Improving healthcare outcomes for all
Impact report 2021
Our vision of a healthier world drives what we do By sharing knowledge and expertise we help to improve patient outcomes through
Better systems Better decisions Better evidence
BMJ impact report 2021 | Contents
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Contents
Creating a healthier world
Supporting information needs during the global pandemic
Better evidence
Better decisions
Better systems
Striving for equity, promoting diversity and campaigning for social justice
Concluding with commitment
“I’m delighted to introduce our first impact report: only by measuring the effectiveness of our activities can we be sure we’re making a positive difference.”
References
Chris Jones, Chief Executive Officer, BMJ
BMJ impact report 2021 | Making a difference with trusted information
A message from our CEO Making a difference with trusted information
Now, more than ever, health professionals need reliable information from authoritative sources to support their work and help them make informed choices.
However, as leaders in this field, we know that meeting those needs is about more than just words. We want our work to have a positive impact on clinical practice to improve outcomes worldwide. For this reason, I’m delighted to introduce our first impact report: only by measuring the effectiveness of our activities can we be sure we’re making a positive difference. When I joined BMJ as CEO at the beginning of 2020, I was immediately impressed by the incredible contributions made by every single staff member towards our vision of a healthier world. It is their tireless efforts
that ensure our organisation retains its reputation for credibility and trust. When the pandemic threw the world into chaos, we knew we had to place the clinical and public health response to this global emergency at the heart of everything we were doing. BMJ has continued to support authors, researchers, health professionals, and students through this time. And along the way, we’ve learned a great deal about our impact as an information provider, as a partner to organisations doing critical work worldwide, and as an employer.
BMJ impact report 2021 | Making a difference with trusted information
Impact measurement framework BMJ is a global healthcare knowledge provider with a vision for a healthier world. We share knowledge and expertise to improve healthcare outcomes.
How do we measure our impact? In support of our vision of a healthier world, we decided to review everything we were doing (our continuum of services) to help deliver better evidence , better decisions , and better systems . These three important healthcare provision components help support improved health outcomes and create a healthier world. And this review has started providing us with the framework for benchmarking and measuring the outcomes of our work. These benchmarks will provide us with the right criteria to track future performance based on external markers with tangible proof of impact. It will also be a guide for setting additional goals across the organisation. Having more evidence of what achieves the best results for health professionals will help unlock new and exciting opportunities for BMJ and hold us to account in delivering our mission.
We do this by providing a continuum of services
Delivering quality research
Improved health outcomes
Policy and guidelines influence
Synthesised learning and best practice
Strengthened workforce
Clearer clinical decisions
Which leads to
Better evidence Patient and provider engagement Improved research integrity Faster and wider access to latest evidence
Better decisions Ability to apply best evidence Improved skills, wellbeing networks and career development Better supported and skilled workforce
Better systems High quality policy and guidelines Open research systems Improved healthcare provision
This ultimately results in
Improved health outcomes
Chris Jones , Chief Executive Officer, BMJ
BMJ impact report 2021 | Creating a healthier world
Creating a healthier world Providing research, knowledge, and education to health professionals since 1840 BMJ serves a truly international community, with six offices worldwide - in the UK, the Americas, India, and China. Health professionals, authors, researchers, and students everywhere benefit from our clinical decision support tools, learning resources, and scientific and allied health titles in 18 languages. Over 10 million users visit our websites each month, and more than 60% of the journals we publish are ranked in the top quartile of medical research journals.
become a globally recognised and trusted source of information for medical researchers and practitioners and is listed as one of the world’s top five most cited general journals. Everything we do at BMJ is underpinned by our dedication to creating better evidence, better decisions, and better systems that contribute to a healthier world for all.
The Provincial Medical and Surgical Journal , established by the forerunner of the British Medical Association in 1840, has evolved into the world-renowned general medical journal, The BMJ . In 1995, it was the very first medical journal to go online. By continuously ensuring the highest editorial standards and embracing technological advances, The BMJ has
BMJ impact report 2021 | Creating a healthier world
Creating a healthier world in numbers *
Reaching over 8 million health professionals
Supporting management of the whole patient by being ‘ first to market ’ with a Comorbidities Manager
Partnering with over 8,000 institutions Serving 10 million online users every month
Maintaining The BMJ’s ranking within the top 5 of all 169 general medical journals
Keeping more than 60% of our journals in the top 25% of indexed publications within their field 1 Attracting over 200 million page views across our journals in 12 months
*As of September 2021: main source Google Analytics
BMJ impact report 2021 | Supporting information needs during the global pandemic
Supporting information needs during the global pandemic
Throughout 2020 and 2021, we’ve worked hard to provide our knowledge resources to institutions and health professionals, wherever they are in the world. We envisage that the initiatives we’ve launched during this time will have a long lasting global impact.
