Published 3 April 2009, doi:10.1136/bmj.b1428
Cite this as: BMJ 2009;338:b1428

News

Promoting hand washing, stroke prevention, and tobacco control are recognised at BMJ Group award ceremony

¹ London

The best in medicine and health care was celebrated in London on 2 April, when 10 exceptional individuals and teams won BMJ Group awards in the inaugural year of the competition to reward excellence.

Identifying best practice—a familiar subject to BMJ readers—was the theme of the evening, which was cosponsored by the Health Foundation, an independent charity that works to improve the quality of health care in the United Kingdom and beyond. Fiona Godlee, editor of the BMJ, said it had been heartening to receive so many impressive nominations and to learn that so much was happening to promote excellence in health care.

Martin Marshall, the Health Foundation’s director of clinical quality, said that he saw the awards as an opportunity to "inspire, motivate, and support people in health care to achieve the highest possible quality." The foundation was proud to sponsor the awards, said Professor Marshall. "They are a great opportunity to celebrate the expertise and commitment of those who work so hard in the health service to deliver high quality care for patients."

The comedian, writer, and presenter Sandi Toksvig, who chaired proceedings at the Marriott Hotel in Grosvenor Square, Mayfair, made no such bold claims. She admitted to no expert knowledge of health care but said she had been reading the BMJ to get herself in the right mood. "Boy, is that a scary publication," she said. "I read one article about the risks of oesophageal cancer from drinking tea in northern Iran. That’s very specific indeed. I’ve decided I’m not drinking tea there again."

Ten awards were given, culminating in the Lifetime Achievement award, given to Judith Mackay, a leader in the battle to control tobacco and a woman once described by the tobacco industry as "one of the three most dangerous people in the world," an accolade that Professor Mackay has since worn with pride.

But the evening began with the award for Research Paper of the Year, to Frank Sullivan and colleagues from the Scottish School of Primary Care in Dundee. Their paper showed that Bell’s palsy is better treated with the corticosteroid prednisolone than the far more expensive antiviral acyclovir (New England Journal of Medicine 2007;357:1598-607, doi:10.1056/NEJMoa072006).

Professor Sullivan and colleagues recruited almost 500 patients from general practices and treated them with one of the drugs, with the two drugs in combination, or with placebo. After nine months 94% of those taking prednisolone had recovered facial function, compared with 85% of those who took acyclovir alone.

"If people with this condition get the right treatment, 96% will fully recover," Professor Sullivan said. "And if they don’t, then about one in five will end up disfigured to a varying degree."

The results of the study are already changing practice. "Winning this award is important, because there is a tendency to think that research is what happens in laboratories," he said. "There’s some really important research answering questions that patients want answered, and that can be done in the community."

Fair trade means a lot more than buying tea, coffee, and bananas from ethical suppliers, as the next award, the Corporate Social Responsibility award, showed. The winners were the Medical Fair and Ethical Trade Group, which was set up in 2007 in response to concerns that surgical instruments were being made in unsafe and unhealthy working conditions, by skilled workers who were being paid far less than they deserved.

A large proportion of the instruments used in the NHS originate in factories in Sialkot, Pakistan. Sold to companies in Europe and the United States, they are then repackaged and sold on for far higher prices. Many surgeons are unaware of their origins or that child workers may be involved in their production.

Mahmood Bhutta, project adviser to the group and a specialist registrar in ear, nose, and throat surgery at the Oxford Deanery, said, "This award is fantastic recognition of all the work that various members of the group have put in.

"By April all hospitals in the NHS should be asking suppliers of all products to the NHS what the labour conditions are in the manufacturing of the various products they make, and this will apply to £20bn [22bn; $29bn] worth of goods every year. We hope other countries will look at the guidance and follow its example."

Dr Bhutta and Olivia Roberts of the BMA have led much of the work, but many others have helped the group, including the Department of Health, the NHS Purchasing and Supply Agency, the NHS Supply Chain, and the Association of British Healthcare Industries.

How would you sell the simple idea of washing your hands with soap? Communicating the latest medical breakthrough is relatively easy, but it is much harder to excite interest in the most basic but neglected hygiene measure available. Val Curtis’s success in putting this issue on the global map won her the award for Health Communicator of the Year.

