A tightening of the rules followed, but two years after our initial investigation, we have returned - and we found that nearly a third of nutrition advisors still have significant ties to the food industry.

Chris Van Tulleken, professor of infection and immunology at University College London, and author of the book “Ultra Processed People”, joins us to explain why he thinks ongoing industry ties are bad for the UK's health.

Also this week. We have tight regulation of medical tech in the UK, but new AI tools don’t fit neatly into that existing process - and so the government has set up a National Commission on the Regulation of AI in Healthcare, 

Alastair Denniston, and Henrietta Hughes, who headed that commission, join us to explain how AI should be monitored, how we can ensure it's safety, and who should be responsible when something goes wrong.

Reading list:

A third of UK government’s nutrition advisers are still paid by food industry, including Coca Cola and Nestlé

National Commission into the Regulation of AI in Healthcare: Recommendations for a future regulatory framework

Our strong primary care system is often credited in the success of the NHS - But changes to how that system works are currently underway. Legislation is quietly proceeding through parliament that will reorganise the way in which local care is structured, and those changes are raising concerns for GPs.

To talk about how we build a stronger primary care system, and stronger NHS we're joined by:

• Victoria Tzortziou Brown, president of the Royal College of General Practitioners
• Sam Everington, a GP in East London, and a non-executive director of NHS England
• Kamila Hawthorne, GP in South Wales, and chair of National Academy for Social Prescribing

We also take the opportunity to hear about where social prescribing fits into this new picture, and why our panel think it's important in changing the UK's health.

Reading list

Building a stronger NHS: an open letter from past and present presidents and chairs of the Royal College of General Practitioners

John McLachlan, professor of medical education at the University of Lancashire, has carried out four reviews of medical exams. He explains what happens to the people who have been marked wrongly, why he thinks re-sits should be done differently, and why multiple choice questions are still in use.

Over the Summer there have been extensive protests from the young people of India, the “Cockroach Janta Party” has led demonstrations across the country, sparked by allegations of cheating in India’s “NEET” exams - the federal tests taken by applicants to India's medical training.

Rohan Krishnan, orthopaedic surgeon in Delhi, and chief of the Federation of All India Medical Association, and Kathir Karuppiah, a house surgeon in Tamil Nadu, join us to explain where India's medical admissions tests are failing students.

We’ll also hear about new research into Chronic Traumatic Encephalopathy in NFL players.  Daniel Daneshvar is associate professor at Harvard Medical School, and he and his co-authors have examined the brains of 338 former players, with the goal of determining how many of them died with CTE neurodegeneration. He joins us to explain his findings, and what it means for competitive sports players and others who play contact sports.

Reading list:

“Cockroach” victory: India’s education minister resigns over medical exam scandal linked to 12 suicides

Prevalence of chronic traumatic encephalopathy at death in National Football League players: retrospective population based cohort study, 2008-21

The UK is already having this conversation. The National Commission into the Regulation of AI in Healthcare released its initial report in June of this year. Among its findings was a call for a ‘lifecycle-based approach’ to regulation. To explain what this means, as well as how doctors can be equipped to ‘surveil’ AI systems as conditions evolve, we’re joined by the co-authors of a new BMJ editorial - Mark Ball from the University of Derby, and Elvira Perez Vallejos from the University of Nottingham.

And lastly, we talk about a research paper from last week that sparked off some concern. Researchers at Stanford University in California have used generative AI to design novel bacteriophage viruses. But, what have these scientists actually accomplished, and how can we put the right safeguards around the technology? Simon Clarke, associate professor in cellular microbiology at the University of Reading, explains the breakthrough and lays out its real implications.

References:

We can, but should we? Red flags for hasty, low integrity AI integration into healthcare

Regulating AI in healthcare: a moving target

Developments in AI designed viruses demonstrate why such research must be done in the open

In the first part of this episode, we discuss new research which aims to help patients and their doctors identify the right treatment. Michele De Prisco, psychiatrist and researcher at the Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques, joins us to discuss his team's comprehensive umbrella analysis of bipolar disorder treatment options.

Also this week, with the malaria vaccines RTS,S and R21 passing regulatory hurdles, and becoming available for populations around the world, the fight against malaria is shifting. Gillian Turner, Principal Research Associate at the Liverpool School of Tropical Medicine, explains the logistical challenges of the malaria vaccine rollout and what steps are needed next to control the disease.

Reading list:

Evidence based interventions for bipolar disorder across phases and age groups

Scaling up Malaria Vaccines in Africa

Global health is changing, after the reduction in financing from wealthy nations, the global community are beginning to implement reforms to improve the situation. However, any change will be unsuccessful until we tackle the fundamental structures that govern outcomes, argue Daniel Bernal-Serrano and Omar Gabriel Torres Valencia from the London School of Hygiene and Tropical Medicine. They join us to explain how economic forces, wealth distribution, and market dynamics undermine health outcomes.

We also learn about the rapid rise in private equity financing of healthcare in the UK, and the dangers that poses to healthcare quality. Bernd Rechel is a researcher at the European Observatory on Health Systems and Policies, and explains how different countries are handling this drive for healthcare profit extraction.

Reading list:

• Private equity involvement in UK healthcare
• Reforming global health architecture requires confronting its political economy

Also this week, Are Doctors Scared of Death? BMJ Careers Editor Abi Rimmer sits down in the studio with Richard Coker, Emeritus Professor of Public Health at LSHTM. Drawing from his early days as an HIV doctor during the onset of the AIDS epidemic, and later with infectious disease outbreaks in South East Asia. Professor Coker discusses the profound experiences of the end of his patients lives that shaped his new book, Timor Mortis: How We Live with Death.

Reading list:

Minimal detectable change of the Patient Health Questionnaire-9, Patient Health Questionnaire-8, and Patient Health Questionnaire-2`

Our panel explore the deeply rooted health inequalities tied to the social determinants of health, the disconnect between local decision-making and national infrastructure, and the urgent need to extend the ability to access social care to more of England's population.

We're joined by

• Michael Marmot: Professor of Epidemiology and Public Health at University College London (UCL) and author of the landmark Marmot Review.

• Sarah Woolnough: Chief Executive of the health think tank, The King's Fund.

• Matt Sutton: Professor of Health Economics at the University of Manchester.

• Devolution can create new opportunities for better health

• Will devolving powers to mayors close England’s health gap?

• Andy Burnham’s goal of good growth could be a health-creating mission that supports environmental action

• The King's Fund responds to Andy Burnham’s comments on social care 

The Ethnicity Data Gap in Research: While sex and gender are reported in 99% of trials, ethnicity is reported in only 48%. Bianca Brijnath, Professor of Health Communication in Society at La Trobe University, joins us to discuss a newly published framework aimed at standardizing the capture and reporting of ethnicity data in clinical trials.

The Evidence Revolution: We celebrate how evidence-based medicine (EBM) has set the gold standard for other areas of science. Mun-Keat Looi, The BMJ’s International News and Features Editor, speaks with Nature editor and science journalist Helen Pearson about her new book, Beyond Belief: How Evidence Shows What Really Works.

Black and Asian doctors are up to 30 times less likely to be offered medical training posts in some specialties, data show 

Measurement of ethnicity in clinical trials: Delphi survey and consensus statement 

Beyond Belief: How Evidence Shows What Really Works by Helen Pearson

This was followed immediately by publication of an independent investigation into maternity and neonatal services in England, conducted by Valerie Amos, which states that the UK's poor maternity care is "on a scale that shames our society".

We speak to  Kate Duhig, clinical senior lecturer at  Kings College London, and Marian Knight, professor of of maternal and child population health at the University of Oxford, about why we keep having reports saying the same thing, but little action to solve the problem.

As many wealthy nations have stepped back from previous aid promises, a new force has emerged to fill the gaps: private finance. David McCoy is professor of global public health at the United Nations University, and explains why turning to investment banks, wealth funds, and private equity in the pursuit of universal health coverage might cause more problems than it solves.

Reading list:

Dangers of finance capital in healthcare

Amos maternity review: Doctors must work differently as units “no longer fit for purpose,” but report is dogged by controversy

Nottingham maternity review: 520 mothers and babies were seriously harmed on “toxic” ward, damning inquiry finds

But how effective are these bans at keeping children away from social media?

New research just published on BMJ.com has looked at that question of efficacy - finding that children are using the most simple tactics to evade the ban.

To dicuss what that means, we're joined by two of the authors of that research Courtney Barnes and Luke Wolfenden from the University of Newcastle, Australia.

We’re also joined by Amrit Purba, from the London School of Hygiene and Tropical Medicine, and Louise Holly, from the Digital Transformations for Health Lab, in Geneva, who have written commentaries to go with that research.

Reading list

Assessing early effects of Australia’s Social Media Minimum Age Act on adolescents’ social media use 

Learning from Australia’s social media age restriction policy  

Early data from Australia indicate that social media companies can’t be relied on to protect children 

Direct-to-consumer (DTC) advertising of prescription medicines is strictly illegal everywhere in the world except for the United States and New Zealand. Deborah Cohen, investigative journalist, joins us to explain how global social media platforms are making borders porous, allowing Hollywood celebrities and high-profile influencers to broadcast drug endorsements directly into the feeds of UK citizens.

Finally, Between 2020 and 2023, the UK government allocated £1.7 billion specifically intended for frontline doctor training. However, a deep-dive investigation has revealed that a staggering £400 million of that funding is completely unaccounted for - David Hutchison, paediatrics registrar, and Jonathan De Oliveira, GP trainee, join us to describe what they found.

• AI warfare demands a new era of humanitarian law
• Bad influencers: How social media imported US-style drug advertising to the UK
• “Black hole” of medical student funding

Two recent position statements from the UK’s national screening committee published in the BMJ show that screening decisions are steeped in complexity. 

The benefits of screening may be easier to grasp, but the harms of overdiagnosis and overtreatment are given less attention. Can we close the divide between the public and academic discourse?

