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We have an interview this month with Dr Margaret McCartney, a Glasgow GP, broadcaster, and writer, who discusses her journey into media, the current challenges faced in general practice, and her views on technology, evidence-based medicine, and contemporary healthcare issues. Margaret shares how her media career began rather unexpectedly and gives some insights into her media engagement. She expresses significant frustration with outdated IT systems in Scottish general practice, in particular the current version of Docman, and argues for improvements and suggests integration of beneficial AI technologies could alleviate some of the administrative burdens. The conversation also covers broader healthcare themes, including the application of evidence-based medicine, highlighting the necessity for doctors to interpret guidelines flexibly, and consider patient-specific contexts and complexities. Margaret discusses the application of shared decision-making, including some situations when this may not be appropriate, the implications of fragmented healthcare teams for continuity of care, and the ethical dimensions of assisted dying, advocating caution against expanding medical powers without adequately considering vulnerable populations. Additionally, the discussion touches on concerns regarding social media's impact on young people's mental health, recommending evidence-based approaches to address negative influences effectively. Margaret McCartney Wikipedia page MedicsVoices: Holding medicine to account The Contented Clinician podcast series BBC Radio 4 Naked Week podcast BBC Radio 4 Inside Health Adolescence: what teen boys really think of girls, influencers and porn – Guardian Today in focus podcast Atul Gawande: Being Mortal Frontline TV Documentary Written submission by Dr Margaret McCartney to the UK Parliament's Public Bill Committee regarding the Terminally Ill Adults (End of Life) Bill Registration and Programme for the 2025 SNUG members' day on May 29, 2025 at Westerwood Hotel
This episode we are joined by Dr Margaret McCartney a practising General Practitioner and a Senior Clinical Lecturer in General Practice at the University of St Andrews. Margaret is a vocal advocate for Evidence Based Medicine and regular journal / newspaper columnist and contributor to the BBC Radio 4 programme Inside Health. Does accepting money for a view affect a healthcare professional's ability to make unbiased decisions in the patient's interest? Should those with a conflict of interest be barred from producing guidelines or providing education? Should it be allowed at all? A controversial issue and an edgy conversation you will not want to miss! For our micro-discussion we get into the equally controversial subject of Weight-Loss jabs. A useful public health intervention or patient safety crisis in the making? We pick up on a recent episode of the BBC Radio 4 Programme Inside Health (https://www.bbc.co.uk/programmes/m001jsly) that examines the impact on the NHS of allowing widespread prescribing of the new weight-loss drugs. Links mentioned in the episode:Financial Conflicts of Interest and the Centres for Disease Control and Prevention's 2016 Guideline for Prescribing Opioids for Chronic Pain: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2598092#ild160076r5Listen to Margaret talk about , and change other Doctors' minds about Conflicts of Interest on the BMJ podcast: https://thebmjpodcast.podbean.com/e/taking-on-the-van-tullekens-how-margaret-mccartney-changed-their-minds-about-cois/As with all of our guests, Margaret shares with us her Memory Evoking Medicine, a career anthem and book that has influenced her career or life. Her drug will almost certainly have an effect on you…!The Apothecaries are on the road again! Come and see our next live show at the Clinical Pharmacy Congress on the 10th May in London. Book your tickets and find out more here: https://www.pharmacycongress.co.uk/london Don't forget to check out Steve's impressive TV debut where he describes the role of a Clinical Pharmacist to none other than Professor Green on BBC Morning Live. This is a must watch for anyone who wants to understand this role and the impact of polypharmacy. A new career beckons… You can watch it here: https://www.rpharms.com/about-us/news/details/polypharmacy-featured-on-bbcs-morning-live. You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg You can view the Aural Apothecary Library here; https://litalist.com/shelf/view-bookcase?publicId=KN6E3O Our website is https://www.theauralapothecary.com/ To get in touch follow us on Bluesky and X @auralapothecary or email us at auralapothecarypod@gmail.com . Don't forget to rate us and comment wherever you have got this podcast from.
I have long followed the work of Dr. Margaret McCartney. She is a general practitioner in Glasgow, Scotland, writer, public speaker, and now PhD. She is a fierce advocate for evidence-based medicine. She holds highly skeptical views of screening for disease—which, to my surprise is quite common in the UK. Her recently finished PhD sought empirical evidence regarding declaration of conflicts of interest in the UK. Here is a link to the document. Screening for atrial fibrillation is a focus of this work. Here is a link to her PubMed listing. We had a nice conversation about all things evidence and conflicts. I learned a lot about the health system in the UK. As an added bonus, Dr. M is also an avid cyclist. As always, thank you for your support of Sensible Medicine. This support allows us to bring medical content free of industry advertising. JMM Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
Send us a textGrab your trainers, your dog lead, your jingle bells, or a cuppa and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom. In the second of two episodes this month, Fiona and Nik discuss: Diagnosing diabetes: do you know MODY from LADA?PSA testing in asymptomatic men. Why don't we have a national screening programme for prostate cancer in the UK?Listen as soon as you can to ensure you have full access to all the free resources. And hear a best intentions story that will have you patting your seat before you sit down!Links:Sign up for GP trainee essentials'Chris Hoy and cancer screening: is celebrity campaigning a bad way to make policy?' Margaret McCartney. BMJ 2024;387:q2604Send us your feedback podcast@redwhale.co.uk or send a voice message Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited. Find out more here. Follow us: X, Facebook, Instagram, LinkedInDisclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast....
There are so many campaigns now to stop stigma and embarrassment - from Davina McCall talking about the menopause to Idris Elba campaigning for black men to get their prostate checked. And when we asked for your stories of how embarrassment impacts your health, our inbox was flooded with stories of incontinence, IBS, genital problems, skin issues, fertility troubles, fatty lumps and more - along with the huge and varied ways these issues are affecting your lives. So, how does embarrassment affect how we behave regarding our health, how can doctors and our health service adapt to alleviate it, and do awareness campaigns really help? To discuss James Gallagher is joined by:Dr Margaret McCartney, GP Dr Vanessa Apea, consultant in sexual health at Barts Health NHS Trust and Medical Director at Preventx Professor Ruth Parry, communications expert who studies clinician-patient interactions about sensitive issues. Plus, James gets some top tips to help alleviate embarrassment when talking to your doctor. Presenter: James Gallagher Producer: Hannah Robins Content Editor: Holly Squire Production Coordinator: Ismael SorianoThis programme was produced in partnership with The Open University.
