'Health and Wellbeing Boards' - hiding the obvious

Does the language we use really matter? A public NHS document includes the following:

'PHARMACY

2.1

Background

Health and Wellbeing Boards (HWBs) in England hold statutory responsibility to publish and keep up to date a statement of the needs for pharmaceutical services of the population in its area, referred to as a pharmaceutical needs assessment (PNA). PNAs are used by the NHS to make decisions on which NHS funded services need to be provided by local community pharmacies.'

I'm not asking, or demanding, change to this but the words we employ do matter. One of them above matters greatly. The question of responsibility and its attribution. In the response to mental illness,  responsibility has always been played out on the public stage. Even when society's response was to leave 'care' to religious and charitable agencies. Then the state stepped in with the first legislation. The state assumed responsibility as per the previous post. Not only where the keys thrown away, but many people admitted there, did not need be. The 'reason for referral' was more accurately described as a social ill. In this way, individuals were incarcerated and forgotten.

It is in the gift of Hodges' model, care of its vertical axis [INDIVIDUAL - GROUP], to be able to negotiate the contextual switch from personal to group and population. There is a marked contrast from self-medication, a nurse doing a medicines round - to the design, testing and research effort of production of a specific drug or intervention. The focus then is obviously at the population scale. The pharmocological business, is not just a business. It is a pharmaco-industrial complex, e.g.

Grouse L. Cost-effective medicine vs. the medical-industrial complex. J Thorac Dis. 2014 Sep;6(9):E203-6. doi: 10.3978/j.issn.2072-1439.2014.09.01. PMID: 25276402; PMCID: PMC4178073.

When we think of dependence it is often framed at the individual level. But how can we expect to change health services, health systems to see them as they truly are: Illness and Infirmity Boards masquerading as Health and Wellbeing Boards?

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

	drugs manufactoring testing
	Sybil Shainwald (April 27, 1928 – April 9, 2025)

Sybil Shainwald 

https://en.wikipedia.org/wiki/Sybil_Shainwald

'Pharma©opia’ (1992) by General Idea outside Museo Jumex © Moritz Bernoully c/o FTWeekend

 INDIVIDUAL
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

	Pharma©opia’ (1992) by General Idea outside Museo Jumex © Moritz Bernoully

Cepeda, G., Mexican art's early champion. Collecting,  FTWeekend, 25-26 November 2023, p.5. 

Image source:
https://www.ft.com/content/96f76039-0703-455f-acbb-d1a74827ee73

With my inversion of the original image.

Southern Sudan Medical Journal: Vol 15 No 3

Dear reader,

The August issue is online here. See details below.
 
SSMJ is now included in the EBSCO scientific research collection. Our articles are also listed in  African Journals Online (AJOL) and the Directory of Open Access Journals (DOAJ) as well as on our website.
 
Questions:
Could you contribute to SSMJ by:

• Sending items for future issues: e.g., research, case studies, news, photos, and/or letters?
• Helping to edit or peer review articles?
• Suggesting topics relevant to health professionals in South Sudan?
• Sharing SSMJ with colleagues and sending us their feedback?

Write to us at southsudanmedicaljournal@gmail.com
 
Thanks to everyone who supports SSMJ - authors, editors, and especially our peer reviewers.

In this issue

EDITORIAL

• Eye care in South Sudan Kenneth Lado Lino Sube

 
RESEARCH ARTICLES

• Prevalence of glaucoma among patients attending Buluk Eye Centre, Juba, South Sudan: a one-year study Kenneth Lado Sube et al
• Social demographic determinants of male participation in antenatal care in Nyamagana District, Tanzania Sarah M. Chamos, Alen Kinyina, and Harrieth Mtae
• Prevalence of HIV among pregnant mothers receiving antenatal care at Kator Primary Health Care Centre, Juba, South Sudan Kon Paul Alier et al
• A survey of tonsillectomy care patterns in Tanzania Daudi Ntunaguzi et al
• Musculoskeletal disorders among patients during a one-day outreach at Juba Military Hospital Mapuor M.M. Areu et al

