A detailed review and evaluation of selected clinical records by qualified professional personnel for the purpose of evaluating the quality of medical care.... medical audit

A statutory body set up by the Dentists Act which maintains a register of dentists (see DENTAL SURGEON), promotes high standards of dental education, and oversees the professional conduct of dentists. Membership comprises elected and appointed dentists and appointed lay members. Like other councils responsible for registering health professionals, the General Dental Council now comes under the umbrella of the new Council for Regulatory Excellence, a statutory body. (See APPENDIX 7: STATUTORY ORGANISATIONS.)... general dental council

A file kept for each patient, maintained by the hospital (medical practitioners also maintain medical records in their own practices), which documents the patient’s problems, diagnostic procedures, treatment and outcome. Related documents, such as written consent for surgery and other procedures, are also included in the record. In addition to facts about a patient’s illness, medical records nearly always contain other information such as clinical, demographic, sociocultural, sociological, economic, administrative and behavioural data. The record may be on paper or computerized.... medical record

Under the strict legal de?nition, negligence must involve proving a clearly established duty of care which has been breached in a way that has resulted in injury or harm to the recipient of care. There does not need to be any malicious intention. Whether or not a particular injury can be attributed to medical negligence, or must simply be accepted as a reasonable risk of the particular treatment, depends upon an assessment of whether the doctor has fallen below the standard expected of practitioners in the particular specialty. A defence to such a claim is that a respected body of practitioners would have acted in the same way (even though the majority might not) and in doing so would have acted logically.... medical negligence

Involves the use of non-numerical data, such as those collected in unstructured and in-depth interviews, focus group discussions, participant observation, participatory research, and the study of documents.... qualitative research

Involves the use of data in numerical quantities such as continuous measurements or counts.... quantitative research

A family of research methodologies which pursue action (or change) and research (or understanding) at the same time.... action research

See LIVING WILL.... advance statements about medical treatment

A complete system of theory and practices that has evolved independently of, and often prior to, the conventional biological approach. Many are traditional systems of medicine that are practised by individual cultures throughout the world. Traditional Oriental medicine and Ayurveda, India’s traditional system of medicine, are two examples.... alternative medical system

See APPENDIX 8: PROFESSIONAL ORGANISATIONS.

British National Formulary (BNF)

A pocket-book for those concerned with the prescribing, dispensing and administration of medicines in Britain. It is produced jointly by the Royal Pharmaceutical Society and the British Medical Association, is revised twice yearly and is distributed to NHS doctors by the Health Departments. The BNF is also available in electronic form.... british medical association (bma)

In 2002 the UK government set up this new statutory council with the aim of improving consistency of action across the eight existing regulatory bodies for professional sta? involved in the provision of various aspects of health care. These bodies are: General Medical Council; General Dental Council; General Optical Council; Royal Pharmaceutical Society of Great Britain; General Chiropractic Council; General Osteopathic Council; Health Professions Council; and Nursing and Midwifery Council.

The new Council for Healthcare Regulatory Excellence will help to promote the interests of patients and to improve co-operation between the existing regulatory bodies – providing, in e?ect, a quality-control mechanism for their activities. The government and relevant professions will nominate individuals for this overarching council. The new council will not have the authority to intervene in the determination by the eight regulatory bodies of individual ?tness-to-practise cases unless these concern complaints about maladministration.... council for healthcare regulatory excellence

See APPENDIX 7: STATUTORY ORGANISATIONS.... council for nursing and midwifery

When a woman is treated for infertility it is necessary to nurture human embryos for a few days (until the ?rst cell divisions of the fertilised egg have occurred) in a specialised laboratory. More eggs are fertilised than are usually needed because not all fertilisations are successful. Surplus embryos may be frozen for use in later attempts to implant an embryo in the womb. Research has been done on very early embryos but the practice is controversial and some countries have either forbidden it or imposed tight restrictions. In the UK such research is controlled by the government Human Fertilisation & Embryology Authority (see ASSISTED CONCEPTION).... embryo research

The collection of extensive narrative data on many variables over an extended period of time in a naturalistic setting in order to gain insights not possible using other types of research. For this type of research, observations are undertaken at particular points of time. Data would include observations, recordings and interpretations of what is seen.... ethnographic research