Being the most valuable resource for health professionals
BMJ company is listed on Google Scholar as one the most credible
The BMJ , our flagship journal, publishes for a global audience, with its unique combination of research, education, and science journalism. From the outset, the pandemic brought an urgent need for relevant evidence- based information about the new virus. Traffic to bmj.com doubled, with over four million unique users and 10 million page views recorded every month throughout 2020. The BMJ was also one of the most trusted and influential news sources throughout the year. According to Altmetric, four of the top 10 scoring articles in 2020 were related to covid-19, all of which were published in The BMJ .
A new podcast for general practitioners and a weekly covid-19 podcast have drawn in thousands of listeners: the only exclusive interview by UK Chief Medical Officer, Chris Whitty, 5 was given to The BMJ’s editor in chief and heard by over 10,000 listeners. In September 2020, nearly 10,000 people tuned into a rare, exclusive interview with America’s chief infectious disease scientist, Dr Anthony Fauci 6 . Also, The BMJ published an exclusive on the cabinet-level leak of the UK government’s plan to spend £100 billion on the Operation Moonshot programme. 7
sources on coronavirus alongside other reputable publications, including JAMA and Elsevier. Towards the end of 2020, as coronavirus infections and deaths continued to soar across the UK, The BMJ published a joint editorial with the Health Service Journal 2 . In it the editors in chief urged the government to reverse its decision to allow household mixing over Christmas to protect the NHS. The editorial was widely quoted 3 across BBC 4 national news outlets, and was used to challenge the Prime Minister in the House of Commons. Soon after, the government changed its plans.
BMJ impact report 2021 | Supporting information needs during the global pandemic
Building confidence with BMJ’s Coronavirus Hub When the pandemic hit, we responded to the global community’s urgent need for the latest information by consolidating all our relevant research, learning and knowledge resources in one place and making all the content freely available around the world. We fast-tracked production of covid guidance by BMJ Best Practice, and updated that resource more than 100 times as new evidence emerged. With this better evidence , we supported health professionals to make better decisions .
“Gosh... this is fantastic stuff. I can’t be any happier and pleased with a short and concise [BMJ Learning] course.” A UK-based general practitioner on the introduction to testing for covid-19 course review.
Since February 2020: 1.4 million people accessed BMJ’s Coronavirus Hub
5.4 million page views were recorded
6 million views of 1,000+ covid- related journal articles in just 6 months
Through this invaluable free service, we equipped clinicians, policy makers, and global public with much of the vital information they needed to help them respond to the devastating effects of covid-19.
2,812 citations were used in policy documents
24,413 citations with an Altmetric 8 score of 121,317 were achieved by our journals collection
Continuing our work Lasting legacy of the coronavirus and long covid While continuing to chart the effects of the pandemic and the world’s response to it , we are now working to understand and respond to the long term consequences of covid-19, in particular its impact on mental and physical health. Health systems need to be rebuilt, communities restored, and research efforts refocused. The damaging impact of this virus will affect many areas of global health for years to come. We will continue to use all the resources at our disposal to create positive change that improves health and healthcare around the world.
In these very challenging times, a trusted source like BMJ will not only help us fight this virus but the misinformation that goes with it.” Dr Elkanah Kabilis , Family Physician in Training, Bingham University Teaching Hospital, Jos, Nigeria.
2 million individuals used the free BMJ Best Practice covid-19 guidance
5 star mean user rating was given to the BMJ Learning covid-19 related modules
BMJ impact report 2021 | Better evidence
Better evidence Promoting knowledge to accelerate discoveries The foundation of our work is research, and BMJ is committed to improving research integrity 9 and dissemination. We do this by ensuring rapid access to the best evidence and increased involvement and access for patients. We also actively promote ethical conduct among scientists around the world and encourage researchers and institutions to share their research or raise concerns.
journals collection are wholly open access, and all research is open access in our The BMJ . During the past year, the majority of our journals migrated to ‘Transformative Journal’ status. This means that they are committed to the goal of transitioning the research they publish gradually to open access. 11 Also, since BMJ is a signatory to the Declaration on Research Assessment (DORA), 12 we fully support the need to use a broad range of metrics to assess research published in journals.
