scholarly journals Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland’s PrEP Journey

Author(s):  
Ingrid Young

AbstractPrEP in Scotland came with great expectation and celebration. As the first country in the UK to offer PrEP through the National Health Service (NHS), Scotland was heralded as a leader in HIV prevention. This chapter asks: how has the anticipation of PrEP shaped provision and use within the health system; how does the emergent and ongoing orientation of PrEP towards specific risk practices affect awareness, access and use, but also wider narratives of prevention, inequalities and ‘progress’; and, what kinds of biosexual citizens does it demand and produce? The chapter explores how the implementation of PrEP and the specific nature of its roll-out contribute to an orientation towards certain (gendered) PrEP users and PrEP use. It considers how the anticipation of PrEP as a biotechnology for particular risk practices, bodies and communities shapes promissory HIV prevention futures and determines what success and ‘celebration’ could be.

2020 ◽  
Vol 237 (12) ◽  
pp. 1400-1408
Author(s):  
Heinrich Heimann ◽  
Deborah Broadbent ◽  
Robert Cheeseman

AbstractThe customary doctor and patient interactions are currently undergoing significant changes through technological advances in imaging and data processing and the need for reducing person-to person contacts during the COVID-19 crisis. There is a trend away from face-to-face examinations to virtual assessments and decision making. Ophthalmology is particularly amenable to such changes, as a high proportion of clinical decisions are based on routine tests and imaging results, which can be assessed remotely. The uptake of digital ophthalmology varies significantly between countries. Due to financial constraints within the National Health Service, specialized ophthalmology units in the UK have been early adopters of digital technology. For more than a decade, patients have been managed remotely in the diabetic retinopathy screening service and virtual glaucoma clinics. We describe the day-to-day running of such services and the doctor and patient experiences with digital ophthalmology in daily practice.


The Lancet ◽  
2005 ◽  
Vol 366 (9487) ◽  
pp. 694-695 ◽  
Author(s):  
William Jeffcoate

2021 ◽  
Vol 66 (4) ◽  
pp. 168-174
Author(s):  
Jenni Lane ◽  
Rahul Bhome ◽  
Bhaskar Somani

Background and aims Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19. Methods Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009–2019 (2009/2010 to 2018/2019 financial years). Results The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010. Conclusions Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.


2020 ◽  
Vol 21 (17) ◽  
pp. 1237-1246
Author(s):  
Richard M Turner ◽  
William G Newman ◽  
Elvira Bramon ◽  
Christine J McNamee ◽  
Wai Lup Wong ◽  
...  

Despite increasing interest in pharmacogenomics, and the potential benefits to improve patient care, implementation into clinical practice has not been widespread. Recently, there has been a drive to implement genomic medicine into the UK National Health Service (NHS), largely spurred on by the success of the 100,000 Genomes Project. The UK Pharmacogenetics and Stratified Medicine Network, NHS England and Genomics England invited experts from academia, the healthcare sector, industry and patient representatives to come together to discuss the opportunities and challenges of implementing pharmacogenomics into the NHS. This report highlights the discussions of the workshop to provide an overview of the issues that need to be considered to enable pharmacogenomic medicine to become mainstream within the NHS.


2018 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
David J. Hunter

AbstractAmidst the NHS’s (National Health Service) success lies its major weakness, although one that Klein overlooks in his reflections on the NHS as it approaches 70. The focus on, and investment in, curing ill-health has been at the expense of attending to the public’s overall health and well-being. This preoccupation poses a greater threat to the NHS’s future than privatisation. Despite the weakness having been diagnosed decades ago, redressing the imbalance has proved stubbornly hard to achieve. Rhetoric has not been translated into reality. Yet, we may be on the cusp of a tipping point where in order to ensure a sustainable NHS, and one that is capable of meeting the 21st century challenges facing it, there is a renewed and overdue interest in promoting health and well-being in communities. But for this to succeed, the NHS will need to embrace its bete noire, local government.


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