Treatment that is usually considered unable to produce the desired benefit either because it cannot achieve its physiological aim or because the burdens of the treatment are considered to outweigh the benefits for the particular individual. There are necessary value judgements involved in coming to an assessment of futility. These judgements must consider the individual’s, or proxy’s, assessment of worthwhile outcome. They should also take into account the medical practitioner or other provider’s perception of intent in treatment. They may also take into account community and institutional standards, which in turn may have used physiological or functional outcome measures.... futile medical treatment

The statutory body that regulates the professions of ophthalmic OPTICIAN (optometrist) and dispensing optician. It promotes high standards of education and professional conduct and was set up by the Opticians Act 1958.... general optical council

Guidelines for doctors on the provision of good medical care laid down by the GENERAL MEDICAL COUNCIL (GMC).... good medical practice

The multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviours affect access to health care, the quality and cost of health care, and ultimately health and well-being. Its research domains are individuals, families, organizations, institutions, communities and populations.... health services research

Research dealing with the entire health system or only part of it, the object being to ensure that the system is optimally planned and organized and that programmes are carried out by the health system infrastructure efficiently and effectively and with appropriate technology.... health systems research

Herbal Medical

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... herbal medical

A statutory body of elected and appointed medical practitioners and appointed lay members with the responsibility of protecting patients and guiding doctors in their professional practice. Set up by parliament in 1858 – at the request of the medical profession, which was concerned by the large numbers of untrained people practising as doctors – the GMC is responsible for setting educational and professional standards; maintaining a register of quali?ed practitioners; and disciplining doctors who fail to maintain appropriate professional standards, cautioning them or temporarily or permanently removing them from the Medical Register if they are judged un?t to practise.

The Council is funded by doctors’ annual fees and is responsible to the Privy Council. Substantial reforms of the GMC’s structure and functions have been and are still being undertaken to ensure that it operates e?ectively in today’s rapidly evolving medical and social environment. In particular, the Council has strengthened its supervisory and disciplinary functions, and among many changes has proposed the regular revalidation of doctors’ professional abilities on a periodic basis. The Medical Register, maintained by the GMC, is intended to enable the public to identify whom it is safe to approach to obtain medical services. Entry on the Register shows that the doctor holds a recognised primary medical quali?cation and is committed to upholding the profession’s values. Under revalidation requirements being ?nalised, in addition to holding an initial quali?cation, doctors wishing to stay on the Register will have to show their continuing ?tness to practise according to the professional attributes laid down by the GMC.

Once revalidation is fully established, there will be four categories of doctor:

Those on the Register who successfully show their ?tness to practise on a regular basis.

Those whose registration is limited, suspended or removed as a result of the Council’s disciplinary procedures.

Those who do not wish to stay on the Register or retain any links with the GMC.

Those, placed on a supplementary list, who do not wish to stay on the main Register but who want to retain a formal link with the medical profession through the Council. Such doctors will not be able to practise or prescribe.... general medical council (gmc)

Research on all aspects of health, the factors affecting it, and ways of promoting, protecting and improving it. It is an essential part of national health development. It includes medical and biomedical research relating to a wide variety of medical matters and involving various life sciences, such as molecular biology and biophysics; clinical research, which is based on the observation and treatment of patients or volunteers; epidemiological research, which is concerned with the study and control of diseases and of situations that are suspected of being harmful to health; and socioeconomic and behavioural research, which investigates the social, economic, psychological and cultural determinants of health and disease with a view to promoting health and preventing disease. Often a multidisciplinary combination of the above kinds of research is needed to solve a health problem.... health research

Equipment, such as hospital beds, wheelchairs and prosthetics, provided by an agency and used at home.... home medical equipment

The study of the interrelationships between humans, the tools they use, and the environment in which they live and work.... human-factor research

These are UK bodies that provide doctors with advice and, where appropriate, ?nancial support in defending claims for medical negligence in their clinical practice. They also advise doctors on all legal aspects of their work, including patients’ complaints, and provide representation for members called to account by the GENERAL MEDICAL COUNCIL (GMC) or other regulatory body. The sharp rise in claims for medical negligence in the NHS in the 1980s persuaded the UK Health Departments to introduce a risk-pooling system called the Clinical Negligence Scheme for Trusts, and the defence societies liaise with this scheme when advising their doctor members on responding to claims of negligence (see MEDICAL LITIGATION; MEDICAL NEGLIGENCE).... medical defence organisations