This week we're questioning the effectiveness of the Gallery Test for early cancer detection with investigation authors Margaret McCartney and Deborah Cohen. They delve into the decision-making and politics behind this test's introduction in the UK. The episode also covers the growing NHS waiting list crisis and how Imran Ahmed and his team at Guy's and St. Thomas' NHS Trust are using high intensity theatre (HIT) lists to increase surgical throughput - and what other teams need to know, if a national rollout of this model is to happen. Reading list Galleri promises to detect multiple cancers—but new evidence casts doubt on this much hyped blood test Are surgical HIT lists the answer to bringing down NHS waiting times?
Last month, Catherine, Princess of Wales shared she'd been diagnosed with cancer. Describing this news as ‘a huge shock' and at age just 42, the Princess' disease falls into a category known as “early-onset cancer” – when the disease affects those under 50. While cases in this age group are still rare, diagnosis rates over the past few years have been growing. And scientists are now on a mission to figure out why. Receiving a cancer diagnosis at any age is devastating, but younger people living with the disease face additional challenges. James Gallagher talks to Emma Campbell, a mum of three young children who was diagnosed with bowel cancer at 36. Emma shares not just how her treatment affected her life, but the difficulties in advocating for herself as a younger person trying to get diagnosed. Professor Helen Coleman, cancer epidemiologist for Queens University Belfast, has been studying these diagnostic rates in younger people and explains possible reasons why more people like Emma are finding themselves living with the disease. A series of videos recently went viral on social media from women claiming their weight loss drugs got them pregnant. These drugs – like Ozempic and Wegovy – help people lose weight by suppressing appetite, but could they impact fertility? James speaks to Dr Charlotte Moffett, lecturer in Pharmacology and Molecular Pathology at the University of Ulster, who is studying if these drugs might alter someone's ability to conceive. James is also joined in the studio by GP, Dr Margaret McCartney, who helps him answer some of your questions. Presenter: James Gallagher Producer: Julia Ravey Content Editor: Holly Squire Production Coordinator: Elisabeth Tuohy TikTok credits: @Dkalsolive | @anastasiamalhotra | @coachkatierogers
Professor Tim Spector was one of the “winners” of the Covid era: his ZOE symptom tracker app accrued millions of users during the pandemicNow he has pivoted back to his true passion, gut health, and taken many of his followers with him. Endorsed by celebrities such as Davina McCall and Carrie Johnson, the new version of the ZOE app promises a personalised nutrition plan and comes with a glucose blood monitor usually used by diabetics. It is proving hugely popular, with over 100,000 subscribers paying up to £600 in their first year — and a further 300,000 on the waiting list.It boasts all the hallmarks of a scientific endeavour, with endorsements by world-leading experts and numerous studies. But how convincing are its claims?Deborah Cohen, Newsnight's former Health Editor, and Margaret McCartney, a GP, undertook a forensic investigation for UnHerd and found that ZOE's scientific foundations aren't as strong as they would have you think… Hosted on Acast. See acast.com/privacy for more information.
There have been so many conflicting views in the media lately on the management of menopause, and HRT has barely been out of the press at all in the last couple of years. As a result of the myriad uncertainties around menopause, many women are left feeling like they're having to fend for themselves, and that their concerns are not being heard by their doctors. Taking segments from The BMJ's webinar in May on known unknowns of menopause, we discuss the controversies around HRT; how we can give women balanced and realistic information about menopause and managing their symptoms; and how we can reframe the messaging around the menopausal transition in a more positive and hopeful way, in order to help empower women in navigating this normal life stage. Our guests: Martha Hickey is Professor of Obstetrics and Gynaecology at the University of Melbourne. Her clinical and research interest is around menopause. Margaret McCartney is a GP in Glasgow, and a freelance writer & journalist. Resources: ‘Therapy for the effects of menopause' (webinar) https://www.youtube.com/watch?v=-hQX2SGlcvY ‘ Normalising menopause' BMJ 2022;377:e069369
Until recently, breakthroughs in treating Alzheimer's disease were non-existent. But two new drugs have shown promise in moderately slowing memory and thinking problems for people with early-stage disease. While welcoming the idea of a ‘new era' for treating Alzheimer's disease, how much of a difference could these drugs make for people living with the condition? James Gallagher visits a Memory Café in Doynton to hear about the daily challenges people living with dementia face, and their feelings about the new treatments on the horizon. Lauren Walker, Alzheimer's disease researcher at Newcastle University, gives an overview of the protein these drugs target in the brain, and Liz Coulthard, Professor of Cognitive Neurology at the University of Bristol, explains how these treatments might impact patient's lives. After listening to our “How hot is too hot for human health?” programme, one of our listeners contacted insidehealth@bbc.co.uk to ask how the heat experienced during a hot flush impacts the body. James asks Clare Eglin, lecturer in applied physiology at the University of Portsmouth, what happens in the body during a hot flush and hears about how many others symptoms are actually caused by the menopause from GP, Margaret McCartney. Presenter: James Gallagher Producer: Julia Ravey Editor: Erika Wright Production Co-ordinator: Johnathan Harris Technical Producer: Tim Heffer
They're the trusted public figures of the medical profession, but many of the most famous medics in the UK will have been approached by, and accepted money from, companies wishing to promote their products - and the public will never know. To talk about conflicts of interest in media doctors, we're joined by two of the most recognisable medics on our screens - Chris and Xand van Tulleken, and the GP who persuaded them to think about what they receive cash for, Margaret McCartney. Read our investigation into how the UK's medical royal colleges receive millions from drug and medical devices companies and Margaret McCartney's plea that “You have to be above reproach”: why doctors need to get better at managing their conflicts of interest
James Gallagher finds out if we've turned into a nation of grinders after reports from dentists of increased clenching and cracking of teeth. Margaret McCartney answers your feedback about the new weight-loss drug, exercise for your back, sperm counts and then goes for retail therapy with James to discover how useful shopping data could be for understanding our health.
