Category Archives: medical

history, links, medical, science

Your Interesting Links

Wow! What’s everyone been up to, cos there’s an enormous amount in this month’s issue!
Science & Natural World
We all know that a vast many parrots and parakeets are bright green. But how did they get this way when so few other creatures are so colourful? [Long read]


Talking of green … there’s a lot more to trees than meets the eye: they have a whole underground communications network. [Long read]
And still with green things … the whole world was changed by a glass terrarium that made it possible to successfully transport plants across the globe.
Which brings us to the seas, where a Portuguese trawler has netted a rare, and rather fearsome, “prehistoric shark”

Health & Medicine
Many major medical advances have their origins in the military, and especially on the battlefield. Here are six which made the move from battlefield to mainstream medicine.
It had to happen, indeed I’m surprised it hasn’t happened sooner: hospitals in Leicester are pioneering free post mortems using CT scanners.
Why isn’t the flu vaccine as effective as it should be? Because simple biology introduces errors during the manufacturing process.
Our body clocks are incredibly important; and the more researchers look the more important the clocks become. They even switch genes and biological processes on and off at various times of day and this can have important implications for medicine.
Our body clocks are related to sleep. And sleep is still a mystery to be untangled.
Do you suffer from exploding head syndrome? If so there’s a group of researchers who want to hear from you.
And finally for this section, unusual and long lost diseases are crawling out of the permafrost as the climate warms up. [Long read]
Social Sciences, Business, Law
Now here’s a novel way to fix the NHS’s funding problems: legalise cannabis! Like everything else, if you legalise it you can regulate and tax it!
Language
I know I swear quite a lot and now I know why: bad language is good for you.
We all know that turkeys don’t come from Turkey, so how is it that they acquired the name?
Art & Literature
John Donne (right), the early Stuart poet, left us a scurrilous manuscript, of which an original has now been discovered hidden in the archives of Westminster Abbey.
History, Archaeology & Anthropology
We’re a load of drunkards, and have been for a long time. Archaeologists analysing residues on pottery, found near Tbilisi in Georgia, have just pushed back the first known winemaking by around 1000 years to 6000BC.
Meanwhile in Egypt archaeologists have been using cosmic rays to image the guts of the Great Pyramid, and have found a hitherto unknown chamber. Two reports, the first from Scientific American and the second from the Guardian.
Exploring the topography of prehistoric Britain through early drawings.

England’s oldest statute law still in force isn’t Magna Carta (that wasn’t passed into statue law until 1297) but the Statute of Marlborough enacted by Henry III in 1267. Much of it has been repealed over the centuries but there are still extant sections on the recovery of debt and the laying waste of farmland.
A silver ring found in Buckinghamshire has been identified as belonging to the royal falconer, Robert Dormer, who died during the Civil War.
London
A Roman temple beneath the City of London has been restored and opened to give an idea of the apparently blood-curdling rites of the cult of Mithras. [Long read]
So why did the Victorians build a series of small green huts across London?
London has 270 extant Underground stations, and quite a number of disused ones. There are also a number of fictional Underground stations and IanVisits provides us with a list of those which have appeared in film or on TV
Lifestyle & Personal Development
Owen Jones in the Guardian makes a compelling case for why we should all be working a four-day week.
Why has UK life-expectancy plateaued in recent years? Danny Dorling investigates.
Finland is trialling the provision of a basic income for everyone, rather than benefits for some. And it appears to be working.
Here are seven things you should never say or do to disabled people.
Food & Drink
Delia Smith doesn’t like modern cookery, describing it as “poncey” and “chefy”. For once I agree with her.
We’re all supposed to eat two portions of oily fish a week. But many of us don’t. Time to rediscover mackerel, anchovies and the humble Cornish sardine.

