Currently, the Yahoo group will only allow us to post up to 20MB of
files, which is fine for meeting adverts but not good for
presentations with a lot of files.

I have therefore created a gmail account:

paed.surgery@...

password: pyloromyotomy

The intention is to email presentations to this account (it has over
2GB storage space, max file size is 10MB): we could have every
presentation at every trainee meeting over a several year period.

I have posted my trainee report as an example.

Presentations bigger than 10MB will have to be broken into smaller
parts.

Note that this comes with several caveats and warnings

1. THIS EMAIL ACCOUNT MUST NOT BE USED FOR EMAIL! PEOPLE SHOULD
ONLY SEND TO THE ACCOUNT AND USE IT AS A FILE STORE
2. ANYONE USING THE ACCOUNT FOR SPAM/PERSONAL USE/PORN etc WILL BE
REMOVED FROM THE YAHOO GROUP AND IF NECESSARY REPORTED TO PROGRAMME
DIRECTOR/RELEVANT AUTHORITIES.
3. IT IS THE RESPONSIBILITY OF THE POSTER TO ENSURE NECESSARY
CONSENTS HAVE BEEN OBTAINED FOR PHOTOGRAPHS AND PICTURES.
GUIDELINES HAVE BEEN PUBLISHED BY THE GMC AND ARE GIVEN AT THE
BOTTOM OF THIS POST. PART 2 OF THE GUIDANCE BELOW IS VERY USEFUL
REGARDING X-RAYS AND SIMILAR IMAGES.

If you have any presentations of your own, feel free to share them!

As usual, please let me know your comments and thoughts.


GMC GUIDANCE ON USE OF AUDIOVISUAL MATERIAL:

Scope of this guidance
This guidance covers all types of audio and visual recordings of
patients, carried out for any purpose. 'Recording' in this guidance
means originals or copies of video and audio recordings, photographs
and other visual images of patients. A 'recording' does not include
pathology slides containing human tissue (as opposed to an image of
such a slide), or CCTV recordings of public areas in hospitals and
surgeries, which are the subject of separate guidance from the
Information Commissioner 1

The guidance sets out some basic principles in part 1 and then
reviews the following topics:

When permission is not required to make and use a recording (part
2).
Obtaining permission to make and consent to use recordings as part
of the assessment or treatment of patients (part 3A).
Obtaining permission to make and consent to use recordings for use
within a medical setting, for example for training or research,
including the use of existing collections (part 3B).
Specific issues about recordings made for public consumption, such
as filming for television (Part 3C)
Part 1: Basic principles
1. When making recordings you must take particular care to
respect patients' autonomy and privacy since individuals may be
identifiable, to those who know them, from minor details that you
may overlook. The following general principles apply to most
recordings although there are some exceptions, which are explained
later in this guidance.

Seek permission to make the recording and get consent for any use or
disclosure.
Give patients adequate information about the purpose of the
recording when seeking their permission.
Ensure that patients are under no pressure to give their permission
for the recording to be made.
Stop the recording if the patient asks you to, or if it is having an
adverse effect on the consultation or treatment.
Do not participate in any recording made against a patient's wishes.
Ensure that the recording does not compromise patients' privacy and
dignity.
Do not use recordings for purposes outside the scope of the original
consent for use, without obtaining further consent.
Make appropriate secure arrangements for storage of recordings.
2. Where children who lack the understanding to give their
permission are to be recorded, you must get to record from a parent
or guardian. Children under 16 who have the capacity and
understanding to give permission for a recording may do so. You
should make a note of the factors taken into account in assessing
the child's capacity.

3. When a mental disability or mental or physical illness prevents
patients giving their permission, you must get agreement to
recording from a close relative or carer. In Scotland, you must seek
agreement from any person, appointed under the Adults with
Incapacity (Scotland) Act 2000, having an interest in the welfare of
the patient.

4. People agreeing to recordings on behalf of others must be given
the same rights and information as patients acting on their own
behalf.

