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Patient centred

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  1. Most definately yes. Once an MHK picked up the phone to tell the psychiatrist how to manage a patient They also can’t pick good people below them. They go for those that speak loads of impressive jargon rather than those with any objective track record.
  2. At the moment, PAs are completely unregulated ( although this is due to change) and generally you get what you pay for.
  3. doctors here can’t get section 12 approval as per the U.K. if you stay here and lose your section 12 approval, you can not recover it because you only work on the IOM with a different mental health act. Ie ‘section 12 approval’ does NOT have the same level of training/ scrutiny etc. This has been a bit of a shock to several doctors working here. Did you know that the doctors determining CESR were being paid to do this work using vouchers form the RCPsych bookshop (I kid you not). In addition, much of the work that has to be put forward for CESR is signed off by other doctors here. You might say that there was a conflict of interest if you want to keep a workforce here in signing off?? CESR is not as rigorous as obtaining a CCST most ( not all I accept) doctors who go for CESR couldn’t pass the RCPsych exam if they were trained in the U.K.
  4. They haven’t been open to it in the past. I know of one who gave up waiting for a post and moved to U.K. to lead a whole training programme for PA’s. Massive loss.
  5. Seems like there are a number of threads on here which could all be amalgamated and have a common thread.
  6. Why don’t you just say that to the patient then? What you are experiencing is nothing to worry about. Come back and see me in two months if still a problem and here are some ways that will help manage it a bit in the meantime? in addition, I think that self care should be part of the school curriculum in PSE. Finally, the health service is a mess because of the poor leadership/ management many of whom have diagnosable personality disorders ( see my posts on mental health shambles) and inability of those at the top to ask pertinent questions , request hard evidence and not accept the platitudes and reassurances given at face value.
  7. I think you are missing the point? I’m guessing you haven’t had any friends or family go through the mental health services and that you hail from the ‘nothing to see here’; ‘ get the next boat out in the morning’ brigade.
  8. Yes but there is no supervision!!!!!!!! Unlike in the U.K.
  9. Exactly but It’s not about not being able to access training here. It’s about getting appropriately trained people in the first place or appropriately supervising and not asking them to work outside their area of competence. You can’t get higher specialist training in any medical specialty on the Isle of Man.
  10. Went kicking and screaming. Old guard take note.
  11. You are absolutely right. They can’t. But they should. Anywhere else they do. That is the role of the job, the job description, why you pay them so much money. The report should have looked at this aspect too. The one cannot be seen in isolation.
  12. There are no ‘associate consultants’ only doctors with limited if any psychiatry training. None have gone through formal psychiatry training. They need proper supervision and support by the Consultant. The ward ( where the illest patients reside) needs significant Consultant presence. None of these things are happening right now.
  13. This report; https://www.gov.im/media/1367006/final-full-report-september-2019-1.pdf illustrates perfectly the main problem with the psychiatric service on the Isle of Man. It is nurse led and pays no heed to, import or understanding of the role of senior doctors. This is at all levels from the department of health down and is sadly perpetuated by the quality of doctors in key positions within psychiatry at the moment who do not lead, innovate, educate, take responsibility, or work collaboratively across professional boundaries. The author, a nurse himself ( albeit with the title of doctor from a research project) has undertaken a piece of work investigating the practices of nursing staff on the acute psychiatry ward with a view to reducing risks and enhancing quality of care. This has been done without interviewing or seeking any input from the Consultant of the ward or Clinical Director. Perhaps the former was away in meetings or eating cake and the other was up in front of the GMC defending himself against gross patient boundary transgressions? Or perhaps they were not asked because the interviewer was a nurse and doesn’t understand that the doctor is a key professional on the ward? the Consultant being the one who takes the final decision and the final responsibility about all patients on the ward or certainly should do. The only doctor interviewed for this report is not on the GMC specialist register for psychiatry and has not even been through any formal psychiatry training scheme. All research shows that wards that do not have good medical leadership are poor. Nurses are not responsible for the overall management or risk assessment of a patient, the named Consultant is, as the head of a multi-disciplinary team. Nurses are not paid to be left wholly responsible for this risk. This is why doctors are paid the big bucks. The report misses any discussion of how the role of nursing staff interfaces with the medical role and instead focusses on multiple policies which I can tell you will not have been read by agency staff and probably live in a folder and never see the light of day. The flawed assumption is that If a policy has been written then it is obviously being followed. There is mention of a psychologist providing supervisors. And support as an add on rather than integrated into the multidisciplinary team decision making but no mention of the medical input on the ward at all. No wonder there are too many in-patients with no clear care plan and no positive risk taking. That’s what you get with a nurse led service as nursing is protocol driven and risk averse. I will also say that from the amazing ratios of patients to staff the unit should be running like clockwork. Much better than anywhere in the U.K. Overall, there is a recurrent problem with management not listening to, dismissing or even asking for senior ( trained Consultant) medical expertise across the hospital services. Similar is happening now with the air ambulance!! Yet another opportunity wasted. I would suggest a Royal College of Psychiatry visit against their audit tool for acute psychiatric wards would have been more rigorous.
  14. I would also ban MGP and southern 100. Stupid time of year to have the MGP ad the other also offers nothing but inconvenience for the sake of old farts having a jolly at the health services expense. I would put money into creating eco tourism aimed at families. Massive dry toboggan runs down the hills; huge zip lines; adult and kids wooden play parks, wallaby watching etc . Sort out reducing transport costs to get here . I would build a luxury spa with heli pad on the site of the ruined hotel at Castletown with 360 views of the sea and heavily promote it to the London set. Subsidised use for residents. generally advertise the iom as a holiday destination to the south of U.K. rather than in the local iom cinema or Liverpool I would offer subsidised ferry and flights to residents during school holidays or TT events. I would create an ethical manifesto for all ministers and civil servants to sign up to and sack them if they transgress. More transparency to government finances and results. Sack the chief minister and champion meritocracy.
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