Seven days in medicine: 26 October to 1 November 2016BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5871 (Published 03 November 2016) Cite this as: BMJ 2016;355:i5871
Music making can aid stroke recovery
A pilot programme by the UK Royal Philharmonic Orchestra and Hull Integrated Community Stroke Service (part of Humber NHS Foundation Trust) showed that creative music making can benefit stroke survivors and carers. The “Strokestra” programme comprised workshops with stroke patients and their carers, led by Royal Philharmonic musicians and NHS health professionals and culminating in a high profile performance at Hull City Hall. All carers reported improvements in wellbeing and personal relationships, 86% of patients reported improvements in cognition, emotional wellbeing, and symptom relief, and 71% of patients reported physical benefits.
GMC warns of doctors’ “state of unease”
A state of unease exists in the medical profession, as well as a dangerous level of alienation among junior doctors, the General Medical Council warned in its sixth annual report on UK medical education and practice. Terence Stephenson, council chair, said that the situation may affect patients as well as doctors. “The signals of distress are unmistakeable. There appears to be a general acceptance that the system cannot simply go on as before,” he said. (Full story doi:10.1136/bmj.i5804)
Budget cuts increase strain on emergency departments
The UK government must urgently tackle underfunding in adult social care to relieve pressure on emergency departments, said the Commons Health Committee in its winter planning report. Unless the shortfall in social care provision is dealt with, it said, people will continue to face avoidable admission and delayed discharge from hospital. Sarah Wollaston, committee chair, said, “Accident and emergency departments in England are managing unprecedented levels of demand. The pressures are now continuing year round, without the traditional respite over the summer months, as departments try to cope with increasing numbers of patients with complex needs.”
Anaesthetists are concerned about safe care
A third of anaesthetists in UK hospitals find it hard to deliver safe and effective patient care because of a wide ranging lack of resources, showed a study by the Royal College of Anaesthetists. They blamed a demoralised, fatigued workforce, inadequate facilities, disengagement, and lack of cooperation by management, saying that the lack of qualified staff restricts delivery of safe and effective patient care.
Patients admitted at weekends have higher death rates
Patients admitted to NHS hospitals in England at the weekend in 2015-16 were 15% more likely to die within 30 days than those admitted during the week, data from NHS Digital showed. Those discharged at the weekend were more likely to be readmitted as an emergency within seven days, and Sunday discharge was associated with a 40% higher readmission rate than discharge on a Wednesday. Friday and Saturday discharges were also linked to increased readmission rates of 9% and 27%, respectively. (Full story doi:10.1136/bmj.i5797)
Performance ratings do not show poor surgeons
Publishing patient death rates of individual surgeons in England is unlikely to highlight those whose mortality rates are above average because case loads vary so much, an analysis in BMJ Open found. Patient death rates by individual surgeons were first published in June 2013 and hailed as a breakthrough in transparency. But performance within the “expected” range is too crude a measure to detect doctors whose practice may be a cause for concern and therefore creates a false sense of security, said the researchers.
Few know dementia risk factors
More than a quarter (28%) of the British public cannot correctly identify any potentially modifiable risk factor for developing dementia, showed findings from the British Social Attitudes survey, commissioned by Public Health England. It studied whether people could identify heavy drinking, smoking, high blood pressure, depression, or diabetes as risk factors, as well as the protective factor of taking regular exercise, and just 2% identified all of them.
UK researchers are not yet affected by Brexit
A dedicated government inbox for reports of discrimination against UK researchers caused by the country’s decision to leave the European Union has not received any concrete examples, MPs heard. Jo Johnson, minister for universities, science, research, and innovation, told the science and technology committee that he had had 132 emails, two thirds relating to funding issues that had been dealt with. “The remaining third were questions related to mobility. We are still listening and looking for evidence of concrete discrimination,” he said. (Full story doi:10.1136/bmj.i5811)
Cancer strategy ambitions are unlikely to be met, radiologists warn
A shortage of skilled staff and adequate resources means that the ambitions of England’s five year cancer strategy are unlikely to be met, the Royal College of Radiologists warned. When the strategy was published last July the college highlighted the “dire state of radiology services,” and its position statement on progress to date concluded, “Fifteen months on and radiology services are in no better state at all. In fact, all the indicators of vacancy rates, the vast spend on outsourcing, and increasing workloads point to services under even more stress.”1
NHS needs extra cash, MPs tell chancellor
MPs on the parliamentary health committee took the unusual step of writing to the UK chancellor, Philip Hammond, to set out their concerns that the government has not sufficiently recognised the pressures on the NHS, ahead of publishing a report of their inquiry into the state of NHS finances. The NHS in England will not be able to deliver the expected transformation as set out in the NHS Five Year Forward View without more money, they warned. (Full story doi:10.1136/bmj.i5842)
Few industry funded studies link sugary drinks to obesity
Research studies funded by sugar sweetened drink makers are significantly less likely to link sugary drinks to obesity or diabetes related outcomes than independently funded studies, a review in Annals of Internal Medicine found. All 26 studies that found no link had funding ties to industry. But only one of the 34 studies to find a link between sugar sweetened drinks and obesity or diabetes was supported by industry (2.9%). (Full story doi:10.1136/bmj.i5852)
Daylight saving time is linked to depression
Putting the clocks back in autumn is linked to an 11% higher rate of unipolar depressive episodes, research in Epidemiology found. But the research, which examined the incidence of hospital appointments for unipolar depressive and bipolar disorder episodes in Denmark, found no change in incidence of unipolar depressive episodes when clocks were put forward to summertime, and clock changes had no effect on incidence of bipolar disorder. (Full story doi:10.1136/bmj.i5857)
Safer, non-invasive prenatal test gets green light
A new prenatal blood test for Down’s, Edwards, and Patau syndromes will be rolled out from 2018, the Department of Health announced. Each year around 10 000 pregnant women considered at raised risk of carrying a baby with one of these syndromes are currently offered amniocentesis, which carries a small risk of miscarriage. Introducing the blood test could cut the number of women undergoing amniocentesis from 7900 to 1400 a year and reduce the number of test related miscarriages from 46 to around 3.