this week NHS RESERVES page 381 • MESH CLINICS page 382 • LIVERPOOL TESTING page 384 LMCs: NHS England briefed against GPs GP leaders have demanded that NHS chair of the BMA’s General Practitioners The BMA’s Richard Vautrey England and NHS Improvement apologise Committee, writing to the NHS chief said it seemed NHS England and retract any communications that may executive, Simon Stevens, asking for had “intentionally sought have harmed their reputation or incited NHSE/I to “apologise to the profession and to create negative media coverage of primary care” complaints by implying that practices had correct damage that has been done.” not been fully involved in care of patients Vautrey wrote, “Implying within the throughout the covid-19 pandemic. press release that GPs are not providing A motion passed at the annual patients with the appointments they conference of England’s local medical need and ‘reminding’ them that they face committees on 27 November said that ‘enforcement action’ if they do not has much of NHSE/I’s communications with presented NHSE/I as antagonistic and GPs, the press, and the public had been completely out of touch with the profession. “abhorrent and insulting.” The conference It also seems to many GPs that NHSE/I has, called for NHSE/I to recognise general by using this tactic, intentionally sought to LATEST ONLINE practice’s contribution to the management create negative media coverage of primary of the pandemic and the continuation of care services. Test for HIV normal service, “particularly given the “The BMA is now hearing large numbers wherever blood is general practitioners who have died in the of reports from practices receiving taken, recommends course of their duties to the public.” complaints and many staff members being UK independent The motion added that it “deplores verbally abused by the public based on commission the habit” of briefi ng journalists before these unsupported and ill-informed media Declarations of communicating with the profession and its articles. pharma funding representatives. This refers to an episode “This is clearly unacceptable, and are still not transparent where NHSE/I briefed journalists on a letter NHSE/I must correct these inaccurate and enough, say critics it had written to all practices reminding GPs damaging stories immediately.” that patients must be off ered face-to-face More than 400 GPs have since signed Investigation into baby’s death appointments when they need them. GPs an open letter raising concerns about reveals “20 year said this led to negative media coverage and inaccurate and harmful media messages. cover-up” of care a reported rise in complaints and abuse. Elisabeth Mahase , The BMJ failures The incident led to Richard Vautrey, Cite this as: BMJ 2020;371:m4684 the bmj | 5 December 2020 379 SEVEN DAYS IN Fewer ethnic minority doctors report wo rkplace improvements during pandemic A GMC poll of 3693 doctors carried out in June and July has found that less than half (46%) of ethnic minority doctors said that the sharing of knowledge and experiences had been positively aff ected by the pandemic, whereas three fi ft hs (61%) of white doctors reported positively. The survey, published in the GMC’s annual State of Medical Education and Practice in the UK report, also showed that 68% of white doctors but 55% of ethnic minority doctors believed that teamwork between doctors had improved during the pandemic. And improvements in the speed of workplace changes were reported by 57% of white doctors but only 38% of ethnic minority doctors. GMC chief executive Charlie Massey said the fi ndings were a concern. “We know BAME [black, Asian, and minority ethnic] doctors too oft en lack the supportive and compassionate leadership that is required to thrive,” he said. “Doctors of all grades, and from all backgrounds, need and deserve the same levels of support if they are to provide the best possible care for patients, in what will continue to be diffi cult months ahead.” MARK THOMAS/SPL Abi Rimmer, The BMJ Cite this as: BMJ 2020;371:m4666 Covid-19 said the funding would not solve good luck rather than design “common situation when Lighter restrictions didn’t longer term problems such as had helped the NHS to care for students may experience racial work, study indicates workforce shortages. patients with the disease . harassment.” It recommended Tier 1 restrictions that applied that universities review their to areas of England with lower Most of England is placed Appraisals procedures for handling rates of covid-19 before the in toughest two tiers Government pledges complaints, define clear channels most recent lockdown had Most of England would be placed “streamlined” approach for reporting incidents, and “little impact” on transmission, under high or very high alert England’s health secretary, systematically collect data on a preprint study suggested. levels when the country’s