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Greg Fell @felly500.bsky.social · 21m

www.theguardian.com/society/2025...

Self regulation in action

Its almost too egregious to be true

Ill have it on loud repeat at every licensing committee meeting Im at

High street slot machine shops pay staff bonuses linked to how much gamblers lose

Exclusive: MPs and campaigners condemn ‘appalling’ reward scheme for Merkur venue managers

www.theguardian.com

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Reposted by Greg Fell

Steve Senior @stevensenior.bsky.social · 23h

It always surprises me that minimum unit pricing isn't pitched as a plan to save the Great British Boozer.

Hazel Cheeseman @hazelcheeseman.bsky.social · 1d

Seems like the solution to the "problem" of people not going to the pub could be to tax off-trade alcohol a bit more and narrow the price difference and incentives a return to the pub while also raising revenue. Would likely have health gains too.

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Greg Fell @felly500.bsky.social · 22h

www.adph.org.uk/2025/10/alco...

Alcohol licensing reforms

From a public health point of view, it's... well a little disappointing...

Its almost as if there wasn't some concern about high and rising alcohol harm and it's impact on families, UKPLC and the NHS

Alcohol licensing reforms - ADPH

www.adph.org.uk

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Greg Fell @felly500.bsky.social · 1d

And this is timely

Seven reasons why GP consultations are getting more complex

www.bmj.com/content/391/...

Seven reasons why GP consultations are getting more complex

General practice has become more clinically complicated, alongside the diminishing workforce and increasing demand. Jo Best explores the causes—and possible solutions Steve Taylor has been a GP for a...

www.bmj.com

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Greg Fell @felly500.bsky.social · 1d

Let's call it for what it is
The gizmo budget is basically the primary care budget

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Greg Fell @felly500.bsky.social · 1d

Our old friend opportunity cost

Nobody likes to talk about him

But he is there.....lurking round the corner of every "amazing new thing" that makes the headlines ....

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Greg Fell @felly500.bsky.social · 2d

www.bmj.com/content/391/...

Plastic pollution is a worsening public health crisis, but there are solutions

Supply side solutions needed
Regulation of fossil fuel industry and its derivatives

Demand side answers mostly pointless

Plastic pollution is a worsening public health crisis, but there are solutions

We need to put humans and the environment before corporate profits, writes Bethanie Carney Almroth Plastics have become a concern at the forefront of public environmental awareness campaigns and in ...

www.bmj.com

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Greg Fell @felly500.bsky.social · 2d

www.bmj.com/content/391/...

Tobacco industry “fighting back” with new nicotine products, WHO warns, with more than 100 million people now vaping

Reasons to not trust the global tobacco industry

Volume 356
Chapter 14

Tobacco industry “fighting back” with new nicotine products, WHO warns, with more than 100 million people now vaping

One in five adults are still consuming tobacco and more than 100 million people are vaping as the industry targets young people to offset falling numbers of smokers, the World Health Organization has ...

www.bmj.com

Greg Fell @felly500.bsky.social · 2d

www.bmj.com/content/391/...

Pay for performance might embed inequalities

V v much so
Care needed in design

Pay for performance might embed inequalities

Majeed and Molokhia provide an insightful assessment of the Quality and Outcomes Framework (QOF).1 But their focus on administrative burdens and diminishing returns may understate a more perilous cons...

www.bmj.com

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Greg Fell @felly500.bsky.social · 3d

www.thetimes.com/life-style/h...

What Mark said!!

Screening for prostate cancer is not a no-brainer. Here’s why

Screening will save some men’s lives, but there is a risk of overdiagnosis, which comes at considerable cost to others

www.thetimes.com

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Greg Fell @felly500.bsky.social · 3d

This is also a good historical overview of trust & Public Health

Charlatans, One and All

www.milbank.org/quarterly/op...

Some of the historical medical malpractice documented in here

Charlatans, One and All | Milbank Memorial Fund

The Senate Finance Committee hearings with Robert F. Kennedy Jr. (RFK Jr.) were explosive. The Secretary of Health and Human Services was accused of

www.milbank.org

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Greg Fell @felly500.bsky.social · 3d

www.bbc.co.uk/sounds/play/...
[06/10, 19:22] Greg Fell: A good telling of the Paloma Shemerani story

Important part of the ecosystem of misinformation

The full story
www.bbc.co.uk/sounds/play/...