Dr Curtis, from the London School of Hygiene and Tropical Medicine, harnessed the power of social marketing to get her message across. She persuaded companies such as Procter & Gamble, Colgate-Palmolive, and Unilever to join an initiative called the global public-private partnership for hand washing with soap.

As a result of her work Unilever has agreed to get a billion people washing their hands by 2015. Dr Curtis said, "That’s better than any public health intervention that any government could do. We now have 20 countries with national hand washing programmes that happened as a result of our work."

One of her greatest coups was to recruit the cricket star Sachin Tendulkar, an icon to millions of fans, to be the face of the campaign in India. "On global handwash day we got enormous press coverage," she said. But the campaign was successful in other countries too, she added. "We had a million children washing their hands in Bangladesh all at once."

"Winning this award means recognition that the areas of hygiene and diarrhoeal infectious diseases in developing countries are finally being taken seriously," Dr Curtis said. This year’s global handwash day, on 15 October, would include the Golden Poo Awards, she said, and she invited Sandi Toksvig to present them. "It’s not often you get offered another gig in the middle of presenting one," said Ms Toksvig, making no promises.

The next award went to a website that communicates about the risks of miscommunication: the NHS Choices website, for its "Behind the Headlines" section. This centres on an evidence based assessment of stories on health appearing in the media. Its aim is to provide a way for doctors and the public to assess the truthfulness and accuracy of such stories.

The site was established by Sir Muir Gray, chief knowledge officer of the NHS, and is run by Bazian, a company that specialises in the analysis of drugs, devices, and healthcare services. Paul Nuki, editor of NHS Choices, accepted the award on behalf of a team that has helped hundreds of GPs and thousands of ordinary users to get the facts straight and has stopped misreported science stories spreading in the media and becoming harmful urban myths.

The work is a joint effort between Bazian and its collaborators, who include the Guardian columnist and author of Bad Science, Ben Goldacre (who was also shortlisted for the Health Communicator of the Year award), the Science Media Centre, and the NHS’s National Knowledge Service.

Quality is now the watchword of the NHS, and its top exemplar at the awards was Peter Garrett, leader of the team at the Western Health and Social Care Trust in Londonderry that won the Best Quality Improvement award.

The team won for the dramatic improvement it achieved in the care of patients needing dialysis. So great was this that the Western Renal Service, based at the trust, moved from being among the worst 10% in the UK to the best 10%.

By working together with units across the border in the Republic of Ireland, Dr Garrett said that the team "showed a marked and sustained improvement." He added: "One of our sites achieved 93% of the gold standard, which is probably as good as or better than at any other centre in the UK." It was particularly gratifying that the award recognised an initiative not from the centre but from the periphery of the UK.

"The BMJ is still probably the primary journal in Europe—and possibly the world—dealing with broad medical issues," Dr Garrett said. "An award from the BMJ Group is a huge honour."

Few clinicians can claim to have changed the treatment of a common condition, but this is the achievement that won for Peter Rothwell and his team at the University of Oxford the Outstanding Achievement in Evidence Based Healthcare, sponsored by Solvay Healthcare.

The team was able to show that transient ischaemic attacks (TIAs) need to be taken much more seriously. In the past it often took weeks for such patients to be examined.

"We studied the natural history of TIA and minor stroke, which showed a very high early risk of major stroke in the first day or two that had been missed by previous studies," Professor Rothwell said.

"Since 2000 we have managed to change this condition from being a bit of a backwater to a medical emergency. All the national and international guidelines now recognise that these patients need to be treated immediately and investigated as an emergency.

"Winning this award means a great deal. There are lots of awards for high quality research in basic sciences, but there are remarkably few awards for clinical research."

Better undergraduate teaching that makes use of a web based course won the award for Excellence in Learning and Education, sponsored by Univadis, for a team led by Imtiaz Shah of the University of Glasgow. Among the benefits of the course was online feedback from students, whose responses showed that they believed they most lacked expertise in treating drug overdoses and acute renal failure.

Dr Shah, also a consultant physician at Crosshouse Hospital, Kilmarnock, said, "I had the opportunity to lead the development of this innovative e-learning course in acute medicine at the university, which has been published in the Emergency Medicine Journal."

Support and guidance during the project came from Dr Shah’s coauthors on the EMJ paper, Matthew Walters and James McKillop, and technical support to set up the website was provided by Elizabeth McAlavey.

"This is a prestigious award, and it is a great way to reward all the hard work that has been put into developing this teaching course," Dr Shah said.

