Category: NHS

Why has prescribing of antidepressants increased over the last 30 years?

In a recent post on the platform X, Elon Musk claimed that antidepressants were over-prescribed. In many countries, the prescribing of antidepressants has increased significantly over the past 30 years. During the 1990s, public health campaigns aimed at reducing the stigma surrounding depression encouraged more people to seek treatment. This contributed to a rise in antidepressant prescriptions in countries such as the UK.

Additionally, antidepressants – particularly selective serotonin reuptake inhibitors (SSRIs) – are now widely used not only for depression but also for other conditions such as anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and chronic pain. This expanded range of indications has been a significant factor in their increased use in recent decades.

One concern regarding antidepressant use is their potential toxicity and their role in suicide. SSRIs are generally considered safer than older antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), which are more likely to be associated with fatal overdoses.

Because of their better safety profile, doctors are more willing to prescribe SSRIs than the older antidepressants. Their relative safety has made SSRIs the preferred choice of drug for many doctors and is also a factor in the increased prescribing of antidepressants.

Antidepressants do play an essential role in managing depression and some other mental health conditions, but over-prescription may occur in some cases due to system-wide barriers like limited access to psychological therapies. Addressing the wider determinants of health is also important. This would include areas such as poverty, housing and access to green spaces and other leisure facilities.

The increase in antidepressant prescribing in the UK has sparked debate about whether they are being over-prescribed. However, antidepressants are a clinically effective option for moderate to severe depression and are now used for a broader range of conditions, such as anxiety disorders and chronic pain. Ensuring a balanced approach, where pharmacological and non-pharmacological treatments are accessible and appropriately used, remains a key goal for improving mental health care in the UK and elsewhere in the world.

Using Mobile Apps for Diabetes Self-Management: A Review of Patient Perspectives

Diabetes is a chronic disease that affects hundreds of millions of people worldwide. Self-management is crucial for people with diabetes to maintain their health and prevent complications.  Mobile applications have emerged as promising tools to help people with diabetes self-manage their condition. Our recent article in the journal BMJ Open – What are the perceptions and experiences of adults using mobile applications for self-management in diabetes? A systematic review – reviewed some of the the research literature in this area to obtain patient perspectives on these apps.

What are the benefits of using mobile apps for diabetes self-management?

Our systematic review explored the perceptions and experiences of adults with types 1, 2, and gestational diabetes using mobile applications for self-management.  The review included 24 qualitative studies that interviewed or surveyed people with diabetes who used mobile apps for self-management.

We found that people with diabetes generally have a positive view of mobile apps for self-management.  App features that were particularly valued included:

  • Monitoring blood glucose, diet, and exercise
  • Receiving reminders about blood glucose checks, medication, and mealtimes
  • Learning about the interrelationship between blood glucose, diet, and exercise

What are the challenges of using mobile apps for diabetes self-management?

We also identified several challenges that people with diabetes face when using mobile apps for self-management. These challenges include:

  • Uploading excessive information
  • Monitoring device incompatibility
  • Episodic app crashes
  • Telephone handling issues

What are the implications of this research?

We concluded that mobile applications are promising tools to help people with diabetes self-manage their condition.  However, it is important to address the challenges that people with diabetes face when using these apps. We also recommended that future research should:

 

  • Include healthcare professionals (HCPs) to get their views on the apps
  • Explore the long-term usage of mobile apps
  • Evaluate the role of AI in providing interactive support for self-management

Conclusion

Mobile apps have the potential to improve diabetes self-management. By addressing the challenges and incorporating the recommendations of this research, we can develop apps that are truly beneficial for people with diabetes.

Tackling Drug Shortages: An Urgent NHS Priority

The NHS in the UK is grappling with a worsening crisis, drug shortages, as we discuss in our recent article in the British Medical Journal. These shortages have doubled since 2022, with supply disruptions affecting vital medications like antibiotics, diabetes treatments, and hormone replacement therapy. The implications for patient safety and healthcare services are profound, making it imperative for the UK government and the NHS to address this challenge .

