Category Archives: Rheumatoid Arthritis

Digital autopsies should be standard for probable natural deaths, says study

Digital autopsies should be the first-line approach in postmortem investigations of probable natural death, and should be offered free of charge to families, researchers have said.

About 90,000 autopsies requested by coroners are carried out in England and Wales every year, with the majority of deaths found to be a result of natural causes.

A switch to body-scanning techniques could prove valuable, say researchers, since a traditional autopsy can be upsetting for the bereaved and a number of religions, including Islam and Judaism, teach that a body should be buried quickly and not violated after death.

“The main benefit is about avoiding the autopsy,” said Bruno Morgan, co-author of the research from the University of Leicester. “The autopsy is not just a simple operation, it is opening [the body] up fully, taking all the organs out and slicing them all into pieces.”

CT scans have long been used to aid postmortem investigations, while more recently studies have explored targeted coronary angiography – another CT scanner-based technique that involves inserting a catheter into an artery and is used to reveal whether blockages are present in the coronary arteries, and to investigate the heart itself.

The latter is a major step forward, since one limitation of digital autopsies has been the difficulty of standard CT scans in establishing causes of death such as coronary heart disease.

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The latest study offers a large-scale comparison of the accuracy of the combined CT techniques to traditional autopsy.

“This paper is the first one that has come out and says this is as accurate as autopsy is in this setting. It works and therefore it is a valid alternative,” said Morgan.

Writing in the Lancet, researchers led by a team at the University of Leicester describe how they studied 241 cases of adults who had died suddenly and unexpectedly of natural causes or had died a non-suspicious unnatural death.

Each was assessed by a postmortem CT scan, with targeted coronary angiography successfully carried out in 85% of the cases. Standard autopsies were then carried out for each case, with the pathologists not told about the findings from the body scans.

After excluding 31 cases, including 24 cases for which the cause of death was clearly traumatic, such as a gunshot wound, the team found that the body-scan approach gave a cause of death, based on “the balance of probabilities”, in 92% of cases.

In 11% of this group, results from either the scans or the autopsy were at odds with findings from a combination of the two. Further analysis revealed that these discrepancies were evenly split between errors in the body-scan approach and errors in the traditional autopsy.

The team say the gold standard for postmortem is the use of both traditional autopsy and body scans, but say the findings support a move to using digital autopsy as the first-line technique in cases of probable natural death. Should more evidence be required, they add, a traditional autopsy can subsequently be carried out.

The public are already allowed to request – usually at a cost of about £500, typically paid by the family – that digital autopsies are used for postmortem investigations where appropriate.

But Morgan says that option should be made available free of charge – a service currently only offered by a small number of councils.

“If you don’t want an invasive autopsy on yourself or on your family, you should be raising the debate and saying why can’t the council pay for this?” he said. “It strikes me that it is wrong that we should make people pay for something that is a statutory obligation,” he added.

Dr Mike Osborn, a fellow of the Royal College of Pathologists, said that postmortem investigations are vital in understanding why people die, as well as improving understanding of disease. But he acknowledged that autopsies can be distressing and clash with religious beliefs.

The development of digital autopsies, including those based on CT scans, he added, was exciting and important. While Osborn noted that some conditions still require a diagnosis from a traditional autopsy, he welcomed further research in the field to reduce the number of traditional autopsies required. “The accuracy of cross-sectional imaging postmortem has improved over the last 20 years and is likely to continue to do so,” he said. “The College fully supports further research in this area while reinforcing the need for thorough and robust governance in this emerging field.”

The great London property squeeze

The first time I met Ian Dick, the head of private housing at Newham council in east London, he took me on a walk to look for “beds in sheds”. It was 2011, and alongside criminal levels of overcrowding in private rental properties, there was a growing problem of people living in illegal structures in back gardens. It was not uncommon to find 10 or 20 people living in a room above a fried chicken shop, in a basement, or in ramshackle outbuildings. When we met again, five years later, he was happy to talk to me, not because these problems had disappeared, but because he was proud of the council’s private rented sector licensing regime. Introduced in 2013, it was the first such scheme in the country and had led to 800 prosecutions and 28 landlords being banned from renting property to tenants.

This time we met in Forest Gate, traditionally one of the most deprived parts of Newham. “This is an area undergoing the most dramatic change – the council doesn’t use the term ‘gentrification’, they use the term ‘regeneration’,” he said as we strolled down a pleasant high street in the sunshine, looking up at Victorian facades renovated by the council. Along the road, hipster cafes and pubs were interspersed with clothing retailers, halal butchers and phone shops. To show me the reality in some of the flats above, he took me around the back, where an entire street was accessed by a badly maintained private alleyway, with a huge pile of mattresses dumped at one end.

The mattresses were outside a property where, until the previous week, 20 people had been living in a makeshift structure in the yard outside. “The landlord is under caution, he’s not arrested, he’s been housing people desperate for accommodation – people were paying £400 a month to stay in this,” Dick said. Further down the back alley, the entrances to a large number of flats were up dangerous-looking fire escape stairs, particularly hazardous for small children. In one of the properties a scooter stood at the foot of a rickety open stairway.

At the back of a large Victorian house, we were met with a smell of leaking sewage, and the once-white walls were now filthy and soot-stained. “This must be illegal. That’s the thing about English housing – there’s little that’s illegal but there’ll be breaches here,” Dick explained, telling me that English property law does not target property standards, but that interventions can be made around public health. In this case, the breaches would be drainage and conditions detrimental to health.


We paused to look at the ‘to let’ signs in the newsagents. One offered a room share for four people for £160 a month

“This is the sort of private rented sector that still exists in 2016, even after all we’ve done,” he said, noting details down in his notebook so that his officers could visit. The interior of one of the flats was visible through a grim-looking security gate at the back door. Through the bars I could see a toddler and his mother. This was no place for a child – or anyone – to live, but it was also obvious that once they were evicted, their fortunes would not necessarily improve. There would be nowhere to go, and even if they qualified for social housing, they would most likely enter the world of substandard temporary accommodation.

Walking back down the high street we paused to look at some of the “to let” signs in the newsagents’ windows. One in particular stood out, offering a room share for four people for £160 a month per person: effectively a bed space in what may or may not be legal accommodation. Renting bed spaces, I had already heard from a number of sources, is becoming more common, with bunk beds visible in the front rooms of nearby terraces. While we sat having a coffee, Dick explained this was partly down to the increasingly common – and highly profitable – practice of what is known as “rent to rent”.