Where should you keep your tomatoes? In the fridge or on the windowsill? The Chronicle Flask takes a look at some of the chemistry to come up with an answer.
And on that foodie note, I’ll wish everyone a very merry Christmas and I’ll hope to see you again soon afterwards.

history, links, medical, natural history, science, sexuality

Your Interesting Links

This month’s large collection of articles encountered which you maybe didn’t want to have missed.
Science & Natural World
First off we must pay our respects to this year’s IgNobel award winners amongst whose investigations were solid and liquid cats, didgeridoos and cheese disgust.
Budburst on many trees is temperature dependent and March temperatures seem to be the key for many. And they’re getting slowly warmer, so budburst is getting earlier.
[Disclosure: I’ve been submitting records to UK phenology research for many years; many more years that the 17 covered by this research. It takes little time and is valuable “citizen science”.]


Another curiosity of British wildlife is that some birds (notably Great Tits, above) are evolving longer beaks as this gives them an advantage at garden bird feeders. Here are two complementary reports, one from the Guardian, the other from the BBC.
Now to chemistry … A look at how poisoners could use clothing as a murder weapon.
The aliens are coming! Well maybe not quite, but there is a mysterious object speeding past the sun which could be visitor from another star system.
Health & Medicine
For those who want a little more of a challenge than normal (it contains some relatively simple maths), here’s a very good article on why vaccination is important in preventing epidemics.
Sepsis is a hidden killer, and one which most people know nothing about because it has so successfully continued flying under our radar.
There’s a small study which suggests that the psychoactive drugs in magic mushrooms “reset” the brains of depressed people. [Do NOT try this at home! The study used very controlled doses in a medical environment.]
And now to some curiosities … First off, and not for the squeamish, an historical report of a man with two penises and two bladders.
Synaesthesia is mind-boggling. The first of our two mentions this month is of a woman who lost her sight due to illness and in regaining it had some terrifying sounding synaesthetic effects.
And to boggle the mind even further, this young lady has a range of different types of synaesthesia (compared with the normal one). I just cannot imagine what this is like!
Sexuality
Two different aspects of a relationship without sex. First there are people who are genuinely asexual: they may have romantic partnerships but have no interest or desire to have sex.
At almost the other extreme there are couples who, while still happy together, just stop having sex.
Social Sciences, Business, Law
Forensic science is coming under increasing scrutiny. Not only has fingerprinting never been scientifically evaluated for its reliability, but DNA is accused of frequent flawed techniques, which can have devastating effects.
Language
Philip Pullman is under fire because his children’s book La Belle Sauvage is littered with swearwords. Emma Byrne in the Guardian suggests this is actually a good thing: most children already know the words and isn’t it better that they learn in a controlled way when they are and are not acceptable?
History, Archaeology & Anthropology
Uncovering the menus for Neolithic man’s feasts: pork and cheese.
The Incas were far better astronomers than previously thought.
The shipwreck which produced the Antikythera mechanism is still turning up interesting artefacts like the bronze arm which suggests there may be a haul of statues waiting to be found – and what may be another piece of the Antikythera mechanism itself.
Why do a number of Scandinavian Viking graves contain burial clothing embroidered with the work “Allah”
But worse is yet to come, for the Vikings may have brought leprosy to this country via their trade in red squirrels.
Coming much more up to date, both sides are now telling the story of the capture and boarding of the German U-boat U-559, which changed WWII by giving the Allies the Germans’ Enigma codes.
So how about a list of the ten best railway stations in Britain, at least according to Simon Jenkins in the Guardian.
London
IanVisits is writing an occasional series on “Unbuilt London”. In an old post he looks at the 1960s plan to replace buses with monorail network. I have a vague memory of this hare-brained scheme.
And here is a really fascinating and detailed map of the London Underground, Overground, DLR, Tramlink & National Rail (small section below). But why does this have to be published by a French company?

