In the 1980s people in prison received a second class health service despite having a high prevalence of health problems. I visited many prisons at that time and wrote a series of articles for The BMJ. In those days the Prison Medical Service was part of the Home Office, and there was an argument that […]
How do doctors manage conversations with patients about the availability (or often non-availability) of certain drugs or treatments within the NHS? In most consultations, the patient’s questions around their illness and treatment can usually be answered by drawing on a combination of medical training, formal guidelines, and clinical experience. However, few doctors will have received […]
NEJM 25 Feb 2016 Vol 374 Aspirin with your cabbage? 728 Most people who undergo coronary artery surgery take aspirin. Nobody knew whether they should carry on or stop when they had their CABG. Now we have the results of a big multinational trial: “Among patients undergoing coronary artery surgery, the administration of preoperative aspirin […]
The stated aim of the recent King’s Fund conference, “Integrating care throughout the patient’s surgical journey” was to align the objectives of the NHS five year forward view and the Royal College of Anaesthetists’s Perioperative Medicine Programme. For me, the message was that trying to see things from the patient’s point of view gave the […]
As I foretold three weeks ago, the UK government’s health secretary Jeremy Hunt recently announced his intention to impose his contract on the junior hospital doctors. His cunctatorial Fabian tactics predicted it. Ramifications of the word “imposition” imply comment. Take the Indo-European root AP or APO, to reach, extend, or put. The derived Greek prefix […]
All health systems need clinical leaders to flourish, but being a clinical leader is hard, particularly in the NHS. Those were the main messages from a recent meeting of the Cambridge Health Network. The reason we need clinical leaders, said Jonathan Fielden, currently medical director of University College London, but about to become director of specialist […]
Spain has been at the forefront of the fight against smoking for many years. Today (25 February) the National Committee to Prevent Smoking (CNPT), the Spanish Medical Colleges Organization (Organización Médica Colegial), and the Catalan Institute of Oncology (Institut Catalá d ́Oncología) have organised a discussion session with representatives from the main political parties to […]
The Ebola and Zika epidemics could be the catalyst to open up and speed up the publishing of science. During the Ebola outbreak, there were examples of researchers being unwilling to share results and data at the required speed, which might have compromised the public health response. After the emergency, leading funders called for incentives […]
Recently the health secretary, Jeremy Hunt, said “I am determined we blaze a trail across the world in developing a truly safe healthcare system with airline levels of safety.” (Economist Radio, 28/1/16) He was commenting on the death of a child from sepsis: a condition often of shocking inexorability. His muscular soundbite was bound to […]
Imagine you are a teacher or headteacher in a good enough local authority school in an area with its fair share of deprivation and a shrinking funding envelope. The school increasingly struggles to balance its books, yet it’s told to make further savings. You are experienced and good at your job. You chose and trained […]