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Nicola Bedlington: Patient involvement in medical devices—an opportunity we may be missing

2 Jul, 15 | by BMJ

nicola_bedlingtonPatient involvement in health and social care is a fundamental right, and an operating principle of European healthcare systems. In the area of medicines patients are recognised as experts and are participating in many aspects of access, innovation, safety, and transparency, thanks, not least, to the commitment to patient involvement of the European Medicines Agency. However, in the area of medical devices a change of mind-set is needed. more…

Marika Davies: Standing up to disrespectful doctors

2 Jul, 15 | by BMJ

marika_daviesMedia reports that chip away at the confidence the public has in doctors occur regrettably often. A recent case in Virginia, USA, in which a patient recorded offensive comments made about him by the medical team during a colonoscopy, will make depressing reading for all those who work hard to earn and maintain the trust of patients. more…

Michael Soljak: Data access for research—Kafka writes again

29 Jun, 15 | by BMJ

Data are the lifeblood of health research, and the UK government is claiming that data collected in the course of NHS clinical care are available to reputable researchers for the purposes of improving health and healthcare. However, the reality is rather different, and it is becoming increasingly difficult to obtain research data.

Anonymised patient level Hospital Episode Statistics (HES) data on inpatient admissions have been available for research and other secondary uses for many years, and their use has led to major improvements in quality, from identifying higher mortality at weekends to sounding the alarm about institutional failures such as those at Mid Staffordshire Foundation Trust. This was achieved with reasonable information security standards and a proportionate approach to the risks and benefits by the Information Centre for Health and Social Care, as it was called then. more…

Martin Marshall: The travesty of the 10 minute consultation

29 Jun, 15 | by BMJ

martin_marshall“Perfunctory work by perfunctory men.” That’s how an eminent physician once described general practice. “A ridiculous claim” cried GPs, rising to the defence of their discipline, “specialists just don’t understand the nature of general practice. They don’t value our ability to make quick decisions based on a deep understanding of our patients and their context, our exceptional skill at managing risk and uncertainty, of using serial consultations to optimise the effectiveness of our diagnostic and therapeutic interventions.” more…

Barbara Harpham: CCGs are not adopting new technologies quickly enough

26 Jun, 15 | by BMJ

barbara_harphamIn December 2011, the NHS identified six ways technology could help patients and, ultimately, save money. A freedom of information request was sent to 211 clinical commissioning groups (CCGs) across England in October 2014 looking for a progress update; 189 (90%) responded.

How did they do? Well, it’s a mixed bag, with CCGs naturally opting to cherry-pick where to focus their efforts. But overall the picture is not healthy. more…

Richard Graham: Is it time to unplug?

26 Jun, 15 | by BMJ


As we approach the first UK National Unplugging Day, one might well ask why there is a need to have a day promoting gadget free time for families. After all, we can switch off our smartphones and tablets any day or at any time, and thus feel reassuringly conscious of and in command of our use of them. Or can we?

Our use of digital devices is now extensive, with Ofcom’s recent “Adults’ media use and attitudes report” indicating that online time for most adults has doubled over the last decade. For young adults, communication and accessing media (predominantly videos now) will take up more than nine hours of each day. For medical practitioners, is this just an issue of lifestyle and choice, or are there consequences of using devices, if only through the disruption of sleep, that we should attend to? Should we consider this use high, problematic, or even a sign of “addiction?” more…

Michelle Webb on the need to improve sepsis recognition and treatment

25 Jun, 15 | by BMJ

Over 100,000 people a year have an episode of sepsis at a cost of around 35,000 lives, more than bowel and breast cancer combined. Sepsis is the third highest cause of death in hospitals and one of the commonest causes of death in pregnancy.

As a result of advances in medicine we are living longer. However, the medicines that we are using more and more to treat cancer, arthritis, and to allow us to perform transplants are also reducing our patients’ ability to fight infection—thereby increasing the risk of sepsis. Over the past 10 years the incidence of sepsis has increased by 8-13%. more…

Iris van der Heide: We need policies to target integrated care for people with multimorbidities in Europe

25 Jun, 15 | by BMJ

PrintThe ICARE4EU project wants to improve the care of people suffering from multiple chronic conditions. It will describe, analyze, and identify innovative integrated care programmes for people with multimorbidity in 31 European countries, and aims to contribute to more effective implementation of such programmes. During the project (from 2013 to mid 2016), members of the ICARE4EU consortium will keep readers of The BMJ informed about project developments.


Natika H Halil on providing emergency contraception to under 16s

24 Jun, 15 | by BMJ

natika_hallRecently the UK’s press went into overdrive reporting on the recent change in emergency contraceptive pill ellaOne’s product licence—now available to buy over the counter for women of “all reproductive ages,” and therefore including under 16s.

Of course levonorgestrel was already available to under 16s in pharmacies in many areas through patient group directions. In these instances, it has been given outside of product licences, but in line with all guidelines relating to contraception and young people, and with pharmacists working within Gillick competency and Fraser guidelines. more…

Anne Gulland: Mental health problems—a gender divide

19 Jun, 15 | by BMJ

Anne_GullandFeckless, hysterical, neurotic, sluttish: these are just some of the adjectives used to describe female patients suffering from psychological illness in the book Good General Practice, an investigation into general practice published in the mid 1950s. [1] The author was Stephen Taylor, an eminent GP and civil servant whose views were typical of an age when it was still thought that women were biologically more prone to mental ill health than men. more…

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