Why Are Drug Shortages Happening?

The root causes of these shortages lie in both global and local factors. Disruptions in international supply chains — driven by the COVID-19 pandemic, geopolitical conflicts like the Ukraine war, and rising energy costs — have hampered the production and transport of essential pharmaceutical ingredients. Domestically, the NHS faces challenges such as manufacturing inefficiencies, logistical delays, and regulatory hurdles.

Brexit has also compounded the problem, introducing new trade barriers, customs checks, and currency depreciation, which have made importing medicines more costly and time-consuming. Moreover, economic measures like the Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) have created financial disincentives for pharmaceutical companies to prioritize the UK market.

Impact on Patients and Healthcare Providers

The repercussions of drug shortages are far-reaching. For patients, unavailability of essential medications can lead to delayed treatments, reduced efficacy, and increased risks. For example, shortages of anti-epileptic drugs such as sodium valproate have heightened seizure risks for affected patients. Healthcare providers, meanwhile, face mounting workloads as they try to find alternatives, often dealing with stressed and anxious patients.

Pharmacists, in particular, bear the brunt of these challenges. Many have had to ration medicines or pay inflated prices, which are not fully reimbursed by the NHS. This financial strain comes at a time when community pharmacies are expected to play a larger role in easing the burden on GPs.

Solutions: Immediate and Long-Term Strategies

Addressing drug shortages requires a multifaceted approach:

Regulatory Reforms: Streamlining approval processes and easing restrictions on drug imports could help bridge the gap in supply. Aligning more closely with the European Medicines Agency could mitigate post-Brexit barriers.

Strengthening Supply Chains: Developing better forecasting tools and stockpiling strategies would help anticipate and respond to demand spikes. Investment in domestic pharmaceutical manufacturing, particularly for generic drugs, is also crucial to reducing reliance on global supply chains.

Support for Healthcare Providers: Allowing pharmacists greater flexibility in prescribing alternatives can prevent delays in patient care. Price concessions for scarce medications would also alleviate financial pressures on community pharmacies.

Patient-Centric Interventions: Providing online resources and national helplines to guide patients during shortages can help reduce anxiety and improve adherence to alternative treatment plans.

Looking Ahead

The drug shortages crisis underscores the need for robust policies that prioritise patient care and support healthcare providers. With timely interventions and strategic investments, the NHS can overcome these challenges and safeguard the health of the UK population. Building a healthier population through prevention and reducing demand for medications must also remain a long-term goal. Tackling drug shortages must be a priority for the NHS. Patients deserve reliable access to the medications they need, and healthcare providers need to certain that access to key drugs remains uninterrupted.

Staying healthy and making more effective use of the NHS in 2025

s we enter the new year, here are some tips on how to stay healthy and well and to make better use of the NHS in 2025:

1. Exercise regularly, aiming to include outdoor activities for sunlight exposure, which can help with physical fitness and improve mood, especially for those affected by Seasonal Affective Disorder (SAD).

2. Don’t smoke. Smoking is a major risk factor for diseases such as lung cancer and heart disease. Quitting smoking significantly reduces these risks.

3. Take-up the offer of any NHS vaccinations that you are eligible for. If you have young children, make sure they are also up to date with their NHS vaccinations.

4. Sunlight exposure may be limited in Winter, so consider vitamin D supplementation if you are in a group that this is recommended for.

5. Attend for NHS health screening appointments when invited.

6. Eat five portions of fruit & vegetables every day and eat plenty of high-fibre foods. Eating a nutritious diet is important for maintaining a healthy weight and reducing the risk of chronic diseases.

7. Limit your sugar and salt intake.

8. Limit your alcohol intake to a safe level.

9. Take time to improve your mental health; including by meeting regularly with friends and family. Mental health is just as important as physical health, and it is important to take steps to protect and improve your mental well-being.

