Euan Lawson is editor of the BJGP.
This update covers the Editor’s Briefings for June, July and August 2022. It is interesting to look back at this point on the Briefings. The June 2022 Briefing lingered on the paper that looked at the NICE Traffic Light system for assessing children and found it is seriously lacking. In August, I jumped on one of my favourite hobby horses for a gallop – we keep creating ever-more complex healthcare systems that are harder to navigate. We don’t do this deliberately, we’re often reacting to the lack of resources and the overwhelm in the system. Unfortunately, it helps drive inequalities as those most in need lack the ability to navigate the processes. It is, of course, a sub-clause of the inverse care law. (Everything in general practice seems to benefit from a nod to Tudor Hart.) Those in greatest need are least able to access services but worryingly, it feels like it has a self-amplifying nature in difficult times. We scramble to reconfigure and push the most vulnerable further away.
In August, I re-read John Diamond’s book and reflected on how little has changed when it comes to language around cancer. There is hope there as well though. We’ve had some recent studies that are showing that people are presenting in various ways before a diagnosis is reached. It is important to say, as we did on the podcast, that this is not because of the actions of GPs. We are detecting a signal, at population level, that is telling us we can do better if we can find the right combination of markers and guidance.
June 2022 Editor’s Briefing links
There are no additional links from the June Briefing. The Briefing talked about the paper by Amy Clark and colleagues on the NICE Traffic Light system – you can reach that here: https://doi.org/10.3399/BJGP.2021.0633
July 2022 Editor’s Briefing links
Here are the relevant links/references that were mentioned in the July 2022 Briefing on how complex systems harm people with complex needs.
“The daily stress of living is not to be underestimated and the cost of living crisis will drag more people into lives where they will, in former Prime Minister Gordon Brown’s words: ‘starve and shiver’.” Available here: https://www.theguardian.com/commentisfree/2022/jun/15/starve-and-shiver-with-sunak-family-poverty-gordon-brown
“as Khan reports this month in Life & Times…”. Available here: https://doi.org/10.3399/bjgp22X719921
“In 2020/21, Trussell Trust foodbanks gave out 2.5 million 3-day emergency food supplies to people in crisis..” Available from: https://www.trusselltrust.org
“As Mercer and colleagues point out: ‘disadvantage is not a given to be endured but a challenge that can be overcome’.”
Mercer SW, Patterson J, Robson JP, Smith SM, Walton E, Watt G. The inverse care law and the potential of primary care in deprived areas. The Lancet. 2021 Feb;397(10276):775–6.
August 2022 Editor’s Briefing links
Here are the relevant links/references mentioned in the August 2022 Briefing that dwelled a little on the language around cancer and the excellent writing of John Diamond.
“Two BJGP studies published this month have flagged that, when we look at large datasets, we can see that people are presenting in various ways for many months before they get their diagnosis.”
Rafiq et al on Hodgkin’s lymphoma: https://doi.org/10.3399/BJGP.2021.0617
Moullet et al on colorectal cancer: https://doi.org/10.3399/BJGP.2021.0563
“The NHS-Galleri Trial offers a tantalising suggestion of a dramatic shift in cancer diagnosis…” Available at: https://www.england.nhs.uk/2021/09/nhs-launches-world-first-trial-for-new-cancer-test/