Lifestyle & Personal Development
Our favourite Soto Zen master, Brad Warner, reflects on “The Center of All That” the implications of being you, here.
We’re losing our skills. The skills to do everyday chores our parents took for granted, like washing up by hand, changing a mains fuse or sewing on a button.
A brief look at some of what happens behind the doors of a London crematorium.
I wasn’t sure whether to put this next item here or under medicine. According to sleep scientists we are chronically underslept and sleepwalking our way through life. That is a real threat to our health, and it isn’t fixed by a couple of good lie-ins. So what to do about it?
Apparently our culture says that emotional friendships are a female thing and that boys cannot have emotional friendships with their own sex and are discouraged from doing so by the time they hit puberty. And this is forcing a large number of men into loneliness despite the outward appearances. [OK, it’s American, but is UK culture so different?]
People

Back in August Geoff Marshall (no relation)and Vicki Pipe completed their challenge to visit all 2,563 National Rail stations in Great Britain. Here they talk about the experience for the National Railway Museum’s blog.
That’s all folks! Another instalment next month.

medical, personal

Final Knees Up

Hopefully this will be a final update on my left knee replacement …
On Wednesday of this week – exactly 6 weeks since surgery – I saw the surgeon of a check-up. It was, as I had hoped, a non-event. He is delighted with my recovery, healing (see photo), and the flex on the knee, and has cleared me for all normal activity. He doesn’t want to see me again unless I have problems and has discharged back into the care of my GP.
As I reported earlier my physio appointment 10 days ago was equally positive. I have another physio appointment next week as we agreed it would be sensible that we meet once we had the surgeon’s update. All being well I suspect will be the last appointment.
Both knees are fine except that they are very stiff and achy – but that’s just the muscles having to rebuild and get accustomed to normal activity again. So now I just need to get the knees walking more and build up the muscles.
I know I’ve had this work done privately (we’re lucky to be able to afford health insurance) but I have to say the care I’ve received has, overall, been absolutely outstanding. The whole hospital is cheerful, friendly and helpful from the consultants right down to the porters and cleaners – everyone has time and a friendly word.
It all looks very much like “job done” and very well done too!

medical, personal

More Knees Up

2 Comments

[Medical trigger warning]
As today is four weeks since surgery, I thought we should have a progress report on the rehab of my left knee.
Things are now definitely getting better physically; but I’m still feeling very low mentally. Most of the bruising has gone as has almost all the swelling – ice-packs several times a day have helped (the hospital provided a specially designed cuff cooler when I had the right knee done). For some days now I’ve been walking around the house without the aid of crutches or sticks – the exception being the stairs where I still don’t feel entirely safe. I’m still taking crutches if I go out, if only for safety.
When I saw my physiotherapist this time last week I had 110° of flex on the knee, and I know it will be even more by the time of my appointment next Monday. Needless to say the physio was very happy; the flex and function of the knee are good although still painful; he even had me on an exercise bike doing gentle to and fro motion (a full cycle is not yet possible, although I did try). I was given an extra set of exercises to do, which are all about strengthening the muscles as well as improving the range of movement; and the exercises are gradually getting easier and less painful. I’m still being subjected to the torture of the green anti-DVT stockings though.
As you can see from yesterday’s photo, the scar itself is healing well and looks as if it might eventually be even less obvious than the one on my right knee. (Incidentally I don’t know if the visible flaking is dead skin, surplus glue from closing the wound or some form of plastic skin which was applied to cover the wound. But the right knee was the same and it seems to be OK.)
The pain is very definitely subsiding. Yesterday was the first day since surgery that I’ve awoken at 6 or 7 AM and not immediately thought “Bloody hell I must have some painkillers”. In fact yesterday I didn’t need to take any painkillers from midnight to lunchtime – although by then the knee was very achy. So with luck I in the next week I can start thinking about tailing off the codeine, if not the paracetamol as well.
Meanwhile I managed to screw up my lower back last week; and yes, on the left side! This entailed two trips to the osteopath. The first on the Monday helped immediately but then the muscles were going into spasm every time I tried to move. This settled down overnight with a couple of small doses of Valium as a muscle relaxant. But by Friday the lower back was giving trouble again, so Saturday saw me back at the osteopath seeing a different guy who comes to osteopathy via a sports training background. I have to say he was brilliant – not just at releasing the back but also at explaining how this was all down to the muscles and joints readjusting to different ways of moving following the operation. His prescription was to walk (do what you can and build up slowly) to get the muscles etc. used to working properly again. I came away walking well and feeling much more at peace mentally. So far I’ve concentrated on walking around the house, but our long back garden is beckoning.
I’m still feeling anxious, depressed and panicky at times but that mostly isn’t the knee but everything else I have piled up getting me down. But with the pain receding, and a more positive outlook for the knee, I am at last managing to catch up on some of the stuff I’ve ignored over the last few weeks.
So the bottom line is: keep going; keep doing what you’re doing; it does get better (even if it doesn’t always feel that way hour-to-hour or day-to-day). Onwards and upwards.