“An estate agent will rent a house to an individual who will then let it out to others, who might also sublet. There’s a whole submarket in rent to rent. It’s all done with no documentation, they don’t ask for references, and when we go round we might find 15 people there. “There’s different levels of this going on – everybody has to share because nobody can afford to rent,” he said, adding that sometimes criminal gangs might rent 20 properties, then re-rent them at a 20% higher price. The council had prosecuted 25 agents, he said, and pointed to how to find them through ads in the local papers: “Where you see agents offer ‘guaranteed rent’, there are no controls on lettings agents.”


Adverts on hoardings all over London show a city populated by smart-looking people in luxury balcony apartments. The city is the destination of choice for foreign investors and the oligarchs, billionaires and super-rich who make up the so-called “alpha elites”, all of whom are attracted by the UK’s favourable tax environment. Entire neighbourhoods – St John’s Wood, Highgate, Hampstead, Notting Hill Gate, Kensington – have changed out of all recognition in the past decade. Estate agents refer to these centrally located, “super prime” areas as “golden postcodes”. They have long been wealthy places, but in the past, like most of London, they were also mixed. Now ultra-high-net-worth individuals have displaced even the wealthy from Kensington; they in turn displace others to suburban areas, creating a domino effect that ripples out through the city, with the consequence that average-income earners and the poor move to the periphery or out of the capital altogether, which places pressure on housing and pushes up prices around the country.

London’s skyline is being transformed by one of the greatest waves of new construction seen in the city, with plans for no fewer than 300 luxury residential towers. From Nine Elms up to Vauxhall and along to Southwark and Blackfriars bridges, mile upon mile of apartments in gated complexes have already been built. At Elephant and Castle the Australian property developer Lendlease is working with Southwark council to render the area unrecognisable, replacing the affordable housing that once characterised it with a forest of gleaming towers. Outside some of these buildings, metal spikes prevent homeless people from sitting or sleeping on the pavement.

There is a direct link between the wealth of those at the top and the capital’s housing crisis – which affects not just those at the bottom but the majority of Londoners who struggle to buy properties, or pay extortionate rents. The 2008 financial crash created a new politics of space, in which people on low incomes are forced out of their homes by rising rent and the wealthy are encouraged to use property for profit. These trends are not limited to London. The same currents of global capital are also transforming San Francisco, New York and Vancouver, European cities from Berlin to Barcelona and towns and cities in the UK from Bristol and Manchester to Margate and Hastings. This isn’t gentrification, it’s another phenomenon entirely. Global capital is being allowed to reconfigure the country.

Public housing accounted for a huge proportion of British accommodation throughout the 20th century. Since the 1980s, public housing stocks have been steadily eroded, through the combination of right to buy, which saw the sell-off of 2m council homes, and buy to let, which has resulted in 40% of those former council homes now being owned by private landlords, who rent them out for three and four times the amount that council tenants pay for the remaining local-authority-owned properties.

During the 1980s a decision was taken to cease building housing for those on lower incomes and to create instead a system whereby housing benefit would “take the strain”, rising to cover increases in rents. At the time it was predicted that the change in policy might lead to higher rents but nobody believed they would rise to the level they are today. The combination of right to buy and the decision to stop building council housing shifted social tenants into private rented housing. Research from the National Housing Federation shows that the amount of housing benefit paid to private landlords doubled from £4.6bn in 2006 to £9.3bn in 2016.

The shortage of affordable housing has given rise to a range of problems in private rented accommodation, from slum landlords and “beds in sheds” to middle-class Londoners under the age of 45 who can no longer afford to live in the city. A generation is being affected and our essential services, such as hospitals and schools, and the majority of our small and medium-sized businesses, are being undermined.


“We think broadly a third of landlords are well-meaning and do a good job,” said Southwark councillor Mark Williams, “a third are well-meaning and do a bad job, and a third are rogue landlords. At the fringes of that, you have slum landlords and criminal human trafficking.” Southwark, in south-east London, despite increasing areas of high-cost development, still includes large pockets of poverty. Williams told me that the council found a two-bedroom flat on the Aylesbury estate with 20 occupants, who were being bussed down to Bromley, 40 minutes away, every day to work in a sweatshop.

Overcrowded rented housing in Newham, east London


Overcrowded rented housing in Newham, east London. Photograph: Newham council

Since Newham introduced its licensing scheme, the council has put a maximum limit on the number of people allowed to share one room and has stipulated that agents must display what that limit is, although some don’t. “Lots of them were non-compliant at the beginning but when we looked at them they started to comply, and then we relaxed and they went back to what they were doing before,” Dick said. It doesn’t surprise him. “Why wouldn’t they? The housing market is broken and the conditions are ripe for exploitation. We’ve got the worst of both worlds – a market which is controlled but not regulated. Most people we’ve prosecuted through the licensing scheme are criminal landlords, although the government prefer the term ‘rogue’.”

Although it is notoriously difficult to get accurate figures, a 2013 report by the Migrants’ Rights Network concluded that Ealing may have as many as 60,000 occupants in illegal structures, and Slough borough council, which deployed planes equipped with thermal imaging equipment in an effort to spot them, may have as many as 6,000 beds in sheds. In 2013 a BBC investigation found estate agents renting out beds in sheds in Willesden Green and Harrow.

Newham’s licensing scheme has been widely praised, and many councils have expressed wishes to emulate it. But in 2015, to the delight of landlords, the government made it clear it did not want to extend the scheme’s use, with then housing minister Brandon Lewis describing licensing as a “tenants’ tax”.

Even though the Department for Communities and Local Government had given Newham £1m to support the licensing scheme, little-known changes to the law have seen some forms of licensing extended, but also made it much harder for councils to introduce licensing in the first place. The new law ensures that councils must now seek permission from the secretary of state for any licensing scheme that would cover more than 20% of their geographical area, or affect more than 20% of privately rented homes.

In Redbridge, north-east London, the council’s application for borough-wide licensing was refused by the secretary of state. As a result, council leader Jas Athwal said it would be “impossible for us to … deal proactively with poor standards of rented accommodation”. It is clear, then, that an effective means of clamping down on rogue landlords has been found – the government just refuses to support it.


Extreme overcrowding is illegal, but poor conditions are also common in the “mainstream” private rented sector. Jan is a university graduate with a good job, who lives in what she describes as “middle-class poverty” despite earning close to £40,000 a year. She and her husband don’t have enough money to make ends meet, even though they both work full time.