BMJ is a pioneer and champion of open access 10 : we support and promote a future built on the principle of unrestricted access to the outputs of medical research, which encourages proper scientific discourse and debate and in turn facilitates further medical advances. We believe that increased access to, and use of, medical scientific research will create a global healthcare system that is shaped by better evidence. This will benefit patients as well as health professionals, policy makers, and the public. The momentum around open access is building. Today, over one third of our
BMJ impact report 2021 | Better evidence
Supporting open dissemination of research
Across BMJ, we publish some of the world’s most widely discussed research that influences health policy and practice worldwide. We want to encourage open dissemination of international medical research and commentary, not just to satisfy mandate criteria, but to ensure that the research is widely visible and accessible. We also want to support improvements in policy and practice. From experience, we know that authors need the best route for publication. Only then, can they achieve real impact and recognition whilst setting the bar for integrity and quality of research. The evidence from the past year shows the success of open access at BMJ.
“At BMJ, we create trust by being transparent and open. We look forward to working with our authors and partners while we help to transition research to open access, with a shared goal of supporting the scientific community to help
create a healthier world.” Claire Rawlinson , Publisher, BMJ
.
19,816 pub lished open access articles 45,286 citations 1 3 3.4 million mentions of our open access articles 14
9th most cited publisher in clinical medicine
BMJ open access content receives 7 times more views than other content
10th most cited in public health
The open access content in BMJ’s hybrid journals receives 4 times more citations
8th most cited in health services research 15
BMJ impact report 2021 | Better evidence
Supporting faster and wider access to the latest evidence BMJ champions all improvements in the creation and dissemination of research evidence. But our journals reflect more than our expert editorial processes and the strength of our publishing platforms and channels. The policies and practices of our journals help shape the research evidence itself, potentially influencing everything from the selection of the research question to the final published text to the post-publication review. After such a challenging year, it is encouraging to see our portfolio increase its impact as judged by Impact Factor, most notably:
medRxiv: making preprints mainstream BMJ is a launch partner in the creation of medRxiv, and we’re proud of the role we’re playing to grow the openness and accessibility of scientific findings. medRxiv helps enhance collaboration among researchers, document the provenance of ideas, and inform ongoing and planned research through more timely reporting of completed research.
We want to reshape the way medical research is conducted and disseminated, and our co-founding of medRxiv with Cold Spring Harbor Laboratory and Yale University is helping us to do that. We are guided by one of our five company values that the best decisions depend on the best evidence , so have made it our responsibility to deliver a service that goes way beyond providing mere repositories for the research output of others. We began to see the real impact of our foundation of medRxiv when covid-19 changed everything: traffic on medRxiv leapt from 1.1m to over 14m page views per month. As early as January 2020, it passed the 1,000 mark in articles posted, some of the very first available about the coronavirus outbreak in China. These were the first of many covid-19-related papers that drove the posting rate to double month-on-month between January and May in 2020. We inferred from this that there was a strong need for better evidence.
Annals of the Rheumatic Diseases Ranked 2nd of 34 Rheumatology journals for average citations
Gut Ranked 3rd of 92 Gastroenterology & Hepatology journals for average citations
“This free, independent service for all health scientists creates an opportunity for the medical research community to rapidly and responsibly share its latest research.”
The BMJ Ranked within the top 5 of all 169 general medical journals.
In 2020, The BMJ’s impact factor rose to 39.89 (up 9.577). Its Citescore is now 6.9. Moreover, 80% of all our journals indexed in Scopus 16 also increased their Citescore, and 34 of the 38 titles that have a journal impact factor received an increase.
Theodora Bloom , Executive Editor, The BMJ
BMJ impact report 2021 | Better evidence
Fostering a genuine partnership with patients
We see these partnerships as an ethical imperative, essential to improving the quality, safety, value, and sustainability of health systems. Across our journals we encourage patient partnership through: BMJ is leading the world of medical journals in patient partnerships. We are committed to partnering with patients and the public across all aspects of our work. Their insights bring a critical dimension to our work and thinking 17 : partnerships with patients, carers, community support networks, and the public will create better evidence.
