Medical Centre

Throughout the pandemic, the UK’s covid-19 data systems have been guiding global as well as local policies. The well-established health information systems combined with the more recently established National Immunisation Management System in England provided timely information on infections, emergence of new variants, and the value of different interventions. But one of the most important contributions from the UK came from the ability to rapidly track vaccine effectiveness.  Vaccination is the best method for societies to reduce the severity of illness and number of deaths from covid-19; and to start to return to a more normal way of living, working , and studying.[1] But vaccination programmes need to be evidence-based, so that vaccines and healthcare resources are used appropriately, and there is equitable vaccine delivery. The covid-19 pandemic has shown the importance of data from medical records and the National Immunisation Management System in guiding national vaccinati...

There was no mention from the Chancellor, Rishi Sunak, in his speech on Wednesday 23 March 2022 about the continued funding of Covid-19 testing for NHS staff in England. We need the government to clarify this urgently and confirm whether twice weekly testing of healthcare workers will continue or stop in April 2022. Under current guidance, NHS staff are required to test for Covid-19 twice weekly and report their results before coming to work. If testing is to continue from April onwards, then the NHS will have to find this funding from its existing budgets, reducing funding for other areas of care. There has been discussion about staff paying for their own testing. My view is that if testing is required by NHS employers, they will need to fund the tests. Staff cannot be asked to fund their own tests if this is a condition of their employment. Ending regular Covid-19 testing of NHS will increase the risk of infection spreading to vulnerable patients. But there are also costs associated ...

The recent increase in Covid-19 rates in the UK is concerning although, to some extent, an increase in rates was expected now that control measures have ended in England, with the other three UK countries also ending most control measures as well.  We are also seeing signs of increased NHS pressures with more presentations of people with suspected or confirmed Covid-19 in primary care and hospital admissions increasing. The number of NHS staff off work due to Covid-19 is also adding to NHS pressures. A key message for the public is that vaccination is essential. Many people have not come forwards for a booster vaccine, particularly in London and other large cities. Three doses of vaccine are essential to reduce the risks of serious illness and death from Covid-19. A second booster programme is also now starting for the most vulnerable people in our society: people aged 75 years and over this living in care home and people who are immunocompromised. The additional booster will provi...

I have much bigger healthcare concerns than getting COVID-19, and the NHS doesn’t help me with them. Why should I bother to help them by getting this vaccine? This is a question that some people often ask. By getting the Covid-19 vaccine, you are protecting yourself as well as reducing pressures on the NHS. Over 10 billion Covid-19 vaccines have been giving globally; and they have proven to be very safe and effective. The number of Covid-19 cases in the UK remains very high. Vaccines are protecting us and without them, we would be seeing many more people who are seriously ill or dying from Covid-19.  By getting vaccinated against Covid-19, you are substantially reducing your risk of a serious illness that may lead to you requiring hospital treatment or even dying. Even if you don’t need hospital treatment, Covid-19 can still be an unpleasant illness that can make you unwell for a few weeks or leave you with long-term complications.  The risks from Covid-19 are particularly hig...

On 24 February 2022, the UK government removed the legal requirement for people in England to self-isolate after a positive covid-19 test result, with the other UK nations also easing restrictions.1 In doing so, the UK is acting ahead of many of its international peers to embark on a “vaccines only” strategy, hoping that existing immunity in the population will allow a “return to normal.” This view is in sharp contrast to public opinion. In a recent poll by market research company YouGov, only 17% of respondents thought that ending mandatory self-isolation was appropriate.2 The removal of legal restrictions makes the people of England part of an experiment in which much remains uncertain.3 This is acknowledged by chief government advisers Chris Whitty and Patrick Vallance, who accompanied Boris Johnson’s announcement with a warning that rates of covid-19 infection and hospital admission remain high.4 Of equal concern, the government’s announcement also introduced plans to scale back tw...

The rise in demand for healthcare by an ageing population together with budgetary constraints has put great pressure on the availability of adult social care (ASC). In response, healthcare organisations and researchers have developed practices of care and support, focusing on prolonging functional independence  This is done through exploring possible risk factors associated with unplanned outcomes, typically readmissions to hospital or through the use of predictive models to forecast outcomes.  Predictive models are widely used by health care providers in the UK and US due to their potential to inform early interventions. However, equivalent models for predicting new onset of long-term ASC, defined as need for help with tasks of daily living in the community or in care homes, are rare, particularly those using administrative data. In this study published in Age and Ageing , we describe risk factors for long-term ASC in two inner London boroughs and develop a risk prediction mo...

The intense micromanagement of general practices by NHS England since the start of the Covid-19 pandemic in early 2020 has shattered the illusion that NHS general practitioners are truly “independent”. For example, during the pandemic, NHS general practices have often received weekly updates from NHS England on how they should provide primary care services.[1] The opening hours and working arrangements of general practices are also highly regulated by NHS England. And general practitioners are not independent contractors in the same way that professionals working in other fields or indeed primary care physicians working overseas would recognise. General practitioners are not even able to offer private medical services to their patients in the same way as NHS Trusts or dentists are able to do. In effect, they have all the disadvantages of being self-employed contractors and none of the benefits of being NHS employees. For more than a decade, primary care in England has suffered from und...