Guest: Sian Taylor-Phillips is professor of population health at the University of Warwick and a member of the UK national screening committee.

Further Reading:

• UK National Screening Committee position statement on surrogate outcomes in cancer screening trials
• Prostate cancer screening: Committee rejects calls for mass testing programme despite pressure

More interviews from the BMJ on our Youtube channel.

Kate Strong, a Scientist at the World Health Organization and Lucia Hug, a specialist in statistics and monitoring for UNICEF, join us to explain the data - and why they are worried about our ability to measure this in the future.

Helen Sharman is the first British Astronaut to make it to space - this week she was at the Royal College of GPs giving the General Medical Council's annual Marx lecture. She joins us to discuss how research in space might impact healthcare on Earth, and what the NHS can learn from cosmonaut teamwork. 

Finally, The government and doctors in England are not getting on well - we’ve had a series of strikes from the resident doctors, GPs are in dispute about the imposition of a new contract, and now consultants are being polled on industrial action.  BMA Consultants Committee co-chairs Shanu Dutta and Helen Neary explain why.

Reading list

Neonatal, Child, and Adolescent Mortality

Global, regional, and national levels and trends in under 5, infant, and neonatal mortality during 1990-2024 with scenario based projections to 2030

Global, regional, and national levels and trends in older child, adolescent, and youth (5-24 years) all cause mortality from 1990 to 2024: modelling study

Systematic estimates of global causes of neonatal and under 5 mortality in 2000-24: secondary data analysis using bayesian multinomial logistic regression

Estimates of global causes of death for children and adolescents aged 5-19 in 2000-24: secondary data analysis using bayesian multinomial logistic regression

Full interview on YouTube:

Why NHS Senior Doctors in England Are Considering Strike Action

In this episode of the Medicine and Science podcast, Kamran Abbasi sits down with healthcare leaders Maureen Bisognano, president emerita of the Institute for Healthcare Improvement and Bob Klaber, director of strategy at Imperial College Healthcare NHS Trust, to discuss why they're calling the lack of humanity in medicine an emergency.

We ask why this dangerous imbalance between the rational (efficiency, data, and metrics) and the relational (human connection, empathy, and listening) has developed in modern medicine. We also learn how simple changes, like asking "What matters to you?" instead of just "What's the matter?, can help us put the humanity back into healthcare.

Reading list

Read the BMJ Article: Healthcare's moral emergency: reconnecting healthcare with its mission and purpose

Michael West on workforce kindness

Amy Edmondson on psychological safety

Len Berry on cancer care & kindness

Together with Hugh Alderwick, Director of Policy and Research at the Health Foundation, we unpack the bill's sweeping centralization of power, the abolition of NHS England, and the contentious role for US tech firm Palantir in the new NHS.

And, we explore a major milestone for women's healthcare. A condition affecting an estimated 170 million women globally has officially been renamed from Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). Rachel Morman, Chair of the PMOS charity Verity, joins us to explain why dropping "cysts" from the name is a vital step toward recognizing this as a complex, multi-system condition, and how this co-designed change will fundamentally reshape diagnosis, treatment, and future research.

Further reading:

Health Bill brings NHS management back into government

PMOS: What's in a name? Everything

PCOS name change to PMOS must be managed to avoid confusing patients, says expert

Guests:

Matthew Bergman is a practicing attorney and the founder of the Social Media Victims Law Center, as well as a professor at Lewis & Clark Law School in Portland, Oregon.

Ilona Kickbusch is an editorial board member of the BMJ and a visiting professor at the Digital Transformations for Health Lab at the University of Geneva, specializing in the commercial determinants of health.

Further reading:

From tobacco to TikTok: what public health litigation history tells us about holding social media accountable

What is the evidence for social media addiction?

We talk with David Strain of the BMA’s board of science to discuss their findings, and hear why they were critical of the Secretary of State, Wes Streeting's response to Cass’s review. And, we hear about new research published with The BMJ that aims to help children with autism. The researchers used a non-invasive magnetic stimulation technique to target specific regions of the brain, with the goal of promoting sociality. We discuss the benefits, and how this technique might translate to treatment plans for patients.

Guests:

David Strain is an associate professor in cardio-metabolic health at the University of Exeter and Chair of the BMA’s Board of Science.

Benjamin Becker is a professor of psychology and neuroscience at the University of Hong Kong, specializing in brain-based interventions for mental disorders.

Further reading:

Puberty blockers: BMA critique vindicates Cass review but questions government “overreach”

Accelerated non-invasive brain stimulation in childhood autism

The deal will

• double the amount that the NHS spends on new medicines, by the end of 2036 (from 0.6 - 0.6% of GDP).
•  increase the threshold that the National Institute for Health and Care Excellence (NICE) sets for drug approvals - which will allow more to be approved, but will also allow companies to charge more for their pharmaceuticals,
•  include a change to the rebate the NHS receives, to ensure that the extra drug spend occurs.

Cumulatively this will increase our drug spend by £56 billion in the next 10 years, which will have to come out of current healthcare spending - which experts are calling a catastrophe for the NHS.

Joining Kamran Abbasi to discuss are Sally Gainsbury, a senior policy analyst Nuffield Trust and Karl Claxton, professor of economics at the University of York. We also hear from Francis Ruiz, policy analyst at the London School of Hygiene and Tropical Medicine.

Reading list

The UK government must publish a detailed impact assessment of the costs and benefits of the US-UK medicines partnership

A budget apart: the case for ringfencing medicines in the UK

We look to Sweden, where new research involving sibling pairs separated by adoption investigates how early-life environments shape long-term health and social outcomes.

Finally, we revisit the dominant medical narrative on Alzheimer’s disease. Why is it so difficult to move towards comprehensive treatments? Has the focus on amyloid plaques hindered our understanding of other critical factors like vascular health and social inequality?

Peter Doshi is a senior editor at The BMJ and an associate professor of pharmaceutical health services research at the University of Maryland.

Erik Peterson is an associate professor at the Karolinska Institute in Stockholm, specializing in psychiatric epidemiology and adoption studies.

Carol Brayne is a professor emerita of public health medicine at the University of Cambridge and a leading expert in the epidemiology of dementia.

Reading List:

Multiple sclerosis: Could Roche's bestselling drug Ocrevus be doing more harm than good in women with primary progressive MS?

Home environment conditions during childhood and psychosocial outcomes across three generations in Sweden: population based adoption-discordant sibling comparison study

Joining Kamran Abbasi are, Fatima Hassan,  human rights lawyer and Director of the Health Justice Initiative in South Africa, and Matthew Herder, Director of the Health Justice Institute at Dalhousie University in Canada explain why they think that the actions and consequences of the Whitehouse meet the bar for WHO to delcare an emergency

We examine the global consequences of recent US policy shifts, including:

• The withdrawal from the World Health Organization (WHO) and its implications for international health governance.

• Significant funding cuts to global health programs, including PEPFAR and the CDC, and how these disruptions affect life-saving HIV and TB treatments in the Global South.

• The rise of "unhinged nationalism" in health policy, from North American measles outbreaks to the extraction of trade concessions in exchange for medical aid.

• The role of US health leadership in fueling vaccine hesitancy and dismantling scientific research at the NIH.

Reading list:

• Trump and his administration as a public health emergency of international concern

• Why the expanded global gag rule is a deadly triple tripwire for recipients of US foreign aid

• The power of the markets: the scandal that keeps on taking

The 15th Strike: As the latest six-day walkout by resident doctors in England concludes, the BMJ's news team examines the state of the ongoing dispute over pay and training places.

Iain Beardsell, consultant in emergency medicine in Southampton explain why he thinks reintroducing compassion could be the key to tackling the systemic issues facing emergency departments

And finally, The BMA announces major changes to how it represents doctors in private practice - we hear why they think the US has some better legislation around health insurance than the UK.

Reading list:

• Resident doctor strikes: Streeting demands to “meet with the organ grinders” as latest action ends
• The BMJ interviews Jack Fletcher 
• Make compassion visible in emergency medicine again
• BMA boosts support for private practice as NHS failings prompt more patients to pay for care

Next we turn our eyes to shisha smoking in the UK. With shisha or “hookah” cafes on the rise, we explore the smoking habit in more detail. What are the effects on health? And why are UK laws poor at regulating the practice?

Kate Jolly is professor of public health and primary care at the University of Birmingham.

Zainab Hussain is a UK-based freelance journalist writing on behalf of The BMJ.

Links:

• Peer support intervention (ABA-feed) to improve breastfeeding: UK based, multicentre, parallel group, randomised controlled trial
• Shisha tobacco’s availability is rising. Why does UK smoking policy fail to tackle it?

From critical NHS shortages like Bone Cement for orthopedic surgery, to persistent IV fluid supply crises plaguing Australian hospitals, we discuss how the conflict in Iran will affect fragile healthcare logistics.

Joining us today are 

• Mark Dayan, Brexit programme lead at the Nuffield Trust) on NHS procurement problems 
• Anny Huang, doctor and journalist in Brisbane,on the three-year  IV fluid shortages in Australia.
• Prashant Yadav a senior fellow for global health at the Council on Foreign Relations, on the potential global effects of the Iranian conflict on international supply chains.

Reading list

Global bone cement shortage: NHS could cancel or delay knee and hip operations

How Australia survived a sudden shortage of IV fluids

Where the Iran War Could Disrupt Pharmaceutical Supply Chains

At the same time, people are struggling to access the NHS, and when they do doctors have little time or the right tools to unpick complicated science, and challenge misunderstandings.

So in this roundtable, we’re asking, are we in danger of the NHS making the problem of misinformation worse, and what can we do to combat that.

