RT Journal Article
SR Electronic
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
FD British Thoracic Society
SP e000307
DO 10.1136/bmjresp-2018-000307
VO 5
IS 1
A1 Matthew Evison
A1 Kevin G Blyth
A1 Rahul Bhatnagar
A1 John Corcoran
A1 Tarek Saba
A1 Tracy Duncan
A1 Rob Hallifax
A1 Liju Ahmed
A1 Alex West
A1 Justin Charles Thane Pepperell
A1 Mark Roberts
A1 Pasupathy Sivasothy
A1 Ioannis Psallidas
A1 Amelia O Clive
A1 Jennifer Latham
A1 Andrew E Stanton
A1 Nick Maskell
A1 Najib Rahman
YR 2018
UL http://bmjopenrespres.bmj.com/content/5/1/e000307.abstract
AB 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.