A study from Imperial College, LSHTM and the University of Leicester published online in the BMJ this week compared the safety of drugs used for the treatment of type 2 diabetes. The findings of the study confirm that Metformin remains the first choice drug for the treatment of type 2 diabetes. Patients taking sulphonylureas were more likely to suffer from heart attacks and heart failure or to die, compared to people taking Metformin. Doctors should therefore consider Metformin as their first choice when treating people with type 2 diabetes, as recommended by national guidelines from NICE. The study was reported by a number of media outlets, including the Guardian, Telegraph and NHS Choices.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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