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Anita Charlesworth: The impact on health of the comprehensive spending review

23 Nov, 15 | by BMJ

anita_charlesworthOn the 25 November the Chancellor of the Exchequer will stand up in Parliament and make a statement that will shape much of the political landscape for the rest of this decade. More substantively these spending review decisions will impact every household in the UK. Given its importance it’s not surprising that, by all accounts, negotiations have been tough. Perhaps more surprising is that health is proving to be one of the most problematic areas of public spending to settle. Health was one of the clear commitments for the new government—the NHS would get the annual increases rising to £8bn over and above inflation in return for delivering £22bn savings based on Simon Steven’s Five Year Forward View. more…

Jane Feinmann: Consumers co-design consumer friendly healthcare

17 Nov, 15 | by BMJ

jane_feinmannI am one of 50 or so attendees on a one day course organised by the Point of Care Foundation learning how patients like myself can work as partners with doctors and nurses to co-design a better healthcare system.

It’s not a new idea. Don Berwick, author of the NHS Patient Safety Review, pointed out ten years ago that “healthcare workers and leaders can often best find the gaps that matter by listening very carefully to the people they serve, patients and families.” While the NHS has so far picked up on the idea of “listening” with initiatives such as the Friends and Family test becoming ubiquitous in GP practices and hospitals, it’s arguable how careful this listening is. more…

John King: Just tick the boxes

12 Nov, 15 | by BMJ

john_king2The atmosphere at the mothers meeting was warm and friendly. All the local mums were looking forward to sharing the latest news and gossip about their children, as they had done for years now. Suddenly the door was flung open and a man in a smart grey suit appeared, with bulging briefcase and an authoritative air.

“Things are going to change” he announced. “It is not enough just to love your children. You have to prove it.” more…

Samir Dawlatly: Do I need to be more mindful?

21 Oct, 15 | by BMJ

In my relatively short career as a GP there has been a surge of interest in talking therapies for mental health problems. It seems that the “one-size-fits-all” population-based research being shoe-horned and imposed onto every patient in the consultation approach is what is needed and required by our paymasters. The current trend of therapy that has been researched and shown to be just as effective as medications in trials that may or may not be representative of my patients is supposed to be offered. Never mind that the waiting list may be [insert random number that sounds big] weeks long. First, cognitive behavioural therapy seemed to be all the rage. Now it appears that mindfulness is popular in both the counsellor’s room and in the mass media. One can even become mindful by colouring in patterns in expensive books, apparently. more…

Amy Godden: Women in surgery

21 Oct, 15 | by BMJ

amy_goddenIn the 13 years since embarking on my medical training I have witnessed unbelievable progress in many different aspects of medicine as a whole, not least, within gender equality.

I am a female general surgical registrar in North West London. I am married to a recently retired professional rugby player. I have no children…yet.

I would like to lay my cards on the table; gender inequality in the operating theatre has been the least of my hurdles. I do not wish to sound flippant or deny that in some spheres it remains a problem. I will be eternally grateful and humbled by my female predecessors that have carved the way for me in a predominantly male profession, enabling me to speak so positively about my experience. more…

Mihail Călin: The impact of the refugee crisis on European health systems

20 Oct, 15 | by BMJ


This year, those participants at the European Health Forum Gastein who were not too busy moving from one session to another, too eager to rub shoulders with top level speakers, or too absorbed in the beautiful landscape, could witness a new reality: refugees had arrived in Bad Hofgastein. There are 55 of them, 25 of which came during the current crisis—most from Syria, some from Afghanistan, Iraq, Libya, and Somalia, Mayor Friedrich Zettinig tells me. Although they can’t work until their status is settled, he says they do receive medical care when needed, can take German language classes, and have appropriate shelter for the coming winter. As far as I could tell from seeing them briefly on the streets of the mountain resort, they seemed relaxed and well cared for. more…

Henry Murphy: The impact of the junior doctor’s protest march

19 Oct, 15 | by BMJ

henry_murphy_nhs_protestI couldn’t sleep yesterday morning. Something was wrong. On Saturday I joined 20 000 people marching in protest at the government’s threats to impose a new contract on all doctors below consultant level. Police in riot vans were parked on Parliament Square, and were met with smiling parents, pushchairs, and a lot of stickers. A helicopter circled overhead, filming the crowd. The chants in union for our union, the BMA, could be heard across London. I was so tired from being on my feet chanting all day, I thought I would have slept like a log, but I woke up on Sunday too early, feeling uneasy and restless. I checked the Junior Doctor’s Contract Facebook campaign group (55 117 members); all was well. I started receiving donations into a crowdfund to thank the organisers of the protest. more…

Neel Sharma: Selection into medical postgraduate training requires a fair and balanced approach

16 Oct, 15 | by BMJ

Prober et al recently voiced their concerns of an over reliance on USMLE step 1 scores in determining residency posts in the States. They highlighted its predominantly scientific or clinical content, the fact that the more competitive specialties require higher scores, the added stress and anxiety faced by learners to score well, and the costs involved preparation wise (1). They call for a more holistic approach to selection to residency which incorporates not simply knowledge based scores, but assessment of more on the job attributes such as team working and professionalism. The authors also highlighted a need to provide merit for additional avenues such as research experience, leadership, and performance during rotations. I fully agree that selection into postgraduate training should not be reliant solely on scientific or clinical based knowledge and a plethora of additional attributes should be accredited. However the level to which the latter is accredited may prove problematic.  more…

Barry Main et al: Time to make research findings CRYSTAL clear?

9 Oct, 15 | by BMJ

By BG Main, NS Blencowe, and JM Blazeby.

Hardly a day goes by without a prominent health story appearing in the press or other media. Headline-grabbing statements about “miracle” breakthroughs or “scare” stories are beloved of journalists, readers, and politicians alike. But hidden behind the headline is often a fundamental misunderstanding or misinterpretation of the results of research whereby trivial increases in risk or benefit are exaggerated and presented out of context. Reporting of relative rather than absolute risks further confuse the picture. This can result in confusion, anxiety, and on some occasions, an incorrect “take home” message. more…

Ahmed Rashid on #RCGPAC 2015: We’re in it together

5 Oct, 15 | by BMJ

ahmed_rashidAt the Royal College of General Practitioners (RCGP) annual conference in 2014, the chair of council, Maureen Baker, likened UK general practice to a dam that was at bursting point. The metaphor was a fitting one and there was a sense amongst the Liverpool audience of GPs that it captured the enormous pressure that they were facing in their surgeries every day.

Fast forward 12 months and the conference reconvened, this time in Glasgow, ready to celebrate the fact that the dam had not burst and the profession had survived another challenging year filled with austerity, high workloads, and demoralising media stories. And what a conference it was. It was the fifth time I’d attended an RCGP conference and it was undoubtedly the best I’ve experienced. The word “inspiring” has become something of a cliché when it comes to describing events and conferences, but there’s no better word I know to describe the effect it had on the GPs that were fortunate enough to attend. more…

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