• Asking authors to complete a patient and public involvement (PPI) statement to document the involvement of patients and the public in their work • Inviting patients and members of the public to review our articles alongside traditional peer review • Welcoming patients and members of the public to write articles and perspectives for us • Encouraging authors to work in partnership with patients as co-authors on articles • Working with patients in developing our patient partnership strategies, including The BMJ international advisory panel, patient advisors, and having patients on our editorial boards
Patient and public reviewers stepping up The BMJ has recruited over 800 patients and members of the public to complete patient peer reviews on our articles. During 2020, as we saw an increase in submissions and a need to fast track articles, we reached out to our patient and public reviewers to ask if they would be willing to sign up to be fast track reviewers. Over 125 members signed up which meant we could continue to complete patient peer reviews, in a timely manner, throughout the pandemic. Between January and September 2020, 75% of the 81 fast track research submissions sent for peer review had at least one patient invited to take part in the review process.
BMJ impact report 2021 | Better decisions
Better decisions
Research alone is not enough. BMJ helps doctors improve their knowledge and skills, apply the best evidence, and make better clinical decisions with evidence-based tools and services underpinned by the latest guidance.
Addressing clinical challenges
Comorbidities are a widespread challenge to the global healthcare system. One in three adults suffers from more than one chronic health issue, and one in three adults admitted to hospital in the UK has five or more conditions. The global covid-19 pandemic has further highlighted the problem, with over 60% of patients admitted to intensive care units having comorbidities.
which prompts healthcare professionals to consider the patient’s comorbidities when accessing treatment information. This produces an initial management plan tailored to the unique needs of the patient. In fact, BMJ Best Practice is the only clinical decision support tool to do this. Access to this information will help professionals and providers improve patient outcomes, reduce costs, and avoid unnecessary treatments.
Now, more than ever, clinical teams need to adopt an integrated approach to patient care. This means recognising a patient’s comorbidities - and how they interact. Simple to say, but how do we put this principle into practice? Since its launch in 2009, multi-award winning BMJ Best Practice has consistently led the way in using the best available evidence to inform clinical practice worldwide. Last year, we launched an innovative Comorbidities Manager
BMJ impact report 2021 | Better decisions
The Comorbidities Manager from BMJ Best Practice is the first of its kind to help clinicians treat the whole patient, and is already supporting healthcare professionals around the world to make the best decisions.
97% of users would consider using the Comorbidities Manager to improve the care that they give in the future. Results from a BMJ-led 1,000+ Comorbidities Manager user survey in 2020 showed that:
Improved accuracy of clinicians’ diagnoses was shown in a 2020 study that routinely collected clinical diagnosis data from electronic medical records of a hospital that had BMJ Best Practice integrated into its clinical decision support system (CDSS).
96% of users said having a treatment
plan that is tailored to your patient’s comorbidities is helpful or very helpful.
Shorter confirmed diagnosis times and
92% of users said the guidance they
hospitalisation days were also found to be associated with CDSS implementation. 18
received as a result of adding the tool to the treatment algorithm page was helpful or very helpful.
“Recently a doctor told me how information he accessed through BMJ Best Practice saved his patient’s life. You simply can’t overstate the importance of this information.” Lisa Jenkinson , Senior Library Assistant, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
BMJ impact report 2021 | Better decisions
Connecting experts to share and compare knowledge
BMJ brings people together for discussion, debate, and learning through our series of events — some in person and, increasingly, some delivered virtually. For many years, BMJ, in partnership with the Institute for Healthcare Improvement, has brought healthcare professionals and educators together for the International Forum on Quality and Safety in Healthcare.
“BMJ plays a big and important role when it comes to innovating in healthcare as a source of global knowledge. They are bringing people together. I really don’t know of any other organisation doing the kind of things BMJ does.” Helen Bevan , Chief Transformation Officer with the NHS Horizons team, England
quality improvement and safety, and has grown over the years, developing new regional Forums in Asia and Australasia. Despite the many challenges of the pandemic, the 2021 Forum operated on an entirely virtual basis and achieved its highest ever satisfaction ratings.
The Forum has been a platform for healthcare professionals to connect, share learning and innovative ideas, and discuss effective approaches to quality and safety improvement. The biggest conference of its kind, it is a platform for dialogue, reflection, and gaining a deeper understanding of
“The opportunities that BMJ Events present are far reaching. They have the potential to change perceptions and mindsets of both healthcare professionals and the regulators of the healthcare systems within which they operate.”
Ian Leistikow , Inspector at Dutch Health and Youth Care Inspectorate and Professor at Erasmus University
BMJ impact report 2021 | Better systems
A message from our editorial director Better systems
BMJ works to improve policies and practice to develop and strengthen health systems, including launching investigations and campaigns to improve transparency in research, clinical practice, and healthcare systems.