Joining Kamran Abbasi, the BMJ’s editor in chief are:

• Deborah Cohen: Freelance Journalist; Senior Visiting Fellow at LSE Health
• Kamila Hawthorne: Chair of the National Academy for Social Prescribing
• Nnena Osuji: Consultant haematologist and CEO of North Middlesex University Hospital NHS Trust

Chapters

• [00:00] The rise of health influencers
• [03:55] Patient satisfaction and the NHS
• [05:58] The "Infodemic" and clinical impact
• [11:04] Digital literacy and health inequalities
• [16:40] Questions from the audience

Reading list:

• Cohen D. Bad Influence: How the Internet Hijacked Our Health. Oneworld Publications; 2026.
• Satisfaction with NHS hits record low, but public still back founding principles - The BMJ

GP contract overhaul: What's included and how has it been received?

Helen Salisbury: Another imposed GP contract

Almost a third of UK children live in poverty. Leading expert Michael Marmot weighs in on the UK’s "steepest rise" in child poverty among OECD countries and why local government "Marmot Cities" like Coventry and Manchester are taking the lead where national policy falls short.

And, a new BMJ collection has just been published on child mental health in conflict zones. 1 in 5 children globally live in conflict zones, creating a staggering mental health toll. We hear about community-led interventions.

Reading list:

• The growing threat of domestic wood burning stoves—and industry’s legal attempts to shut down clean air campaigns
• Michael Marmot: Labour has reneged on its child poverty promises
• Child mental health in conflict settings

Kamran Abbasi is joined by:

Angela Rasmussen - Virologist, University of Saskatchewan.

Azeem Majeed - Professor of Primary Care and Public Health, Imperial College London.

Next, we dive into a landmark study from Sweden that is overturning the conventional notion of autism as a predominantly male condition. Historically, autism has been cited as having a 4:1 male-to-female ratio, but new data suggests this gap may be a byproduct of timing rather than biology. We speak with Dr. Caroline Fyfe, a medical epidemiologist at the University of Edinburgh, and Dr. Natasha Marrus, a child psychiatrist at Washington University in St. Louis. They discuss their analysis of 2.7 million individuals, which revealed a significant female catch-up during adolescence, showing that by age 20, the diagnosis ratio approaches 1:1. The team explores why girls are so often missed in childhood and what this shift means for the future of sex-sensitive diagnostic practices.

For more details on the research discussed in this episode, you can access the full papers on bmj.com:

• Cancer is a chronic disease: why don’t we treat it as one? Adam R, Hogg DR, Ritchie LD, Nekhlyudov L. BMJ 2026;392:e086624.
• Time trends in the male to female ratio for autism incidence: population based, prospectively collected, birth cohort study. Fyfe C, et al. BMJ 2026;392:e084164.

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This has led to accusations of "delaying tactics" or "filibustering" to run down the clock deliberately and run this bill off the road. Although some of these amendments have been described as unworkable, repetitious and unnecessary; others reflect serious, legitimate concerns, around the prevention of coercion, how to identify victims of domestic abuse and the broader impact on the disabled community, and whether it’s wise to introduce assisted dying while palliative and social care services are so stretched.

300 territories around the world, allow physician assisted death - so we asked experts from Canada and California to reflect on those objections, and if there is any evidence of this issues arising where they live.

James Downer is Professor and Head of the Division of Palliative Care at the University of Ottawa, and Catherine Forest is clinical associate professor of family medicine at the University of California San Francisco.

Reading list:

Scrutiny of the assisted dying bill is vital but obstruction in the House of Lords could mean it never becomes law

In this conversation with BMJ Editor, Kamran Abbasi, they discuss the ways in which online information can both empower and mislead, the role of big tech in shaping our wellbeing and the complex and disturbing ways wellness influencers are becoming more trusted than the NHS.

With insights drawn from extensive research and a deep understanding of the digital landscape, Deborah Cohen sheds light on the critical issues at the intersection of technology and healthcare, and challenges anyone who consumes health information online to think differently about what they're doing.

Firstly, they pledge to move care from hospitals to the community, an increased focus on prevention rather than sickness, and shift from analogue to digital with an improved NHS app where patients can access records, seek advice and control some aspects of their care. However, accessing primary care and getting a GP appointment is still a key area of concern for patients and healthcare staff. 

In a new research paper on bmj.com, a group of researchers have performed a qualitative study asking 70 patients about their experiences of accessing primary care in England. We're joined by Hugh Alderwick and Luisa Petigrew from the Health Foundation to discuss what the findings mean for the 10 year plan.

Also this week, online gambling is a growing problem. The immediacy of access, combined with advertising and push notifications, and a proliferation of new gambling companies, undermines traditional ways of managing a gambling addiction.

A new analysis argues that these new forms of online gambling requires new forms of regulation. Spencer Murch from the University of Calgery offers some ideas on how that could work.

Reading list

Experience of access to general practice in England

Policies to increase access to general practice may have unintended consequences

Online gambling requires greater government regulation

​‪ @RichardJMurphy‬, political economist and tax campaigner, joins Kamran Abbasi, Editor in Chief of The BMJ.

In the UK an ongoing dispute between resident doctors and the Labour Government saw doctors go on strike in mid-December. With Winter pressure piling on and cost-of-living on the rise, do doctors have a credible case of pay rises? And more broadly, how can the economic situation of the NHS be improved?

00:00 Introduction 01:30 Doctor Pay Claims 04:33 Inflation Measures 07:29 Affordability Crisis 09:48 Market Forces Arguments 12:52 NHS Affordability 15:00 Youth Unemployment 19:14 Political Priorities 23:10 Neoliberal Capitalism 27:35 Mixed Economy Alternative 32:32 Prescription for NHS

Weight regain after cessation of medication for weight management: systematic review and meta-analysis 

Also, The BMJ reports on news from Gaza. The Israeli government has issued new directives to strip 37 NGOs of their licences to provide essential aid to the population. This includes Médecins Sans Frontières, the charity directly supporting many of the critically important hospitals in the territory. Gaza is experiencing an especially harsh Winter and MSF warn that this measure could leave Palestinians without lifesaving medical care.

Gaza: Israel moves to ban dozens of aid groups in "cynical and calculated" move  Gaza in winter: 29 day old baby dies of hypothermia amid dire conditions

The BMJ’s annual appeal is supporting the work of Médecins Sans Frontières (MSF). Around the world, MSF teams are providing maternity care, containing outbreaks, and performing vital surgeries. In areas overwhelmed by conflicts and natural disasters, more lives can be saved when we are in the right place at the right time.

Donate today at https://msf.org.uk/bmj-annual-appeal-2025

Kim Stanley Robinson is the acclaimed author of a trilogy of novels, exploring the terraforming and settlement of Mars. His most recent novel, 'Ministry for the Future', was published in 2020.

'Ministry for the Future' sets out a vision for real solutions to our climate crisis, covering global finance, the animal kingdom, rising sea levels, energy production and much more. The book imagines a Ministry that begins its work in 2025.

Five years after publication, with 2025 past and gone, The BMJ spoke to Robinson to explore how closely the novel's vision for the future has reflected reality.

01:00 BMJ's New Climate Change Initiative 01:21 Kim Stanley Robinson's Ministry for the Future 04:02 The Role of Political Violence in Climate Action 10:50 The Concept of the Carbon Coin 12:51 The Importance of Global Collaboration 27:32 The Role of Medicine in Climate Change 32:33 Youth and Climate Activism 37:53 Hope and Despair in Climate Action 41:29 Conclusion and Future Works

Read more about The BMJ's climate coverage in the latest issue: https://www.bmj.com/content/392/8479

Practicing medicine can be a very visceral experience - and the English language can’t always adequately capture the sights, sounds, smells. So Matt Morgan, intensivist and BMJ columnist, is creating medical neologisms, and joins us to share a few.

Madhvi Joshi, a GP in London, has written about longevity science, and we hear how the “biohacking” of internet influencers like Bryan Johnson is making its way into the consultation.

Navjoyt Ladher and Tim Feeny take us though this year’s festive research, and are joined by Anupam Bapu Jena from Harvard, who has been looking at self censorship in the time of Trump, and Melanie de Lange, from the university of Bristol, who has been investigating the impact of daylight savings time.

Reading list:

A dictionary for medicine’s unnamed moments https://www.bmj.com/content/391/bmj.r2476

Science of longevity medicine  https://www.bmj.com/content/391/bmj.r2536 

Changes in diversity language in National Institutes of Health grant awards https://www.bmj.com/content/391/bmj-2025-087222 

Acute effects of daylight saving time clock changes on mental and physical health in England https://www.bmj.com/content/391/bmj-2025-085962 

David Navarro, a research fellow in generative AI at the Australian Institute of Health Innovation, Charlotte Blease, associate professor at the Participatory eHealth and Health Data Research Group at Uppsala University, and Marcus Lewis, GP in London, reflect on what we know about the real way in gen AI is being used - and what “triadic care” (doctor, patient and AI) will mean for the future of the therapeutic relationship.

We also hear from Teppo Järvinen, professor of orthopaedic surgery at Helsinki University, about surgical subacromial decompression - a 10 year follow up of a double blinded placebo controlled trial, confirms that surgery is no more effective than standard care. Yet surgical interventions continue - we hear why.

Finally, we go to a Cholera clinic in Nigeria, where Médecins Sans Frontières are running cholera treatment centres, which you can help by donating to our Christmas appeal.

Links

Generative AI and the clinical encounter

The BMJ appeal 2025-26: Inside MSF’s response to cholera in Nigeria: a day in the life of an emergency doctor

Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome

Now a new umbrella review - a review of reviews - tries to give a broad overview of the whole evidence base. Corentin Gosling, associate professor at the Université Paris Nanterre, joins us to set out the benefits and harms of ADHD therapies.

Also, the BMJ’s been investigating the employment of doctors on “local” contracts in the NHS - and our latest look at this exposes what some have described as a “gig economy”, with doctors plugging rota gaps but missing out on training, development, and salary progression. Rebecca Coombes, head of journalism at The BMJ explains more.