An executive agency of the Department of Health in the UK. Set up in 1994, it is responsible for regulating and advising on the sale or use of any product, other than a medicine, used in the health-care environment for the diagnosis, prevention, monitoring or treatment of illness or disease. Equipment ranges from pacemakers (see CARDIAC PACEMAKER) to prostheses (see PROSTHESIS), and from syringes to magnetic resonance imaging (see (MRI).... medical devices agency

Medical Dictionary

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... medical dictionary

An error or omission in the medical care provided to an individual. Medical errors can occur in diagnosis, treatment, preventive monitoring or in the failure of a piece of medical equipment or another component of the medical system. Often, but not always, medical errors result in adverse events such as injury or death. See also “malpractice”; and “incidence monitoring and reporting”.... medical error

See INFORMATION TECHNOLOGY IN MEDICINE.... medical informatics

See ONCOLOGY.... medical oncology

This term is used to de?ne the process of learning and knowledge-acquisition in the study of medicine. It also encompasses the expertise required to develop education and training for students and learners in all aspects of medical health care. Studies for undergraduate students, postgraduate students and individual health-care practitioners, from the initial stages to the ongoing development of a career in medicine or associated health ?elds, are also included in medical education. The word ‘pedagogy’ is sometimes applied to this process.

A range of research investigations has developed within medical education. These apply to course monitoring, audit, development and validation, assessment methodologies and the application of educationally appropriate principles at undergraduate and postgraduate levels. Research is undertaken by medical educationalists whose backgrounds include teaching, social sciences and medicine and related health-care specialties, and who will hold a medical or general educational diploma, degree or other appropriate postgraduate quali?cation.

Development and validation for all courses are an important part of continuing accreditation processes. The relatively conservative courses at both undergraduate and postgraduate levels, including diplomas and postgraduate quali?cations awarded by the specialist medical royal colleges (responsible for standards of specialist education) and universities, have undergone a range of reassessment and rede?nition driven by the changing needs of the individual practitioner in the last decade. The stimuli to change aspects of medical training have come from the government through the former Chief Medical O?cer, Sir Kenneth Calman, and the introduction of new approaches to specialist training (the Calman programme), from the GENERAL MEDICAL COUNCIL (GMC) and its document Tomorrow’s Doctors, as well as from the profession itself through the activities of the British Medical Association and the medical royal colleges. The evolving expectations of the public in their perception of the requirements of a doctor, and changes in education of other groups of health professionals, have also led to pressures for changes.

Consequently, many new departments and units devoted to medical education within university medical schools, royal colleges and elsewhere within higher education have been established. These developments have built upon practice developed elsewhere in the world, particularly in North America, Australia and some European countries. Undergraduate education has seen application of new educational methods, including Problem-Based Learning (PBL) in Liverpool, Glasgow and Manchester; clinical and communications skills teaching; early patient contact; and the extensive adoption of Internet (World Wide Web) support and Computer-Aided Learning (CAL). In postgraduate education – driven by European directives and practices, changes in specialist training and the needs of community medicine – new courses have developed around the membership and fellowship examinations for the royal colleges. Examples of these changes driven by medical education expertise include the STEP course for the Royal College of Surgeons of England, and distance-learning courses for diplomas in primary care and rheumatology, as well as examples of good practice as adopted by the Royal College of General Practitioners.

Continuing Professional Development (CPD) and Continuing Medical Education (CME) are also important aspects of medical education now being developed in the United Kingdom, and are evolving to meet the needs of individuals at all stages of their careers.

Bodies closely involved in medical educational developments and their review include the General Medical Council, SCOPME (the Standing Committee on Postgraduate Medical Education), all the medical royal colleges and medical schools, and the British Medical Association through its Board of Medical Education. The National Health Service (NHS) is also involved in education and is a key to facilitation of CPD/CME as the major employer of doctors within the United Kingdom.