“Diet and exercise” has been the weight-loss mantra for decades – but a drug designed for diabetes patients could now offer hope to people who are obese, at a time when researchers are warning that half of the world's population are expected to be overweight or obese by 2035. One of the first to have injections of Semaglutide in the UK was Jan who's battled with her weight since childhood. Once the medication took effect she lost 4 stone and said her hunger disappeared. Professor Stephen O'Rahilly from the University of Cambridge explains how the drug mimics our body's natural appetite signalling – but its effects disappear once you stop the weekly injections. Family doctor Margaret McCartney says it might help some who are obese – but warns that it's also gained a reputation as a “Hollywood skinny drug", reflecting some of society's ideas about beauty and celebrity culture. Presenter: Claudia Hammond Producer: Paula McGrath
This week, Simon Day, co-author of The TV Delusion, and I put 'preventative medicine' under the microscope!Drawing on the book 'The Patient Paradox: Why Sexed-Up Medicine Is Bad For Your Health', by Margaret McCartney, as well as personal experiences, we delve into the propaganda around so-called healthcare.Are 'screenings' really helping patients, and if so, how many, and what, if any, are the "unintended" consequences?If you would like to purchase a copy of 'The TV Delusion' but would rather not give your money to evil Amazon, then please email Joanna: jvdl77911@gmail.com to order a signed copy at a reduced price of £10 (+P&P).Education, not indoctrination.Sarah PlumleyThinker-Teacher-Truther Get full access to Sarah Plumley at sarahplumley.substack.com/subscribe
PUBLISHED ON AUGUST 4TH Do we still need GPs? In this episode of the Swift Half with Snowdon, IEA Head of Lifestyle Economics, sits down with GP, Dr Margaret McCartnety, to discuss general medical practice and how it can be improved.
Rashes, a runny nose and weird poos are all common in babies. Parents are sometimes told these symptoms mean their baby is allergic to cows milk and are prescribed low allergy formula or advised to avoid dairy if they are breastfeeding. Marijke Peters cut dairy out of her diet to try and help the gut problems her new baby Eva was having - but it made no difference and she's still trying to find out why she has blood in her poo. Dr Robert Boyle sees babies with allergies in his clinic at St Mary's hospital in London. Those with a cows' milk protein allergy can safely drink low-allergy formula milk - but Dr Boyle thinks that more than the expected 1% of babies are being diagnosed with the allergy. So he looked at the number of prescriptions for these specialised formula milks dispensed in the UK, Norway and Australia. In the UK he says that ten times the number you'd expect to see are prescribed. Professor Paula Moynihan who's Director of Food and Health at the University of Adelaide says these formula milks could pose a risk to children's teeth because they contain different sugars than the type found in milk - which bacteria in the mouth can feed on, making it more acidic and potentially damaging the teeth. She says that any babies given the dairy-free formulas should have their teeth brushed twice a day with a fluoride toothpaste and start seeing a dentist as soon as the first tooth appears. Dr Margaret McCartney explains how long-Covid patients are going to extraordinary lengths to try unproven treatments in the hope that they will alleviate their symptoms. We hear how an investigation by the British Medical Journal uncovered how a special type of blood filtering called apheresis and hyperbaric oxygen therapy - costing thousands of pounds - are offered to long-Covid patients in European clinics but there is no evidence that they will help them. Margaret recommends instead signing up for NHS trials investigating potential treatments in a regulated way. Gout is incredibly painful but many adults diagnosed with the condition aren't taking the recommended medication a year after they were told they had it. Dr Mark Russell from Kings College hospital in London found that only a third of people with gout were taking medication to help lower urate levels in their blood which can turn into crystals in the joints and organs like the kidneys if it is too high.
Hovedtaleren på DSAM's årsmøde den 1. oktober 2021 var Margaret McCartney, der indtog scenen med sit charmerende mundrappe skotske. McCartney er praktiserende læge i Glasgow med interesse for evidensbaseret medicin, forfatter til flere bøger og radiovært for BBC − alt med fokus på almen praksis. Hun redegjorde for familielægens udfordringer, når det gælder kontinuitet og læge-patient-relation. Practicus 258, side 14-15.
I denne podcast kan du høre et interview med Margaret McCartney, praktiserende læge i Glasgow, Skotland. Practicus mødte hende under årsmødet til en snak om kontinuitet i lægarbejdet. Kan vi fastholde kontinuiteten, hvis vi skal arbejde mere i teams? Vi fik også hendes syn på, hvorfor evidensbaseret medicin skal være fundament for vores arbejde – både når vi skal samarbejde med andre faggrupper, på det politiske niveau og med vores patienter. Og vi får hendes syn på det, der skal til for at få et sundhedsvæsen, der fokuserer på de rette indsatser.
I have become hooked on playing online chess during this lockdown and after watching the Queen’s Gambit. So we’ll find out if it is actually doing my brain any good and whether it and similar games can ward off dementia. Margaret McCartney takes us on a fascinating tour through the history of deliberately infecting people with diseases, as the first “challenge trials” with coronavirus are about to start. Listeners David and Barbara tell us about a treatable condition called normal pressure hydrocephalus that is often mistaken for dementia. PRESENTER: James Gallagher PRODUCER: Beth Eastwood Clip from the Netflix series 'The Queen's Gambit', directed by Scott Frank. Music copyright: ‘Training with Mr Schaibel’ by Carolos Rafael Rivera from the official soundtrack of The Queens Gambit
What has the pandemic done to our sex lives? We’ll hear if there’s been a baby boom with Dr Margaret McCartney and Dr Rebecca Thomson-Glover has the lowdown on sexually transmitted infections. We’ll also explore changes to contraception and sexual health services. Meanwhile it feels like we’re on the march to normality, but what about the backlog of patients whose treatment has been cancelled. We speak to Charmayne whose surgery has been held up by the pandemic and Nick Arresti from the British Orthopaedic Association to see how such waiting lists can be tackled.
