If Richard Branson was PGDME he might say……..

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A thought for all those preparing to welcome our new doctors in August. Train them so well that they want to stay here or come back as a consultant. It’s no small task and we are not an airline, but there is truth in those words. As DME it’s pretty clear to me that although there is clearly a link between workload and satisfaction there is a also a strong association between satisfaction and being valued. We need our trainees to feel part of a team, to feel valued and to feel they are learning here in a hospital with fantastic developmental opportunities.

One to think about in the last few weeks before the biggest induction of the year.

Look after your staff and they will look after your customers (patients)



AKI Care app – helping identify and treat AKI

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By Dr Rachael Challiner, Consultant in Nephrology and Intensive Care Medicine CMFT & Chair of the AKI group for the Strategic Clinical Network for Greater Manchester, Lancashire and Cumbria


We are excited to announce the launch of the AKI Care app; a mobile application for iOS and Android that assists medical staff in the identification, treatment and real-time documentation of episodes of acute kidney injury (AKI).  


The app moves beyond working as a simple risk calculator and helps users assess for, and then treat, the life-threatening complications of AKI. 


Why should clinicians use the AKI Care app?

AKI complicates up to 20% of hospital admissions and is strongly associated with an increased risk of death. An NHS report last year suggested up to 40,000 people may be dying each year from this preventable condition. Key to improving these outcomes is early identification.


The AKI Care app is simple-to-use and analyses patient data to provide instant guidance. It follows NICE clinical guideline on acute kidney injury (CG 169) and immediately identifies whether a patient has suffered an AKI episode. This standardisation of care allows clinicians with differing levels of experience (and spread over a large geographical area) to manage AKI in the same, optimal manner.


In addition to the life-threatening complications of AKI, these patients have an increased risk of becoming systemically unwell often due to the underlying condition that is causing their AKI. The app recognises this and encourages users to consider the patient as a whole rather than focusing entirely on the AKI.


Referral to specialist kidney units is a vital step in managing AKI. If the patient needs referral the app uses the smartphone’s location to identify the appropriate local specialist unit and helps the clinician assess the patient’s suitability for transfer. It then provides contact details allowing the referral process to begin.


The app will email a summary of each assessment, allowing clinicians to append a summary to patient notes; and will anonymously records details of AKI cases in which the user has been involved. Providing evidence of this kind is a key aspect of medical training.


The AKI Care app is regulated by the MHRA in the UK and carries the CE mark.


Who has created the app?

The Greater Manchester, Lancashire and South Cumbria Strategic Clinical Network which includes the renal departments of Central Manchester University Hospitals NHS Foundation Trust, Lancashire Teaching Hospitals NHS Foundation Trust and Salford Royal NHS Foundation Trust. All information has been provided by consultant nephrologists from within these hospitals and follows NICE (National Institute for Health and Care Excellence) clinical guideline on acute kidney injury (CG 169).


How do I get it?

The app is free-to-use. Simply download and register your details.

Download the AKI Care app on the App Store
Get the AKI Care app on Google Play


Screenshot here….


Vocera messaging and the death of the SHO

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The term SHO is dead, defunct and in some people’s opinions dangerous. That’s the view of the deanery and the GMC so it’s something that we have been challenged to remove from day to day parlance here at CMFT.

However, much as it is rather tricky to stop people calling the department of emergency medicine…. ‘Casualty’ it’s tricky to stop people using the term SHO. So, in order to make a small step in the right direction you may notice something different when using the VOCERA badges recently introduced at MRI and soon to be used in other areas of the trust.

If, for example, you ask for ‘ED SHO’ the badge will reply ‘Calling ED Core Trainee’. Pretty clever stuff courtesy of infomatics and hopefully a step in the right direction.

Now this is all a bit Star Trek and no doubt you will have had plans

If you want to try out a few easter eggs, try commanding genie with these:
– good bye
– beam me up
– beam me down
– shut up

or if you’re brave command the badge with ‘turn funny genie on’ – remember to turn it off before entering a patient area though:-)


24/7 – one minute

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Just in case you were wondering about the acute care teams over Christmas and New Year, we have decided to match the opening hours of Southampton NHS Foundation Trust. (courtesy of @docib)

Screenshot 2014-12-22 07.44.30

Spare a thought for those working over the holiday period, and wonder what happens between 11:59 and midnight. As the staff face the moonlight I rather hope that it’s music & laughter, (though doubtful there will be love or romance……), but we do love the idea of 1 minute of ballroom dancing😉

However, I suspect it will be no more glamorous than a quick mince pie break:-)



Vic Brazil lecture. 14th August 2014

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The following text first appeared on the St.Emlyn’s website and welcomes anyone interested in Medical Education to join us on the 14th August for a lecture by Vic Brazil from Brisbane. This was written by Natalie May, one of our new EM consultants (who is similarly fantastic).


