Healthcare Republic
in
email bulletins

This Blog

Syndication

Editors' Blog

December 2008 - Posts

  • Putting public health at the heart of our soaps

    For those of us who gain all our lifestyle advice from the Mitchell Brothers, there is bad news afoot: soap operas are not providing us with trustworthy guidance.

    The criticism is that soap characters with bad habits do not experience the disastrous health consequences they actually would suffer, were they not mere figments of storyliners' imaginations. Apparently, many of the characters who are smoking, eating unhealthily or drinking excessively are portrayed as being in implausibly fine fettle.

    So says private healthcare firm Bupa, which has successfully grasped a Christmas marketing opportunity by releasing its ‘top ten' unhealthiest soap characters and arguing that they should be used to hammer home health messages. (Those of you who are on the ball will note that this is not the first time Bupa has named and shamed hard-living soap characters, but only cynics would criticise its motivation for doing so time and again.)

    Topping this year's list is Eastenders' Dot Cotton who Bupa feels is not realistically affected by her chain smoking but should be wheezing and dragging an oxygen tank behind her. Second is some binge-drinking fellow from Emmerdale (which I'm afraid I don't watch) and in third place comes Tyrone Dobbs, a Coronation Street regular whose unhealthy diet leaves him tubby but remarkably healthy.

    Soap producers maintain that certain characters do get their rightful comeuppances: Corrie butcher Fred Elliot's unhealthy lifestyle ended in a fatal heart attack while Walford-based heavy smoker Jim Branning suffered a stroke. Meanwhile, the Street's supermarket stalker Anne Malone launched a vendetta against co-worker Curly Watts..and died after getting trapped in a commercial freezer.

    Besides, there are quite a few non health-related discrepancies between soaps and true life, such as characters returning from the dead, becoming serial killers and even falling in love with Ian Beale. These might lead viewers to take all storylines and characterisation with a large pinch of salt.

    Having said that, there are undoubtedly people who really cannot differentiate between the real world and fantasy, viewers who are unduly influenced by the programmes they watch and whose needs ought to be catered for. In the mental health sector.

    For the rest of us, I'd argue that preachy storylines tend to drive us towards drink rather than away from temptation, though subtle didacticism might not go amiss. Nobody wants health messages rammed down their throats while watching their soap operas of choice but the odd alcohol-induced coma or STD-laden one night stand could prevent a few viewers from ending up in A&E or under the mistletoe with their brother's wife.

    Thankfully, the BBC feels it is already doing its bit, pronouncing that ‘medical dramas such as Holby and Casualty often show the more subtle nuances of medical health matters'.

    To back up its claim, last week the Beeb screened a ‘Dickens' Christmas Carol' style episode of Holby, surely designed to alert viewers to the perils of drinking while writing a script (plus the difficulties of fitting a filming schedule around Tom Chambers' rehearsals for Strictly Come Dancing).

    If this wasn't the point of this episode, which involved bizarre flashbacks; glimpses into the future; and a long-lost (American) son who was also a musical virtuoso, I really, truly can't think what was.

  • Revealed: Gordon Brown's new year resolution for 2009

    I have just emerged, blinking and certainly less sane, from underneath a pile of newspapers going back to Boxing Day armed only with a pair of scissors and cuts of the most notable health stories.

    Yes, you've guessed it, it's the first working day after Christmas and I'm the only member of the HCR reporting team in the office.

    So, what have I learned?

    Well, I'm still recovering from pictures of Prince William's new beard, am choosing to ignore how a pint a day raises cancer risk by a fifth and can't quite forget the tale of the CIA's deployment of Viagra as its weapon of choice against the Taliban.

    But I'm with film critic Barry Norman who tells the Daily Telegraph today that he thinks 2009's recession will encourage people to be a little kinder to each other after a 20-year obsession with outdoing your neighbour.

    It's a nice thought and perhaps one to be broken gently to the parents the DoH is to accuse on Friday of killing their children with kindness and then encourage to better tackle their children's obesity as part of its Change4Life campaign.

    I can empathise. I'm coming to terms with the excessess of the Christmas party season and vowing to shed those extra pounds gained should probably be my new year's resolution.