medical, personal, ramblings

Ten Things

Having just had my second knee transplant (sorry, total prosthetic knee replacement) I thought that for this month’s Ten Things I should maybe write a few of the important things I’ve learnt about knee replacement operations.
Ten Things I’ve Learnt about Knee Replacement
I’m taking as read all the usual stuff about operations, general anaesthetics, etc. (like anti-DVT stockings, morphine causing constipation). This is knee replacement specific things. First of all it is important to realise that no two knee operations are the same, so what follows is based on my experiences; yours may be different.

  1. There are three key people in a good outcome: a good surgeon, a good physiotherapist and you! Yes, you! A good surgeon and good physio are critical, but it is equally critical that you put in the work at rehab!
  2. If you can find out who your surgeon will be, check him (or her) out. If you have a choice, ensure you get someone who specialises in knee replacements rather than a generalist. What’s their track record? How many have they done? The more experienced they are the better.
  3. Anything you can do before your operation to strengthen your legs muscles, specifically the quads at the front of the thigh, is going to be helpful in rehab.
  4. Before you go into hospital ensure everything is ready at home, especially think about trip hazards: gangways are clear, rugs are stuck down or removed.
  5. Get a urinal (maybe two) with a lid – something to pee into in the middle of the night. (They’re cheap and many come with a “female funnel attachment”.) Even with a light on, you do not want to be staggering to the bathroom, on crutches, maybe in pain, barely half-awake, in the wee small hours and while trying to avoid the lurking cats and dogs.
  6. Unless you have a “slave” (aka. a partner) to fetch and carry for you, get a good bag (shopping bag size) which you can put over your shoulder or round your neck to carry things around when you’re using crutches.


    7. A typical before and after x-ray; note the realignment of the femur and tibia

  7. Post-op your enemy is infection. Ensure no-one (and I mean no-one) touches your operated leg without having visibly washed their hands and are preferably wearing disposable gloves.
  8. Do as much as possible to ensure you get a good physiotherapist. Poor, or no, physio is the fastest way to ensure you don’t recover your mobility. Rehab physio will start in hospital; they’ll likely have you standing with a frame and walking a few gentle paces just 12 or so hours after your operation. You will be given exercises to do. Do them – as much as you can through the pain (but stop when it gets too painful). And keep doing them. Make sure you get as much post-op out-patient physio as you can and that your first session is within 7-10 days of leaving hospital; these sessions will help monitor your progress and adjust the exercises to your needs. The physios are not there to be sadistic (though sometimes it feels like it!) but to get you doing the right exercises, the right way, and at the right time, to ensure the best possible outcome.
  9. Recovery is painful! Think about what has been done – someone has done around 90 minutes serious carpentry to remove the degraded bone and replace it, very accurately, with some highly engineered metalwork; and that’s all on one of the most complex joints in the body. Discuss pain control with your clinicians; they will prescribe the right analgesics. Although the pain will recede over time, do not expect to be pain-free for several weeks. But a good outcome is well worth the pain.
  10. You should be provided with elbow crutches and taught to use them in the day or so after your operation. You will need them for several weeks. Go carefully and don’t get over-confident as this will lead to accidents. On the other hand you should be encouraged to dispense with the crutches as soon as you safely can.