 
MAIN ARTICLE

• How to use experience to improve teaching practice Rich Bregazzi

 
CASE REPORT

• Lower back musculoskeletal hydatid cyst: a rare presentation in a South Sudanese patient Lodu Swokiri N Kuju et al

SHORT COMMUNICATIONS

• “How-to” Teaching Videos–inspired by work in South Sudan Deborah Van Dyke
• Role of the community pharmacy in the control of pandemics in South Sudan Oliver Batista Ugoro
• Profile of the Department of Paediatrics and Child Health, Al-Sabbah Children’s Hospital, Juba, South Sudan Amanda Billy Berto Madison

OBITUARY: Dr Frederick Khamis Tawad
BACK COVER: WHO: Recovering from Monkeypox at home
 

The SSMJ team
Email: southsudanmedicaljournal@gmail.com
Website: http://www.southsudanmedicaljournal.com
Follow us on Twitter@SSMedJournal and Facebook

Eroom's Law

Stephanie F. Scholtz

 

individual
|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

digital literacy health literacy ...	Moore's Law*
social justice 'laws' translated social capital	Eroom's Law

 

*This is not to underestimate the economic impacts of Moore's law, or in both instances the question of access to digital technology and health care.

Kill or Cure? Technology Quarterly - Personalised Medicine, The Economist, 434: 9185; 14-20 March 2020. pp.9-11.

https://www.stephanie-f-scholz.com/

The science and sociology of 'Labelling'

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

On-Label Off-Label	On-Label Off-Label
On-Label Off-Label	On-Label Off-Label

My source:
Hannah Kuchler, Nick Verbitsky, Tom Jennings, Shaun Connaire, Opiods sales chief admits to lacking morals, FT Weekend, 25-26 January, 2020, p.13. (additional reporting: Annie Wong, Rebecca Blandon).

Books: [ Gold Fever ]

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

The Drugs That Changed Our Minds	Natural Causes
Too Many Pills	GOLD FEVER

...
Cured of what we suffered from

And sufferin' from the cure ...

Gold Fever, lyric

My sources:

The Drugs that Changed Our Minds and Natural Causes, Sunday Times, 25 March & 1 April 2018
Too Many Pills, FT Weekend, 26-27 May 2018

Visual Patient Drug Interactions Display (when?)

This past week I've been reminded of the complex health and social care problems that an individual person can present. These problems with multiple pathology can mean that 2-3 clinical consultants are involved; a key focus of their input being specific advice on prescribing across neurology, mental health and physical care respectively. In between are families, care home staff, home management, acute, primary, secondary care and the care commissioners all striving to provide the best care possible amid a complex situation.

In such instances of shared care I wondered about what technology can bring to bear in terms of visual tools. Polypharmacology is the permanent front page headline of our Caring Times. Is it possible to present graphically the medication list for an individual and have the latest dynamic clinical and pharmacological data presented and coded in graphical links between the drugs? As drugs are added or excluded, could the efficacy of the drug regimen be measured? Eventually, lab results might also be factored in. Thinking of technical and engineering applications the tools are probably already out there?

I've done a brief search, but have not found anything significant so far beyond this tabular HIV drug interactions tool. There are bound to be many projects and research papers out there. Perhaps the pick-list tabular format is sufficient? The principle of KISS should apply here given the safety concerns. The data to feed such an illustrated beast is loaded not just with facts and (marketing) hyperbole, but major socio-political issues too. Fancy graphics may add complexity, not reduce it?

Such tools are inevitable though. Can you imagine (amid possible cries of heaven forbid!) when the public have access to pharmacological knowledge and the referral battle is one between the medical decision support system as it supervises requests and suggestions from the 'patient' (i.e. the patient's e-health care manager) regards their drugs. Of course, in future as drugs become personalised the demand for this may reduce..?

A standardised way to display drugs information graphically, revealing at a colour-line-sound coded glance the various interactions would be a major step-forward. I can just see the clinical consultants being able to remotely annotate and update the shared drug display with their notes. The patient and/or their family also being privy to the dialogue.

The existing tabular format is text-bound to struggle as bio-genetic data is added to this personal prescription suite. Another search shows that XML, XSL and SVG can all help to make this happen. I hope so and soon.