    Looking back on all those work-related dos, I can't help but wonder if we should look for any hidden meaning in the NHS Confederation's choice of venue: the Cabinet War Rooms? But I digress ...  

    I didn't get the chance to bowl up to Gordon Brown at any of this year's health bashes and ask him what his new year's resolution would be but what do you think?

    The papers are full of election speculation but I would imagine the PM would resolve not to hold one until Labour has been consistently ahead of the Tories in the polls for a good few months. And I can't see that happening next year. My money's on 2010.

    Perhaps the only good thing about the recession is that it has opened up the divide between Labour and the Conservatives.

    Should we be spending our way out of recession? Or are we back to killing with kindness? In the words of Celebrity Big Brother starting Friday, you decide.

  • Healthcare Republic - the best of 2008

    You must now be in full Christmas mode, some of you running frantically around shopping centres to get those last-minute gifts, others setting up their Sky + for the whole festive period. Don't feel guilty, I have already reached full capacity of our Sky box with Gavin and Stacey's Christmas Special, Harry Hill's TV Burp Review of the Year, the best of Top of the Pops, and other Christmas TV specials... all ready to be recorded while I comfortably sip my mulled wine near the fire.

    So while you eagerly wait for your first bite of roasted turkey and before the present unwrapping frenzy officially kicks off, I thought you'd enjoy our very own Healthcare Republic's 2008 highlights with the most-read articles of the year. We have compiled the most popular stories that have made the headlines in the past 12 months. Some of them we brought to you exclusively; others even made the front pages of the national papers.

    January - Just prescribe generics: it's cheaper
    The Public Accounts Committee urges GPs to follow government prescription guidelines, as the NHS spends £200m more than it should on branded medicine.

    February - Extended hours are not that bad...
    The extended hours' debate reaches a turning point as the GPC encourages GPs to accept the DoH contract offer on extended hours after 'sufficient movement' by the government, arguing that the government's offer is less damaging to general practice than the imposition. And the rest is history...

    March - The harsh reality of extended hours
    The initial excitement is short lived as just a few weeks later the government releases further details of how the extended hours DES will work and GPC warns GPs face working 12-hour days under the new arrangement as practices will not be allowed to move consultation time from the day to the evening or weekends to give GPs time off.

    April - Shame on you Darzi
    Lord Darzi comes under fire as LMCs called for the immediate resignation of the health minister at the annual Scottish LMCs conference thanks to our story exclusively revealed in GP newspaper.

    May - Practices feel the pain
    GP exclusively reveals that every practice in the UK is threatened by one of a raft of government policies including polyclinics, APMS contracts, and changes to dispensing rules. These mean that every practice in England will face either pressure on their income, or be forced to close altogether. Some GPs see this as the culmination of a series of sustained attacks on GPs over the past months.

    June - The £1m Darzi Review is finally published
    The review includes a firm commitment to scrap the MPIG, to ensure fair allocation of NHS resources. Lord Darzi appears to have forgotten the role that the DoH's negotiators played in the creation of MPIGs.

    July - Rate your doctor
    Libel lawyers write to the creator of a new website iwantgreatcare.org that reviews GPs, warning of impending legal action. Any member of the public can post and read reviews about named GPs on the website, set up by Dr Neil Bacon, founder of doctors.net.uk. But Carter-Ruck Lawyers, which specialises in defamation and media law, issues a formal notice on behalf of 37 doctors to express their concerns about the website.

    August - Smartcards idea not so smart

    The government reveals that private healthcare companies and social care organisations could be given the power to issue NHS Smartcards so their staff can access patient records. The primary care strategy, released alongside the Darzi review, suggests that staff at non-NHS bodies which provide patient care would be given access to the NHS Care Records Service.

    September - Extended hours, yes. But not for non-NHS services.
    The DoH confirms that GPs may be breaching their contracts by offering flu jabs and travel vaccinations to patients in extended hours and as a result, GPs may no longer be able to offer services that have proven hugely popular with patients outside of the normal working day.

