Medical Centre

1. Covid-19 Case Numbers.  Some signs that case Covid-19 numbers and hospitalisations are increasing. Continue to promote take-up of Covid-19 vaccination (and flu vaccination) in eligible people. 2. NHS COVID Pass. The NHS COVID pass service closed on 4 December 2023 as vaccination status no longer needs to be shown for UK or international travel and the pass is no generally needed. Patients who still need to show proof of Covid-19 vaccination can do so via the NHS App. 3. Structured Medication Reviews. Resources to support patients having a Structured Medication Review. https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/patient-information/ 4. NHS England Vaccination Strategy. NHS England’s new vaccination strategy is likely to see the end of the current GP practice enhanced services and QOF targets, with ICBs set to take over population-level management. Under the new strategy, infants and pre-school children vaccinations will probably continue to be deli...

The balance between free speech and its limitations is a challenging aspect of modern society, including academic environments like universities. In the context of universities, the promotion of free speech is vital to academic freedom and the pursuit of knowledge. Universities are traditionally places where diverse ideas and perspectives can be explored and debated. However, this freedom comes with the responsibility to ensure that speech does not incite violence, promote hate, or harm others. The legal limits on freedom of speech in societies like the UK are in place to protect individuals and groups from harm, such as laws against hate speech, incitement to violence, and defamation. These laws acknowledge that while the free exchange of ideas is fundamental, there are boundaries necessary for the protection of public order and individual rights. In  addition to these legal limits on freedom of expression, there are also social constraints on what can be said which vary from soci...

At this time of year, I am often asked by patients about Seasonal Affective Disorder (SAD) . This is a is a type of low mood or depression that is related to changes in the seasons. It typically begins and ends at about the same times every year. Most people with SAD experience symptoms starting in the Autumn that continue into the winter months. Symptoms of SAD may include: - Feeling depressed most of the day, nearly every day - Losing interest in activities you once enjoyed - Low energy and fatigue - Sleep disturbances (oversleeping or insomnia) - Changes in appetite or weight (often craving for foods high in carbohydrates) - Feeling sluggish or agitated - Difficulty concentrating - Feelings of hopelessness, worthlessness, or guilt In more severe cases there can also be thoughts of self-harm, death or suicide. The causes of SAD are not fully understood but are believed to be related to the reduction in sunlight in Autumn and Winter. This decrease in sunlight may disrupt the bod...

In the UK's National Health Service (NHS), the language we use to describe medical professionals holds significant weight. The term 'junior doctor,' a longstanding descriptor for doctors in training or those in their early postgraduate years in the UK, is now being re-evaluated. The British Medical Association (BMA) has highlighted the need for a terminology update to more accurately reflect the expertise and responsibilities of these vital healthcare professionals. Our article in BJGP Open discusses this issue further.  The Need for Change The term 'junior doctor' has been a staple in the UK medical lexicon for decades, but it fails to capture the breadth of experience and skill these doctors possess. These professionals, who may have up to a decade of training, are fully qualified and play a crucial role in patient care, performing a wide range of duties from diagnosis to complex medical procedures. The current term may inadvertently diminish their value and expe...

Pregnancy is a time of anticipation and preparation. But it's also a time when expectant mothers must be vigilant about their health — not just for themselves but for their unborn children as well. Vaccinations against COVID-19, influenza, and pertussis are vital during this period, yet many pregnant women hesitate to get these lifesaving shots. Let's delve into recent research that sheds light on effective strategies to increase vaccine uptake among pregnant women. Our study published in the Journal of Travel Medicine reviewed studies from January 2012 to December 2022, following the gold-standard PRISMA guidelines, to identify interventions that successfully increase vaccine uptake in pregnant women. The meta-analysis focused on three key diseases: COVID-19, influenza, and pertussis — all of which pose significant risks to both mother and child. Key Findings Out of 2,681 articles, 39 studies were relevant, comprising over 168,000 participants from nine different countries. I...

1. Varicella (chickenpox) vaccination The Joint Committee on Vaccination and Immunisation (JCVI) has recommended a vaccine against varicella (chickenpox) should be added to the UK’s routine childhood immunisation programme. The vaccine would be offered to all children in 2 doses, at 12 and 18 months of age.  The JCVI has also recommended a temporary catch-up programme for older children be included in the initial rollout. Chickenpox cases were significantly reduced during the pandemic due to social restrictions, meaning there is currently a larger pool of children than usual without immunity. The catch-up programme would offer them protection against greater risks from the illness through later childhood or as adults, when chickenpox can be more severe. Many other countries (such as Germany, Canada, Australia and the USA) already offer children chickenpox vaccination. The final decision about approving the proposed programme lies with the Secretary of State for Health and Social C...

