Just a few points in support of Gautam:
NICE is a stautory body, whose guidelines "are likely to constitute a
reasonable body of opinion for the purposes of litigation" according to the
first Chairman of NICE. He added that "doctors are advised to record their
reasons for deviating from guidelines".
The Trust has a statutory duty of quality, which is monitored by CHI and
overseen locally by the person responsible for Clinical Governance - usually
a non-Exec Director.
The implementation of the NICE Head Injury Guidelines locally is a challenge
for the Trust as a whole and as frontline staff whom this would affect we
should be involved in discussions at Board level about its implementation.
We should enter these discussions with a well thought out analysis of what
our departments needs are to implement the guidelines. Once the Trust has
signed up to the guidelines multi-diciplinary audit, and monitoring of
complaints and adverse incidents would be a way of ensuring that standards
are maintained.
I think that it is worth going back to the root - Quality and Clinical
Governance - to see that we are not on our own in this.
Tony Adams
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Goat
Sent: 05 July 2003 09:58
To: [log in to unmask]
Subject: Re: NICE Head Injury Guidance
John and others have both pointed out that the radiologists must be on-board
to implement the
new guidance. NICE, despite the negative comments on this list, should be a
useful ally in
levering recalcitrant radiologists into participating in best practice
rather than resource
rationing.
Regarding Bolitho v Bolam, I'm not sure that much has changed. Bolitho
(paraphrasing) qualifies
Bolam by establishing that the "reasonable body of opinion" much loved of
medical defence
lawyers, must satisfy the Court that be supported by evidence, as judged by
the court. This
puts an end to a defence based on a few maverick medics being hauled onto
the witness stand to
defend dubious practice. Looked at another way, Bolitho suppresses atypical
individuals that
can be tommorrows medical innovators.
Anyone interested in more info could look at:
http://www.nature.com/cgi-taf/DynaPage.taf?file=/bdj/journal/v188/n5/full/48
00441a.html
from which I quote: "The House of Lords did not abandon Bolam, but merely
qualified its use"
Would be interesting to hear from any of the medico-lawyers lurking on the
list.
Gautam
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