    October - Finally some good news... for GPs
    The GPC says GPs are to receive a boost of more than 20% in pension dynamisation for the first three years of the new GMS contract. The additional funds will be backdated and added to GPs' pension lump sums with interest. GPs are happy, but practice nurses not so much.

    November - 2,000 GPs left BlackBerry-less
    Pearl Medical, the company which provided subsidised BlackBerry email devices to more than 2,000 GPs, ceases trading. In a notice posted on its website, the company says it has ‘unfortunately not been able to raise the short-term financing required to continue operations from the constrained capital markets'. GPs who used the service and wish to retain their email address can do so by paying £5 a month directly to email provider IT Energy's Opality.

    December - GPs compensated for patients lost to Darzi centres
    Stoke-on-Trent PCT announces it is offering £1.25m to practices due to lose patients when three new Darzi centres open next year. GPs across are expected to lose 200 patients on average when the new health centres open - so the PCT is offering funding to all GPs equivalent to £60,000 for a 10,000-patient practice.

    A merry Christmas and happy new year from the Healthcare Republic team...

  • Médecins Sans Frontières offer a top 10 of 2008 worth reading

    It wouldn't be Christmas without a couple of ‘best ... of 2008' or ‘top ten worst .... of 2008'.

    Countdown lists are goldmines for TV channels. 2008's most annoying celebrities are ranked among their peers. Channel 4 counts down 100 of the best/worst comedies/musicals/festive moments and just about anything else that the omnipresent talking heads can gush over with as much over-eager saccharine sincerity as they can muster. ‘Didn't you just love it when...?' ‘It was a defining moment in my childhood when...' Yeah right.

    Amongst the media's obsessive need for list-making at this time of year, there are some top tens it is worth paying attention to.

    Médecins Sans Frontières published a list of what it considers to be the ten most significant humanitarian crises of 2008. The list includes specific countries, such as Somalia or Zimbabwe, or health issues, such as HIV, TB and malnutrition. MSF regards this as a list of the most urgent medical and humanitarian issues the world faces, yet many of them are going ignored by the media.

    The worst humanitarian and medical emergencies in the world in 2008 as seen by MSF workers:

    - Somalia's humanitarian catastrophe worsens
    - Myanmar: despite attention brought on by cyclone, medical needs go ignored 
    - Civilians trapped as war rages in Eastern Congo 
    - Health crisis sweeps Zimbabwe as violence and economic collapse spread  
    - Millions of malnourished children left untreated despite advances in lifesaving therapies 
    - Civilians denied assistance in Ethiopia's Somali Region 
    - Civilians killed and forced to flee as fighting intensifies in Northwestern Pakistan  
    - No end in sight to conflicts in Sudan
    - Iraqi civilians in urgent need of assistance 
    - HIV/TB co-infection: a health battle on two fronts.

    Obviously Christmas is a time when the charity collection box is shaken a little more vigorously than usual and even in these credit-crunched times we all give what we can. But it's not money that is being asked for here, it is awareness. I don't want to dwell on doom and gloom at Christmas time but a simple acknowledgement from all of us that even in the rosy times of festive cheer or the stomach-churning times of a looming recession, some bigger global problems still remain.

    Far be it from me to try to jump on the Band Aid bandwagon (only 24 years too late); the take home message is simply that just because Bono/Chris Martin/ the latest X Factor finalist isn't singing about poverty-related disease or humanitarian crises this year, it doesn't mean they have gone away.

    Just take a moment to peruse the list above and remind yourself of it later on when it feels like the world will end if you don't get to the supermarket before the best of the Brussels sprouts have gone.

    From Médecins Sans Frontières this year, I deliver to you the gift of perspective. Merry Christmas.

  • More reasons to fear sheep at Christmas

    Oh dear. I was listening to an enlightening radio programme on the development of the brain last week, when I heard that the structure of a chimpanzee's brain is virtually indistinguishable from that of a human.

    The only obvious difference is the size, in that most human brains are much larger - the main exceptions being the punters who call football phone-ins and the people who create graphics for TV news programmes.

    But I digress. What really shocked me was the declaration that sheep could remember faces. At first I thought he'd said ‘faeces', which would hardly have been surprising given the lives that most sheep lead.

