Medicine and Science from The BMJ

Behind the campaign promises - what the NHS means for the election

UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast.
We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail.
This week we're focussing on what the NHS means to the election, from people who have been inside the political process and know about how campaign promises are made. We talk about retail pledges, and why spending claims which don't cause real change might come back to bite politicians.
Joining us are Sally Warren, director of policy at The King's Fund,
Siva Anandaciva, chief analyst at The King's Fund and Bill Morgan, former policy advisor and founding partner of Incisive Health
www.kingsfund.org.uk/Podcast‎
https://www.kingsfund.org.uk/topics/general-election-2019

Behind the campaign promises - Health beyond the NHS

A UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast.
We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail.
This week we're focussing on health beyond the NHS - public health spending, and pledges to tackle air pollution and climate change. To discuss we're joined by Jennifer Dixon, chief executive of the Health Foundation, and Nicky Philpott, director of the UK Health Alliance on Climate Change.
Reading list
The BMJ's 2019 election coverage
https://www.bmj.com/content/general-election-2019
Health Foundation report: Mortality and life expectancy trends in the UK
https://www.health.org.uk/publications/reports/mortality-and-life-expectancy-trends-in-the-uk
UK Health Alliance on Climate Change general election briefing
http://www.ukhealthalliance.org/general-election-briefing/

Behind the campaign promises - Health and social care spending

A UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast.
We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail.
This week we're focussing on spending pledges. NHS budgets have not been keeping up with healthcare demand, and social care is in dire financial straits. David Oliver, consultant physician in Berkshire and author of the weekly BMJ “Acute perspective” column, and Hugh Alderwick, assistant director of policy at the Health Foundation.
Reading list
Acute perspective column
https://blogs.bmj.com/bmj/category/columnists/david-oliver/
Health Foundations analysis of spending
https://www.health.org.uk/news-and-comment/blogsf
talk through what the parties are promising

Behind the campaign promises - GP numbers, and appointment slots

A UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast.
We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail.
This week has seen pledges about GP numbers, so we're focussing on primary care - and are joined by two GPs, Clare Gerada, co chair of the NHS Assembly, and former chair of the Royal College of GPs, and Rebecca Rosen, who is also a senior fellow at the Nuffield Trust.
Reading list:
Health, wellbeing, and care should be top of everyone’s political agenda
https://www.bmj.com/content/367/bmj.l6503
Labour pledges to outspend Conservatives on health with £26bn NHS “rescue plan”
https://www.bmj.com/content/367/bmj.l6537
Tories promise 6000 extra GPs by 2024
https://www.bmj.com/content/367/bmj.l6463
Is the number of GPs falling across the UK?
https://www.nuffieldtrust.org.uk/news-item/is-the-number-of-gps-falling-across-the-uk

Reversing our preconceptions about where innovation comes from

Reverse innovation may sound like some attempt to return to the dark ages - but it has a specific meaning, especially when it comes to med-tech. It’s about where we look for innovation - and overturning our preconceived ideas of where new ideas come from.
Mark Skopec, and Matthew Harris - both from Imperial College London are two of the authors of a new analysis, setting out to highlight those preconceptions, and creating new routes to bring innovation into the NHS.
Read the analysis:
https://www.bmj.com/content/367/bmj.l6205

Talk Evidence - aggravating acronyms, a time to prescribe, and screening (again)

Talk Evidence is back, with your monthly take on the world of EBM with Duncan Jarvies and GPs Carl Heneghan (also director for the Centre of Evidence Based Medicine at the University of Oxford) and Helen Macdonald (also The BMJ's UK research Editor).
This month Helen talks about the messy business of colon cancer screening - which modality is best, and in what population is it actually effective (1.40)
Carl talks about how the Netherlands did the right research at the right time to stop a new pregnancy scan before it became routine (10.35)
The Rant: acronyms in research papers (17.45)
Mini Rant: politicisation of the NHS, and Carl pitches for yet another job (25.15)
Research in the news has talked about the importance of when drugs are taken, to maximise efficacy. Melvin Lobo, cardiologist specialising in hypertension joins us to explain that research and why we seem to have forgotten about that effect.
Reading list:
Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline
https://www.bmj.com/content/367/bmj.l5515
Effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes in low risk pregnancy (the IRIS study): nationwide, pragmatic, multicentre, stepped wedge cluster randomised trial
https://www.bmj.com/content/367/bmj.l5517
Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial
https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz754/5602478

Creating a speak out culture

Giving staff the confidence to speak out is important in healthcare - It's a key aspect of the WHO patient safety checklist, decreasing incidence of medical error, but it's also important to stop incidents of harassment and abuse which undermine staff and increase burnout.
Creating that culture is a difficult task, but two hospitals in the southern hemisphere have been trying to do do that by putting in place ways which support staff in making complaints when they wouldn't normally feel confident to do so.
In this podcast we hear from Alex Sia, CEO of KK hospital Singapore, Jeanette Conley, medical executive at Adventist Healthcare in Sydney and Mark O”Brien, medical director of the Cognitive Institute, who talk about their challenges and successes in changing the way they work.
For more on burnout;
https://podcasts.apple.com/co/podcast/burnout-dont-try-to-make-canary-in-coal-mine-more-resilient/id283916558?i=1000446459269
http://www.bmj.com/wellbeing

Creating support for doctors in the NHS

The NHS Practitioner Health Programme - once only for doctors in London, now it’s being rolled out across the NHS to provide the largest, publicly funded, comprehensive physician health service, in the world.
However, while helping the individual is essential, systemic change needs to be made to support doctors in our healthcare system.
Clare Gerada, GP and medical director of NHS PHP joins us to talk about how the expanded service will work, and what role regulation and inspections should play in wellbeing.
For more on the NHS PHP
https://blogs.bmj.com/bmj/2019/10/31/clare-gerada-protecting-practitioners-health/
020 3049 4505
https://php.nhs.uk/

Nudging the calories off your order

There has been a lot of noise made about calorie counts on labels - the idea being it’s one of those things that might nudge people to make healthier choices.
So much so that in 2018, in the USA, it became mandatory for food chains with more than 20 outlets to label the calories in their food.
But the effectiveness of that is hard to gauge - it’s relied on reporting from customers, which leads to an incomplete picture. The really killer data would be from the chains themselves, but they’re reluctant to share that widely.
That's where new research comes in - and we're joined in the podcast by Joshua Petimar, postdoctoral researcher at the Harvard T.H. Chan School of Public Health, and Jason Block, associate professor at Harvard Pilgrim Healthcare Institute & Harvard Medical School, to discuss what they've done.
Read the full research:
https://www.bmj.com/content/367/bmj.l5837

Testing for TB is only skin deep

A TB infection can take two forms, active and latent. Active disease is transmissible, and causes the damage to the lungs which makes TB one of the biggest killers in the world.
In the latent form, the bacteria Mycobacterium tuberculosis is quiescent and can stay that way for years until it becomes active and causes those clinical signs.
Testing for the active version of the disease is done directly, but when it comes to latency, we use the tuberculin skin test to see if someone has an immunological response - and when that happens we consider them to have latent disease.
However, in this podcast Lalita Ramakrishnan, professor of immunology and infectious diseases at the University of Cambridge; Paul Edelstein, professor of pathology and laboratory medicine at the University of Pennsylvania; and Marcel Behr, professor of medicine at McGill University question that conclusion.
Read their full analysis:
https://www.bmj.com/content/367/bmj.l5770/
Their previous analysis:
https://www.bmj.com/content/362/bmj.k2738.abstract
And search for their previous podcast - "Have we misunderstood TB's timeline?"