Out of the harrowing and often tragic cases that were highlighted by the Mid Staffordshire NHS Inquiry, Sir Robert Francis has started an extremely important conversation about whistleblowing with his follow-up review of the reporting culture in the NHS. The recommendations from his report, depending on how they are implemented, could have a far reaching […]
Category: NHS
Jim Sherifi: I am an antibiotic resistance denier
I write as a humble jobbing GP incapable of sound clinical practice without instruction, guidance, and supervision from the National Institute for Health and Care Excellence (NICE), my clinical commissioning group, my colleagues, or by reading today’s newspapers. Despite practising medicine for 40 years, it is apparent to all that I am still incapable of differentiating a minor […]
John Appleby: The cost of reform
Asked in 1972 whether the French Revolution had been good or bad, the then Chinese Premier Zhou Enlai said that it was “too early to say.” As it turns out this was not an extreme example of the Chinese long view: Enlai was apparently opining about events that happened four years previously—in 1968—and not that […]
Mohammed Bahgat et al: Is the friends and family test a true feedback tool of NHS services?
The NHS friends and family test (FFT) was launched in April 2013 to support the fundamental principle that people who use NHS services should have the opportunity to provide feedback on their experience. [1] The results are submitted to NHS England monthly. When combined with supplementary follow-up questions, the FFT provides a mechanism to highlight […]
James Buchanan: Genomics, the data revolution, and health economics—the 2015 Astellas Innovation Debate
It’s early days, but 2015 is already shaping up to be another exciting year for researchers in genomics. In his State of the Union address last month, Barack Obama launched a new $215m Precision Medicine Initiative, which aims to collect genomic sequencing data for one million individuals. In the UK, we’re slightly further down this […]
Guddi Vijaya Rani Singh: What matters—medicine, culture, and the space in between
My grandfather passed away last year. Surrounded by travel weary loved ones (from an extended family that also extends across continents), this man from rural India was promised a peaceful death in dignity. Except that he died in 2013 in one of Delhi’s largest private hospitals, with every medical test and procedure made available by […]
Saurabh Jha: The overdiagnosed party/ the false positives rave
Consider this equation. Early Diagnosis = Early Diagnosis + Overdiagnosis (1.1) This sort of unequal algebra will fail GCSE mathematics. A new NHS initiative is arithmetic defying as well. Patients who think they have symptoms of cancer will be allowed to book medical imaging directly, without seeing their GP. This is to catch cancer early. The logic […]
Ted Willis: Consequences of the “John Wayne” contract (“A GP has to do what a GP has to do”)
Why is general practice unpopular, with low morale, falling applications for training, and—according to some experts—poor overall performance? I have worked as a GP for over 25 years and it is clear to me that this is an inevitable result of the way we are paid mainly according to capitation, rather than by item of […]
Ahmed Rashid: Leadership in primary care—the “odd one out”
Picture the scene. It was the first day of the NHS national medical director’s clinical fellow scheme induction. A group of junior doctors, who had successfully applied to take a year out of their training programmes to develop clinical leadership skills, were sat around meeting tables, making introductions in a grand committee room in the […]
David Oliver: Discharging patients from overcrowded hospitals—fewer “progress chasers” and more “doers” please
This year, urgent activity in English NHS hospitals has reportedly hit a record high. Officially reported “delayed transfers of care” (inpatients medically fit to leave, but awaiting community health and care services) have also peaked. These figures routinely underestimate the real number of people in beds whose needs no longer require the full facilities of the […]