July 31, 2014

Doom and gloom?

It has been a bad week for general practice. The Times (and the Sun, another Murdoch paper) carried a news item provided by the Royal College of General Practitioners on its front page on July 28th. The story was that millions could not get appointments with their family doctor, and more money would be needed to keep general practice going. This news prompted Stephen Pollard, writing the Times’ ‘Thunderer’ column, to condemn the RCGP for blackmailing the citizenry and urging GPs to open at the convenience of the public, not themselves. He noted the high incomes GPs earn, their limited face-to-face contact with patients (22.5 hours per week on average) and their escape from out-of-hours’ work.

Pollard described only part of the problem in NHS general practice. The management of long term conditions is now within the remit of general practice and fills working time. General practitioners are not working less, only less hours. The amount of face-to-face contact with patients is in part determined by the quantity of audit and reporting required by the GP contract introduced in 2004, as well as the interminable debates about commissioning promoted by this government. General practice is industrialised and micro-managed, features that fit a personal service industry poorly. The spectacular hike in income after 2004 restored general practice to parity with other professions for the first time since the late 1960s, and it is being clawed back, piecemeal. And there are some difficulties in recruiting doctors and nurses to general practice, partly because new graduates are watching to see what happens before committing themselves. Finally, the argument is awash with dubious statistics, it being difficult to count things that do not happen –consultations allegedly forgone being an example.

Nonetheless Pollard had a point. General practitioners are independent, for-profit, contractors to the NHS who do not want to eat into their profits by hiring extra staff to meet demand. The number of appointments is set by general practitioners, who are working to rule having written the rule themselves. The Royal College of General Practitioners was criticised for ‘perpetuating a trench war of specialities’ by the Lancet on July 26th, and should be careful what it wishes for. Its claim, on July 30th, that there were 16 days left to save general practice (by getting one million patients to sign a petition) adopted the histrionic, catastrophist tone that is now obligatory in NHS politics. Projecting an image of lengthening queues of patients and growing unmet need does the NHS no favours, and an outward show of inflexibility makes general practice look ripe for privatisation.

Steve Iliffe 30th July 2014

continue reading
July 29, 2014

New online awareness campaign launched for the thousands of South Asians affected by potentially fatal disease

Multi-lingual online platform seeks to educate at-risk South Asian and Somali communities in the UK about hepatitis C.

 Today marks the launch of  ‘Hepatitis C: Find the Facts’, an online platform developed to inform an estimated 1.8 million South Asians and Somalis throughout the UK1 about the risks of this serious, yet curable disease, by providing simple, engaging and digestible information. The platform, endorsed by the British Liver Trust and Love Your Liver, aims to confront cultural challenges, misconceptions and the stigma attached to hepatitis C in these communities through tailored resources, which are now available for the first time in Hindu, Urdu, Nepali and Somali.

The online resources have been developed in partnership with hepatitis C oral swab test pioneer, Nurse Consultant, Dean Linzey from the Royal Berkshire NHS Foundation Trust in Reading, and Safina Shahin, Blood-Borne Virus (BBV) Asian Head Champion and Administrator of local initiative to increase testing of hepatitis C for South Asians and Somalis in Reading.

Nurse Consultant, Dean Linzey commented: “The UK has one of the lowest hepatitis C diagnosis and treatment rates throughout the EU, and detection is particularly challenging in the South Asian population. Raising awareness within these communities, and testing and treating the disease early in is the best way to control the progression of the disease. The resources available on the ‘Hepatitis C: Find the Facts’ website is the first step in improving the management of hepatitis and preventing hepatitis C-related liver disease or liver cancer in this hard-to-reach patient population.”

Translated campaign videos and factsheets on the risks of transmission and appropriate treatment options, which are available on the platform, addresses commonly held myths about hepatitis C among the South Asian and Somali communities, where in some parts of the UK have a prevalence rate five times higher than the general population in the UK.2 These resources will aim to educate and empower these groups to make an informed decision to get tested if they have put themselves at risk, particularly when travelling or visiting family back at home.

Safina Shahin, BBV Asian Head Champion and Administrator commented: “We’ve made real progress to increase awareness of hepatitis C through our initiative in Reading. There are many Asians living in the UK who are getting infected when they travel back home and receive medical, dental or cosmetic treatments that use unsterile injections. Not only is there lack of knowledge, but there are also common misconceptions among this community as most Asians believe they have been vaccinated against hepatitis C. It is great to see that ‘Hepatitis C: Find the Facts’ addresses these issues and myths, while also overcoming the cultural barriers about hepatitis C.”

Monday 28 July 2014, Welwyn Garden City

continue reading
July 23, 2014


Responding to an announcement today by Help the Hospices calling on the Government to back a scheme to reduce the number of people dying unnecessarily in hospital, Ciarán Devane, Chief Executive of Macmillan Cancer Support, says:

“It is crucial the Government understands the needs of people at the end of life and puts in place the support they need so that they can spend their last few days or weeks in the place of their choosing. An estimated 36,000 people with cancer die in hospital each year when they would have preferred to have died at home, so this is a hugely important issue1.

“Macmillan Cancer Support strongly urges the Government to implement free social care at end of life. Not only would this help enable thousands of people with terminal conditions to die where they would like, but we estimate it could save the NHS up to £345 million a year2. The moral and financial arguments for free social care at end of life have been made. The question is whether or not the Government decides to do something about it.”


continue reading
July 16, 2014

Making several lifestyle changes improves memory and thinking in older adults

Researchers in Finland have determined that making many simultaneous lifestyle changes can help to improve memory and thinking skills in older adults who are deemed ‘at risk’ of developing dementia.

The study, which was presented at the Alzheimer’s Association International Conference 2014, was a two year randomised controlled trial involving participants aged between 60 and 77. All participants had been classed as ‘at risk’ of developing dementia score based on cardiovascular health and other lifestyle factors. The participants were split into two groups. The ‘control’ group was given health advice only, whereas the ‘intervention’ group had several lifestyle factors changed, including nutritional guidance, physical exercise and management of heart health. The study found that after two years, the memory and thinking skills of the intervention group were better than that of the control group. The researchers are planning on a seven year follow-up study to validate these preliminary results and measure the incidence of dementia.

Dr Laura Phipps of Alzheimer’s Research UK, the UK’s leading dementia research charity, said:

“While this study showed benefits of exercise on memory and thinking performance rather than focusing on whether it could prevent dementia, the results add to previous suggestions that adopting an overall healthy lifestyle is important for brain health as we get older. The findings build on previous evidence that several different lifestyle factors may be involved in our cognitive health, including exercise and heart health.

“It will be interesting to see the results of an extended version of this study and to look at the effects of these interventions on overall dementia risk within the group. It is also important for research to take into account other potential factors such as genetics in addition to age and cardiovascular health as indicators of dementia risk.”


continue reading
July 10, 2014


Responding to monthly NHS England waiting time statistics for tests which can detect cancer, Duleep Allirajah, Head of Policy at Macmillan Cancer Support says:

“It is extremely worrying that the proportion of people who face delays in receiving vital tests which can diagnose cancer has doubled since this time last year, from 1.0% to 2.2%.1

“Despite the fact that waiting times are significantly lower since the introduction of the six-week waiting time target in 2008, it’s alarming to see them creeping back up again2. The NHS is under strain and cancer risks being overlooked and not given the focus it needs.

“Each individual hospital has a responsibility to meet these targets, or they risk putting a patient’s best chance of survival at risk. However, this government and the next also need to take responsibility. Macmillan Cancer Support is urging all political parties to make cancer a top priority at the upcoming general election.”

continue reading