Margaret McCartney: Breaking down the silo walls

The “silo mentality” in medicine, in which information is kept secret from others in the broader team, is rightly castigated—for example, NHS organisations not sharing data, or separate professional workforces duplicating work without sharing results. Silos need breaking open, but the NHS creates and enforces these working patterns daily.

Take, for example, the worthy campaign to reduce antibiotic prescribing. Quite right: this should lead to fewer drug resistances. But there’s also a campaign to recognise and treat potential sepsis earlier—with antibiotics. The two campaigns inevitably conflict.

Or consider the push for patients to be …