The family last moved three years ago after their landlord put their rent up by £450 a month. He wanted to sell to a developer who planned to turn the flats into one luxury home, and needed the tenants out. Conditions where they were living were far from ideal: the heating didn’t work properly and Jan and her partner slept in the front room so that their two children, a 10-year-old boy and seven-year-old girl, could have their own rooms. That isn’t possible in the tiny two-bedroom flat they are in now, so she is thinking of putting a mattress in the alcove in the hallway for her daughter. “I’m going to put a curtain up and have her in that, but when I think about that, it’s Dickensian,” she told me. Revealing how low her expectations have sunk, she added: “We’re in a flat which is substandard accommodation, but what we love about it is that the heating works.”

The other advantage is that the overcrowded, moth-infested flat is cheaper, but it is in the wrong catchment area for the secondary school her son has applied to, which is causing him great anxiety. An estate agent has found Jan’s family a larger flat in West Norwood, where they used to live, but that would, as before, eat up two-thirds of her salary. “We can stay here and clear our overdraft or go back to West Norwood, have a kitchen diner and live totally beyond our means. It’s these ridiculous choices,” she explained. The other option would be moving to Croydon or Mitcham, but prices aren’t much lower there. “We might be able to get a semi with a garden but the kids would not be in the catchment area for their schools, there’s a massive commute and you lose all your networks.”

Jan is paid far above the average salary and her partner works full time as a teaching assistant. But after deducting the cost of childcare, they have nothing left to spare – “it’s second-hand clothes and no holidays. They call it ‘the squeezed middle’ but it’s poverty. It impacts on a whole range of things you can’t begin to anticipate,” she said.

To cap it all, on the day we met she’d had a terrible journey into work with cancelled trains and her Oyster card had charged her an extra £20 by mistake. “I just stood on the platform crying. It’s beyond my capacity to cope with any of it,” she told me as we sat in her office.

For the past 30 years, Britain’s economy and culture have been built on the Conservative ideal of home ownership. But, despite all the rhetoric surrounding this issue, home ownership in Britain has not exceeded the European average of 70% since the early 2000s. In fact, it has fallen to 64% – the lowest level in 30 years. And in 2017 private renting overtook mortgaged home ownership in London.


There are more requirements to run a cattery than to rent out a home

Betsy Dillner, Generation Rent

“This is a middle-class issue now,” Betsy Dillner, director of Generation Rent, the campaign group for better private renting, told me. “People think we represent this middle-class professional group, but if you can find a way of making the private rented sector work for the most vulnerable people in society, then it will work for everyone.” Today, 11 million people in Britain rent privately in an overlapping series of sub-markets, ranging from slums to luxury housing.

As an organisation, Generation Rent would like to see rent controls, a national register of landlords and fully licensed lettings agents – all of which Dillner admits are highly unlikely in the current ideological climate. “There are more requirements to run a cattery than to rent out a home. There should, of course, be regulations to look after pets, but I’d like the same rights to be afforded to the place we call home,” she said.

Like 2.3 million other Londoners, the Green party London Assembly member Sian Berry is a private renter, and has shelled out more than half her pay in rent and lived in six different houses since she moved to London 20 years ago. In 2016, she published the Big Renters Survey of more than 1,000 renters. According to those surveyed, rising rents were the most common problem experienced, and seven in 10 renters suffered from repairs and maintenance not being done. Damp, mould, broken boilers and dangerous electrics feature prominently in the responses, with many reports of landlords who evict tenants rather than pay for repairs.

The type of accommodation known as ‘beds in sheds’, in Brent, north-west London.


The type of accommodation known as ‘beds in sheds’, in Brent, north-west London. Photograph: Brent council

One said: “After thousands of pounds’ worth of electrical items all broke down at once, an electrician assessed our flat. The wiring was the worst he’d ever seen and was, in his words a ‘death trap’. We were living there with a newborn baby. Our landlord chose to evict us, making us homeless, rather than carry out repairs.”

Another responder reported that they had to wear rubber gloves in the shower to avoid electric shocks and a third wrote: “Once a ceiling of an old house fell on me and all my stuff. I let my landlady send workers into the house to fix it for two months, during which time we still had to pay some rent. Immediately afterwards she put the rent up to a level we could not afford and we had to move out.”


Yet another factor placing great pressure on the private rental market is the growth of companies such as Airbnb. By allowing owners to rent properties on a night-by-night basis to affluent visitors, their business model removes accommodation from the longer-term rental market while keeping purchase prices high. As a result, Airbnb has become a focus for housing activists across Europe and in the US, particularly in cities that attract large numbers of tourists such as New York, Barcelona, Berlin – and London. In New York, Barcelona and Berlin, city governments have restricted owners’ ability to rent out whole properties through Airbnb. But while oversight is being introduced in some places, it is a notoriously hard business to regulate, particularly when there are significant profits to be made.

The bedroom tax, introduced in 2013 for occupants of housing association or council property, presents a mirror image of Airbnb. In a society where the idea of public housing has collapsed, a financial penalty is imposed on people in social housing with a spare room, while those who are lucky enough to own a house with extra space find themselves with an additional source of revenue.

Another feature of the new economy in private renting is property guardianship, where developers offer lower rents to people prepared to live in properties due to be redeveloped. Often these are in edgy locations, such as the Ernő Goldfinger-designed Balfron Tower in east London, where groups of artists move in on a temporary basis, taking advantage of the subsidised accommodation costs and bringing cachet to the area. In the past, artists squatted abandoned buildings in places such as Shoreditch in east London and Brixton in the south, creating communities that have long been credited with maintaining the city’s diversity while also setting in motion a more manageable process of gentrification. In 2013, however, legislation was passed that made squatting residential buildings illegal, with a maximum penalty of six months in jail and a fine of £5,000. Property guardianship can be seen as an attempt to co-opt the “desirable” elements of squatting by young, creative people in a blatant bid to accelerate gentrification. At the same time, it is a highly lucrative, unregulated business, and “guardians”, who have no property rights, often have to put up with poor conditions and can be evicted at short notice.

The major concern for the government and employers in London is that people who do not earn enough to meet extortionate rents will leave, hollowing out the city and threatening its labour market and culture. “We see this with employers saying they’re having a really hard time retaining professional level jobs, let alone cleaners. London is losing teachers – they’re commuting from Luton and they’re giving up – it’s having a massive knock-on effect,” Dilner said.