A fever, cough or loss of smell and taste are criteria for a Covid-19 test, but what if you have different symptoms? James Gallagher discusses whether more symptoms should be added to the UK government's list with resident GP, Margaret McCartney and Dr Thomas Struyf of KU Leuven. Cardiologist Dr Rohin Francis explains what symptoms he sees when patients with coronavirus arrive in hospital. One of the most common symptoms of Covid-19 is the loss of the sense of smell. It returns after a few weeks in most people but a significant minority still can’t smell anything many months later. James Gallagher talks to Prof Carl Philpott of Norwich Medical School who has led an international panel of nose doctors, assessing the evidence for the best therapies to restore the olfactory sense to people who have lost it following respiratory infections. So-called smell training comes out top as the most evidence-based approach. Carl explains how it works and we hear from two people who are trying to regain their sense of smell. And Dr Carly Welch from the British Geriatric Society says that delirium has emerged as another symptom of Covid-19, particularly in the elderly.
One or our listeners, Katharine, asks whether mouthwash can help stop the spread of coronavirus. We hunt down the answer with the help of biochemist Valerie O’Donnell, from the University of Cardiff, and our own Dr Margaret McCartney. Then it’s our turn in the dentist’s chair. Dentistry is up close and personal with a fair amount of splatter, the perfect place for coronavirus to spread. So dentist Paul Woodhouse and University of Newcastle dentist and researcher, Richard Holliday, are on to explain how to make it safe. PRESENTER: James Gallagher PRODUCER: Beth Eastwood
In Covid, oxygen levels in the body can crash without noticeable symptoms - it’s known as “silent hypoxia”. This week we’ll be discussing whether letting people monitor their oxygen levels at home with a pulse oximeter could save lives. James talks to Chris Harris, who’s been using one, and two pioneers of the project - Dr Matt Inada-Kim, Consultant in Acute Medicine at Hampshire Hospitals NHS Trust, and Dr Caroline O'Keeffe who runs oximetry@home in North Hampshire. And the hotly debated topic of rapid, or lateral flow, testing. Local councils are rolling them out for people who can't work from home, and the hope is that they could help us keep on top of the virus by picking out people with Covid. Could it be a way out of the pandemic or could it cause more harm than good? Prof Irene Petersen and our own Dr Margaret McCartney are on the case. Dr Navjoyt Ladher answers some of the most common questions about vaccines. PRESENTER: James Gallagher PRODUCER: Beth Eastwood
Dr Margaret McCartney, a practising GP in Glasgow, discusses communication of science, particularly during the pandemic, the nature of 'expertise', investigating the efficacy and potential harms of non-drug interventions, the nuances of screening and more.
Should you take vitamin D pills to ward off coronavirus? Our own Dr Margaret McCartney has been sifting through the evidence in search of answers. Also clinical trials expert Dr David Collier of Queen Mary University London tells us about new treatments for Covid-19 that are in the pipeline. And is the mysterious “nocebo effect” causing most of the side-effects from statins? Janice Richardson from Hebden Bridge shares her experience on the pills and we chat to researcher and Dr James Howard of Imperial College and cardiologist Dr Rohin Francis. Presenter: James Gallagher Producer: Geraldine Fitzgerald
2020 was awful. So what about 2021? I chat with Prof Neil Ferguson to see how this year could play out and when life might return to normal. Cardiologist Dr Rohin Francis and cancer nurse Aly Foyle are both back to share their experiences of coping during Covid. I promise you, it’s not all bad news. And our own Dr Margaret McCartney, alongside Cancer Research UK’s Jodie Moffat, scrutinises a new blood test that promises to find cancer early. It's a good programme, James. PRESENTER: James Gallagher PRODUCER: Beth Eastwood
Covid-19 damages the lungs, leaving people struggling to get enough oxygen into their body. In the early stages of the pandemic many patients needed a lot of support in intensive care - including artificial ventilation. But there are other ways of boosting oxygen levels in the body - which are being studied in the Recovery-RS trial. Professor Gavin Perkins from the University of Warwick is comparing oxygen delivered by a mask called CPAP with both regular and high-flow oxygen to see which works best. Physiotherapy is one of the hands-on therapies which has been disrupted by the lockdown. Patients who need to do bespoke exercises following a fall or a heart attack might have been offered online sessions instead. But Manchester University researcher Dr Helen Hawley-Hague says these don't suit everyone - including people who don't have access to the internet or a smartphone. We hear from Jennifer and George - both of them have taken part in Helen's studies and have accessed physiotherapy either face-to-face or via a phone app. An Inside Health listener wanted to know if live vaccines like the polio vaccine could protect us against Covid. Oxford University's Andy Pollard explains about the theory behind this idea and how it might help. Dr Margaret McCartney looks at whether it makes a difference if you do a Covid throat and nose yourself - or if it's carried out by a healthcare professional.
This week Claudia Hammond looks at the role of touch in health care, revealing some of the results of the Touch Test, an online study commissioned by Wellcome Collection in collaboration with the BBC. Doctors often need to physically examine patients – but many consultations are now online. Family doctors Margaret McCartney and Ann Robinson explain how important touch is in the consulting room. One of the experts behind the Touch Test, Greenwich University’s Dr Natalie Bowling explains how men said they found touch helped them to communicate better with their doctor. And Deborah Bowman who’s professor of Bioethics at St George’s University in London reflects on how she helps trainee doctors to respect their patients’ dignity by practising on each other. Can touch play a role in talking therapies? Or is hugging a distressed client too risky, following #metoo? And we hear from Anne Townsend who has lost her sense of touch as a side effect of chemotherapy for ovarian cancer. Reflexology – where the feet are gently massaged – has helped to relieve some of her symptoms like pain and breathlessness – and she is looking forward to the birth of her first great grandson later this month. Presenter: Claudia Hammond Producer: Paula McGrath (Picture: A health worker and patient share a hug. Photo credit: Sanjeri/Getty Images.)
Margaret McCartney on National Test and Trace and why households are receiving multiple calls. Beth tells of being contacted many times when her child tested positive and began to think all the family had been separately in contact with different cases, until the penny dropped that the calls were all about the same contact - her daughter. Professor Kate Ardern, director of Public Health in Wigan explains why these calls from the national system aren't joined up. And is there time in a pandemic to do trials for non-drug interventions like pub curfews or social distancing? Professor Paul Glaziou explains that there are currently just 8 such trials globally, while Professor Martin McKee highlights the problems involved. And Margaret hears from Professor Atle Fretheim who is trying to set up a trial in Norway into the impact of school closures on infection control.
