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Margaret Chirgwin

  • Virgin Care beats GP federation to £176m adult health services contract

    Margaret Chirgwin's comment 30 Aug 2016 1:11pm

    Robert Koefman - just wanted to say that unfortunately Brexit has very little to do with how procurement is being done - there is a fair amount of flexibility in the "Light Touch Regime" that now applies to health services - it is the government who chooses to use it to penetrate the whole of the NHS with competition because they believe this will improve the services (haha). The procurement system could be set up to support NHS providers/GP providers to be the provider of choice and avoid the huge costs of a full procurement and as noted above the crazy processes that means the best written proposal wins rather than the best provider. This is about UK politics - the Conservatives believe that market will do something good despite the evidence to the contrary and therefore the system that has been developed requires commissioners to make the case for not using a competitive procurement process and we are discouraged from doing so with the threat that we might get challenged by a provider such as Virgin if we opt for a non-competitive process. Far better that we should have to make the case for why we want to use a competitive process and the default being working with the local providers to develop and transform services. In non-competitive procurement we simply have to ensure the prices is right/value for money is achieved. We do not have to procure as we do because of the EU - there is lots of flexibility to the LTR which we do not use. So Brexit will not help - sadly!

  • Government experts want everyone to take vitamin D supplements

    Margaret Chirgwin's comment 04 Aug 2015 12:28pm

    Oh but you are - there is good evidence for its role in the immune system. Canada has already decided to do this and supplements food etc. Would very likely reduce A&E activity and your work for those with self limiting infections and probably reduce days off work for these infections.

    There are lots of articles - quick google to find one:

    J Investig Med. Author manuscript; available in PMC 2012 Aug 1.

    Published in final edited form as:
    J Investig Med. 2011 Aug; 59(6): 881–886.
    doi: 10.231/JIM.0b013e31821b8755

    PMCID: PMC3166406
    NIHMSID: NIHMS291217

    Vitamin D and the Immune System
    Cynthia Aranow, MD, Investigator
    Abstract

    It is now clear that vitamin D has important roles in addition to its classic effects on calcium and bone homeostasis. As the vitamin D receptor is expressed on immune cells (B cells, T cells and antigen presenting cells) and these immunologic cells are all are capable of synthesizing the active vitamin D metabolite, vitamin D has the capability of acting in an autocrine manner in a local immunologic milieu. Vitamin D can modulate the innate and adaptive immune responses. Deficiency in vitamin D is associated with increased autoimmunity as well as an increased susceptibility to infection. As immune cells in autoimmune diseases are responsive to the ameliorative effects of vitamin D, the beneficial effects of supplementing vitamin D deficient individuals with autoimmune disease may extend beyond the effects on bone and calcium homeostasis.

    This will identify me are NHS Manager but I am a medical doctor with a lot of public health experience. We cannot predict the full impact of this kind of population intervention but no significant downside and probably big upside. I am glad to see us finally taking this step.