An outbuilding rented to multiple tenants.


An outbuilding in east London. Photograph: Barking and Dagenham council

The vacancy rate for nurses at London’s hospitals is 14-18%, according to a report from the King’s Fund thinktank, and the number of entrants to teacher training has fallen 16% since 2010, according to Ofsted. But it’s not just carers, nurses, teachers, artists and university lecturers who can’t afford to live in London. Fifty Thousand Homes is a business-led campaign group – including the Royal Bank of Scotland, the CBI and scores of London businesses – formed to push the housing crisis up the political agenda. Its research shows that on current trends, customer services and sales staff at almost every level are being pushed out of the capital. Three-quarters of business owners believe that housing costs are a significant risk to London’s economic growth and 70% of Londoners aged 25 to 39 report that the cost of their rent or mortgage makes it difficult to work in the city.

Vicky Spratt is a 28-year-old journalist who worked as a producer of political programmes at the BBC but left because she felt the issues affecting her generation, such as the housing crisis, were not being covered properly. “A lot of issues were dismissed by the older generation – it didn’t affect them. They all owned their own homes,” she told me. Spratt joined the digital lifestyle magazine The Debrief, aimed at twentysomething women, and began an online petition against lettings agents’ fees that gathered more than 250,000 signatures. As a result, Philip Hammond, as chancellor of the exchequer, banned lettings agents’ fees in his 2016 autumn statement – the biggest victory for private renters to date.

Spratt describes herself as a reluctant campaigner, but her circumstances pushed her into it. She currently pays £1,430 per month, not including bills, for a one-bedroom flat which she can afford because she shares with her boyfriend, but she used to live in a room “which was literally the size of a bed”. “The walls were very thin because it had originally been part of one room, which the landlord split into two. I noticed after about six weeks my mental health deteriorated. If I wasn’t in a relationship I would be looking at going back to that,” she said. Spratt earns enough to get a mortgage but, because rents are so high, not enough to save for the 20–30% deposit required.

“The common thread for people my age is that we don’t own our own homes and potentially we never will. The housing crisis is older than me and it shocks me that nobody did anything about this, and I want it on the news agenda,” she said. “This is structural neglect. The buy-to-let boom and the unregulated market have a lot to answer for.”

Spratt believes that a key reason for this political failure is that “people who don’t experience this issue are in charge”, pointing out that almost a third of MPs are buy-to-let landlords. An Oxford graduate who has worked in Westminster, she also suspects that a factor behind the success of her campaign is because “I look and sound like them”.

Betsy Dillner, director of campaign group Generation Rent, said: “This is the neoliberal free market ideology which has been alive and well in the US for a long time and it is certainly taking over here.”

Dillner fears that the outcome will be that the city will become soulless, “a place where you can’t raise families, be young, start up new businesses – all those things that make the city we love – housing costs will suck the soul out of that.”


While population shifts to other towns may seem like a good way of rebalancing the wider British economy, the problem is that with nearly every FTSE 100 company headquartered in the capital, the majority of jobs are there too.

It is not possible to contemplate real solutions to the housing crisis without profound structural economic change. A weak private sector in the regions and public-sector jobs shrinking rapidly as a result of cuts mean that many people still look for work in the capital. And while some will leave the city, others will put up with otherwise unacceptable conditions in order to keep their jobs and family ties. This means that generation rent must pay through the nose to live in an increasingly sterile city – a playground for the rich in the centre, surrounded by gentrifying hipster hinterlands, and substandard housing for cheap labour in places such as Barking, Dagenham and Edmonton.

The exterior of a multiple-occupancy rental property in Brent.


The exterior of a rental property in Brent. Photograph: Brent council

Expecting people to move each time they are priced out of an area brings its own problems. Moving house is rarely an easy experience, even when the move is voluntary. But it’s incomparably worse when it involves being wrenched away from the support networks, daily routines and the sense of identity that comes with being able to call a place home. Even the threat of being uprooted, known as housing insecurity, is a significant contributor to mental health problems.

A secure and stable place to live is the most important factor in personal wellbeing, according to a study by psychiatrists Ciaran Abbey and TBS Balamurali. The study, titled “Housing the Mind”, cites evidence that prolonged periods in temporary accommodation can adversely affect a person’s mental health – and so can spending more than 30% of income on housing. “When a disproportionate amount of income is spent on housing, this leaves people less able to purchase other necessities such as adequate food, increasing the family’s vulnerability to disease but also the anxiety and sense of helplessness that results when unable to make ends meet,” says Abbey. When individuals lose their homes, they can lose not just physical shelter but their entire world.

This is not just about building more houses, it’s about the kinds of houses that we build and who we build them for. It is also about our priorities as a society. Property is being built in London – for wealthy foreign investors instead of the people who need homes most. As the stock of social and genuinely affordable housing dries up, rents are soaring and the taxpayer is being forced to contribute billions of pounds in housing benefits for poor-quality private lets. So far, the proposed solutions from both main political parties involve only tinkering with the existing situation. Instead, we need a new social contract that ensures housing is once again viewed as a right for all, not just an asset for the few.

This is an edited extract from Big Capital by Anna Minton, which will be published 1 June by Penguin

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This is what the blood donor service does after an attack – and how you can help | Jane Green

I was overwhelmed by how generously the people of Manchester responded to this horrific attack. Both our blood donor centres in Manchester had queues outside the doors before they even opened. Our national call centre was taking about 1,000 calls an hour by 10am, from people who wanted to help save lives by donating blood.

The response was driven by well-intentioned social media posts from the public. The desire to help was incredible. However we already had enough blood to supply the hospitals treating the victims, and we did not appeal for extra donors. We plan ahead to build in reserves to deal with major incidents. We hope that people who want to help will now become regular donors, because that is how they can best help us save lives when there is a tragedy.

Many people wanted to donate to help that day, but when you donate blood, it is not taken straight to a patient. We need time to test it and process it. The different components such as platelets and red blood cells need to be separated out. Typically, your blood donation will only reach a patient two or three weeks after you donate. The blood used to treat the Manchester victims would have been donated several weeks earlier, and those donors would have been from across the country.

Hospitals order blood from us in advance, without the need for blood to be brought in for each patient. We supply hospitals through our regional stock-holding units (what people refer to as “blood banks”) mainly through routine deliveries. Over Monday night we made 21 deliveries of blood to hospitals in Manchester, including 15 “blue light” emergency deliveries, delivering 346 units of red blood cells. We were able to meet all the hospitals’ requests, and our stocks remained good. We don’t know exactly how this blood was used, and much of the blood from the routine deliveries would have gone to patients not affected by the attack. But this was an exceptionally high level of local emergency demand and many of those precious donations would have been transfused into attack victims.

