Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
When I was lucky enough to work with NICE on the Fever in Childhood
guidance one of the driving motivations in the group was to see an
improvement in child mortality from serious infections. The UK falls
behind many Western Nations in this regard. Two theories for this were
discussed. Do GPs have too high a bar for admitting sick children with
fever? Once admitted does secondary care manage these children
effectively?
These are admissions so I presume do not include children assessed by
secondary care and sent home the same day. Whilst the results might
reflect more serious illnesses amongst this group of children, it might
equally reflect GPs effective use of NICE guidance and Secondary care's
management of these children. The question I would love answered is what
happened to childhood mortality from infection over this period. If it has
fallen despite the rise in admissions then perhaps we can reflect in a job
well done rather than cynically imagining it is coding inflation or
manipulation.
Guidance might just be working
When I was lucky enough to work with NICE on the Fever in Childhood guidance one of the driving motivations in the group was to see an improvement in child mortality from serious infections. The UK falls behind many Western Nations in this regard. Two theories for this were discussed. Do GPs have too high a bar for admitting sick children with fever? Once admitted does secondary care manage these children effectively?
These are admissions so I presume do not include children assessed by secondary care and sent home the same day. Whilst the results might reflect more serious illnesses amongst this group of children, it might equally reflect GPs effective use of NICE guidance and Secondary care's management of these children. The question I would love answered is what happened to childhood mortality from infection over this period. If it has fallen despite the rise in admissions then perhaps we can reflect in a job well done rather than cynically imagining it is coding inflation or manipulation.
Competing interests: None declared
Competing interests: No competing interests