Hospital admissions for sickle cell disease in England

Sickle cell disease (SCD) is a rising cause of mortality and morbidity in England and consequently an important policy issue for the National Health Service. In an article published recently in the Journal of Public Health, Ghida Aljuburi and colleagues examined SCD admission rates in England using data from the Hospital Episode Statistics database. They reported that the admission rate for SCD per 100 000 people in England has risen from 21.2 in 2001/02 to 33.5 in 2009/10, a rise of over 50%. London accounted for around 75% of all SCD admissions in England. Nearly 60% of patients admitted with SCD were discharged within 24 hours. The authors concluded that because over half of all patients admitted with SCD were discharged within 24 hours, some of these admissions could be prevented through better ambulatory care of patients with sickle cell disease.

In a letter also published in the Journal of Public Health in response to some comments from Radoslav Latinovic and Allison Streetly, Ghida Aljuburi and I discuss how this analysis could be improved: for example, through the use of linked data that would allow examination of the role of re-admissions and the quality of patients' primary care services.

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MPH Student Presentations on the NHS Care.Data Programme

As part of a session on primary care data in the Health Informatics module on the Imperial Master of Public Health Programme, I asked students to work in two groups to present arguments for and against the NHS Care.Data programme. Care.Data is an NHS programme that will extract data from the medical records held by general practitioners (GPs) in England. The Care.Data programme takes advantage of the very high level of use of electronic medical records by GPs in England. After extraction, data will be uploaded to the NHS Health and Social Care Information Centre (HSCIC). The data will then be used for functions such as health care planning, monitoring disease patterns and research. The programme has been controversial with proponents arguing that the programme will bring many benefits for the NHS and the population of England; and opponents arguing it is a major breach of privacy. You can view the two presentations to help inform you further about these arguments: Arguments fo...

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...

Talking to Patients About Weight-Loss Drugs

The use of weight-loss drugs such as GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) has increased rapidly in recent years. These drugs can help some people achieve significant weight reduction, but they are not suitable for everyone and require careful counselling before starting treatment. By discussing benefits, risks, practicalities, and uncertainties, clinicians can help patients make informed, realistic decisions about their treatment. Key points to discuss with patients 1. Indications and eligibility These drugs are usually licensed for adults with a specific BMI. They should be used alongside lifestyle interventions such as dietary change, increased physical activity, and behaviour modification. 2. Potential side effects – some can be serious Common adverse effects include nausea, vomiting, diarrhoea, and abdominal discomfort. Less common but more serious risks include gallstones, pancreatitis and visual problems. Patients should know what to watch for a...

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