Trauma patients require more than just red blood cells. They also need platelets to help their blood clot, and other more specialised products: O-negative blood is especially important in emergencies because it can be given to anyone when time is short and you don’t have time to test for blood groups. We always need new O-negative donors because their blood is so valuable.

As Tuesday morning progressed, people began queueing to donate. Some had friends or family members caught up in the incident. We were worried they might be confused or upset about why there was no capacity or urgent need for them to donate that day.


We were inspired to see the diversity of people coming forward, because we need more black and Asian donors

We tried to spread the message about how people could best help across social media and through the press. I was working at Plymouth Grove donor centre, next to Manchester Royal Infirmary, where many victims were being treated, and I spoke to many people face to face. We were inspired to see the diversity of people coming forward, which was moving and very important – because we need more black and Asian donors. Patients benefit from closely matched blood, which will often come from donors of the same ethnicity.

Our message is that blood can best save lives in a tragedy when our stocks are already good through regular donations. Thanks to our loyal army of nearly 900,000 active donors, many of whom give blood three or four times a year, we can do that. But every year many of these donors have to drop out because of age, ill health and many other reasons. We need nearly 200,000 people to register as new donors every year.

If people have been inspired to donate for the first time, please go online, make an appointment, and donate. Blood saves lives, and your donation will help other people in urgent need, and make sure we are again ready for any major incident.

Nurse job interview tips: top nine questions and answers

Compassion and communication, respect and resilience, accountability and adaptability – a good nurse possesses a daunting set of qualities. If you’re newly qualified, how can you convince employers you have what it takes?

We asked those responsible for hiring band five nurses to tell us how they identify the right candidates. Here, they reveal some of the most common interview questions, as well as tips on how to answer them.

Why do you want this job?

The first question is usually broad. Candidates shouldn’t go into lots of detail but obviously shouldn’t give an answer that’s too short. If they’re newly qualified, they should think about what brought them into nursing in the first place. Why that specific branch of nursing … did they work there on a placement?
Wendy Preston, head of nursing practice, Royal College of Nursing

Why do you think you’re a good nurse and how can you evidence this?

They have got to show integrity and honesty, and also courage – we want to know they’re going to be a good advocate for their patients. They need to show they work according to the values of the six Cs – care, compassion, competence, communication, courage and commitment.We incorporate scenario question during the interview that will assess a nurse’s integrity. For example: “If you witnessed a nurse administering an incorrect drug, what would you do?” We ask for examples and to provide evidence from their career to date. Their answer will show their thinking processes and whether they know the right procedures to follow.We also understand the value of a happy team, so we want someone who can demonstrate they work well in a team and have a positive, can-do attitude. We want enthusiasm to shine through – you can see when someone’s energised by the work they do.
Ann Duncan, matron, Royal Marsden hospital, London

What does compassionate care mean to you and how do you deliver it?

I’m looking for someone who wants to care. I can teach you any skill, with help from my team, but caring and compassion is inherent. Answers often include kindness, empathy, treating the person as I would want myself or my family to be treated, listening to what it is the patient perceives as the problem and addressing that issue (often different from the clinical issues requiring nursing care).
Jo Thomas, director of nursing and quality, Queen Victoria hospital, Sussex

It is often good to ask a nurse if there has been a time they felt they were unable to give compassionate care and explore their answers. This can give us a good insight at interview. Examples staff have given include exhaustion, abnormally busy, low morale, poor skill mix/staffing levels, poor teamwork, challenging or abusive patients or relatives. Clearly we do not want this to be the norm for a nurse but understand there may be barriers to giving compassionate care all the time. We are looking for honesty and self-awareness. It is important to listen to what they say and how they say it.

Ann Duncan, matron, Royal Marsden hospital, London

How have you dealt with conflict in the past?

Interviewers are looking to see that the nurse can de-escalate a situation, that they know some basic conflict resolution strategies – such as taking people away from the area, sitting them down, finding out the root of the problem – and that they know when they need to escalate to a senior member of staff.
Wendy Preston, head of nursing practice, Royal College of Nursing

What makes a good shift?

We want to hear about the delivery of safe, effective care, and we want it to be documented and evidenced. We don’t want them to believe that high numbers of staff always equates to the best care. Some days, you will be short, but that doesn’t mean they are the worst shifts. It’s good when they say they know the importance of breaks and having catch-up time with staff.
Ann Duncan, matron, Royal Marsden hospital, London

There’s usually a question on resilience. We have to bear in mind that retention of staff is difficult and we want to encourage nurses to stay in the profession. Interviewers will want to know how they manage their time, cope with stress, stay hydrated. The best answer would be about work-life balance.
Wendy Preston, head of nursing practice, Royal College of Nursing

What are you most proud of in your nursing career to date?

Even though some of them have been student nurses they will have moments they are proud of, and we ask them to give an example of when they went above and beyond for a patient. We want to hear a personal story and we want them to be illustrating that they are kind, caring and compassionate, and that they are prepared to do everything they possibly can to ensure safe and effective care.

The stories can vary from nurse to nurse, but we will be able to hear and see if a nurse has genuine pride in their work, and we’ll gain an understanding of what is important to them.
Ann Duncan, matron, Royal Marsden hospital, London

Tell us about a mistake you have been involved with

Often they will talk about someone else’s mistake, not theirs. It’s good if they talk about their mistake, what they’ve learned from it, what they’d do differently, how they have changed their practice, how they have worked with others to change their practice. Interviewers will be looking for how they use evidence in their practice and how they learn from things.
Wendy Preston, head of nursing practice, Royal College of Nursing

What would others say about you in three words?

This is an end-of-interview question. I’m looking for someone who is self-aware, but also whether the three-word description matches the answers and examples they have given to the other questions. Some answers I’ve had in the past include loyal, compassionate and fair; genuine, caring and professional; equitable, passionate and reliable.

The point of the question is to assess how effective the individual is in seeking feedback and reflection, and whether they can articulate this in single words. Being able to answer can demonstrate that you have the insight and maturity to seek the opinions of others. A follow-up question, depending on the seniority of the role, might be: have you changed your practice as a result of feedback from others?
Jo Thomas, director of nursing and quality, Queen Victoria hospital, Sussex

Do you have any questions for us?