Several learned societies embrace medical education at all levels. These include ASME (the Association for the Study of Medical Education), MADEN (the Medical and Dental Education Network) and AMEE (the Association for Medical Education in Europe). Specialist journals are devoted to research reports relating to medical educational developments

(e.g. Academic Medicine, Health Care Education, Medical Education). The more general medical journals (e.g. British Medical Journal, New England Journal of Medicine, The Lancet, Annals of the Royal College of Surgeons) also carry articles on educational matters. Finally, the World Wide Web (WWW) is a valuable source of information relating to courses and course development and other aspects of modern medical education.

The UK government, which controls the number of students entering medical training, has recently increased the quota to take account of increasing demands for trained sta? from the NHS. More than 5,700 students – 3,300 women and 2,400 men – are now entering UK medical schools annually with nearly 28,600 at medical school in any one year, and an attrition rate of about 8–10 per cent. This loss may in part be due to the changes in university-funding arrangements. Students now pay all or part of their tuition fees, and this can result in medical graduates owing several thousand pounds when they qualify at the end of their ?ve-year basic quali?cation course. Doctors wishing to specialise need to do up to ?ve years (sometimes more) of salaried ‘hands-on’ training in house or registrar (intern) posts.

Though it may be a commonly held belief that most students enter medicine for humanitarian reasons rather than for the ?nancial rewards of a successful medical career, in developed nations the prospect of status and rewards is probably one incentive. However, the cost to students of medical education along with the widespread publicity in Britain about an under-resourced, seriously overstretched health service, with sta? working long hours and dealing with a rising number of disgruntled patients, may be affecting recruitment, since the number of applicants for medical school has dropped in the past year or so. Although there is still competition for places, planners need to bear this falling trend in mind.

Another factor to be considered for the future is the nature of the medical curriculum. In Britain and western Europe, the age structure of a probably declining population will become top-heavy with senior citizens. In the ?nancial interests of the countries affected, and in the personal interests of an ageing population, it would seem sensible to raise the pro?le of preventive medicine – traditionally rather a Cinderella subject – in medical education, thus enabling people to live healthier as well as longer lives. While learning about treatments is essential, the increasing specialisation and subspecialisation of medicine in order to provide expensive, high-technology care to a population, many of whom are suffering from preventable illnesses originating in part from self-indulgent lifestyles, seems insupportable economically, unsatisfactory for patients awaiting treatment, and not necessarily professionally ful?lling for health-care sta?. To change the mix of medical education would be a di?cult long-term task but should be worthwhile for providers and recipients of medical care.... medical education

Legal action taken by an individual or group of individuals, usually patients, against hospitals, health-service providers or health professionals in respect of alleged inadequacies in the provision of health care.

In the hospital service, claims for clinical negligence have risen enormously since the 1970s. In 1975 the NHS spent about £1m a year on legal claims; by 2004 the NHS faced over £2 billion in outstanding claims. In 1995 a risk-pooling Clinical Negligence Scheme for Trusts (CNST) was set up in England, and is administered by the NHS Litigation Authority. NHS trusts are expected to follow a set of risk-management standards, the ?rst being that each trust should have a written risk-management strategy with an explicit commitment to managing clinical risk (see RISK MANAGEMENT).... medical litigation

Research on measures of changes in outcomes, that is, health status and satisfaction, resulting from specific interventions.... outcome research

A process in which the researcher facilitates analysis by a range of stakeholder groups of the themes being investigated.... participatory research

The process by which manuscripts submitted to a publisher or research applications are evaluated by experts in appropriate fields (usually anonymous to the authors) to ensure quality.... peer review (in research)

In medicine, the collation and assessment of existing facts and knowledge, and the critical systematic investigation of the normal and abnormal functioning of the body, along with the EPIDEMIOLOGY of diseases and disorders affecting it – the aim being to increase the sum of knowledge in respect of the prevention, diagnosis and treatment of disease.

