Taster Membership

Policy Update February 2014 - NHS 'care.data' Project

Tom Smith, BSG Chief Executive

On the 18th February, and following a lot of media pressure, NHS England were forced to announce that they would delay the introduction of the 'care.data project' admitting they had not done enough to explain the scheme to the public. NHS England promised that it would soon be launching a "very exciting" programme designed to better communicate the purpose and benefits of the data-sharing scheme. For the long-term benefit of the NHS, we should hope this step-change is meaningful and successful.

Phil Booth, of the campaign group MedConfidential, was one of many who were pleased by the decision to pause care.data. He said, "Finally officials at NHS England have seen reason. To upload millions of patients' confidential data without providing full and proper information or seeking consent would have been the largest breach of confidence in NHS history."

Several problems came to light. The public were not aware their data was being uploaded. There were concerns that private information would be accessed. There were fears from some that the private sector would purchase the data, something that was reinforced by a Telegraph report that an agency linked to the insurance industry had previously bought data, though they failed to explain that the data was aggregate and not individual. NHS England said this would not happen now and that decision was made prior to its creation. Not many people will have been reassured and NHS England now have a lot of work to do to increase confidence in its ability to handle data.

The row partly became political because of concerns the government were not seeking to explain the scheme to people and because there are proposals to share the data with NHS partners some of whom are private companies. Some of these companies provide analytical services to the NHS, supporting commissioning and there is a fear that they will use access to the data to grow other aspects of their business. In The Times, Hugo Rifkind noted that discussion over medical information was becoming another battlefront for an ideological discussion of whether the NHS is being privatised. "This is blinkered nonsense at the best of times, and particularly so here. For one thing, Care.data is a medical project, not a political one, and your 'Tories want to sell the NHS' antenna has to be set to a ragingly high paranoia rating not to realise this."

The basic problem has been a failure to demonstrate that systems are in place to answer public concerns. As Labour health spokesman Jamie Reed said: "This is another NHS shambles of this Government's own making. Along with health professionals, we raised concerns about the security of the data to be shared. Patients need to be assured that their records will be genuinely anonymous and that they have had the opportunity to opt out." Both the BMA and Royal College of General Practitioners have warned that patients have been kept in the dark about plans.

When the Health Select Committee asked NHS England officials for the plans that had been made to handle the project they found that no code of conduct had been drawn up for the implementation of care.data even though one should have been drawn up under the terms of the 2012 Health Act.

A good idea, collecting information to better inform clinical management is a good idea but the apparent lack of preparation risks jeopardising an important project. This view was best expressed by Sharmila Nebhrajani, the new chief executive of the Association of Medical Research Charities, who said care.data was a good idea in principle that had been "stymied by its execution". She said: "Charities and their supporting patient groups have always said that sharing data for research can be a really valuable opportunity to speed medical research but it must be done with care, competence and consent."

The Financial Times was irritated by the debate and expressed concern that that those encouraging a backlash against NHS plans may do patients a mis-service. They note fears that the state could know too much about people and that the public is being encouraged to revolt. 'But what about the opposite dystopia? Powerless patients forced to take what they are given by a state that is ignorant of what works best. The tyranny of not knowing.'

Over the next six months care must be taken to explain the benefits of collecting large data sets while pointing patients to the safeguards that exist. As a GI community we have a responsibility to help explain the benefits of having large data sets with meaningful clinical information. Important initiatives like the IBD Registry could be stymied be a backlash against the centralisation of data (though the public may have more faith in a patient-professional partnership holding the data than in NHS England).

The IBD Registry will provide local, regional and national perspectives in order to better define the pattern of IBD and as a resource to help advance understanding of and response to the condition. The Registry will enable researchers to access up-to-date real time information about services, patient characteristics, the natural history of the condition, and drug treatments and their outcomes.

As well as national gains there are significant local advantages in collecting data locally. At Luton and Dunstable Matthew Johnson and colleagues are using the additional data to change the way they care for patients. They have set up virtual clinics offering telephone advice and support, freeing up slots in the hospital, providing greater access and helping commissioners to save money by reorganising services. They have been shortlisted by the BMJ for Gastroenterology Team of the year!

The Registry provides a vehicle for easily collecting and using real time clinical information to feed into a UK-wide data set and future IBD Audit. Collecting information will help to strengthen standards and provide a foundation for improving care for IBD patients. We should play our part both in explaining the benefits of central data collection and in encouraging NHS England to come up with the safeguards that will turn the tide of public debate in support of large-scale data analysis.