We start this week's episode off with a monologue covering a few current events, notably the recent editorial on the COVID-19 pandemic in the USA published by the New England Journal of Medicine titled "Dying in a Leadership Vacuum". From there we interview Dr. Margaret McCartney on her recent opinion piece in the BMJ titled "We need better evidence on non-drug interventions for covid-19"; we talk about masks, schools, the need for randomized trials, and more. Finally, we interview Dr. Jason Sheltzer on his recent papers on cancer biology and the implications of his findings on clinical medicine. NEJM editorial: doi.org/10.1056/NEJMe2029812 Non-Drug Interventions: https://blogs.bmj.com/bmj/2020/08/28/margaret-mccartney-we-need-better-evidence-on-non-drug-interventions-for-covid-19/ Dr. Sheltzer's research: https://www.sheltzerlab.org/research You can reach Dr. Sheltzer at sheltzer at cshl dot edu. Back us on Patreon! www.patreon.com/plenarysession Check out our YouTube channel: www.youtube.com/channel/UCUibd0E2kdF9N9e-EmIbUew
"Why do our tummies rumble - and when they do, does it always mean we are hungry?" asks listener James, aged 12. For this series, with lockdown learning in mind, Drs Rutherford and Fry are investigating scientific mysteries for students of all ages. To get to the bottom of this noisy problem, the doctors tune in to our guts. Geneticist Giles Yeo studies food intake and obesity. He explains the wavy workings of our digestive system, and how those audible rumbles are a sign that digestion is taking place – a phenomenon thought to be onomatopoeically named 'borborygmi' by the ancient Greeks, and explored further in the gruesome 19th century experiments of surgeon William Beaumont. However, tuning in to the gut’s sounds can tell us more than whether we need a snack. Family doctor Margaret McCartney takes us through the process of how and why she and her medical colleagues may use a stethoscope to listen to your abdomen for both particular noises and silence. Microbiologist Barry Marshall has taken medical listening one step further in his Noisy Guts Project. Inspired by microphones used to listen for termites hiding in walls, the Nobel Prize-winning scientist is trialling an acoustic belt, which could be worn to help diagnose and treat Irritable Bowel Syndrome. Presenters: Hannah Fry, Adam Rutherford Producer: Jen Whyntie
How will this year's expanded flu vaccine programme be delivered? In addition to usual groups the flu vaccine will be offered to all eleven year olds, any household contacts of vulnerable people told to shield, more health and social care workers and - the biggest change - everyone over 50! Dr Margaret McCartney discusses the difficult logistics for GP practices and pharmacies trying to work out how to immunise around half the population, whilst managing PPE, social distancing and infection control. Dentistry and Covid - Eddie Crouch, Vice Chair of the British Dental Association discusses how practices open since lockdown are coping. And a good news story of how the pandemic has instigated change in the diagnosis of coeliac disease. Dr Hugo Penny, one of the authors of new interim guidance, explains while Radhika tells of her personal experience of coeliac disease. Plus NHS preparations for winter. Trevor Smith, Divisional Director of Medicine at Southampton General Hospital, and Professor Neil Mortensen, President of the Royal College of Surgeons in England, both share their forecasts..
As the Government announces GPs should start to prescribe cycling Margaret McCartney examines the evidence for exercise referrals with Harry Rutter, Professor of Global Health at the University of Bath. Temperature checks are popping up in bars, restaurants and receptions but do they work or are they giving false reassurance? Plus while the pandemic progresses Professor Carl Heneghan explains another type of false result, that the chance of false positive tests go up. Navjoyt Ladher, Head of Education at the BMJ, talks us through two highly topical terms - specificity and sensitivity. Amateur choirs have been closed due to Covid-19. Margaret talks to Professor Jackie Cassell who is currently researching what aspect of choirs congregating is particularly dangerous and whether the singing is actually a red herring. Producer: Erika Wright Studio Manager: John Boland
Another socially distanced DTB podcast features James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor), who provide an overview of the July issue of DTB. This includes an editorial that discusses some of the challenges in supplying low-dose aspirin to pregnant women for prevention of pre-eclampsia, a DTB Forum article by Margaret McCartney on some of the challenges to evidence-based medicine during the coronavirus pandemic and a DTB Select update on the safety of ibuprofen in people with COVID-19. The main article discusses managing antiepileptic drugs before and during pregnancy for women with epilepsy, and this month's case report is of amiodarone-induced diffuse alveolar haemorrhage. Read the full issue: https://dtb.bmj.com/content/58/7 Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening. Go well and stay well.