Ethics of research Although Britain has had legislation governing aspects of research on animals since the 19th century, there is no over-arching statute regulating research on humans and human material. Such activity is covered in law by the vaguely de?ned common-law concept of consent, and by piecemeal legislation such as the DATA PROTECTION ACT 1998 and the HUMAN FERTILISATION & EMBRYOLOGY ACT 1990. Nevertheless, extensive and very detailed ethical guidance on aspects of research has been published by a wide range of national and international organisations (see ETHICS COMMITTEES). Several basic principles feature in all statements about research ethics: these include the importance of ensuring that research is independently and rigorously scrutinised by appropriately constituted ethics committees; verifying that any risk to the research subject is reasonable in relation to the anticipated bene?t; and ensuring that all e?orts are made to minimise possible harm. The research subject’s willingness to tolerate some risk does not relieve researchers of the responsibility of making sure that all risks are kept to a minimum. Above all, a key feature of ethical research has involved seeking informed consent from research participants. This rule, initially applied to actual involvement by human subjects in research, has gradually been extended to include seeking informed consent from patients or from their relatives to the use of data and to the use of human organs and tissue in research, including after POST-MORTEM EXAMINATION. (See also EVIDENCE-BASED MEDICINE.)... research

The procedures and methods, including ethical considerations, predetermined by an investigator, to be adhered to in conducting a research project.... research design

See “futile medical treatment”; “advanced directive”.... withholding / withdrawing medical treatment

See ETHICS.... world medical association

Quarterly publication of the National Herbalists Association of Australia. Australian medicinal plants, Government reports, case studies, books, plant abstracts. For subscription details and complimentary copy of the Journal contact: NHAA, PO Box 65, Kingsgrove NSW 2208, Australia. Tel: +61(02) 502 2938. Annual subscription (Aus) $40 (overseas applicants include $15 for air mail, otherwise sent by sea mail). ... australian journal of medical herbalism

Legal guidance sought by the sufferer when making claims against a doctor or health authority is available from: Action for Victims of Medical Accidents (AVMA), Bank Chambers, 1 London Road, Forest Hill, London SE23 3TP. ... medical accidents

The collection and analysis of numerical data relating to medicine.

Information on the incidence and prevalence of various conditions is an important aspect of medical statistics.... statistics, medical

(AMA) a professional organization for US physicians. Its purposes include dissemination of scientific information through journals, a weekly newspaper, and a website; representation of the profession to Congress and state legislatures; keeping members informed of pending health and medical legislation; evaluating prescription and non-prescription drugs; and cooperating with other organizations in setting standards for hospitals and medical schools. The AMA maintains a comprehensive directory of licensed physicians in the US.... american medical association

Research misconduct is de?ned as behaviour by a researcher that falls short of good ethical and scienti?c standards – whether or not this be intentional. For example, the same data may be sent for publication to more than one medical journal, which might have the e?ect of their being counted twice in any META-ANALYSIS or systematic review; or the data may be ‘salami sliced’ to try to make the maximum number of publications, even though the data may overlap. Fraud in the context of research is de?ned as the generation of false data with the intent to deceive. It is much less frequent than carelessness, but its incidence is estimated as between

0.1 and 1 per cent. A ?gure of 1 per cent means that, in the United Kingdom at any one time, maybe 30 studies are being conducted, or their results published, which could contain false information. Examples include forged ethics-committee approval, patient signatures and diary cards; fabricated ?gures and results; invention of non-existent patient subjects; or sharing one electrocardiogram or blood sample amongst many subjects.

Research fraud should be ?rst suspected by a clinical-trial monitor who recognises that data are not genuine, or by a quality-assurance auditor who cannot reconcile data in clinical-trial report forms with original patient records. Unfortunately, it often comes to light by chance. There may be suspicious similarities between data ostensibly coming from more than one source, or visits may have been recorded when it was known that the clinic was shut. Statistical analysis of a likely irregularity will frequently con?rm such suspicion. The motivation for fraud is usually greed, but a desire to publish at all costs, to be the original author of a medical breakthrough, to bolster applications for research grants, or to strengthen a bid for more departmental resources are other recognised reasons for committing fraud.

In the USA, those proved to have committed fraud are debarred from receiving federal funds for research purposes or from undertaking government-funded therapeutic research. The four Nordic countries (Denmark, Finland, Norway and Sweden) have committees on research dishonesty that investigate all cases of suspected research misconduct. In the United Kingdom, an informal system operated by the pharmaceutical industry, using the disciplinary mechanism of the General Medical Council (GMC), has led to more than 16 doctors in the past ten years being disciplined for having committed research fraud. Editors of many of the world’s leading medical journals have united to form the Committee on Publishing Ethics, which advises doctors on proper practice and assists them in retracting or refusing to publish articles found or known to be false. (See ETHICS; ETHICS COMMITTEES.) Where an author does not o?er a satisfactory explanation, the matter is passed to his or her institution to investigate; where an editor or the committee is not satis?ed with the result they may pass the complaint to the appropriate regulatory body, such as the GMC in Britain.... research fraud and misconduct

A General Medical Council style organisation with a single Register, common ethics and disciplinary procedures for its members. To promote high standards of education, qualification and treatment; to preserve the patient’s freedom of choice.

