Medical Centre

As the NHS braces for a challenging winter season, it is grappling with a "quad-demic" of health emergencies caused by influenza, Covid-19, norovirus, and respiratory syncytial virus (RSV). This confluence of viral threats poses a significant risk to public health in the UK as well as putting strain on healthcare resources, emphasising the importance of preventive measures to safeguard public health. Public health measures such a vaccination and good personal hygiene are pivotal in reducing the impact of these illnesses, particularly for vulnerable groups. The Four Viruses: What Are They? Influenza: A highly contagious respiratory infection that causes significant illness each winter. It can lead to severe complications, particularly in the elderly, young children, pregnant women, and those with chronic health conditions. Covid-19: Though its most acute phase has passed, Covid-19 remains a concern, especially as new variants of SA...

Pregnancy is a time filled with excitement, anticipation, and often, a touch of anxiety. Among the many decisions expectant parents make, one of the most crucial involves protecting the health of both the mother and the baby. Vaccination during pregnancy plays a vital role in this, yet uptake remains worryingly low in many regions. The Importance of Vaccination During Pregnancy Vaccines offered during pregnancy, such as those against influenza, pertussis (whooping cough), COVID-19, and the newly added respiratory syncytial virus (RSV) vaccine in the UK, are designed to safeguard the health of mothers and their babies. For example: Influenza vaccine : Protects against severe complications from flu, which can be more serious during pregnancy. Pertussis vaccine : Provides critical early protection for babies against whooping cough until they are old enough to be vaccinated themselves. COVID-19 vaccine : Reduces the risk of severe disease and complications from COVID-19 during pregnancy. D...

From the end of 2026, the UK government will require the addition of folic acid to non-wholemeal flour. This is an important step forward in public health; an intervention that could prevent up to 200 cases of neural tube defects annually as well as improving the health of pregnant women and their babies.  Why Folic Acid Matters Folic acid is essential for healthy cell growth and development. For pregnant women, folic acid plays a critical role in the early stages of foetal development, particularly in forming the neural tube, which develops into the brain and spinal cord. An insufficient folic acid intake during pregnancy can lead to neural tube defects such as spina bifida and anencephaly—serious conditions that can result in lifelong disability for the child or even loss of life. While women planning to become pregnant are encouraged to take folic acid supplements, about half of pregnancies in the UK are unplanned. This means that many women may not be taking supplements at the ...

The NHS App, launched in 2019, was designed to revolutionise how patients engage with their healthcare, offering features such as booking appointments, viewing medical records, and ordering prescriptions. While the app has seen substantial uptake—with millions registering and engaging—it appears that the benefits of this digital innovation are not evenly distributed across the population as we report in our article in the Journal of Medical Internet Research . The Promise of the NHS App Digital health tools like the NHS App hold the potential to empower patients, improve self-management of health, and increase access to care. From March 2020 to June 2022, millions of users logged into the app, ordered prescriptions, and accessed medical records. However, a closer look at the data reveals disparities in who is using these features. The Digital Divide in Action Our recent study highlights how sociodemographic factors influence app engagement. Key findings include: Socioeconomic Disparit...

In today's interconnected world, migration is a key feature of modern societies. The UK has become home to a significant number of migrants seeking new opportunities or fleeing difficult circumstances. Yet, this group often faces unique healthcare challenges, including the risk of undiagnosed infectious and non-communicable diseases and incomplete vaccination records. Addressing these issues is crucial not only for individual well-being but also for broader public health. In a recent article published in the journal BMC Medicine , we evaluated Health Catch-UP!, a digital tool designed to bridge these healthcare gaps. Understanding the Need Migrants when compared to local populations are more vulnerable to certain health conditions that are common in their countries of origin. These range from infectious diseases like hepatitis and latent tuberculosis (TB) to non-communicable conditions like diabetes and high cholesterol. Unfortunately, current healthcare services in the UK often ov...

The UK and many other countries saw the implementation of numerous non-pharmaceutical interventions (NPIs) during the Covid-19 pandemic. Policy-makers, clinicians and public health specialists need to be more aware of the limitations of observational studies in evaluating non- NPIs. The lack of high-quality randomised controlled trials (RCTs) during the Covid-19 made it difficult to isolate the specific effects of individual NPIs and disentangle them from the complex interplay of different interventions. While observational studies provided rapid insights in an evolving crisis, they also presented challenges due to confounding factors and the concurrent implementation of multiple NPIs. Prioritising adaptive frameworks for real-time RCTs, particularly cluster-randomized trials, in future health crises could strengthen the evidence base and provide more robust insights for policymakers. Although the UK has a good public health data infrastructure compared to many other countries, it can ...