    But I've already had one unnerving sheep revelation in 2008 (all sheep look different) and quite frankly that was sufficient. I'm one of those people who always thinks that farm animals are looking at me funny. And now I have extra justification for my paranoia.

    Incidentally, if badgers have the same ability to remember faces, then this puts a whole new sinister light on the government's proposed culling in Wales. Do those badgers simply know too much?

    Anyway, I am now worried about my traditional walk in the countryside on Boxing Day. Will I see the same sheep as last year?

    Will I recognise them? Unlikely. Will they recognise me? Probably. I was the bloke who shouted: ‘Sheep! Stop looking at me!'. But what's their hearing like?

    Well, if anything happens to me I'll blame the NHS. This year's excellent sensible drinking adverts have come a year too late. If I had seen them last year I would never have over-indulged on Christmas Day, would not have been so grouchy the following morning, and would never have shouted at those lovely sheep. Honest.

  • Heart-stopping sandwich

    However exciting our eating experiences over the next week or so, none of us is likely to miss a heartbeat in anything more than the most clichéd song-lyric sense.

    Not so for the 25-year-old woman whose case is reported in this week's Lancet.

    Dr Christopher Boos and colleagues from University Hospital Birmingham first saw the woman in January this year. She reported that several times each week she would feel lightheaded and then ‘suddenly and alarmingly unwell'.

    Clinical investigations threw up nothing. Nor did an initial review of her history. Dr Boos and his team didn't give up there, though.

    ‘On questioning, she remarked that her episodes tended to occur when she ate certain kinds of food, especially sandwiches, or drank fizzy drinks,' they report. ‘We kept her in hospital, and continuously monitored her ECG and blood pressure. We offered her a sandwich.' (Cue dramatic orchestra flourish.) The woman immediately began to feel light-headed. Her blood pressure did not drop, but her heart stopped beating for more than two seconds.

    The researchers diagnosed the woman as having swallow syncope without vasodepressor response. In fact, patients with swallow syncope, defined as a transient alteration or loss of consciousness during swallowing, can languish for years because the diagnosis is little known, the researchers say.

    Dr Boos's case report may go some way to improving knowledge of the condition, but how common it might actually be, and why sandwiches and fizzy drinks might trigger episodes, is far from clear. But at least the woman described in the study now has an easier way to shift all that leftover turkey.

  • Does district nursing have a bright future?

    In 1859 a Liverpool merchant and philanthropist called William Rathbone hired a woman called Mary Robinson to nurse his wife at home during her final illness. After his wife died, he continued to employ Ms Robinson so that others who could not afford to pay for nursing were able to receive care in their own homes.

    Mr Rathbone was so impressed with what nursing in the home could achieve that he went on to work with Florence Nightingale to develop the service. They couldn't find enough trained nurses to begin with, so Mr Rathbone set up a nursing school in Liverpool to train nurses for the city's 18 districts.

    This was the beginnings of today's district nursing service, which next year celebrates its 150th anniversary.

    To mark the occasion, the Queen's Nursing Institute is launching a new website tomorrow: www.districtnursing150.org.uk

    The website provides a fascinating insight into the history of the profession, including rare footage, pictures, articles and personal accounts from district nurses from the past 150 years. Something that will be of particular interest to today's nurses are the Queen's Nurse exam papers, which show the level of skills required to be a district nurse in years gone by.

    It's clear that district nursing has a long and proud history. But what of the future?

    In recent years there has been much debate and hand wringing about where district nursing is heading. There was concern about the future of district nurse training and whether it equipped nurses with the skills needed in today's health service. Also, figures released earlier this year showed the number of district nurses fell sharply between 1997 and 2007.

    In 2009, there will be more uncertainty for many community nurses. By April, PCTs have to separate their commissioning and provider functions, which means nurses could find themselves working for a community foundation trust, a social enterprise or even their local acute trust.

    But, despite all these upheavals, community and district nurses are of paramount importance if the government is to achieve its goal of delivering more care in the community. Organisational structures may change and the skills district nurses need may shift over time, but the principles of providing good quality care in people's homes - and the benefits that this can bring - are exactly the same as they were 150 years ago.