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Meet Your Committee...

Name: Dr Laith Alrubaiy

Position: Chair

Representing: Wales

Grade: ST4

I am an academic clinical trainee in Gastroenterology from Wales. What I like about the specialty is the diversity of patients and their presentations. Gastroenterology combines both the theoretical aspect of medicine with the practical skills of endoscopy. You won't get bored doing Gastroenterology, as you will come across new challenging cases on daily bases. Anyone is welcome to join us, as there is always a need for young and enthusiastic gastroenterologists.

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laithalrubaiy@gmail.com


Name: Dr Louise China

Position: Secretary

Representing: NE Thames

Grade: ST5 (OOPR)

Interests: Hepatology, Medical Education

I'm a Gastroenterology SpR currently undertaking a Hepatology research fellowship (3 years) and have just finished a year out as a clinical teaching fellow at UCL medical school. I chose Gastroenterology not only because of the variety, but also because of the people you get to work with - Gastroenterologists tend to be an intelligent, competitive and aspirational bunch who are good fun! The range of patients (age, condition & personality) and the practical side mean you'll never have a boring day at work. There's also many avenues other than clinical work you can explore within the specialty.

Ask Louise a Question:
louise.china@ucl.ac.uk


Name: Dr Charlotte Rutter

Position: Former Chair

Grade: ST7

I currently work in Gloucester as a Severn Deanery trainee. I started out as a basic surgical trainee but a career in medicine appealed as I missed the diagnostic challenge of being a physician.

Gastroenterology is a varied specialty combining patients of all ages, acute emergencies, such as upper gastrointestinal bleeding, and enables you to utilise your practical skills in endoscopy. It is a fantastic choice of specialty and I look forward to offering advice to any potential gastroenterologists in the making!

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crutter@nhs.net


Name: Dr Max Hu

Representing: Northern

Grade: StR5

Interests:Endoscopy & Medical Education

Gastroenterology is an expanding specialty with a good variety of subspecialty interests for you to develop in the future. There is never a dull moment as the spectrum of clinical situations we encounter is arguably amongst the most challenging and exciting out there. I would highly recommend applying for Taster Membership to have a better grasp of what Gastroenterology and the BSG have to offer.

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Name: Dr Sujata Biswas

Representing: Oxford

Grade: ST6

Interests: Luminal gastroenterology with interest in endoscopy and IBD

I am a Gastro trainee and MRC clinical research training fellow in Oxford. I was drawn to Gastroenterology by the wide spectrum of disease and the diversity of the patient population. I like the contrast of acute emergencies with chronic illness management. It's certainly not a specialty you get bored in easily and there's of course plenty of scope for research. It won't disappoint!

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Name: Dr Nidhi Sagar

Representing: West Midlands

Grade: Clinical Research Fellow in Gastroenterology (ST6)

Interests: Luminal gastroenterology, general hepatology and postgraduate medical education

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Dr Nidhi Sagar


Name: Dr Prakash Ramachandran

Representing: East of Scotland

Grade: ST4

Interests: Hepatology, Academic Medicine, Basic Science Research

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prakash.ramachandran@nhs.net


Name: Dr Margaret Corrigan

Representing: Mersey

Grade: ST5

Interests: Hepatology, Medical Education

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margaretcorrigan@doctors.org.uk


Name: Dr Shairoz Samji

Representing: Yorkshire & Humber

Grade: ST5

Interests: Endoscopy, Medical Education

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shairozsamji@gmail.com


Name: Dr Durayd Alzoubaidi

Representing: East of England

Grade: ST5

Interests: Upper GI and Hepatology

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d.alzoubaidi@nhs.net


Name: Dr Elaine Robertson

Representing: West of Scotland

Grade: ST5

Interests: General Gastroenterology with an interest in oesophageal disorders and IBD

I knew from early on that I wanted to do hospital medicine but wasn't sure about a specialty. One of the gastroenterology consultants that I worked with during my medical rotation was very enthusiastic. She encouraged me to come along to scope lists and supported my training in clinics and on the ward. A career in gastro was a natural progression. I definitely made the right decision. I really enjoy scoping and there's a good mix of clinical challenges from the patients with chronic illnesses like IBD to the acutely unwell patients with liver disease. I would highly recommend it!

