The Virgin brand is well recognised and seems to be generally associated with good customer service. Will this drive up the level of service at your local health centre? Will doctors want to work for the company?

On the other hand the British Medical Association has just started a campaign against the commercialisation of the NHS. They would prefer that NHS services were not provided by private companies.

There's one outcome we can safely predict: As we head towards a general election the debate will get louder.

In order to make clear the distinction between suicide and murder or manslaughter the DPP gives the following example:

"If a victim attempts to commit suicide but succeeds only in making him or herself unconscious, a person commits murder or manslaughter if he or she then does an act that causes the death of the victim, even if he or she believes that he or she is simply carrying out the victim's express wish."

The BBC has been accused of bias in the way the subject has been covered. Should we just be celebrating the fact so much open debate is being generated? Or has the BBC a case to answer?

He suggests allowing doctors to legally kill people would lead to a loss of trust in the caring professions. Improvements in palliative care are his preferred way forward.

When people had discussed where they would like to die, and it had been properly recorded, they were more likely to die where they had specified. Recommendations of good practice are highlighted in End of Life Care in Primary Care - a national snapshot from Omega. 

"What would you do if it was your child?"  is a question often put to health professionals. In this case the GP posed it to his colleagues and friends. If the child was otherwise healthy, the result was evenly divided. Some help possibly, but hardly a resounding recommendation. Is it any wonder there has been a low uptake of the vaccination if the professionals are not convinced of the benefit?

Todays post is entitled 'A bad case of nerves'. Warm, interesting and well-written, it evokes the humanity of medicine.

I look forward to hearing all that he has to say for he is always eloquent and interesting. However, could the resulting diversion of monies from NHS services to lawyers' pockets ever be justified? If this could go before NICE (which it can't) I doubt it would get off the starting blocks. One figure that is often overlooked is that only @130 people have travelled to Dignitas in Switzerland in 10 years.

There is usually no right of reply on the televised lecture. We shall have to watch the subsequent debate played out over the following days.

However, in their analyses, there was an exception: If you are female, aged over sixty and with an above average IQ (IQ>100).  Now, I'm not there yet and haven't ever done an IQ test but I feel those researchers better get a move on. I'm not convinced blonde highlights offer a sufficiently protective effect.

You can read the full article courtesy of the BMJ.

I'm still looking out of the window at a snowy scene. Obviously, much work has been done since I wrote that on the last entry ! No view stays the same though and you are going to see some changes to the website too.

We have been listening to your feedback and plan improvements. Let us know what you would find helpful or even possibly dislike by emailing us now. This is your invitation to influence the new look. Thank you in advance.

Some doctors have felt uneasy about the extent of use of feeding through tubes, especially in patients with dementia or those who are dying. A lack of agreement on best practice lead to this new report from the Royal College of Physicians.

Wishing you all the best Christmas possible. 

Two thirds of the patients benefited from the targeted radiotherapy. A phase 2 trial with more patients is therefore being planned.

The findings are reported from an expert review commissioned by the government. Care Services Minister Phil Hope has announced an action plan to address this issue.

An early and accurate diagnosis of dementia is important because it may mean certain drugs could be beneficial. It also allows the person concerned to understand and plan as appropriate.

Drinking alcohol and smoking are both risk factors for oral cancer. More preventative work could be carried out by dentists such as prescribing nicotine replacement therapy if resources were made available.

Patient appointments are now an average of 11 minutes long. The GPs surveyed by  Pulse said they felt a move to 14 minutes would be desirable.

One aspect that was interesting was that Maria went to the studios as requested but was by herself! Lara was in another studio 30 miles away. To the listener it was seamless though.

Why should the reason someone is in hospital influence whether we send a card? Surely if they are friends or loveds ones, they are in our thoughts and  we wish them well? Let's tell them all that......by card, with flowers, with a visit.

We then moved indoors and they took a number of silent images. It was only then we learned that much of the outdoors talk would be put over these pictures: The editing and end result are in their hands now. Our fingers are crossed !

Is this targeted marketing or the acknowledgement of a universal truth ? No man ever had a mere cold nor suffered quietly.

The guidelines do not and cannot decriminalise assisted suicide. The DPP also states quite clearly that euthanasia remains murder or manslaughter.

