Euan Lawson is Editor of the BJGP. He is on Twitter @euan_lawson and DMs are open if you want to get in touch.
*Note: the Jan ’22 issue doesn’t go live online until 31 Dec so some links may not work until then.
When I wrote the Briefing for the Jan ’22 issue a couple of weeks ago there was a great deal of uncertainty around the impacts of the Omicron variant. No one would deny that the lag between infections and bad outcomes adds a significant element of challenge to any decision. The evidence from South Africa is beguiling, offering hope this is a variant that will be defined by significant transmissibility but mild outcomes. Yet, we can’t know and England now stands in isolation.
It might be the most nakedly political decision of the pandemic from a Prime Minister trying to shore up his position. Boris Johnson, ‘The Gambler’ in the sub-title of Tom Bower’s biography of him, has rolled the dice.
London hospitalisation update for 28/12. It’d be good to know what ministers consider to be an acceptable rate of hospitalisation. We’re all agreed that what happened last January was *bad*, right? pic.twitter.com/5y7rBk6gB3
— Colin Davis (@ProfColinDavis) December 28, 2021
The Christmas period has been a curious lacuna. There has been little in the way of data and and it will likely be skewed by various holiday pressures. It does seem to be emerging again and London, as before, seems to be ahead of the rest of the country and could be the bellwether. Data on admissions there suggests it is rising and the staffing situation across the NHS is a deep concern.
What is absolutely nailed on is that nobody can be quite sure what is going to happen in the coming weeks but there are worrying indicators. There are certainly many people fearing the worse. And while most of the attention is focused on the immediate threat to the NHS the longer term consequences of this variant are unknowable.
It is now a near certainty that the UK will be seeing a hospitalisation rate that massively exceeds the capacity of the NHS. Many thousands of people have been condemned to death by The Conservative Government.
— Robert West (@robertjwest) December 27, 2021
One of the challenges with Covid has been that there is so much data around that many people have been, as is their wont, moulding it to their own beliefs. I don’t necessarily think that is what Prof West is doing here — the magical thinking regarding the possible outcomes has seemed far more common with those who have sought to downplay the pandemic.
More tediously, there have been plenty of rent-a-quotes willing to tell us what life will look like next spring or summer. Anyone offering opinions on those lines should be treated with caution, if not outright derision. As Yogi Berra said: “It’s tough to make predictions, especially about the future.”
BJGP news: making life easier for authors
One major change with the BJGP in 2021 was the move to open access for all our research so you will now, at the turn of the year, be able to access all the research content below without any difficulties. The first change in 2022 will be noted by anyone who wants to submit a research article as we move to ‘format free’ submissions. The aim here is to remove some of the detailed formatting requirements that we ask for when articles are initially submitted via the ScholarOne system. As everyone knows, we can’t take all papers forward and accept everything and it is an enormous amount of work for authors to keep re-writing and re-formatting papers to suit the idiosyncrasies of individual journals.
In reality, this will be more ‘format lite’ as we do still expect manuscripts to have some over-arching structure but it should ease one of the pain points felt by authors. We do have some specific requirements in how we present papers to ensure they best communicate their message but we won’t be asking for those until your paper is a little further along in the process.
January 2022 Editor’s Briefing papers
Here are the links to the papers I mentioned in the Briefing.
Gut feelings papers
There were three of these and they make a good collection.
- Understanding the role of GPs’ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence
https://doi.org/10.3399/bjgp20X712301 - GPs’ use of gut feelings when assessing cancer risk: a qualitative study in UK primary care
https://doi.org/10.3399/bjgp21X714269 - Building the case for the use of gut feelings in cancer referrals: perspectives of patients referred to a non-specific symptoms pathway
https://doi.org/10.3399/BJGP.2021.0275
CXRs and lung cancer
Another collection of papers with three of them in the past year — and slightly beyond as well.
- Associations between general practice characteristics and chest X-ray rate: an observational study
https://doi.org/10.3399/BJGP.2021.0232 - Factors affecting the decision to investigate older adults with potential cancer symptoms: a systematic review
https://doi.org/10.3399/BJGP.2021.0257 - Chest X-ray sensitivity and lung cancer outcomes: a retrospective observational study
https://doi.org/10.3399/BJGP.2020.1099 - Estimating lung cancer risk from chest X-ray and symptoms: a prospective cohort study
https://doi.org/10.3399/bjgp20X713993 - Sensitivity of chest X-ray for detecting lung cancer in people presenting with symptoms: a systematic review
https://doi.org/10.3399/bjgp19X706853
Cancer editorials
These three were all mentioned in the Briefing and shouldn’t be missed.
- Rapid Diagnostic Centres and early cancer diagnosis
https://doi.org/10.3399/bjgp21X717413 - Urgent cancer referrals: how well are they working and can they be improved?
https://doi.org/10.3399/bjgp21X716801 - Approaches to diagnosing cancer earlier in general practice
https://doi.org/10.3399/bjgp21X715613
Continuity papers
Two research papers and a thorough Analysis are worth ensuring you have to hand.
- Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway
https://doi.org/10.3399/BJGP.2021.0340 - Is continuity of primary care declining in England? Practice-level longitudinal study from 2012 to 2017
https://doi.org/10.3399/BJGP.2020.0935 - What mechanisms could link GP relational continuity to patient outcomes?
https://doi.org/10.3399/bjgp21X716093
Remote consulting
The redoubtable and apparently indefatigable Professor Trisha Greenhalgh…
- Remote by default general practice: must we, should we, dare we?
https://doi.org/10.3399/bjgp21X715313 - Changing media depictions of remote consulting in COVID-19: analysis of UK newspapers
https://doi.org/10.3399/BJGP.2020.0967
Other editorials
Clare Gerada and Iona Heath offer their views on the GP crisis and their thoughts on the future.
- General practice in crisis: stop skinning the cat
https://doi.org/10.3399/bjgp21X716153 - Rewilding general practice
https://doi.org/10.3399/bjgp21X717689
Best New Voice 2021
We don’t have a BJGP annual prize for best new talent/emerging voice but if we did it would be an easy decision this year. Here are three of Julia Darko’s articles from this year and we look forward to more in the future.
- Post-pandemic planning: how should general practice change?
https://doi.org/10.3399/bjgp21X715985 - Addressing the elephant in the room: COVID-19 vaccine hesitancy in Black and Asian communities
https://doi.org/10.3399/bjgp21X715433 - How can general practice improve the mental health care experience of Black men in the UK?
https://doi.org/10.3399/bjgp21X715097
Featured photo by David Travis on Unsplash
