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Tim Ballard: Will a tax on sugary drinks work?

7 Sep, 15 | by BMJ

tim_ballard2Channel 4 recently aired a documentary by Jamie Oliver called Jamie’s Sugar Rush. Following on from his successful advocacy aimed at improving the nutritional quality of school meals he has now moved his attention to the obesity epidemic and in particular the part that sugary drinks play. In addition to obesity the documentary aims to raise awareness of the thousands of children undergoing dental extractions under a general anaesthetic each year on the NHS as a consequence of sugar filled soft drinks. more…

Abi Rimmer: Seven day services lack definition

4 Sep, 15 | by BMJ

abi_rimmer2What exactly are “seven day services?” This is something that I have been wondering ever since David Cameron announced in March that the NHS would run a seven day service by 2020. And, despite all the rhetoric from Cameron and health secretary Jeremy Hunt, the government doesn’t seem to have a clear definition of what seven day services are going to involve.

Without a clear definition, it will be impossible to measure whether we have “seven day services.” Lots of the doctors already work at evenings and weekends, so we need to understand how these new plans will be different from the services already offered by the NHS. more…

Samir Dawlatly: Could general practice survive without the NHS?

25 Aug, 15 | by BMJ

General practice is often described as the cornerstone of the NHS. Though its funding doesn’t necessarily reflect this, having its proportion of funding decline in recent years, 90% of all interactions with patients happen in general practice. It is therefore easy to predict that if, for whatever reason, general practice were to collapse or cease to exist as we know it, that the NHS itself would be threatened. The only alternative place for patients to go would be hospitals, via accident and emergency. That is probably an apocalyptic view given that one would hope that if general practice, as we know it, was to cease to exist that this would not happen overnight. more…

Jim Sherifi: The tyranny of excellence

24 Aug, 15 | by BMJ

Jim Very Good[2]When one reads the history of any autocratic, despotic regime, one is always struck by how they managed to secure the submission of the educated and intelligent through remarkably simple methods. Doctors in the NHS are currently being subjected to the same tried and trusted processes of indoctrination used by totalitarian regimes.

These may be dressed up under laudable banner headlines, such as the General Medical Council’s (GMC) “Working with doctors: Working for patients,” but then Mao also used vague exhortations such as the “Great Leap Forward.” Anodyne words suggesting a greater good, a striving for excellence. Sadly, the consequences are often the reverse and require years to recover from. more…

Phillippa Hentsch: A new way of paying for urgent and emergency care services

21 Aug, 15 | by BMJ

Phillippa Hentsch-Different parts of the urgent and emergency care (UEC) pathway are paid for in different ways. Acute and specialist facilities are predominately funded through the national tariff, whereas UEC services offered by mental health and community trusts—such as rapid response, crisis teams, and psychiatry liaison services—are paid predominately through block contracts. For commissioners and providers attempting a system wide redesign of UEC services, this patchwork of payment approaches gives you a headache. more…

Samir Dawlatly: Can you measure what is good about general practice?

18 Aug, 15 | by BMJ

The Health Foundation, at the behest of the government, is gathering thoughts from professionals and the public on the use of data to inform the quality of primary care until 24 August 2015. Although they say that this will not be used to “rate” practices, data about so-called quality has been used to “band” or should that be “brand” practices in the past, with the media immediately interpreting them as ratings. Putting that aside I would like to make three broad points: more…

Dominic Patterson: Why general practice

13 Aug, 15 | by BMJ

Dominic PattersonGeneral practice is in crisis.

Those are the first words on my site—launched in July along with the hashtag #whyGP—which aims to be a space for positive messages about general practice.

Strange first words for such a site, but they are of deliberate choosing. I’m no crisis denier, and I recognise personally and from spending time with friends and colleagues that perhaps now, more than ever, we are a profession on the edge. We are stretched. We are bending. And some of us are breaking. more…

Samir Dawlatly: There is no dementia wonder cure

13 Aug, 15 | by BMJ

The daughter of one of my patients booked an appointment to see me*. She often came to see me about her father who had lived alone ever since his wife had died five years ago. He was in the early stages of dementia, probably Alzheimer’s, but was still just about managing to live at home with support from his family and social services.

She sat down and took out a tablet of some sort that her own daughter had encouraged her to buy. She held it in an unfamiliar way. more…

Samir Dawlatly: Will general practice survive?

28 Jul, 15 | by BMJ Group

Just before I completed my training as a GP the 2012 Health and Social Care Act was passed. I had a sinking feeling that general practice wasn’t quite going to be what I thought it was. Up until that time I had been concentrating on passing my exams and assessments and not really taken much of an interest in medico-politics. At times I felt like there was little hope of stability and security in primary care.


Ferelith Gaze: The NHS is a duty to uphold, not just a function to devolve

17 Jul, 15 | by BMJ

Ferelith_gazeThe government is heralding the Cities and Local Government Devolution Bill—currently making its way through parliament, with broad cross party support for its intentions—as reversing 150 years of centralisation.

The bill opens up a number of exciting opportunities. Local partners—from Manchester to Cornwall, from Dorset to Hertfordshire—are making headway in their plans, with strategically aligned and integrated services at the top of the “to do” list. more…

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