There is a lot more I can say, and I do intend to try to write all this up for the benefit of others. But that will do for now!

medical, personal

Knees Up Again

1 Comment

[If you don’t like things medical, skip this.]
So it’s now a week and the day since I was let out of hospital after a complete left knee replacement to match the right one that was done at the beginning of the year. On the left, here’s the knee before (notice the impressively neat scar on my right knee that was prepared earlier) and on the right dressed post-op:


I suppose the knee is getting better although it doesn’t feel like that much of the time. Initially when I was in hospital it was a lot less painful than the right one had been but since I’ve been home the pain has been more like the same and at times obviously quite bad – which is very frustrating, depressing and demoralizing; but I guess that all part of healing process.
Admittedly all this is being done privately – we’re very lucky in that we can afford medical insurance – and generally I cannot fault hospital. [For anyone contemplating having knee surgery privately, don’t expect any change out of £15,000 per knee.] I had the same surgeon, the same anaesthetist, most (if not all) the same theatre team, and even the same physio on the ward – and I’m even booked in with the same guy as before for outpatient physio – that’s just one of the benefits of going private!
I had a spinal anaesthetic (so I was conscious; recovery is much nicer than a general anaesthetic) and was in theatre on the Wednesday afternoon (13 September) for about two hours. This was followed by an hour in recovery and overnight in the HDU because of my sleep apnoea. Then back in my room for lunch on Thursday.
I still don’t understand how the medics do this! They can rip you open; do 90 minutes serious carpentry; glue you back together; and have you on your feet 12 hours later. In fact the physio had me out of bed and walking few steps with a frame at 10 o’clock the following morning. Rinse and repeat twice a day. On the Friday morning the physio took the Zimmer frame away and left me with crutches; they also made me do a very small, test, staircase in their gym – this was fine although I had struggled with it back in December.
On Saturday morning my surgeon ran in about 8:20, wearing jeans and a rugby shirt, had a quick look, said yes OK you can go home, I’m now off to Portugal for a week (playing golf, needless to say!). Later that morning a physio arrived and took me to do a complete flight of stairs (down and up) and walk a corridor, which was all OK. All the boxes ticked I was allowed my freedom at lunchtime.
What annoyed me was that everyone arranged follow-up appointments according to some notional idea of what they should be and not what the surgeon had told me to do, and as I had requested. They then left me to chase around on the Monday to rearrange everything. That I was not impressed with.
By the time left hospital I had about 80° of flex on the knee; I probably now have about 90° – which is more quite a few people manage after a year; so I guess I should not be too downhearted.
However since I’ve been home everything seems to have been more painful. My GP had a quick look at the knee on Thursday as she was slightly concerned I might have wound infection. However the nurses at hospital changed the dressing on Friday and were very happy everything was OK and no infection. In fact the wound was actually very good and healing well as you can see from the photograph below.

Yesterday, Saturday, I was worried because I seemed to be able to do nothing except sleep all day; totally unable to stay awake. I just could not get the knee comfortable: sitting at my desk was unbearable, lying down slightly better. It’s still not great, but a bit better today.
What more is there to say? Obviously I’m still on crutches and painkillers and will be for a while – although my surgeon says to get rid of the crutches as soon as possible. Obviously I’m also having to do exercises and I know once I see the physio in out-patients in a couple of days time they will get more and harder.
Noreen is being heroic in putting up with me – anxiety, misery, depression and all – and everyone has been sending me good wishes (thank you, one and all!). To top it all, to cheer me up, my lovely friend Katy has sent me a tasting box of various gins (below) which I shall enjoy exploring once I’m no longer on wall-to-wall codeine.

history, links, medical, science

Monthly Interesting Links

There seems to be quite a lot in thus month’s round-up of links to items of interest which you may have missed the first time round. So let’s get straight in …
Science & Medicine
A lump of rock the size of a house is apparently going to whiz past Earth on 12 October at a distance of 44,000 km – that’s like an eighth of the way to the moon. And yes, astronomers are confident in the predicted distance so DON’T PANIC, but do take a towel!


