Professor Azeem Majeed

The impact of noise pollution on health ### What you need to know A 52 year old man presents with persistent sleep disturbance, tiredness, and difficulty concentrating. His partner reports increasing irritability. The couple have recently ...

New paper in the @bmj.com.

Noise pollution affects millions and contributes to heart disease, sleep problems, and mental ill health.

We outline practical ways to recognise and reduce its effects across patient, provider, and policy levels.

Read here: doi.org/10.1136/bmj-...

#PublicHealth #health

A Community Health and Wellbeing Worker smiling and waving. #ARCimpacts logo

Community Health & Wellbeing Workers have been supporting over 20,000 households with proactive & culturally sensitive care.

This new approach co-developed by @arc-nwl.bsky.social is projected to deliver a £3 return for every £1 invested!

arc-nwl.nihr.ac.uk/news/communi...

💫 #ARCimpacts

Factors influencing primary care physicians recommending patients to use digital health technologies for self-management: A cross-sectional study across 20 countries Expanding access to self-management via Digital Health Technologies may supplement traditional care, mitigating pressures on primary care through self-management. Primary Care Physicians (PCP) can ...

Factors influencing primary care physicians recommending patients to use digital health technologies for self-management: A cross-sectional study across 20 countries. www.tandfonline.com/doi/full/10....

Factors Influencing the Use of Online Symptom Checkers in the United Kingdom: Cross-Sectional Study Background: The National Health Service faces increasing strain. Concurrently, demand for health information, consumer empowerment and health awareness continue to grow. These trends, coupled with the ubiquity of smartphones and internet access, are positioning online symptom checkers (OSCs) as promising tools for preliminary diagnosis and triage. While there is increasing data on the demographics, motivations and perspectives of current and potential users of OSCs globally, no study has yet quantified or ranked the various factors associated with the use of OSCs in the United Kingdom (UK). Objective: The aim of this study was to assess key trends and user perceptions on the #usability and effectiveness of OSC in the UK. We also sought to identify concerns related to the privacy, security and accuracy of OSCs, and to quantify the weight of these various factors on the use of OSCs. Methods: A cross-sectional survey of UK adults was conducted using an electronic questionnaire. A convenience sample was recruited between February and March 2024 through online platforms and personal networks. The survey included questions on awareness, use, perceptions and concerns regarding OSCs, as well as respondents’ demographics. Responses were pseudo-anonymised and analysed using univariable and multivariable logistic regression models to assess relationships between demographic factors, perceived #usability, reliability and risks and OSC use. Results: The survey collected responses from 634 participants. The majority (85.7%) had used OSCs, primarily the NHS 111 service (78.6%). Younger age (below 46 years old), being female (aOR=1.79, 95%CI 1.05 – 3.06) and having children (aOR= 3.19, 95%CI 1.56 - 6.51) were associated with higher odds of using OSCs. Key motivations for using OSCs included understanding symptoms (79.0%) and determining the need for medical care (77.4%). Key concerns negatively impacting use related to privacy (aOR=0.58) and fear of replacing traditional, face-to-face consultations (aOR=0.47). The most important factor found to affect the decision to use OSCs was the perceived ease of use (adjusted odds ratio =8.17), followed by the perceived helpfulness in decision-making (aOR=2.96), and respondents’ trust in their diagnostic accuracy (aOR=2.24). Conclusions: OSCs are widely used in the UK, particularly the NHS 111 service, driven primarily by ease of use and perceived helpfulness in decision support. However, privacy and security concerns, as well as fears of OSCs replacing traditional consultations, pose significant barriers. Addressing these concerns is crucial for enhancing user trust and maximizing the benefits of OSCs in supporting self-care and improving healthcare efficiency.

JMIR Formative Res: Factors Influencing the Use of Online Symptom Checkers in the United Kingdom: Cross-Sectional Study #HealthTech #OnlineHealth #SymptomChecker #NHS #DigitalHealth

"The shift from controlling glucose alone to preventing heart + kidney disease could have major benefits for patients + the #NHS.”

@azeem-majeed.bsky.social on 🆕 draft NICE guidance that could transform how #T2Diabetes is treated.

@pulsetoday.bsky.social www.pulsetoday.co.uk/news/clinica...

