Out with pacey surgical ward rounds; pain controlled, E+D, BO, OE – alert, obs stable, neurovascularly in tact, plan – drain out, fluids down, OT/PT, home when safe, OP 6/52. Out with debates about thromboprophylaxis, clotting and bleeding. Out with preadmission clinics. Out with being the crash team leader – I’ll not be sad to relinquish that duty. And in with a new hospital, a new team, and a new specialty.  I packed my bag after my night shift as the orthopaedic SHO oncall, left for good, and began preparations to start in paediatrics the next day, whatever that entails. more…

The award-winning experiential health website, healthtalkonline.org, launched a new section devoted to carers of people with a terminal illness on Wednesday. The website’s real life stories are proving a valuable resource not only to patients but also to health professionals.

healthtalkonline already hosts thousands of videos of people talking about their experiences of different medical conditions, from autism to pregnancy. The new section features 240 video clips taken from interviews with 40 men and women who have cared for a dying loved one. They cover the hidden aspects of caring, from dealing with financial issues to coping with conflicting emotions following the death. more…

I am very glad the Cochrane Collaboration exists. However, it is important to consider how its activities might be harmful and to take every effort to mitigate this risk.

I periodically re-read Joel Lexchin’s review of outcome in industry supported vs non industry supported studies to remind myself of the powerful and pervasive impact that conflict of interest has on the evidence base. Given most randomised controlled trials are industry funded, there is a risk that Cochrane Reviews  lend this biased evidence base legitimacy. more…

On the Today programme on Radio 4 on Monday morning there was a feature on these recently released data. Two areas were discussed. Hospital mortality is higher out of hours ie nights and weekends. The other item discussed was the smaller number of senior doctors in the hospital out of hours.

John Humphrys interviewed a spokesman for Dr Foster and one for the NHS Confederation. Unfortunately nobody who knows anything about the working of a hospital was interviewed. There is nothing unusual about this state of affairs. more…

Why are patients in English hospitals more likely to die at the weekend? A good question, put to Dr Mark Porter, head of the BMA’s consultants’ committee by John Humphrys on the Today programme on Radio 4 yesterday morning.

It was a difficult question for him to answer in a couple of sound bites. The question emerged (or perhaps re-emerged) in light of annual figures from the research company Dr Foster which show a 10% spike in weekend deaths, compared with weekdays. more…

‘Most doctors and nurses will have a deep well of patient stories – examples of great fortitude and its converse. It is clear to any clinician that some patients either feel their symptoms (or report them) more than others.

It’s the first week of August and in the NHS that can only mean one thing. Changeover has arrived and thousands of newly qualified doctors are let loose on the wards.

For decades, patients and doctors alike have joked that it is best to avoid a hospital stay in August. Lately, this myth has been gathering evidence with suggestions of increased mortality around the changeover period. [1] Whilst by no means conclusive, the trend shouldn’t be ignored. more…

For a medic still just under thirty, I have deviated from the traditional medical career path several times. Working as a healthcare management consultant, setting up a start up enterprise and being on secondment to the Department of Health have broadened my understanding of the healthcare landscape.

The controversy over the planned NHS reforms has got me thinking about clinical leadership.  Empowered clinical leaders will be crucial to implementing the reforms and the NHS should look to other industries for lessons on developing future leaders.  Whilst junior doctors are treated as bottom of a hierarchy, their private sector counterparts are nurtured, trained and valued. Retaining and investing in talent is big business. Other industries wouldn’t dream of labelling the next generation of leaders with the pejorative term “junior.” Yet this is exactly what we do to future medical leaders. more…

The following account is based on an email I wrote to my friends and family on 23 February, describing my experiences working as a house officer at Christchurch Public Hospital when the devastating earthquake struck on 22 February 2011. more…

Medical students and doctors belonging to the newly created organisation “Big Society NHS” organised a Valentine’s Day themed protest against the Health and Social Care Bill, currently being debated in parliament. The bill, if passed through parliament, would pave the way for free-market style reforms within the NHS. The demonstration was held outside the Sherfield building, where secretary of state for health Andrew Lansley was delivering a speech to mark the opening of the Imperial College School for public health. more…