Founder groups: The National Institute of Medical Herbalists, College of Osteopaths, British Naturopathic and Osteopathic Association, The British Chiropractic Association, The Society of Homoeopaths, The British Acupuncture Association, The Traditional Acupuncture Society and the Register of Traditional Chinese Medicine.

Objects: to provide vital unified representation to contest adverse legislation; to promote the interests of those seeking alternative treatments; to maintain standards of competent primary health care; to protect the practice of alternative medicine if Common Law is encroached upon. The Council prefers to work in harmony with the orthodox profession in which sense it is complementary. Council’s first chairman: Simon Mills, FNIMH. Address: 10 Belgrave Square, London SW1X BPH. ... council for complementary and alternative medicine

Est. 1864. The oldest and only body of professional medical herbalists, now known as phytotherapists, in Europe. Membership by examination after completion of course of training. A stipulated period of clinical practice must be completed before the final examination is taken.

Members are directly involved with patient-care, carrying full responsibility for their recommendations, prescribing medication suitable to the individual biological requirements of each patient. Their role includes patient-counselling, health education and research.

Official recognition of the Institute, indicating its growing importance in the field of medicine came with the historic Grant of Arms by Her Majesty’s College of Heralds. Members regard this as evidence that the Royal Charter of King Henry VIII still stands and that there is no monopoly in healing the sick. See: HENRY VIII, HERBALISTS’ CHARTER.

The Institute played a major role in winning vital concessions for the survival of the herbalist in the passage through Parliament of the Medicine’s Bill. See: MEDICINE’S ACT, 1968.

In connection with the NIMH degree courses in herbal medicine are available at a London University, and Exeter University.

The Institute provides professional indemnity cover for its members, and is engaged in a series of clinical trials to evaluate traditional remedies.

All members are required to adhere to a strict professional Code of Ethics and are entitled to carry after their names the letters of qualification: MNIMH or FNIMH.

Members have a key role in preventative medicine and health promotion in their contribution to improvement of the nation’s health.

Address: 56 Longbrook Street, Exeter EX4 6AH, from which a list of members is obtainable. ... national institute of medical herbalists

(BMA) a professional body for doctors and also an independent trade union dedicated to protecting individual members and the collective interests of doctors. It has a complex structure that allows representation both by geographical area of work and through various committees, including the General Practice Committee (GPC), Central Consultants and Specialists Committee, Junior Doctors Committee, and the Medical Students Committee.... british medical association

(CMO) the most senior medical adviser to the UK government, who is responsible for providing expert advice on health issues (including health-related emergencies). The CMO is responsible to the Secretary of State for Health and acts as leader of profession for Directors of Public Health. There are separate CMOs appointed to advise the devolved governments in Scotland, Wales, and Northern Ireland.... chief medical officer

Tests may be performed to investigate the cause of symptoms and establish a diagnosis, to monitor the course of a disease, or to assess response to treatment. A medical testing programme carried out on apparently healthy people to find disease at an early stage is known as screening.

The accuracy of a test is based on its sensitivity (ability to correctly identify diseased subjects), specificity (ability to correctly identify healthy subjects), and predictive value.

The predictive value is determined by a mathematical formula that involves the number of accurate test results and the total number of tests performed.

The best tests have both high specificity and high sensitivity, and therefore high predictive value.... tests, medical

see community health.... clinical medical officer

the supervisory body of *advanced life-support courses in Europe, responsible for updating the content of the courses based on best evidence from all countries represented.... european resuscitation council

(GMC) the regulatory body of the medical profession in the UK, which was established in 1858 by the Medical Act and has statutory powers. It licenses doctors to practise medicine and has the power to revoke licences or place restrictions on practice. The governing body of the GMC, its Council, comprises 12 members, 6 of which are medically qualified and 6 of which are not. Its purpose is to protect, promote, and maintain the health and safety of the public by ensuring proper standards in the practice of medicine and medical education and training. Following various high-profile cases involving malpractice, there has been a shift in the role of the GMC from one of simple registration to that of *revalidation of doctors.