The guidelines are actually in the form of interim policy whilst a public consultation is undertaken. Details on how to participate in the consultation exercise can be found on the Crown Prosecution Service website.

The research is published in Nature Neuroscience.  The Cambridge News gives a more simple summary.

There are concerns that some practices may be left with an imbalance of older more unwell patients. Younger healthier people may choose to register with a surgery nearer to their place of work. However, allowing people a choice may lead to an improvement in standards as Practices seek to retain and attract patients.

These national awards recognise the brightest and best in health information and communications technology. We are up for Best Use of IT in Patient and Citizen Involvement in Healthcare. I would love to tell you more about our holiday but there's a powerpoint presentation to be made beautiful for those judges.

Meanwhile in an effort to reduce incidences of diarrhoea/ flu etc the NHS is running a Give Soap a Chance campaign.

The National Institute of Clinical Excellence, which approves new drugs and treatments, does not want to lead on a programme of disinvestment. Although it is planning more work reviewing money-saving technologies and  diagnostics, according to its chief executive Andrew Dillon. HSJ

My husband raised one question to which we have yet to find the answer. At what age do the comments move from 'that's no age at all' to ' he had a good innings'?

Partly this is a result of birth rates post the second world war. Also, improved health care means people are living longer. Reuters

The Care Not Killing Alliance (made up of a number of interested groups) viewed the amendment as likely to result in people being persuaded to go to suicide clinics against their will. The amendment to the law was proposed by Lord Falconer and he was supported by Dignity in Dying (formerly known as the Voluntary Euthanasia Society).

To read the speeches made in the House of Lords go to Hansard and scroll down to Encouraging or Assisting Suicide.

Good luck if you are running in one of the races to come. I'm told a bag of frozen peas helps hugely the next day !

Do older adults know their spouses' end of life treatment preferences? S Moorman et al, Research on Aging vol31 (4) 463-491

The research by Dr AC Phelps and others is published in the Journal of the American Medical Association 2009 301 pp1140-1147.

The article in People Management makes reference to the recession but does not clarify what is behind this figure. Is it need for money? Wanting to appear indispensable?

At least more people still buy additional holiday time than sell it back. Holidays are good for your health. Holidays without work intrusions even better ! 

Funnily enough I can't say it was for one of our target terms but it's a big stepping stone in the right direction. I guess not many can claim to be 1st of 129,000,000 !!!

I firmly believe holidays should be protected from work intrusions. However, I have to confess to being thrilled to receive a number of messages saying we were a quarter page article in the local press. The laptop will still be staying at home next time though.

The 90+ Study is a long-term study and over 14,000 people over the age of 65 have participated. The New York Times reports more details.

People were impressed that it recognised a tongue twister and also recognised and continued a Bob Dylan lyric. In answer to the question "answer to life, the universe and everything" it returns "42 according to the Hitchhiker's guide to the universe". The technical clever bits extend to complex mathematical queries, science and finance. I can see it may be a quick source of data eg with one query you can compare mortality in different countries. We just need to see if the information is consistently high quality.

by the way, if you want to follow us on twitter find @respectourwish.

As a user of this site, you can learn more about why it should give you reassurance by clicking here

Here at Respect Our Wishes we are geared towards working with adults because advance decisions under the Mental Capacity Act are for those aged 18 or over. My eyes were opened talking to Alison from the Childhood Bereavement Network. They have carried out research recently on the effect of bereavement on children in custody. If you would like to learn about their services visit http://www.childhoodbereavementnetwork.org.uk/

KCFM have certainly been a pleasure to work with. There was initially a small factual error but a quick email and it was corrected by the second bulletin. Most impressive.

So, if other events over the weekend are not more exciting, you should be able to hear some snippets on what we are up to in the early morning news bulletins on Monday.

To learn more about how the figures are calculated and see the results on the NHS Choices website click here

Later in the week social networking and new media was fascinating. The one statistic that has stayed with me is that more people in the USA now earn income from blogging than are employed as firemen.

Researchers are extremely short of brains to examine the causes of Parkinson's and work towards a cure. They would like people to donate whether they have Parkinson's disease or not.