"Why do our tummies rumble - and when they do, does it always mean we are hungry?" asks listener James, aged 12. For this series, with lockdown learning in mind, Drs Rutherford and Fry are investigating scientific mysteries for students of all ages. To get to the bottom of this noisy problem, the doctors tune in to our guts. Geneticist Giles Yeo studies food intake and obesity. He explains the wavy workings of our digestive system, and how those audible rumbles are a sign that digestion is taking place – a phenomenon thought to be onomatopoeically named 'borborygmi' by the ancient Greeks, and explored further in the gruesome 19th century experiments of surgeon William Beaumont. However, tuning in to the gut’s sounds can tell us more than whether we need a snack. Family doctor Margaret McCartney takes us through the process of how and why she and her medical colleagues may use a stethoscope to listen to your abdomen for both particular noises and silence. Microbiologist Barry Marshall has taken medical listening one step further in his Noisy Guts Project. Inspired by microphones used to listen for termites hiding in walls, the Nobel Prize-winning scientist is trialling an acoustic belt, which could be worn to help diagnose and treat Irritable Bowel Syndrome. Presenters: Hannah Fry, Adam Rutherford Producer: Jen Whyntie
Tanya has rheumatoid arthritis, a compromised immune system and heart problems. Getting the virus is a risk she cannot take and this is the tenth week that she's been isolating at home with her husband and teenage daughter. But how long will this last and will she have to self isolate in her own home away from her family for the foreseeable future, if her daughter goes back to school? Tanya talks to Claudia about the impact of the pandemic on her life and says why those in the shielding group must not be forgotten. The arrival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the human population has popularised vocabulary that was previously the preserve of scientists and medics. In just a matter of weeks, phrases like the R Number, Herd Immunity, Case Fatality Rate and All Cause Mortality have become part of everyday language. A new pandemic lexicon has emerged. Inside Health regular Dr Margaret McCartney and Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine at the University of Oxford, discuss the meanings of these very precise descriptions and reveal their personal bugbears, the misuse of such terms. And in her final visit for this series to University Hospital Southampton, Inside Health's Erika Wright, talks again to Trevor Smith, Divisional Director for Medicine, about the enormous challenges ahead as the hospital adapts to living with Covid-19. And she talks about the Banksy art work currently hanging at the hospital which reveals a Super Nurse displacing the traditional comic book superheroes, Batman and Spiderman. Healthcare workers have been lionised as heroes, putting themselves on the front line, risking their own lives, to save others. It's a sentiment which troubles some. Dr Michael FitzPatrick, a gastroenterologist in Oxford and Co-chair of the Royal College of Physicians Trainees Committee, describes why heroes are almost entirely the wrong comparators for healthcare workers. Producer: Fiona Hill Clips used in programme: Batman theme by Danny Elfman (composer) from Batman (1989) Copyright Warner Bros. Avengers Theme by Alan Sivestri (composer) from The Avengers copyright Disney Clip from Infinity War , Joe Russo, Anthony Russo (Directors) Copyright Disney Clip from Justice League by Zac Snyder and Joss Whedon (Directors) Copyright Warner Bros Clip from Iron Man by Jon Favreau (director) copyright Disney Clip from Avengers Endgame by Joe Russo, Anthony Russo (directors). Copyright Disney
There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid. Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation against the virus in the US, and from James Gill, Honorary Clinical Lecturer at Warwick Medical School, who’s been following the latest game-changing refinement of this therapy. Just as the rest of us have been getting better at zoom meetings and remembering to unmute ourselves when we want to speak, so have GPs who are now getting rather good at having online consultations. Will this change the way we “go to the doctor” forever or is there sometimes no substitute for face to face contact? Dr Margaret McCartney gives a GP’s insights. As more people begin to wear face masks what kind of impact does it have on communication when a person’s mouth is covered up and it’s hard to tell whether someone is happy or cross? Claudia discusses this question with George Hu, a clinical psychologist in Shanghai where masks have now become ubiquitous, and Alexander Todorov, Professor of Psychology at Princeton University and author of the book “Face Value : The Irresistible Influence of First Impressions”. Are we more versatile in interpreting a masked person’s mood or intentions than we think? Producer: Adrian Washbourne
Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 infection. Erika Wright is back at University Hospital Southampton NHS Foundation Trust. Clinical lead and consultant in critical care, Dr Sanjay Gupta, talks about success giving critically ill patients oxygen using non-invasive ventilation: CPAP - continuous positive airway pressure. He also describes reorganising the hospital's critical care into four sections: patients positive for Covid, negative for Covid, those waiting for test results and those who test negative but are symptoms positive. Nationally, he tells Erika, those who falsely test negative, is between 5-10%. And Inside Health contributor Dr Margaret McCartney delves into the accuracy of antigen swab tests (the test that tells you whether you have the virus or not). False negatives, test results that report the person doesn't have the virus when in fact they do, have serious implications for health care professionals, who might return to work on the basis of a mistaken result. Caution is advised, Dr McCartney advises, when symptoms contradict the test result. A cytokine storm is a variant on a hyperactive immune reaction, where the body thinks its own tissues are invaders. Cytokines are small proteins that trigger more immune activity or less. In a cytokine storm the cytokines rage through the bloodstream, throwing our immune system out of balance and leading to severe illness and even death. This hyper inflammation has been seen in Covid-19 patients and Dr Jessica Manson, consultant rheumatologist at University College London Hospitals and co-chair of the national group of hyper inflammation doctors, tells Claudia what is and isn't known about how to treat cytokine storms in patients with coronavirus. Producer: Fiona Hill
A range of potential treatments have been suggested for Covid-19 but nobody knows if any of them will turn out to be more effective in helping people recover than the usual standard hospital care which all patients will receive. Inside Health regular Dr Margaret McCartney talks to Claudia about how the first randomised trials are now setting out to test some of these suggested treatments with unprecedented speed and adaptability as potential new drug candidates emerge. During lockdown some find their mental health is put at higher risk. Katie Connebear is a mental health campaigner and blogger who was diagnosed with bipolar disorder eight years ago. She has experienced psychotic episodes and has coping strategies in place for when she feels her mental health deteriorating. She offers her thoughts on how to make small progressive steps in the absence of family and friends who she normally relies on when times are difficult. We’ve the latest in Inside Health’s regular visits to test the temperature at Southampton General Hospital. During the current pandemic maternity wards have to make sure that the birth of babies happens in a way that keeps expectant mothers, their birth partners and staff safe from the virus. Government advice includes pregnant women in the “vulnerable group" who need to take extra steps to socially distance, with extra attention after 28 weeks. Consultant obstetrician Jo Mountfield is keen to allay pregnant women’s concerns. And with isolation set to continue, we can also learn from people who have lived in a different kind of lockdown – and one that was in many ways more extreme. Beth Healey is an intensive care doctor currently working in Switzerland who spent 14 months at Concordia research station in the Antarctic, investigating how the team coped with living in such an isolated environment She reveals the similarities in life there and life under lockdown here. Producer Adrian Washbourne