Finally, Tom Frieden is former head of the US Centers for Disease Control, and current CEO of Resolve to Save Lives - he’s written a new book on public health. He joins us to talk about what actually improves health at a population level, and why the current US administration’s approach to staffing the CDC is leaving the country open to danger.

Reading list

Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making

Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts

"Damning” and “unforgivable failures” is how some papers headlines reacted to criticism of former UK prime minister Boris Johnson in the second of 10 reports from the UK Covid Inquiry.

Under pressure, in 2001 Boris Johnson announced a covid inquiry led by a former judge, Baroness Hallett. Each report is examining a different area of the pandemic's impact, and module 2 is about decision making and political governance.

The report describes inertia, toxic cultures, and an inability to learn lessons - disfunction that contributed to many extra deaths. 

To dissect the report and discuss what needs to change, we're joined by;

• Rebecca Coombes - The BMJ’s head of journalism
• Kevin Fong - anaesthetist and lead for major incident planning at University College Hospital
• Matthew Flinders - Professor of Politics and Public Policy at the University of Sheffield

Firstly, climate change is fuelling conflict, and exacerbating the impact it has on fragile healthcare systems. Andy Haines, from the London School of Hygiene and Tropical Medicine, and Barbora Sedova, from Potsdam Institute for Climate Impact Research, discuss how climate and conflict intersect, and what they think needs to be done to combat it.

“Car spreading”, the recent tendency for cars to become bigger and heavier is not only harming the climate, but it’s also harming pedestrians.  Anthony Laverty, associate professor of public health at Imperial College London, and trauma surgeon Cleo Kenington explain why SUVs are more lethal in accidents, and why France is bucking the trend in sales.

Finally, Jocalyn Clark, the BMJ’s international editor joins us to talk about women’s health innovation and why tech bros aren’t the people to be leading it.

Reading list:

The climate issue: Brazil and the climate crisis

Tackling the complex links between climate change, conflict, and health

Reducing the harms from ever larger cars

Transforming women’s health through innovation

That has made a group of medics decide it’s time for doctors and other healthcare professionals to use their voice and speak up - against the demonisation of migrants into the UK, and for their fellow NHS staff. They are demanding that those in positions of power do so too.

Some of those medics join us on the podcast today;

Alistair Stewart, consultant psychiatrist in Manchester 

Omnya Ahmed, resident doctor in London 

Jordan Rivera, occupational therapist in London

Also this week, doctor, researcher, comedian and Matt Hutchinson is adding author to his list, and has released the book “Are You Really the Doctor? My Life as a Black Doctor in the NHS” - he joins Shivali Fulchand to talk about balancing all of this bits of his career - and how standup comedy has helped him maintain his career in the NHS.

Reading list

Everybody’s business: call to all NHS staff to oppose the influence of racism and the far right

The BMJ investigates Q-COLLAR, an American device that distributors claim can reduce brain injury from contact sports. Investigators James Smoliga and Mu Yang take us through the evidence, and former NFL punter turned US bobsled team member Johnny Townsend explains what this means for sportspeople.

Bin Wang from Zhejiang University School of Medicine explains what the new network metaanalysis finds is the best exercise options for knee osteoarthritis

And, what our patient panel really think about “patient choice”.

links

How an FDA cleared “brain protection” device built on shaky science made it to the NFL

Comparative efficacy and safety of exercise modalities in knee osteoarthritis

The BMJ's patient and public partnership

In July this year, the Government published their 10 year health plan for England - A new analysis just published on BMJ.com takes an in depth look at the chances of that plan succeeding, and where the government needs to focus time and resources. Bob Klaber, paediatrician and director of strategy, research and innovation at Imperial College Healthcare, and Helen Salisbury, GP and columnist for the BMJ join us to discuss.

Journalist Chris Stoker-Walker's grandfather suffered from delirium at the end of his life, but the journey to that diagnosis was difficult - Chris joins us to talk about the impact that had on his family, and Elizabeth Sampson, professor of liaison psychiatry from Queen Mary University of London, explains why it's under-researched.

Finally, we've been reporting from Gaza for 2 years, and it's been very difficult to get accurate information out of the region. However, new research published on bmj.com has surveyed medics there, to document the patterns of wounding in the civilian population - to improve the medical response to the conflict. Omar El-Taji and Ameer Ali, resident doctors in the NHS join us to explain what they found.

Reading list:

Delivering on the 10 year health plan for England

Why can’t we do anything about delirium?

Patterns of war related trauma in Gaza during armed conflict

The BMJ’s Elisabeth Mahase speaks to Labour MP Kim Leadbeater, sponsor of the Assisted Dying Bill. Why did she propose the legislation? What has been her impression of its movement through Parliament and the opposition it has faced? We also hear from Jamilla Hussain and Gareth Owen, doctors who attended a BMJ parliamentary roundtable on the topic.

Finally, the BMJ’s Duncan Jarvies talks to our research editors about new ways to develop evidence from observational studies. What are the limits to this new technique of causal inference?

Reading list

MP behind assisted dying bill warns that terminally ill people and their families are being failed, ahead of Lords debate

Assisted dying bill: Lords debate concerns over lack of safeguards

Transparent reporting of observational studies emulating a target trial: the TARGET Statement

• Rethinking how we measure the harm caused by the  arms industry
• The life long, and multigenerational, impact of starvation in Gaza
• What is the appropriate focus on prevention in general practice?

The BMJ's international editor, Jocalyn Clark talks about a new series we've just published - examining the arms industry as a commercial determinant of health. Jocalyn also speaks to Mark Bellis, from Liverpool John Moores university about why he thinks it’s time we take the impact of the arms industry on health seriously.

The blockade on food reaching Gaza is in place again, risking more starvation. Elizabeth Mahase, clinical reporter for the BMJ, has been finding out about the acute, chronic, and generational impact on the palestinian population. She speaks to Jonathan Wells, professor of anthropology and paediatric nutrition at University College London, and Tessa Roseboom, professor of early development and health at the University of Amsterdam, Marie McGrath former head of the Emergency Nutrition Network, and Chris McIntosh, humanitarian response advisor for the charity, Oxfam.

Finally, an analysis we published earlier this year made the case that "tsunami" of preventative care is destabilised the work of GPs. Helen Macdonald was at the Preventing Overdiagnosis conference and spoke to some of the authors - Minna Johansson, associate professor at University of Gothenberg, Stephen Martin, professor at UMass Chan Medical School, and Iona Heath, retired GP and former president of the RCGP.

Reading list

Arms industry as a commercial determinant of health

Starvation is a lifelong sentence: Gaza’s civilians must be protected in accordance with international humanitarian law

Sacrificing patient care for prevention: distortion of the role of general practice

Also this week, a new investigation on bmj.com has looked at a number of British companies who are offering to collect children's teeth for stem cell extraction and storage. Freelance investigative journalist Emma Wilkinson explains the "outrageous" claims she found them making.

Finally - we’re finishing with the football. Team GB had a strong showing this year -  our over 25 men’s team brought the trophy home, and our womans team competed for the first time To explain more about the medical world cup we're joined by Minnan Al-Khafaji, captain of the women’s team, and Jamie Thoroughgood, captain of the men’s team.

Read more.

Banking baby teeth: companies may be misleading parents with “outrageous claims”

CRISPR therapy for sickle cell disease

Follow the British Medical Football Team on instagram

A new series of article in The BMJ revealing serious concerns with the reliability of these home tests, and raises questions about their regulation.

Jonathan Deeks, professor of Biostatistics at the University of Birmingham, joins us to discuss what these tests are, and how his team have rated their usability.

Also this week, the sad death of a child in Liverpool from measles highlights the growing outbreak in the UK - and this may be one of the first times many doctors have come across the infection. Frances Dutton, GP at the Small Heath Medical Practice reminds us how to recognise the sign of the infection.

Reading list

Direct-to-consumer self-tests sold in the UK in 2023

How to recognise and manage measles

She sits down with Kamran Abbasi, editor in chief of The BMJ, to discuss her findings. In the UK, the rollout of physician associates, NHS staff who took on some of the tasks of doctors, has been both haphazard and controversial.

Originally copied from similar roles in the U.S., British PAs were introduced in the early 2000s. The level of clinical responsibility they were asked to take on began to vary around the country, driven mostly by the workforce needs of individual Trusts.

The lack of clarity about their roles lead to disquiet with doctors, worry for patients, and an increasingly toxic debate on social media.

• 01.00 What is the Leng Review?
• 10:00 Recommendation one: Renaming
• 14:00 Recommendation two: Easier identification
• 16:00 Recommendation three: How to work?
• 20:00 Recommendation four: Diagnosis
• 25:00 Recommendation five: Oversight & Regulation
• 32:00 Prescribing and ordering ionizing radiation?
• 40:00 A failure of workforce planning and vision ?
• 49:00 The NHS 10 year plan

On the 3rd of July the UK’s Prime Minister, Kier Starmer finally announced the NHS’ 10 year plan. His Labour government laid out a vision for where the healthcare service should head over the next decade.

The announcement has been met with mixed responses. The plan has some good ideas - but a lack of vision combined with scarcity of detail leave many questions about how well its aims can be implemented.

In this podcast we're joined by 3 experts to dissect the details of this plan

• Jennifer Dixon is chief executive of the Health Foundation
• Katie Bramhall-Stainer is a working GP, and chairs the BMA’s General Practice committee.
• David Oliver is a consultant geriatrician, and a columnist for the BMJ

Reading list

News analysis: What is the NHS 10 year plan promising and how will it be delivered?

Editorial: Government’s 10 year plan for the NHS in England

David Oliver's column: The NHS 10 year plan—more a set of ambitions than a plan

Watch this interview on our YouTube.

Peter Doshi, senior editor in the BMJ’s Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.

Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it’s ineffective and potentially reinforces damaging stigma. 