    I'd be interested to hear what others think about this. Does district nursing have a bright future, or have there been cutbacks that are affecting the service in your area? If you're a district nurse are you worried about the changes coming next year or do you think they will provide you with more opportunity to innovate? You can comment below to share your views.

     

  • 'Tis the season to be vomiting...

    .... tra la la la la, la la la la.

    Yes folks, norovirus is upon us, spreading in its dependably virulent way in the lead up to the Christmas festivities. Cases are on the rise but this is not unusual for the season, says the Health Protection Agency, providing scant comfort to patients or health professionals.

    Of course, some patients look on the bright side, hoping to contract norovirus at the ‘right time' (ie during the working week, pre party season) in order to profit from multiple hours of daytime telly, plus the opportunity to show of a temporarily trimmer figure.

    A few might feel that this more than makes up for the ‘sudden onset of nausea, followed by projectile vomiting and watery diarrhoea'; others, who have experienced - or shared a home with - such symptoms, might not.

    Warn patients that well-timed norovirus is unlikely. Sod's Law says they'll be struck down on Christmas Eve, thus ruining their one legitimate day of present-opening, turkey-bingeing and relative-baiting.

    Since Christmas illness wastes their own precious time, rather than that of their employers, it might be sensible to follow advice given by the RCGP's Professor Steve Field. This, as GMTV spelt out in words of one syllable earlier in the week, mainly involves improving hygeine...and presumably riding the tube ‘hands free', changing TV channels telepathically and refusing to shake hands with anyone throughout the norovirus season.

    To those who do contract the dreaded lurgy, rather than billious martyrdom, Professor Field suggests staying off work for a further 48 hours after symptoms go, and drinking plenty of fluids.

    With, perhaps, an element of professional self-interest, he also begs all but the oldest or youngest noro-sufferers to bypass surgeries and hospitals to avoid spreading the bug onwards. After all, it's not dangerous, cannot be treated and most people recover of their own accord, within 2 days. By contrast, venturing forth can, in extreme cases, lead to to the closing of entire hospital wards.

    Meanwhile, where norovirus fails to strike, another highly unpleasant seasonal affliction often presents. This can be just as debillitating as norovirus and is also best treated with time off work; plenty of fluids; and intense doses of ‘Deal or No Deal'.

    To aid health professionals in guiding patients through their apocalyptic hangovers, NHS Choices provides handy advice on preventative measures (such as limiting oneself to one drink an hour), plus an explanation of causes and effects.

    As a non-doctor, I was surprised to learn that malnutrition is one side-effect of excess boozing because alcohol uses the body's store of vitamins and minerals and reduces blood sugar levels. Fortunately, I remembered that the human brain has evolved to counter this with its determination to find a kebab shop at any cost.

    Since even the worst hangovers are fairly short-lived, those who fancy a longer period out of the workplace may turn to flu as their ailment of choice. (By flu, I mean the one that knocks you out for a week, not the ‘man flu' so often presented to health professionals in the form of minor sniffles, irritating coughs and overwhelming self-pity.)

    The bad news for the NHS is that people are quite likely to contract flu this year: according to Professor Field, data from GPs and NHS Direct suggests that both have already been seeing more people with flu symptoms. He warns that there could be a flu outbreak around Christmas.

    However, the good news is that those presenting with symptoms caused by toxic poinsettias; forgetting to wear a hat; or extreme sugar-gorging, can be given short-shrift. Simply signpost these time-wasters to BMJ.com, which has generously exposed a range of festive medical myths, much to the misery of skivers and hypochondriacs everywhere.

  • Revalidation becomes a reality

    At last we have some real detail on the process of revalidation for GPs, after years of discussion and delay.

    So, will GPs be happy with what the RCGP is proposing? Well, nobody is ever going to be happy about extra work to do, especially when your livelihood depends on the successful completion of said work.

    And the consultation document sent to every practice last week states that the proposals are ‘deliberately high level'.

    Have you had a chance to read it yet? Will you manage to do so by the end of the consultation period on 9 January? Well, we at Healthcare Republic would love to hear what you think so please drop us a line asap.