Claudia Hammond reports on Covid-19 and "moral injury" - when the virus peaks, some healthcare staff will find themselves in a situation never faced before, forced to make decisions they would never normally have to make. This puts them at risk of a so-called “moral injury” which might harm their mental health. It’s more often associated with life in the armed services and Neil Greenberg, Professor of Defence Mental Health at Kings College London, explains how he's applying lessons from research in the military to support staff starting work at the new Nightingale Hospital in London. And some of the million recipients of letters saying they should shield themselves by not going out at all for 12 weeks are people who have asthma. Margaret McCartney examines the evidence for how those with asthma receiving letters were selected. Plus the latest dispatch from University Hospital Southampton: consultant Chris Hill explains that the emergency department has been split into Red and Blue areas based on the probability of arrivals having Covid-19. And what’s happening to mental health services during this time of crisis when seeing someone face-to-face needs to be avoided as much as possible? Claudia finds out from psychiatrist Dr Sri Kalidindi. Producer: Erika Wright
When hospitals are full of patients, they're said to be "hot". The coronavirus crisis will push up the temperature of hospitals across the UK and in the first in a special series of weekly dispatches from the medical front line, producer Erika Wright will be taking the temperature of University Hospital Southampton - or The General - in Hampshire (which services almost two million people in the south of England) as they cope with the influx of Covid-19 patients. In this first dispatch, Erika talks to the Divisional Director for Medicine, Dr Trevor Smith, who says as patients have been moved out of this large teaching hospital to make space for coronavirus patients, the hospital's current temperature reading is "cold", but all staff know that this will soon change. This virus is deeply frightening for everybody, but often for older people and those with underlying health conditions it is even worse. The fear is that if hospitals are overflowing, then crude cut-offs by, for example, age, might determine who does or doesn't, get a a bed in intensive care. But Dr Mark Roberts, consultant in acute and geriatric medicine and chair of the British Geriatric Society in Northern Ireland, tells Claudia that health care professionals don't and wouldn't make such arbitrary decisions based on age. Instead, he says, decisions about access to intensive care beds (or in-patient care) will continue to be made at the bedside, with compassion, and with a focus on who has the greatest capacity to benefit. Some people have already decided that they won't go to hospital if NHS services are overwhelmed but they do want reassurance that they would get urgent care at home should they become seriously ill. Retired GP Dr Lyn Jenkins has written to the Prime Minister calling for this to be addressed as a priority. He's in good health, only 69 years old, but believes that he has a moral obligation not to use up scarce hospital resources if critical care beds can be given to younger people. For those who need it, he wants a quick response team to bring pain relief and supplementary oxygen and importantly, the presence of another person, a carer, so people who were very sick wouldn't be alone. GP and Inside Health regular Dr Margaret McCartney talks to Claudia about supplies of personal protective equipment and whether long-promised supplies are finally arriving and she delves into the evidence to find out whether the loss of a sense of smell or taste could be a symptom of coronavirus. Listener Rachel says she can't smell cheese, garlic or lavender oil and she's worried that she could have the virus. Producer: Fiona Hill
Margaret McCartney on COVID-19 and how the military has been deployed to get protective equipment supplies to critical care staff. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard tells of the difficult ethical decisions staff are facing. And Professor Carl Heneghan - suffering from COVID-19 symptoms himself - explains the importance of fast action when treating secondary pneumonia in the elderly; while Deirdre Hollingsworth explains the term "Viral Load". Plus Margaret McCartney visits the famous Belford Hospital in Fort William - specialising in hostile environment trauma - and hears a story of intense mountain rescue.
The UK has one of the lowest numbers of critical care beds in Europe but as the coronavirus threatens to engulf us, drastic measures are being taken to increase capacity. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard, tells Saleyha that the NHS has been asked to plan for doubling, trebling and then quadrupling the number of critical care beds. So far, health authorities in England, Northern Ireland, Scotland and Wales have identified how they can increase the number of beds from just under 5,000 to around 10,000 but as Nicki Credland, Chair of the British Association of Critical Care Nurses says, increased beds mean more specialist intensive care nurses in numbers that can't be invented overnight. Additional non-specialist staff are being earmarked to help fully qualified intensive care nurses in the current virus crisis. Dr Margaret McCartney addresses the confusion around two medications: ibuprofen for viral symptoms and the potential risks to Covid-19 patients who are using ACE inhibitors for their high blood pressure or heart failure. Meanwhile away from coronavirus, Saleyha reports on new advances for the treatment of glaucoma, a condition which involves increased pressure to the eye and damage to the optic nerve. It's usually treated using eye drops, but laser treatment could be coming to a hospital near you. Saleyha watches as Gus Gazzard, Professor of Ophthalmology at University College London, uses a laser to treat the high pressure in Veenay Shah's right eye. Evidence from the LiGHT trial, which showed the laser works for newly diagnosed glaucoma patients, is likely to lead to new NICE guidelines which could give patients the choice: eye drops or laser. Faecal incontinence is one of the most debilitating conditions and patients can go for years without even seeking help. But at Sandwell General Hospital in West Bromwich, a revolutionary non-surgical approach is transforming lives. Called the FINCH service, Lead Nurse Kelly Stackhouse, colorectal consultant Rajeev Peravali and patients 21-year-old Lara and 74-year-old John, tell Saleyha how the new approach works. Producer: Fiona Hill
Inside Health hears from two patients, Surinder Biant and Sam Begum who went for a free eye check up with Optical Express. Both were surprised by a diagnosis of cataracts when previous eye tests hadn't uncovered these. Both felt that they were given a hard sell and felt pressurised to have cataract surgery and both had independent second opinions which brought the diagnosis and proposed treatment into question. And the President of the Royal College of Ophthalmologists, Mike Burdon, explains what cataracts are and how doctor and patient can decide together when surgery is required. GP and regular Inside Health contributor, Dr Margaret McCartney talks about the language we use in healthcare which blames both patients and doctors unfairly. Words and phrases like "compliance", "bed-blocker" and "unnecessary admissions" are singled out as particular culprits. The travel clinic at The Hospital for Tropical Diseases in London aims to help people with complex medical conditions get to where they need or want to go for work, family or just some winter sun. We meet Elisabeth, who is partially sighted and wants to travel to East Africa with her grandson; Robert who has lymphoma but is far more concerned that he won't be able to fly to a country he loves, Japan, and to Robin, who wants to start a career in Uganda but is allergic to some of the components of essential vaccines. Dr Nicky Longley, consultant in infectious disease and travel medicine runs the clinic. Producer: Fiona Hill