To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen

Reading list

Doubts over landmark heart drug trial: ticagrelor PLATO study

Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca’s billion dollar drug

Beyond body mass index: rethinking doctors’ advice for weight loss

In November 2024 Wes Streeting, the UK’s health and social care minister, announced that he was planning to introduce league tables for hospitals - and would be linking managers' pay and continued employment to those outcomes. 

Richard Lilford, from the University of Birmingham, Timothy Hofer, from the University of Michigan, and Ian Leistikow, an inspector at the Dutch Health and Youth Care Inspectorate, join us to explain why this is a bad idea.

Non-prescribed ketamine use is rising in the UK

Hospital league tables, targets, and performance incentives should be used with care

Also, John Downey, from the Centre of Health Technology at Peninsula Medical School, and Martha Lee from NHS Devon Integrated Care Board, have written about Plymouth's "Living Lab" - which has been set up to test how health tech can actually work in the real world, but also (importantly, critically) how it can be properly evaluated and integrated into the NHS and social care.

Reading list

How Not to Die (Too Soon)

Harnessing predictive prevention to shift elderly care from hospital to community in England

For a long time doctors have campaigned for nuclear disarmament, and Chris Zielinski, president of the World Association of Medical Editors, makes the case for returning WHO's mandate to measure the potential impact of nuclear war.

Also the militarization of the region is detrimental to the health and wellbeing of the populations in both India and Pakistan. co-chairs of The BMJ's South Asia editorial board, Sanjay Nagral and Zulfiqar Butta, explain why a focus on the daily material and health needs of citizens is the way to change political rhetoric in the region.

Gordon Guyatt, distinguished professor at McMaster University, was one of the people responsible for starting GRADE - which is a structured system for assessing the quality of evidence in systematic reviews and clinical practice guideline. Gordon thinks that process has become too complicated - so he’s now championing “Core GRADE”. He joins us to explain why.

Reading list

Ending nuclear weapons, before they end us

Why Core GRADE is needed: introduction to a new series in The BMJ

Sonia Saxena, professor of primary care at Imperial College London, and Miguel O’Ryan, dean of the medical faculty of the University of Chile join Kamran to talk about what broke academic medicine, and why it's time for a revolution.

New research shows that data from retracted papers is still having an alarming effect on clinical practice. Chang Xu, Hui Liu, and Fuchen Liu from the Naval Medical University in Shanghai, and Suhail Doi from Qatar University, join us to talk about their study which has maped retracted papers impact on systematic reviews and clinical guidelines. 

Reading list

Malaria control lessons from China

Vision 2050: a revolution in academic medicine for better health for all

Investigating the impact of trial retractions on the healthcare evidence ecosystem (VITALITY Study I)

- An example of the BMJ's approach to updating metaanalysis after a study retraction 

To discuss we're joined by a panel of experts on end of life;

• Scott Murray, emeritus professor of primary palliative care at the University of Edinburgh
• Simon Etkind, assistant professor of palliative care at the University of Cambridge
• Nancy Preston, professor of supportive and palliative care, Lancaster University
• Suzanne Ost, professor of law, Lancaster University

Reading list

Assisted dying and the difficulties of predicting end of life

Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach

Also in this episode, we dim the lights and raise the curtains - there is a public fascination with doctors who kill and the stage show turned podcast, ‘An Appointment with Murder’, takes a deep dive into the crimes of GPs John Bodkin-Adams and Harold Shipman.

Kamran is joined by Harry Brunjes and Andrew Johns to talk medical murder.

An Appointment With Murder on Apple Podcasts

Watch this interview on our YouTube.

Trump’s second term has touched everything in the US political sphere - and health is no exception. With research funding for medicine and science weathering under Trump’s storm of cuts, how can Americans who care about public health and data navigate a course through the swells?

Professor Jha discusses how to resist an anti-vaccine resurgence, and comments on revisionist narratives that drive ill-conceived public health policies.

• 02:20 The MAHA movement and RFK Jnr.
• 07:40 Does evidence still matter?
• 13:35 Trump administration is helping China
• 15:10 Policymaking in Trump’s shadow
• 23:35 Where do universities go from here?
• 28:48 Censorship, research funding and academic freedom
• 33:35 Health inequalities within America
• 36:20 A resurgent anti-vax message
• 41:24 What Ashish’s got wrong about the pandemic response
• 45:31 When is enough for research data?
• 47:14 Future hope and how to pushback in smart ways

Reading list:

Professor Jha’s December 2024 editorial on the Trump admin’s plans for American healthcare coverage 

Also, Suzanne O'Sullivan, consultant neurologist and author, joins us to talk about her new book "Age of Diagnosis". The book used clinical cases to explore the issues of medicalisation, and Suzanne explains why overdiagnosis doesn't mean that care isn't needed.

Reading list;

UK welfare reforms threaten health of the most vulnerable

Guardian edited extract from "The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far"

On the international stage, the Trump administration's withdrawal from the WHO is throwing global health into disarray - Illona Kickbusch, founder of the Global Health Centre at the Graduate Institute in Geneva, joins us to explain which new alliances are emerging, why the funding that has disappeared may never be replaced, and how tech will surpass pharma when it comes to industry influence.

Finally, there is a triple burden of malnutrition for adolescent girls in south Asia - which creates a cycle of ill health that is hard to break. However, Zulfiqar Bhutta, chair in global child health at the Hospital for Sick Children in Toronto, thinks the region can come together to change both government and society to champion young women’s health. Reading list:

Abolishing NHS England: risks and opportunities

https://www.bmj.com/nhs-commission

https://www.bmj.com/collections/nourishing-south-asia

Habib Naqvi is director of the NHS Race and Health Observatory, and is holding up a mirror to the NHS on it's support for ethnic minority patients and doctors - he joins us to talk about the work they've done, and why Reform UK's manifesto pledge to disband the Observatory is a matter of pride. 

Finally, our annual trip to the Nuffield Summit is not complete without a roundtable, this year we asked the question "What is stopping staff from speaking up?". Our panellists raised the usual issues of hierarchy and psychological safety, but also how the lack of positive change from senior leadership has habituated people into thinking "why bother".

Our panel;

Katie Bramall-Stainer, chair of the General Practice Committee of the BMA Jugdeep Dhesi, consultant in geriatric medicine at Guys and St Thomas Hopsital Henrietta Hughes, the UK's patient safety commissioner Thea Stein, chief executive of the Nuffield Trust 

Reading list

Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research

Together we can challenge the racism that persists in healthcare

In this podcast, Kamran Abbasi, the editor in chief of The BMJ, spoke to Phil Banfield, chair of the BMA’s council.

They talk about the ongoing pay discussions, how the BMA is working with the new government - touching on both speciality training places, and the role of physician assistants.

The conversation also covers the BMA's changing strategy, which aims to empower local members to take on the fights they care about, and how the organisation is linking both their trade union and professional activities.

In this final episode of The BMJ’s podcast series on quality of care, Rachael Hinton, BMJ Editor, speaks to three healthcare leaders. They discuss how fostering kind and compassionate leadership and care can improve morale, combat burnout, and contribute to better patient outcomes.

01:48 Lydia Okutoyi talks compassionate leadership in Kenya

08:39 Pedro Delgado talks refocusing on the human factor and tools for kind leadership

15:02 Alexander Ansah Manu talks reaping quality of care benefits in Ghana

This podcast was produced as part of the BMJ Collection on Quality of Care, developed in partnership with the World Health Organisation and the World Bank. Visit bmj.com/qualityofcare to view the full Collection. The BMJ commissioned, edited, and published this podcast. This episode edited by Brian Kennedy.

Sticking with industry behaving badly, May van Schalkwyk, from the University of Edinburgh, wonders why we haven't learn lessons from the attempts to control big tobacco companies, when it comes to other industries that harm health.

And finally, AI in healthcare - Karim Lekadir, from the University of Barcelona, explains new guidelines which can help evaluate which AI applications are trustworthy.

Reading list

McDonald’s triumphs over councils’ rejections of new branches

FUTURE-AI: international consensus guideline for trustworthy and deployable artificial intelligence in healthcare

Julia Sinclair, professor of addiction psychiatry at the University of Southampton, explains how the NHS has lost sight of the impact alcohol consumption has on clinical care, and why we need a strategy to tackle it.

Finally, Matt Morgan, consultant in intensive care and BMJ columnist, has written another book - this time about patients who are revived after cardiac arrest, and the profound effect it can have on their outlook in life. 

Reading list:

Relative efficacy of prehabilitation interventions and their components

UK needs national strategy to tackle alcohol related harms

A Second Act

Will they really exit, or can a deal be made? Lawrence Gostin hopes so, and as a professor of law at Georgetown, and director of the World Health Organisation Collaborating Center on National and Global Health Law, he is working with senior US and WHO officials to try and understand what reforms could be made to WHO what would allow a such a deal to be be struck.

Gostin also believes that the president cannot withdraw from the WHO with an executive order, but instead requires congressional approval - and is exploring the options for legal challenge to the move.

00:00 Intro

01:01 US history with the WHO

03:31 Executive order

06:35 WHO’s relationship with China

11:14 Funding

12:47 Benefits to US from the WHO

18:05 H5N1 threat

19:43 World benefits from US involvement

21:57 A deal to be made?

24:55 Legal action?

26:37 Administration responses

Read Professor Larry Gostin’s co-written opinion piece on the dangers of a US withdrawal from the WHO here: https://www.bmj.com/content/388/bmj.r116

Tim Feeny and Navjoyt Ladher take us through this year's Christmas research papers.

And finally, Mari Martensen, a paramedic, explains what makes being a medic in Svalbard bear-able.

Reading list.

• The dangers of industrialisation—why we need to rebuild a convivial society
• Televised medical talk shows—what they recommend and the evidence to support their recommendations
• Christmas 2024: How to transport a polar bear, and other idiosyncrasies for Arctic emergency medical services
• The full Christmas archive

A new research paper has identified a link between eating chocolate and lower rates of diabetes. Binkai Liu, doctoral student and Qi Sun, associate professor, at the Harvard T.H. Chan School of Public Health explain what they found.

