{"title":"Gaza: Aid agencies ready to enter territory if ceasefire holds, but $10bn is needed to rebuild health system.","authors":"Luke Taylor","doi":"10.1136/bmj.r112","DOIUrl":"https://doi.org/10.1136/bmj.r112","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"5 1","pages":"r112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Scale of NHS's \"corridor care\" is revealed in Royal College of Nursing report.","authors":"Jacqui Wise","doi":"10.1136/bmj.r99","DOIUrl":"https://doi.org/10.1136/bmj.r99","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":"r99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evangelos Paraskevaidis, Antonios Athanasiou, Laura B Ellis, Sarah J Bowden, Maria Kyrgiou
Decision to treat surgically should be weighed against the rate of complications The introduction of organised cervical screening programmes has enabled the early diagnosis and treatment of cervical intraepithelial neoplasia (CIN), reducing the incidence of invasive cervical cancer and mortality from the disease.1 However, surgical treatments for CIN that excise a cone shaped part of the cervix are not without complications. In a large linked study from Denmark (doi:10.1136/bmj-2023-078140), Aagaard and colleagues obtained data from nationwide registries and investigated short and long term complication rates after conisation for CIN.2 Τhe authors compared the outcomes for more than 48 000 women who underwent conisation with a matched population who had colposcopically directed biopsy alone. The authors explored long term outcomes that included cervical stenosis, fertility related consultations or treatment, infertility diagnosis, and death. The adjusted incidence rate ratio of cervical stenosis for treated women compared with untreated women was 12.6. This risk increased with age and increasing number of conisations. Data on the treatment technique, length of excision, and menstrual phase at operation3 were not recorded in the registry and were not reported. The use of cervical sutures to control intraoperative or postoperative bleeding …
{"title":"Individualised care for cervical precancer","authors":"Evangelos Paraskevaidis, Antonios Athanasiou, Laura B Ellis, Sarah J Bowden, Maria Kyrgiou","doi":"10.1136/bmj.r7","DOIUrl":"https://doi.org/10.1136/bmj.r7","url":null,"abstract":"Decision to treat surgically should be weighed against the rate of complications The introduction of organised cervical screening programmes has enabled the early diagnosis and treatment of cervical intraepithelial neoplasia (CIN), reducing the incidence of invasive cervical cancer and mortality from the disease.1 However, surgical treatments for CIN that excise a cone shaped part of the cervix are not without complications. In a large linked study from Denmark (doi:10.1136/bmj-2023-078140), Aagaard and colleagues obtained data from nationwide registries and investigated short and long term complication rates after conisation for CIN.2 Τhe authors compared the outcomes for more than 48 000 women who underwent conisation with a matched population who had colposcopically directed biopsy alone. The authors explored long term outcomes that included cervical stenosis, fertility related consultations or treatment, infertility diagnosis, and death. The adjusted incidence rate ratio of cervical stenosis for treated women compared with untreated women was 12.6. This risk increased with age and increasing number of conisations. Data on the treatment technique, length of excision, and menstrual phase at operation3 were not recorded in the registry and were not reported. The use of cervical sutures to control intraoperative or postoperative bleeding …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jemima Sneddon and Alexander Mafi argue that last minute changes to specialty training recruitment criteria are creating unfair and inappropriate assessments of doctors applying for training posts As 2025 specialty training application offers approach, resident doctors in the UK are reaching the conclusion of what is likely to be the most competitive round of recruitment yet. For those applying it has been alarming to discover that recruiting organisations have yet again made unfair and late changes to interview scoring criteria.1 These changes not only threaten widening participation and the fairness of the process, but raise serious questions about the skill set and qualities the NHS values in its future clinical workforce. The internal medicine training (IMT) recruitment programme announced changes to the scoring system for the 2025 intake with less than a year’s notice and confirmed the final scoring system online just weeks before the application deadline.1 This year's applicants no longer gained points towards interview places based on leadership experience or prizes achieved. Instead, they had to rely more heavily on a narrower set of criteria. A disproportionate number of points were …
{"title":"Unfair specialty recruitment practices threaten the NHS’s future workforce","authors":"Jemima Sneddon, Alexander Mafi","doi":"10.1136/bmj.r110","DOIUrl":"https://doi.org/10.1136/bmj.r110","url":null,"abstract":"Jemima Sneddon and Alexander Mafi argue that last minute changes to specialty training recruitment criteria are creating unfair and inappropriate assessments of doctors applying for training posts As 2025 specialty training application offers approach, resident doctors in the UK are reaching the conclusion of what is likely to be the most competitive round of recruitment yet. For those applying it has been alarming to discover that recruiting organisations have yet again made unfair and late changes to interview scoring criteria.1 These changes not only threaten widening participation and the fairness of the process, but raise serious questions about the skill set and qualities the NHS values in its future clinical workforce. The internal medicine training (IMT) recruitment programme announced changes to the scoring system for the 2025 intake with less than a year’s notice and confirmed the final scoring system online just weeks before the application deadline.1 This year's applicants no longer gained points towards interview places based on leadership experience or prizes achieved. Instead, they had to rely more heavily on a narrower set of criteria. A disproportionate number of points were …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We are grateful to Iacobucci for drawing our attention to the latest childhood obesity figures.1 Once again they are shocking statistics. Prevalence is higher in England than in comparable countries, and children in the most deprived parts of England are twice as likely to have obesity as those in the least deprived areas. Many people in deprived areas lack reliable access to enough nutritious …
