Clin Med
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Patients referred to secondary care for specialist respiratory review frequently undergo multiple hospital attendances for investigations and consultations. This study evaluated the potential of a preclinic telephone consultation and subsequent coordination of tests and face-to-face consultations to reduce hospital visits. Total hospital attendances were recorded for three cohorts (participants, non-participants and comparators) for 6 months from first specialist contact. ⋯ In total, 20.8% of the participant group had three or more hospital attendances compared with 42.9% of the non-participant group (p = 0.001) and 44.7% of the comparator group (p = 0.002). Participants had fewer follow up visits and lower rates of non-attendance/late rearrangement of appointments. This service reduces unnecessary hospital visits, seems to improve patient compliance and may save costs associated with non-attendance and follow up consultations.
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With increasing shift work the importance of effective handover is becoming more widely recognised, resulting in the production of guidelines on written handover documentation. A particular area of poor compliance was handover from the week to weekend teams for medical inpatients, as shown through an audit cycle. ⋯ Qualitative data showed multiple benefits, but also problems with logistics in computer terminals, networks and access. Solutions to such problems are discussed, with the importance of carefully implemented longer-term changes being emphasised.
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Osteoarthritis represents a massive and rapidly increasing burden on our society and the NHS. Current treatments are limited in efficacy and have significant toxicities. A conference was organised in conjunction with the British Society of Rheumatology with the aim of updating frontline clinicians and researchers on the size and causes of this problem, with a focus on modern management.