In an article published in the BMJ, Dr Adrian Raby - a Senior Teaching Fellow in the Department of Primary Care & Public Health at Imperial College London - and one of his patients discuss how they dealt with his patient's alcoholism. Health problems caused by excessive alcohol intake are increasing in society. The article highlights the importance of clinicians in all fields of medicine being able to detect problem levels of drinking in their patient and wither intervening to aim to limit the harms associated with excessive alcohol intake or referring patients to specialist services or to voluntary groups such as Alcoholics Anonymous. One of the respondents to the article also highlighted the need for doctors to act as good role models for their patients.
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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