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Vic Brazil

There simply aren’t enough superlatives to describe the magnitude of inspiration on offer from the world’s finest critical care speakers. Who you may ask?

The answer to that question comes naturally – Victoria Brazil.

Victoria Brazil’s opening talk – Timing, Tribes & STEMIs – was spellbinding; if you haven’t seen it, stop reading this page immediately and please watch it! Her nuanced approach to communication across healthcare specialties and disciplines voices a challenge to each of us which cannot be ignored.

Victoria’s wisdom, passion, perception and insight are matched with exceptional presentation skills (when offered a time-check for her 20-min talk at SMACC she simply eyeballed Roger Harris and said, “It’s 20 minutes long.” She was right on the nose). She is a master of delivery and performance, captivating to watch and listen to. Every time I see or hear her speak I realise just how much I have to learn about owning the stage!

Like the St Emlyn’s team, Victoria is a supporter of FOAM. She is a founding member of the FFF, a member of the SMACC organising committee and a contributor to iTeachEM, an international collaboration of EM educators. She is an associate Professor at Bond University in Australia and works clinically in Queensland. In 2008 she was awarded the Australian College of Emergency Medicine’s Teaching Excellence Award.

We are so unbelievably fortunate to be able to welcome Victoria to St Emlyn’s on Thursday 14th August when she will be giving a free talk entitled Talking, Teaching and Technology in conjunction with the Manchester Medical Society. If you are interested in medical education, this is a talk you shouldn’t miss!

The event will take place at the Stopford Building, part of the University of Manchester, from 19:00 on Thursday 14th August 2014.

If you want to book a place then fill in the form available on the the St.Emlyn’s website. We’d love to see you there.

St.Emlyn’s website



Local induction guidance is now out

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Screenshot 2014-07-08 09.08.27We are working hard to improve local induction. Medicine is perhaps a strange profession in that our juniors are often expected to turn up and work almost immediately with little preparation or planning. Historically as DME and as foundation lead I have seen docs fall into difficulties as a result of a lack of an effective local induction. We really need to make sure that our new starters are safe to practice for the benefit of our teams, our trust and most importantly for our patients.

So, with a few weeks to go it’s time to think hard about how you are going to make this year’s induction the best that it has ever been.

Click on the link below to look at our guide for local induction and do the best that you can for our new starters. Welcome them into the trust, train them, help them and welcome them.

Local Induction Leaflet

At CMFT we have an induction lead for the trust in John Bright (Acute Medicine Consultant) who can be contacted for further information and help.




Effective role modelling. CMFT Educators conference.

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Screenshot 2014-06-05 08.21.11At the CMFT Medical Educators Conference on the 24th April Leena Patel and I ran a workshop on being an effective role model. Learning from role models is really important in medical education; it is happening in the workplace all the time. It is how students and trainees learn the application of our knowledge and skills, professionalism, and how we influence their career choices. Research indicates that being an effective role model is a set of skills that we can learn; yet few teacher training programme specifically teach these skills, which is why this workshop was developed.

We know that students and trainees consider as positive role models those who:

  • Excel in their clinical knowledge and skills
  • Through communication skills maintain good professional relationships
  • Are effective and enthusiastic teachers

Learning from our role models is occurring all the time and is a complex process; but they Screenshot 2014-06-05 08.24.24learn “to talk, from talk” – by actively observing and reflecting on the behaviours, attitudes and skills of their trainers, and assimilating and adopting these. We can enhance this learning in the workplace by actively demonstrating our knowledge and skills and by enhancing learning by:

  1. Attention: Drawing attention to what we are doing; by emphasising it,  providing a narrative, asking questions and by breaking down a complex skill
  2. Retention: Enhance retention by repetition, drawing parallels and by relating new to existing knowledge
  3. Production: Facilitating experience with an appropriate level of autonomy
  4. Motivation: Sharing what you get from it! Job satisfaction, financial gain, improved profile, position of influence etc etc.

Most of all, we inspire those around us by our enthusiasm and enjoyment for our work, and for our teaching and training!


Dr Margaret Kingston

Consultant Physician in Genitourinary Medicine

Associate Director Postgraduate Medical Education

Central Manchester University Hospitals NHS Foundation Trust