NEWS
Blair calls for digital infrastructure investment
Former Prime Minister, Tony Blair, has called for urgent investment in the digital infrastructure required to ensure that UK healthcare continues to improve and advance. Mr Blair, founder and patron of the Tony Blair Institute for Global Change (TBI), made the call in the Royal College of Physicians’ Future Healthcare Journal. With co-writer Chris Yiu, head of technology and public policy at the TBI, Mr Blair argues that advances in technologies like sensors, artificial intelligence, drug discovery and regenerative medicine have the potential to deliver a step-change in the efficacy and affordability of health interventions. The article acknowledges that technological advances have already been made in certain areas such as mental health and social care, often in the form of mindfulness apps, or online services. But it also points to mistrust of big data and artificial intelligence. According to Blair and Yiu, both have the potential to increase the accuracy of diagnoses and help personalise treatments: “Bungled implementations have caused people to question how well patient data
is being protected and whether decision-makers are putting private profit before the public interest. “Better civic engagement and a more honest public debate about why change is needed will be essential if we are to move forward rather than set progress back by decades.” The authors also take note of the difficulty in encouraging people to let go of decades of paper-based administration and bureaucracy, and instead embrace digital solutions that will last. Digital transformation, they say, is hard to achieve when a system must continue to run efficiently throughout those major changes. Blair and Yiu warned that strong and committed political leadership will be essential, and they encourage leaders to consider short- term experimentation and risk-taking in order to realise long-term progress: “In the end, technology is driven by people, and the wave of change it is bringing about is breaking upon every country.
“If ridden with intelligence and purpose, it
can carry us to a bright future, but if let pass, it will maroon us in a sea of irrelevance and decline.”
Specialist mouth cancer surgeons
welcome findings from HPV jab study The British Association of Oral and Maxillofacial Surgeons (BAOMS) has welcomed new study findings from the two-year Cancer Research UK-funded study in Scotland that the HPV vaccination for boys may substantially reduce head and neck cancer. BAOMS had been involved in successfully lobbying for the extension to the HPV to boys last year in England and Northern Ireland. Typically, life-threatening HPV-related cancers can develop during middle age, but boys had been excluded from the national HPV vaccination programme. Since the UK-wide immunisation scheme for girls aged 12 and 13 was introduced in 2008, data shows a reduction of up to 90% of pre-cancerous cells in the smear tests among women aged 20. BAOMS chair, Patrick Magennis, (pictured) explained that the cost of treating just HPV-driven mouth and throat cancer to the NHS is approximately £30m a year: “Between 2010 and 2012 nearly 2,000 men had HPV-related head and neck cancer. Over half of these oropharyngeal cancers are caused by HPV, and in the last decade alone the incidence of these cancers has doubled
in the UK population.” He welcomed the
publication of the new study, which found that over two years 235 male patients in Scotland with head and neck cancer HPV was present in 60% of cases. The findings follow an earlier report, which suggested routine vaccination of schoolgirls in Scotland with HPV had led to a dramatic reduction in cervical disease in later life. Oral and maxillofacial
cancer surgeons’ specialist skills include removing mouth, jaw and tongue cancer and replacing the missing parts with flesh and bone borrowed from the leg, hip or arm. They say that effective and timely cancer treatment for HPV-positive oropharyngeal cancer has excellent survival results. But patients frequently have serious and debilitating life-long side-effects from treatment that have a profound impact on the quality of life of the cancer survivors. “Current evidence suggests that vaccination of boys in their teenage years will prevent them from developing HPV-related cancers in middle age. The introduction of male vaccination is timely,” Patrick Magennis said.
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MDU welcomes call for better BAME support
A report published by the General Medical Council (GMC) identifies some of the factors likely to account for the disproportionate referrals of black, Asian and minority ethnic (BAME) doctors to fitness to practise procedures. Research commissioned by the GMC found several factors, including those relating to the working environment such as poor induction and support, difficult working patterns and lack of feedback from managers which alone or in combination could explain the disparity. This effect can be compounded where organisations focus on blaming individuals when something goes wrong, rather than trying to identify the cause and learn from the incident. Responding to the report, Dr Caroline Fryar, head of advisory services at not-for-profit organisation Medical Defence Union, commented: “The MDU welcomes the recommendations of the Fair to Refer report to which we contributed. When supporting BAME members, the difficulties some have encountered informed our view that there must be better induction support and follow up. Equally, while there are Trusts who do it well, it seems that too many still approach investigations with a view to singling out a doctor to blame, rather than trying to find out exactly what went wrong so they can put it right and it won’t happen again.
“It’s the wrong approach to take the view that a doctor must be individually at fault when an incident happens. There are almost always mitigating systemic factors which contribute to an error such as lack of induction, training concerns and suboptimal staffing levels. “We look forward to working with the GMC and other organisations to take forward the report’s recommendations. It is reassuring to see that delivery of the initiatives outlined will be measured and evaluated. We must see appreciable and positive change.”
Dr Caroline Fryar, head of advisory services at not-for-profit organisation Medical Defence Union
AUGUST 2019
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