And now to the more mundane … New Scientist has a rather spectacular feature on the variety of jellyfish in the oceans. You never knew they were so beautiful!
Octopus and squid have the unhelpful habit of producing ink to cover their escape. But why? And what is the ink?
Don’t breathalyse a goldfish. At least not in the winter. For you see they avoid being frozen to death by turning turning the lactic acid in their body into alcohol.
Now you don’t expect a new species to be discovered in the UK, and certainly not right under our noses. But it seems that our (not so common) grass snake is actualy two different species.
Most of us don’t like ants in our kitchens, however the humble ant is a rather amazing creature, as researchers are beginning to understand. And there are lots of them too!
Wasps! Yes they’re intensely irritating at this time of year. But that’s only the handful of social wasps we have; there are many thousands more species of solitary wasps. Without them we would be knee deep in creepy-crawlies as they are excellent predators of other insects (as well as your BBQ burger). They are also important pollinators. But surprisingly little is known about the UK’s wasps, which a citizen science project is now trying to delve into.
Incidentally ants, wasps and bees are all quite closely related and are all members of the order Hymenoptera.
Now to our pets! Very few animals can be said to know themselves, at least according to the standard test using a mirror. And on that scale dogs are not included. However it seems that they probably do know who they are using smell.
We all know that in emergency we can give CPR to our fellow humans. But did you know it works on cats and dogs too? Here and here are a couple of items on the subject.
And finally in this section … Medics are now coming to realise that some common surgical procedures are no better than a placebo, just as some drugs aren’t.
Social Sciences, Business, Law
Constant worry, anxiety and panic about the future now seems to be a part of everyday life. But it is counter-productive and leads to burn-out rather than action.
Art & Literature
Here’s one for your diary … Next Spring the National Portrait Gallery will be showing Lewis Carroll’s photographs of the real Alice among an exhibition of early Victorian portraits.
History, Archaeology & Anthropology

I wasn’t sure whether to put this under “science” or “history” … It appears that trigonometry wasn’t discovered by the Greeks, but around a millennium earlier by the Babylonians. As one might expect it was all recorded in cuneiform on clay tablets. And they used a totally different system from that used today. However, Evelyn Lamb in Scientific American has pointed out that in fact little of this is actually new knowledge.
You wouldn’t really expect biologists to be doing research on ancient manuscripts, but they are … and they’re discovering all sorts of odd things about the parchment, the book covers and even the monks who did the calligraphy.
While on the medieval, and in other research, historians are coming to realsie that many of the supposedly iconic medieval images of the plague are nothing of the sort.
London
Did you know that for just £10 you can visit the Royal Mews and see all the Queen’s horses and carriages?
Lifestyle & Personal Development
Author Kasey Edwards discovers that so many people would like not to be married and just stay together for all sorts of reasons – but she isn’t one of them.
Berlin is designing new unisex urinals for its unisex public toilets.
Food & Drink
And finally … another that could have gone under “science” … geneticists have been hard at work on the apple and have traced its roots back along the Silk Road to Kazakhstan and China. The Romans may have brought the desert apple to England, but it had a long journey before that.

As usual more next month!

history, links, medical, science

Your Monthly Links

So here’s our round-up of links to items which have caught our attention in the last month. There’s a lot in this month, so here goes …
Science & Medicine
Suspicious that expiry dates on products are a nonsense? Well that might be justified for some drugs.
The expected continual rise in life expectancy is slowing down. A leading medic suggests austerity is to blame.
It seems like what you always suspected may be true: a broken heart may damage your health.
We all know that cats purr. But do they purr only for our benefit?
An American veterinary service is working on making vet visits stress and fear free for nervous pets.
You thought plague was a thing of the past? Wrong. It is still alive and well in the American Southwest. Here’s the story of how one biologist tracks and identifies plague outbreaks before there’s harm to humans. [Long read]
Flying ants all seem to emerge on the same day. But do they?
Sexuality
Good news, lads! Science says you should masturbate 21 times a month – not that you needed an excuse! (Well actually they mean you should ejaculate that often; not necessarily the same thing.)
Environment
Jason Hickel in the Guardian posits that even if we all adhere to the Paris climate deal that isn’t going to be enough to save us – our future depends on de-growth
There’s a plan to reintroduce Eurasian lynx to the Kielder Forest.
Art & Literature
Worried about your books? Why not protect your library the medieval way with horrifying book curses?
History, Archaeology & Anthropology
Archaeologists are suggesting that a find of buried tools and pigments means humans reached Australia 65,000 years ago – that’s 18,000 years earlier than previously thought.
Yes, we knew the Romans had concrete. And now we know why it was so good that it still stands today when our modern concrete decays.
Infertility isn’t just a modern phenomenon. The mediaevals recognised it and realised that it could be the man at fault rather then the women – not really surprising as many in medieval times believed the embryo originated solely from the man. Oh and in true medieval style they concocted some horrid cures.