Evidence is building about the impact of air pollution on health, but the relationship between the cocktail of chemicals, gases and particles in the air we breathe and the direct effect on an individual's health is a tricky one to prove. Dr Farrah Jarral cycles to Kings College London to hear about a new study by researcher in respiratory toxicology, Dr Ian Mudway, which revealed, to the surprise of Ian and his colleagues, that particles from brake dust had the same damaging impact on our lung immune system as that familiar culprit, diesel exhaust. It's a result that demonstrates that the toxic risk to our health doesn't just come out of the exhaust pipe and suggests the concept of a zero emissions vehicle might need further work. COPD or Chronic Obstructive Pulmonary Disease is an umbrella term for a range of respiratory conditions that used to be known by names like emphysema or chronic bronchitis. COPD flare ups or exacerbations are the second largest cause of emergency hospital admissions in the UK. Dr Jennifer Quint, consultant physician in respiratory medicine at the Royal Brompton Hospital tells Dr Farrah Jarral about a world-first study where the individual air pollution exposure of COPD patients was tracked in real time to find out how toxic air can make their condition worse. What's it like for healthcare professionals working on the front line of infectious disease outbreaks? Dr Michael Kiuber, a consultant in emergency medicine at University Hospital Southampton NHS Foundation Trust, volunteered to treat patients with the deadly infection, Ebola, in Sierra Leone and he describes the challenges to Farrah of caring for very sick adults and children while taking every safety step to avoid contracting the Ebola virus himself. And Inside Health regular contributor, Dr Margaret McCartney outlines the challenges for the NHS in planning how to protect staff as the UK grapples with the global outbreak of Covid-19. There's a growing trade in female cosmetic genital surgery including hymenoplasty, which claims to the restore the hymen to its virginal state. Scores of private clinics in the UK are offering the procedure with advertising claims like "Get your virginity back!" and "Restore your innocence within one hour!". Dr Leila Frodsham, consultant gynaecologist, specialist in psychosexual medicine and spokesperson for the Royal College of Obstetricians and Gynaecologists discusses the ethics of the procedure. Producer: Fiona Hill
It's not a household name but RSV or Respiratory Syncytial Virus is responsible for 30,000 children under five ending up in hospital every year in the UK. The virus can cause serious infections of the lungs and airways (like pneumonia and bronchiolitis). Hannah and Sean from Oxfordshire had baby girls, Millie and Freya, born prematurely in October last year. Just weeks later, the twins spent 12 days in intensive care and then 3 days in the high dependency unit at the John Radcliffe Hospital in Oxford with bronchiolitis caused by RSV. Andrew Pollard, Professor of Paediatric Infection and Immunity at the University of Oxford tells James, the BBC's Science and Health Correspondent, about the dangers of RSV in lower income settings where the virus claims more babies' lives under 12 months old than any other disease apart from malaria. Hopes are that a vaccine for RSV to protect children during the vulnerable first years is imminent. And as one of the world's leading experts on vaccinations (and chair of the UK's Joint Committee on Vaccination and Immunisation) Professor Pollard tells James that he is confident that a vaccine for the coronavirus, which some experts have suggested could become a pandemic, could be developed by the end of this year. Inside Health regular contributor Dr Margaret McCartney raises the issue of unnecessary vaginal examinations. A new American study in JAMA Internal Medicine suggests that more than half of the bimanual pelvic examinations performed on girls and women aged 15 to 20 in the USA are potentially unnecessary and could cause harm. The fact this is still routine for many American women contradicts clear guidance which states there is no evidence for such internal examinations to be carried out in healthy girls and women who don't have symptoms. It doesn't happen in the NHS, Margaret reports, but they are carried out in the private sector under the banner of "well women checks". Could you tell somebody that they were going to die? Could you comfort family members after their loved one has passed away? Crucially could you do this as part of your job, day in, day out, without it affecting you? James talks to nurses at the Royal Marsden Hospital in Surrey which has been raising "compassion fatigue" as an occupational hazard within the profession. Producer: Fiona Hill
James Gallagher, BBC health and science correspondent, and Dr Margaret McCartney talk about the new coronavirus and how GPs have been advised to manage a patient at risk. He meets listeners Rich and Lucy who have asked about probiotics and gut health in early life after one of their twins had a vaginal delivery while the other a C-section. They want to know whether the different types of birth might impact on the good bacteria passed from mother to child. What is the evidence for the potential impact on long term health and can probiotics help? Dr Trevor Lawley at the Sanger Centre and Dr Lindsay Hall of the Quadram Institute provide the answers. Debi Bhattacharya of the University of East Anglia and James discuss pill organisers and whether arranging medicines into one single packet is always a good idea. And Prof John Pasi explains the results of trials on a 'Holy Grail' treatment for Haemophilia A and Shaun, who took part in the trial at Guy's and St Thomas in London, reveals how it has changed his life.
Nigel Edwards, Chief Executive of the health think tank the Nuffield Trust, joins Dr Margaret McCartney for this special programme about the challenges of remote and rural healthcare. Margaret travels by boat from Mallaig to the Hebridean islands of Eigg, Muck, Rum and Canna off the north west coast of Scotland where, after 100 years the islanders lost their resident doctor. When it was clear there wouldn't be a replacement, the islanders and NHS Highland instead opted for a radical new healthcare model. Taking inspiration from indigenous tribes in Alaska, the NUKA model has been adapted for the Small Isles and it is very different, with a high level of community engagement. The idea is that local people own their own healthcare rather than having healthcare delivered to them, as passive recipients. Local people are trained up in first aid and become salaried Rural Health and Social Care Workers. They are the eyes and ears of healthcare professionals. Volunteers also act as First Responders coordinating helicopter and lifeboat rescues in emergencies. Dr Margaret McCartney joins GP Dr Geoff Boyes on his weekly visit to Eigg and discovers how the community has adapted to this new way of delivering care. She hears from Gill McVicar, former NHS Highland Director of Transformation and Camille Dressler, chair of the Small Isles Community Council, about how the reorganisation was managed; from Julie McFadzean about the new health and rural health and social care worker role; from Sheena Kean, the Eigg healthcare practice manager who makes sure everything runs smoothly and to Eigg residents about how they think their new healthcare model is working. Producer: Fiona Hill Credit Photo of Margaret McCartney: Paul Clarke
General practice is similar in the Netherlands and the UK yet it appeals far more to young Dutch doctors than to their British counterparts. In collaboration with the Dutch medical journal Nederlands Tijdschrift voor Geneeskunde, Roger Damoiseaux, professor of general practice, and Margaret McCartney, Glasgow GP and The BMJ columnist, met to try to work out why. Sophie Arie reports Read the feature: http://www.bmj.com/content/351/bmj.h6870
In this week's podcast, Margaret McCartney examines Hydration for Health, Quentin Anstee explains how big a problem non-alcoholic fatty liver disease is, and Patrick Keown explains the association between provision of mental health beds and the involuntary admission of mental health patients.