The Care Quality Commission must overhaul the way it deals with whistleblowers who report safety concerns, a review has concluded.1The health and social care regulator for England commissioned the review—published in two parts—after an employment tribunal found that a consultant surgeon who blew the whistle had been unfairly sacked from his position as a part time specialist adviser to the CQC.2Shyam Kumar, a consultant orthopaedic surgeon, was seconded to the CQC in 2014 to provide clinical input on inspections. He blew the whistle on his own employers, University Hospitals of Morecambe Bay N ..read more

Verma and colleagues discuss the need to encourage healthy forms of masculinity to promote gender equity and wellbeing.1 A prominent feature of masculinity is the suppression of vulnerability. Signs of weakness are shameful to many boys and men, from which follows a reluctance to seek help and contempt for frailty in others, both male and female. Yet, even before birth,2 the male fetus is more fragile.3 Boys of mothers with antenatal anxiety more often become inattentive and hyperactive,4 and maternal depression after birth leads to more academic failure in teenage boys.5The higher number of w ..read more

Integrated care systems (ICSs), the partnerships created to deliver more joined-up health and care, are hampered by too much central control and a lack of preventive public health voices, MPs have said.MPs on the parliamentary Health and Social Care Committee have called for more autonomy to be given to ICSs so that they can achieve their potential. The committee published a report on 30 March in which it noted much optimism about the 42 ICSs that became operational in England in July of last year,1 but it argued that they needed greater freedom to achieve results their own way.The committee’s ..read more

The European Congress on Obesity has removed Nestlé as a sponsor, following widespread condemnation on social media.Now an open letter, published in The BMJ, is calling for the organisation to go further and remove all corporate sponsorship and presence at its scientific events.1“Nestlé’s sponsorship of a congress on obesity is precisely the same as a tobacco company sponsoring a congress on smoking related disease,” Christoffer van Tulleken, associate professor at University College London and one of the letter’s authors, told The BMJ. “Their business depends on increasing global sales of foo ..read more

bmj;380/mar31_6/p746/FAF1faJohn Leonard Wilkinson, known to all as Len, was the son of a Methodist minister, theologian, and academic. He entered Manchester University Medical School in 1942, followed by a doctorate in Tropical Medicine from Liverpool.In 1954 Len left for Sierra Leone as a medical missionary, taking the position of medical superintendent and surgeon at the Nixon Memorial Hospital. He stayed for 18 years, dedicating himself to surgery, the treatment of tropical diseases, and research. He established a network of outreach clinics serving outlying areas where particularly leprosy ..read more

AbstractObjectiveTo evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe.DesignDocument content analysis.SettingEuropean Medicines Agency.ParticipantsAnticancer drugs granted a first marketing authorisation by the European Medicines Agency, 2017-19.Main outcome measuresWhether written information on a product addressed patients’ commonly asked questions about: who and what the drug is used for; how the drug was studied; types of ..read more

AbstractObjectiveTo determine the relative efficacy of structured named diet and health behaviour programmes (dietary programmes) for prevention of mortality and major cardiovascular events in patients at increased risk of cardiovascular disease.DesignSystematic review and network meta-analysis of randomised controlled trials.Data sourcesAMED (Allied and Complementary Medicine Database), CENTRAL (Cochrane Central Register of Controlled Trials), Embase, Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and ClinicalTrials.gov were searched up to September 2021.Study sel ..read more

Informed consent is a central tenet of ethical clinical practice and shared decision making, and it requires that patients have easy access to independent and comprehensive information about medicines. For instance, is accurate information about benefits and harms available, is it complete, and is it presented in ways that ensure patients understand the benefits and harms from key research findings and the extent of remaining uncertainties?In a linked paper, Davis and colleagues (doi:10.1136/bmj-2022-073711) set out to answer these questions for new anticancer drugs approved by the European Me ..read more

Black and colleagues recognise the complexity of journeys to diagnosis (or timely diagnosis).1 Their pragmatic, considered analysis resonates with our experience of clinical care, highlighting opportunities for improvement of a complex problem without simplifying or diminishing the challenges. These include considering potential diagnoses when the positive predictive value for symptoms in isolation might be low or uncertain or when symptoms occur variably, non-specifically, and across different body systems. We support their call to move away from single consultation interventions or linear (o ..read more

The systems approach proposed by Black and colleagues to aid cancer diagnosis looks enticing.1 But there seems to be discrepancy between the proposed solution and the breadth of the current problem, and the apparent interchangeability between a systems approach and technology based approach might be confusing to some. A systems approach acknowledges the connections between components to develop a better understanding of a problem and to formulate appropriate strategies to tackle it.2 A systems approach to cancer diagnosis delays should start by gathering information alongside multiple stakehol ..read more