Seven days in medicine: 6-12 July 2016
BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i3874 (Published 14 July 2016) Cite this as: BMJ 2016;354:i3874
Regulation
Single register for health and care staff is considered
The body that oversees the major regulators of UK health professionals is considering a single register to stop people who have been struck off from practising under a different title. The lead officers of the Professional Standards Authority appeared before the parliamentary health committee for a one-off evidence session on 5 July to answer questions about the authority’s performance, as well as that of the professionals’ regulators. (Full story doi:10.1136/bmj.i3775)
GPs are told to get more involved in child protection
The Care Quality Commission said that healthcare staff and leaders in England need to do more to identify and listen to children at risk of harm. The regulator reviewed child protection cases and found variable involvement, particularly of staff in primary care, with no contribution from general practitioners at all in many cases. The Not Seen, Not Heard report said, “GPs are often in the unique position of knowing the child and their family for many years and can make significant contributions to the safeguarding process.”
Politics
National Health Action chair resigns
Clive Peedell, the consultant oncologist and cofounder of the National Health Action Party, resigned from his position as party leader. Peedell helped establish the UK party in 2012 to campaign in support of the NHS and against the government’s stewardship of the health service. Peedell said, “I can no longer take things forward due to irreconcilable differences of opinion within the [party] executive.” But he said that he would continue to defend “the NHS, public services, and the idea of a fairer society.”
All areas of government must tackle causes of ill health
UK politicians and health experts called for cross government action to tackle the causes of poor health and warned of the impact of myopic funding cuts. Their report said that the link between a difficult childhood (as a result of deprivation or abuse, for example) and psychosis in later life was about as strong as the link between smoking and some types of lung cancer. The experts called for more coordinated measures and resources to tackle underlying deprivation—especially childhood poverty, financial and social inequality, loneliness, and social isolation. (Full story doi:10.1136/bmj.i3793)
NHS services
Congenital heart units are set to close
Specialist heart services at the Central Manchester, Leicester, and Royal Brompton hospitals in England are due to be closed under new proposals, and care will focus instead on centres of excellence that meet tough new standards. NHS England said that the changes were necessary to ensure consistently high quality services across England for patients with congenital heart disease. The condition affects as many as 9 in 1000 UK babies, with differing types of disease and levels of severity. (Full story doi:10.1136/bmj.i3807)
Research news
Nursery policies may encourage antibiotics
Nursery policies excluding children with acute infective conjunctivitis until they recover or have been treated can mean that general practitioners are pressured into prescribing unnecessary antibiotics, a UK audit found. Public Health England recommends that these children need not be excluded, but the audit of 164 childcare providers’ sickness policies found that 86.7% said they should be kept at home, and almost half required them to be treated with antibiotics before returning to nursery. Nearly half of GP respondents said that they had been influenced by childcare policies when deciding whether to prescribe antibiotics for a child with conjunctivitis. (Full story doi:10.1136/bmj.i3754)
Most pregnant women do not need supplements
Multivitamin and mineral supplements are not needed by most pregnant women and are an unnecessary expense, a review by the Drug and Therapeutics Bulletin concluded. It found that marketing claims did not translate to better outcomes for mother or baby. It recommended that women focus on improving their overall diet and taking folic acid, which had strong evidence for reducing neural tube defects, and vitamin D supplements, although the evidence for these was less clear cut. (Full story doi:10.1136/bmj.i3821)
Alcohol duty rise may help cut violence
A small increase of just 1% above inflation in the duty imposed on alcohol sold in retail outlets, pubs, and restaurants could reduce violence related emergency department attendances by 6000 a year across England and Wales, a modelling study estimated. This approach may be more effective at reducing injuries sustained through violence than minimum unit pricing for alcohol, the researchers said. (Full story doi:10.1136/bmj.i3829)
News from the US
Theranos CEO is banned from running labs for two years
US federal regulators banned Elizabeth Holmes, the founder and chief executive officer of the biotechnology company Theranos, from operating blood testing laboratories for at least two years, revoking the company’s laboratory certification. Theranos was scrutinised last year when reports emerged that the company was using its finger prick blood testing technology on only a small fraction of tests and instead relied on other companies’ standard devices to test blood samples. (Full story doi:10.1136/bmj.i3824)
US medical boards often shield doctors guilty of sexual misconduct
Sexual misconduct by doctors is common in the United States but its extent is hard to determine because of a lack of transparency by state medical boards, an investigation found. The Atlanta Journal-Constitution newspaper launched the inquiry after finding that, in the state of Georgia, two thirds of doctors disciplined for sexual misconduct were permitted to practise again. US state medical boards often keep penalties secret, use vague language in public documents, and allow doctors to avoid disciplinary actions by allowing them to enter “impaired physician” programmes, it found. (Full story doi:10.1136/bmj.i3845)