TY - JOUR T1 - Providing safe and effective pleural medicine services in the UK: an aspirational statement from UK pleural physicians JF - BMJ Open Respiratory Research JO - BMJ Open Resp Res DO - 10.1136/bmjresp-2018-000307 VL - 5 IS - 1 SP - e000307 AU - Matthew Evison AU - Kevin G Blyth AU - Rahul Bhatnagar AU - John Corcoran AU - Tarek Saba AU - Tracy Duncan AU - Rob Hallifax AU - Liju Ahmed AU - Alex West AU - Justin Charles Thane Pepperell AU - Mark Roberts AU - Pasupathy Sivasothy AU - Ioannis Psallidas AU - Amelia O Clive AU - Jennifer Latham AU - Andrew E Stanton AU - Nick Maskell AU - Najib Rahman Y1 - 2018/08/01 UR - http://bmjopenrespres.bmj.com/content/5/1/e000307.abstract N2 - Physicians face considerable challenges in ensuring safe and effective care for patients admitted to hospital with pleural disease. While subspecialty development has driven up standards of care, this has been tempered by the resulting loss of procedural experience in general medical teams tasked with managing acute pleural disease. This review aims to define a framework though which a minimum standard of care might be implemented. This review has been written by pleural clinicians from across the UK representing all types of secondary care hospital. Its content has been formed on the basis of literature review, national guidelines, National Health Service England policy and consensus opinion following a round table discussion. Recommendations have been provided in the broad themes of procedural training, out-of-hours management and pleural service specification. Procedural competences have been defined into descriptive categories: emergency, basic, intermediate and advanced. Provision of emergency level operators at all times in all trusts is the cornerstone of out-of-hours recommendations, alongside readily available escalation pathways. A proposal for minimum standards to ensure the safe delivery of pleural medicine have been described with the aim of driving local conversations and providing a framework for service development, review and risk assessment. ER -