10. Use the NHS app to book appointments, view your GP medical record and order repeat prescriptions.

11. Attend for appointments for medication reviews and for the management of long-term conditions when invited. This helps to ensure that your medication is up-to-date and that your condition is being managed effectively.

12. Be aware of the range of options for NHS care – including opticians, pharmacists, self-referral services (e.g. Pharmacy First, podiatry, IAPT, smoking cessation), and NHS 111.

13. Use the NHS electronic prescription service so that your prescription is sent directly to a pharmacy.

14. For queries about hospital care, contact the hospital Patient Advice and Liaison (PALS) team rather than your general practice. The PALS team is there to help patients and their families with any concerns or questions they have about their hospital care. The contact details are usually present on the hospital’s website.

15. Apply for online access to your hospital records if this is available

16. Check your own blood pressure. Blood pressure machines are now relatively cheap. In some parts of England, the NHS may be able to provide you with a machine. High blood pressure is a major risk factor for stroke and heart disease, so it is important to monitor your blood pressure regularly.

17. Take your medication as prescribed.

18. Get a good night’s sleep.

19. Reduce the risk of injury by wearing seatbelts and bike helmets, and driving or cycling safely

20. Listen to experts on health issues and not uninformed people on social media. There is a lot of misinformation about health issues circulating on social media, so it is important to get your health information from reliable sources, such as the NHS website or healthcare professionals.

21. Use telehealth options for accessing healthcare when appropriate, to save time and minimise exposure to potential infections.

22. Keep a well-stocked first aid kit and know how to use the basic items. This can be particularly useful for minor injuries and illnesses.

23. Keep your home safe. Falls and accidents are common during the winter due to icy conditions. Making your home slip-proof can prevent unnecessary hospital visits.

24. Keep Emergency Numbers Handy. Important contact numbers should be easily accessible, whether it’s on your fridge or saved in your phone.

25. Regular Hand Washing. Promote good hand hygiene, especially if interacting with vulnerable populations like the elderly or very young.

26. Ensure food is stored safely to reduce the risk of food-borne illnesses such as gastroenteritis.

27. Know the Signs of More Serious Conditions: Understanding the early symptoms of conditions like strokes, heart attacks, and other acute illnesses can save precious time in an emergency.

28. Improve indoor air quality. Try to keep up the air quality in your home and at work; for example, through ventilation.

29. Community Support. If possible, check on neighbours and family members who might be vulnerable during the winter months, whether due to age, health conditions, or social isolation.

30. Use of Over-the-Counter (OTC) Medication. Understand when to use OTC medications for minor illnesses and when to seek professional advice.

Let me know about any other suggestions for staying healthy.

Protecting Against the “Quad-demic”: Influenza, Covid-19, Norovirus, and RSV

As the NHS braces for a challenging winter season, it is grappling with a “quad-demic” of health emergencies caused by influenza, Covid-19, norovirus, and respiratory syncytial virus (RSV). This confluence of viral threats poses a significant risk to public health in the UK as well as putting strain on healthcare resources, emphasising the importance of preventive measures to safeguard public health. Public health measures such a vaccination and good personal hygiene are pivotal in reducing the impact of these illnesses, particularly for vulnerable groups.

The Four Viruses: What Are They?

  • Influenza: A highly contagious respiratory infection that causes significant illness each winter. It can lead to severe complications, particularly in the elderly, young children, pregnant women, and those with chronic health conditions.
  • Covid-19: Though its most acute phase has passed, Covid-19 remains a concern, especially as new variants of SARS-CoV-2emerge. Severe illness continues to disproportionately affect older adults, those with underlying health conditions and people who are immunocompromised.
  • Norovirus: Known as the “winter vomiting bug,” norovirus is a leading cause of gastroenteritis. It can spread rapidly in closed environments like hospitals and care homes, causing outbreaks that pose a risk to health and which can disrupt health and care services.
  • Respiratory Syncytial Virus (RSV): A common virus that primarily affects young children and older adults. It can lead to bronchiolitis and pneumonia in severe cases, particularly among infants and the elderly.