People with many long-term conditions are at increased risk of cardiovascular disease. If you or someone you care about is living with a long-term condition, here are some practical steps people can take to reduce their risk: 1. Attend for Scheduled Check-Ups: Make sure you attend for any scheduled check-ups. For example, to check your blood pressure, weight, blood sugar levels and cholesterol; or to review your medication. 2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity and avoiding smoking; all of which can reduce the risk of cardiovascular disease. For exercise, you should aim for at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week. But even small changes – such as a modest increase in the amount of exercise you take each day – can have positive benefits. A diet rich in fruits, vegetables and whole grains and with less intake of processed foods and sugary drinks is also helpful for your hea...

Multiple sclerosis (MS) is a complex neurological condition that affects the central nervous system. While much of the focus on MS is often on the symptoms related to the nervous system, recent research has shed light on another important aspect: the increased risk of vascular diseases, such as diabetes and hypertension, in people living with MS (PwMS). Let's take a closer look at what this means and how it impacts overall health based on the findings of a recent paper from my team published in the Multiple Sclerosis Journal . What the Research Shows A large study conducted between 1987 and 2018 looked at the health records of over 12,000 people with MS and compared them with over 70,000 individuals without MS. The findings were significant: Increased Risk of Diabetes : People living with MS have a higher risk of developing type 2 diabetes after being diagnosed with MS. Over 10 years, the incidence rate of diabetes was notably higher in people with MS compared to those without. Wom...

The COVID-19 pandemic was a profound global health crisis that exposed vulnerabilities in our public health systems and forced rapid adaptations worldwide. In the absence of effective pharmaceutical solutions at the pandemic's onset, non-pharmaceutical interventions (NPIs) such as physical distancing, mask-wearing, and lockdowns became essential tools to mitigate the spread of SARS-CoV-2. While NPIs were crucial in reducing transmission and preventing healthcare system overload, their implementation came with significant social, economic, and psychological costs. Reflecting on these measures - as we do in our recent article in the British Medical Journal - offers valuable insights into preparing for future health shocks. Evaluating the Effectiveness of Non-Pharmaceutical Interventions NPIs aim to limit person-to-person contact and control the spread of infectious diseases, but they are not without challenges. The simultaneous application of multiple interventions during the pandem...

Increasingly, academic dissertations and papers require a lay summary as well as a scientific abstract. It is important to distinguish between the style and content of the scientific abstract and the lay summary. These sections serve different purposes and are intended for different audiences. In this blog, I aim to help you write both effectively, supported by examples. Scientific Abstract The scientific abstract is written for experts, researchers and professionals in your field. It is a concise summary of your research that includes the background, methods, key findings, and implications. The language used is technical and generally assumes the reader has a good understanding of the subject. What to Include in the Abstract: Background/Context: Briefly explain the problem your research addresses. Aim: State the specific objectives of the study. Methods: Summarise the methods used, including any important experimental techniques or data sources. Results: Clearly outline the main findi...

A high-fibre diet is crucial for maintaining overall health and well-being. Fibre, a type of carbohydrate that the body cannot digest, plays a key role in various bodily functions. Here are some of the primary benefits of incorporating more fibre into your diet: 1. Improved Digestive Health:  Fibre is essential for maintaining a healthy digestive system. It adds bulk to the stool, which helps prevent constipation and promotes regular bowel movements. Insoluble fibre, found in foods like whole grains and vegetables, passes through the digestive tract relatively intact and speeds up the passage of bowel contents. 2. Helps with Weight Management:  High-fibre foods can be more filling than low-fibre foods which help controls appetite and reduce overall calorie intake. By slowing the digestion process fibre can make you feel fuller for longer thus aiding in weight management and reducing the likelihood of overeating. 3. Lower Cholesterol Levels:  Soluble fibre, found in foods ...

Asthma is a chronic condition that affects many millions of people worldwide, making it difficult for them to breathe due to inflamed airways. Inhaled corticosteroids (ICS) are a cornerstone of asthma treatment, significantly improving patients' quality of life by reducing symptoms, preventing asthma attacks, and improving lung function. However, while the benefits of ICS are well-established, there are concerns about potential adverse effects, particularly at higher doses. The Role of Inhaled Corticosteroids Inhaled corticosteroids are anti-inflammatory medications that are commonly prescribed to manage asthma. They work by reducing inflammation in the airways, making it easier to breathe and reducing the frequency of asthma exacerbations. According to current guidelines, patients should use the lowest effective dose of ICS to manage their asthma effectively. Key Findings from Our Recent Research Study Our recent study in the American Journal of Respiratory and Critical Care Medic...

The Conservatives, Labour and Liberal Democrats have set out ambitious plans for the NHS in their respective election manifestos. The challenge for the next government will be achieving targets in areas such as workforce and access to health services at a time when public sector finances are under severe pressure and there are calls for increased spending in many other areas.  Labour for example has pledged to recruit 8500 additional mental health staff but don’t provide much detail on how this workforce expansion will be funded. The Liberal Democrats have promised to recruit 8000 more GPs to ensure everyone can see a GP within seven days or within 24 hours for urgent needs. However, the recent decline in NHS GPs in England casts doubt on the feasibility of this pledge. The Conservatives propose cutting 5500 managers to save £550 million for frontline services. Yet, the NHS relies on managers to plan services, manage budgets and ensure compliance with healthcare standards. These cu...

