Clin Med
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The optimal management of acute ventilatory failure lies in a multidisciplinary approach focusing on doing simple things correctly, close liaison between healthcare professionals and adequate communication with patients and carers. The use of NIV support is increasing in a variety of conditions, both inside and outside the ICU.
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There is a long history of problems in the relationship between doctors and managers. The reasons for this stem from the values of each group and the effect that these have on their views on a number of key aspects of healthcare and its delivery. ⋯ Both groups have skills and knowledge vital to the other, so each needs to recognise the strengths of the other and find ways to develop a productive partnership. Clinical work can be improved by the application of management techniques, and management would benefit from more clinical leadership.
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Whilst patients and doctors each bring a collection of rights and responsibilities with them into the consulting room, these parties must not be seen in isolation. The government of the day and its representatives have an absolute right to influence the future direction of the health service but they also have very grave responsibilities.
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The aim of revalidation is to reassure the public that doctors are up to date and fit to practise. The Royal College of Physicians has developed various programmes of work, both ongoing and under development, in support of revalidation. ⋯ These methods include ways of assessing both professional standards and clinical competence. Although the conclusions of the Chief Medical Officer in terms of the absolute requirements for revalidation are still unknown, the College is committed to supporting its Members and Fellows to prepare for revalidation through setting educational, professional and clinical standards in medicine.