Repeat prescriptions are expensive and time consuming – it’s time for an NHS rethink

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Rupert Payne, University of Bristol and Céline Miani, University of Bielefeld

Over a billion NHS prescription medicines are issued by pharmacists in England every year – at a cost of over £9 billion. Many of these are prescribed by GPs to manage long-term health conditions, such as diabetes or cardiovascular disease.

The current “repeat prescription” system allows patients to request a further supply of medicines without the inconvenience of another doctor’s appointment. Continue reading

No single food or nutrient is to blame for obesity, so what is the right balance?

Dr Laura Johnson, Senior Lecturer in the Centre for Exercise, Nutrition and Health Sciences, discusses her new paper in which she assesses the impact of dietary patterns on obesity and how modelling may help influence change in both personal habits and public policy.

No single food or nutrient is to blame for obesity. There so many routes from diet to overeating and weight gain, and in real life foods and nutrients aren’t eaten on their own. So, it’s misleading to look at foods that way in research, it’s the overall balance of diet that matters. Continue reading

‘You are unfit for the city’: Bodies of right and rights of bodies in Iran

Image credit: Ali Rankouhi

By Dr Marzieh Kaivanara  

Why does Iran have one of the biggest markets in the world for aesthetic surgery? In seeking the answer to this question, I found that a number of different factors are at play: the market for cosmetic surgery is informed by culture, geographic and urban spaces, religion, and even politics.[1]

In Iran, bodies are scrutinised to be physically “fit” within the narrowed-down standards of beauty, ability, health, gender, age, class and so forth. Cities have the power to constantly eliminate individuals’ bodies that are considered “unfit” for the urban space; these include, but are not limited to: the so-called overweight, oversized, obese, visually impaired and people with any mobility impairment, wheelchair users, the elderly, cyclists, runners and even people using pushchairs. In a sense, all people are dealing with some form of disability and at some point in their lives will become disabled by the city’s physical layout. The city’s physical structure reinforces the notion of ‘the right body’, and raises urgent questions around the right to access – a fundamental human right.

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Why the idea of ‘good work’ in a gig economy remains a distant ideal

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Tonia Novitz, University of Bristol; Alan L Bogg, University of Bristol; Katie Bales, University of Bristol; Michael Ford, University of Bristol, and Roseanne Russell, University of Bristol

Don Lane’s employment contract for his work as a courier described him as an “independent contractor”. This meant he was neither an “employee” nor a “worker”, so not entitled to legal rights such as protection against dismissal, paid holidays, or statutory sick pay.

The 53-year-old also suffered from diabetes, and had previously been fined £150 by the delivery firm he worked for for missing work to attend a hospital appointment. He died in January 2018 after working through the Christmas season despite his illness. Continue reading

Management consultants don’t save the NHS money – new evidence

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The NHS is strapped for cash.
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Andrew Sturdy, University of Bristol

Few topics in the NHS have provoked as much controversy as the use of external management consultants. They provide advice on strategy, organisation and financial planning, and help implement new IT systems and other changes.

While some claim that this brings much needed improvements, critics question their value – particularly at a time when the NHS is strapped for cash. Even Patrick Carter, recently charged with reviewing NHS efficiency, admits that he has “a bugbear with employing management consultants”. Continue reading

Brexit negotiations phase two – here’s what happens next

Image: EPA/ Eric Vidal

Nieves Perez-Solorzano, University of Bristol 

The European Commission will advise the leaders of the 27 EU member states meeting at the European Council on December 15 to proceed with the second phase of Brexit negotiations. It judges there has been sufficient progress on the three key issues that it insisted should constitute the first phase of talks. Those are citizens’ rights, the Irish border and the UK’s financial settlement.

That doesn’t mean that a final solution has been achieved on any of these issues – just that there is enough common understanding between the EU27 and the British government to continue to the next phase of negotiations.

So, what next? Expect more of the same: time pressures, a well-choreographed approach from the EU leadership and a weak British government gradually converging with the European position. Continue reading

Why the annual winter health crisis could be solved in homes, not hospitals

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Richard Morris, University of Bristol

As winter continues, so does the usual soul searching about the state of the UK’s National Health Service (NHS). Images of ambulances backing up outside emergency departments and patients lying on trolleys in corridors haunt politicians and the public alike.

Demand on the NHS, which is always high, increases over the coldest of seasons, when threats to health are greatest. Generally, more than 20,000 extra deaths occur from December to March than in any other four-month period in England and Wales. That number varies considerably, however – from 17,460 in 2013-4 to 43,850 in 2014-5 (which was not even a particularly cold winter). And there has been no evidence of a decreasing trend since the early 1990s, despite the national flu immunisation programme. Continue reading

Blog: Never mind the policymakers

Never mind the policymakers, it is the policy wonks that researchers should be engaging with…

James Georgalakis, Director of Communications and Impact at the Institute of Development Studies (IDS)

Perhaps one of the laziest terms used by the research and policy community across sectors is ‘policymaker’. Research funding bids, how to guides, blogs, academic papers and policy briefs are all awash with references to the ubiquitous policymaker. And before you point it out – yes I am guilty of it also. Who exactly are these policymakers and how do they use research evidence? This is the question the ESRC-DFID Impact Initiative for International Development Research asked in a scoping study of evidence use behaviours amongst those working to reduce global child poverty and inequality. Continue reading

Lessons learned from imposing performance-related pay on teachers

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Simon Burgess, University of Bristol

 

One of the toughest subjects in classrooms at the moment is the recruitment and retention of teachers. Their level of pay is often cited as a problem – and possibly part of a solution.

In England, the public sector pay freeze of recent years has meant real terms pay cuts for many teachers. But another part of the picture is the procedure which decides how much an individual teacher gets. Until recently this has been the pervasive public sector approach under which pay has generally increased automatically over time. Continue reading