Editor's Choice

Collaboration and patient centred care

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3070 (Published 02 June 2016) Cite this as: BMJ 2016;353:i3070
  1. David Payne, digital editor
  1. The BMJ
  1. dpayne{at}bmj.com

At the Our Future Health conference in the Dutch city of Nijmegen (ourfuturehealth.org)last week, more than 40 speakers talked about innovations that straddled medicine, engineering, architecture, and app development.

Patients quite rightly took centre stage. But should patient care, or at least our current understanding of it, always come first? In the journal this week Jeffrey Aronson suggests not. He argues (doi:10.1136/bmj.i2926) that it can compromise others’ needs, priorities, and preferences. Prescribe a drug costing £60 000 (€77 000; $87 000) per quality adjusted life year (QALY), and you deprive three patients of effective medicines costing £20 000 per QALY. Aronson concludes that it is collaborative care—not patient centred care—that we should be aiming for.

The future of clinical coding in the NHS is another collaborative exercise highlighted this week. Stephen Andrews (doi:10.1136/bmj.i2875) reminds us that doctors need to work cheek by jowl with the coding teams to make sure that the recorded data are of a high enough quality to support research, audit, service development, and quality improvement.

There is a similar call for collaboration from Ian Haines and colleagues (doi:10.1136/bmj.i2574), who want access to data from two major trials to help resolve the controversy around prostate cancer screening.

Collaboration is as important for politicians as it is for healthcare innovators. Coverage of Donald Trump’s campaign for the US presidency has tended to focus on his “isolationist” foreign policy—arguably the opposite of collaboration. Will his plans for healthcare be more inclusive? Leigh Page (doi:10.1136/bmj.i2996) compares them with rival candidate Hillary Clinton’s.

Supporters of the European Union argue that its collaborative ethos benefits science and research, trade, and migration of citizens between member states. How would a Brexit vote affect the NHS, both as a service provider and employer? Anne Gulland (doi:10.1136/bmj.i3027) investigates.

Find out more at bmj.com/brexit.

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