Seven days in medicine: 1-7 June 2016

BMJ 2016; 353 doi: (Published 08 June 2016) Cite this as: BMJ 2016;353:i3177

UK news

End “chemical restraint” of people with learning disabilities

New guidance from NHS England and the Royal College of General Practitioners is urging GPs to review prescriptions for patients with learning disabilities or autism and to make sure that psychotropic drugs are continued only when the person poses a severe risk to themselves or others and all other alternatives have been exhausted. A review published last year found that between 30 000 and 35 000 people in the United Kingdom with learning disabilities or autism were taking an antidepressant or an antipsychotic despite not having the conditions for which the drugs are indicated. (See full BMJ story doi:10.1136/bmj.i3137)

Pregnant women in Scotland to get free vitamins

Every pregnant woman in Scotland is to be offered free vitamin supplements from next year as part of a drive to improve the health of mothers and babies. The announcement is part of a package of measures that includes a “baby box” for every newborn, with clothing, bedding, books, toys, and a toothbrush, and the box itself can be converted into a basic crib. A similar initiative has been in operation in Finland since the 1930s, where it has been seen as an important support for new mothers. (Full story doi:10.1136/bmj.i3129)

New complaints authority must be independent, say MPs

The body created to oversee and improve the complaints system for the NHS in England must be allowed proper independence outside NHS control, MPs on the parliamentary public administration and constitutional affairs committee have said. The new Healthcare Safety Investigation Branch, which began in April, would succeed only if the government brought forward legislation making it fully independent of the NHS, to help secure a statutory “safe space” in which clinicians, patients, families, and carers could speak frankly about serious risks to patient safety, the MPs said. (Full story doi:10.1136/bmj.i3100)

GPs acquitted of manslaughter

Two GPs who were prosecuted for the manslaughter of a 12 year old patient have been acquitted after the judge presiding over the trial at Cardiff Crown Court ruled that there was no case for them to answer. Lindsay Thomas, 42, and Joanne Rudling, 46, were charged with gross negligence manslaughter over the death of Ryan Morse from Addison’s disease on 8 December 2012. The prosecution argued that Ryan would have lived had either GP visited him or summoned an ambulance after a phone call the previous evening from his mother. But Justice Nicola Davies ruled that there was insufficient evidence on which a jury could convict either doctor. (Full story doi:10.1136/bmj.i3098)


Concern over bullying of ethnic minority staff

Simon Stevens, chief executive of NHS England, described as deeply concerning the results of a survey that found that black and minority ethnic (BME) staff were more likely to be bullied than their white colleagues. Three quarters of the 153 acute care trusts surveyed reported a higher percentage of BME staff being harassed, bullied, or abused by staff in comparison with their white staff. Most acute care trusts (86%) had a higher percentage of BME staff who said that their organisation did not offer equal opportunities for career progression or who said that they had experienced discrimination from a manager, team leader, or colleague. (Full story doi:10.1136/bmj.i3124)


Wristband that logs drinking wins award

BACtrack, a medical device maker in San Francisco, took the $200 000 (£140 000; $180 000) top prize in a competition run by the US National Institutes of Health (NIH) with a wristband that measures blood alcohol concentrations through sweat on the skin. The device, BACtrack Skyn, cannot be used to test real time alcohol concentrations because it takes 45 minutes for ethanol to be transmitted through the skin. But it does provide a log of recent alcohol use. The NIH’s George Koob said, “It can help doctors accurately measure a patient’s drinking history and not just depend on the most recent tests. This can help a lot with the treatment.”

Research news

Long term treatment cuts breast cancer recurrence

Extending the use of adjuvant aromatase inhibitors from five to 10 years in women treated for primary breast cancer significantly increases rates of disease free survival and the risk of cancer occurring in the other breast, shows a study published in the New England Journal of Medicine. However, extended use of the drugs was not found to affect overall survival or to increase fractures. (Full story doi:10.1136/bmj.i3153)

Healthy fats not linked to weight gain

An unrestricted calorie Mediterranean diet enriched with healthy vegetable fats (olive oil) does not increase weight gain or waist circumference any more than a low fat diet does, concludes a study published in Lancet Diabetes & Endocrinology. The authors concluded that the study indicated that current health guidelines that recommend a low fat, low energy diet create unnecessary fear of healthy fats. But Susan Jebb, professor of diet and population health at the University of Oxford, said, “The strongest finding . . . is that to successfully lose weight you need to limit overall food (calorie) intake.” (Full story doi:10.1136/bmj.i3171)

Global health

WHO is open to business “lobbying”

The World Health Organization has been warned that it has made itself open to undue influence from commercial interests after member states agreed a framework for its relations with industry, bodies from academia, non-governmental organisations (NGOs), and philanthropic organisations. These non-state actors can now attend WHO meetings and consultations; provide financial or other types of contributions, such as donations of medicine; provide evidence; advocate on health issues; or provide technical support. However, 60 NGOs said that the framework did not protect WHO from influence from the private sector and would “once and for all, legitimise lobbying by business associations.” (Full story doi:10.1136/bmj.i3134)

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