Mary Higgins: Where dartboards and dominos meet after an adverse event

Occasionally, when talking to women who have experienced an adverse outcome, I come across someone who takes me completely by surprise with their kindness and generosity. These are people who entered pregnancy expecting only one outcome, and exited with a completely different one—their dreams in shreds. And yet these amazing people can ask how a […]

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Jonathan A Michaels: Bridging the gap between academics and practitioners

During my career as a clinical academic I have seen considerable changes to the clinical, academic, and financial structures within the NHS associated with the introduction of evidence-based practice and elaborate systems for evaluating and recommending on the use of healthcare technologies. [1] Whilst the improved use of research evidence and explicit consideration of the […]

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Katherine McKenzie: Supporting human rights, one patient at a time

I saw the first asylum seeker around ten years ago in my clinic. He came from a country with an autocratic president against whom he had peacefully protested. The government would not accept dissent from its citizens and they arrested, detained, and tortured him. He was released, but he was told that he would be […]

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Nick Fahy: Can real inter-sectoral working address deep-seated inequalities?

Many doctors will have had the frustration of dealing with health problems that are actually the result of much more deep-seated social inequalities, some with their roots going all the way back to education and childhood. But how do we avoid just putting plasters on these underlying problems? How do we address these wider issues […]

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Amy Webster: Engaging trainees in quality improvement

NHS improvement has recently published a document entitled “Developing people—improving care.” [1] This outlines a framework to guide action on developing leadership in the NHS, with a focus on delivering improvement. The framework outlines five conditions common to high quality systems that “interact to produce a culture of continuous learning and improvement.” I read with […]

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Daniel Whitney: Mental health has still not achieved “parity of esteem”—even among some medical professionals

It’s late morning; little piles of lists and notes from assessments carried out in the past 24 hours are littered between me and the PC. The assorted paraphernalia that seems to accumulate around me after a night on-call clutters my surroundings: a dictaphone, the British National Formulary, Maudsley guidelines, and the semi-completed audit I glance at […]

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