Alan Cribb is Professor of Bioethics and Education at King’s College London and co-director of the Centre for Public Policy Research.
The consensus that 'something needs to change' among the Rethinking Medicine Working Group (and indeed among the constituencies with which it has engaged) has been remarkable - see 'Why we are rethinking medicine'.
Nonetheless, the emerging Rethinking Medicine 'movement' has a lot still to do to clarify and communicate the change message and to tackle the 'how' of change. This includes understanding sceptical reactions, avoiding getting drawn into simple 'x=good, y=bad' dichotomies, and acknowledging the complexities of change while clearly signposting a direction.
I'm writing this blog after screaming at the telly as the Public Health England's chief executive told us we need to 'know our numbers'. He meant our cholesterol and blood pressure readings, but other numbers are far more important.
The numbers that people really need to know are their odds of having a heart attack or a stroke – and this is an area where GPs genuinely are best placed. So if the government wants to reduce health spend and improve outcomes, it needs to value the GP consultation more.
Angela Coulter is a health policy analyst and researcher, with special interests in patient and public involvement.
Did you hear the tragic story publicised by the BBC last week? Gemma Nuttall was diagnosed with ovarian cancer during her pregnancy. She faced an agonising choice of undergoing immediate treatment, with obvious risks to the baby, or delaying this until after the birth. She chose to delay and a few months later gave birth to a healthy baby girl.
But the cancer spread quickly and she was told she had only months to live. Faced with this appalling news, her family launched a desperate search for a cure.
Lucia Lazzereschi is a medical sciences graduate from the University of Exeter, currently in her second year of graduate medicine at Southampton Medical School.
In my first year of university I signed up for a new scheme that was being set up by medical students across the country on social prescribing. I had not come across the term before, but after reading an article by the College of Medicine about it I realised I had to sign up.
Considering I am thinking of becoming a GP when I graduate, the opportunity to spread awareness and teach other people about it seemed like a no-brainer. But what exactly is social prescribing?
Andrew Rix is an independent research and evaluation consultant, and Honorary Researcher at Swansea University School of Medicine.
At the end of the recent Rethinking Medicine webinar, I felt uneasy. At one level the 'movement' is repositioning medicine in the broader context of the socioeconomic determinants of health and wellbeing, but in practice what is happening on the ground is the development of a whole range of changes to service delivery, concerning both the 'what' and the 'how'.
New ways of thinking are leading to new ways of working, changed relationships and, most importantly, a reappraisal of the position of evidence-based medicine and the role of the patient.
We heard of a 'narrative' to plot progress, but it seemed to be mainly a retrospective account of initiatives that been tried and have attracted support.
The central tenet of managing healthcare (at least publicly funded healthcare) is reducing unplanned hospital attendances.
A patient who attends hospital in an 'unplanned' way is seen as a potential failure of the system. The system should have looked after the patient better outside the hospital since once in the hospital, everyone could pay a high price for this failure: the public purse pays over the odds for quite possibly unnecessary care, and even iatrogenic damage to the patient.
The trouble is that despite all the attempts to keep patients away from hospitals when their problem shouldn't really 'need' hospital care, their numbers keep going up and up.
I was recently on the 'other' side of receiving care, as a relative of a patient. I had the opportunity to have a front row seat in viewing the exchange of communication between different healthcare professionals and said patient. Or should I say, the lack of communication.
In urgent care, the triage nurse tutted and sighed when we asked how long it was going to be until my relative was seen….to point out, this was after four hours of waiting without any form of communication. After waiting close to five hours, we received the required referral to the surgical team.
This question became prominent during the study because patients' understandings of 'care' often seemed at odds with those of healthcare professionals. What particularly puzzled me was that healthcare professionals often espoused concepts of good care such as 'shared decision-making', while patients found that the interactions involved did not meet their needs.
While healthcare professionals thought they were 'sharing decisions' or 'involving' patients, patients could simultaneously feel that they were struggling to 'get a conversation' with the doctor or nurse.
I was shocked to learn at a recent meeting that some clinical geneticists think it's OK to screen patients for underlying cancer risk without discussing the options with them and without seeking their informed consent.
Up to then I'd believed that the clinical genetics specialty was ahead of the game when it came to sharing decisions with patients, so this was depressing news.
So, what is Rethinking Medicine and exactly what needs to be re-thought? Medicine is constantly changing – so, what has happened that requires us to rethink the process and perhaps bring it back into line?
Medical training and care provision have developed throughout the centuries to recognise the current knowledge as well as reflecting disease profiles and social mores. It is imperative that medical training and on-going professional development are based on the needs of individual patients and the population who will benefit from the resultant knowledge and skills.