The Role of Vaccination

Vaccination remains a cornerstone of prevention for influenza, Covid-19, and RSV. For those eligible, timely vaccination can significantly reduce the risk of severe illness, hospitalisation, and complications.

  • Who is eligible for vaccines?
    • Influenza Vaccine: Recommended annually for individuals over 65, pregnant women, children aged 2–10, frontline healthcare workers, and those with specific medical conditions.
    • Covid-19 Vaccine: Offered as part of booster campaigns, particularly for high-risk groups such as the elderly, those with weakened immune systems, and frontline healthcare workers.
    • RSV Vaccine: A relatively recent addition, now available for certain at-risk populations, including older adults and during pregnancy.

Vaccination campaigns are a critical public health tool, reducing the overall spread of these viruses and protecting vulnerable populations.

The Importance of Hygiene in Preventing Norovirus and Beyond

While vaccines are effective for influenza, Covid-19, and RSV, combating norovirus relies primarily on hygiene measures. Norovirus spreads easily through contaminated food, surfaces, and person-to-person contact. The following practices are crucial:

  1. Regular Handwashing: Wash hands thoroughly with soap and water, especially after using the toilet and before eating.
  2. Cleaning and Disinfection: Clean surfaces and commonly touched items with a bleach-based disinfectant to kill the virus.
  3. Proper Food Handling and Storage: Avoid preparing food for others if experiencing symptoms of gastroenteritis, such as vomiting or diarrhoea. Ensure food is stored correctly.
  4. Respiratory Hygiene: Although norovirus is not a respiratory virus, maintaining good respiratory etiquette, such as covering coughs and sneezes and disposing of tissues promptly, helps prevent other infections.

Why Prevention Matters

The intersection of these four viruses can lead to increased pressure on the NHS, with simultaneous outbreaks stretching resources and sometimes overwhelming healthcare services. By preventing illness, individuals not only protect their health but also contribute to easing the burden on the NHS.

Vaccination campaigns and hygiene education are crucial public health strategies. For eligible groups, staying up-to-date with vaccinations is essential, while everyone can benefit from reinforcing good hygiene practices. Together, these measures can help mitigate the impact of the “quad-demic” and support the resilience of our healthcare system during this challenging season.

Taking Action: A Collective Effort

In the face of this “quad-demic,” a proactive approach is essential. Whether through getting vaccinated, promoting hygiene, or supporting public health initiatives, we all have a role to play. By taking these steps, we can protect ourselves, our loved ones, and our communities while reducing the strain on healthcare resources.

This winter, prevention is the best medicine. Let’s work together to stay healthy and keep our NHS strong.

Why Vaccination During Pregnancy Matters

Pregnancy is a time filled with excitement, anticipation, and often, a touch of anxiety. Among the many decisions expectant parents make, one of the most crucial involves protecting the health of both the mother and the baby. Vaccination during pregnancy plays a vital role in this, yet uptake remains worryingly low in many regions.

The Importance of Vaccination During Pregnancy

Vaccines offered during pregnancy, such as those against influenza, pertussis (whooping cough), COVID-19, and the newly added respiratory syncytial virus (RSV) vaccine in the UK, are designed to safeguard the health of mothers and their babies. For example:

  • Influenza vaccine: Protects against severe complications from flu, which can be more serious during pregnancy.
  • Pertussis vaccine: Provides critical early protection for babies against whooping cough until they are old enough to be vaccinated themselves.
  • COVID-19 vaccine: Reduces the risk of severe disease and complications from COVID-19 during pregnancy.

Despite the proven benefits, many pregnant women remain unvaccinated, leaving them and their babies vulnerable to preventable diseases.

