Intended for healthcare professionals


Seven days in medicine: 30 Nov to 6 Dec 2022

BMJ 2022; 379 doi: (Published 08 December 2022) Cite this as: BMJ 2022;379:o2933


Government is “nowhere close” to easing crisis

NHS vacancy data showed 133 446 unfilled posts in secondary care in England as of September.1 Latifa Patel, chair of the BMA’s representative body, said that the ongoing increase in unfilled posts was “a clear sign that the government is nowhere close to getting a grip on the NHS workforce crisis.” She added, “It’s well within the government’s power to address by paying staff fairly, improving retention, and investing in proper workforce planning.”

Ambulance workers plan to strike before Christmas

More than 10 000 ambulance workers in England and Wales voted to strike over the government’s imposed 4% pay award, which they described as another massive real terms pay cut. The GMB union is now meeting representatives to discuss potential strike dates before Christmas. Rachel Harrison, GMB national secretary, said, “Ambulance workers—like other NHS workers—are on their knees. No one in the NHS takes strike action lightly: today shows just how desperate they are. This is as much about unsafe staffing levels and patient safety as it is about pay.”

Digital NHS

Rollout of patient access to records is halted

NHS England instructed the IT system suppliers EMIS and TPP not to switch on automatic patient access to GP records at any practices that have requested more time, after talks with the BMA. The Accelerating Citizen Access to GP Data programme was supposed to see all general practices switch to automatic patient access from 1 November, but concerns over safeguarding and the workload required to prepare the records led to an extension to 30 November. That deadline has been suspended until further notice. (Full story doi:10.1136/bmj.o2902)

HEE outlines plan for “digital first” NHS

Health Education England outlined plans to equip current and future healthcare workers with greater digital technology skills to deliver the ambitions of the 2019 Topol review, which concluded that doctors needed training in genomics, artificial intelligence (AI), and other digital healthcare technologies. The training will focus on a mix of online, digital, and face to face learning. HEE said that simulation and immersive technology, AI, and haptic robotic technologies had the potential to replicate the clinical environment and interactions with patients, enabling more efficient and rapid skill development. (Full story doi:10.1136/bmj.o2921)


BMA calls for review of UK’s healthcare estate

Crumbling, outdated, and poorly laid out buildings in need of repair and modernisation are hampering doctors’ efforts to provide safe and high quality care to patients, said a damning report from the BMA. More than a third of doctors (38%) who responded to a survey said that the overall physical condition of their workplace was poor or very poor, and 43% said that the condition of their workplace was having a negative effect on patient care. Latifa Patel, chair of the BMA’s representative body, called the situation “a national scandal” and said that all UK governments must review the condition of the primary and secondary healthcare estates.

Deep brain stimulation

Surgery is suspended at Birmingham trust

Deep brain stimulation surgery for movement disorders has been suspended indefinitely by University Hospitals Birmingham NHS Foundation Trust after an independent review of 22 procedures found poor clinical results, with most patients deriving little or no benefit. The trust commissioned the review from consultant neurosurgeons at King’s College Hospital, London, after a serious incident investigation of a patient who underwent deep brain stimulation for Parkinson’s disease. The external panel looked at all 22 procedures, performed on 21 patients with movement disorders from January 2017 to October 2019. (Full story doi:10.1136/bmj.o2905)

Transgender care

Delays in England are challenged in court

Lawyers have argued in the High Court that NHS England is acting unlawfully in failing to tackle delays lasting years for transgender patients to get treatment. Mr Justice Chamberlain is expected to rule within weeks on the judicial review case brought by the Good Law Project campaigning group, along with four patients awaiting treatment and the transgender rights charity Gendered Intelligence. Their counsel, David Lock KC, claimed that NHS England was in breach of its statutory duty by failing on its target to ensure that 92% of patients started treatment within 18 weeks of referral. (Full story doi:10.1136/bmj.o2923)


Gender inequalities “hold back” end of pandemic

A “feminist route map” is the only effective course to ending the HIV and AIDS pandemic, said a report from the Joint United Nations Programme on HIV and AIDS (UNAIDS), which found that gender inequalities and harmful gender norms were delaying progress. The annual report warned that the global AIDS response had been “pushed badly off track” with new infections rising in many parts of the world, while decreases in new HIV infections and AIDS related deaths had notably slowed. (Full story doi:10.1136/bmj.o2893)

GP contract

NICE publishes two potential QOF indicators

Two draft indicators2 for potential inclusion in the 2023-24 Quality and Outcomes Framework have been published by the National Institute for Health and Care Excellence. Anticoagulants for people with atrial fibrillation and an increased risk of stroke is an update to an existing indicator: it differentiates between direct acting oral anticoagulants (DOACs) and vitamin K antagonists, aiming to promote the use of DOACs over vitamin K antagonists unless DOACs are declined by the patient or are not indicated. The second is a new indicator aiming to allow more people with severe mental illness to receive recommended physical health checks. (Full story doi:10.1136/bmj.o2904)

Hepatitis C

NHS is “on track” to eliminate virus by 2025

The NHS reported that it was on track to eliminate hepatitis C in 2025, five years before the World Health Organization’s 2030 target. Since a five year contract worth almost £1bn (€1.16bn; $1.22bn) was signed to purchase antiviral drugs for thousands of patients, deaths from hepatitis C—including liver disease and cancer—have fallen by 35%. John Stewart, national director for specialised commissioning at NHS England, said, “These figures demonstrate the ability of the NHS to use its commercial capabilities and purchasing power to tackle population health challenges, benefiting tens of thousands of people.”

Assisted dying

MPs will examine real world evidence

The UK Parliament’s Health and Social Care Committee will hold a new inquiry next year to examine different perspectives in the debate on assisted dying and assisted suicide, with a focus on the role of medical professionals, access to palliative care, protections needed to safeguard against coercion, and criteria for eligibility. MPs will also look at what can be learnt from international experiences. The committee chair, Steve Brine, said that real world evidence was now available, as some form of assisted dying or assisted suicide is now legal in at least 27 jurisdictions worldwide.