Medical Centre

Demand for urgent care in England continues to rise with increasing numbers of attendances at emergency departments, and the associated growth in unplanned hospital admissions and healthcare costs. With NHS budgets under severe pressure, using emergency services appropriately will be important in an era of financial austerity in healthcare. Estimates of patients attending with conditions deemed non-urgent or inappropriate for accident and emergency services vary widely, from 6 to 80%. Previous research suggests that general practitioners (GPs) working in emergency departments can reduce referral rates, diagnostic testing, the proportion of patients who become emergency hospital admissions, and inappropriate attendances. However, little of this previous research is recent (much of it was published nearly 20 years ago) and new models of care for GPs working in and alongside emergency departments have now been developed, which remain to be evaluated. In a paper published in JRSM Shor...

In a paper published in the journal PLoS One , Dr Jessica Jones Neilsen and colleagues from the Department of Primary Care & Public Health at Imperial College London reported that the number of children admitted to hospital for problems related to obesity in England and Wales quadrupled between 2000 and 2009. Nearly three quarters of these admissions were to deal with problems complicated by obesity such as asthma, breathing difficulties during sleep, and complications of pregnancy, rather than obesity itself being the primary reason. Although some of the increase is likely to be due to improved case ascertainment, conditions associated with obesity in children and young people are imposing greater challenges for health care providers in English hospitals. The authors concluded that most inpatient care is directed at dealing with associated conditions rather than primary assessment and management of obesity itself. With levels of admissions for obesity-related diagnos...

Patients with more timely access to general practitioner (GP) appointments make fewer visits to accident and emergency departments, suggests a study published in the journal PLoS One . The findings of the article reinforce the need for more investment in GP services . People living in more affluent areas areas also had lower rates of use of A & E. Improving access to GPs by employing more GPs in deprived, urban areas and giving primary care teams more resources could help improve access to health services, improve quality of care and reduce pressures on other parts of the NHS. Lead author Thomas Cowling, from the School of Public Health at Imperial College London, said: “ This is the first national evidence of an association between access to GP appointments and rates of A&E attendances in England. Policy makers should consider this relationship when designing plans to reduce the use of A&E departments. A new era of service commissioning, led by GPs, has just started in ...

Countries across the Eastern Mediterranean Region face unprecedented health challenges, and are buffeted by demographic change, a dual disease burden, rising health costs, and the effects of ongoing conflict and population movements – exacerbated in the near-term by instability arising from recent political upheaval in the Middle East. However, health agencies in the region are not well positioned to respond to these challenges because of a dearth of good quality health research. An article published in the Journal of the Royal Society of Medicine by Professor Salman Rawaf and colleagues presents an assessment of the current state of health research systems across the Eastern Mediterranean based on publicly available literature and data sources. The review finds that – while there have been important improvements in productivity in the Region since the early 1990s – overall research performance is poor with critical deficits in system stewardship, research training and human resour...