As the year draws to a close….

There will be lots of people who will or have celebrated their successes this year and others who may feel a little deflated. Do not under-estimate your achievements. Some people unfortunately did not make it through 2023 and are not here to celebrate with us, acknowledge that you have made it to the end of 2023! 

This year has been an interesting one and I am sure many wish it had been a lot less eventful. Let’s have a look back. 

A is for physician associates as all clinical professions are keen for them to have formal regulation and formal job descriptions for employers. 

B is for burnout. The GMC survey of trainees showed high levels of burnout this group of doctors (23% at high risk, up from 19% last year), as well as their trainers and educators (12%). 

Remember that there is support if you are struggling. 

But B is also for blood pressure – maintaining a healthy blood pressure is essential for cardiovascular health. A healthy diet and exercise can go a long way to do this. 

C is for the Covid inquiry. This opened in June 2022, however, Prime Minister Rishi Sunak, former prime minister Boris Johnson, former health secretary Matthew Hancock, former NHS England chief Sir Simon Stevens, chief scientific adviser Sir Patrick Vallance and BMA chair Professor Philip Banfield have all given evidence this year. 

C is for chronic diseases too such as diabetes, hypertension, and cardiovascular diseases are major contributors to health challenges and long-term disability. 

D is for debt and diet. Many doctors are in debt, with examination fees and cost of living, this is not a financially sustainable model. Poverty leads to poor diet and poorer health. 

E is for exercise. The benefits of regular exercise are improved physical and mental health. Try a habit-forming regular activity once you have tried a variety to discover what suits you most. 

F is for ‘flu vaccination. This year the lower age limit for the seasonal ‘flu and covid vaccination was raised to 65 years old in England. 

G is for general practice shake-up. All political parties have unrealistic ideas about this. They need to discuss with primary care staff, especially general practitioners, how recruitment and retention can be improved as the current arrangement has doctors and other primary care clinicians leaving at a much faster rate than recruiting. 

H is for health secretary changes again! Although only two health secretaries this year compared with the FOUR changes in 2022 (where Barclay was in the role for two separate periods last year.) Victoria Akins has inherited a pay dispute with unions, worsening NHS waiting lists, a workforce crisis and poor public health post-pandemic. 

I is for infectious diseases due to global warming such as tropical diseases entering northern parts of Europe as the continent warms. 

J is for joint health. Maintaining a lower weight will lessen the burden on weight-bearing joints and strengthening the muscles around joints will improve the support. 

K is for kidneys that filter and eliminate waste from our bodies. A good blood pressure is essential in maintaining their efficiency. 

L is for lifestyle choices such as regular exercise, low alcohol intake, and not smoking tobacco. But is also for lipid therapy for all as NICE considers lowering the thresholds for recommending treatment. This may mean that 15,000,000 of us meet this lower threshold leading to further difficulties with G. 

M is for medical apprenticeships they are coming in September 2024. This will lead to two distinct pathways to achieve medical training, university five years full time or “earn while you learn” apprenticeship. 

N is for the norovirus mystery. Noroviruses cases in the community are like previous years but recent hospitalisations are three times higher than in the same period in 2022. 

O is for obesity. This has a major impact on health and leads to disability. 

P is for pensions update. A headache for doctors and other senior NHS staff. The McCloud judgement this year, with the government releasing details of its proposed changes to the NHS pension scheme as a result. All very complicated. 

Q is for QOF. After 20 years, hopefully reform is on the way with the qualities and outcomes framework. 

R is for respiratory health. Air quality and smoking cessation are important factors with this. 

S is for sleep. Maintain a routine and get up at the same time every day. Limit screens and caffeine later in the day. Alcohol reduces the quality of sleep. Try to have a cool, quiet and dark bedroom, with a comfortable bed. 

T is for telemedicine. The lockdowns in the pandemic have ensured that this is possible. We need to improve it. 

U is for urgent care. This is entwined with G. Both need significant investment and patient education to be sustainable in the future. 

V is for virtual wards are expected to expand across the country giving patients hospital-level care in their own homes and freeing up hospital beds for more acute patients. The wards may be virtual, the staff required to support the patients are not and therefore not a solution for staff shortages. 

W is for women’s health. There is increasing awareness of reproductive health to menopause, and the importance of regular screenings. 

X is for X-Rays and Imaging. The non-invasive imaging is still a useful resource. 

Y is for yoga that is one way we can manage stress and exercise. This is needed as Y is also for yet more patients waiting. The NHS in England continued to battle worsening waiting lists throughout the year, a record 7.77 million patients waiting at the end of September. 

Z is for zinc. It is an essential mineral that is involved in healing, immune function, blood clotting and thyroid function. 

HAPPY 2024! 

Perfectly imperfect