Skip to main content


Showing posts from May, 2016

How would a decision to leave the European Union affect medical research and health in the United Kingdom?

In an article published in the Journal of the Royal Society of Medicine, I argue that the UK must remain in the European Union (EU) to protect the health of UK residents. Also at risk following a vote to leave the EU would be the recruitment of doctors and healthcare workers to the NHS, medical research and teaching and the continued world-leading status of the top UK universities.

The most important impact of a ‘leave’ vote on health would arise from its economic effects, A Treasury analysis concluded a vote to leave the EU could lead to a £36 billion a year drop in tax receipts. The economic shockwaves following a departure from the EU could lead to substantial cuts to health and social care, and there would be an immediate negative impact on the health of UK residents. Lower levels of spending on social care would further increase pressures on both community and hospital services. For example, it would become more difficult to discharge frail, elderly patients from hospitals.

In t…

How do I encourage a patient to see a pharmacist?

We are employing a pharmacist to help with treatment reviews and to see minor acute illness but we are finding resistance from some patients to seeing him, with receptionists reporting that patients are requesting appointments with 'a proper doctor' instead. How do we respond?

Pharmacists offer many potential benefits to general practices. They can free up doctors’ time, deliver cost-savings to the NHS through more rational prescribing, and improve the quality of patient care. For example, pharmacists can improve patients’ understanding of their medication and their adherence to their drug regime. An increasing number of general practices are now using pharmacists and their role will be further expanded when the GP Forward View is implemented. However, some patients may be unwilling to see a pharmacist and insist on seeing a doctor.

To overcome this resistance, it is essential that all staff are briefed about the role of the pharmacist and what to say to patients who express c…

Public Health and Primary Care in England: What does the future look like?

Earlier this week, I spoke at a joint training day for primary care and public health registrars in London on the topic of Public Health and Primary Care in England: What does the future look like?

The key points from my presentation were:
Some new NHS investment – but investment is very low by historical standardsWill the new models of healthcare delivery deliver the £22 billion efficiency savings the Treasury expects?What impact will contractual changes have? Junior doctors, consultants, GPs, public health consultantsCan primary care attract and retain enough doctors?What impact will cuts in public health budgets have on health improvement programmes and on careers in the specialty? My presentation can be viewed on Slideshare.

Impact of the National Health Service Health Check Programme on cardiovascular disease risk

Our analysis of impact of the NHS Check programme on cardiovascular disease risk was published in the Canadian Medical Association Journal on 2 May 2016. The programme had statistically significant but clinically modest impacts on the risk for cardiovascular disease (CVD) and individual risk CVD factors, although diagnosis of vascular disease increased.

Overall program performance was substantially below national targets, which highlights the need for careful planning, monitoring and evaluation of similar initiatives internationally. The effect of the programme on CVD risk was the equivalent of one CVD event (e.g. heart attack) prevented for every 4,762 people who attended a health check in a year.

For the NHS health check scheme to be effective, it needs to be better planned and implemented – our work will help highlight how this can be done. In future we plan to evaluate whether particular groups – for instance older patients – have greater health benefits from the check than young…