As we approach a general election in the UK, the different political parties are all now starting to present their proposed health policies. It is crucial for the public, journalists and health professionals - and also for politicians from other political parties - to rigorously scrutinise these proposals. This assessment should be based on key criteria to determine their effectiveness and value for money. The following essential questions should be considered when doing this: 1. Will This Policy Improve Patient Experience? Accessibility: Does the policy make healthcare services more accessible to patients, including underserved populations such as poor and ethnic minorities? Quality of Care: Will the policy enhance the quality of care patients receive, including aspects such as safety, effectiveness, and patient-centeredness? Patient Satisfaction: How will the policy impact patient satisfaction and overall experience with the NHS? Equity: Does the policy address health disparities and...

Polypharmacy, or the use of multiple medications simultaneously, is a growing concern, especially among older people. Nearly one-third of people aged over 65 years of age in the UK take five or more medications daily. This is because people are living longer and often have multiple chronic illnesses that require medication. The Risks of Polypharmacy When people take many medications, there's a risk that some may not be necessary or might even be harmful. This can lead to: A heavy burden of managing multiple medications daily, which is time-consuming and stressful for patients. Difficulty in sticking to complex medication routines, especially for people with low health literacy or poor English language skills. Increased chances of adverse drug reactions and interactions, leading to potential harm and is severe cases to hospital admission. Given these risks, optimizing medication use is crucial, especially for those with multiple health issues. Medication Reviews (MRs) One way to add...

Alzheimer’s disease (AD) is a devastating condition affecting millions of people worldwide, with a significant impact on patients, families, and healthcare systems. Recent breakthroughs in diagnosis and treatment are offering new hope. Let’s explore these exciting developments and what they mean for the future of Alzheimer’s care based on our recent article in the The Journal of Prevention of Alzheimer's  Disease. The Rising Challenge of Alzheimer’s Disease Globally, Alzheimer’s disease is the most common cause of dementia, contributing to the majority of late-onset dementia cases. With an aging population, the number of people affected by Alzheimer’s is expected to rise, even if the age-specific rates of incidence and prevalence remain stable. This increase poses a significant challenge to healthcare systems, families and carers. Current Diagnostic Pathways Traditionally, diagnosing Alzheimer’s involves a combination of clinical assessments, imaging studies, and cerebrospinal...

The recent media coverage on semaglutide's potential in reducing the risk of cardiovascular disease (CVD) has raised hopes and questions alike. While the drug has shown promise in reducing cardiovascular risk, it's crucial to look beyond the relative risk reduction figures often highlighted in the news. To truly understand the impact of semaglutide, we must delve into the absolute risk reduction, cost-effectiveness, and long-term safety data. While the reported relative risk reduction is significant, it's crucial to consider the absolute risk reduction to accurately assess the semaglutide's effectiveness and calculate the number needed to treat ( NNT ) to prevent one adverse CVD event. These principles can be used to look at how any drug should be used in healthcare system’s such as the UK’s NHS. What are the key considerations? Relative Risk Reduction (RRR): Indicates the percentage reduction in risk between the treatment group and the control group. Absolute Risk Redu...

In some parts of England, proposals are emerging to divide NHS primary care services into separate pathways for acute, same-day care and long-term, complex care. While this approach aims to manage the growing workload in general practice, it raises significant concerns about potential negative impacts on patient care and NHS efficiency. We discuss the implications of these proposals in an article published in the British Medical Journal . The Holistic Strength of General Practice One of the key strengths of general practice lies in its holistic approach, where GPs offer continuous and comprehensive care. This continuity allows GPs to maintain a thorough understanding of a patient's medical history, lifestyle, and psychological aspects, leading to effective and cost-efficient care. Fragmenting services by separating acute and long-term care threatens this holistic approach and can undermine the management of chronic conditions, which often include acute episodes linked to ongoing he...

In our study published in the journal BMC Medicine , we report significant vulnerabilities to infectious diseases among UK migrants due to under-vaccination for diseases preventable through routine immunisations - such as measles, mumps, rubella, and polio. Our mixed-methods study, conducted between May 2021 and September 2022 across several London-based general practices, sheds light on the urgent need for improved healthcare strategies that ensure migrants receive necessary catch-up vaccinations. Background Migrants in the UK and Europe are often at increased risk of vaccine-preventable diseases (VPDs) due to incomplete childhood vaccinations and systemic marginalisation from health services. The COVID-19 pandemic further exacerbated these disparities, highlighting the critical gaps in vaccination coverage among adult and adolescent migrants. The study aimed to quantify these vaccination gaps and explore new strategies to improve vaccination uptake through better integration into pri...