Medical Centre

Among the many public health challenges facing the UK, the issue of equitable access to vaccinations stands out, particularly for adult migrants who might have missed critical immunisations due to disrupted healthcare services in their countries of origin or during the migration process. Our recent in-depth study published in Vaccine provides valuable insights into the experiences and perspectives of adult migrants regarding catch-up vaccinations and outlines strategies to improve their immunization coverage. The study focused on adult migrants in the UK, including refugees, asylum seekers, undocumented migrants, and those without recourse to public funds. It used in-depth interviews to gather data on migrants' experiences with and attitudes towards vaccination since arriving in the UK. Despite the UK having guidelines for offering catch-up vaccinations, the study revealed a significant lack of awareness and implementation at the primary care level. One of the critical findings wa

Too many people in the UK are not physically active enough; leading to an increased risk of health problems. Counting the number of steps you take each day is a good way to monitor and increase your physical activity.  But how many steps should you take? 10,000 steps daily is a reasonable target for an active adult. For older people or those with medical conditions that limit their physical activity, a smaller number of steps may be sufficient. The common recommendation of 10,000 steps per day is often used as a benchmark for a healthy activity level and it's a good target for active adults looking to maintain or improve their overall health.  What about specific groups? For older adults, as mobility and energy levels can decrease with age, a lower step count might be a more realistic target and can still be beneficial. Even 6,000 to 8,000 steps per day can significantly benefit older adults. In fact, any amount of physical activity is beneficial.  For those with chronic health con

Our article in the Journal of Medical Internet Research " Regulatory Standards and Guidance for the Use of Health Apps for Self-Management in Sub-Saharan Africa: Scoping Review " explores current landscape of health app regulation within Sub-Saharan Africa. In the digital age, health apps have become vital tools for managing health and wellness, significantly in regions like Sub-Saharan Africa, where such innovations can leapfrog traditional healthcare barriers.  However, the proliferation of health apps also presents a challenge: ensuring these apps are safe, effective, and beneficial to the users. This is the focus of a recent scoping review from Imperial College London, which evaluates the current regulatory standards and guidelines for health apps dedicated to self-management across Sub-Saharan Africa. The Current Landscape of Health App Regulations The review highlights a critical gap: while health apps hold tremendous potential to support disease management and health p

Measles cases in the UK have increased recently; putting at risk the health of children who are unvaccinated.[1] What can primary care teams do to boost measles (MMR) vaccine uptake? I discuss some actions that general practices can take in a recent comment in the British Medical Journal . Implementing an effective vaccination programme within a general practice requires a multifaceted approach; combining clear leadership, comprehensive staff training, patient education, and meticulous record-keeping. The collective effort of the entire practice team is essential for its success. Assigning a dedicated team member to lead the vaccination programme ensures focused oversight. It is crucial that all staff are well-informed about the vaccination programme, including eligibility criteria and the benefits of vaccination for individuals, families, the NHS, and society. This knowledge can be enhanced through free online training.[2] Developing a set of Frequently Asked Questions based on offici

In the quest to refine healthcare delivery in England, this innovative approach, inspired by Brazil's successful community healthcare model, is a promising solution to the challenges faced by the NHS. The strategy focuses on the deployment of Community Health and Wellbeing Workers (CHWWs) to foster more efficient, localised healthcare services. Our recent article in the British Journal of General Practice discusses the potential of this model and how it could revolutionise healthcare in communities across England. The Inspiration from Brazil Brazil's community healthcare model stands as a testament to the power of grassroots health initiatives. Over the past two decades, this approach has led to significant improvements in health outcomes, including reductions in cardiovascular mortality, hospital admissions, and health inequalities. The core of Brazil's success lies in the integration of CHWWs into the healthcare system. These workers serve as pivotal links between GPs, c

The rapid shift towards digital health solutions, propelled by the COVID-19 pandemic, has underscored the critical need for innovative approaches to healthcare delivery in the UK's NHS. The BP@Home initiative, as explored in our recent study published in the journal  PLOS ONE , stands out as a beacon of such innovation, aiming to revolutionise hypertension management in primary care settings across London. The initiative, a response to the pandemic-induced transition to remote healthcare, supports patients with hypertension in self-monitoring their blood pressure at home. This programme not only aims to maintain continuous care for high-risk patients but also addresses a long-standing challenge of hypertension management — a leading contributor to cardiovascular diseases globally - in trying to improve blood pressure control. Barriers and Facilitators to BP@Home Implementation Despite its promise, the BP@Home initiative faces significant hurdles, primarily stemming from resource co

In an era where artificial intelligence (AI) is rapidly reshaping the landscape of healthcare diagnostics, our recent BMJ article sheds light on a critical issue: the equity gap in AI healthcare diagnostics. The UK's substantial investment in AI technologies underscores the nation's commitment to enhancing healthcare delivery through innovations. However, this evolution brings to the forefront the need for equity: defined as fair access to medical technologies and unbiased treatment outcomes for all. AI's potential in diagnosing clinical conditions like cancer, diabetes, and Alzheimer’s Disease is promising. Yet, the challenges of data representation, algorithmic bias, and accessibility of AI-driven technologies loom large, threatening to perpetuate existing healthcare disparities. Our article highlights that the quality and inclusivity of data used to train AI tools are often problematic, leading to less representative data and biases in AI models. These biases can advers

