A newly published Cochrane systematic review by Nik Tuah and Colleagues reported that there is currently limited evidence that the transtheoretical model stages of change (TTM SOC) method is effective in producing weight loss. The transtheoretical model describes a step-by-step way in which people move from unhealthy behaviours to healthy ones. The five stages of change that the model anticipates are pre-contemplation, contemplation, preparation, action and maintenance. The BBC reported on the study and noted that behavioural change to promote weight loss was very difficult to achieve.
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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