Medical Journal News

bmj;388/feb27_1/r400/FAF1faGeoff was born in Manchester and after attending Manchester Grammar School went to Manchester Medical School. He completed house jobs at Manchester Royal Infirmary and Crumpsall Hospital, before choosing a career in anaesthesia.During his training his major interest was cardiothoracic anaesthesia, but at the time there was a shortage of consultant posts and this led him to the new specialty of intensive care medicine.In 1975 he took up a consultant position at the Royal Shrewsbury Hospital, his brief being to set up and direct a new intensive care unit. He dedicated all his hours to the management of the unit, his omnipresence leading him to be affectionately referred to as “God” by the intensive care staff.Outside medicine Geoff had a strong interest in other means of supporting health. He was an early adopter of vegetarianism, practised tai chi and the Alexander technique, and, after a trip to China, he trained...

A London hospital is to investigate why over half of its patients with multiple sclerosis (MS) who switched from disease modifying therapy Tysabri (natalizumab) to biosimilar Tyruko have had to be switched back because of “significant and continuing side effects.”Imperial College Healthcare NHS Trust said it was asked by NHS England in January 2024 “to be the first service in London to switch to Tyruko” and after a period of “preparation and planning” it started switching patients in May 2024. It noticed, however, that patients were reporting side effects “over and above the relatively mild, short term side effects we expected to see.” Following a clinical review the trust returned just over half of the patients to Tysabri.“We have raised our experience and concerns with NHS England and the Medicines and Healthcare Products Regulatory Agency (MHRA), and at a local level we are continuing to work closely with our patient...

The Isle of Man is set to become the first place in the British Isles to legalise assisted dying, after a bill to allow terminally ill residents to end their life passed its final hurdle in the island’s lower elected house.Members of the island’s House of Keys voted in favour of final amendments to the bill in line with recommendations from its proposer, Alex Allinson, a GP and member of the house. It is now expected to pass, subject to final approval in the Isle of Man’s Legislative Council.The bill proposes to introduce the choice of assisted dying to residents who are mentally competent and have less than 12 months to live. Its proponents hope that the service will be available from 2027, after royal assent and an implementation period.The option of an assisted death will be limited to self-administration and will not involve a doctor ending a person’s life....

NHS England’s chief executive, Amanda Pritchard, has announced that she is to step down at the end of next month after three and a half years in the post.The surprise announcement on 25 February followed recent strong criticism by two high profile parliamentary committees that questioned the ability and “dynamism” of NHS leaders to implement the changes to the health service desired by the government.Pritchard, who has also been chief operating officer at NHS England since 2019 and previously served as chief executive of Guy’s and St Thomas’ NHS Foundation Trust in London, said she believed that now was the time for her to leave, with the NHS continuing to make progress in its recovery from the covid-19 pandemic.“It has been an enormous privilege to lead the NHS in England through what has undoubtedly been the most difficult period in its history,” said Pritchard, the first woman to hold the...

The doctor who took over as medical director of the NHS trust that employed Lucy Letby has told a public inquiry that her predecessor told her she should report the paediatricians who raised concerns that the nurse might be killing babies to the General Medical Council, as he hadn’t done.Susan Gilby, who soon after became acting chief executive of the Countess of Chester Hospital NHS Foundation Trust and took on the substantive role in August 2018, told appeal court judge Kathryn Thirlwall’s inquiry into the circumstances surrounding Letby’s activities that the outgoing medical director, Ian Harvey, told her as they were leaving their handover meeting, “You need to refer those paediatricians to the GMC.”Harvey had earlier denied in evidence to the inquiry that he had made the comment. But Gilby said that, when asked why he had not referred the paediatricians to the regulator himself, “He jokingly said, ‘I don’t...

Two people in the US have been admitted to hospital with H5N1 avian flu, adding to concerns over the growing number of infections in cattle, poultry, wildlife, and humans worldwide.As of 24 February, a woman in Wyoming remains in hospital while a man in Ohio has been discharged. Both patients had severe “respiratory and non-respiratory symptoms,” the CDC said in its weekly flu report.1“This shows that H5N1 can be very severe, and we should not assume that it will always be mild,” Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organisation at the University of Saskatchewan, told the Guardian.2The hospital admissions bring the total number of patients with severe cases of H5N1 in the US to four since the first was reported in December 2024. The first death was recorded in Louisiana in February this year.3Concerns about avian flu have been growing since early 2022, when a surge...

by Cameron Razieh, Bethan Powell, Rosemary Drummond, Isobel L. Ward, Jasper Morgan, Myer Glickman, Chris White, Francesco Zaccardi, Jonathan Hope, Veena Raleigh, Ashley Akbari, Nazrul Islam, Thomas Yates, Lisa Murphy, Bilal A. Mateen, Kamlesh Khunti, Vahe Nafilyan

Background

Electronic health records (EHRs) are increasingly used to investigate health inequalities across ethnic groups. While there are some studies showing that the recording of ethnicity in EHR is imperfect, there is no robust evidence on the accuracy between the ethnicity information recorded in various real-world sources and census data.

Methods and findings

We linked primary and secondary care NHS England data sources with Census 2021 data and compared individual-level agreement of ethnicity recording in General Practice Extraction Service (GPES) Data for Pandemic Planning and Research (GDPPR), Hospital Episode Statistics (HES), Ethnic Category Information Asset (ECIA), and Talking Therapies for anxiety and depression (TT) with ethnicity reported in the census. Census ethnicity is self-reported and, therefore, regarded as the most reliable population-level source of ethnicity recording. We further assessed the impact of multiple approaches to assigning a person an ethnic category. The number of people that could be linked to census from ECIA, GDPPR, HES, and TT were 47.4m, 43.5m, 47.8m, and 6.3m, respectively. Across all 4 data sources, the White British category had the highest level of agreement with census (≥96%), followed by the Bangladeshi category (≥93%). Levels of agreement for Pakistani, Indian, and Chinese categories were ≥87%, ≥83%, and ≥80% across all sources. Agreement was lower for Mixed (≤75%) and Other (≤71%) categories across all data sources. The categories with the lowest agreement were Gypsy or Irish Traveller (≤6%), Other Black (≤19%), and Any Other Ethnic Group (≤25%) categories.

Conclusions

Certain ethnic categories across all data sources have high discordance with census ethnic categories. These differences may lead to biased estimates of differences in health outcomes between ethnic groups, a critical data point used when making health policy and planning decisions.

The World Health Organization has warned that urgent action is needed to reduce the number of children dying from preventable causes in its European region.In its latest report summarising health trends in the region,1 which covers 53 countries across Europe and Asia, WHO said that protecting the health of children required specific attention, with 75 647 children dying before their 5th birthday in 2022.The report, which is produced every three years, highlights the need to improve population health and access to essential healthcare services to improve outcomes. “Too many infants still die unnecessarily before the age of 5 years,” it says. “Closing the gap between the member states with the highest and lowest mortality rates remains a challenge, especially since some have recorded relatively higher rates over the past 5 years.”Across the region, neonatal mortality ranges between 0.7 and 23 deaths per 1000 live births, and under 5 mortality ranges...

New England Journal of Medicine, Volume 392, Issue 9, Page 892-901, February 27, 2025.

New England Journal of Medicine, Volume 392, Issue 9, Page 930-932, February 27, 2025.

New England Journal of Medicine, Volume 392, Issue 9, Page 929-930, February 27, 2025.

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New England Journal of Medicine, Volume 392, Issue 9, Page 923-926, February 27, 2025.

New England Journal of Medicine, Volume 392, Issue 9, February 27, 2025.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.