Medical Centre

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...

Our new study published in the British Journal of General Practice examines uptake of the NHS App in England. The NHS App was launched in January 2019 as a "front door" to digitally enabled health services, allowing patients to access their personal health information online. With the advent of the COVID-19 pandemic, the app saw a significant increase in downloads, especially with the introduction of the COVID Pass feature. However, the uptake of the app has revealed some important trends and inequalities that need to be addressed. The Study A comprehensive observational study used monthly NHS App user data at general-practice level in England from January 2019 to May 2021. Different statistical models were applied to assess changes in the level and trend of use of various functionalities of the app, particularly before and after the first COVID-19 lockdown. Key Findings Between January 2019 and May 2021, the NHS App was downloaded 8,524,882 times and registered 4,449,869 us...

Doctors and other NHS professionals in England are often asked to write in support of patients applying for benefits such as Personal Independence Payments (PIP) or Employment Support Allowance (ESA); which support people with disabilities and long-term health conditions.  These benefits are vital for people suffering from long-term health conditions and disabilities, offering them financial help that can significantly improve their wellbeing and quality of life. Given the critical nature of these benefits and the stringent criteria often applied during the assessment process, the letters we write can play an essential role in securing this much-needed support for our patients. Here is some guidance on how to write a more effective and relevant letter of support based on my long experience as an NHS doctor in writing such letters. 1. Introduce yourself and describe your relationship to the patient, including how long you have known them and in what capacity. This will help establis...

The importance of the global emphasis on physical activity for health cannot be understated. However, it is crucial to address one of the adverse effects of contact sports—specifically, sport-related concussions. Sport-Related Concussion is a traumatic brain injury caused by a direct blow to the head, neck, or body resulting in an impulsive force being transmitted to the brain. Sport-Related Concussion can present with a wide range of signs and symptoms, and can affect a person's thinking, concentration, memory, mood, and behaviour. These incidents are common and account for a significant number of emergency department visits. They also have some long-term risks, including cognitive and neurological problems. Recent publications, like the consensus statement from the Concussion In Sport Group and the UK Government's landmark concussion guidance, offer valuable insights in the management of Sport-Related Concussion. This blog – based on our recent article in the British Jour...

Electronic healthcare records (EHRs) are increasingly being used to collect and store data on patient care. This data can be used for a variety of purposes, such as improving clinical care, conducting research, and monitoring population health. However, it is important to be aware of potential biases in EHR data, as these can lead to inaccurate or misleading results..  The reliability of diagnostic codes in primary care EHRs is a subject of ongoing debate and a topic we investigated in paper published in BMJ Open .  These codes not only guide clinical decisions but also shape healthcare policies, research, and even financial incentives in the healthcare system. A recent retrospective cohort study explored whether the frequency of these codes for long-term conditions (LTCs) is influenced by various factors such as financial incentives, general practices, patient sociodemographic data, and the calendar year of diagnosis. The study comes at a crucial time, shedding light on signi...

I am sometimes asked by junior researchers or by the public how the academic publication process works. The academic peer review timeline varies depending on the journal, but it typically takes several months (sometimes even longer) from submission to publication. 1. Submission : You submit your paper to the journal. Make sure your paper is well-written, checked for spelling and grammatical errors, follows the journal's style and formatting requirements, and that you submit your paper to a journal that is a good fit for your work. 2. Initial screening : An editor at the journal reviews your paper to make sure it is within the scope of the journal & meets the journal's style and formatting requirements. Some articles are rejected at this stage, without external peer review (particularly, by larger journals). For example, articles may be rejected if they are outside the scope of the journal, if they are poorly written or have major methodological flaws, or do not include the...

The COVID-19 pandemic had profound effects on many aspects of life, from healthcare to lifestyle habits. One of the most impacts has been the mental and physical well-being of individuals, particularly those who are older. Our study published in PLoS One aimed to quantify the relationship between shielding status and loneliness at the start of the pandemic and how these factors affected physical activity (PA) levels throughout the period. Conducted in London, the study surveyed 7748 cognitively healthy adults aged 50 and above from April 2020 to March 2021.  Methods The study used the International Physical Activity Questionnaire (IPAQ) short-form to assess the physical activity levels of participants before the pandemic and six more times over the next 11 months. Linear mixed models were used to explore the relationship between shielding status and loneliness at the onset of the pandemic with physical activity over time. Key Findings Loneliness and Physical Activity The study rev...

You will often see the NNT mentioned in clinical guidelines; and when different health interventions are being prioritised or assessed for their clinical effectiveness and cost effectiveness. For example, the NNT was used to inform decisions to recommend statins for people with an elevated risk of cardiovascular disease. The NNT is a measure used to quantify the effectiveness of an intervention or treatment. It is the average number of patients who need to be treated with a particular therapy for one additional patient to benefit. How is NNT calculated? In mathematical terms, the NNT = 1/[Absolute Risk Reduction] Where Absolute Risk Reduction (ARR) = Control Event Rate (CER) - Experimental Event Rate (EER) Control Event Rate (CER): The rate of an outcome in a control group. Experimental Event Rate (EER): The rate of an outcome in an experimental group treated with the intervention. For example, consider a drug that reduces the risk of heart attack from 4% to 2%. The ARR i...

It's that time of year when students are starting to enrol in higher education courses at universities and colleges. Every year, when marking essays and dissertations, I encounter numerous errors in students' writing.  What are these errors, and how can you avoid them to make your dissertation more readable? Here are my top 10 tips for improving your academic writing: 1. Plan Your Outline Most importantly, spend time planning the outline of your essay or dissertation. For dissertations, this means thinking about chapter headings and subsections for each chapter. Decide on the key tables, figures, and graphs you need to include to complement the main text. These visual elements should add value; they shouldn't merely repeat what's already said but should provide a different perspective or clearer illustration of your points. 2. Avoid Complexity Many students assume that longer words are "more scientific" and thus preferable to shorter ones. For example, they mi...

What steps can primary care providers take to maximise the uptake of flu vaccination? The NHS is now offering free vaccination to eligible patients in England but careful planning is needed to ensure the flu vaccine programme is implemented effectively and achieves a high uptake. In this post, I list some of the key steps in implementing flu vaccination in your practice. This guidance can also be used by primary care providers in other countries. Give one member of the practice team responsibility for leading the vaccination programme, supported by the wider practice team. Ensure staff are informed about the programme; including start dates, who is eligible and the benefits of vaccination for the individual patient, their family and society. Prepare FAQs to common questions from patients. These are usually available on government websites such as those published by NHS England and the UKHSA. Ensure staff know where to look for these FAQs, which ar...