Intended for healthcare professionals

Editor's Choice

24/7 technology—who needs it?

BMJ 2015; 350 doi: (Published 28 May 2015) Cite this as: BMJ 2015;350:h2894
  1. Cath Brizzell , deputy editor, The BMJ
  1. cbrizzell{at}

At the Conservative party spring conference David Cameron pledged that, if they formed a new government, the party “would substantially extend weekend working of NHS services.” Post-election, the question is how will it be possible to resource a fully functioning 24/7 NHS when we are struggling to afford the current system? Provision of care seven days a week will increase the demand on already stretched primary and secondary care services, and therefore we need to ask who exactly will be expected to provide it.

In a research paper, Fiona Warren and colleagues analysed results of the GP Patient Survey related to out of hours care (doi:10.1136/bmj.h2040). They found that commercial providers were associated with poorer scores for overall patient experience of out of hours GP care than not for profit providers. Poorer overall experience was reported specifically by Asian service users and those unable to take time away from work.

A linked editorial by Nicola Walker and Richard Baker (doi:10.1136/bmj.h2185) describes the ongoing confusion that patients may experience when trying to navigate the various routes to accessing care out of hours. They argue that now more than ever the growing numbers of older people and those with multimorbidities need greater integration and continuity of care “in hours,” with presentations to general practice becoming more challenging. With the further £22bn of efficiency savings that are targeted for 2021 and services already stretched, achieving this need will be a challenge.

An education article on investigating intracerebral haemorrhage (doi:10.1136/bmj.h2484) highlights that because there are many potential causes, “further imaging beyond plain CT is warranted.” The authors outline appropriate imaging techniques to aid prognosis and treatment. But as our technology gets ever more sophisticated is it always of benefit to patients? Teppo Järvinen and colleagues, in an Analysis article in our Too Much Medicine series (doi:10.1136/bmj.h2088), argue that current fracture risk predictors have at least doubled the number of candidates for drug treatment for osteoporosis. The authors report that “sales of bone densitometry devices and bone building drugs have exploded.” The harms are described for those patients with a diagnosis who the authors say have a “psychological burden” imposed on them. Not forgetting the burden of associated adverse events.

And finally, still on the topic of technology, let’s celebrate one definite success story. The BMJ’s website was 20 years old this week (doi:10.1136/bmj.h2821), with the site now receiving 1.3 million user sessions a month compared with The BMJ’s weekly print run of 120 000. Our online content now includes blogs, videos, podcasts, and infographics tailored to the web, which are delivered through continuous online publication. As we strive for 24/7 online services, editor in chief Fiona Godlee (doi:10.1136/bmj.g6970) hopes that we can continue to “challenge, inform, annoy, and entertain you wherever you are in the world.”


Cite this as: BMJ 2015;350:h2894


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