Barriers to Uptake

Several factors contribute to low vaccination rates during pregnancy:

  1. Concerns About Safety: A common barrier is worry about the vaccine’s safety for the baby. While extensive research confirms the safety and effectiveness of these vaccines, misinformation – often spread online or through social networks – fuels hesitancy.
  2. Access Challenges: Some pregnant women face logistical hurdles, such as needing separate appointments for vaccination instead of being offered vaccines during routine antenatal visits.
  3. Socioeconomic and Demographic Disparities: Vaccination rates are often lower among women from ethnic minority backgrounds and those living in deprived areas. For instance, a study in London showed significantly lower COVID-19 vaccination rates among Black women and those in economically disadvantaged areas.

Overcoming the Barriers

Improving vaccine uptake requires a multi-pronged approach involving healthcare providers, public health campaigns, and structural changes. Here’s how:

  1. Empower Through Education: Healthcare professionals, including midwives, general practitioners, obstetricians and pharmacists, play a critical role in addressing concerns, countering misinformation, and sharing the benefits of vaccination. These conversations should focus on the risks of not vaccinating and provide clear, evidence-based information about vaccine safety.
  2. Enhance Accessibility: Offering vaccinations during routine antenatal visits and using reminder systems (text messages, emails, etc.) can make it easier for pregnant women to get vaccinated.
  3. Tailored Interventions: Targeted campaigns in communities with low vaccination rates can address specific barriers and build trust. Community leaders and trusted figures can help spread positive messages about vaccination.
  4. Efficient Record-Keeping: Ensuring up-to-date vaccination records prevents unnecessary reminders and allows healthcare providers to focus their efforts on those who are unvaccinated.
  5. Supportive Healthcare Settings: Designating a staff member in clinics or practices to lead vaccination efforts ensures a coordinated approach and provides a point of contact for women with questions.

A Shared Responsibility

Vaccination during pregnancy not only protects mothers but also provides early immunity for their babies, saving lives and preventing illness. Addressing vaccine hesitancy and improving access to vaccines requires a collective effort from healthcare providers, public health bodies, and the community.

As an expectant parent, you have the power to make informed decisions that protect your health and that of your baby. If you have questions or concerns about vaccines, talk to your healthcare provider. Together, we can create a safer, healthier future for you and your child.

For more information, visit the NHS vaccinations in pregnancy page.

Read also my recent article in the British Medical Journal.

Why I Support the Fortification of Flour with Folic Acid

From the end of 2026, the UK government will require the addition of folic acid to non-wholemeal flour. This is an important step forward in public health; an intervention that could prevent up to 200 cases of neural tube defects annually as well as improving the health of pregnant women and their babies.

Why Folic Acid Matters

Folic acid is essential for healthy cell growth and development. For pregnant women, folic acid plays a critical role in the early stages of foetal development, particularly in forming the neural tube, which develops into the brain and spinal cord. An insufficient folic acid intake during pregnancy can lead to neural tube defects such as spina bifida and anencephaly—serious conditions that can result in lifelong disability for the child or even loss of life.

While women planning to become pregnant are encouraged to take folic acid supplements, about half of pregnancies in the UK are unplanned. This means that many women may not be taking supplements at the crucial time when the neural tube is developing, often before they even know they are pregnant. Fortifying a staple food such as non-wholemeal flour ensures that more women—and the population in general—have a better intake of folic acid, thereby reducing the risk of neural tube defects.

A Proven Public Health Measure

Folic acid fortification is not a new concept. Countries such as the USA, Canada, Australia and New Zealand have implemented similar policies with with positive public health outcomes. In the USA, for instance, neural tube defect rates dropped after folic acid was added to flour in 1998. This policy has been hailed as one of the most effective public health interventions in recent decades.

By adopting a similar strategy, the UK stands to achieve comparable benefits. The planned fortification could prevent up to 200 neural tube defect cases annually. Beyond these direct health benefits, the policy will also reduce the emotional and financial burden on families and the healthcare system.

Reaching Vulnerable Groups

One of the most main advantages of folic acid fortification is its ability to reach vulnerable populations. People from poorer backgrounds are less likely to take dietary supplements and may have diets that are lower in naturally occurring folate. Fortification ensures that everyone has access to an additional source of this vital nutrient, which can hep in reducing health inequalities.