Finally, Sam Hutt is a doctor in the NHS, but is better known by his stage persona “Hank Wangford”. Hank performed a celebration of the NHS at Glastonbury this year, and has now released that song. He joins us to talk about what inspired him.

Reading list

Hank Wangford

Also, every year the BMJ has a Christmas appeal - and this year we have chosen the International Rescue Committee as our partner. To talk more about what they do, and to give us some insight into how geopolitics are affecting health we're joined David Milliband, president and chief executive officer of the International Rescue Committee, and former UK foreign secretary.

Reading list;

Nurse and doctor turnover and patient outcomes in NHS acute trusts in England

The BMJ Appeal 2024-25: David Miliband on hospital attacks, Trump, and the International Rescue Committee in a “flammable world”

In that vein, we’re joined by Christos Christou, international president of Médecins Sans Frontières (MSF) to talk about attacks on healthcare staff, and the difficulty and importance of maintaining neutrality in conflict zones.

Ara Darzi, surgeon, executive chair of the conference, and author of the recent NHS review, joins us to talk about  antimicrobial resistance, and how diagnostics and a small funding commitment could head off the problem.

And finally, we change our focus to the US, and hear about new research into adverse events during surgery with authors Antoine Duclos and David Bates from Harvard Medical School.

Reading list.

We need to do more to keep antibiotics working

WISH report - Tackling Antimicrobial Resistance: How to Keep Antibiotics Working for the Next Century

Safety of inpatient care in surgical settings: cohort study

Menaka Paranathala and Emma Rourke, from The BMJ, are on to talk about improving research into women’s health. A new UK project, MESSAGE, aims to give consideration to sex and gender in life science research.

Palliative care is not just for end-of-life, and rethinking how it’s integrated into every speciality is the key to improving care for patients, argue Richard Harding, Anna Peeler, and Oladayo Afolabi from the Cicely Saunders Institute.

Links

• WISH report - Protecting Health in Armed Conflict
• MESSAGE (Medical Science Sex and Gender Equity) project
• BMJ Opinion - Palliative care is an overlooked global health priority
• WISH report - Palliative Care

In this week’s episode, we’ll hear about our annual climate edition from two of The BMJ’s editors, Sophie Cook and Juliet Dobson. 

We’ll be diving into Cli-Fi and asking how climate fiction can galvanise our collective response to climate change. Our panel includes Howard Frumkin, professor emeritus at University of Washington. Lakshmi Krishnan, internist and Director of Medical Humanities at Georgetown university, and Sarah Grossman, journalist and author of Fire So Wild.

And Finally, Tereza Kasaeva, director of the WHO’s Global Tuberculosis Programme, explains how migration and food insecurity, exacerbated by climate change, are affecting TB - and why, despite effective treatment, there are still over a million deaths from the disease annually. 

Our panel's cli-fi book recommendations

• A Fire So Wild - Sarah Grossman
• The Last Man - Mary W. Shelly
• The Broken Earth  - NK Jemisin
• Oryx and Crake - Margaret Attwood
• The Ministry for the Future - Kim Stanley Robinson
• Olga Dies Dreaming - Xóchitl González
• Land of Milk and Honey - C Pam Zhang
• Day of the Triffids - John Wyndham

Links

• The BMJ’s annual climate issue
• Cli-Fi—helping us manage a crisis
• Writing towards a healthier future amid climate disaster
• WISH report - Tuberculosis

Lakshmi’s references

• Fundamental Role of Arts and Humanities in Medical Education 
• Capable of being in uncertainties’: applied medical humanities in undergraduate medical education
• The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity
• The medical humanities at United States medical schools

One of the seemingly intractable issues when it comes to legislative change in the US is gun control.  One reason policy change is so difficult, is the US specific evidence vacuum, but that’s beginning to change.

We're joined by Louis Klarevas, an academic at the University of Colombia and author of the book “Rampage Nation, securing america from gun violence" and Shannon Watts, from Moms Demand Action which is a grassroots movement of Americans fighting for public safety measures that can protect people from gun violence.

Even when there is evidence, the trade-offs needed for legislative change can still paralyse policy makers. Citizen assemblies, a form of democratic participation that asks the public for their views, has helped clarify some key healthcare issues, from assisted dying in Jersey, to abortion access in Ireland.

Rebecca McKee from the Institute of Government argues they could be used to fix the NHS, and joins us to explain how.

Reading list

More gun regulation, less firearm harm

Citizens’ assemblies, health, and health policy

The Bill and Melinda Gate’s foundation has just released their Goalkeepers' report - highlighting the detrimental impact that poor nutrition is having on children’s health.  Rasa Izadnegahdar, director of Maternal, Newborn, Child Nutrition & Health at the foundation joins us to explain how they are targeting nutritional interventions.

Also this week, a new investigation in The BMJ has found that the UK government’s  Scientific Advisory Committee on Nutrition - the people who help guide the UK’s nutrition policy - have competing interests with the food industry. We hear from Chris van Tulleken, University College London; Rob Percival, the Soil Association; and Alison Tedstone, chair of the Association for Nutrition.

Reading list:

Goalkeepers Report 2024

UK government’s nutrition advisers are paid by world’s largest food companies, BMJ analysis reveals

After the games, olympians and paralympians return to their normal lives - but what does that mean for their healthcare, especially in the US where insurance is expensive? Jonathan Finnoff, chief medical officer for the US Olympic and Paralympic committee joins us to explain how athletes are supported outside the games.

Reading list;

GP leader: “If general practice is the bedrock of the NHS, then the NHS is collapsing”

The episode also covers the growing NHS waiting list crisis and how Imran Ahmed and his team at Guy's and St. Thomas' NHS Trust are using high intensity theatre (HIT) lists to increase surgical throughput - and what other teams need to know, if a national rollout of this model is to happen.

Reading list

Galleri promises to detect multiple cancers—but new evidence casts doubt on this much hyped blood test

Are surgical HIT lists the answer to bringing down NHS waiting times?

However, mega sporting events don't always have that effect, and Fiona Bull, head of physical activity for the WHO, joins us to explain why it's increasingly important that they do.

We'll also hear from Professor Sir Denis Perera Gray about how a lifetime of general practice, and why continuity needs to be at the heart of any improvement to primary care.

Finally, Harry Brunjes went from being a village GP to the chair of English National Opera, and explains what the two careers have in common.

Reading list

Olympic Games: linking sports mega events to population physical activity

Highlights:

01:52 - The Patient "takeover" 05:43 - Social care with Charlotte Augst 19:53 - Peer support groups with Claire Reid and Partha Kar 31:48 - WHO’s resolution on social participation with Mark Barone

Reading: Editor's Choice - Listening to patients at all levels of healthcare, Emma Doble, patient editor

New U.S. guideline on breast cancer screening  have been extended to women in their 40s -  Katy Bell, from the University of Sydney, and Stacy Carter, from the University of Wollongong explain why the good intention of that change wont be mirrored in outcomes - and may even induce harm.

Research in The BMJ shows epidurals during labour can reduce severe maternal morbidity Rachael Kearns describes why analgesia may improve those outcomes, and why some myths about epidurals may be reducing their usage.

Lastly,  a GP confronts the Prime Minister on the disintegration of the NHS and its effects on general practitioners.

02:23 Breast cancer screening guidelines

14:00 Epidurals and maternal morbidity

26:42 A GP confronts the Prime Minister 

Reading list:

Breast cancer screening from age 40 in the US

Epidural analgesia during labour and severe maternal morbidity: population based study

GP who confronted Rishi Sunak received “hundreds” of supportive messages from doctors

Our commission on the future of the NHS has released a manifesto for a sustainable NHS that still meets it's founding principles. Helen Salisbury, GP and BMJ columnist, joins the podcast to lay it out.

Finally, a musical interlude from the World Doctor's Orchestra.

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.

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 Crisis 10:50 The Kafkaesque Dilemma of GP Unemployment 23:10 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 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 Safety 10:24 The Impact of Corporate Funding on Public Health 19:57 Addressing NHS Workforce Challenges: Insights and Solutions

Reading list;

Our new podcast - Future Health

International forum keynote -  Medscape caves in on courses funded by tobacco giant Philip Morris, while medics fear global push into medical education Investigation - 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

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

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

How is technology changing clinician-patient relationships?

Mandatory data and code sharing for research published by The BMJ

Scalpels and spotlights: bringing theatre to the theatre

Awakening from anaesthetic is difficult enough, but imagine you're three and only communicate through sign language - which no one can understand. We hear from Kirsten, a mother who thinks everyone should learn at least a few key sign language phrases.

Finally, the London Medical Orchestra is turning 70 - having had their start in The BMJ's letters pages. Stuart Delve and Peter Gough help explain the orchestra's longevity.

01:00 The Supreme Court Case on Medical Abortion

10:27 The Role of Journal Editors in Scientific Integrity

19:54 The Impact of Deafness on Patient Experience

30:57 The Joy of Music in a Medical Career: London Medical Orchestra

References

Analysis: Correcting the scientific record on abortion and mental health outcomes

WYPIT: The importance of British Sign Language

Asha's instagram for BSL tips

London Medical Orchestra's 70th anniversary concert - 6:30pm, Sun, 10 Mar 2024

Next on the podcast, research just published in The BMJ looks at the efficacy of exercise at controlling depressive symptoms - but helps finally answer the key question - which exercise works best. Lead author, Michael Noetel, senior lecturer in psychology at the University of Queensland, joins us to explain the research, and how well exercise stacks up against pharmacological treatments.

