to. As pharmacists are being upskilled, the lines between a pharmacist and physician may start to blur, but it should be noted that both professions have distinct roles in the treatment of a patient, and they are key members of the multidisciplinary team.

Pharmacotherapy is the most common therapeutic intervention in healthcare, but more than 200 million medication errors occur every year in England alone. This may in part reflect greater awareness and better reporting; however, the incidence of patient harm from medication has remained broadly unchanged for decades, despite concerted national campaigns and global safety initiatives. Rapid technological and therapeutic advances together with the complexity of modern healthcare make reducing harm from medicines more challenging than ever. This opinion piece will provide a perspective on some of those challenges, as well as highlighting areas of best practice and emerging work. While system and process improvements are required, individual clinicians need to remain vigilant and reflect on medications at each patient interaction.