Safety and Wholemeal Flour Exemption

Some people have expressed concerns about potential risks of folic acid fortification, such as masking vitamin B12 deficiency in older adults. However, evidence from countries with fortification policies shows that these risks are very low and far outweighed by the benefits.

Moreover, wholemeal flour will not be fortified under the new policy, as wholemeal flour is less commonly consumed and many people who choose it also prioritise less processed foods. However, those who consume wholemeal flour should be mindful of their folic acid intake and ensure this is adequate through other sources, including supplements or other products fortified with folic acid.

Looking Ahead

The move to fortify non-wholemeal flour with folic acid is a proactive approach to improving public health. By addressing one cause of neural tube defects, this policy will have a lasting positive impact on many families across the UK. It is a reminder of the power of preventive measures in public health when even a small change can make a large difference at a population level.

As we move toward the implementation of this policy, it is crucial to continue raising awareness about the importance of folic acid, particularly among women of childbearing age. Together, we can support a healthier future for mothers, babies, and society as a whole by supporting positive public health interventions such s folic acid fortification.

Bridging the Digital Divide in Healthcare: Understanding the Use of the NHS App

The NHS App, launched in 2019, was designed to revolutionise how patients engage with their healthcare, offering features such as booking appointments, viewing medical records, and ordering prescriptions. While the app has seen substantial uptake—with millions registering and engaging—it appears that the benefits of this digital innovation are not evenly distributed across the population as we report in our article in the Journal of Medical Internet Research.

The Promise of the NHS App

Digital health tools like the NHS App hold the potential to empower patients, improve self-management of health, and increase access to care. From March 2020 to June 2022, millions of users logged into the app, ordered prescriptions, and accessed medical records. However, a closer look at the data reveals disparities in who is using these features.

The Digital Divide in Action

Our recent study highlights how sociodemographic factors influence app engagement. Key findings include:

  • Socioeconomic Disparities: People in more deprived areas are significantly less likely to use the app. For instance, the rate of app registrations was 34% lower in the most deprived practices compared to the least deprived.
  • Ethnic Differences: Practices serving populations with higher proportions of White patients showed far greater engagement. Prescription ordering rates in these areas were over double those in more ethnically diverse regions.
  • Age and Health Needs: Younger patients were more likely to use appointment booking features, while those with long-term conditions engaged more with medical record views and prescription services.
  • Gender Gaps: Practices with higher proportions of male patients reported lower app engagement overall.

Why Does This Matter?

The NHS App aims to make healthcare more accessible for all, but these disparities suggest that its benefits may not be reaching those who need them most. This mirrors the “digital inverse care law,” where digital solutions are disproportionately used by those with better access and resources, potentially exacerbating health inequalities.

How Can We Close the Gap?

To ensure the NHS App works for everyone, targeted efforts are needed:

  1. Digital Literacy Programmes: Equip underserved communities with the skills needed to navigate digital tools.
  2. Tailored Outreach: Highlight the App’s benefits to specific groups, such as ethnic minorities and those in deprived areas.
  3. Enhanced Support Services: Offer helplines or in-person assistance for individuals less familiar with digital health platforms.
  4. Collaborations with Community Groups: Partner with local organizations to raise awareness and build trust in digital healthcare solutions.

A Call for Inclusive Digital Health

The findings of our study underscore the importance of continuously monitoring and adapting digital health strategies to meet the needs of diverse populations. The NHS App is a powerful tool with the potential to enhance healthcare accessibility, but its success depends on equitable adoption and use.

Let’s work towards a future where digital health bridges gaps rather than widens them, ensuring better health outcomes for everyone, regardless of their background.

Improving Migrant Healthcare: An Evaluation of of Health Catch-UP!

In today’s interconnected world, migration is a key feature of modern societies. The UK has become home to a significant number of migrants seeking new opportunities or fleeing difficult circumstances. Yet, this group often faces unique healthcare challenges, including the risk of undiagnosed infectious and non-communicable diseases and incomplete vaccination records. Addressing these issues is crucial not only for individual well-being but also for broader public health. In a recent article published in the journal BMC Medicine, we evaluated Health Catch-UP!, a digital tool designed to bridge these healthcare gaps.

