Medicine and Science from The BMJ

Obioma Ezekobe GP - patients need to be educated about resources

Obioma Ezekobe is a GP in an urgent care centre in Central Middlesex Hospital.
She believes that the public need to be educated about the use of NHS resources, and be taught when it is appropriate to seek care.
If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of work.

Katherine Henderson A and E consultant - lack of ward beds is hitting A and E the hardest

Katherine Henderson is the clinical lead of the emergency department at St Thomas's hospital in London.
She worries that lack of ward space is having a domino effect throughout A and E and is the cause of increased waiting time for both patients and ambulances.
If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of work.

Has the balance of screening for AAA tipped towards harm?

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they rupture, which is fatal in more than 80% of cases.
Screening aims to detect the aneurysm before it ruptures, enabling preventive surgery and hence reducing morbidity and mortality. However, preventive surgery has a mortality of 3.9-4.5%.
As the prevalence of risk factors, ie smoking, decreases and the definition of the condition is expanded, Minna Johansson from the University of Gothenburg and colleagues wonder if the balance of benefit and harm may have tipped.
Read the full analysis:
http://www.bmj.com/content/350/bmj.h825

Nuffield summit - Ashish Jha explains Acountable Care Organisations

Ashish Jha, professor of health policy and management at Harvard School of Public Health, talking about how the Affordable Care Act has fostered new models of integrated service delivery in the United States
Read more from the summit:
http://www.bmj.com/content/350/bmj.h1172

Nuffield summit - Bastiaan Bloem on parkinsons.net

Bastiaan Bloem, consultant neurologist at Radboud University Nijmegen Medical Centre, Netherlands, discussing his revolutionary approach to patient centred care.
Read more from the summit:
http://www.bmj.com/content/350/bmj.h1172

How to diagnose overdiagnosis

Overdiagnosis means different things to different people. Stacy Carter, associate professor at the Centre for Values, Ethics and the Law in Medicine at the University of Sydney argues that we should use a broad term such as too much medicine for advocacy and develop precise, case by case definitions of overdiagnosis for research and clinical purposes.
Read the full analysis article:
http://www.bmj.com/content/350/bmj.h869
For the full overdiagnosis digital edition:
http://www.bmj.com/specialties/digital-theme-issue-overdiagnosis

Overdiagnosis in breast cancer - 45 years to become a mainstream idea

In this podcast Alexandra Barratt, professor of public health at the University of Sydney, discusses how questions about overdiagnosis in breast cancer screening programmes were first raised 45 years ago, and why it has taken so long for the concept to become mainstream.
Read her full analysis:
http://www.bmj.com/content/350/bmj.h867

Roundtable: Hopes for the NHS, the election and beyond

The BMJ held a breakfast roundtable at the annual health policy summit held by the Nuffield Trust think tank to explore some of the key policy discussions that took place during the ​proceeding day. These included NHS England chief executive Simon Stevens' five year plan, whether politics can be removed from the NHS, and what the creation of a central unit to coordinate care for Manchester means for the rest of the ​NHS in England.
Chaired by Fiona Godlee, editor in chief of The BMJ, the particpants were:
Richard Jones - Clinical director of the Wessex Cardiovascular Strategic Clinical Network
Suzie Bailey - Development director at health service regulator Monitor
Jonathan Michael​ - ​chief executive of Oxford University Hospital NHS Trust
Steve Field - Chief inspector of general practice for the Care Quality Commission
Nigel Edwards - Chief executive of The Nuffield Trust
Jeremy Taylor - Chief executive of health and care charity National Voices
Massoud Fouladi - Chief medical officer of Circle Partnership
Rebecca Rosen - GP and clinical commissioner of Greenwich Clinical Commissioning Group, London
Jennifer Dixon - Chief executive of the Health Foundation

Assessment and management of alcohol use disorders

As the level of alcohol consumption goes up, so the risk of physical, psychological, and social problems increases.
In this podcast we’re joined by Ed Day, consultant addiction psychiatrist at Kings College London, Alex Copello, professor of addiction research at the University of Birmingham, and Martyn Hull, GP with a special interest in substance misuse at the Ridgacre Medical Centres in Birmingham.
They discuss practical aspects of the assessment and treatment of alcohol use disorders from the perspective of the non-specialist hospital doctor or general practitioner.
Read the full clinical review:
http://www.bmj.com/content/350/bmj.h715

Jackie Applebee GP - the funding formula is hurting deprived practices

Jackie Applebee is a GP in Tower Hamlets in London, and is concerned that the way the GP funding formula is working doesn't take account of the earlier health needs of people in deprived areas.
For more about the Tower Hamlets Save Our Surgery campaign, visit their facebook page https://www.facebook.com/SaveOurGPsurgeries
BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com.
If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of work.