The Commonwealth Fund The Issue How medical practices are organized and structured keeps changing. But as more practices merge and more physicians sell their practices to hospitals, we don’t have a good understanding of whether, and how, these factors affect the quality and cost of health care. Using 2012–2013 data from the National Study of Physician Organizations linked with Medicare claims, Commonwealth Fund–supported researchers writing in Health Services Research (July 5, 2018) examined how the size of a practice, along with other characteristics, relate to the total amount spent on a patient’s care and the quality of care provided. Quality was […]
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New BMA poll show nine out of ten doctors regard latest government pay award as “unacceptable” A BMA poll of more than 12,000 doctors in England shows that nine out of ten regard the recent pay offer from the government as unacceptable, while a similar number believe that their morale has worsened in the wake of the announcement. The BMA received responses from 12, 717 doctors to its survey asking for their opinion on the pay uplifts for doctors in England which were published in July 2018. In making the award, the government ignored the recommendations of the independent review […]
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Consultation events in Birmingham, Exeter, Leeds, London on government plans for dismantling England’s NHS https://www.events.england.nhs.uk/search/30/Icps

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Radical Statistics  (Radstats):  2019 Annual Conference & AGM Liverpool:  Saturday  23  February  2019 Inequalities  and  the  Life-course  – the  Impact  of  Austerity  across  Generations Key questions for this conference include: How do inequalities affect life chances?  What effect has austerity had on inequalities across generations?     Does austerity affect younger cohorts differently than older ones? How does this differ across social groups, class, gender, etc.?  How to measure inequalities across the life-course?    What data exists; what is needed?

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I trust that the latest episode of “Hancock’s Half Hour” made you laugh a lot. The transcript of his speech, exactly as it was delivered on 20 July 2018, is available here, in case you missed it. It was the same script, more or less, but delivered by a different newsreader. As once said, it was the ‘same meat but different gravy’. One of the lines delivered is this: “Paramedics, doctors, nurses, community health staff, managers, IT workers and support staff all working together to provide the best care possible.” Trish Greenhalgh immediately saw the problem with this.     […]
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Fabian Tract no 160 THE final aim of Socialism includes the socialization of the national wealth. But before coming to close quarters with this great problem we have to recognize that a large amount of spade work, of a nature less dazzling, perhaps, than direct Socialist propaganda, but not less necessary, must take the shape of organiz­ing for social purposes those services called the professions, which contain a large proportion of the intellectual and trained members of the community, by whose efforts, even though hitherto only to a small degree secured for public ends, the cause of social reform has […]
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“This is about the standards you want to abide by as a country” So uttered Theresa May in defending a ‘carve out’ in a mythical trade agreement with the U.S. We do not know what these standards are. For all I know, the NHS could be about to launch innovations which are the equivalent of ‘chlorinated chicken’.   Donald Trump, POTUS, admitted this week that he didn’t give Theresa May ‘advice’ on negotiating with the European Union, but he did make a ‘suggestion’. It eventually turned out that Trump advised May to ‘sue the EU’ according to May in her […]
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The thing I’ve learnt the most from my experience as a patient is that the world doesn’t actually “do” binaries. My law training gave me training in being able to argue both sides of a case, and to present the case convincingly, so that I almost believed myself. A client pays a lawyer to win the case, and not to sit on the fence – or even worse, argue the opposite side. As a doctor, I am taught to believe that people have diseases or not, and that each disease will have a relatively predictable outcome assuming that all the […]
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  I am not sure it’s feasible just to use “length of stay” and “avoidable admissions” together only as yardsticks. Imagine if the only metric you had of how effective the provision of weekly groceries was was how much time you spent in a supermarket. But that’s actually the level of the argument. Or, in the alternative, imagine for a moment if a lot of effort was put in, by external advisors, into drawing up lists of how to avoid inappropriate trips to the supermarket; or screening for members of the public who might be at high risk for running […]
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  It may not be actually necessary to abolish the term ‘patient activation measure’. It is such an unappealing term anyway, it is hard to feel that patients themselves, despite free tickets as campaigners and leaders to industry-sponsored conferences, wish to be perceived as ‘activated’ like washing machines. The idea that patients are not passive recipients of medical advice is a crucial one, but that is not the issue. When I was asked what I would replace the term ‘patient activation measure’ with, I was of course obligated to look up the accepted definition of “patient activation”. This is helpfully […]
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For a moment – guess who said this, and when? “We will be studying the report carefully to identify learning points.  We are committed to taking any further action necessary in light of information revealed by this report.” Do we need another report? More lessons learned? It seemed like – not that long ago – we were discussing Southern Health or Winterbourne? This saying above was in fact reported to have been the responseof Charlie Massey, CEO of the General Medical Council (GMC), in response to the events at Gosport War Memorial Hospital. Dr Jane Barton, meanwhile, the doctor at […]
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Grenfell laid raw the harsh realities for many living in London today. Many stories unfolded in the aftermath. There was the tale of two cities. The question of worth. The story of inexcusable inequality, and lives cut short by political failings. There was also the story of invisibility and fear. The undocumented migrants who died in the fire, forever anonymous, and the survivors who went into hiding, too scared to seek help. I went to Grenfell with the charity Doctors of the world UK, a week after the fire. At Westway, the pop-up relief centre, we enquired who to liaise […]
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