Medical Centre

The Special Allocation Scheme (SAS) aims to protect NHS staff and other patients from individuals who are violent, aggressive, or pose a serious threat, while at the same time ensuring that these patients continue to receive essential primary care services in a secure environment. The decision to refer a patient to the Special Allocation Scheme is a significant one and rightly requires careful clinical and ethical consideration. However, in practice, such decisions often need to be made rapidly and under stressful or unpredictable circumstances, such as following a serious verbal or physical assault on a member of staff. Updated guidance from NHS England and the additional requirements introduced by some Integrated Care Boards (ICBs), including the need for written confirmation that all alternative approaches have been considered, are well-intentioned. These measures are designed to ensure that referrals to the Special Allocation Scheme are proportionate, lawful, and respectful of pat...

 Our recent article in the Journal of the Royal Society of Medicine discusses the potential role of AI-enabled ambient voice technology in healthcare and the implications for doctors and patients. While interest in ambient voice technology , particularly in primary care, continues to grow, evidence regarding its feasibility, acceptability and real-world impact in primary care remains limited. This includes data on cost, staff training and implementation (including integration with current electronic medical record systems).  Questions also remain about how ambient voice technology  handles complex consultations, including with non-native English speakers, and its broader integration into routine practice. As ambient voice technology  develops, further research is needed to assess its usability, acceptability, feasibility, cost-effectiveness and unintended effects on clinical interactions and decision-making. If demonstrated to be effective, ambient voice technology...

The aims of the government’s 10 year health plan – such as the shift from prevention to cure – are not new and have been priorities in many other health plans over the last 35 years. The question we need to ask is why have previous plans failed in achieving these objectives? The short-term electoral cycle prioritises funding for immediate, visible hospital crises over long-term strategies whose benefits are not seen for years. This is compounded by a health system that is designed to reward the treatment of sickness, not the promotion of wellness.  The persistent fragmentation between the NHS, public health and social care, and pressures from an ageing population and widening health inequalities have created a reactive environment where long-term strategic goals are perpetually sacrificed to manage immediate demands. The UK government and NHS staff do not lack insight into what improves health. Unless we redesign the incentives, protect public‑health budgets and hold every departme...

There was a lot of discussion in the government’s 10 year health plan about digital interventions such as giving people online access to their medical records. But does this improve healthcare delivery and clinical outcomes? This was the topic of our recent systematic review published in the journal BMJ Quality and Safety . We found that giving people online access to their medical records increased self-reported patient-centredness and improved some aspects of patient safety. But many questions about the benefits of online access remain unanswered.  The Good News: Empowering Patients On the positive side, we found clear evidence that giving people online access to their medical records increased self-reported patient-centeredness. What does that mean in simple terms? Patients felt more involved, informed, and in control of their own care. This shift from a passive recipient to an active participant is a cornerstone of modern healthcare and is a significant win for patient empowerm...

The government's recently published 10-Year Health Plan outlines a strategic vision for the National Health Service (NHS) in England, focusing on shifting care from hospitals to community settings, making greater use of digital technology like the NHS App to improve the efficiency and accessibility of health services, and prioritising preventive care over reactive treatment. While these objectives are commendable, they have been present in government plans spanning the last three decades, raising concerns about how successfully they will be implemented. Although very welcome, the increases in NHS funding in the plan are not as large as those seen under the previous Labour government from 1997-2010. This disparity in financial commitment could significantly impact the scope and pace of the proposed reforms if not matched by substantial increases in NHS efficiency and productivity. Furthermore, a heavy reliance on digital solutions, risks excluding vulnerable populations. Elderly ind...