national Matt Hancock, pledged shorter reports, “including incidents that Researchers from the University lockdown ended appraisals for doctors as part of are resolved informally.” of East Anglia found that tier 2 on 2 December, a drive to reduce bureaucracy rules were effective in only around said the health in the NHS. A new appraisal Cancer half of local authority areas, while secretary, Matt format, which takes only 30 NHS pilots “liquid biopsy” stricter tier 3 restrictions seemed Hancock, on minutes to prepare and requires blood tests to be effective in most areas. But 26 November. far less supporting evidence, The NHS in England will pilot the they said that regions were not Under the has been in place since October use of an innovative blood test allocated swiftly enough to the revised tier system, areas with 2020, after appraisals were with the potential to spot more most appropriate tier and urged the toughest restrictions (tier 3) suspended in March because of than 50 types of cancer. The ministers to heed their findings as include Greater Manchester, the covid-19 pandemic. Hancock Galleri blood test, a liquid biopsy the tier system is reintroduced. Bristol, the West Midlands, and said that the process would be developed by the US company Kent. Most areas in England have retained subject to evaluation, GRAIL, can detect early stage NHS will get £3bn been placed in tier 2, including alongside other measures such cancers through a simple blood “recovery” funding Liverpool and London. Only as making professional regulation test. The pilot, which is due to The NHS will receive an extra Cornwall, the Isle of Wight, and proportionate, giving GPs more £3bn next year to help services the Isles of Scilly are in tier 1. time to focus on clinical work, and recover after the pandemic, the greater digitisation of services. UK chancellor announced in his Government failed to react spending review. Rishi Sunak said to ventilator shortage Racial harassment that this would include £1bn to The NHS managed to provide Doctors welcome action tackle the elective care backlog, care to all those patients with by universities on racism around £1.5bn to help ease covid-19 who needed mechanical The BMA welcomed a report start in mid-2021, will involve existing pressures in the NHS ventilators earlier this year offering practical guidance to 140 000 people aged 50 to 79 caused by covid-19, and around despite the government being universities on tackling racial years who have no symptoms £500m to improve access to underprepared and slow in harassment. The report by but who will have annual blood mental health services and responding to hospitals’ needs, Universities UK said that the tests for three years, together invest in the NHS workforce. a report from the parliamentary Equality and Human Rights with 25 000 people with possible Andrew Goddard, president of Public Accounts Committee Commission had identified cancer symptoms who have been the Royal College of Physicians, concluded. The MPs said that medical placements as a referred in the normal way. 380 5 December 2020 | the bmj SIXTY SECONDS MEDICINE ON . Period products Schools, colleges, and universities NHS RESERVES Scotland becomes first in Scotland will make period products freely available RUNNING ABOUT IN CAMOUFLAGE to legislate for free access GEAR AT THE WEEKEND? Period products will be No, silly, that’s NHS army reservists. We’re obtainable free of charge in talking about NHS reserves, a similar idea Scotland for every person who but for clinical and non-clinical volunteers to needs to use them, after the support the NHS. country became the first in the world to pass legislation CLINICAL VOLUNTEERS? BUT WE’RE on the issue. A bill passed UNDERSTAFFED Well, yes, but the idea is that these unanimously in the Scottish volunteers will come from some of the 75 000 parliament requires all local clinical staff who leave the NHS every year. authorities in Scotland to ensure So they’ll come back to work—but for free. that period products are freely Drug pricing available. Schools, colleges, and Bipolar drug remains VACCINES UH-HUH. WHOSE IDEA IS THIS? universities must also make them on market after deal It was proposed by Alan Mak (below), MP for Russia reached Havant and vice chair of the Conservative available free of charge in their Priadel, a brand of lithium widely an agreement toilets, and the government has used to treat bipolar disorder, Party. Speaking in the House of Commons the power to make other public will remain on the market after with the drug on 24 November, he introduced the National organisations do the same. a new deal was struck between company Hetero to Health Service Reserve Staff Bill. It was supported by England’s health secretary, its manufacturer, Essential Matt Hancock. Obstetrics Pharma, and the Department for produce 100 Female doctors are less Health and Social Care.