What's next for #GeneralPractice under the #NHS10YearPlan?

"It is essential the plan is backed up by the necessary contractual changes and workforce developments to make it work."

🎙️ @azeem-majeed.bsky.social comments on @pulsetoday.bsky.social's podcast. www.pulsetoday.co.uk/analysis/pul...

Impact of online patient access to clinical notes on quality of care: a systematic review Background Access to electronic health records (EHRs) has the potential to improve the quality of care. Clinical notes, free-text entries documenting clinicians’ observations and decisions, are centra...

📰 New Systematic Review Shows Giving Patients Online Access to Medical Records Notes Boosts Safety & Engagement
📊Improved trust, safety & satisfaction, especially for underserved groups.
⚕️No added burden for staff
👍Supports NHS’s digital-first future
🔗 arc-nwl.nihr.ac.uk/news/giving-...

Recorded consultations are here to stay, but the current ad hoc approach leaves clinicians and patients vulnerable.

Clear guidance is necessary as recording of consultations becomes the norm, write @azeem-majeed.bsky.social and Waseem Jerjes
www.bmj.com/content/390/...

How difficult can it be to run the GMC? You provide a monopoly service because no one else in the UK can register and regulate doctors. You decide how much doctors will pay you each year. And you are not at all accountable to doctors because they have no say in who is appointed to manage the GMC.

General practice is one of the few areas of the NHS in England where productivity has increased in recent years. It’s essential to invest in core GP services so that capacity and productivity can be increased further instead of in costly clinical programmes that will fragment primary care.

It was a great pleasure to welcome GPs from across the UK to Imperial College’s Annual GP Teachers Conference. As well as teaching clinical skills, GP teachers also shape the professional identity and core values of medical students and their knowledge of the role of primary care in the NHS.

When examining the proposed health policies being put forward by politicians, NHS staff and the media need to ask will this policy improve patient experience, clinical outcomes and NHS efficiency, and is it cost-effective? Essential questions when public funding is tight.

One of the questions that some of my GP colleagues ask is why they can’t see the x-rays they request for their patients. They will receive a written report from a radiologist but generally can’t view the image. With modern NHS IT systems, this should be possible.

For doctors, the ability to accept some clinical risk is important in their professional role. Experienced clinicians are more aware of the appropriate level of risk to accept. Less experienced clinicians will often follow guidelines rigidly or practise in a very risk averse way.

Safety and Efficacy of Digital Check-in and Triage Kiosks in Emergency Departments: Systematic Review Background: Emergency departments (EDs) globally face unprecedented pressures due to aging populations, multimorbidity, and staff shortages. In response, health systems are adopting technological solu...

Digital check-in and triage Kiosks in emergency departments can identify high-acuity patients but their impact on productivity is unclear. High over-triage rates and poor concordance with nurse-assigned triage scores may limit their use in busy settings. www.jmir.org/2025/1/e69528

Our new article in BMJ Open: Triple cardiovascular disease detection with an artificial intelligence-enabled stethoscope (TRICORDER): design and rationale for a decentralised, real-world cluster-randomised controlled trial and implementation study. bmjopen.bmj.com/content/15/5...

I spoke to BSc students at Imperial College recently about what they should consider when applying for an MSc course. One key consideration is for BSc students to clearly define their motivations for further study; whether this is for career progression, specialisation or for research aspirations.

Universities in the UK face major financial constraints; resulting in limited opportunities for permanent academic positions for clinicians. Hence, the number of permanent positions has not kept pace with the growing pool of post-doctoral researchers wanting academic posts.

One problem with clinical academic training in England is that there are now many opportunities for funding for doctorates and post-doctoral fellowships from funders such as the NIHR but a major bottleneck in permanent lecturer and senior lecturer posts in universities.