Exceptionally sad

The Global Story - Are conspiracy theories America’s biggest export? - BBC Sounds

One British family deals with the devastating consequences of health conspiracies

www.bbc.co.uk

Greg Fell @felly500.bsky.social · 3d

www.bbc.co.uk/sounds/play/...

an excellent contemporary telling of Wakefield

The Global Story - The disgraced UK doctor behind autism misinformation - BBC Sounds

How a British doctor created the vaccine myth behind Trump's autism announcement.

www.bbc.co.uk

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Greg Fell @felly500.bsky.social · 3d

An awful lot of "public health" is delivered by staff who dont have those two words in their job title

The workforce really really matters
We can do better on this

Good report from @rsph.bsky.social

Royal Society for Public Health @rsph.bsky.social · 4d

🚨The UK is facing a health crisis.

But there are 1.5 million people who could help solve it.

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Reposted by Greg Fell

David Oliver @mancunianmedic.bsky.social · 7d

"something must be done"

"well *this* is something"

"Great. Something has been done"

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Reposted by Greg Fell

David Oliver @mancunianmedic.bsky.social · 7d

www.hsj.co.uk/quality-and-...

The trust league tables are not robust, meaningful or fair

Matthew Hankins and Dr Jonathan Pearson-Stuttard highlight the concerns arising from the use of NHS trust rankings and suggest solutions to make them more robust, relevant and just.

www.hsj.co.uk

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Greg Fell @felly500.bsky.social · 7d

@mancunianmedic.bsky.social on League tables
www.bmj.com/content/391/...

Well established metrics
Nod to safety & experience
Stat critique
usual stuff with compound indicators
Adjusting 4 many confounders
Gaming
What's it FOR?
undermining good will (short supply)
Not addressing underlying issues

David Oliver: League tables are no solution to the problems in NHS hospitals

On 9 September NHS England published its first quarterly league tables of NHS provider trusts’ performance,1 as promised in the NHS 10 year plan.2 There are scores, tables, and rankings covering speci...

www.bmj.com

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Greg Fell @felly500.bsky.social · 8d

vimeo.com/1122470127

Why do we tolerate the activities of the gambling industry?

Great summary video to accompany and amazong piece of scholarship
www.sciencedirect.com/special-issu...

HT @maizie333.bsky.social

Why do we tolerate the activities of the gambling industry?

Based on a true article: van Schalkwyk MC, Cassidy R. Why do we tolerate the activities of the gambling industry? Future Health J. 2025 Jun 30;12(2):100267. doi:…

vimeo.com

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Greg Fell @felly500.bsky.social · 11d

publications.aap.org/pediatrics/a...

Turns out that social media influencer promotion of food affects children’s food intake

Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial

In this study, we examine the impact of influencer marketing of foods (healthy and unhealthy), via popular YouTube vloggers on social media, on children’s food intake.

publications.aap.org

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Greg Fell @felly500.bsky.social · 11d

ebm.bmj.com/content/earl...
Hidden risks of predictive models in healthcare

Hidden risks of predictive models in healthcare

Joseph Alderman et al argue that predictive models in healthcare lack adequate oversight and regulation. They highlight the potential risks to patients and call for improved governance to ensure the s...

ebm.bmj.com

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Greg Fell @felly500.bsky.social · 11d

And at this point a reminder of the Naci paper. High prices = opportunity cost and lost lives in net terms

This is where the primary care budget is!

www.thelancet.com/journals/lan...

thread here
bsky.app/profile/fell...

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Greg Fell @felly500.bsky.social · 11d

it is a classic trade off between UKPLC (and to be fair life sciences is enormously important to the economy) and the health care budget. I'd love to see that trade off done very openly and transparently ....

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Greg Fell @felly500.bsky.social · 11d

There is a bit more of this going on at the moment.

TBF they've said this on and off for at least last 2 decades

but don’t (English language, favourable corporation tax regime, from Heathrow you can get anywhere in the world etc etc)

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Greg Fell @felly500.bsky.social · 11d

www.bmj.com/content/390/...

The old "cough up more for medicines, or we will go overseas" line

So many reasons why pharma industry might be thinking it's falling on hard times. My guess is the UK regime is not one of them (but can be a good opportunity to ask for more £)

Is big pharma falling out of love with the UK?

Amid a string of cancelled projects and investments, Jacqui Wise looks into why drug companies seem to be turning their back on Britain The UK government was dealt a major blow earlier this month whe...

www.bmj.com

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Greg Fell @felly500.bsky.social · 11d

All the usual tools
Price (price in the externalities, no fuel duty or VAT on kerosene but there is on petrol
Advertising (a tool to directly sell, but also strategically used to shape attitudes and opinion)
Availability and ease of access

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