Medical Centre

General practice or family medicine has historically been lauded as the “jewel in the crown” of the English National Health Service (NHS). General practice, at the heart of primary care, has continued to contribute to the high ranking of the NHS in international comparisons and evidence from several decades of research has shown that general practice in the UK has improved the nation's health. Furthermore, it has provided equitable, cost-effective, and accessible care for all with the flexibility to adapt rapidly to a changing society and political climates, such as during the COVID-19 pandemic when there was rapid implementation of remote consultation models. However, this much-admired public sector service has recently come under unprecedented political and media spotlight instigated by the pressures of the current pandemic on the NHS. This coupled with collapsing morale among general practitioners (GPs), a shrinking GP workforce, inexorable demands, increasing workload, and decr...

The government has just announced that all covid-19 restrictions in England are set to end. Boris Johnson, the UK prime minister, told MPs that he plans to remove the remaining restrictions, including the legal requirement to self isolate for people infected with covid-19. Instead of legislation, voluntary guidance will “advise” people with covid-19 not to attend workplaces. Employers will once again need to develop and implement new rules for their workplaces when the legal requirement to self isolate with covid-19 comes to an end. They should consider carefully how to develop and implement new policies fairly and safely in the workplace so that staff and customers—particularly those who are clinically vulnerable—are not put at risk. Presenteeism occurs when employees go to work despite not being well enough to perform their duties. The NHS is the largest employer in England and the NHS Staff Survey showed a drop in presenteeism in 2020 compared to preceding years.1 This is likely an ...

If you only have mild symptoms how safe is it to go into an office or other workplace? The question you should ask yourself is would you be comfortable being in the same office as someone who had a positive Covid-19 test the day before? Now that the legal requirement to isolate after a positive test in England is ending, employers will need to carry out risk assessments and implement their own infection control policies. My advice would be for employers to remain cautious for now and advise employees with symptoms or a positive Covid-19 test to stay off work for a period until we have more experience about the effect of the change in rules. I’ve had plans to go for dinner and drinks with friends for a birthday party but have tested positive. If we’re all triple vaccinated how big a risk is it if I still go? People who are fully vaccinated can still become infected. If you test positive for Covid-19, I would advise not attending the event, particularly if it is going to be in a cr...

A new report by the NHS Race and Health Observatory makes robust recommendations—we must act on them The magnitude of racial health inequalities reported in the NHS Race and Health Observatory’s recent review comes as no surprise.1 It highlighted the overwhelming, stark, widespread, and longstanding inequalities that people from ethnic minorities in the UK experience in access to healthcare and outcomes. The report found that this occurs “at every stage, throughout the life course, from birth to death” and is “rooted in experiences of structural, institutional, and interpersonal racism.”1 This evidence has been known for a long time, with the disproportionate impacts of covid-19 on people from ethnic minorities drawing even greater attention to and wider recognition of these facts.23 Will evidence, however, be enough to compel those charged with the nation’s health to acknowledge and take urgent action to redress these egregious inequalities? Firstly, there are significant gaps in the ...

Despite health applications becoming ubiquitous and with enormous potential to facilitate self-management, regulatory challenges such as poor application quality, breach of data privacy and limited interoperability have impeded their full adoption. While many countries now have digital health-related policies/strategies, there is also a need for regulatory standards and guidance that address key regulatory challenges associated with the use of health applications. Currently, it is unclear the status of countries in Africa regarding regulatory standards and guidance that address the use of health applications. This protocol published in BMJ Open describes the process of conducting a scoping review which aims to investigate the extent to which regulatory standards and guidance address the use of health applications for self-management within the WHO African Region countries. The review will follow the methodological framework for conducting a scoping study by Arksey and O’Malley (2005)...

The Health Secretary, Sajid Javid, announced on 26 January that a ‘national vaccination service’ is required to provide mass covid-19 vaccination to the population of England.[1] Speaking at a House of Commons Health and Social Care Committee meeting, Mr Javid suggested the proposed service could cover other vaccines as well as vaccines for covid-19. The rationale is that NHS General Practice is under great strain, and by removing some services that can be provided elsewhere, it will free up time for primary care teams to concentrate on their core work. Traditionally, mass vaccine programmes in England have relied largely on general practices, increasingly supported by community pharmacies in recent years. This was demonstrated to great effect during the first wave of covid-19 vaccinations where the majority of vaccines were delivered by primary care teams. GP teams have secure electronic patient record systems, and are experienced in cold storage chains, and have medical support on ...