Often people are flummoxed and say no, but it’s good to be prepared with a couple of questions. A good question to ask, if it hasn’t come up, is about what kind of preceptorship programme, or learning and development, can they offer. If you have got any holidays booked, this is the time to say it.
Wendy Preston, head of nursing practice, Royal College of Nursing

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Coca-Cola’s ‘health by stealth’ wheeze is sneaky. But if it works so be it | Gaby Hinsliff

It had been a long day. I was knackered, and frankly not concentrating. Which is how I managed recently to bake a plum cake and forget to put the sugar in. The damn thing was already cooked and cooling by the time the penny dropped, so there was little option but to keep quiet and dish it up. But surprisingly, plates were licked clean. It tasted fine, if a little drier than usual. And yes, there is a point to this tedious domestic mishap, which is that Coca-Cola just did something similar to millions of its customers, in a move that has interesting implications for the debate over public health and the nanny state.

The soft drinks giant started by silently reducing the calories in Sprite. People didn’t seem to mind, so two weeks ago it secretly cut the sugar in Fanta by a third, and again sales held perfectly steady. So much for all the outraged spluttering over government plans to introduce a levy on sugary drinks next year – the reason Coca-Cola changed its recipes, since both drinks will now escape the tax – and how it would ruin much-loved brands. People literally didn’t notice.

There is admittedly something mildly disconcerting about the concept of “health by stealth” – although health is, in this case, a relative term. The acid in fizzy drinks is still no friend to teeth, and swapping sugar for other sweeteners does nothing to discourage the craving for sweetness. Who knows? In a few years we may all be panicking instead about some unforeseen side-effect of stevia, the natural plant-based sweetener substituted in Sprite. But it remains a rare example of a company fooling its customers into better choices, not worse ones – for once. They’re treating us like children. This is, after all, the equivalent of smuggling hated vegetables into pasta sauce and brazenly liquidising the evidence. But then, there’s nothing like a public health intervention for provoking a national tantrum.

Andy Burnham was accused of waging war on parents only four years ago for promising that a future Labour government would act to reduce sugar in cereals such as Frosties. Last year, when George Osborne finally unveiled plans for a tax on sweetened drinks, libertarian Tories were outraged.

Yet in a few years’ time we’ll surely look back and wonder what the fuss was about, for such is the way of health and safety interventions, from the ban on smoking in public places to the introduction of compulsory seatbelts. Outrage turns to grudging acceptance, before mellowing into surprise that things were ever any different.


If you announce you’re lowering fat, sugar or salt, then consumers glumly assume the result will be thin and joyless

It seems genuinely astonishing now that until 31 people died in the King’s Cross station fire in 1987, which was started by a dropped cigarette, nobody seemed to think smoking on the tube was a problem. My son boggles at the idea that back in the 1970s, kids would travel piled on top of each other in the backseat of a car or rolling around in the boot. But it still requires political courage to get past the initial wall of resistance, which is constructed of corporate inertia plus kneejerk irritation among consumers at being told what to do. Legislation can obviously overcome the former, but what’s less often noted is that it can also prompt imaginative responses to the latter.

Once, food manufacturers who made their products healthier would shout it from the rooftops, but increasingly they’re learning to do it on the sly. If you announce that you’re lowering fat, sugar or salt then consumers glumly assume the result will be thin and joyless; since so much of eating is about anticipation, that may be exactly how it tastes to them. But do it quietly and – as any slapdash home cook will know – you can get away with murder. Even in baking, which does depend on measuring ingredients accurately, it’s the ratio of fat to flour and liquids that seems crucial to the chemistry, rather than the sugar. A diabetic friend was advised by nurses that most recipes will still work even if you halve the sugar – which is roughly what I did by accident, since the plum cake recipe I screwed up still contained honey, fruit and golden syrup – at least so long as you don’t tell. Sneaky?

Coca-Cola’s ‘health by stealth’ wheeze is sneaky. But if it works so be it | Gaby Hinsliff

It had been a long day. I was knackered, and frankly not concentrating. Which is how I managed recently to bake a plum cake and forget to put the sugar in. The damn thing was already cooked and cooling by the time the penny dropped, so there was little option but to keep quiet and dish it up. But surprisingly, plates were licked clean. It tasted fine, if a little drier than usual. And yes, there is a point to this tedious domestic mishap, which is that Coca-Cola just did something similar to millions of its customers, in a move that has interesting implications for the debate over public health and the nanny state.

The soft drinks giant started by silently reducing the calories in Sprite. People didn’t seem to mind, so two weeks ago it secretly cut the sugar in Fanta by a third, and again sales held perfectly steady. So much for all the outraged spluttering over government plans to introduce a levy on sugary drinks next year – the reason Coca-Cola changed its recipes, since both drinks will now escape the tax – and how it would ruin much-loved brands. People literally didn’t notice.

There is admittedly something mildly disconcerting about the concept of “health by stealth” – although health is, in this case, a relative term. The acid in fizzy drinks is still no friend to teeth, and swapping sugar for other sweeteners does nothing to discourage the craving for sweetness. Who knows? In a few years we may all be panicking instead about some unforeseen side-effect of stevia, the natural plant-based sweetener substituted in Sprite. But it remains a rare example of a company fooling its customers into better choices, not worse ones – for once. They’re treating us like children. This is, after all, the equivalent of smuggling hated vegetables into pasta sauce and brazenly liquidising the evidence. But then, there’s nothing like a public health intervention for provoking a national tantrum.

Andy Burnham was accused of waging war on parents only four years ago for promising that a future Labour government would act to reduce sugar in cereals such as Frosties. Last year, when George Osborne finally unveiled plans for a tax on sweetened drinks, libertarian Tories were outraged.

Yet in a few years’ time we’ll surely look back and wonder what the fuss was about, for such is the way of health and safety interventions, from the ban on smoking in public places to the introduction of compulsory seatbelts. Outrage turns to grudging acceptance, before mellowing into surprise that things were ever any different.


If you announce you’re lowering fat, sugar or salt, then consumers glumly assume the result will be thin and joyless

It seems genuinely astonishing now that until 31 people died in the King’s Cross station fire in 1987, which was started by a dropped cigarette, nobody seemed to think smoking on the tube was a problem. My son boggles at the idea that back in the 1970s, kids would travel piled on top of each other in the backseat of a car or rolling around in the boot. But it still requires political courage to get past the initial wall of resistance, which is constructed of corporate inertia plus kneejerk irritation among consumers at being told what to do. Legislation can obviously overcome the former, but what’s less often noted is that it can also prompt imaginative responses to the latter.