BMJ exists to improve the quality of medical research and practice, to help doctors make better decisions, to promote partnership with patients, and to work towards a healthier world for all. Integrity and independence are core to everything we do, and we believe that transparency and openness increase the trustworthiness and therefore the usefulness of what we produce. As well as providing the most reliable and up to date information based on the highest editorial standards, our policies are
designed to push the boundaries in ways that encourage better medical research and education and better outcomes for patients. We aim to stimulate informed debate about the future of health and healthcare. We also see it as our role to campaign against wrongdoing, inequity, or injustice and to challenge the status quo in the public interest. Dr Fiona Godlee FRCP Editor in Chief, The BMJ and BMJ Editorial Director Editor of the Year, Association of British Science Writers Awards 2021
BMJ impact report 2021 | Better systems
The BMJ investigation into the formula industry has proved one of the most powerful levers for change I’ve ever been involved with. Chris van Tulleken , honorary senior lecturer, University College London, UK
The BMJ Asking questions. Questioning answers
authors to rapidly and openly respond to any issues that arrive post-publication. Moreover, The BMJ is a world renowned agent of change. Its investigative journalism has: • uncovered institutional research fraud and misconduct 21 • led to changes in national clinical practice guidelines 22, 23 • triggered parliamentary inquiries in Europe 24, 25 • moved a prominent professional society to divest from formula milk revenues 26, 27 We are now taking our investigative journalism to the next level with the launch of The BMJ Investigations Unit to tackle more instances of institutional, corporate, governmental, and regulatory
misconduct that harm patients and the public. Our work is intended to protect patients and the public’s welfare and improve health systems worldwide. A recent grant has boosted our investigative journalism capability, and allowed us to escalate our impact and influence on healthcare improvement. We plan to scale up and produce at least five investigative series over the next five years, as well as continue to seek external support for our independent journalism. The BMJ has been lauded for taking on medical, political, and corporate vested interests. We will continue to challenge the status quo where it goes against the public interest.
We’re also known for what we don’t do: no conflicts of interest are allowed in our educational articles and editorials—their power to shape clinical practice is just too great to allow for any risk of influence by vested interests. We also don’t over-focus on novel or positive results when selecting which research papers to publish—such content may be more newsworthy. Still, that sort of selection bias can tend to mislead. Other examples of editorial innovation include The BMJ’s ‘open data’ policy that demands greater transparency throughout the scientific publishing process. In addition, Rapid Recommendations was introduced to fast-track the process of turning original research evidence into clinically actionable insights. We always encourage readers to post Rapid Responses to articles, and ask
The BMJ is a known innovator in this area, often among the first to adopt a new standard. We then roll this out more widely across the BMJ journal portfolio, and are often emulated by other publishers. For instance, in the critical area of peer review, The BMJ , together with the Journal of the American Medical Association (JAMA), is a co-convenor of the prestigious biennial Peer Review Congress. 19 We have brought transparency to the peer review process through ‘open peer review’. And our use of patient reviewers also helps keep journals and authors focused on the impact a research paper might have on patient care. That focus on ‘Patient and Public Partnership’ 20 is demonstrated further by the way we challenge every submitting author to specify whether and how they have involved patients in their research.
BMJ impact report 2021 | Better systems
Challenging institutional corruption In May 2021, we co-hosted a public meeting with the All-Party Parliamentary Group to establish a ‘mandatory register of financial interests’ for UK doctors. 28 A mandatory register would list any money or benefits doctors receive in addition to their NHS salary. We continue to support campaigns for research integrity, and our organisation will continue to challenge institutional corruption. Dr Kamran Abbasi, executive editor of The BMJ has written articles on ‘state corruption’ and ‘social murder’ 29,30 in relation to the pandemic. His arguments were captured in the journalist, Owen Jones’ podcast, 31 and he was selected to feature in the Truth to Power exhibition 32 ; a multimedia photography project funded by the Arts Council that celebrates people in the media who have covered some of the biggest stories of the pandemic.
Using our health data and economics expertise to improve health systems
The BMJ Technology Assessment Group (BMJ-TAG) conducts health research for a range of institutions. This year’s work has led to some revolutionary changes to the way patients receive treatment through the NHS.
disorder. It was recently approved for NHS treatment by NICE after its appraisal by the BMJ-TAG team. This life-extending and life-enhancing treatment 35 is the most expensive drug in history to be made available by NICE and is likely to become a benchmark for subsequent gene therapies.
Work with the National Institute for Health and Care Excellence (NICE) led to the most significant breakthrough in ovarian cancer treatment in decades. Now, more than 3,000 more women each year will have access to niraparib, 33 a medicine that will keep tumours at bay for years.
