Recorded Tuesday 5th Jan 2021

As the UK enters lockdown, again, schools are closed, the NHS struggles under the surge of cases, new variants of SARS-COV-2 virus stalk the world, and vaccination programmes make a faltering start.

In this podcast, Fiona Godlee, editor in chief of The BMJ, talks to Matt Morgan, a consultant in a intensive care medicine in Cardiff, Helen Salisbury, GP in Oxfordshire, and Nisreen Alwan, public health consultant in Southampton, about the pressure on critical care, England's vaccination roll out, the closure of schools and why communication is undermining trust in the vaccines.

All the BMJ's corona virus coverage is currently free to access
www.bmj.com/coronavirus

Coronavirus second wave - The UK’s fourth lockdown

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In the UK, a general election has been called - and around the world, ½ the global population will be voting this year; so in this episode we’ll be talking about how elections and health intersect.
Firstly, what are the UK parties’ plans for health? Abi Rimmer, The BMJ's UK features editor joins us with the latest information.
The world’s largest democracy is polling, so how are Indian politicians talking about health?  Sanjay Nagral, surgeon and director of the Department of Surgical Gastroenterology at Jaslok Hospital & Research Centre in Mumbai takes us through the campaign promises.
And finally, Jody Heymann is founding director of the WORLD Policy Analysis Center at UCLA and explains why this is the most consequential US election for woman's health in a generation.
 

01:30 Election Fever and NHS Plans
07:35 Impact of Elections on Health in India
21:20 Women's Health in the US Elections
 
Reading list
Feature: The untold health toll of voting
Editorial: Workplace rights around pregnancy and childbirth

Electing to be healthy

With the anticipation of a new government in the UK, shadow health secretary Wes Streeting will hit the ground running - with a winter season (and it's inevitable crisis) and ongoing industrial desputes with junior doctors. Elisabeth Mahase ask him about his plans to handle these challenges if elected.
We also find our selves in the puzzling situation of potential GP unemployment in the UK despite a high demand for primary care doctors, Helen Salisbury, GP and columnist for The BMJ explains how we've got into this situation.
Finally, Peter Doshi has been looking at the financial entanglement of FDA heads with the companies they are regulating - 9 of the previous 10 FDA heads have gone on to work for industry in some respect. He has also investigated how complex financial instruments can make these conflicts more opaque.
02:03 Anticipating a New Government and the NHS Winter Crisis10:50 The Kafkaesque Dilemma of GP Unemployment23:10 FDA Leaders' Financial Entanglements: A Deep Dive
Reading list
Workforce and winter under Labour: Wes Streeting on his plan for the NHS
Helen Salisbury: No jobs for GPs—we’ll be missed when we’re gone
Revolving doors: board memberships, hedge funds, and the FDA chiefs responsible for regulating industry

The prospect of unemployed GPs

Where next for psychological safety? Amy Edmundson is professor of Leadership and Management at the Harvard Business School. Her work on psychological safety has underpinned so much quality improvement, and she joins us fresh of the stage at the International Forum on Quality and safety in healthcare to talk about the next steps in creating a safe work place.
The BMJ has published two new investigations, looking at the alcohol and tobacco industry funding of public health and education - we’ll hear how the companies who create the problems, are now styling themselves as the solution. Rebecca Coombes joins us to explain what The BMJ has found, and May van Schalkwyk, a researcher from the London School of Hygiene & Tropical Medicine, explains how commercial conflicts are shaping the wrong education tactics.
And finally, our NHS commissioners have more recommendations - this time on workforce issues. Mary Dixon-Woods, director of THIS institute at the University of Cambridge, and Matt Morgan, intensive care consultant in Cardiff, tell the NHS to get serious about staffing.
02:03 Amy Edmondson on Future Health and Psychological Safety10:24 The Impact of Corporate Funding on Public Health19:57 Addressing NHS Workforce Challenges: Insights and Solutions
Reading list;
Our new podcast - Future Health
International forum keynote -  "Learning to fail" with Amy Edmundson and Don Berwick
Investigation - Medscape caves in on courses funded by tobacco giant Philip Morris, while medics fear global push into medical educationInvestigation - Big alcohol: Universities and schools urged to throw out industry-funded public health advice
Commission on the future of the NHS - The future of the NHS depends on its workforce

Fixing healthcare's workforce problems

Hilary Cass, the former president of the Royal College of Paediatrics, has spent the last 3 years collating the evidence for treatment of gender questioning young people; engaging with those young people, their families and their clinicians - all with the aim of improving NHS treatment of this complex and vulnerable group.
In this interview, Kamran Abbasi, editor in chief of The BMJ, speaks in depth to Cass about her review - about evidence base for transitioning, but also about the way in which the siloing of care for young trans people has failed them. 
They discuss the need to support young people in their journey - Cass is clear that the NHS should allow young people to explore their gender, but that ultimately, that may not mean medical intervention at all. 
 
Reading list
The Cass Review - final report
The systematic review and meta-analyses published in Archives of Disease in Childhood
BMJ Opinion: Gender medicine for children and young people is built on shaky foundations

Improving NHS gender identity services - Hilary Cass

Derogation, the way in which striking doctors can be recalled to the ward to protect patient safety, was agreed by NHS England and the BMA. Now, new data The BMJ has uncovered shows that the mechanism was rarely used - and when it was tried, was often rejected. Gareth Iacobucci explains what that means about relations between the government, the NHS, and doctors.
Felice Jacka, director of the Food & Mood Centre at Deakin University, is one of the authors of our recent ultra-processed foods umbrella review - and joins the podcast to talk about the link between diet and health; and why goverments need to pay more attention to the food system.
Finally, John Appleby, senior associate at the Nuffield Trust, and Gillian Leng, dean and president elect of the Royal Society of medicine, have been thinking about healthcare funding, and how more stability is essential in securing the service's future.
 
Reading list
Hospital leaders warned that failure to recall striking doctors risked patient safety in some trusts, documents show
Ultra-processed food exposure and adverse health outcomes
NHS funding for a secure future
 
Chapters
00:31 Derogation and doctor strikes
06:59 Ultra processed food producers and health
13:59 Rethinking NHS funding

Coronavirus second wave - The UK’s fourth lockdown

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