Once, food manufacturers who made their products healthier would shout it from the rooftops, but increasingly they’re learning to do it on the sly. If you announce that you’re lowering fat, sugar or salt then consumers glumly assume the result will be thin and joyless; since so much of eating is about anticipation, that may be exactly how it tastes to them. But do it quietly and – as any slapdash home cook will know – you can get away with murder. Even in baking, which does depend on measuring ingredients accurately, it’s the ratio of fat to flour and liquids that seems crucial to the chemistry, rather than the sugar. A diabetic friend was advised by nurses that most recipes will still work even if you halve the sugar – which is roughly what I did by accident, since the plum cake recipe I screwed up still contained honey, fruit and golden syrup – at least so long as you don’t tell. Sneaky?

The work of the Salford venereal diseases clinic – archive, 18 May 1929

On April 1 last year a municipal clinic for venereal diseases was established in Salford, and the first annual report, for the nine months’ working, has just been issued by Dr. E. T. Burke, venereal diseases medical officer for the city. The existence of the venereal diseases scheme of the Ministry of Health implies the existence of a venereal diseases problem, he writes. In pre-war times the question of venereal disease was something of a national taboo. The great – almost inevitable – increase in venereal disease occasioned by the Great War was driven into the public consciousness. “It was realised,” he writes, “that, covered by a carefully fostered conspiracy of silence, the ulcer of venereal disease was gnawing at the very vitals of the national health.

A new generation has sprung up, and the memories of the older generation are short. There has been a tendency to rest upon our oars; and the ancient taboo – the pernicious policy of ‘hush-hush’ – has been gradually reasserting its anaesthetic effect.”

“Campaigns against cancer and consumption are very necessary,” he goes on. “They are popular; they are respectable, and they have a wide appeal both among the medical profession and the laity. An anti-venereal campaign starts with the dice heavily loaded against it. The thought that the venereal problem is but one of very minor importance is fathered by the wish that it might be so.”

Venereal disease prevention poster, 1920.


Venereal disease prevention poster, 1920. Photograph: Smith Collection/Gado/Getty Images

Misleading Returns
After reviewing the various researches to discover the proportion of cases of syphilis in the community, Dr. Burke says that the neat proportion of deaths from syphilis are hidden under various other labels in the mortality lists of the Registrar General. Confidential death certification would go a long way toward turning an annual mass of figures, in many respects both useless and misleading, into something of practical value. The truth as to the killing power of syphilis lay at the bottom of the Registrar General’s statistical well. They found by scientific analysis that about 10 per cent of the total deaths were due to syphilis, and as gonorrhea was about twice as common syphilis the grand total of venereally infected persons was brought to about 500,000 or 14 per cent of the population of the whole country. In the city of Salford, with a population of 250,000 (assuming that the community was infected at a rate no higher than the country generally, there would be at least some 30,000 infected persons. That meant about 1,000 annual fresh infections, and 200 deaths from syphilis every twelve months.

The cost of the clinic in its first year (April to December had been £5,600. It was necessary to consider whether that was justifiable. The devastating economic effect could be gauged by an investigation undertaken by approved societies with a membership of 3,000,000. The average duration of disablement per member per year was found to be: all diseases 7,2 weeks, venereal disease 10,9 weeks. The effect of this in causing a decrease in industrial production and an increase in the cost of living was self-evident. The attitude of the British employer to venereal disease had been either to ignore or penalise it. Both were suicidal policies.

The Care of Children
The report goes on to deal with the actual working of the Salford clinic. It is shown that the total attendances for the nine months were 35,503 (intermediate attendances 26,155) and 1,220 new cases were treated. In comparison with the twelve months’ figures of other big centres, it is seen that the Salford clinic has dealt with more new patients and registered more attendances than any other treatment centre with a similar size of population. Of the total number of patients 21.5 per cent were Manchester residents.

Dr. Burke states that very few children are being treated at the clinic, which fact he regards as unsatisfactory. “It is felt,” he writes, “that school-children suffering from general debility, backwardness, heart disease, epilepsy, &c., should be thoroughly examined for evidence of syphilis.” He also urges the need for a hostel to which women could be admitted while undergoing treatment to enable them to continue in their employment, and he emphasises the necessity of a treatment station within the dock boundaries, with placards, telling of its existence in different languages, to be placed in seamen’s and firemen’s quarters in every ship entering dock. The number of patients belonging to the mercantile marine was 138, 11 per cent of the total.

Manchester Guardian, 18 May 1929.


Manchester Guardian, 18 May 1929.

Warning pregnant women over dangers of alcohol goes too far, experts say

Women are being unfairly alarmed by official guidelines that warn them to avoid alcohol completely during pregnancy, experts claim.

Some mothers-to-be may even be having an abortion because they are worried they have damaged their unborn child by drinking too much, it is claimed.

The British Pregnancy Advisory Service, maternal rights campaign group Birthrights and academics specialising in parenting say official advice on drinking in pregnancy is too prescriptive.

Revised guidelines that came into force in January 2016 are not based on reliable evidence, they say. The advice, endorsed by the four UK nations’ chief medical officers, deleted a longstanding reference to pregnant women potentially having one or two units of alcohol once or twice a week while expecting and instead said that they should not drink at all.

“We need to think hard about how risk is communicated to women on issues relating to pregnancy. There can be real consequences to overstating evidence or implying certainty when there isn’t any,” said Clare Murphy, director of external affairs at BPAS, the contraception and abortion charity.

“Doing so can cause women needless anxiety and alarm, sometimes to the point that they consider ending an unplanned but not unwanted pregnancy because of fears they have caused irreparable harm.”

Ellie Lee, director of Kent University’s centre for parenting culture studies, said the advice means pregnant women also shun social occasions unnecessarily.

“As proving ‘complete safety’ [of drinking in pregnancy] is entirely impossible, where does this leave pregnant women? The scrutiny and oversight of their behaviour the official approach invites is not benign. It creates anxiety and impairs ordinary social interaction. And the exclusion of women from an ordinary activity on the basis of ‘precaution’ can more properly be called sexist than benign,” Lee added.

