Loitering with Intent

Euan Lawson

After the white-knuckle ride of 2020, it seems scarcely credible that 2021 is already past. Before we plunge into 2022, we should loiter with intent around the highlights. In 2021, the BJGP has published 46 editorials, 111 research articles, and over 120 viewpoints and reviews in Life & Times. And that doesn’t include scores of letters, all the Analysis and Clinical Practice articles, as well as daily content on BJGPLife.com. In addition, there are now over 50 BJGP Interviews podcast episodes, with videos teasing out findings with authors and how they influence clinical practice and policy. There is much to choose from to guide us as we face the challenges of 2022.

There have been many important editorials and articles on cancer in 2021 and it remains a priority area for the BJGP. This issue marks the publication of the third article about gut feelings in a remarkable series by Claire Friedemann Smith and colleagues. We also publish the latest in a suite of articles on the use of chest X-rays and the diagnosis of lung cancer by Stephen Bradley. The prompt diagnosis of cancer, always a concern, has become more pressing as the pandemic has disrupted normal processes. Editorials in 2021 have explored the use of Rapid Diagnostic Centres, considered how well urgent cancer referrals are working, and how we can, indeed, diagnose cancer earlier as part of improving outcomes.

Earlier in the year, the Sandvik article on continuity in Norway added to the evidence suggesting enormous benefits of continuity of care, including reduced mortality, yet the article from Peter Tammes in June 2021 pointed to a decline in continuity in England. We are losing this battle.

In January 2021 we published research from the indefatigable Trisha Greenhalgh and team on the media coverage of remote consulting. It built on earlier work on the depiction of general practice — but few of us would have predicted the pitchfork mob mentality of the politically motivated media and their savagery in the latter half of 2021. Dame Clare Gerada, now President of the Royal College of General Practitioners, took a tilt at that GP crisis in the July issue.

The challenges for 2022 stare unblinking at us, not least the fact that COVID-19 is not done by any measure. The UK has been running hot, often recording 1000 deaths a week through the autumn and, at the time of writing, the full implications of the Omicron variant are being unpicked. If there is increased transmissibility and evasion of vaccines we will see more deaths.

Yet, many of the most inspiring voices in the BJGP in 2021 bring hope. Iona Heath has offered us the underpinning philosophy of rewilding general practice to guide us forward and there are also new and exciting voices emerging: Julia Darko’s writing on mental health in Black men and vaccine hesitancy in Black and Asian communities was a particular highlight this year. One to watch for 2022.

• © British Journal of General Practice 2022