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NHS

David Kerr: Dr Uber

23 Apr, 15 | by BMJ

david_kerr_2015picThe hot topic in the technology world at the moment is the so called “sharing economy.” A great deal of money is being made by companies, such as Uber and Airbnb, where the internet is used to match buyers and sellers without the need for the huge upfront costs of purchasing, for example, cars and properties. The question is whether the concept of a sharing economy could also be of value in healthcare? more…

Richard Vize: Facing the NHS funding reality

21 Apr, 15 | by BMJ

richard_vizeThe intervention by former NHS England chief executive Sir David Nicholson in the election debate on the NHS exposes the chasm between manifesto rhetoric and funding reality.

Nicholson pointed out that the political parties are promising extra services while the Five Year Forward View from NHS England—on which the widely accepted additional funding need of £8 billion a year is based—makes hugely optimistic assumptions about efficiency savings simply to get the service repositioned for sustainability, without heroic promises about more and better care. more…

David Payne: What would you ask a future UK health secretary?

14 Apr, 15 | by BMJ Group

Jeremy Hunt

Jeremy Hunt

If you were in the same room as health secretary Jeremy Hunt, Labour shadow health secretary Andy Burnham, Liberal Democrat health spokesman Norman Lamb, and UKIP’s Louise Bours, what would you ask them? Now is your chance. more…

Samir Dawlatly: What if En Aitchess was my patient?

8 Apr, 15 | by BMJ

“Enfield Aitchess?” I called to the waiting room.

A 65 year old man shuffled towards me and shook my hand. He seemed slightly out of breath.

“My name is Dr Dawlatly, please come in and take a seat, Mr Aitchess,” I said as we entered my room.

As he sat down he mumbled, “Most people just call me ‘En,’ actually, doctor.”

“Okay, En, what brings you here today?” I asked.

“It’s these darn winters doctor. I just don’t seem to be able to cope with them,” he started. I looked at him, encouraging him silently to continue.

“I seem to have some sort of functional deficit once the weather turns cold. Nothing seems to work properly, and I was wondering if you had some sort of diagnosis or treatment doctor?” he asked, looking at me hopefully. more…

Samir Dawlatly: How general do we want general practice to be?

26 Mar, 15 | by BMJ

As a medical student I got a parking ticket and three points on my driving license. The mistake I had made was parking in the wrong place on an unmarked road in the Peak District. When I sent in my fine I wrote a short note along the lines of, “I realise that being ignorant of this law is not a valid defence.”

For what it is worth, there has been a stir in social media this week over the publication of a survey carried out by ResilientGP, a fledgling organisation that purports to “stand up for general practitioners.” The organisation argues that one of the stressors in primary care, and there are many, is the unnecessary use of the NHS by patients with problems that seem unconnected to any health problem. more…

Chris Naylor: Integrated care—the end of the hospital as we know it?

25 Mar, 15 | by BMJ

Hospitals are often seen as an impediment to integrated care. The concern frequently voiced is that their dominant role in the health system makes it harder for commissioners to shift resources into the community, and to develop more coordinated services that cross organisational boundaries.

It is certainly true that an over-reliance on hospital based care—and the political reluctance to challenge this—has long been a barrier to necessary change in health systems across the world. Jean Rebert, one of the principal architects of the PRISMA integrated care system in Quebec, Canada, has made this case forcefully. Speaking at the World Congress on Integrated Care in Sydney last year, he said that in his experience, the greatest obstacle to integrated care is the political attractiveness of prioritising investment in hospitals over other forms of care. more…

Tony Kelly: Is being confident to speak up enough?

24 Mar, 15 | by BMJ

Tony KellyLast month we saw two key messages come through regarding patient safety. The first was the publication of Sir Robert Francis’s “Freedom to Speak Up report.” The second was a report by the Parliamentary and Health Service Ombudsman (PHSO), which found significant variation in the quality of NHS investigations into complaints of avoidable death and avoidable harm. Both reports have generated significant coverage and debate. more…

Samir Dawlatly: Do I obsess too much about the NHS?

17 Mar, 15 | by BMJ

When I was a teenager, I was obsessed with playing guitar. I taught myself to play on my sister’s guitar, taking it off her when she came back from lessons. For my GCSE music performance I sang and played an Eric Clapton song. While I was at medical school, I became obsessed with climbing after working in a children’s multi-activity centre one summer, where I also used to play the guitar every night in the bar with the staff after the children had gone to bed. more…

David Wrigley: Manchester—the birth and death of the NHS

12 Mar, 15 | by BMJ

david_wrigleyOn 5 July 1948, in Manchester, Labour Secretary of State for Health, Aneurin Bevan announced the birth of the NHS.

On 27 February 2015, in Manchester, Conservative Chancellor of the Exchequer, George Osborne signed a piece of paper that would bring about the end of a National Health Service.

There is no longer an NHS in Manchester—it is now the MHS—the Manchester Health Service.

These two events are 67 years apart but signal huge differences in how healthcare will be provided to the population. more…

Playing the percentage game: the arts of playing football and practising medicine

11 Mar, 15 | by BMJ

martin_marshallI’m proud to be working among a group of GPs in east London who, against all the odds, are delivering a remarkable level of clinical performance.

Ninety two per cent of our patients with cardiovascular disease have their blood pressure controlled, despite our practice serving one of the most socio-economically and ethnically diverse communities in the country. Ninety per cent of children are immunised at 2 years of age, despite more than a third of the whole population in Newham changing every year. And most of the patients at high risk of hospital admission have completed care plans, despite inadequate premises, and massive problems with recruiting and retaining GPs and practice nurses.

Yes, I’m proud, but sometimes it feels like a hollow kind of pride. more…

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