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What, if anything, does the EuroHealth Consumer Index actually tell us?

9 Feb, 16 | by BMJ

Since 2005, the Health Consumer Powerhouse has produced its annual EuroHealth Consumer Index, ranking European health systems according to their performance on a host of indicators around (i) patient rights and information, (ii) accessibility, (iii) outcomes, (iv) range and reach of services, (v) prevention and (vi) pharmaceuticals. In its most recent iteration, the United Kingdom ranked only 14th of 35 countries studied. This is in stark contrast to the assessment by the Commonwealth Fund just a year before, in which the UK was rated as the best performing health system among a set of high-income countries in 2014. more…

Aeesha NJ Malik: Improving children’s eye health in Pakistan

2 Feb, 16 | by BMJ

aeesha_malik1.5 million children in Pakistan are blind. Many from eye diseases which are preventable and treatable. Often children don’t know they have a vision problem because they assume they see the way everyone around them sees. However childhood visual impairment or blindness has a huge impact—its effects last a lifetime and affect not just the individual, but their family and society. more…

Tim Lobstein: Community interventions for healthy bodyweight—can we make them work?

2 Feb, 16 | by BMJ

tim_lobsteinGroups like mine which advocate for market interventions to restrict advertising, raise taxes, control fast food outlets and the like, are having a tough time making progress. Governments prefer to change health behaviour at the individual level through education, through subtle nudges and social marketing campaigns, and, especially, by devolving responsibility to local, community-level interventions.

There is no denying that community interventions have potential: the Ottawa Charter for health promotion clearly recognised community empowerment as the key to better community health. Community interventions provide valuable opportunities, especially if we take care not to widen health inequities by failing to reach those who need them most, and not to increase victim-blaming or a sense of failure among participants who fail to lose weight, or a sense of failed community cohesion if a project suffers high drop-out. more…

Jeanelle de Gruchy: Should David Bowie have spoken out about the cause of his cancer?

28 Jan, 16 | by BMJ

jeanelledegruchy2David Bowie has died. From cancer. So much outpouring of grief. And yes I participated, posting #RIPBowie tweets and reminiscing about seeing him in concert in Montreal as an 18 year old with all who would listen, shedding a tear listening to the day long radio tributes as I felt my youth slipping away with his passing. And yet everything I watched, on TV, on YouTube, on Facebook and in the many pictures, there it was, revelling in its strong silent presence and mocking us for our complicity, the killer that took him away from us aged only 69. The swell of adulation for one of the greatest musicians, pop stars, cultural icons, and boundary pushers was wonderful; the lack of comment on what killed him prematurely was pitifully duplicitous. more…

Paul Sooby: The last of an endangered species? The view of a LAT trainee

27 Jan, 16 | by BMJ

paul_soobyIn January 2016 NHS employers withdrew locum appointed for training (LAT) posts in England. The numbers of doctors undertaking LATs has fallen since 2014 and there were vacant posts last year. There are concerns that doctors staying in LATs year after year gain pay progression without career progression, and that direct observation and educational supervision can be harder to review.

So, the solution to these potential problems was simple—scrap the whole programme.

My confession, I did not get my specialty training number (NTN) at first attempt. This was not because I didn’t prepare enough for the interview, or didn’t have enough clinical exposure, or wasn’t engaged in enough academic activity to enhance my CV. It was because on the day, on what should be considered an exam rather than a job interview, I didn’t score as highly as my peers in one station. I ranked six places below the cut-off for a NTN. I can’t begin to tell you how demoralising that was, and how hard it was to realise that all the work, preparation, and courses had been in vain. more…

Elizabeth Wortley: Please refrain from using that kind of language

26 Jan, 16 | by BMJ

We talk a lot about communication in medicine and try to teach the right skills to students, such as the importance of body language and simplifying medical terminology. But how often do we look at non-medical language and the effect it has?

Suzanne Gordon’s BMJ blog “Medicine’s F word—Fail” in early December reminded me to do better with our population of somataform/psychological/recurrent disorders (what is the correct term?) whilst also battling my fear of them. In paediatrics we don’t often talk of our patients “failing,” but we do have our own language problems. As a registrar, I’ve had multiple approaches to the recurrent patient “problem” explained and demonstrated, and perfectly nice people (myself included) find themselves ranting behind closed doors, only to then attempt their best “comms skills scenario” face in the clinic room. I can’t say I believe this is a successful tactic, and the only times I’ve seen it done well are by the small and select group who understand the impact their baseline attitudes have towards these encounters. more…

John Fabre: The absence of a national leadership structure within the NHS

26 Jan, 16 | by BMJ

2015_0922_1725_Neil&EllaBarclay&John&ClarissaFabre_JW_DSC_8336The strike by junior doctors illustrates a fundamental fact about the National Health Service: the de facto chief executive is the minister for health, and there are no advisory or decision making bodies between him and doctors and nurses at the coal face. While there was a broad consensus for the principles underlying the NHS, this was not a serious problem. Over the past 20 or 30 years it has been the root cause of the initially slow and now accelerating demise of the NHS. more…

Sadie Boniface and Sally Marlow: Mother’s ruin? New guidelines for alcohol consumption during pregnancy

25 Jan, 16 | by BMJ

sally_marlowsadie_bonifaceThe Chief Medical Officer’s proposed new drinking guidelines were announced on the 8th January. These included specific advice about drinking during pregnancy, to which we could not do justice in our previous post about drinking guidelines. The new guideline says “if you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep the risks to your baby to a minimum.” This is out for public consultation, with the rest of the proposed guidelines (closing date 1st April). more…

Steve Ruffenach: Tech, my new medical assistant

21 Jan, 16 | by BMJ

steve_ruffenachI have a new medical assistant (MA) and I’m trying to learn how to get along with him.

My new MA is named Tech and I bet you have one too. I see him with nearly everyone in clinics and it seems no one can do their rounds without him in the hospital. Everybody, every day, always brings along their new constant companion and quiet confidant.

And why not? I tell Tech things and he in turn tells me things back. He is always with me ensuring I am right on schedule. He sends and collects memos for me. I can ask him medical questions and he quickly delivers answers. He entertains me too with stories and songs, and he knows directions to anywhere I want to go. more…

Richard White et al: Efficiency savings in wound care must not compromise patient care

19 Jan, 16 | by BMJ

richard_whiteThe Department of Health together with the NHS Supply Chain are trying to push through Generic Specifications (known as the Carter Report) where the specification criteria can be applied so that products, including dressings, will be able to be used in 80% of circumstances and where the output is “good enough” and “fit for purpose.” In addition, there is the intention to develop a National Formulary that will replace local formularies. We believe these recently announced initiatives to be ill-considered from the outset and that they will neither reduce costs, nor maintain, yet alone improve, the current levels of patient care. more…

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