Finally, while it’s tempting to try and put the pandemic behind us, its effects linger - and many healthcare staff are still dealing with their experience of that time. Rachel Clarke, a palliative care doctor in the UK, joins us to explain why she has felt the need to document the pandemic, first in a book and now in a new TV drama set to air in the UK next week. 

06:15  Heidi Larson on vaccine confidence and social media

15:31 Exploring the effectiveness of exercise for depression

26:56 Rachel Clark on seeing her experiences reflected on screen

Reading list

BMJ Collection: How are social media influencing vaccination

Feature: Medical misinformation on social media—are the platforms equipped to be the judge?

Research: Effect of exercise for depression

Every two weeks we’ll be bringing you a magazine style show, more variety and perspectives on medicine, health, and wellbeing.

• Former chief executive of the NHS, Nigel Crisp, explaining why the UK is  facing a national health and care emergency (01:22)
• The guest editors of our US covid series, Gavin Yamey and Ana Diez Roux, discuss the US pandemic response, and how problems are built into the US constitution (19:48)
• How The BMJ’s ActionAid appeal will help people in Gaza, Syria and Somalia (33:06)

• The BMJ Commission on the Future of the NHS
• US covid-19 lessons for future health protection and preparedness
• The BMJ Appeal 2023-24: ActionAid offers immediate and long term help

In this festive edition of the BMJ podcast, we hear about what medicine can learn from music, when it comes to giving a convincing performance, and how we can grow an evidence base for nature prescribing.

Professors Roger Kneebone and Aaron William of the Centre for Performance Science raise the curtain on the performance of medicine, and we hear what your consultation technique could learn from a hairstylist.

Ruth Garside, Professor of Evidence Synthesis, Kerryn Husk, Associate Professor of Health Sciences and Edward Chapman from the Health and Environment Public Engagement Group then discuss 'nature prescribing', and wonder about how to balance maintaining the joy derived from nature and yet create an evidence base for the medicinal benefits associated with it.

Reading list

Medicine: a performing art

Nature prescribing

00:13 Introduction to the BMJ Podcast 00:36 Exploring the Themes of the Christmas Edition 01:38 The Intersection of Medicine and Performance 02:33 The Art and Science of Performance in Medicine 05:04 The Role of Performance in Music 06:29 The Similarities Between Medicine and Music 08:06 The Role of Experiential Learning in Performance 14:11 The Impact of Audience on Performance 19:04 The Benefits of Nature and Green Prescribing 24:52 The Challenges of Measuring the Impact of Nature Prescribing 30:37 The Community's Engagement with Nature Prescribing 33:01 Conclusion and Farewell

The use of oxytocin to prevent bleeding after birth is an example of this - WHO quality guidelines clearly measure and incentivise use of the drug, but in more wealthy healthcare systems, adherence patient preference is the key measure.

How can we ensure that less wealthy healthcare systems are also patient centred?

Our guests for this discussion;

Nana Twum-Danso, ​senior vice president, Institute for Healthcare Improvement (IHI)

Paul Dsane-Aidoo, health specialist, UNICEF Ghana

Keith Cloete, head of department at Western Cape Government: Health

Hosted by Emma Veitch, Collections editor for The BMJ

This podcast is part of The BMJ Quality of Care collection, in collaboration with the World Health Organization and the World Bank, which offers critical thinking on both the unfinished agenda and emerging priorities for improving quality of care in low- and middle-income countries.

00:00 Introduction to the podcast

00:48 Introduction of experts and their backgrounds

02:54 Challenges in healthcare systems: south africa's perspective

04:15 The importance of patient-centred care

04:56 The role of data in improving quality of care

06:11 Community engagement and feedback in healthcare

07:58 Tackling global disparities in healthcare

08:41 Balancing clinical outcomes and patient-centred care

10:58 Addressing inequities in healthcare

22:43 The role of governance in improving quality of care

32:56 Overcoming resource constraints in healthcare

36:22 The need for system redesign in healthcare

37:18 Adapting to changing times in healthcare

The discussion covers athe  wide array of issues young people face, with a particular focus on the unique challenges of adolescence from a social perspective. The episode unpacks the significance of having supportive relationships within families, schools, and communities and the influence of these relationships on the mental and behavioural health outcomes of adolescents. 

It also explores the impact of digitalization on adolescent connection, with discussions on how to balance online interactions with offline engagements. Importantly, it highlights the need for further research into understanding digital and social media interactions and their influence on the health and wellbeing of adolescents in a rapidly evolving digital landscape.

Our guests:

Ulises Ariel Vélez Gauna, Transmitiendo Diversidad

Flavia Bustreo, Fondation Botnar 

Richard Dzikunu, YIELD Hub

Shelani Palihawadana, Young Experts Tech for Health.

Joanna Lai, United Nations International Children’s Emergency Fund (UNICEFUnicef)

Hosted by Adam Levy

Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing.

00:04 Introduction to the podcast series

00:36 Understanding adolescence from a social perspective

01:00 The impact of community and connection on adolescents

01:07 Personal experiences: growing up as an LGBT+ teenager

01:38 The role of supportive relationships in adolescents' lives

02:05 The importance of connectedness in adolescence and beyond

03:27 Treating safe spaces for LGBT+ adolescents

05:23 The unique role of community during adolescence

07:02 The impact of political landscape on LGBT+ community

07:54 The importance of community and connectedness: expert opinions

08:56 The interconnection of social, health, and educational well-being

12:14 The role of digital technology in adolescents' lives

16:56 The importance of investing in adolescents' well-being

43:18 The role of schools in fostering connectedness

45:41 Conclusion: personal reflections on connectedness

The podcast explores physical and mental health issues affecting young people globally, particularly in sexual and reproductive health. We hear how young people are excluded from decisions about their own health, and how grassroots groups around the world are empowering them to take responsibility for their own wellbeing.

We also hear how young people are becoming leaders in social movements, from tackling structural racism to improving nutrition in schools, and how their unique perspectives are vital in making those changes.

Our guests:

Natasha Salifyanji Kaoma, Copper Rose Zambia

Alaa Murabit, The Bill and Melinda Gates Foundation

Donald Bundy, London School of Hygiene and Tropical Medicine

Anshu Banerjee, World Health Organisation

Dev Sharma, Bite Back 2030

Hosted by Adam Levy

Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing.

00:05 Introduction to adolescent health

01:00 Young womens’ menstrual health

02:11 Discussion on candid pride project

03:29 Importance of sexual and reproductive health

04:49 The role of young people in health advocacy

06:17 The epidemiology of early health and lifecourse

10:08 Impact of adolescent health on future generations

18:29 How young people become activists

28:51 Advocacy for women in Libya

28:54 Global forum for adolescents

40:15 Success stories 

44:54 Conclusion and preview of next episode

This podcast explores barriers, burdens and possibilities of change in the educational system to better support young people, and how the traditional system of schooling is failing to equip young people with the skills and knowledge to lead healthy lives.

We also hear how the value of informal education and its impact on subjects ranging from health to gender equality, and that learning isn’t limited to young people, and the intergenerational benefits of education and its role in shaping societal norms and individual health. 

Our guests;

Maziko Matemvu, Uwale

Joanna Herat, UNESCO

Janani Vijayaraghavan, Plan Canada

Atika Ajra Ayon, Plan International

Stefan Germann, Fondation Botnar 

Hosted by Adam Levy

Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing.

00:03 Introduction to the podcast

00:11 The importance of education for adolescents

03:26 The role of education in health and wellbeing

04:43 The impact of education on society

10:21 The power of peer education

11:15 The role of media in education

12:31 The importance of meaningful engagement in education

14:45 The impact of education on health

17:48 The challenges in access to education

26:25 The role of education in combating child marriage

36:37 The impact of climate change on education

44:53 The role of education in mental wellbeing

45:59 Conclusion of the podcast

First patient consent and data - in the UK,  two stories that have made the public worry about the use of their health data. Firstly the news that UK biobank, who hold a lot of genomic and health data, allowed research by an insurance company, and second that the NHS has entered a contract with Palentir to do analysis on NHS data.

Natalie Banner, director of ethics at Genomics England has been thinking hard about putting patients at the centre of decision making about their data, and explains why she thinks a sole reliance on a consent model falls short.

Next, uncertain power supplies, such as in conflict or disaster zones, means uncertain refrigeration. Hard enough for most people to survive, but if you need to keep your insulin cold, it can be lifethreatening. However a new cochrane review has found good news about the thermostability of insulin at room temperature.

We ask Phillipa Boulle, MSF Intersectional NCD Working Group Leader and Cyrine Farhat,is  a global diabetes advocate based in Lebanon, how this will affect care for patients around the world.

Reading list

Thermal stability and storage of human insulin

Outline

00:06 introduction and overview

00:24 the challenge of seeking consent in big data sets

01:34 understanding consent issues in large datasets

01:52 the role of participant panels in data accountability

02:44 the complexity of public attitudes towards data use

04:54 the importance of transparency and engagement in data use

05:48 the impact of external factors on public trust in data use

07:49 the ethical challenges of using health data

09:17 the limitations of consent in ethical discussions

09:23 the need for more conversation about group benefits, risks, and harms

10:41 the role of governance in ethical decision making

12:05 discussion on the interview with natalie banner

14:59 the challenge of managing chronic conditions in disaster zones

15:15 the impact of temperature and storage conditions on insulin

17:32 interview with Philippa Boulle from medecins sans frontieres

29:10 interview with Cyrine Farhat, a person living with diabetes in lebanon

36:18 discussion on the interviews and the challenges of diabetes management

Lessons he learned during his time as the White House Covid-19 coordinator have convinced him we should be taking a different approach to the winter season.

In this interview with Mun-Keat Looi, The BMJ's international features editor, we hear about living with COVID, the future of antivirals, vaccines, and surveillance. They talk about long COVID, the investment required to fight future outbreaks effectively, and the role of the US in the global health response.

