The human side of immigration policies in the NHS

Shondpicture blog

ICS Council Member, Dr. Shondipon Laha, looks at the human impact on overseas doctors who staff the NHS, and stresses the importance of a diverse representation on our professional bodies.

The Windrush debacle and the tier 2 visa caps preventing immigrant doctors alleviating pressures in the UK are part of a saga that’s been ongoing for decades. According to the British Association of Physicians of Indian Origin (BAPIO), there’s evidence suggesting that the GMC treats Black and Minority Ethnic (BME) doctors ‘differently and harshly’. A view reinforced recently by the treatment of Dr. Bawa-Garba.

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On the receiving end!


Gary Masterson, President of the Society, recently experienced NHS care from the relative’s perspective. He reflects on some of the lessons he has learnt.

An elderly family member recently sustained a fractured neck of femur. I would like to share my observations with you as, having looked at our provision of care from a relative’s perspective. I think there are some useful lessons to take away.

The ambulance service, although slow to respond, was excellent. The paramedics were kind and caring. It’s easy to forget how important these simple human traits are.

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The Society and UK Critical Care Research

Jeremy Groves, ICS Council Member, took the opportunity to attend the Society’s Foundation Board and Research Committee meetings in January and looks at the Society’s contribution and commitment to UK Critical Care Research.


I’ve always been a believer in evidence based medicine. However, in day to day practice one hears lots of opinion about best practice but, as fallible humans, much of what we believe is not born out by the facts.

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BED 12 – Review

Julie Cahill, who has been an intensive care patient and is a member of the Society’s Patients and Relatives Committee, reviews Alison Murdoch’s book ‘Bed 12’.

Julie PACT profile circle

When renowned Buddhist and radio contributor Alison Murdoch’s husband falls suddenly and severely ill with viral encephalitis her entire world is turned upside down. As Simon spends five weeks in a London ICU, Alison soon realises that the hospital has become her own, sanitised world within a world, and that she is merely ‘visiting’ the rest of her life in her brief moments of respite from her husband’s bedside.

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What we really need to teach our trainees!


Richard Innes considers some of the more stressful decisions critical care consultants have to take and laments the lack of training in these areas.

When was the last time you sat with colleagues worried about how to treat someone with septic shock or ARDS?

A long time ago I suspect.

Much more likely they will be stressed about managing beds: who should have a bed, who should be discharged to let the next patient in,what to do about the patients waiting in recovery or ED who urgently, or not so urgently, needs a critical care  bed? The latter may require you to be pragmatic and  decide that a patient can be  managed outside of ICU as beds are short. If this is the case then you shoulder some, or all, of the responsibility should the patient deteriorate.  After all, you said they were OK to go!

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Serious Hazards of Transfusion Report

Jeremy Groves, ICS Council representative on the SHOT Steering Group, reflects on their latest report.


One of the great things about being on the ICS Council is the privilege of being able to represent the profession on various national committees.  Committees aren’t every ones cup of tea of course and when at a recent Council meeting, a vacancy came up for an ICS representative on the SHOT committee, everyone suddenly seemed more interested in their computers.

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GMC vs Bawa-Garba responses.


Dr Gary Masterson, president of the society, reflects on the Intensive Care Member response to the case of GMC Vs Bawa-Garba.

Following the recent judgement in the case of GMC vs Bawa-Garba in the High Court the Society has expressed its concerns to its members and passed on advice from the Academy of Medical Royal Colleges (AOMRC). We’ve received a number of replies from you, all of which offer food for thought.

There is, not surprisingly, serious concern expressed, both from working and retired members.

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Jeremy Groves considers the facts behind the recent Independent article on critical care winter activity and NHS England’s response.

You may have seen the article about critical care in the  Independent a couple of weeks ago.  In it our president, Gary Masterson, outlined the pressure units were under this winter.  NHS England’s press office went into overdrive.  Tweeting via NHS Media they said “It’s simply not true that intensive care beds are full”.  So where do they get their information from?

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Is ICM Training Fit for Purpose?

Montgomery Hugh Prof 75

Professor Hugh Montgomery considers the evolution of the patients and diseases we manage and worries that training may be too slow to adapt to change.

Some 252 million years ago, the Permian Mass Extinction saw the loss of the 96% of marine life and 70% of terrestrial vertebrate species due to a failure to adapt to their changing environment.

Arguably, the great polio epidemic of 1952 first led to the concept of ‘ICU’, the goal being to deliver life-saving mechanical ventilation. The requirement then was for staff who understood this domain, and that meant anaesthetists.

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Winter Pressures


Dr Gary Masterson, President of the Society, reflects on the current winter pressures facing those working and being treated in intensive care and high dependency units.

I’ve just completed a week covering my ITU and I suspect that many of you have or are currently experiencing the same sort of chaos I have just endured. There’s no doubt that this winter is intensely busy for us and the NHS in general. Many hospitals are log jammed with sick patients from the front door (ED), through the wards, including critical care, to our discharge lounges. This makes it difficult for all the nurses, AHPs, consultants and trainees working on our units.

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