I did a literature review on the use of "verruca socks" a few years ago.
The studies on which their recommendations were based generally found that it was likely that HPV infections causing verrucae could be acquired from changing/locker rooms; however the ones that had actually considered users of locker rooms found that a very high proportion of people with a verruca did not know they had it. Given that most sources of infection were not identified, it seemed more appropriate to advise that people with immune suppressive conditions that would make them unusually susceptible to warts should consider the risks, and consider wearing verruca socks; but that stigmatising those people who are aware they have a verruca (and who are honest enough to admit it) by requiring them to wear a sock - when most of the infectious load would come from others - seemed pointless.
When evaluating the value of a planned scheme such as NHS Health Checks we need to consider both the potential value - if, for example, all the people likely to benefit attend for screening - and also the likelihood of this happening.
With NHS Health Checks there's a big concern that - even if the potential benefits stack up - the people who most need them are likely to be those least likely to take them up.
Sadly, NHS Health Checks were introduced by a prime minister (Brown), before an election, in a vain attempt to improve his prospects, and in the knowledge that - whatever their actual value - there is a signficant chunk of the voting public who like the idea of an entitlement to regular health checks. As they say, it's hard to reason yourself out of a position that you didn't get into as a result of good reasoning; and similarly, it's hard to find sufficient evidence to stop doing something which you started doing for political reasons, rather than because the evidence supported it. (NHS Health Checks is one example; many others exist, including port screening for Ebola.)
An EHIC [card] permits a citizen of one EEA country to obtain immediately necessary treatment in another, on the same terms as a resident of that country. It seems extremely unlikely that a resident of Hungary would be able to charge the UK for treatment in Hungary, just by obtaining a UK EHIC. I don't find this story plausible. See more on the EHIC at http://www.ganfyd.org/index.php?title=Travel_health#European_Health_Insurance_Card_.28EHIC.29
This is an idea that has been around (closely related to the "make the easy choices the healthy choices" idea) for a very long time; and its implementation is long overdue. Thank you, Kailash, for raising it like this.
(We must be a little careful with comparisons with smoking. I think we would encourage everybody to give up smoking completely; but sugars and refined carbohydrates are unavoidable: it's unnecessary and unrealistic to expect anybody to eliminate them from their diet. But the need for legislation is just as great as it was for smoking.)
One of the problems, it seems to me, is that with all of these issues there's a risk - particularly if something bad happens (no matter how unpredictable) - the GP who [did not] act will be blamed; and that they will be investigated, hauled over the coals, NCAS and the GMC will do a fishing expedition to try to find something to blame them for, and they'll be lucky to escape with their life and sanity, let alone their career. Regardless of how carefully they thing about what they might do.
(See e.g.  below.)
1. Dyer C. GP should have seen child who was being starved within 48 hours of contact, says tribunal, 2015 (http://www.bmj.com/content/350/bmj.h3255).
Hunt says NHS has enough cash, boy taken from smoking parents and claims around HPV jab side effects
I believe the smoking was probably the least of the reasons why the child was removed from the home.
And wrt the DM report on HPV vaccine - there's an excellent critique of a similar article in the Independent at https://drjengunter.wordpress.com/2015/06/01/the-independent-claims-hpv-vaccine-unsafe-science-says-the-independent-is-wrong/
No doubt the admindroids at DH will right now be scrabbling to find some way of interpreting this as improper, unprofessional, and grounds for referring the doctors and nurses in the practice to the GMC and NMC...
If you're interested in this, you might want to read (and follow) this blog:
The screening test has poor sensivity and sensitivity.
There's no agreed and acceptable treatment to offer.
There's no time or resource to do this.
The patients you're worried about are NOT, in any case, the ones in residential homes - they're the vulnerable patients living at home uncared for.
(Reminiscent in a way of Samuel Shem's "House of God" - one of the books that helped me get through.)
This document goes some way to explaining the PHE position.
1. Public Health England. The use of antivirals for the treatment and prophylaxis of influenza: PHE summary of current guidance for healthcare professionals. London: Public Health England, 2014 (November); (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/370673/AV_full_guidance.pdf).
The new antibiotic 'super-drug' and the Prime Minister put on spot for claiming A&E is performing better than ever
A comment by an anonymous commentator suggesting that the crisis in the NHS is an invention designed purely to discredit the government, and with no basis in reality, should be ignored as trolling, possibly posted by a tory plant.
See http://www.ganfyd.org/index.php?title=Get_a_note_from_your_doctor for sample ganfyd deflectors.
A Spartacus moment...
Yes, JM-T is a surgeon at the Royal Marsden Hospital.
He previously had things to say about "Why having so many women doctors is hurting the NHS" - see http://www.donotlink.com/cH6 .
Yes, JM-T is a surgeon at the Royal Marsden Hospital.
He previously wrote "Why having so many women doctors is hurting the NHS" - see http://www.donotlink.com/cH6 .
I'm with Sara on this.
Targets will lead to micromanagement.
The issue of antibiotic prescribing is too complicated and nuanced for crude targets to be effective.
Either you'll be scapegoated by your employer as a whistleblower for raising genuine concerns or sanctioned by the GMC.
Look how WBs are routinely treated - standard response if for management to look at every aspect of their practice, hold it up to an ivory tower standard, check every expense claim, and institute investigations which are fishing expeditions to try to find something to accuse them of, then spend several years forcing them to work under supervision, undergo humiliating investigations, admit they're bad doctos on pain of referral to GMC for "lack of insight"...
If GMC were to discipline any medical director, NCAS assessor, or medical investigator who colludes in these processes then that might start to make a difference. But unless they do that to a few people before they ever start in on the doctors who raise concerns, this will be pie in the sky. People will, rightly, see that they're better off keeping schtum.
That guidance is likely to be updated - possibly quite frequently. It might be better to use https://www.gov.uk/government/collections/ebola-virus-disease-clinical-management-and-guidance as the link to save - this is where revised/updated guidance will be posted.
It's one of those areas where heavy-handed approach can't work. Antimicrobial resistance is a huge and very serious problem. But if you don't give antibiotics when they are needed, patients will die. The right balance must be struck.