Seven days in medicine: 25-31 July 2018BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3341 (Published 02 August 2018) Cite this as: BMJ 2018;362:k3341
Severe obesity in 10-11 year olds hits record high
Some 4% of children in school year 6 were severely obese in 2016-17, up from 3.2% a decade earlier. Public Health England’s analysis of the National Child Measurement Programme found that the prevalence of excess weight, obesity, overweight, and severe obesity was higher in the most deprived areas than in the least deprived. The trend is happening at a faster rate in year 6 than in reception (ages 4-5).
Lists rise while number of surgeries falls
NHS Digital data showed 59 178 163 patients registered at general practices in England on 1 July, up three million from five years ago (56 063 596). During that time the number of general practices fell by 11% from 8053 to 7148. List sizes also increased: in July 2013 the largest proportion of practices (23.1%) had 2000-3999 registered patients, but in July 2018 the largest proportion (19.3%) had 4000-5999. These totals are higher than the population owing to patients still being registered when they die or emigrate, as well as patients not completing the population census, such as homeless people or refugees.
GP clinics aim to be “veteran friendly”
General practices in England are signing up to become “veteran friendly” under a national scheme designed to improve medical care and treatment of former members of the armed services. The initiative, backed by NHS England and the Royal College of General Practitioners, aims to offer support to ex-military personnel who may face additional challenges when they return to civilian life. It was devised by Mike Brookes, a North Yorkshire GP who served in Iraq.
NHS made “complete mess” of Capita deal
MPs criticised NHS England for its handling of a contract with the private company Capita to run primary care support services, calling it a shambles. In a rush to cut the £90m (€101m; $118m) bill for providing these services by a third, NHS bosses failed to consider its impact on GPs, dentists, opticians, and pharmacists, said the Commons Public Accounts Committee. In a critical report the committee said that NHS England and Capita had failed to understand the service that was being outsourced and had misjudged the potential risks. (Full story doi:10.1136/bmj.k3228)
“Groundbreaking” scheme aims to cut illicit drug use in prison
A three year pilot programme to tackle illegal drug use in prison by helping inmates to fight their addiction and by tightening security to shut down supply is already making progress, the government announced. Healthcare workers have been drafted in to support recovering offenders as part of the £9m (€10.1m; $11.8m) pilot at HMP Holme House in County Durham, which began in April 2017. The scheme aims to help prisoners transition from custody to community by arranging appointments for drug and alcohol treatment, financial and accommodation advice, and family engagement.
Deaths in custody are highest for a decade
Some 23 deaths occurred in or shortly after police custody in 2017-18, the Independent Office for Police Conduct’s annual report showed—nine more than the previous year and the highest number for a decade. Three people died in police cells, five died in hospital after becoming unwell in custody, nine were taken ill at the scene of arrest and died in hospital, four were taken ill while in a police vehicle, and two died after being released from police custody. Mental health and links to drugs or alcohol were common factors among the people who died.
Latest outbreak in DR Congo is over, says WHO
The World Health Organization declared the end of the ninth outbreak of Ebola in the Democratic Republic of the Congo. Unlike the previous outbreaks this affected four separate locations, including an urban centre with river connections to the capital and to neighbouring countries and remote rainforest villages, prompting concerns that the disease would spread. WHO urged the country’s government and the international community to build on the positive momentum generated by the quick containment of the virus.
Online tool is available to primary care professionals
Doctors of the World UK, the University of Sheffield, and the social enterprise Yoomee launched migrant.health, an online platform for people working in primary healthcare. Funded by the Health Foundation and supported by the National Institute for Health Research, the tool has fact sheets covering healthcare entitlement, “how to” guides, the facility to share “bright ideas,” links to national resources, and a community platform to consult colleagues.
Regulator urges targets for reporting patient results
The Care Quality Commission called for national standards for the time it should take for patients to receive their results from radiology examinations, after it found “significant variation” in reporting times throughout hospitals in England. It inspected three NHS trusts—Worcester Royal Hospital, Kettering General Hospital, and Queen Alexandra Hospital in Portsmouth—and found serious delays in reporting on radiology examinations that had led to backlogs. Inspectors also identified images that had been reported on only by non-radiology clinicians who were not adequately trained to do so, which was putting patients at risk. (Full story doi:10.1136/bmj.k3168)
Boys in England will be vaccinated from next year
The government will make the vaccine against the human papillomavirus (HPV) available to boys aged 12-13 in England from next autumn, after the Joint Committee on Vaccination and Immunisation recommended extending the current programme. Until now only girls, and some men who have sex with men, have been offered the vaccine in the UK. The vaccine protects men from HPV related diseases, such as oral, throat, and anal cancer, and helps reduce the overall number of cervical cancers in women through herd immunity. (Full story doi:10.1136/bmj.k3237)
Falklands votes in favour of assisted dying motions
The Legislative Assembly of the Falkland Islands backed a motion that terminally ill residents should have the right to die at the time and place of their choosing, subject to robust legislation and safeguards. A second motion stated that, if assisted dying legislation is introduced in the UK, the Falkland Islands would consider adopting it. Both motions passed by four votes to three, with one abstention. Earlier this year Guernsey voted against a similar proposal that would have created the first such regime in the British Isles.
NHS launches action plan to cut stillbirths
Around 600 stillbirths could be prevented each year if NHS maternity units adopt national best practice, NHS England said. An independent evaluation published on 30 July found that clinical improvements, such as better monitoring of a baby’s growth and movement in pregnancy and better monitoring in labour, saved 160 babies’ lives in 19 maternity units. Stillbirths fell by a fifth in maternity units where national guidance had been implemented. Best practice guidance is now being introduced around the country.
New consultants in the community are lacking, report warns
Vulnerable children may fall through gaps because of an “extreme shortage” of newly qualified paediatric consultants in the community, the Royal College of Paediatrics and Child Health warned. It found that just 9.6% of newly trained paediatricians took up a consultant post in community child health—the specialty also responsible for assessing children for abuse or neglect and for treating conditions including attention deficit/hyperactivity disorder and obesity. This compares with recruitment rates of 65% consultants in general paediatrics and 27.7% in specialist paediatrics such as neonatology.