Our drug assessments have seen ribociclib, a life-extending drug for incurable breast cancer, approved for NHS use – potentially benefiting 3,300 women a year. 34 Onasemnogene is one of the very first gene therapies used to help protect babies from the impact of their inherited muscle-weakening
BMJ impact report 2021 | Better systems
Acting against racism for a healthier, more equal, world
In February 2020, The BMJ highlighted the racial discrimination and health inequalities experienced by both patients and doctors in a special campaigning issue. Its huge success contributed to the launch of the NHS Health and Race Observatory in May 2021. Guest-edited by Victor Adebowale, chair, NHS Confederation, and Mala Rao, professor, Imperial College London and Medical Adviser to NHS England on Workforce Race Equality, our award winning Racism in Medicine 36 issue was the first journal publication solely focused on calling for action against racism in medicine.
The impact of this issue was considerable:
•
Prompted the NHS to announce the creation of the Health and Race Observatory 37 Exposed the lack of data on ethnic health inequalities Won the PPA Diversity and Inclusion Award 2021
• Led the University of Nottingham’s Medical Society to reverse a policy not to allow a representative from an ethnic minority group to sit on its committee • Claimed that harassment of ethnic minority students was not being monitored. This led to the BMA launching a charter calling on medical schools to end this abuse 38
•
•
“Racism is suddenly and at last everyone’s business, and acting against it is everyone’s responsibility. More so at this time than ever, we now realise, since we cannot fight covid-19 unless we fight racism.” Dr Fiona Godlee , Editor in Chief, The BMJ
We want this to be the start of wider coverage of the problems faced by patients and doctors from ethnic minorities. Racism is a public health matter – a fact made even more apparent when covid-19 struck. We will continue to raise awareness of new developments, research, and reports aimed at ending racism in medicine. We will also provide regular updates on the topics explored in our special issue.
Guest editor Lord Victor Adebowale CBE
BMJ impact report 2021 | Striving for equity, promoting diversity and campaigning for social justice
“One of the best things about BMJ is its people.” This is a familiar phrase heard regularly amongst our staff from all backgrounds and working at all levels across our business. BMJ’s commitment to diversity and inclusion is one of the reasons that our culture is so unique. We will never discriminate against anyone based on race, gender, marital status, ethnic origin, nationality, disability, sexual orientation, religion, or age. This is not just a statement. It’s something we live and breathe every day: maintaining a workplace that welcomes everyone is part of what defines us. Our diversity and inclusion team celebrates the many different minorities that make up our workforce. Their encouragement has led volunteers within the organisation to create a series of dedicated support networks. These efforts seem to be working. We were incredibly proud to read a recent diversity data collection study that provided the welcome insight that our people feel they can be open and honest about who they are. Striving for equity, promoting diversity and campaigning for social justice Leading by example in equality, diversity, and inclusion
“I want BMJ as a company to have the most inclusive environment and be an active ally of all under- represented groups. I encourage everyone at work to speak out when they witness unjust behaviour and highlight areas where we can do better.” Chris Jones, CEO
BMJ impact report 2021 | Striving for equity, promoting diversity and campaigning for social justice
Reducing the gender pay gap Relative to our competitors, BMJ has the lowest mean and median pay gap, by a significant margin – but there is still more to do.
Making all-male panels a thing of the past Women remain underrepresented in discourse and decision making around the world. Despite increasing female representation in academia, men continue to publish more than women during their careers. And, though women make up 46% of the UK’s medical workforce, few appear as experts in medical journals or on healthcare panels, and fewer still in the rooms where decisions are made. BMJ staff will not participate in, or chair, panels made up exclusively of men. When qualified women are absent, perspectives are missed, inequalities are perpetuated, and everyone loses.
The median gender pay gap for BMJ is 5.5% in favour of men. This is well below the sector average of 16%, and the current national figure which shows that on average men earn 15.5% more per hour than women As we strive for further improvement, we have implemented the following initiatives over the last 12 months: • Recruiting a dedicated lead on diversity and inclusion • Reviewing our reward processes and grading structure to ensure fairness • Evaluating hiring practices and the workplace environment to ensure women have access to equal opportunity • Tackling conscious and unconscious bias in the workplace
“Women play a vital role in the workplace which is not always reflected in their pay and position in the labour market. Undervaluing their work and under- utilising their skills is damaging to our economy. Closing the pay gap is not just beneficial to women, it will also benefit businesses and society as a whole.”