Part 2: Recordings for which permission is not required
5. You do not need to seek separate permission to make the
recordings listed below. Nor do you need consent to use them for any
purpose, provided that, before use, the recordings are effectively
anonymised by the removal of any identifying marks (writing in the
margins of an x-ray, for example):

Images taken from pathology slides
X-rays
Laparoscopic images
Images of internal organs
Ultrasound images
6. Such recordings are unlikely to raise issues about autonomy and
will not identify the patient. It may nonetheless be appropriate to
explain to the patient, as part of the process of obtaining consent
to the treatment or assessment procedure, that a recording will be
made.

Part 3: Recordings for which permission is required
3A. Recordings made as part of the assessment or treatment of
patients
7. You must seek permission to make any recording for the assessment
or treatment of patients, other than those recordings listed in Part
2 above. You should explain that a recording will be made, and why.
You need only give an oral explanation. You should record in the
medical notes that the patient has given permission.

8. When conducting a hospital post-mortem examination, you must seek
permission from a close relative or carer before making any
recording from which the deceased may be identifiable. If the death
is the subject of a medico-legal investigation, the proposed
recording should be discussed with the coroner or Procurator Fiscal
(in Scotland) who has authorised the investigation.

9. Recordings made for clinical purposes form part of the medical
record. As such, when considering disclosure of a recording, you
should treat the recording in the same way as any other part of the
medical record. In general, that means that you should seek consent
for the disclosure. However, if you are sure that the patient will
not be identifiable from the content of the recording, and the
recording is effectively anonymised by the removal of identifying
marks, you may use the recording for teaching purposes without
consent.

10. When making a judgement about whether the patient may be
identifiable, you should bear in mind that apparently insignificant
features may still be capable of identifying the patient to others.
Since it is difficult to be absolutely certain that a patient will
not be identifiable from a recording, no recording other than those
mentioned in paragraph 5 above should be published or used in any
form to which the public may have access, without the consent of the
patient. The GMC booklet Confidentiality: Protecting and Providing
Information sets out detailed guidance on disclosure of personal
information.

11. In exceptional circumstances, you may judge that it is in the
patient's best interests to make an identifiable recording of a
patient without first seeking permission, and to disclose the
recording to others without their knowledge. Before proceeding you
should discuss the recording with an experienced colleague. You must
be prepared to justify your decision to the patient and, if
necessary, to others. If the recording will involve covert video
surveillance of a patient, it is likely to be within the scope of
the Regulation of Investigatory Powers Act 2000 and you should seek
advice before proceeding. A decision to use covert video
surveillance, for example in cases of suspected induced illness in
children, will normally be based on discussions amongst all the
agencies involved, and the surveillance itself should be undertaken
by the police

3B. Recordings made for the training or assessment of doctors,
audit, research or medico-legal reasons

12. You must obtain permission to make and consent to use any
recording made for reasons other than the patient's treatment or
assessment. The only exceptions to this are outlined Part 2.

13. Before the recording, you must ensure that patients:

Understand the purpose of the recording, who will be allowed to see
it - including names if they are known - the circumstances in which
it will be shown, whether copies will be made, the arrangements for
storage and how long the recording will be kept.
Understand that withholding permission for the recording to be made,
or withdrawing permission during the recording, will not affect the
quality of care they receive.
Are given time to read explanatory material and to consider the
implications of giving their written permission. Forms and
explanatory material should not imply that permission is expected.
They should be written in language that is easily understood. If
necessary, translations should be provided.
14. After the recording, you must ensure that:

Patients are asked if they want to vary or withdraw their consent to
the use of the recording.
Recordings are used only for the purpose for which patients have
given consent.
Patients are given the chance, if they wish, to see the recording in
the form in which it will be shown.
Recordings are given the same level of protection as medical records
against improper disclosure.
If a patient withdraws or fails to confirm consent for the use of
the recording, the recording is not used and is erased as soon as
possible
Existing collections used for teaching purposes
15. Some doctors may have existing collections of recordings which
they use solely for teaching purposes within a medical setting. Both
this guidance, and the previous edition published in 1997, require
permission to be obtained to make any recording which is not part of
the patient's assessment or treatment, regardless of whether the
patient may be identifiable. However, recordings may have been made
for teaching purposes prior to 1997 without it being recorded
whether or not permission had been obtained. Such collections may
have a significant value for teaching purposes.

