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Will!

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    Where the debris meets the sea.

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  1. With regard to driving, there are certain medical conditions which the DVLA requires drivers to report to them. The GMC says that doctors should inform patients of the patients need to report these to the DVLA. However, if the doctor has reason to believe that the patient has not or will not report to the DVLA (how the doctor might have reason to believe this is not suggested) then the doctor should tell the patient that they (the doctor) is going to report to the DVLA, report to the DVLA and inform the patient that they have reported to the DVLA.
  2. With difficulty. The doctor - patient relationship relies on trust. If a patient believes that their doctor will report them to the DVLA if they seek medical attention for a certain condition then they may not seek medical attention for that condition, which may paradoxically increase the risk of harm.
  3. Much to unpack there. Regarding a patient’s medical records being disclosed to someone other than the patient. One of two things are required: 1. Patient consent. In the example of the pilot, they’ll need to know to what they’re consenting so they’ll need to see a copy of their records first. 2. Overriding public interest. This is a high bar to cross. In criminal investigations it needs a court order from a judge. Coroners (who are also judicial officers) can request medical records. What the GP think’s should be disclosed doesn’t really matter. The GMC says doctors should assist in the prevention and detection of serious crime, but doesn’t provide a particular definition of “serious”. I can’t speak for other doctors but I’ve never provided medical records without an order from a judicial officer, although I’m always dealing with people after something has gone wrong.
  4. https://yourlogicalfallacyis.com/black-or-white The pilot's not obliged to show his medical records to BA. Conversely BA is not obliged to let him fly. It's quid pro quo. The Mail story implies, but does not explicitly state, that the pilot was given his medical records to pass onto BA and he doctored them. Regardless of what his medical history is, that's a probity issue.
  5. I don't have anywhere near your level of technical knowledge so I appreciate your answer. I think TPP and EMIS were indeed quick and dirty fixes for an immediate problem with no thought to scaling up and interoperability. The HL7 standard and using XML are a good example of going for the lowest common denominator. In fairness to NHS Digital and its predecessors, if they'd tried to improve on HL7 they'd probably have prevented any overseas electronic health record company from offering a product in the UK. In the event no such company made an offering anyway, but I suppose the NHS wasn't to know that. Read codes are indeed dreadful, but at least they're being deprecated now. That's true. NHS Trusts regard recruiting people from the private sector with immense suspicion at best. I once worked with one ex-private sector service manager who'd snuck in. He was excellent and showed up a lot of the useless people. He was got rid of.
  6. For @Bruce Banner and anyone else interested in patient record confidentiality please see file attached. It's too long to quote in full. A Short Friendly Guide to using SystmOne p 36 to 41.pdf
  7. From a "A Short Friendly Guide to using SystmOne", which is written by a SystmOne user group not TPP. A Short Friendly Guide to using SystmOne v5.6 p 7 to 9.pdf
  8. The Phoenix Partnership (TPP)'s big product is SystmOne an Electronic Patient Record used by GPs and other community services. TPP has almost a duopoly on that market with EMIS (recently bought by UnitedHealth). That duopoly allows TPP high margins for a mediocre product.
  9. Telegraph: Halifax to impose new age limit on thousands of older mortgage borrowers (turn off JavaScript to read) Their age limit was 75? Whiskey Tango Foxtrot.
  10. She's sucking the life out of Whitby, but she's following a precedent.
  11. BBC News' Faisal Islam has noticed too. From Jeremy Hunt's Budget was more radical than it looked
  12. Brexit took away one of the shells in the shell game.
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