The Russian Hermitage Museum employs 74 cats just to keep its basements mice-free.
London
IanVisits investigates a south London experiment in tube tunnelling.
Lifestyle & Personal Development
What brings you happiness? Money? Stuff? Time? Surprisingly research is suggesting that you can gain the most happiness from freeing up time, even if that is paying someone to do things for you so you have the time to devote elsewhere.
So how often should you wash your bed sheets? A microbiologist looks at the problem.
On a similar note, here are a few suggestions for getting rid of pests and bugs the Buddhist way. While I can see some of this would work, a lot does seem rather unlikely.
To me this seems like a non-question: should teachers be allowed to have tattoos? Well why shouldn’t they; isn’t it all part of the life we’re supposedly educating our kids to navigate?
From which it is but a short step to asking whether witches are the ultimate feminists.
Shock, Horror, Humour
Two amusements to conclude this month …
An American researcher has used a neural network to generate a whole host of quaint, and sometimes rude, British place names.
And finally this summer’s latest fashion trend: Glitter Boobs …

medical

NHS Data Sharing – II

What follows in this post is a very short summary of two of the NHS data sharing initiatives (care.data and Summary Care Records) which I wrote back in 2014 when they were new and care.data was still very much alive. I record this here in order to provide more background and clarity to my post of yesterday on NHS Data Sharing. This is unedited and provided in its entirety; note the date at the bottom!

Summary Care Records and Care.data
A Very Brief Introduction

By Keith Marshall, Chairman, Barnabas Medical Centre PPG, Northolt

The NHS currently has two initiatives to share patient medical data electronically: Summary Care Records and care.data. The two initiatives are very different. Let’s look at them.
Care.data is the initiative which was in the news a lot early in 2014, and is what was referred to in the leaflet which should have been put through your door in January 2014. It is about sharing aggregated data with a variety of organisations (public and commercial) to enable better healthcare planning and research. The programme will take GP and hospital records, remove or obscure anything which can identify you, and then merge all the records into a single national database. Any record which can identify you, as a patient, is not permitted to be shared outside the NHS. This is not new: hospital records have been used in this way for many years and the system is now being extended to include GP records. The intention is that over time this improves everyone’s healthcare by looking at where, and why, better outcomes are being achieved. The start of this has been delayed to at least Autumn 2014 in recognition that it has not been well communicated.
Summary Care Records [SCR] are different; they are about sharing data within the NHS for the provision of your immediate medical care. They will make your essential data (your drugs, allergies, drug reactions) available electronically to other parts of the NHS, but only when they need to treat you. So A&E and out of hours services can see your record if you need emergency treatment. This will mean you, as an individual, get better and safer care especially if you end up, unconscious, in A&E. Only healthcare staff with a special authorisation card and a PIN number will be able to access your data – just like you using your credit card – and if you are conscious and capable they must ask your permission at the time of access.
A very senior A&E consultant of my acquaintance, who works at a major South Coast hospital, recently commented to me:

Please think very carefully before opting out. I have just received my SCR access card, and it has been a revelation. Most elderly people are on lots of medicines and can remember about 10% of them. They turn up at my Emergency Department confused and unable to remember much. I can now get their medication list and their past history exactly and it means that they get much better treatment, especially with medications like Parkinson’s disease ones that are time-critical. I’m not saying that you are elderly and confused, but I am saying that you may be one day, and you won’t have opted back in. Is SCR secure? It seems no worse than the security to access my bank account.
Quite reasonably many people have concerns about the privacy of both Summary Care Records and care.data records. While we can never absolutely guarantee that security cannot be breached or abused, there is no reason to believe your data will be less secure in future than it is now.

Of course, you may opt out of one or other or both of these systems. Opting out of one does NOT opt you out of both. It is your right to opt out if you wish to do so – you just need to tell your GP. But please think very carefully before you do opt out.
Version 2 filed: 2 November 2014