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David Wrigley: Like another bad penny?

31 Oct, 14 | by BMJ

david_wrigleyWe have just seen another report from a London based “think tank,” suggesting profound changes to the way the NHS works. These reports seem to turn up with annoying regularity and are often not written with any evidence base to support them, but they do seem to promote the views of organisations that donate vast sums of money to them. A few months ago we had Reform suggesting that we should introduce a regular payment for all patients to use the NHSan organisation that receives around a million pounds of funding from the very same insurance firms and private companies who would benefit from a “cash for treatment” healthcare system…

The latest idea can be found in a report from the Centre for Policy Studies (CPS)—a think tank founded by Margaret Thatcher in 1974, now chaired by Lord Saatchi, with CPS council members including David Willets MP, Brooks Newmark MP, John Redwood MP, Oliver Letwin MP, and Tim Montgomerie.


William C Cayley: Social history on the back roads

31 Oct, 14 | by BMJ

bill_cayley_2Social context and relationships may shape what drives our patients, but sometimes the best way to ponder these is on a drive!

En route to a home visit today, I was met at the edge of town by a road crew doing last-minute sealing work before the onset of winter (despite what you may have heard, Wisconsin only has two seasons—winter and road construction!). As I sat mildly frustrated at the wait until they let us pass, I found myself wondering how many of the road crew, might actually be my patients. (In the end, no faces were familiar, but still it left me thinking).

The home visit was actually relatively straightforward, nothing new going on, no new needs requiring attention. On departing, I decided to both avoid another road construction delay, and take some back roads into town that I seldom explore.


Mary E Black: Inside the mind of a Member of Parliament

31 Oct, 14 | by BMJ

maryeblack copy

I had the opportunity to listen to a number of MPs explain how they think during the excellent Westminster experience  organized by Cumberlege Eden & Partners as part of my NHS Executive Fast Track Programme. I took notes from the MPs—current and recent—whom we met. The session was targeted at senior people in the NHS, but it could be generally applicable to other organizations.

Here are 10 examples of what might be running through their minds as you approach them for a long-awaited meeting.


Cordelia Galgut: Emotional support through breast cancer

30 Oct, 14 | by BMJ


Before being diagnosed with primary breast cancer myself, aged 49 in 2004, I would offer emotional support to women with this diagnosis, and arrogantly assume I understood pretty well what they were going through, at all stages—and my then clients were too polite to tell me to the contrary. Little did I know! Life on the other side of the breast cancer divide, as a patient, not a psychologist, differed hugely from how I understood it to be. For a start, it was a much more harrowing, long drawn out process, both physically and psychologically, than I could ever have imagined. It challenged my sense of myself as a woman much more than I could ever have foreseen, to say nothing of my theoretical beliefs as a psychologist. Indeed, I still suffer breast cancer’s fallout 10 years on. more…

Suzie Bailey: Strategy development – starring role or chorus line?

30 Oct, 14 | by BMJ

Suzie-BaileyIs “transformation” one of the most overused words in relation to the NHS and the issues it faces? Just last week, I heard a NHS deputy CEO joke that the word should be banned, and thought I’d happily join him! On the other-hand, “strategic development” is rarely mentioned. This is strange, as isn’t the NHS going to need to do more of both to overcome its quality, demand, and financial challenges?

The Five Year Forward View echoes this sentiment, that strategy is a vital part of the NHS. So, if strategic development has a starring role in helping the NHS’s clinically and financial sustainability—whose job is it?


Tara Lamont: On biography, cancer, and Richard Doll

27 Oct, 14 | by BMJ

Tara_Lamont_3I’m a sucker for the lives of great men (and, occasionally, women) in medicine. This is particularly the case when it comes to those who lived in the 20th century, whose lives are punctuated with big moments: from the great depression, to active service overseas in the second world war, to the formation of the NHS shortly after. Their lives are marked by quiet heroism and lives well lived—before you even come to their impact on health and science. There seems to be that much more space for these individuals to make their mark on history. more…

Abdullah Aljoudi: An epidemic free Hajj

15 Oct, 14 | by BMJ Group

My photo 1 “Complete the pilgrimages … for the sake of God” Quran 2:196

The 2014 Hajj was epidemic-free, according to Saudi Arabia’s acting health minister. In addition to the regular Hajj health regulations, this year the Saudi government decided to ban pilgrims from Mano river Union countries (Guinea, Liberia, and Sierra Leone) because of the Ebola threat. The World Health Organization said there was “no report of MERS-CoV among pilgrims,”  and more than two million attended. more…

David Oliver: What would my mum think? The new CQC regime for care home inspection

9 Oct, 14 | by BMJ

david_oliverOn 9 October, the Care Quality Commission (CQC) announced the details of its new inspection regime for care homes, after a lengthy consultation and evidence gathering process.

The proposals amount to a step change in the depth, breadth, and consistency of inspections. They attempt to move away from superficial visits, focussing on minimum compliance standards and “tick box” approaches towards identifying excellence. The proposals also announce the use of “intelligent monitoring,” utilising a range of data to target homes that ought to be on the inspectors’ radar. The approach will also permit care homes to continuously upload and update their performance data, rather than relying only on the “big bang” of episodic inspections. more…

Abdullah Aljoudi: Are you fit for the journey of a lifetime?

2 Oct, 14 | by BMJ Group

My photo 1“Pilgrimage to the House is a duty owed to God by people who are able to undertake it.  Quran 2:97.

On Friday 3 October, over three million Muslims from more than 180 countries will come together for the Hajj, probably the largest human gathering on earth. more…

Alex Horne: The expense of neglecting adolescent mental health

24 Sep, 14 | by BMJ

alex_horneThe chief medical officer, Dame Sally Davies, recently called for more support for mental health services in her annual report, which highlighted how mental illness led to the loss of 70 million working days last year—an increase of 24% since 2009.

Of particular importance is the report’s call for improved support for young people with mental illness. More than 50% of adult mental health illnesses develop during adolescence, but the diagnosis is often missed at this stage and not picked up until many years later. GPs have an important role in supporting parents and picking up on any early warning signs—distinct from “normal” adolescent moods—so that they can act accordingly. more…

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