Ask Elaine a Question:
elainevrobertson@gmail.com


Name: Dr Charlotte Ford

Representing: S Thames

Grade: ST6

Interests: IBD, Medical education

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charlotte.ford@southlondon.HEE.nhs.uk


Name: Dr Fergus JQ Chedgy

Representing: KSS

Grade: ST6 (Currently OOPR)

Interests: Advanced Endoscopy, Research, Barrett's Oesophagus

I am Gastroenterology registrar in the KSS region, currently taking time out to do research in Endoscopy. I have found Gastroenterology the perfect career choice as it offers a balance of both acute and chronic diseases, with the opportunity to develop practical skills in endoscopy. I don't think I could have chosen better!

Ask Fergus a Question:
ferguschedgy@yahoo.co.uk


Name: Dr Shivkumar Budihal

Representing: East Midlands

Grade: Speciality Registrar, ST6

Interests: Hepatobiliary Medicine and Advanced Endoscopy

Deanery: East Midlands South Deanery

Place of Work: University Hospitals Leicester

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shivbudihal@gmail.com


Name: Dr Liam Morris

Representing: North West

Grade: ST4

Interests: Medical education, Endoscopy

Ask Liam a Question:
ldmorris@doctors.org.uk

I am an ST4 in the North West of England currently working in Blackpool. The diversity within gastroenterology is what drove me to the speciality. I find that the mix of practical skills and complex clinical situations keep the speciality interesting and challenging. It is also an evolving field with high quality research leading to regular changes in clinical practice. There is always more to learn!


Name: Dr Steve Dixon

Representing: Severn & South-West Peninsula

Grade: ST5

Interests: Endoscopy, Luminal Gastroenterology & Nutrition

Ask Steve a Question:
stevewdixon@doctors.org.uk

I am a gastroenterology registrar with a diverse range of interests. I'd be delighted to hear from anyone interested in the career.


Name: Dr Kesavan Kandiah

Representing: NW Thames

Grade: St6 (Currently in OOPR)

Interests:Luminal gastroenterology with interest in advanced endoscopy

Ask Kesavan a Question:
kesavankandiah@gmail.com

I am a gastroenterology SpR in the NW Thames rotation, currently in OOPR in Queen Alexandra Hospital, Portsmouth. Finding a specialty that one would like to commit to for the rest of his/her life can be challenging. Gastroenterology was an easy choice for me. The case mix, the interdisciplinary team interaction and the technical skills required make this specialty a truly exciting one. I’m thoroughly enjoying my career in gastroenterology and am certain that i will continue to do so in the many years to come!


Name: Dr John Eccles

Representing: Northern Ireland

Grade: St5

Interests: Endoscopy, Medical Education

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johnkeccles@hotmail.co.uk


Name: Dr Suranga Dharmasiri

Representing: Wessex

Grade: ST5 (OOPR)

Interests: IBD, Clinical and basic science research

Ask Suranga a Question:
surangadharmasiri@gmail.com

I am a gastroenterology trainee in the Wessex region. I was attracted to gastroenterology early in my career as it offered the opportunity to work in several different settings and work closely with other specialities. My training has confirmed that this was a great choice for me. The procedural elements and clinics ensure that you don't get ward fatigue, while caring for patients on the ward means you keep those emergency situation where the adrenalin gets pumping. I have a speciality interest in IBD and I am engaged in both clinical and basic science research in this area. I look forward to speaking to any future potential gastroenterologists.


Name: Dr Michael Hewitt

Representing: CT2

Grade: CT2

Interests: Endoscopy, Hepatology

I am currently a core medical trainee with a strong interest in gastroenterology, having completed a BSc and two clinical posts in the specialty. The combination of practical skills with a diverse range of pathology and patient demographics makes it a very appealing career choice that I am looking to pursue.

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drmichaeljhewitt@gmail.com


Name: Dr Giovanna Sheiybani

Representing: CT1

Grade: CT1

Interests: Endoscopy/Hepatology and Medical Education

I am currently a Trust Grade in Stroke medicine and I am due to start Core Medical Training in the Peninsula Deanery. My enthusiasm to pursue Gastroenterology in the future stems from working with very enthusiastic and practical Consultants from my Foundation Years. My aim is to specialise in Endoscopy or Hepatology.
Being involved in various projects in Gastroenterology and presenting at the BSG conferences, I have been able to thrust myself into the challenges of the practical and academic aspects of this field. Working in this field is immensely rewarding, even as a junior, and the variety of endoscopy, outpatient and inpatient work is what interests me. I have a great interest in medical education and I am currently developing an undergraduate course in using drama to demonstrate the patient narrative and to use these skills to improve history-taking.

Ask Michael a Question:
drmichaeljhewitt@gmail.com