Talk to almost any public health specialist and they’ll express their biggest concern about the current NHS reforms in England as fragmentation of the public health service. To understand why fragmentation is a bad thing, we first need to know what it is that could be broken up. Public health has traditionally consisted of three main domains […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklCategory: Douglas Noble
Douglas Noble on GP commissioning
A few weeks ago I attended a conference for GPs on commissioning in the brave new world of GP consortia, proposed in the recent health bill. The day started with a very upbeat GP seeking to enthuse the audience of about 70 participants with a reverberating war cry: “commissioning! who’s up for it?” One hand shot […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on Euthanasia
The current issue of the BMJ includes four letters venting an angry response to an opinion piece on euthanasia on 22nd December 2010. The rapid responses reveal even greater depth of feeling. At the heart of the issue is the view that there has not been even-handed coverage, and the pro-euthanasia lobby has been given unfairly […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on the public health white paper
Last week the British Medical Association hosted a listening event for over 200 public health professionals, including representatives from various public health bodies (Faculty of Public Health, Royal Society for Public Health, UK Public Health Association, Chartered Institute for Environmental Health, Association of Directors of Public Health and Royal College of Nursing). […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on maternity care
Five days in hospital for the delivery of our first child was a sobering reminder of the harsh realities of life (our newborn had a post-natal stay on ITU), the inner workings of the NHS system, and on several occasions a personal reminder of just how far we still have to go to realise high […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on healthcare public health
The recent move to transfer the balance of commissioning power within the NHS to GPs, although laudable, raises a number of serious questions. Perhaps they are best summed up by a comment made to me recently by a GP colleague. In exasperation he declared: “I only get seven minutes to see a patient, so where […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on the World Health Assembly
I recall when I first attended a medical science teaching committee meeting at St Andrews University in 1995. I was overawed by the complexity of running a medical curriculum, bringing all the academics on board, and agreeing teaching plans. I was there because someone thought it was a good idea to have a student in […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble: Easter and transplantation
Sally Slater last week celebrated the tenth anniversary of her life-saving heart transplant. Sally was only six when she had the operation and was pictured with Billie Piper after the operation. Now, at 16, she is turning her attention to improving health policy. In last week’s Telegraph (News Digest, March 29) she called for nationwide […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on patient safety curricula
WHO recently released a medical school curriculum in patient safety. To date the number of downloads is in the 1000s. The curriculum includes teaching resources on systems thinking in healthcare, medical errors and other key areas of patient safety. […]
djfhdkfdkjfhakdjfhkadsfhldksjfajdfkdajfhkdlsfhkdlsfhkdsfhskldfhdkfhdsklDouglas Noble on checklists
I remember as a medical student when the Rockall score for GI bleeding came into common practice. As with all checklists and tick box style scoring systems, well thumbed photocopies of ever decreasing quality slowly surfaced in emergency departments and acute medical units. The first time I ‘scored’ a patient I was surprised that their […]
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