During the COVID-19 pandemic, healthcare systems worldwide grappled with unprecedented challenges, particularly in managing vulnerable populations. Among these, older adults with multimorbidity and depression faced heightened risks, underscoring the need for targeted healthcare interventions to improve their health outcomes. Our recent study published in PLOS ONE offers helpful insights into this issue, focusing on unplanned emergency hospital admissions among patients aged 65 and older with multimorbidity and depression in Northwest London during and after the COVID-19 lockdown. The study used retrospective cross-sectional data analysis, leveraging the Discover-NOW database for Northwest London. It included a sample of 20,165 registered patients aged 65+ with depression, analysing data across two periods: during the COVID-19 lockdown (23rd March 2020 to 21st June 2021) and an equivalent-length post-lockdown period (22nd June 2021 to 19th September 2022). Using multivariate logistic r

Our study in published in  BMJ Medicine  in February 2024 examined the effect of defining timeframes for long-term conditions on the prevalence of multimorbidity in England, and on the role played by sociodemographic factors. Using primary care electronic health records from the Clinical Practice Research Datalink Aurum, the study included over 9.7 million adults registered in England as of 1 January 2020, focusing on 212 long-term conditions. Key Findings Varying Prevalence Rates: The prevalence of multimorbidity, defined as the coexistence of two or more long-term conditions, varied widely based on the timeframe used for definition. It ranged from 41% with stricter criteria (requiring three codes within any 12-month period) to a 74% when a single diagnostic code was deemed sufficient. Using conditions marked as active problems resulted in the lowest prevalence rate at 35%. Sociodemographic Influences: The study revealed that younger individuals, certain minority ethnic groups, and th

The National Health Service (NHS) in England requires the ability to maintain adequate staffing levels across all professional groups. A crucial aspect of this challenge is managing sickness absence rates among NHS staff, which not only impacts patient care and operational costs but also plays a pivotal role in workforce retention and overall healthcare efficacy. Our recent paper in the Journal of the Royal Society of Medicine discusses this important challenge for the NHS. Recent data published by NHS Digital indicates a worrying trend: sickness absence rates have been on a steady rise across all NHS staff groups since 2009, with a notable surge during the COVID-19 pandemic. This trend has resulted in absence rates remaining elevated above pre-pandemic levels, signaling a potential crisis in staffing and healthcare delivery. The Dynamics of Sickness Absence Rates Before the pandemic, monthly sickness absence rates typically varied between 4% and 5%, with expected seasonal variations.

Pharmacies in England to begin treating patients for seven common conditions. How can we work successfully across the health and care system to make a success of Pharmacy First? 1. The Pharmacy First scheme aims to provide convenient access to healthcare through community pharmacies. Patients with minor ailments or common conditions can seek advice and treatment directly from their local pharmacy instead of visiting a general practice, urgent care centre or emergency department. The conditions covered by the scheme may vary depending on local funding arrangements and participation of pharmacies.  2, A potential problem with Pharmacy First is pharmacists misdiagnosing a patient's condition. It may also lead to delays in patients seeing doctors when medical assessment is needed. To mitigate these risks, appropriate safeguards and referral pathways should be established, ensuring timely medical assessment when necessary. The scheme will also increase the workload of pharmacies, thereb

In recent years, the UK has repeatedly suffered from shortages of many key drugs. As well as creating extra work for doctors and pharmacists, these shortages are also very stressful for patients. The government has recently published details of how it might address this issue. We need effective implementation of these plans as well. In particular, we need a combination of a strong UK manufacturing base to produce the drugs the NHS needs along with secure contracts with overseas suppliers.  Developing a robust domestic manufacturing base for pharmaceuticals offer several benefits. It reduces reliance on international supply chains, which can be vulnerable to global events, trade disputes, and logistical challenges. UK manufacturing can also facilitate quicker responses to the UK’s health needs and stimulate economic growth and job creation within the UK. However, building such infrastructure requires substantial investment, time, and expertise. While bolstering domestic production, it i

The UKHSA has warned that the UK is seeing a surge in measles cases ; putting at risk the health of children and others who are unvaccinated. What can primary care teams do to boost measles vaccine uptake in their patients and help bring the number of measles cases down?  In this post, I list some of the key steps in implementing measles (MMR) vaccination in your practice and raising vaccine uptake. This guidance can also be used by primary care providers in other countries. 1. Give one member of the practice team responsibility for leading the vaccination programme, supported by the wider practice team. 2. Ensure that all staff are informed about the programme; including who is eligible; and the benefits of vaccination for the individual patient, their family, the NHS and society. There are many free online programmes on vaccination and addressing vaccine hesitancy for health professionals. Ensure that vaccination is discussed regularly at team meetings to review progress and address