    For what it's worth, my initial response to the plan is that it could have been a lot worse. On top of the annual appraisal, we're talking about two clinical audits, five significant event audits, and four feedback exercises, all over a five-year period.

    I would imagine that the general public would have expected GPs to be already undertaking learning activity of this magnitude - and of course many will be doing so, and much more besides.

    But this is not everything. There is a new CPD system being introduced alongside revalidation and this looks far more exacting than anything previously undertaken in general practice.

    GPs will have to collect at least 50 learning credits per year, but the lion's share of the credits will come from demonstrating the ‘impact' of the educational activity on your practice. It will not be sufficient to read 50 copies of a journal a year - you will have to show how your performance has improved as a result.

    And what choice will you have if you are a locum, for example, and the credit system and audit requirements do not really fit with your work schedules? Or what if you simply do not like the system on offer and would like to learn in a different way? Well, there'll be exams waiting for you every five years.

    So, what do you think? Has the RCGP got it right? Will you be ready, willing and able to start in 2010? Or is this just another sledgehammer being swung around general practice in a misguided response to Shipman? Please let us know you views.

  • Should GPs face prosecution for refusing to follow NICE guidance?

    This week GP revealed that the Care Quality Commission could prosecute GPs who fail to follow NICE guidance.

    It is a time of unprecedented influence for NICE after GP revealed this summer that it would overhaul quality framework indicators and identify priorities on the basis of cost-effectiveness.

    What is worrying is that there is not always agreement that NICE guidance is best for patients.

    For example, ‘Doctors ‘ignoring drugs warning' ran the headline on the BBC website back in June. A survey of 355 GPs had found that more than half prescribed risperidone and olanzapine to elderly dementia patients despite a 2004 safety warning.

    Here at GP we wondered how best to tackle a story critical of GPs.

    So, first we established the severity of the problem for GPs as a minister warned of zero tolerance for such action and a legal expert explained that GPs could be struck off for such prescribing.

    And then we quantified the scale of the problem. Showing first that by the end of this year it is estimated that the number of anti-psychotics prescribed by GPs will have increased by 9.6% and later that PCTs were actually cutting dementia services.

    Weeks later the Daily Mail launched a campaign raising funds for the Alzheimer's Society on the back of GP's exclusive figures showing that - far from being a government priority - dementia services were actually being axed.

    Here at GP we're quite happy that over the course of 5 months we've managed to turn the news agenda around from one that was critical of GPs for prescribing antipsychotics for dementia - against NICE guidance potentially - to one where PCTs are taking the flak for axing the services that could render the need for the frowned-upon GP prescribing obsolete.

    So we hope we've explained that by failing to follow NICE guidance GPs are just doing the best for patients in a difficult situation.

    But should GPs really face prosecution for it? We don't think so.

     

  • Does the law on assisted dying need to change?

    Assisted suicide has been much discussed over the past day or so after a number of events brought the issue to the fore.

    Yesterday the CPS announced that the parents of rugby player Daniel James will not be charged for helping their son to die. Then last night Sky Real Lives screened a documentary that appeared to show the moment motor neurone disease sufferer Craig Ewert died after going through with an assisted suicide at the Swiss Dignitas clinic. And, earlier this week MSP Margo MacDonald, who suffers from Parkinson's disease, launched a campaign to legalise assisted dying in Scotland.

    Assisted dying is a thorny issue for clinicians for obvious reasons and there are passionate advocates on both sides of the argument. On the one hand should doctors and nurse stand by and do nothing while patients endure horrendous suffering and desperately want to die with dignity? On the other, if the practice were legalised would it be open to abuse by carers? And, if you are a patient, does knowing that your doctor or nurse could help you to die somehow undermine the care you receive?

    There are no easy answers here. This is why every few years the topic is debated and discussed within professions as representative bodies try to establish where they and their members stand on the issue. Indeed, the RCN announced this week that it is to consult its members for their views on the subject.

    Gordon Brown weighed into the debate yesterday during prime minister's questions revealing that he is opposed to assisted dying because patients could end up feeling under pressure to agree to this - an argument used by many people.