GMC website: includes the Council’s guide to Good Medical Practice... general medical council

a *special health authority of the NHS established following the Health and Social Care Act 2012 to promote and protect the interests of patients in health research and to simplify the regulation of research. The Health Research Authority inherited the functions of the National Research Ethics Service, which closed in 2012.... health research authority

see HEMS.... helicopter-based emergency medical services

(LMC) a group of representatives of the general practitioners working in a defined geographical area. There are separate LMCs for each area, and the members speak on behalf of the local practitioners by whom they are elected. Similar arrangements and responsibilities apply for dentists, pharmacists, and optometrists practising in the NHS outside hospitals.... local medical committee

adj. 1. of or relating to medicine, the diagnosis, treatment and prevention of disease. 2. of or relating to conditions that require the attention of a physician rather than a surgeon. For example, a medical ward of a hospital accommodates patients with such conditions.... medical

1. a health service worker who is not a registered medical practitioner (often in the armed forces) working in association with a doctor to undertake minor treatments and preliminary assessments. In poorer countries, particularly in rural areas where qualified resources are short (e.g. China), agricultural workers receive limited training in health care and continue in a dual role as barefoot doctors; elsewhere, limited training concentrates more on environmental issues: the workers so trained are known as sanitarians. 2. in the USA, a person – licensed or unlicensed, certified or uncertified – who provides administrative and/or clinical assistance in a physician’s office or other health-care facility. Administrative duties typically include filling out insurance forms, billing, and bookkeeping, while clinical duties may include taking medical histories, preparing patients to be examined, and preparing blood and urine specimens.... medical assistant

a certificate stating a doctor’s diagnosis of a patient’s medical condition, disability, or fitness to work (see statement of fitness for work). It is known informally as a ‘fit note’ (formerly a ‘sick note’). See Appendix 8.... medical certificate

see local medical committee.... medical committee

(MET) a team, usually consisting of a group of physicians, anaesthetists, and senior nurses, that can be summoned urgently to attend to patients with deteriorating medical conditions. The aim is to prevent further deterioration and to decide if enhanced levels of care are appropriate (e.g. on the high-dependency or intensive care units). The team will also assume the role of the *cardiac-arrest team.... medical emergency team

the study or practice of the legal aspects of medicine. See forensic medicine.... medical jurisprudence

travelling internationally to undergo surgery or otherwise be treated for an illness or condition. This may be done to save money, to avoid having to wait for treatment, or to receive a treatment not available in the home country.... medical tourism

the standards of conduct required of medical professionals and also the academic study of ethical issues arising from the practice of medicine. From the *Hippocratic oath onwards, standards are designed to reassure that professionals subscribing to them will act in the *best interests of, and will avoid harming, their patients. Today they lay greater emphasis on patient *autonomy, while the contemporary study of medical ethics is concerned with a great variety of complex societal and social issues related to medical practice and research. Medical ethics is now taught in all medical schools in the UK as an essential part of a professional training, and the wider field of *bioethics is becoming a recognized academic specialty. See also clinical ethics; feminist ethics; public health ethics; publication ethics; virtue ethics.

Guidance on good medical practice from the website of the General Medical Council... medical ethics

(NIHR) a national organization, funded through the *Department of Health and Social Care, that coordinates, supports, and funds research within the NHS.

NIHR website... national institute for health research

(NMC) a statutory body that regulates the nursing and midwifery professions in the public interest. See nurse.... nursing and midwifery council

(PAR) a radical approach to public health issues that actively involves communities in collaboration, reflection, data collection, and activities that empower them to improve their own health. See empowerment.... participatory action research

see ethics committee.... research ethics committee

a type of scientific enquiry that focuses on developing practical application from the findings from basic scientific research. The field of translational research is sometimes described as comprising T1 research and T2 research. The former focuses on developing novel clinical treatments from laboratory-based basic science; the latter on embedding the findings of clinical trials into everyday practice. See also academic health science network.... translational research