16. You may continue to use recordings from which the patient is not
identifiable, and which were made for teaching purposes prior to
1997. You should, however, seek to replace such recordings at the
earliest opportunity with similar recordings for which permission
can be shown to have been obtained. You may also continue to use
effectively anonymised recordings that were originally made for
treatment or assessment purposes, in line with paragraph 9 above.
However, you should not use any recording, from which a patient may
be identifiable, for teaching purposes if you cannot demonstrate
that consent has been obtained for that use.

Recordings of emergency treatment and of unconscious patients
17. If recordings are to be used only for training or clinical
audit, you may record patients who need emergency treatment but
cannot give their permission for the recording to be made. You do
not need a relative's agreement before starting the recording but
must stop it if a relative objects. Before these recordings are
used, however, the patient's consent must be obtained or, if the
patient has died, a relative must agree to it.

18. When no recording has been planned, but a record of an
unexpected development would make a valuable educational tool, you
may record patients undergoing treatment. If you cannot get
permission at the time because, for example, the patient is
anaesthetised, you must ensure the patient is later told about the
recording and gives consent to its use.

19. With recordings made in these circumstances, you must follow
patients' instructions about erasure or storage. The only exception
is if you think you need to disclose the recording because of the
advice in the GMC booklet Confidentiality: Protecting and Providing
Information, for example to protect the patient or others from risk
of death or serious harm.

20. Hospital policy on recording the treatment of unconscious
patients should be adequately publicised, for example through
notices in waiting areas.

Telephone calls
21. Recordings of telephone conversations fall into a category of
their own. Anyone using a telephone is subject to licence conditions
under the Telecommunications Act 1984. They require you to make
every reasonable effort to inform callers that their call may be
recorded, and maintain a record of the means by which callers have
been informed.

22. Given the sensitive nature of calls to medical advice lines or
similar services, you should pay particular attention to ensuring
that callers are aware that their call may be recorded. You must not
make intentionally secret recordings of calls from particular
patients.

3C. Recordings for use in public media (television, radio, internet,
print)
23. In general, the considerations set out in 3B above also apply to
recordings for use in public media. There are, however, some issues
that are specific to recordings to which the public will have access.

24. You must not make recordings for use in publicly accessible
media without written permission, whether or not you consider the
patient to be identifiable. 'Publicly accessible media' includes
medical journals. The only exceptions to this are outlined in Part 2.

25. Before making any arrangements for external individuals or
organisations to film patients in a health care setting, you must
inform your employing or contracting body and the organisation in
which the patients are being treated if this is different. You
should obtain appropriate permission for the recording. Within the
NHS, a contract with the filmmaker will normally be required.

26. If you are involved in any way with recording patients for
television or other public media, you should satisfy yourself that
patients' permission has been properly obtained, even if you are not
responsible for obtaining that permission or do not have control of
the recording process. Both the BBC and the Independent Television
Commission issue guidance for television programme makers that
requires permission to be obtained in a way that is consistent with
this guidance.

27. In addition, you should make sure that patients understand that,
once they have agreed to the recording, they may not be able to
withhold their consent for its subsequent use. If patients wish to
restrict the use of material, they should get agreement in writing
from the owners of the recording, before recording begins.

28. You should be particularly vigilant in recordings of those who
are unable to give permission themselves. You should consider
whether patients' interests and well-being, and in particular their
privacy and dignity, are likely to be compromised by the recording,
and whether sufficient account has been taken of these issues by the
programme makers. If you believe that the recording is unduly
intrusive or damaging to patients' interests, you should raise the
issue with the programme makers. If you remain concerned, you should
do your best to stop the recording, for example by halting a
consultation, and withdraw your co-operation