In this episode:

Helen Macdonald take a deep dive into cancer screening tests, prompted by a paper in JAMA which showed most have no effect on all cause mortality, and news that the NHS is evaluating a single test which screens for 50 common cancers - we ask Barry Kramer, former director of the Division of Cancer Prevention, at the U.S. National Cancer Institute to help explain how to hold those two pieces of knowledge.

Juan Franco has been looking into diet and obesity, prompted by new research in The BMJ and a new Cochrane review, looking at the role of low glycemic index foods in weightloss - we ask Khadidja Chekima, nutritional researcher at Taylor’s University in Malaysia, to define low GI foods, and why it’s so hard to research their role in diet and weightloss 

Reading list;

JAMA research - Estimated Lifetime Gained With Cancer Screening Tests; A Meta-Analysis of Randomized Clinical Trials

The BMJ news - Clinicians raise concerns over pilot of blood test for multiple cancers

The BMJ research - Association between changes in carbohydrate intake and long term weight changes: prospective cohort study

Cochrane review - Low glycaemic index or low glycaemic load diets for people with overweight or obesity

Our panel

• Kamran Abassi, editor in chief, The BMJ, London, UK
• Omolara Akinnawonu, Foundation year doctor, Essex, UK, and outgoing co-chair of the BMA medical students committee
• Latifa Patel, elected chair of the UK BMA's Representative Body and BMA EDI lead
• Host - Navjoyt Ladher, clinical editor for The BMJ
•  

Our panel

• Samuel Oti, senior program specialist, International Development Research Centre, Ottawa, Canada, and member of the Global Health Decolonization Movement in Africa (GHDM-Africa)
• Muneera Rasheed, clinical psychologist and behaviour scientist and former faculty, Aga Khan University, Karachi, Pakistan
• Liam Smeeth, professor of clinical epidemiology and director of the London School of Hygiene and Tropical Medicine, London, UK
• Angela Obasi, senior clinical lecturer, Liverpool School of Tropical Medicine, UK
• Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia
• Jocalyn Clark, international editor, The BMJ, London, UK
• Host - Navjoyt Ladher, clinical editor for The BMJ
•  

Our panel

• Raewyn Connell, sociologist and professor emerita at the University of Sydney, Australia
• Sarah Hawkes, professor of global public health and director of the Centre for Gender and Global Health, University College London, UK
• Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK
• Asha George, professor and South African research chair in health systems, complexity, and social change, University of the Western Cape, South Africa
• Host - Navjoyt Ladher, clinical editor for The BMJ
•  

Our panel

• Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia
• Catherine Kyobutungi, Ugandan epidemiologist and executive director of the African Population and Health Research Center, Nairobi, Kenya
• Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK
• Chelsea Watego, professor of Indigenous Health at Queensland University of Technology, Australia
• Host - Navjoyt Ladher, clinical editor for The BMJ

Our panel

• Annabel Sowemimo, sexual and reproductive health registrar and part-time PhD student and Harold Moody Scholar at King’s College London, UK
• Thirusha Naidu, head of clinical psychology, King Dinuzulu Hospital, and associate professor, Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
• Subhadra Das, UK based researcher and storyteller who specialises in the history and philosophy of science, particularly scientific racism and eugenics
• Amali Lokugamage, honorary associate professor, Institute of Women's Health, University College London, and consultant obstetrician and gynaecologist, Whittington Hospital, London, UK
• Host - Richard Hurley, collections editor at The BMJ

In this last podcast of the series, we’re delving into that - how to talk to colleagues and patients, in ways which connect with their own needs and preferences.

To help with that, we’re joined by David Pencheon, director of the Sustainable Development Unit for NHS England, who’s been successfully talking about these issues for years, and Kate Wylie, executive director of Doctors for the Environment Australia.

To help us with this we’ll be joined by Prof Ben Newell (cognitive psychologist from University of New South Wales, whose research interest includes judgement and decision making). and Dr Lucas Chartier,  emergency medicine physician at the University Health Network in Toronto.

Ben Newell also has also recently released a book, Open Minded, co-authored with David Shanks on the role of the unconscious mind in our decisions making 

Singing for breathing is a type of social prescribing to help people with chronic lung disease manage their breathlessness, reducing their need to be reliant on healthcare to do this, while also finding joy and a sense of community. Stephen is one patient who has benefited from this service, and will tell us more about the impact it had on his life.

In another example, Lynn Riddell, an HIV consultant will tell us how a change in their clinical pathway helped a cohort of patients reduce the amount of travelling to and from the clinic, still manage their condition safely and give them back precious time and control. 

https://www.bartscharity.org.uk/our-news/singing-sessions-to-improve-patients-lung-health/

In a system where healthcare workers are continually described as overworked and burnt out, how can we expect them to find the time to act on the climate? In this episode we turn that assumption on its head, and, in fact, show how acting to reduce the environmental impact of healthcare can help staff find joy in their work again. Our two guests today are Tracy Lyons, founder of Pharmacy Declares and medicines optimisation pharmacist in Dorset, UK, and David Smith, general surgeon at North York General Hospital in Toronto, Canada.

The very worst thing is sometimes to have a problem you feel you can’t solve, and action mitigates anxiety: these are two of the many lessons that came out of today’s episode. We also touch on the different levels that you can start to take action at: from the small and tangible to influencing change at a system level. 

Related links:

https://cascadescanada.ca/ 

https://www.pharmacydeclares.co.uk/ 

https://twitter.com/TLyons00  

In this episode, they talk about home testing, sustainability and screening. They're also joined by two guests to talk about the overdiagnosis of obesity - when that label is stigmatising and there seem to be few successful treatments that medicine can offer, and the need to educate students in the concepts of overdiagnosis and too much medicine, to create a culture change in medicine.

Links;

The Preventing Overdiagnosis conference

The BMJ EBM papers on choosing wisely.

Guests for this episode:

Nicola Wilson, lead clinical educator, Great Ormond Street Children’s hospital, and Maria Koijck, artist and former patient. You can read more about the Gloves are Off project here https://www.gosh.nhs.uk/news/gloves-are-off/  

You can see Maria’s film here: https://www.mariakoijck.com/

In this episode we’ll discuss that first radicalising moment. That moment where you start to see all the things you can do to make healthcare more sustainable and how it is hard to un-see that. For everyone, that moment may come from a different place, or different perspective.

Our guests for this episode:

Gareth Murcutt who was at first reluctant until he saw the size of the impact he could make; Gwen Sims whose eyes were opened by moving health systems (and continents) and Alifia Chakera who didn’t expect to find a huge sustainability saving so close to home when she took up a new clinical role before the pandemic. 

Hosts:

Loren De Freitas and Florence Wedmore, the BMJ

Each year the UK's General Medical Council, the doctor's regulator, surveys trainees in the NHS to ask them questions about stress and burnout, harassment and discrimination, and how well supported they feel in their training. They also ask trainers about the same things.

Unsurprisingly, the year the results look bad - with increasing levels of burnout across the board, but particularly in new trainees. At the same time trainers are feeling unable to use their time supporting learning, and instead are propping up the system.

To discuss this, Clara Munro and Ayisha Ashmore are joined by Colin Melville, medical director, and director of education and standards, at the GMC. 

All the data discussed, and the interactive tool that Colin mentions, are available on the GMC's National training survey 2023 results page.

Ensuring the integrity of research could be made both easier, and harder, by the ascendance of large language models, Ian Mulvany, BMJ's chief technology officer joins us to talk about how we can harness the power of this new technology.

To talk about conflicts of interest in media doctors, we’re joined by two of the most recognisable medics on our screens - Chris and Xand van Tulleken, and the GP who persuaded them to think about what they receive cash for, Margaret McCartney.

Read our investigation into how the UK's medical royal colleges receive millions from drug and medical devices companies and Margaret McCartney's plea that “You have to be above reproach”: why doctors need to get better at managing their conflicts of interest

Firstly, the news about the end of the covid-19 pandemic was trumpeted, but the changes to research funding have been more quite - and the team discuss what this means for ongoing work to understand the effects of covid, but also in terms of preparedness for the next pandemic.

Next, breast cancer screening recommendations, in the USA, have been reduced from women over the age of 50, to those over the age of 40. We discuss the modelling study which lead to that recommendation change, and what the consequence may be in terms of overdiagnosis.

Finally, 40 years ago, the U.S. Orphan Drug act was passed to encourage the development of treatments for rare conditions - but new research looks at how many clinically useful drugs have come onto market, and an analysis examines the way in which the system could be gamed by narrowing disease definitions to create small populations of patients.

Reading list

Is the UK losing its world leading covid surveillance network just when it needs it most?

Breast cancer: US recommends women start screening at 40

FDA approval, clinical trial evidence, efficacy, epidemiology, and price for non-orphan and ultra-rare, rare, and common orphan cancer drug indications

In this episode of Doctor Informed, we're hearing from two doctors who are out and proud at work, about what  it's been like to be queer in medicine, and what good allyship looks like.

Our Guests

Michael Farqhuar is consultant in sleep medicine at the Evelina London Children's Hospital, he also helped set up the NHS Rainbow badge scheme.

Greta McLachlan is a general surgical trainee, and member of the Royal College of Surgeon's Pride in Surgery Forum

However, The BMJ are not the first organisation to highlight the problems - Surviving in Scrubs  have been collating stories of sexism in healthcare, and making waves about the issues for a while.

In this episode of Doctor Informed, Clara Munro is joined by the founders of Surviving in Scrubs, to discuss their campaign, how to create a culture of zero tolerance for sexism at the ward level, and why they think sexism should be a professional issue.

Our guests;

Becky Cox is an academic GP researching domestic abuse and GP specialist in gynaecology in Oxford.

Chelcie Jewitt is an emergency medicine trainee in Liverpool.

Bron Biddle, founder of Ambulance Voices, and an employee in the ambulance service.

Links;

https://www.bmj.com/me-too-investigation

Previous Doctor Informed interview with Baroness Helena Kennedy