    This is a valid point, but what is clear from both cases mentioned above is that many people want the option to choose how and when they die, particularly if they have a debilitating and progressive illness. Should it be their right to do so?

    The CPS's decision not to prosecute the James' suggests a change in how relatives who assist terminally ill patients to commit suicide will be treated by the law. Yesterday, The Guardian reported that the Labour peer Lord Joffe is likely to introduce a bill proposing a new legal framework for assisted suicide next year. Personally, I think this is long overdue - pursuing bereaved relatives with the threat of prosecution is surely not the best use of the courts' and police time. The law needs to be much clearer in this area.

    Assisted dying will always remain controversial, but it is something that needs to be openly discussed and debated. This is why, whichever side of the argument you are on, Ms MacDonald's move in Scotland and the RCN's consultation are to be welcomed.

     

  • How to catch the happiness bug

    Apparently, there is something just as infectious as MRSA but less regularly found in NHS hospitals: happiness.

    Research recently published on bmj.com states that happiness rubs off. It argues that happiness is not just an individual experience or choice, but depends on the happiness of others to whom individuals are connected directly and indirectly. The findings suggest that clusters of happiness result from the spread of happiness and not just a tendency for people to associate with similar individuals.

    Happiness requires physical proximity to spread, say Professor Nicholas Christakis from Harvard Medical School and Professor James Fowler from the University of California, San Diego, the authors of Dynamic spread of happiness in a large social network: longitudinal analysis of the Framingham Heart Study social network'. For example, a friend who becomes happy and lives within a mile increases your likelihood of happiness by 25 per cent.

    In fact, a person is 42 per cent more likely to be happy if a friend who lives less than half a mile away becomes happy. However, the effect is only 22 per cent for friends who live less than two miles away, and this effect declines and becomes insignificant at greater distances.

    Somewhat unexpectedly, the study claims that live-in partners who become happy increase the likelihood of their partner being happy by only 8 per cent. For siblings who live close by the figure rises to 14 per cent and for neighbours 34 per cent. Colleagues do not affect happiness levels, a finding that suggests that ‘social context may curtail the spread of emotional states'.

    From this, we glean that our friends affect our happiness more than partners or relatives (ie Winnie-the-Pooh might have been a happier bear had Eeyore not been living quite so close by, though Tigger probably more than made up for it).

    We also learn that we can ignore the joys or miseries of our (irrelevant) colleagues, while social networking sites are red herrings in the happiness stakes, conferring a false sense of community without lifting our spirits in the way that our physically present friends can do.

    Why is this interesting? Well, firstly, it is a warning that partaking in the current mood of recession-related melancholy is likely to damage not only our own mental health, but that of our loved ones. If happiness can spread through communities, then surely depression can too.

    As the authors say: ‘Changes in individual happiness can ripple through social networks and generate large scale structure in the network, giving rise to clusters of happy and unhappy individuals.'

    Secondly, and on a happier note, the study endorses the vital work of primary and community healthcare. In the words of the authors:

    ‘Most important from our perspective is the recognition that people are embedded in social networks and that the health and wellbeing of one person affects the health and wellbeing of others.

    This fact of existence provides a fundamental conceptual justification for the specialty of public health. Human happiness is not merely the province of isolated individuals.'

  • Splashing the cash: Is the NHS the new City?

    Forget banks and greedy City workers. Now NHS trusts could be the new scapegoats exposed for splashing out with other peoples' money.

    I was just reading that a NHS trust is being blamed for spending £30,000 on a staff party last month... What were they thinking? Of course there is nothing wrong with throwing a party to reward your hard-working staff and celebrate a big event (the NHS 60th anniversary).

    But splashing £30,000 of public money on entertainment 1) in the middle of an economic recession, 2) a month before Christmas, 3) when some patients can't get treatment on the NHS, doesn't sound like the wisest thing to do to me...

    Especially since only a derisory part of the cost was paid by the staff who attended - they were asked for a nominal £5 donation - while the rest was from NHS Blackpool's single health budget. Let's put things into perspective here though - according to media reports, the cost of the event was a fraction of 1% of the trust's annual £260m budget. But still.

