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Lambeth CCG 2017 Award for Outstanding Contribution to Primary Care

I was very honoured to have won the 2017 Lambeth CCG Award for Outstanding Contribution to Primary Care. Lambeth CCG noted that "Dr Majeed has made a huge contribution to primary care research knowledge as well as provide high quality kind care to his patients. Dr Majeed was recognised recently in Pulse magazine as one of the 50 most influential GPs in the UK."
Recent posts

We need activity-based funding and a more tightly defined contract for NHS general practices

In a letter published in the British Medical Journal, I respond to comments from Dr David Shepherd and Dr Hendrik Beerstecher about an editorial I wrote on shortages of general practitioners in the NHS. Dr Shepherd argues that capitation-based funding for general practice can work if the total amount of funding was increase and better methods were used to allocate funds to general practices. Dr Beerstecher argues that there is a mismatch between the supply of general practitioners and demand for their services.

In my response, I state that that increasing the amount of funding for primary care would be a step forward. Moving from the current Carr-Hill formula for allocating budgets to general practices to a formula with more patient level clinical data would also be helpful. But case mix adjusted formulas such as the Johns Hopkins adjusted clinical groups (ACG) system have limitations—particularly when used for smaller populations such as those covered by the typical NHS general prac…

Video consultations can improve both access to GPs and patient experience

The NHS should make better use of video consultations because they can boost patient access and save time and money for both patients and doctors, concludes preliminary research presented at this year’s International Forum on Quality & Safety in Healthcare in Kuala Lumpur (24-26 August).

Current challenges in the UK medical workforce are well known, making accessing a GP in a timely manner difficult, say the researchers (including myself) from Chelsea and Westminster Hospital NHS Foundation Trust and the Department of Primary Care and Public Health at Imperial College London.

The estimated total number of consultations in England rose from 224.5 million in 1995-6 to 303.9 million in 2008-9, with an average wait for a GP appointment of two weeks in some parts of the country. In light of these difficulties, weset up a trial video consultation clinic in two busy London general practices, with lists of nearly 10,000 patients.

Twice weekly video clinics were set up for 23 months to ga…

Global deaths, prevalence and disability for chronic obstructive pulmonary disease and asthma

A recent paper from the Global Burden of Disease (GBD) Chronic Respiratory Disease Collaborators examined the burden of ill-health caused by chronic obstructive pulmonary disease (COPD) and asthma. The paper was published in the journal The Lancet Respiratory Medicine.

COPD and asthma are common diseases with a heterogeneous distribution worldwide. In the paper, we presented findings for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year.

We found that in 2015, 3.2 million people died from COPD worldwide, an increase of 11·6% compared with 1990. There was a decrease in age-standardised death rate of 41·9% but this was counteracted by population growth and ageing of the global population. From 1990 to 2015, the prevalence of COPD increased by 44%, whereas age-standa…

Does the use of point-of-care testing improve the cost-effectiveness of the NHS Health Check programme?

A paper published in the journal BMJ Open examines if the use of point of care testing is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check programme in primary. To address this question, we carried out an observational study, supplemented by a mathematical model with a micro-costing approach.

We collected data on cost, volume and type of pathology services performed at seven general practices using point of care testing and a pathology services laboratory. We collected data on response to the NHS Health Check invitation letter and DNA rates from two general practices.

We found that the costs of using point of care testing to deliver a routine NHS Health Check is lower than the laboratory-led pathway; with savings of £29 per 100 invited patients up the point of cardiovascular disease risk score presentation. Use of point of care testing can deliver NHS Health Check in one sitting, whereas the laboratory pathway offers patients…

Gender differences in hospital admissions for cardiovascular events and procedures in people with and without diabetes

An article published in the journal Cardiovascular Diabetology examines gender differences in hospital admissions for major cardiovascular events and procedures in people with and without diabetes.

Secondary prevention of cardiovascular disease (CVD) has improved immensely during the past few decades but controversies persist about the cardiovascular benefits among women with diabetes. We investigated 11-year trends in hospital admission rates for acute myocardial infarction (AMI), stroke, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) in people with and without diabetes by gender in England.

We found that diabetes-related admission rates remained unchanged for AMI, increased for stroke by 2% and for PCI by 3%; and declined for CABG by 3% annually. Trends did not differ significantly by diabetes status. Women with diabetes had significantly lower rates of AMI and stroke compared with men with diabetes. However, gender differences in admission rates f…

The diagnosis and management of Scarlet Fever in primary care

An article published in the London Journal of Primary Care discusses the diagnosis and management of Scarlet Fever. There has been a recent increase in the incidence of scarlet fever with most cases presenting in General Practice and Emergency Departments. Cases present with a distinctive macro-papular rash, usually in children. In patients who have the typical symptoms, a prescription of a suitable antibiotic such as phenoxymethylpenicillin (Penicillin V) should be made immediately to reduce the risk of complications and the spread of infection.

A typical presentation of scarlet fever
An 8-year-old girl is brought to see you at your practice. She has a sore throat, abdominal pain and has been vomiting. Her health was fine until two days ago. Initially, she noticed pain on swallowing and had a temperature of 38 °C. Her parents decided to seem medical advice once they noticed the ‘sandpaper-like’ rash on her trunk and the inside of her elbows. When you examine her tongue, the enlarged …