Stacey Lambert HR Director
• Highlighting gender pay gap issues to managers
•
Ensuring that all staff have opportunities for development irrespective of gender
BMJ impact report 2021 | Striving for equity, promoting diversity and campaigning for social justice
Our values Give us the focus and direction to bring about our vision for a healthier world by sharing knowledge and expertise to help health professionals improve healthcare outcomes.
Evidence-based
Patient-centred and customer-focused
Independent, courageous and unbiased
Transparent, open and trusted
Proud of people
BMJ impact report 2021 | Concluding with commitment
Concluding with commitment In this, our first-ever annual impact report, we have reflected on BMJ’s impact and mission delivery, and we’ve developed a bespoke impact measurement framework to deliver consistent understanding and reporting of our mission-driven outcomes.
As an organisation, we need to balance our financial health and our mission-driven outcomes. As we sharpen our ability to measure BMJ’s impact on better evidence , better decisions , and better systems , we will become more confident in holding ourselves accountable for delivering meaningful improvement. The new framework we’ve introduced in this report will focus our efforts around improving health outcomes through the different areas of work we undertake. These include disseminating research-
integrating policies and guidelines; strengthening the global healthcare workforce; helping professionals to make better clinical decisions, and showcasing evidence of best practice. Our new impact measurement framework sets out our broad mission to share knowledge and expertise to improve healthcare outcomes. It also highlights the nine non-financial mission outcomes that sit under our focus areas of better evidence , better decisions , and better systems.
We look forward to reporting more on our progress and learning over the next 12 months, in our 2022 impact report. Ruth Staunton Head of Corporate Marketing
BMJ impact report 2021 | References
References
8. Altmetric are metrics and qualitative data that are complementary to traditional, citation-based metrics. Available from: https://www.altmetric.com/ 9. Research integrity at BMJ offers a safe platform to share their research or raise concerns. Available from: https://www.bmj. com/company/researchintegrity/ 10. Open access at BMJ illustrates how we are actively reshaping the way medical research is conducted and disseminated. Available from: https://www.bmj.com/company/openaccess/ 11. Transformative journal status means that a journal is transitioned from a subscription or hybrid model to fully open access. 12. As a signatory to the Declaration on Research Assessment (DORA) , BMJ fully supports the need to use a broad range of metrics to assess research published in journals. Available from: https://sfdora.org/
17. Partnership in Practice . Co-produced monthly series published in BMJ Opinion. Available from: https://www.bmj. com/content/partnership-practice 18. Tao L, Zhang C, Zeng L, Zhu S, Li N, Li W, Zhang H, Zhao Y, Zhan S, Ji H. Accuracy and Effects of Clinical Decision Support Systems Integrated With BMJ Best Practice–Aided Diagnosis: Interrupted Time Series Study. JMIR Med Inform 2020;8(1):e16912. doi: 10.2196/16912 PMID: 31958069. PMCID: 6997922 19. BMJ is a co-convenor of the International Congress on Peer Review and Scientific Publication , which establishes the evidence base on which scientists can improve the conduct, reporting, and dissemination of scientific research. Available from: https://peerreviewcongress.org/ 20. Patient and public partnership The BMJ partners with patients and the public in all aspects of its work. Available from: https://www.bmj.com/campaign/patient-partnership 21. Deer B. How the case against the MMR vaccine was fixed . The BMJ . January 2011. Available from: https://doi. org/10.1136/bmj.c5347 22. Cohen D. The truth about sports drinks . The BMJ . [Internet] 2012 Jul. Available from: https://www.bmj.com/content/345/ bmj.e4737 23. Henkel D. Rapid Response to:The truth about sports drinks The BMJ . July 2012. Available from: https://www.bmj.com/ content/345/bmj.e4737/rr/595667
