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Douglas Noble

Douglas Noble: US healthcare and the Harkness fellowship

4 Dec, 12 | by BMJ

Having decided to write a blog during this academic year living in the US, I hadn’t anticipated my tardiness would be because moving the family overseas was vastly more effort than I anticipated. A stroke in a family member at home came suddenly and unexpectedly, and a hurricane hit the city I’m currently calling home. The after effect of Sandy still continues to disrupt normal life for many. These events, combined with an unpredictable, and at times ugly, presidential election has made the start of the Harkness fellowship rather fascinating, if at times nerve wracking.

My interest in the Harkness fellowship in healthcare policy and practice originated some years ago whilst I was working at the Department of Health, and taking part in discussions comparing UK and US healthcare. I’ve now found, though, that actually being here, immersed in the system, has given me a fresh understanding of just how complex healthcare is across the Atlantic, something that was harder to appreciate from within the Ivory Towers. For all the learning to be had from best practice, like integrated care arrangements, there are many other warnings of paths better not trod. more…

Do we now need a public health media centre?

18 Jun, 12 | by BMJ Group

The effectiveness of the public health workforce hinges on its ability to effectively communicate its key messages to the public. As the Department of Health undertakes yet another consultation on public health the question is: do we now need a public health media centre? more…

Douglas Noble and Dianna Smith on historical health inequalities

1 Mar, 12 | by BMJ Group

This month we published a report on risk of type two diabetes in East London, with an accompanying paper in BMJ Open, and underpinned by a previous systematic review in BMJ. We took a risk scoring algorithm, the QDScore, and used it on just over half a million electronic records to identify high risk groups. QDScore is validated based on certain risk factors. For example, deprivation, body mass index, and certain ethnicities result in a higher score.   more…

Douglas Noble on the Falconer report

5 Jan, 12 | by BMJ Group

Last year I blogged about the commission set up by Lord Falconer on assisted suicide.  It was clear from the outset that this commission was fatally flawed, not least because of the pro-assisted suicide stance of almost every member of the committee. 

Unsurprisingly the collection of evidence and hearings was unlikely to have a major impact given its biased beginnings. Most notably the British Medical Association refused to give evidence, and at the annual representative meeting in Cardiff in 2011, the association spoke clearly against the commission. more…

Douglas Noble and Felix Greaves: stealth attack on public health

19 Dec, 11 | by BMJ Group

Last month we drew attention to three critical pieces of data that painted a picture of the piece by piece dismantling of the public health specialist workforce. Consultant appointment processes have dropped considerably in the last three years, registrars at end of training are failing to get substantive full time consultant posts, and academic public health seems to be declining. 

What’s really behind this is not clear, but findings in an important paper in this month’s Journal of Public Health continue to show this is a real stealth attack on the public health specialist workforce, and not just disparate pieces of unconnected information. Harrell and colleagues present a scholarly piece of research directly comparing recruitment in public health to that of hospital consultants.  more…

Douglas Noble on Lifebox

13 Dec, 11 | by BMJ Group

It’s great to see patient safety getting such a prominent focus on bmj.com this Christmas with support for the charity Lifebox. Lifebox’s first aim is trying to ensure a pulse oximeter gets into every operating theatre across the world. I hope we’ll all manage to give generously http://www.bmj.com/multimedia/video/2011/12/02/lifebox-appeal-atul-gawande

The desire for safer surgery has gathered momentum in recent years, especially with the interest shown by the World Health Organization’s Patient Safety Programme. I had the privilege in mid-2006 when working with WHO of meeting with Atul Gawande’s two wingmen in a quiet corner of L-Building at WHO headquarters in Geneva. They outlined an impressive vision for a surgical checklist and within months international consensus building was underway. I always thought this drive for patient safety in surgery would go a long way, but never quite imagined just how far in only five years. Once the American drama Emergency Room had featured it in one of their episodes success seemed certain.  more…

Douglas Noble on vaccinating doctors

10 Oct, 11 | by BMJ Group

douglas nobleAs I lay in Regents Park on Saturday 1 October showing my one year old daughter the falling autumnal leaves and conkers it hardly felt like winter was approaching. Not least because it was thirty degrees Celsius, and there was more ice cream on sale than climate change proponents could swallow. Yet, winter is on the way and unofficial reports suggest it may be as cold as last year.  more…

Douglas Noble on the riots

18 Aug, 11 | by BMJ Group

douglas nobleThe recent riots in London and across the UK have been an awakening for many to realise the deep seated social problems in post modern British society.  The right look for thugs to be prosecuted, while the left demand further description and analysis of the complex “causes of the causes.” Both approaches are polarised and neither is satisfactory.  more…

Douglas Noble on reforming the reforms

21 Jun, 11 | by BMJ Group

douglas nobleThe pause ended in dramatic fashion last week with the publication of the NHS Future Forum’s recommendations

Most interesting was the orthopaedic surgeon at Guys Hospital who confronted the prime minster and deputy prime minister in a rage because the camera crew were not suitably dressed for a hospital. 

It hit home on all sorts of levels.  more…

Douglas Noble on the BMJ Group Awards 2011

23 May, 11 | by BMJ Group

douglas nobleThe 3rd BMJ Group Awards took place on 18th May. All the great and good in healthcare, national and international, assembled for 13 awards, including the prestigious lifetime achievement award. As the medical bigwigs entered the palatial Hilton Metropole Ballroom in triumphal procession, they were greeted with flashing multicoloured lights, rock music, and a definite sense of occasion. Stella Dutton CEO of BMJ Group appropriately dubbed the ceremony as the “medical oscars” in her opening remarks.  more…

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