Medical Centre

There was a lot of discussion in the government’s 10 year health plan about digital interventions such as giving people online access to their medical records. But does this improve healthcare delivery and clinical outcomes? This was the topic of our recent systematic review published in the journal BMJ Quality and Safety . We found that giving people online access to their medical records increased self-reported patient-centredness and improved some aspects of patient safety. But many questions about the benefits of online access remain unanswered.  The Good News: Empowering Patients On the positive side, we found clear evidence that giving people online access to their medical records increased self-reported patient-centeredness. What does that mean in simple terms? Patients felt more involved, informed, and in control of their own care. This shift from a passive recipient to an active participant is a cornerstone of modern healthcare and is a significant win for patient empowerm...

The government's recently published 10-Year Health Plan outlines a strategic vision for the National Health Service (NHS) in England, focusing on shifting care from hospitals to community settings, making greater use of digital technology like the NHS App to improve the efficiency and accessibility of health services, and prioritising preventive care over reactive treatment. While these objectives are commendable, they have been present in government plans spanning the last three decades, raising concerns about how successfully they will be implemented. Although very welcome, the increases in NHS funding in the plan are not as large as those seen under the previous Labour government from 1997-2010. This disparity in financial commitment could significantly impact the scope and pace of the proposed reforms if not matched by substantial increases in NHS efficiency and productivity. Furthermore, a heavy reliance on digital solutions, risks excluding vulnerable populations. Elderly ind...

As a university academic, I am disheartened by the way some politicians and sections of the media portray overseas students. Rather than acknowledging the many economic, cultural, and academic benefits these students bring to the UK, they are too often depicted as a burden. This is a narrative that is not only misleading but potentially damaging. International students choose to come to the UK because of the global reputation and quality of our universities. Despite the very high tuition fees they are charged, they continue to enrol in large numbers. These students bring with them diverse perspectives, enrich our academic communities, and foster global networks that benefit British research, innovation, and diplomacy. The financial contribution of international students is also well established. They help sustain many of our universities, support thousands of jobs across the country, and contribute billions to the UK economy each year. Beyond that, they play an integral role in cultura...

My new editorial in the BMJ discusses the GP Quality and Outcomes Framework (QOF). My conclusion is that QOF in England requires selective reform rather than wholesale abolition. While QOF initially improved recorded quality of care through financial incentives,  these gains are not always sustained long-term and may not reflect true clinical improvements. Policymakers should be encouraged to retain the most effective elements — particularly those related to early detection and management of long-term conditions — while removing less useful or overly bureaucratic aspects. Going forward, QOF should be integrated into a broader strategy that supports sustainable quality improvement, continuity of care, and minimised administrative burden, using developments in information technology to support better outcomes and reduce health inequalities. Majeed A, Molokhia M. Impact of pay for performance in primary care . BMJ 2025; 389 :r1171 doi:10.1136/bmj.r1171

A properly weighted and adequately resourced funding model for general practices n England is essential if we are to reduce health inequalities and ensure high-quality primary care for all. The announcement of a review of the Carr-Hill Formula is therefore very welcome and long overdue. The current NHS funding formula for general practice in England has not kept pace with changing population needs and does not sufficiently account for levels of deprivation or the complexity of care required in more disadvantaged communities. We know that general practices in deprived areas face higher levels of multimorbidity, greater social complexity, and significantly greater demand. Yet NHS funding for primary care has not adequately reflected these realities. It is also essential that any changes to the Carr-Hill Formula are accompanied by an overall increase in funding for NHS general practice in England. Simply redistributing a fixed pot of funding risks creating new pressures in other areas tha...

MPs who voted in support of assisted dying — and indeed many doctors and other healthcare professionals who support such measures — may not have fully considered the profound practical challenges this would present for the NHS and for medical education and training. Implementing an NHS-based assisted dying service would be a vast and complex undertaking. At present, the NHS is neither prepared nor equipped to deliver such a service in a safe, equitable, and ethical way. There is no public funding allocated for assisted dying. As Secretary of State Wes Streeting has rightly pointed out, any future funding would inevitably have to come at the expense of other health services that are already under considerable strain. Beyond funding, the educational and professional implications for the medical workforce have barely been addressed. There has been no clear plan for how assisted dying would be integrated into undergraduate medical education or postgraduate clinical training — nor how issue...