Seven days in medicine: 31 August to 6 September 2016
BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4836 (Published 08 September 2016) Cite this as: BMJ 2016;354:i4836
Vaccination
NICE consults on vaccination rates
The National Institute for Health and Care Excellence launched a consultation on how to increase child vaccination in England in response to falling rates. It recommends following up missed immunisations with phone calls or texts and recording all vaccinations in GP records, personal child health records, and child health information systems. Other plans include checking records of young offenders entering prison or other secure settings for any missed vaccinations. (Full story doi:10.1136/bmj.i4769)
Funding
Planned cuts to pharmacy budget are delayed
David Mowat, a UK health minister, announced in a speech to the Royal Pharmaceutical Society’s annual conference in Birmingham that the government’s planned 6% cut to community pharmacy funding in October would be delayed to “make sure that we are making the correct decision.” The government had estimated that the £170m (€201m; $227m) cut could lead to 3000 pharmacies closing, which pharmacy leaders argued would make it difficult for them to relieve pressure on general practitioners and emergency departments by providing health advice.
Air pollution
Childhood air pollution affects adult lung function
People who lived in the United Kingdom’s most polluted areas as a child in the 1950s are nearly twice as likely to die from a respiratory condition as those who lived in the least polluted areas, showed a study reported at the European Respiratory Society Congress. To highlight the research, the Healthy Lungs for Life Campaign offered free lung function tests in three giant “clean air bubbles” in Trafalgar Square, London.
Surgery restriction
NHS England intervenes in CCG’s surgery plan
NHS Vale of York clinical commissioning group (CCG), which had threatened to delay non-life threatening procedures by a year for patients with a body mass index above 30 and by six months for smokers, agreed to rethink the plan after NHS England intervened. NHS England can mediate because the CCG is under special measures.
Obesity
Children gain weight in primary school years
One in 10 children starting primary school in England at a healthy weight is obese or overweight on leaving, figures from Cancer Research UK showed, and a third overall (33%) are overweight or obese on leaving. To highlight this, the charity transformed a shop front into an “XL” school uniform shop. It said that being overweight or obese contributed to 18 100 cases of cancer a year and that the government’s childhood obesity strategy had not offered an adequate solution.
Councils urge doctors to prescribe exercise
The Local Government Association urged general practitioners in England and Wales to issue exercise prescriptions to obese or overweight patients outlining moderate physical activity goals, after pilot schemes in some areas. These may be for organised walks, conservation work, activities in parks, gardening at home, or exercise classes run by local councils. Izzi Seccombe, chair of the association’s Community Wellbeing Board, said, “Not every visit to a GP is necessarily a medical one. By writing formal prescriptions for exercise, it would encourage people to do more physical activity.”
Dentistry
Patients go to doctor with toothache
An estimated 600 000 appointments a year are made by patients requiring dental care, a study of general practice consultations by the British Dental Association showed. Henrik Overgaard-Nielsen of the British Dental Association blamed the government for “ramping up England’s dental charges.” He told the Times newspaper, “Increasingly they look like a tax on health. These inflated charges are pushing those who can’t pay towards overstretched GPs.”
Respiratory conditions
Children’s respiratory admission risk is assessed
Seven characteristics in children with respiratory tract infections seen in general practice are independently associated with hospital admission, a study in England found: age under 2 years; current asthma; illness duration of 3 days or less; moderate or severe vomiting in the previous 24 hours; severe fever in the previous 24 hours; body temperature of 37.8°C or more at presentation; and clinician reported wheeze on auscultation. Children with four or more of these have the highest risk of admission and should be monitored for signs of deterioration and followed up within 24 hours. Those with fewer features do not need immediate antibiotics. (Full story doi:10.1136/bmj.i4763)
Vitamin D may cut severe asthma attacks
Taking vitamin D supplements in addition to standard asthma drugs reduced the risk of severe asthma attacks needing admission or emergency department care, a Cochrane review of clinical trials in adults and children found. A meta-analysis of placebo controlled trials lasting at least 12 weeks found seven trials including 435 children and two studies involving 658 adults. (Full story doi:10.1136/bmj.i4809)
Medicolegal
Doctor convicted of fraud is struck off
Anthony Madu, who qualified in Nigeria and worked as a registrar in obstetrics and gynaecology in Cardiff, UK, was struck off the UK medical register after being convicted of fraud for working as a locum while on extended leave and sick leave without divulging his true circumstances to any of his employers. A Medical Practitioners Tribunal Service hearing considered the sanction “necessary in order to maintain the reputation of the profession.” (Full story doi:10.1136/bmj.i4761)
Former faculty member is charged with shooting dean
Hengjun Chao was charged with attempted second degree murder for allegedly shooting Dennis S Charney, dean of the Icahn School of Medicine at Mount Sinai, New York City, USA, on 29 August. Chao, who was sacked from the school in 2010, had conducted research into gene therapy for haemophilia and muscular dystrophy. He was fired after an inquiry concluded that he had sought to alter research data. (Full story doi:10.1136/bmj.i4755)