Intended for healthcare professionals

Letters NHS hierarchy disruptors

Clinicians need time, not videoconferencing

BMJ 2019; 366 doi: (Published 21 August 2019) Cite this as: BMJ 2019;366:l5156
  1. Nick Mann, general practitioner
  1. London E9 7TA, UK
  1. drnickmann{at}

ECHO (extension for community healthcare outcomes) has a catchy name but seems to be less disruptive innovation and more a product patented in the United States being sold back to the NHS as “something new.”1 Notwithstanding the many differences between primary …

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