{"title":"Childhood obesity: positive change is possible","authors":"Michael Craig Watson, Angela Towers","doi":"10.1136/bmj.r80","DOIUrl":"https://doi.org/10.1136/bmj.r80","url":null,"abstract":"We are grateful to Iacobucci for drawing our attention to the latest childhood obesity figures.1 Once again they are shocking statistics. Prevalence is higher in England than in comparable countries, and children in the most deprived parts of England are twice as likely to have obesity as those in the least deprived areas. Many people in deprived areas lack reliable access to enough nutritious …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Plans to reform elective care must avoid the trappings of over-investigation and fragmented and inappropriate care, writes Ella Hubbard “We need more activity, and less waste,” says Wes Streeting in his introduction to NHS England’s plan to reform elective care.1 The recently published proposals set out how this will be achieved via: “productivity-boosting tools,” a “focus on improving experience and convenience,” and paying £20 to GPs who use the advice and guidance system to seek a secondary care opinion before, or instead of, making a formal onwards referral. The plan was illustrated by the story of a patient named Sarah, whose convoluted route to receiving a diagnosis of rhinitis and a hearing aid exposes the risks of focusing on itemisable activity instead of solutions to the deeper problems overwhelming the health service. The case study featuring Sarah was quietly removed from the document after a flurry of GPs pointed out that her treatment managed to be both idealistic and wholly inappropriate. But the most bemusing fact about her meandering clinical journey—seemingly invented without reference to either …
{"title":"Elective care reform: more activity does not necessarily mean better care","authors":"Ella Hubbard","doi":"10.1136/bmj.r105","DOIUrl":"https://doi.org/10.1136/bmj.r105","url":null,"abstract":"Plans to reform elective care must avoid the trappings of over-investigation and fragmented and inappropriate care, writes Ella Hubbard “We need more activity, and less waste,” says Wes Streeting in his introduction to NHS England’s plan to reform elective care.1 The recently published proposals set out how this will be achieved via: “productivity-boosting tools,” a “focus on improving experience and convenience,” and paying £20 to GPs who use the advice and guidance system to seek a secondary care opinion before, or instead of, making a formal onwards referral. The plan was illustrated by the story of a patient named Sarah, whose convoluted route to receiving a diagnosis of rhinitis and a hearing aid exposes the risks of focusing on itemisable activity instead of solutions to the deeper problems overwhelming the health service. The case study featuring Sarah was quietly removed from the document after a flurry of GPs pointed out that her treatment managed to be both idealistic and wholly inappropriate. But the most bemusing fact about her meandering clinical journey—seemingly invented without reference to either …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sudan: Deadly attacks on hospitals and ambulances continue as war rages on.","authors":"Elisabeth Mahase","doi":"10.1136/bmj.r109","DOIUrl":"https://doi.org/10.1136/bmj.r109","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"74 1","pages":"r109"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luke Craddock describes what it’s like working in an emergency department as winter pressures bite I’ve only been working as a foundation year 2 doctor in an emergency department for six weeks and already I’m physically and mentally exhausted. Our department has far too few staff to match the ever increasing demand—a familiar story that is playing out across the country.1 Every day I see colleagues working tirelessly to offer the best care they can for their patients, but the current provision doesn’t let us deliver the gold standard care I was taught to give and aspire to provide. As doctors, we’ve had years of practice interacting with patients under our care to hone our empathy. In this dystopian system, however, it’s not only doctors empathising with patients but also patients empathising with doctors. I’ve had patients commiserate with me over the relentless conditions …
{"title":"NHS emergency department pressures are not because of a single point of failure, it’s the whole system that’s struggling","authors":"Luke Craddock","doi":"10.1136/bmj.r95","DOIUrl":"https://doi.org/10.1136/bmj.r95","url":null,"abstract":"Luke Craddock describes what it’s like working in an emergency department as winter pressures bite I’ve only been working as a foundation year 2 doctor in an emergency department for six weeks and already I’m physically and mentally exhausted. Our department has far too few staff to match the ever increasing demand—a familiar story that is playing out across the country.1 Every day I see colleagues working tirelessly to offer the best care they can for their patients, but the current provision doesn’t let us deliver the gold standard care I was taught to give and aspire to provide. As doctors, we’ve had years of practice interacting with patients under our care to hone our empathy. In this dystopian system, however, it’s not only doctors empathising with patients but also patients empathising with doctors. I’ve had patients commiserate with me over the relentless conditions …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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