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Inadequate neurology services undermine patient care in the UK

“Neurology for the masses” announced The BMJ’s then editor, Richard Smith, in 1999.1 Old stereotypes may associate neurology with rare syndromes and a fondness for diagnosis not treatment, he went on, but it is also a specialty of common illnesses such as epilepsy and Parkinson’s disease. He might also have mentioned that neurological symptoms include some of the commonest complaints such as headache and fatigue. Sixteen years on and despite a doubling of consultants, a damning parliamentary report,2 thrombolysis for stroke, and an awareness of increasing neurodegenerative disease only people living in select areas, or able to travel, will encounter a neurologist. The Neurological Alliance, a patients’ organisation in England, reports that 31% of patients had to see their primary care doctor five or more times, and 40% waited more than 12 months with symptoms before seeing one.3 The UK is the only developed nation with this problem. We have one neurologist per 90 000 people4; the European average is one per 15 000,5 and in the United States concern has been expressed that one per 19 000 isn’t enough.6  
feeds.bmj.com
over 6 years ago
Static.www.bmj
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New consultant contract will exclude “opt-out” for weekend working, says government

The BMA has set itself up for a six week battle with the government over reforms to consultants’ contracts, after the health secretary said that a new contract would be imposed on the profession if negotiations over seven day working with the union were not fruitful.  
feeds.bmj.com
over 6 years ago
Www.bmj
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12

How might 3D printing affect clinical practice?

If a picture is worth a thousand words, the value of a three-dimensional printout could be considerable. 3D printing is starting to disrupt the manufacturing industry, from jewellery to firearms, rapid prototyping to motor racing components. Inevitably, it has now reached healthcare.1 Last year Craig Gerrand, consultant orthopaedic surgeon at Newcastle upon Tyne Hospitals NHS Trust, used computed tomography guided 3D printing to develop a titanium pelvis for a patient with chondrosarcoma.2 And doctors at University of Michigan’s Mott Children’s Hospital have implanted 3D printed plastic splints into the trachea of neonates to rectify tracheobronchomalacia.3  
feeds.bmj.com
over 6 years ago
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An introduction to pain pathways and mechanisms [Feb 2012]

Dr Danielle Reddi is a Pain Research Fellow and Speciality Registrar in Anaesthesia at University College London Hospital, London, NW1 2BU, Dr Natasha Curran is Consultant in Pain and Anaesthesia, UCLH and Dr Robert Stephens is Consultant in Anaesthesia, UCLH.  
ucl.ac.uk
over 6 years ago