    The question is whether it was judicious to have spent what seems like such an indecent amount of money on a party at a time when people are feeling the effects of the credit crunch.

    Perhaps the problem comes from the fact that there are no restrictions on the amount that the NHS can spend on staff parties. According to the National Audit Office, PCTs do not have to publish the amount spent and it can only be accessed through a freedom of information request. NHS Blackpool perhaps thought they would get away with it...

    It is no surprise that some people are feeling outraged but on the other hand if we start looking into how much money is being 'wasted' on staff bashes two weeks before Christmas and what amazing things could be done instead with the money, I predict a riot.

    A lot of people have been made redundant or at least being threatened to be in the past couple of months, and if on top of this they had to hear that the only light in the tunnel - aka the much anticipated work Christmas party - is no longer happening, I don't see how staff can stay motivated...

    But what people are complaining about - understandably - in this case is why spend so much and why choose the worst economic time to do it?

    Even in the City, lavish £50,000 Christmas parties where Dom Perignon is kept flowing, are being replaced with "team nights" at Nando's where employees are asked to pitch £20 a head from their own pocket.

    Moreover, HBOS is cancelling its staff Christmas celebrations to avoid a public backlash!

    Well now NHS Blackpool will have to give some answers to the council watchdog and I wouldn't be surprised if NHS bosses get a grilling over the whole thing.

  • Does the NHS really love its patients?

    Patients love the NHS but does the NHS love patients?  I read an article in The Observer yesterday that quoted the vice-chairman of the Patients Association as saying: ‘We all love the NHS, but the death rates in some hospitals are too high.'

    Does that statement strike anyone else as strange? He's almost apologising for speaking out of turn. Patients may be dying unnecessarily in hospitals because of poor management or substandard care, but do we really need to make a fuss about it?

    The Observer article revealed how the Healthcare Commission is to launch ‘hit squads' to swoop on hospitals with unusually high rates of ‘death, infections, and botched operations'. I wonder if these are also the hospitals with unusually high charges for car parking and using the telephone?

    Apparently the NHS is the first healthcare system to operate such a system. Another reason for the NHS to be the envy of the world? Of course, the investigators may find that there are good reasons for the high rates, as I'm sure there often are, but would the commission be implementing this scheme if there was not genuine reason for concern?

    The very fact that such a service is needed to inform certain hospital managers that their patients are dying needlessly is shameful. When so many dedicated health professionals, who truly care for their fellow human beings, are let down by the careless few, it tarnishes the name of the whole NHS.

    No matter how old and beloved our national health service may be, it should never be immune from constructive criticism. But some fundamental principles need to be observed by those in charge if it is to retain the long-term faith of the public. Top of the list is: first do no harm.

     

  • Virtual world gets a second life with nurse training

    I don't know who does the PR for Second Life but they are doing a bloody good job.

    The online 3D virtual world got bad press in recent weeks and many assumed we'd seen the end of Second Life. But the lights are still glowing and Second Life is far from gone.

    It seems that the platform is not just a means of escapism, a virtual world where 'normal people' can escape the daily grind of their real world and enjoy life in a virtual utopia, but is now used as an e-learning tool.

    The US Army, news agencies, and universities use Second Life for training purposes. And this week Glasgow Caledonian University announced it has bought an island on Second Life that student nurses will be able to use to enhance their training from next year. The island includes the campus nursing and midwifery school's virtual laboratory.

    The student nurses will be encouraged to create their own character to assess and treat virtual patients. The assessments will then be recorded and analysed later with the student's tutor.

    The advantage of course is the low cost of the training and the secure and safe environment where learners can make mistakes without consequences. And - as my colleagues rightly pointed - you can make you virtual self look as good as you want. Or at least that's what we thought.

    Well maybe the people at Glasgow Caledonian University should have taken some notes before choosing the hairstyle of the male nurse on the presentation video they posted on YouTube.

    What is wrong with improving your medical skills and look like a supermodel?

    But more importantly, and I think this is crucial for the success of such scheme: are nurses allowed to call older patients 'love' or 'dearie' on Second Life? Or is that still not respectful enough, even in a virtual world?

More Posts Next page »

This site is intended for healthcare professionals only