doctors not leading by example BMJ column on this http://www.bmj.com/content/349/bmj.g6464notes on what food chains are on NHS premises http://www.telegraph.co.uk/health/healthnews/11006903/NHS-hospital-cafes-are-helping-to-fuel-the-obesity-crisis.html RCP audit of workplaces Click to access organisational-audit-of-implementation-of-nice-public-health-guidance-for-the-workplace-full-report_0_0.pdf advice to stop smoking from doctors http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28587/ http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000165.pub4/abstract smoking vs non smoking doctor advice http://www.sciencedirect.com/science/article/pii/S0738399108003935 overweight vs non overweight doctors advice http://onlinelibrary.wiley.com/doi/10.1038/oby.2011.402/abstract http://www.sciencedirect.com/science/article/pii/S0091743513001503

are all available online here 

Here is my response to PHE consultation on Healthchecks. It has to be submitted by the 19th Dec.     Overall comments The tone of the document is disappointing. The Healthchecks programme has been mandated for some time, in the ‘absence of direct randomised controlled trials to guide it’ – in the words of PHE.  […]

New book. I feel frustrated by the care provided to many people at the end of life. For something that’s inevitable we seem fairly poor at many things – especially enough accurate information and support around choices at the end of life. This is the book in 14 tweets. 1)We are all going to die; […]

1) CQC. I think I said that the data dump by the CQC was mince and that I was very concerned about the lack of proven validity and the chosen targets which supposedly exemplify quality. I should have a column in the BMJ about this soon. 2) Obesity. I reiterated that GPs do not have […]

  Sent in tonight. I’m very concerned that it’s going backwards in terms of having a safer NHS, more transparent doctors acting professionally in the best interests of their patients. A blame and shame culture ultimately harms patients.   http://www.gmc-uk.org/concerns/fitness_to_practise_consultations.asp I’m very concerned about the proposed changes.   1) Taking action in all cases where […]

COMARE report Click to access COMARE_16th_Report.pdf In recent years there has been an emerging use of CT to scan asymptomatic individuals. This issue was covered in the 12th COMARE report (COMARE, 2007), which determined that the benefits to the individual would not be the same as those for a symptomatic patient and that the practice […]

The weekly columns I write for the BMJ are – hurrah – all now open access (at least they should be, there are still glitches.)   recent columns include Dementiagate – how politicised pay prevents GPs from working for patients What use is mass flu vaccination ? Does the GMC deserve it’s current powers? Have we […]

    NICE recommendation on anticoagulant machines http://www.nice.org.uk/Guidance/DG14 Lancet systematic review on safety http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61294-4/fulltext NICE cost effectiveness report https://www.nice.org.uk/guidance/dg14/resources/dg14-selfmonitoring-coagulation-status-in-people-on-longterm-vitamin-k-antagonist-therapy-who-have-atrial-fibrillation-or-heart-valve-disease-pointofcare-coagulometers-the-coaguchek-xs-system-and-the2 Scotland about 1% of patients are using INR test strips http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_50.aspx Scottish questions on warfarin self testing in parliament Click to access WA20140321.pdf

Complaint to the ASA https://www.betterasone.co.uk/about-us/ this is not much better after previous complaint http://www.asa.org.uk/Rulings/Adjudications/2014/7/Better-asone-Ltd/SHP_ADJ_264546.aspx#.VD_wqfldU41 “Even if you have private medical insurance, you have to go through your GP to see a specialist and can experience frustration and delays” – where is the evidence of this “Our patients are diagnosed right first time privately, ” I […]