Multimorbidity could cause a healthcare crisis – here’s what we can do about it

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Older patients often suffer from multiple conditions.
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Professor Chris Salisbury, Primary Health Care, University of Bristol

Multimorbidity is one of the biggest challenges facing healthcare. In recent years, a succession of research studies have shown that people with multiple health problems are more likely to have a worse quality of life, worse mental health and reduced life expectancy. The more health problems someone has, the more drugs they are likely to be prescribed and the more frequently they are likely to consult a GP or be admitted to hospital.

You might think this is all rather self-evident – it’s hardly a surprise that sick people get ill, take medicines and go to doctors more often than healthy people.

So why has multimorbidity become so prominent in discussions about healthcare over the last decade?

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Global Health: Antibiotics and Superbugs

In 1928 Alexander Fleming discovered penicillin, thus bringing one of the greatest medical advances of our time: antibiotics.

Innocuous infections, operations and injuries were no longer a death sentence.

Since then, antibiotics have been developed to treat an array of diseases but this slowed, and then stopped in the 1980s. Although our arsenal of development ceased, the bacteria, viruses and fungi did not stop evolving.

This asymmetric development has resulted in an antimicrobial resistance problem: bacteria causing common infections and illnesses are now increasingly resistant to the drugs used to treat them.

By 2050, the death toll could be a staggering one person every three seconds if AMR is not tackled now. Infographic from the AMR review

Creative Commons Attribution 4.0 International Public License. Attribution notice: ‘Review on Antimicrobial Resistance.’ From the O’Neill Report in 2016.

Solving this issue is not straightforward.

It involves a complex landscape of policy makers, clinicians, vets, law makers, and many others.

As part of Bristol Doctoral College’s Research without Borders Festival 2017, a public discussion was held exploring the problem of superbugs and antibiotic resistance, in both the context of research happening at the university of Bristol, and from a wider perspective.

Discussions revolved around patent law, and how it may affect development of new drugs and solutions, the role of agriculture, in particular dairy farming, in reducing antimicrobial resistance, and what we can do as individuals to help address this problem.

Below is a brief snapshot of the research relating to antimicrobial resistance being undertaken across the University of Bristol by the postgraduate researchers who took part in the RWB discussion panel. Continue reading

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Are management consultants losing their place as masters of the universe?

Professor Andrew Sturdy, Head of Department of Management and Chair in Management, University of Bristol

Professor Andrew Sturdy, Head of Department of Management and Chair in Management, University of Bristol

Dr Joe O'Mahoney, Reader, Cardiff Business School, Cardiff University

Dr Joe O’Mahoney, Reader, Cardiff Business School, Cardiff University

Management consultants are powerful beasts. They can mould businesses and guide governments, both in high-profile projects and behind the scenes. They do this largely free from any specific regulation and, if revenue is anything to go by, continue to thrive in our uncertain world.

But there are constraints and scrutiny at work too – and they are increasing. A recent studyby researchers at the universities of Bristol and Cardiff in the UK shows how one of the most powerful consultancies, McKinsey & Co., is facing up to new and threatening pressures from clients, governments, NGOs and market forces.

Consulting firms like McKinsey, Booz Allen or Boston Consulting exercise power in three main ways: they have vast resources at their disposal; they are able to intervene in decision-making processes; they can influence what their clients think. In terms of resources, McKinsey not only possesses significant economic capital but its CEO-heavy alumni network provides it with an instant sales route into the Fortune 500 list of major companies. Its knowledge resources are the envy of universities the world over. The McKinsey Global Institute, for instance, is one of the largest management research organisations.

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