 The Joint Committee on Vaccination and Immunisation (JCVI) recommending the inclusion of the chickenpox vaccine in the UK's childhood immunisation schedule is a significant step for public health. This decision aligns the UK with many other countries that have already integrated the chickenpox (varicella) vaccine into their routine childhood immunisation programmes. The implementation of the chickenpox vaccine on a national scale offers several benefits: 1. Reduction in cases: Widespread vaccination among children has the potential over time to significantly reduce the incidence of chickenpox, a highly contagious disease, among children and the wider community. 2. Prevention of complications: While chickenpox is often mild, it can lead to serious complications such as secondary bacterial infections, pneumonia and encephalitis; and can be particularly severe in immunocompromised individuals. Vaccination will help reduce the risk of these complications. 3. Healthcare burden: By redu...

The objective for the NHS in England to provide high-quality, personalised care for all patients is a vision that requires a transformative approach to healthcare delivery. This shift signifies a move from the primarily finance and target-driven models of healthcare delivery that we have now to ones that are more patient-centred, emphasising the importance of individual patient needs and outcomes as well as the well-being of NHS staff. In the international context, healthcare systems around the world are grappling with similar challenges: how to deliver care that is both high-quality and cost-effective, while also addressing the needs of an aging population and the rise of chronic diseases. Many countries are looking towards patient-centred care as a solution. The World Health Organization (WHO) has also advocated for patient-centred care as part of its strategy to strengthen healthcare systems globally. It emphasizes that patient-centred approaches can lead to better health outcomes, ...

Regular exercise is essential for good health, contributing to benefits that extend across the lifespan. In the United Kingdom, public health guidance emphasizes the importance of physical activity as a modifiable lifestyle factor that can significantly influence overall health and well-being. A dults are advised to engage in at least 150 minutes of moderate-intensity activity each week, or 75 minutes of vigorous-intensity activity, along with strength exercises on two or more days a week that work all the major muscles. Cardiovascular health sees marked improvements with regular physical activity. Exercise promotes heart efficiency, allowing it to pump blood more effectively, and reduces the risk of heart disease and stroke, which remain common health problems in the UK. Additionally, regular exercise can also help lower blood pressure and cholesterol levels, contributing to a healthier circulatory system. Bones also benefit from exercise, particularly weight-bearing activities ...

A diet rich in fruits and vegetables , complemented by a variety of high-fibre foods , is one of the foundations of good health. Eating at least five portions of fruits and vegetables daily is not just a number to aim for - it's essential for a healthier life. Here's a deeper dive into why these dietary staples are so crucial for your health: 1. The Powerhouse Pair: Fruits and Vegetables Rich in essential vitamins, minerals, and dietary fibre, yet low in calories, fruits and vegetables are the unsung heroes of a health-conscious diet. Regular consumption of this dynamic duo can significantly diminish the risk of chronic conditions such as heart disease, hypertension, and certain cancers. The presence of vitamin C, along with a symphony of phytonutrients, bolsters the body's health defences, offering a spectrum of benefits that go beyond basic nutrition. 2. The Fibre Effect: Sustenance and Protection High-fibre foods act as the body's natural sweep, promoting a robust di...

The European Centre for Disease Control (ECDC) has highlighted a stark reality: migrants in Europe are disproportionately affected by undiagnosed infections, including tuberculosis, blood-borne viruses, and parasitic infections. Many migrants also fall into the category of being under-immunised. The call to action is clear — innovative strategies must be developed to deliver integrated multi-disease screening within primary care settings. Despite this call, the United Kingdom's response remains fragmented. Our recent in-depth qualitative study published in the Journal of Migration and Health delves into the current practices, barriers, and potential solutions to this pressing public health issue. Primary healthcare professionals from across the UK participated in two phases of this qualitative study through semi-structured telephone interviews. The first phase focused on clinical staff, including general practitioners, nurses, healthcare assistants, and pharmacists. The second pha...

In a letter published in the British Medical Journal , I discuss why the UK government must be more proactive about drug addressing shortages in the NHS. The lack of drugs such as methylphenidate required for the treatment of attention deficit/hyperactivity disorder (ADHD) is the latest of many medication shortages we have seen in the UK in recent years.1 These shortages are now too frequent and waste the time of NHS staff such as general practitioners and pharmacists who have to spend time counselling patients and sourcing alternative drugs instead of focusing on more relevant work. They are also very stressful for patients who risk going without key drugs with potentially adverse consequences for their health. For people with ADHD, for example, this could mean going without medication that they require to function effectively at work and school and in their personal relationships. We need a much more proactive approach from the government, which needs to work with drugs manufacturers...

