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Shortage of general practitioners in the NHS

In an article published in the British Medical Journal, I discuss the implications of the current shortage of NHS general practitioners. Ensuring that countries have sufficient primary care doctors is a key challenge for health planners globally because of the important role that primary care plays in supporting cost-effective health systems that promote equity in health outcomes. For example, the USA is predicted to need 7,800 to 32,000 additional primary care physicians by 2025.[1] We also know that the National Health Service (NHS) in the United Kingdom is short of general practitioners.[2] What we do not know is the size of the shortage; and how many additional general practitioners the NHS needs to provide comprehensive primary care services.

In its plan for general practice published in 2016, NHS England set a target of 5,000 additional general practitioners by 2020.[3] However, no data was presented to show that this was a sufficient number to meet the needs of primary care in…
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Key priority areas for patient safety improvement strategy in Libya

A paper published in the journal BMJ Open describes a protocol for a study examining patient safety in Libya. Patient safety is a global public health problem. Estimates and size of the problem of patient safety in low-income and developing countries are scarce. A systems approach is needed for ensuring that patients are protected from harm while receiving care. The primary objective of this study will be to use a consensus-based approach to identify the key priority areas for patient safety improvement in Libya as a developing country.using a modified Delphi approach.

A three-phase modified Delphi study will be conducted using an anonymous web-based questionnaires. 15 international experts in the field of patient safety will be recruited to prioritise areas of patient safety that are vital to developing countries such as Libya. The participants will be given the opportunity to rank a list of elements on five criteria. The participants will also be asked to list five barriers that th…

The divergence of minimum unit pricing policy across the UK

A paper published in the Journal of the Royal Society of Medicine discusses the implementation of a minimum unit pricing policy across the UK. Above recommended levels of intake, alcohol use is associated with harm including hypertension, haemorrhagic stroke, liver disease, mental health disorders and cancers, as well as accidents, injuries and assaults. The 2015 UK Global Burden of Disease study indicates that 2.9% of disability-adjusted life years and 1.9% of mortality are attributable to alcohol use, and the 2013 Health Survey for England found that 23% of men and 16% of women in England drink at levels associated with risk to health.

Despite the ongoing discussion about minimum unit pricing policy across the UK, and although it is difficult to predict what it would take for the Westminster Government to revert to a minimum unit pricing policy, any minimum unit pricing policy that does come to be implemented in Scotland or England and Wales will only be implemented because the rel…

Evaluation of the NHS Health Check Programme in reaching under-served groups

A recent paper from my department published in the journal BMC Health Services Research assessed how effective the NHS Health Check Programme was in reaching under-served groups.

Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England’s National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups.

Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appo…

Health Effects of Overweight and Obesity in 195 Countries

Globally, more than 2 billion children and adults suffer from health problems related to being overweight or obese, and an increasing percentage of people die from these health conditions, according to a new study published in the New England Journal of Medicine.

They are dying even though they are not technically considered obese. Of the 4.0 million deaths attributed to excess body weight in 2015, nearly 40% occurred among  people whose body mass index (BMI) fell below the threshold considered “obese.”

The findings represent “a growing and disturbing global public health crisis,” according to the authors of the paper published today in The New England Journal of Medicine.  In the UK, nearly a quarter of the adult population – 24.2% or 12 million people – is considered obese. Additionally, 1 million British children are obese, comprising 7.5% of all children in the UK.

Among the 20 most populous countries, the highest level of obesity among children and young adults was in the Unite…

Sophie the very helpful dragon

A story for five-year olds

Written by Professor Azeem Majeed

Sophie the dragon was sad. Why was Sophie sad? Because the children in the nearby village wouldn’t play with her. Each time Sophie approached the children, they would run away screaming. She often asked her mother why the children would not play with her.

“It’s because the people of the village are afraid of dragons.” Her mother said. “The village chief, Donald, has told the villagers that dragons are terrible creatures; that we will burn down their houses, eat their farm animals, and carry off their children.”

“That’s a horrible thing to say.” Said Sophie. “We dragons are kind and gentle, and want to help others”.

“True.” Said Sophie’s mother. “But Donald is their chief and the other villagers believe what he says.”

One day, Sophie could see the villagers collecting wood and placing it into a big pile in the middle of the village green.

“What are they doing?” Sophie asked her mother. “It will be bonfire night soon.” Replied …

Current and future perspectives on the management of polypharmacy

A paper published in the journal BMC Family Practice discusses the management of polypharmacy (the concurrent use of multiple medications by one individual). Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common.

Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death. Hence, having systems in place to ensure that medications are started only when there is a suitable indication, ensuring patients are fully aware of the benefits and complications that may arise from their treatment, and reviewing patients regularly to ensure their medication regime remains appropriate, are essential.

The development and rapid uptake of el…