Stella Vig, a surgeon at Mayday Healthcare Trust in Croydon, won the Clinical Leadership award for achieving dramatic improvements in the care of wounds resulting from diabetes. In three years the number of major amputations fell by 30% as a result of the new care model. "I have a passion and mission to reduce amputation rates and encourage recognition for peripheral arterial disease," said Miss Vig. "My biggest contribution has been to urge others to believe that this vision is possible.

"Ours is a small district general hospital with limited money, and we have shown we can do it. I am humbled and delighted to have won the award."

Philanthropists have a long and honourable tradition in medicine, but few have contributed on the scale of Bill and Melinda Gates, whose philanthropy rivals the gross domestic product of a small country. Their foundation was the winner of the Global Leadership award, for focusing attention on the healthcare challenges in developing countries and pouring millions of dollars a year into initiatives such as eradicating polio, tackling neglected tropical diseases, and reducing tobacco use.

Alas, neither Bill nor Melinda was present to receive the award, but a spokeswoman for the foundation said that nothing could have been achieved without its partners, "the key to our success in global health."

A stunning roster of high achievers competed for the final award of the evening, the Lifetime Achievement award, which was voted on by readers on bmj.com. Judith Longstaff Mackay, who has lived in Hong Kong since 1967, first heard the call to campaign against tobacco in 1984.

Reflecting on those days, she said it had been a lonely job at the start. "There were no job opportunities, no pay, and I faced the opposition of the tobacco companies," she said. She had been heartened by support from bodies such as ASH and the Bloomberg Foundation. A consultant to the World Health Organization, she was instrumental in developing WHO’s framework convention on tobacco control, to which more than 162 countries are now signed up.

"Some people say public health is boring, but I’ve never found it so. I’ve been held at gunpoint in Mongolia and survived typhoons in Hong Kong and the explosion of an ammunition dump in Cambodia quite close to where I was talking, which brought the ceiling down around me."

Until now, she said, her proudest boast was to have been named among the three most dangerous people in the world by the tobacco industry and to have received death threats from a group of smokers’ supporters. "But this award truly trumps anything I have received from the tobacco industry," she said. "It is a marvellous recognition of public health, prevention, global health issues, and tobacco control."

Winners of the first BMJ Group Awards Research Paper of the Year: Frank Sullivan and colleagues from the Scottish School of Primary Care for "Early treatment with prednisolone or acyclovir in Bell’s palsy" (New England Journal of Medicine 2007;357:1598-607, doi:10.1056/NEJMoa072006) Corporate Social Responsibility: Medical Fair and Ethical Trade Group Health Communicator of the Year: Val Curtis, director of the Hygiene Centre, London School of Hygiene and Tropical Medicine Best Innovation in Medical Communication: NHS Choices, for "Behind the Headlines" Best Quality Improvement: Western Renal Service at the Western Health and Social Care Trust, Londonderry Outstanding Achievement in Evidence Based Health Care: Peter Rothwell, professor of clinical neurology at the University of Oxford Excellence in Learning and Education: Undergraduate Medical School, University of Glasgow Clinical Leadership: Stella Vig, clinical lead for surgery and trauma/orthopaedics and urology at Mayday Healthcare NHS Trust, Croydon Global Leadership: Bill & Melinda Gates Foundation Lifetime Achievement: Judith Longstaff Mackay, senior adviser to the World Lung Foundation

Cite this as: BMJ 2009;338:b1428

---

The full list of the award sponsors is the Health Foundation, BMA News, BMJ Evidence Centre, PriceWaterhouseCoopers, Solvay Healthcare, Univadis, McKinsey & Company, and MediSave.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Judith Mackay: brandishing a sword for health

Jane Parry
BMJ 2009 338: b1689. [Extract] [Full Text]

Good medicine

Trish Groves
BMJ 2009 338: b1455. [Extract] [Full Text]

Prescribe prednisolone alone for Bell’s palsy diagnosed within 72 hours of symptom onset

Vishnu Madhok, Gavin Falk, Tom Fahey, and Frank M Sullivan
BMJ 2009 338: b255. [Extract] [Full Text]

Rapid Responses:

Read all Rapid Responses

Recognition of promotion of Handwashing

Dr .Edwin Dias
bmj.com, 4 Apr 2009 [Full text]

Online poll

Find out more on doc2doc >>