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

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

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

‘People like us just shouldn’t fall in love’: how British immigration rules are separating fathers from their families

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Melanie Griffiths, University of Bristol and Candice Morgan, University of Bristol

Couples are being subjected to painful separations, uncertainty about their future and financial hardship by the UK’s strict immigration rules, according to our new research.

Between 2014 and 2017, we followed nearly 30 couples where the man had irregular or insecure immigration status in the UK but his partner or children were citizens of Britain or the European Economic Area (EEA). Continue reading

Putting algae and seaweed on the menu could help save our seafood

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If we have to feed 9.8 billion people by 2050, food from the ocean will have to play a major role. Ending hunger and malnutrition while meeting the demand for more meat and fish as the world grows richer will require 60% more food by the middle of the century.

But around 90% of the world’s fish stocks are already seriously depleted. Pollution and increasing levels of carbon dioxide (CO₂) in the atmosphere, which is making the oceans warmer and more acidic, are also a significant threat to marine life. Continue reading

Why doctors need to improve the way we discuss assisted dying

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Paul Teed, University of Bristol

Assisted dying can be a divisive and polarising subject. But there is one aspect on which most people probably agree – the need to improve the conversations people have about death.

At the moment, there is uncertainty in the UK regarding what people – especially health professionals – can and cannot say when the topic of assisted dying comes up. Conversation can become especially stilted when it turns to patients obtaining the medical documentation required for an assisted death abroad. Continue reading

Evacuating a nuclear disaster areas is (usually) a waste of time and money, says study

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Over 110,000 people were moved from their homes following the Fukushima nuclear disaster in Japan in March 2011. Another 50,000 left of their own will, and 85,000 had still not returned four-and-a-half years later.

While this might seem like an obvious way of keeping people safe, my colleagues and I have just completed research that shows this kind of mass evacuation is unnecessary, and can even do more harm than good. We calculated that the Fukushima evacuation extended the population’s average life expectancy by less than three months.

To do this, we had to estimate how such a nuclear meltdown could affect the average remaining life expectancy of a population from the date of the event. The radiation would cause some people to get cancer and so die younger than they otherwise would have (other health effects are very unlikely because the radiation exposure is so limited). This brings down the average life expectancy of the whole group.

But the average radiation cancer victim will still live into their 60s or 70s. The loss of life expectancy from a radiation cancer will always be less than from an immediately fatal accident such as a train or car crash. These victims have their lives cut short by an average of 40 years, double the 20 years that the average sufferer of cancer caused by radiation exposure. So if you could choose your way of dying from the two, radiation exposure and cancer would on average leave you with a much longer lifespan. Continue reading

The menopause: dreaded, derided and seldom discussed

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Sign of caution – or celebration?
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Author: Isabel de Salis, University of Bristol

Women experience the menopause between the ages of around 45 and 55, but their experiences of this significant stage of life are diverse. Each woman’s menopause is unique.

Common themes run through women’s stories, however. From our research talking with women in midlife, we found that they often talk about menopause as a normal, inevitable and natural process, which of course, it is. Seeing menopause in this way allows women to minimise symptoms and behave stoically. “It’s no big deal,” one woman told us. “You just get on with it.”

But this positive approach can also be a rebuttal of a common perception in society of the menopause as a negative event – a view which leads to denigrating women who react differently to the menopause. Continue reading

Complex guidelines on eating fish when pregnant mean that mothers – and babies – are missing out

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Caroline Taylor, University of Bristol

As soon as women find out they’re pregnant, they are overwhelmed with information about what they can – or more likely can’t – eat and drink. Off the menu go soft cheeses, partially cooked eggs, raw meat, pâté, liver, caffeine, alcohol. It’s a lot to remember.

But the advice on eating fish when pregnant is the by far the most complex. Does it need to be so complicated? What is the actual evidence of the risks and benefits of eating fish for a mother-to-be? Continue reading