1. Ranking is based on both the JCR Impact Factor and ESI Total Citations. Clarivate, 2021 2. McLellan A and Godlee F. Covid 19: Christmas relaxation will overwhelm services . The BMJ . December 2020. Available from: https://doi.org/10.1136/bmj.m4847 3. Morales A and Donaldson K. UK Should Ban Christmas Household Mixing, Medical Journals Say . Bloomberg . December 2020. Available from: https://www.bloomberg. com/news/articles/2020-12-15/u-k-should-ban-christmas- household-mixing-medical-journals-say 4. Triggle N. Covid: Rash Christmas rules will cost many lives . BBC News . December 2020. Available from: https://www.bbc. co.uk/news/uk-55311717 5. Exley. C. The BMJ interview: Chris Whitty, England’s chief medical officer, on covid-19 . The BMJ . November 2021. Available from: https://doi.org/10.1136/bmj.m4235 6. Godlee F. Interview with Anthony Stephen Fauci OMRI , physician-scientist and immunologist serving as the Director of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor to the President - on changing science, long-covid, and political intrusion into health agencies via YouTube. Sept 2020. Available from: https://youtu.be/ bkoip6-yeBE 7. Iacobucci G and Coombes R. Covid-19: Government plans to spend £100bn on expanding testing to 10 million a day . The BMJ . September 2020. Available from: https://doi. org/10.1136/bmj.m3520
13. ‘ 45,286 BMJ Journal citations.’ Dimensions, 2021
14. ‘3.4 million mentions of our open access articles.’ Altmetric, 2021
15. ‘8th most cited in health services research.’ Analysis of most cited publishers ranked by total citations in 2018, 2019 and 2020 broad research areas. Dimensions, 2021 16. Scopus is the largest abstract and citation database of peer- reviewed literature. Available from: https://www.scopus.com/ home.uri
BMJ impact report 2021 | References
30. Wenham C. What went wrong in the global governance of covid-19? The BMJ . February 2021. Available from: https://doi. org/10.1136/bmj.n303 31. Are Governments Guilty of Social Murder over COVID-19? : The Owen Jones Podcast 2021 Feb; Available from: https:// www.listennotes.com/podcasts/the-owen-jones/18-live- show-are-governments-Osqb7J3jeQH/
24. Godlee F. Conflicts of interest and pandemic flu . The BMJ . June 2010. Available from: https://doi.org/10.1136/bmj.c2947 25. O’Dowd A. MPs call for full results of all past clinical trials to be made public . The BMJ . January 2014. Available from: https://doi.org/10.1136/bmj.g13 26. van Tulleken C. Overdiagnosis and industry influence: how cow’s milk protein allergy is extending the reach of infant formula manufacturers. The BMJ . December 2018. Available from: https://doi.org/10.1136/bmj.k5056 27. Mayor S. Royal college stops taking funding from formula milk firms . BMJ . February 2019. Available from: https://www. bmj.com/content/364/bmj.l743 28. Rimmer, A. Why the UK needs a mandatory register of doctors' interest: In 2021, The BMJ released a series of features articulating how nine out of 10 medical professional bodies think patients have a right to know if their doctor had financial or other links with pharmaceutical or medical device companies. Available from: https://www.bmj.com/mandatory- register-doctors-interest 29. Abbasi K. Covid-19: Social murder, they wrote―elected, unaccountable, and unrepentant . The BMJ . February 2021. Available from: https://doi.org/10.1136/bmj.n314
36. ‘Racism in medicine’ . The BMJ special issue . February 2021. Available from: https://www.bmj.com/racism-in-medicine 37. NHS Race and Health Observatory . Available from: https:// www.nhsconfed.org/networks-countries/nhs-race-and-health- observatory 38. A charter for medical schools to prevent and address racial harassment. The BMA. Available from: https:// www.bma.org.uk/media/2030/bma-med-school-charter- implementation.pdf 39. Richards M, Bloom. T and Franco. J A commitment to equality, diversity, and inclusion for BMJ and our journals . The BMJ Opinion . July 2021. Available from: https://blogs.bmj. com/bmj/2021/07/23/a-commitment-to-equality-diversity- and-inclusion-for-bmj-and-our-journals/
32. Truth to Power Exhibition . Available from: https:// truthtopowerexhibition.com/
33. Oppenheim. M. Thousands of women with ovarian cancer to access groundbreaking new drug with biggest breakthrough in three decades. The Independent . February 2021. Available from: https://www.independent.co.uk/news/ health/ovarian-cancer-niraparib-drug-women-b1787331.html 34. Campbell D. Life-extending drug for incurable breast cancer approved for NHS use. The Guardian . February 2021. Available from: https://www.theguardian.com/society/2021/ feb/26/life-extending-drug-ribociclib-incurable-breast- cancer-approved-for-nhs 35. Mahase E. NHS England agrees deal for gene therapy for spinal muscular atrophy . The BMJ . March 2021. Available from: https://doi.org/10.1136/bmj.n653
BMJ impact report 2021
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This impact report was produced by BMJ: Ruth Staunton, Ingrid Bray, Caroline Hird and Moira McClatchey. But it also had input from many others across the business. Without the latter, this report would not have been possible so we are very grateful for their knowledge and expertise.
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