Intended for healthcare professionals


NHS in 2017: A medical profession in step with today’s NHS?

BMJ 2017; 356 doi: (Published 17 January 2017) Cite this as: BMJ 2017;356:j204
Read all the articles in this series on the NHS in 2017
  1. Gareth Iacobucci, senior reporter, The BMJ
  1. giacobucci{at}

In the fourth article of his series,Gareth Iacobucciexamines what is required of a modern medical workforce and the barriers to change

This series has explored how societal changes and shifts in government policy have affected the NHS. Clinicians have inevitably seen their role change, too. As well as mastering clinical expertise, today’s clinicians are under pressure to show that their performance matches that of their peers, that they are aware of patient safety, and willing to blow the whistle. They are also now expected to develop skills to improve services, move away from tribalism, embrace collaborative working, and adapt to new technologies. In the past, these were seen as desirable rather than essential attributes, but modern care standards demand more from clinicians.

How the UK measures up

The Organisation for Economic Cooperation and Development (OECD) concludes that while access to care is good in the UK, the quality of care remains variable and continues to lag behind that in many other developed countries.1

Although cancer survival rates have improved over the past 10 years in line with the OECD average, the UK is still in the bottom third of OECD countries in five year relative survival for colorectal cancer, breast cancer, and cervical cancer.

In acute care, UK survival rates after hospital admission for cardiac arrest or stroke improved faster than the OECD average in the five years leading up to 2013, but they are still worse than in many OECD countries.

The UK compares favourably to other developed countries in avoiding hospital admissions for people with diabetes, but less so for other chronic diseases such as asthma and chronic obstructive pulmonary disease.

Unwarranted variation

Tackling unwarranted variation in clinical practice would help improve some of these headline figures and provide more cost effective care. The pioneering US researcher Jack Wennberg first coined the …

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