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International Primary Care Association
 
 
 

Clinical Focus Volume 8 N1

Volume 8 Issue 1 - 2014

The winter rains, hurricanes and floods will hopefully have subsided by the time this issue reaches you. Spring was edging out the winter blues as I write this editorial. This will be an exciting year as it is the lead up to the general election and no doubt the politicians will pick up the NHS football to garner votes.

 

The Health and Social Care legislation has slowly become embedded, warts and all. Many CCGs have started some semblance of commissioning, the main focus of the restructuring, but are hampered by a very wieldy and bureaucratic tendering system. It is difficult to understand the need for such a process for services that have no more than one supplier or are innovations, which means divulging intellectual property to third parties. Furthermore, the bigger private sector organisations have an army of “Tendering Experts”, whose sole tasks are to get through the bidding process, which they do very successfully. Little surprise then that the assurances given to the SMEs, including CIC and Social Enterprises that this would be a level playing field ring a resounding hollow. They just do not have the resources of the larger companies. Whatever the hue of the next government the tendering process needs to be overhauled.

 

With obesity levels, in adults and children, rising and rising (we are following the USA trend of course), the awareness of the role of nutrition to our health is vital. Katey Halliday busts some of the myths (p.30). UK has one of the highest incidence of unwanted pregnancies in Europe. I find this hard to square given the myriad of methods of contraception available as neatly detailed by Anusha Dias (p.8).

 

Mackenzie brings us right up to date by addressing problems such as fractures, adrenal suppression, hyperglycaemia……. (p.19).

 

Enjoy this issue. Please let me have your suggestions and comments. By the time of the next issue the Football World Cup tournament will have concluded. As a football fan I shall be rooting for England, in the hope rather than the expectation that my gut feeling of their level of performance is wrong.

 

Professor Ram Dhillon

Editor

Abstract

Although we still do not have a ‘perfect contraceptive’, one which is safe, effective, and free from any side effects; a great deal has changed since Casonova first advised using half a lemon with the juice removed as a cervical cap in the 18th century. The launch of new contraceptives has increased choice and new, simplified recommendations on their use have increased the acceptability of all methods.

Abstract

At any time, 1% of the UK population is receiving oral glucocorticoids, and their use is increasing. Toxicity related to glucocorticoids is potentially fatal, and often missed during a clinically latent phase, during which a number of steps can be taken to minimise their risks.

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