Further information may be found on their website:  www.parkinsons.org.uk/research/parkinsons_brain_bank.aspx

The boys will be wearing football kit. They're excited because the route not only goes around but into the KC Stadium - home of Hull City AFC (and Hull FC). I think they hope if I go there for this I'll suddenly be converted into a soccer fan.

Lady Christine Eames, Chair of the working group responsible for drafting the guidance said: “Good end of life care helps patients to live as well as possible until they die and to die with dignity."

Full information may be found at

www.gmc-uk.org/end_of_life_care/index.asp

The charity concerned is Dove House Hospice and we also supported them by attending a dinner at the end of last year. This time it's burning off the calories. I'll let you know which I think is the more fun !

This one paragraph, taken from the Healthcare Commission website, just makes me want to weep. Most people who have worked in the NHS will have come up against budget pressures, lack of equipment etc but they still try to do their best. Compassion and empathy are what we would all hope for as patients feeling vulnerable. They are core to a caring professionalism, cost nothing yet they were lacking here. 

The investigation into the hospital trust was triggered by two things. Higher than average death rates and complaints from local people. This brings me back to my thoughts on Comic Relief . Patients commenting on their experiences can lead to better services and there is most definitely still room for improvement.

The research took the form of interviews with patients, carers, doctors and nurse in the USA. The patients all had cancer or chronic obstructive pulmonary disease and faced the possibility of dying within 12 months.

The research was carried out by Dr Back and colleagues in Seattle, USA. The full article can be read in the Archives of Internal Medicine vol 169 no. 5, 9th March 2009.

Would I recommend Yorvale ? Most definately !

I confess that the use of  'AD' to refer to the advance directive jarred a little. However, as I've said elsewhere, jargon is widespread in the NHS so I guess it added to the realism.

The three main points that have stayed with me are;

1. It was an interesting session not only for the content but also for the diverse range of people. The only common link was our shared IT partners. So, there was no-one else present from the health care sector. This proved a useful reminder on the perils of the use of jargon, whether it be NHS jargon or IT jargon.
2. From the main presentation, the key phrase for me was "actionable intelligence". Data is the raw material which becomes meaningful as information. From the reams of information we all receive these days we need to distill the "actionable intelligence".
3. The wintery weather once again showed that those who live furthest from their work destination often arrive before those who live nearby.

Did the seminar merit my drive through the snow? On balance, I think it did.

I'm pleased to say the Christmas spirit of generosity to others beat fears of the credit crunch hands down. Bidding on a 'dinner for ten', kindly donated by the landlord, became quite competitive though ! Well done to those who organised the evening and made it a great success.

Dove House Hospice is in Yorkshire and provides palliative care to those with cancer, motor neurone disease, HIV / AIDS and other life-limiting illnesses.

How did we decide upon our logo? The idea of the dog came from Maria. We both have dogs and she also keeps horses, sheep, geese and chickens. We wanted a logo that would be meaningful to our clients and make us smile. No random swirls thank you. The dog logo is a retriever which we felt was symbolic not just of retrieving documents but also loyalty.

The trademark application process has definitely been a learning curve. We can highly recommend the free patent and trademark searching service at Leeds central library.

There are two factors which probably triggered the idea in that instant: Firstly, I was driving past Castle Hill Hospital at the time and who can drive past a hospital without pausing to think about those who are unwell and their families? Secondly, I had recently read 'No! I don’t want to join a bookclub' by Virginia Ironside. In that novel, the diarist admits to having copies of her living will in many places in the hope it will be remembered. That fear, of not having your wishes followed, struck a chord and must have set me off in problem-solving mode.

Whilst we are obviously a business founded on modern technology, I find I still cannot rush to embrace all that is available. The business centre has invested in equipment in the conference room so that we can hold teleconferences with the wider world. The screen is huge! I confess I did not volunteer us to be one of the first users. What is it about seeing yourself on a screen that is so unsettling?

For those that don’t know, Market Weighton is an historic town on the edge of the Yorkshire Wolds. In the Domesday Book of 1086 the entire town and surrounding area was valued at £30!

We are hoping to grow as quickly as some of the other companies who are based in the business centre. Who knows what top tips will be shared as we pass in the corridors?