BMJ Today: Reassurance on varenicline, caring (or not) for NHS staff, and more holiday for emergency doctors

Good news for quitters


A research paper in The BMJ today “is the most comprehensive published review to date of the neuropsychiatric safety of varenicline.” It was necessary, say the authors from Bristol University, because while several studies have found no evidence of an increased risk of neuropsychiatric side effects with varenicline, these studies have been criticised for being observational and sponsored by industry.

The review of 39 randomised controlled trials also found no increased risk of neuropsychiatric adverse events with varenicline, including suicide or attempted suicide, suicidal ideation, depression, irritability, aggression, or death. The findings should “provide some reassurance for users and prescribers,” say the authors.

NHS staff not very well cared for

stressed_drIn a news story in BMJ Careers we learn that the NHS is not very good at looking after the health and wellbeing of its staff. A report by the Royal College of Physicians found that just two thirds of trusts in England have a plan for staff health and wellbeing. Sickness absence in the NHS is 46% higher than the average for all sectors, catering—especially at night—is commonly “cheap confectionery and junk food,” and many staff feel pressured to attend work when unwell.

The RCP’s Sian Williams said: “Staff wellbeing should no longer be treated as optional extra for the NHS—it is critical to patient care.” That means focusing on the design of buildings, the work environment, the work that staff do, and the way they are managed.

Give emergency doctors the time off they deserve

shift_workAt a conference earlier this month delegates heard that the conditions for doctors working in emergency medicine need to change if retention is to improve. The key was not to offer these doctors more money, said Clifford Mann, president of the College of Emergency Medicine, but to give them a “fair equality of leisure and family time” to compensate for night, evening, and weekend work—meaning that out-of-hours work should be linked to annual leave. “That way I can say to my daughter, “Yes, I spend far fewer Saturdays with you [than other parents spend with their children]. But, as a family, you spend the same number of days per year together at times of our choosing just like those other families do,” said Mann.

Zosia Kmietowicz is the news editor, The BMJ. Follow Zosia @zosiamk