Understanding the Need

Migrants when compared to local populations are more vulnerable to certain health conditions that are common in their countries of origin. These range from infectious diseases like hepatitis and latent tuberculosis (TB) to non-communicable conditions like diabetes and high cholesterol. Unfortunately, current healthcare services in the UK often overlook these needs, leading to underdiagnosed health issues and missed opportunities for early treatment and prevention.

What is Health Catch-UP!?

Developed as a Clinical Decision Support System (CDSS), Health Catch-UP! is integrated into primary care practices to prompt healthcare providers to offer tailored screening and catch-up vaccinations for at-risk migrant patients. The tool works by collecting key demographic information (such as age, sex, and country of origin) and using this data to recommend relevant health checks and vaccinations according to current UK guidelines.

Key Findings from the Study

Our recent evaluation of Health Catch-UP! in two London-based primary care practices revealed several important insights:

Successful Data Collection: The tool enabled almost complete coding of essential patient demographics, which are often missing from standard records.

High Screening Uptake: Over 60% of the participating migrant patients were eligible for screening, with an impressive 87% choosing to undergo the tests.

New Diagnoses: Through the screening, 12 new health conditions were identified, showcasing the tool’s potential to detect previously unrecognized health issues.

Challenges with Vaccinations: Despite identifying gaps in vaccination coverage, the actual uptake of vaccines was low. This highlights the need for more patient engagement and support in this area.

Patient and Healthcare Staff Perspectives

The feedback from both patients and healthcare professionals was largely positive. Patients appreciated being offered comprehensive health checks, especially when these were explained clearly by their providers. Clinicians found the tool to be user-friendly and felt it integrated well with existing practices. However, they noted that certain questions, such as asking about the date of arrival in the UK, could make some patients uncomfortable. Clear communication was key to overcoming this challenge.

The Road Ahead

While Health Catch-UP! has shown promise in improving healthcare access and outcomes for migrants, there are hurdles to overcome. Low vaccination uptake suggests that more robust patient education and logistical support are needed. Additionally, financial and staffing resources will be critical for widespread implementation, particularly in high-migrant areas.

Conclusion

Health Catch-UP! is a step forward toward more inclusive and effective healthcare for migrants in the UK. By tailoring healthcare to the needs of this diverse group, we can ensure better health outcomes and a stronger, more equitable healthcare system for all.

Cardiovascular risks in people with long-term conditions

People with many long-term conditions are at increased risk of cardiovascular disease. If you or someone you care about is living with a long-term condition, here are some practical steps people can take to reduce their risk:

1. Attend for Scheduled Check-Ups: Make sure you attend for any scheduled check-ups. For example, to check your blood pressure, weight, blood sugar levels and cholesterol; or to review your medication.

2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity and avoiding smoking; all of which can reduce the risk of cardiovascular disease. For exercise, you should aim for at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week. But even small changes – such as a modest increase in the amount of exercise you take each day – can have positive benefits. A diet rich in fruits, vegetables and whole grains and with less intake of processed foods and sugary drinks is also helpful for your health.

3. Medication Management: If you are prescribed drugs for conditions such as hypertension (high blood pressure) or diabetes, make sure to follow the treatment plan closely. Discuss any side effects or concerns with your doctor or another health professional.

4. Stay Informed: Understanding how your own health condition interacts with other diseases helps you stay informed about your health and reduce your risk of cardiovascular disease. This is an example of what health professionals call “health literacy”; which is increasingly important because of the greater focus in health systems on areas such as prevention and self-care.

5. Connect with Others: Joining a support group for people with your condition can provide valuable emotional support and practical advice from people who understand your challenges. These groups can be in-person or online.

Finally, remember that this list is not comprehensive. Every individual has their own health needs and personal circumstances that will affect their health.