Last year’s revised guidelines followed the first in-depth UK review of the evidence on drinking in pregnancy since 2008. It concluded that “definitive evidence, particularly on the effects of low-level consumption [on a baby’s health] remains elusive”. Despite that, it nevertheless recommended that: “If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.”

The NHS’s start 4 life website, which promotes healthy behaviour, says: “What you drink, your baby drinks too. Play safe and cut out alcohol.”

Jennie Bristow, senior lecturer in sociology at Canterbury Christ Church University, criticised the negative effects of advice to mothers to be. “Does it simply make for healthier pregnancies or is it scaring women about their bodies and their babies? Promoting fear is not a good way to care for pregnant women.”

The guidelines state that: “Alcohol, like a numbr of drugs, is a teratogen, which means something that can disturb the deveopment of a fetus. Teratogens may cause a birth defect, or may halt the pregnancy.” The risks to the child also include the child being born prematurely or very small or having behavioural problems.

The Royal College of Midwives believes that any woman who is or is trying to become pregnant should shun alcohol altogether. “Our message [is]… that there is no evidence that any level of consumption is safe for the growing baby,” it said when the guidelines came out last year.

Corbyn’s inspiring manifesto takes me back to Labour 1945 blueprint for hope | Harry Leslie Smith

It was at Bradford University on Tuesday that Jeremy Corbyn unveiled the Labour party’s election manifesto. In the grand hall, Corbyn spoke to an enthusiastic gathering of students and party faithful about the concrete plans Labour has to transform Britain into a country where the many will prosper instead of the few. Corbyn spoke about the need to properly fund the NHS, provide free tuition to students, end the blight of zero-hours contracts, and raise the living wage to £10 an hour.

For me, a man who was born and bred in the harsh poverty of Britain after the first world war, it was inspiring. But what moved me most was the venue he chose to announce this manifesto of equality and fairness – because Bradford University is built on ground that, in my youth, was a site of great suffering and death.

You see, within the boundaries of what is now the university campus, my boyhood dreams and idealism were crushed under the cruel weight of austerity during the Great Depression. When I was young, this was not a place where one’s future was made but where it was condemned. The grounds that now hold this university contained a slum, and hope never penetrated its dark, enveloping canopy of destitution.

My family arrived in the neighbourhood that once covered this well-maintained university as penniless and jobless economic migrants from Barnsley in 1929. Then, it was an endless, warren-like landscape of dilapidated houses that nestled in cul-de-sacs where no one expected to enjoy either a decent or a long life because there was no welfare state or NHS. If hard luck struck, all that was available was poor relief, which paid a mean weekly stipend that guaranteed either starvation or homelessness.

My family couldn’t survive on poor relief, so we ended up living cheek by jowl in a doss house with a multitude of other desperate characters. Like us, all of them had been washed up on its doorstep like the flotsam that crashes on to a desolate beach after a terrible tempest. Soldiers from the first world war who had been promised a land fit for heroes by lying politicians resided in the doss where my family kipped. During the day, they still tried to hold themselves up bravely.

Like my dad, these Tommies looked for work in a city whose factories had been hushed by the collapse of the world’s economies. But at night when they tried to sleep, weary from unemployment and PTSD, I’d hear their cries of terror because their dreams had sent them back into battle at Ypres or the Somme.

As for me, my childhood was a nightmare of indentured servitude and malnutrition. At bedtime, my sister and I would huddle together for warmth on a piss-stained flock mattress on an unlit garret floor. We would try to quell the gnawing in our stomachs by wondering what our king had eaten for his tea that evening.

Even while playing, my boyhood was never blissful. In this part of Bradford I was always reminded that death for the poor is miserable, brutal and lonely: from open windows, I heard the inhuman howls of cancer sufferers dying in agony because poverty denied them the dignity of morphine.

But all of that changed in 1945 when, at the end of the second world war, the Labour party fought a general election on a manifesto that promised the creation of the NHS, affordable education, an end to that era’s housing crisis and fair conditions for all workers. The Labour party’s 2017 election manifesto echoes the sentiments found in Labour’s 1945 manifesto that inspired my generation to build a just society.


I can tell you as a very old man: I am afraid for the future of ordinary people in Britain

When I remember all the pain and sadness that once populated the part of Bradford that now houses its university, I can’t think of a better tribute to all those whose lives were blighted by the Great Depression than for Labour to have unfurled its manifesto here for the nation to see.

But I fear that the 2017 manifesto, no matter how just and how right for our times, may not catch the wind it needs to help this country sail forward to hope and prosperity because we have forgotten the hardships, tragedies and triumphs of my generation. It’s sad for me to ponder how on Remembrance Sunday people speak solemnly about their commitment to never forgetting those who fell in war, while those uncountable lives that were cut short because of economic injustice throughout the early part of the 20th century are forgotten.

I can tell you, as a very old man, that I am afraid for the future of ordinary people in Britain. Because by the time the next general election is scheduled, in 2022, most of those from my generation, who have survived for so long, will be dead or incapacitated. No one then may be left alive to remember the profound suffering, the hardship, the sorrow and the eventual victory all those nameless, ordinary people achieved in 1945 with election of a Labour government.

Forgetting them, and the lessons your parents or grandparents taught you from their lives about how to overcome austerity and build a proper and just society, will condemn you to something far worse than I experienced growing up.

Are you a doctor in Australia struggling with mental health issues?

The issue of mental health among Australia’s doctors and medical students has been in the headlines. Four junior doctors from one cohort have taken their lives within six months. Last week, Australian gastroenterologist Andrew Bryant died in his office after battling depression.

The National Mental Health Survey of Doctors and Medical Students shows that the profession experiences higher rates of mental illness than the general community. Though doctors report that talking about it is taboo within the high-performing culture of medicine.

Dr Ranjana Srivastava writing for the Guardian said: “When it comes to mental illness, we hear a lot from the experts but not enough from the sufferers. Nothing would be more welcome than the insights of doctors who have endured mental suffering and worse, been on the brink of suicide. What healed them and who helped them? What could their colleagues have said or done differently at the time? What workplace adjustments would have meant the most? These stories are clearly among us – hearing them could illuminate the dark corners of our understanding and help link theory and practice.”

Share your experiences

We’d like to hear from doctors who have experienced mental health issues. What helped you through it? What could your colleagues have done differently at the time? You can share your experiences, anonymously if you prefer, by filling in the encrypted form below. We will do our best to keep your information secure. We will not publish any responses without contacting you first.

In Australia, the crisis support service Lifeline is on 13 11 14. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255