As the Covid-19 Inquiry progresses, it provides an opportunity for reflection on the many challenges faced by healthcare workers like myself during the early days of the pandemic. At that time, the SARS-CoV-2 virus was a largely unknown entity; clinical guidelines were still under development; and personal protective equipment (PPE) was scarce. For those on the NHS frontline, the experience was marked by a mix of anxiety, urgency, and dedication to the patients we were trained to serve.  Unfamiliar Territory  In the initial stages, Covid-19 was a "novel" coronavirus, the key word being "novel." There was a scarcity of data, and the disease was manifesting in ways that were not entirely well understood. As primary care physicians, we were suddenly thrust into the realm of the unknown, treating patients with undifferentiated respiratory illnesses that did not yet have well-defined and evidence-based treatment protocols.  The Personal Risk Factor  One of the most daunt...

Postgraduate students in universities in the UK will generally undertake a research project as part of their degree. How can academics successfully support their students to ensure they have a good learning experience and successfully complete their research project? The first meeting with the student sets the foundation for a successful supervisory relationship. It’s essential for academics to establish clear expectations, foster effective communication, and provide the necessary guidance to support the student during their research project. 1. Introduction & Background: Begin the meeting by introducing yourself and providing an overview of your research expertise and experience. Ask the student to introduce themselves and their background, including their research interests and motivations for pursuing the project. 2. Research Project Overview: Provide a detailed overview of the research project, including its objectives, scope, and any specific research questions that need to ...

With England’s NHS under immense pressure even before the full onset of winter, here are some tips on how you can make the most of the NHS, use health services more appropriately, and obtain the care you and your family need to protect your health and wellbeing. Attend for appointments for medication reviews and for the management of long-term conditions when invited. This is important because it helps to ensure that your medication is up-to-date and that your condition is being managed effectively. Take-up the offer of Covid-19 and flu vaccinations if you are eligible. Vaccinations are the best way to protect yourself from these serious illnesses. Also take up any other NHS vaccinations you and your family are eligible for. Use the NHS app to book appointments, view your GP medical record and order repeat prescriptions. This is a convenient and efficient way to manage your healthcare. Be aware of the range of options for NHS care – including opticians, pharmacists, self-referral servi...

In this post, I will discuss methods used to measure the frequency of disease: incidence and prevalence . These are essential tools for governments, health care planners, doctors, public health specialists, and epidemiologists in their efforts to protect the health of the public. Incidence is the rate at which new cases of a disease occur in a population during a specified time period. It is calculated by dividing the number of new cases by the population at risk during that time period. Incidence Rate =  Number of new cases / Person-time at risk  × N Where N is a number such as 1,000 or 100,000. For example, if there were 100,000 myocardial infarctions in England each year, the annual incidence would be 1.75 per 10,000 people (100,000 / 57,000,000 x 10,000). Prevalence is the proportion of individuals in a population who have a disease or other health outcome of interest at a specified point in time (point prevalence) or during a specified period of time (period pr...

A new campaign from NHS England and the UKHSA aims to raise awareness about the prevalence and risks of urinary tract infections (UTIs), particularly among older people and carers, and to reduce hospital admissions related to UTIs. The campaign offers advice on preventive measures. It emphasizes the importance of staying hydrated, going to the toilet as soon as the need arises, and maintaining hygiene in the genital area. Resources, including posters, are being made available to healthcare services, charities, royal colleges, and care homes to disseminate this information as widely as possible. The guidance comes ahead of a potentially busy winter season for the NHS, a time when the health service is usually under increased pressure. As part of a larger effort to manage healthcare resources, the campaign encourages the use of alternative services like NHS 111, community pharmacists, and urgent care walk-in centres for less critical cases. This is in line with the broader NHS plan of e...

In this post, I will discuss sensitivity, specificity and positive predictive value in relation to diagnostic and screening tests. Many more people have become aware of these measures during the Covid-19 pandemic with the increased use of lateral flow and PCR tests. In clinical practice and public health, sensitivity, specificity, and predictive value are important measures of the performance of diagnostic and screening tests. These measures can help clinicians, public health specialists and the public to understand the accuracy of a test and to make informed decisions about its use in patient care. Sensitivity: The proportion of people with a disease who test positive on a diagnostic or screening test. Sensitivity = True Positives / (True Positives + False Negatives) Specificity: The proportion of people without a disease who test negative on a diagnostic or screening test. Specificity = True Negatives / (True Negatives + False Positives) Positive predictive value (PPV): The proporti...