Seven days in medicine: 20-26 July 2016
BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4148 (Published 28 July 2016) Cite this as: BMJ 2016;354:i4148
Patient care campaigner is mourned
Doctor dies after raising £250 000
Kate Granger, the geriatrics consultant who led a campaign to encourage NHS staff to introduce themselves properly to patients and who published diaries of her experience with cancer, died aged 34. Granger raised more than £250 000 for the Yorkshire Cancer Centre from sales of her two books about having cancer. Her “Hello, my name is . . .” social media campaign has been adopted by more than 400 000 NHS staff across 90 NHS organisations and in about 100 countries. (Obituary doi:10.1136/bmj.i4144)
General practice
Patients will wait a week for GP by 2020
Patients will have to wait more than a week to see a GP on 100 million occasions by 2020-21, an analysis by the Royal College of General Practitioners showed, compared with 69 million times in 2015-16. Demand for appointments will be so high in 2020-21 that 52 million patients will be unable to get one. In 2015-16, 9.4 million were unable to secure a GP appointment and had to seek healthcare elsewhere.
Public health
Vitamin D is urged in autumn and winter
Children and adults should take a daily supplement containing 10 micrograms of vitamin D in autumn and winter to protect bone and muscle health, as it is difficult to meet this intake from dietary sources, Public Health England recommended. Evidence showed that vitamin D supplementation improved bone health in adults over 50 and bone health indices in newborns whose mothers took the supplement while pregnant. (Full story doi:10.1136/bmj.i4061)
Nearly 6000 cases of FGM were identified last year
Some 5700 new cases of female genital mutilation (FGM) were recorded in 2015-16 in the UK, 18 of which were performed there, the first annual statistics from the Health and Social Care Information Centre showed. FGM was most common in girls aged 5 to 9 (43%), and more than one third (37%) of the girls were born in Somalia.
Clinical trials
European rules for first-in-human trials to be tightened
The European Medicines Agency (EMA) proposed changes to its current guidance on first-in-human clinical trials, to reduce risks to participants. The changes were outlined in a concept paper and follow lessons learnt from the phase I first-in-human clinical trial of Bial’s FAAH anxiety drug BIA 10-2474. In the January 2016 trial in Rennes, France, one patient died and five were seriously injured.
Medical workforce
Call for action to keep older doctors in work
The Association of Anaesthetists of Great Britain and Ireland urged a review of the demands on older doctors so that their working patterns can be adapted to allow them to keep working safely. Doctors must work until 67 to claim a full NHS pension, but many retire earlier, leaving gaps in rotas, which are predicted to worsen. Job and career plans for anaesthetists must reflect their capacity to adapt to night work and their mental and physical strengths, the association said.
Surgeon is suspended for altering dead patient’s notes
Jose Mullerat, a consultant surgeon, was suspended for four months after a fitness to practise tribunal found that he had retrospectively added a line to a patient’s notes after her death and claimed that it was contemporaneous. Lyn O’Reilly, 57, of Tilbury, Essex, died of peritonitis from a burst abscess a week after gastrointestinal surgery. Mullerat added a line to her notes after learning of her death, leading to a finding of impaired fitness to practise because of dishonesty. (doi:10.1136/bmj.i4059)
Research news
Flu vaccine reduces admissions
Patients with type 2 diabetes who receive flu vaccine are less likely to be admitted to hospital for myocardial infarction, stroke, or heart failure, a study of 124 503 adults from 300 general practices in England found. Flu vaccination was associated with a 19% reduction in the rate of hospital admissions for acute myocardial infarction, a 30% reduction in admissions for stroke, a 22% reduction in admissions for heart failure, and a 15% reduction in admissions for pneumonia or flu. (doi:10.1136/bmj.i4130)
Simpler treatment may be as good as CBT
Behavioural activation, a simpler type of psychological treatment than cognitive behavioural therapy (CBT) that helps people focus on changing how they act rather than how they think, is as effective as and cheaper than CBT in treating adults with depression, a large randomised study showed. (doi:10.1136/bmj.i4114)
Evidence on skin cancer screening is lacking
Evidence is insufficient to determine whether early detection of skin cancer, including melanoma, through routine visual skin examination by a clinician reduced morbidity or mortality, the US Preventive Services Task Force concluded in JAMA. The task force gave its recommendation an “I” designation, indicating insufficient evidence to make an assessment. The evidence was adequate, however, to conclude that the risks of such examinations are small. (doi:10.1136/bmj.i4155)
Illicit drugs
UK festival goers get their drugs tested
Music fans attending the Secret Garden Party in Cambridgeshire from 21 to 24 July were able to have their illegal drugs tested to find out exactly what they were taking, for the first time ever in the UK. Around 200 people made use of the police backed scheme, run by a community interest company, The Loop. Concerns were raised over around 80 samples, including ketamine cut with malaria tablets and ammonium sulphate sold as MDMA. Around a quarter of people asked for their drugs to be disposed of after they were analysed.