A Novel Framework to Assess Clinical Information in #digital #health Technologies: Cross-Sectional Survey Study Background: #digital #health is a critical driver of quality, safety, and efficiency in #healthcare. However, poor quality of clinical information in #digital #health Technologies (DHTs) can compromise the quality and safety of care. The Clinical Information Quality (CLIQ) framework was developed, based on a systemic review of literature and an international eDelphi study, as a tool to assess the quality of clinical information in DHTs. Objective: The aim of this study is to assess the applicability, internal consistency, and construct validity of the CLIQ framework. Methods: This study was conducted as a cross-sectional survey of #healthcare professionals across the UK who regularly use SystmOne #ehrs. Participants were invited through emails and social media platforms. The CLIQ questionnaire was administered as an online survey. Spearman’s correlation coefficients were computed to investigate the linear relationship between the dimensions in the CLIQ framework. The Cronbach’s alpha coefficients were computed to assess the internal consistency of the global scale (i.e., CLIQ framework) and the sub-scales (i.e., the informativeness, availability and usability categories). Confirmatory factor analysis was used to assess the extent to which the survey data supported the construct validity of the CLIQ framework. Results: A total of 109 #healthcare professionals completed the survey, of which two-third (n = 67; 61.5%) were doctors and a quarter (n = 26; 23.9%) were nurses or advanced nurse practitioners. Overall, the CLIQ dimensions had good quality scores except for portability which had a modest score. The inter-item correlations were all positive and not likely due to chance. The Cronbach’s alpha coefficient for the overall CLIQ framework was 0.89 (95 CI%: 0.85 – 0.92). The confirmatory factor analysis provided a modest support for the construct validity of the CLIQ framework with the Comparative Fit Index of 0.86 and Standardised Root Mean Square Residual of 0.08. Conclusions: The CLIQ framework demonstrated a high reliability and a modest construct validity. The CLIQ framework offers a pragmatic approach to assessing the quality of clinical information in DHTs and could be applied as part of information quality assurance systems in #healthcare settings to improve quality of #health information.

New JMIR MedInform: A Novel Framework to Assess Clinical Information in #digital #health Technologies: Cross-Sectional Survey Study

Without addressing these issues, healthcare systems like the NHS force doctors to spend much of their time on tasks that are well below their skill level. This not only leads to inefficiency and burnout but also compromises the quality and timeliness of patient care.

We sometimes hear that doctors “need to work at the top of licence” meaning they should do work that other staff cannot do. But how can doctors do this when in many hospitals and health centres they lack administrative support, office space and appropriate IT facilities?

The recent deal reached between the UK and EU shows how Brexit is far from “done” as claimed by some politicians but rather is a dynamic and ongoing process with negotiations and compromises - driven by economic, political and global realities - that will continue indefinitely.

Becoming a doctor in the UK is an achievement to be proud of. There are many highly-qualified applicants for each place in medical school. Medical students then complete an arduous course of up to 6 years, followed by years of postgraduate training and professional development.

Doctors are part of a global professional community. This international network allows us to obtain support, advice and knowledge from medical colleagues globally to help improve patient care and tackle the many clinical, healthcare and public health challenges we face.

Frontiers | The unseen costs of medical training in the UK: a growing crisis Waseem Jerjes 1 , Azeem Majeed 1 (1) Faculty of Medicine, Imperial College London, UKThe silent financial strain of medical training Medical training in the ...

The funding challenges faced by medical trainees are more than just the cost of professional examinations or membership fees. They are symptoms of a broader failure to treat medical training as an investment in the healthcare system's future. www.frontiersin.org/journals/med...

The article may have come across harsher than intended. The main focus of the article is on the need for better training, adequate time and resources, and better monitoring of people with ADHD in primary care.

Frontiers | General practitioners, attention deficit hyperactivity disorder and the risks of stimulant mismanagement General practitioners have been increasingly made the gatekeepers of ADHD stimulant medications, a role normally meant for specialists. Though GPs are used t...

GPs are managing an increasing number of people with ADHD but a lack of resources, training and support raises concerns over the potential misuse of stimulant drugs. The article from Waseem Jerjes and myself discusses how these risks can be reduced. www.frontiersin.org/journals/med...

Many patients are unaware of the choices of treatment centres available to them and prefer to rely on their GP’s recommendation. Ultimately, while choice can benefit some people, what patients generally want is timely, convenient, high-quality and trustworthy care close to home.

Over the past 30 years, the NHS has repeatedly tried to enhance patient choice of specialist providers, aiming to drive up quality through competition. However, my experience is that most patients prioritise rapid access to high-quality, local services over choice of provider.