US federal and state authorities have charged 324 people with healthcare fraud offences, seized $245m (£180m; €208m) in cash and assets, and broken up criminal networks that collectively billed Medicare and private insurers for $14.6bn, the Department of Justice has announced. Of these claims, just $2.9bn was paid out.“This record healthcare fraud takedown delivers justice to criminal actors who prey on our most vulnerable citizens and steal from hardworking American taxpayers,” said attorney general Pam Bondi. The previous record for a coordinated healthcare fraud operation involved $6bn in claims, she noted.Such coordinated efforts typically involve multiple fraud rings. It has become standard practice for the justice department to lay charges in several cases at once, in order to generate news coverage.1 While the current announcement involves the largest amount in false claims, it is not the biggest in terms of arrests and charges.2It does, however, include the largest single healthcare...

The government has unveiled its 10 year plan to transform the NHS in England, underpinned by housing more services under one roof in community settings to relieve pressure on hospitals, boosting use of technology, and sharpening the focus on preventing ill health.1Central to the plan are new “neighbourhood health centres” offering GP appointments, diagnostic and blood tests, scans, postoperative care, mental health support and rehabilitation, dentistry, debt advice, employment support, and smoking cessation and weight management advice in a single location.Many of these services are already offered in urgent treatment centres or minor injuries units, but the government wants to expand their scope to move more care out of hospitals into community settings.The new centres will “eventually” open 12 hours a day, six days a week, with each covering around 250 000 people. The government said it would start by establishing them in places with the lowest healthy life expectancy...

In an inauspicious beginning to one of the biggest weeks in the NHS’s history, England’s Department of Health and Social Care press released its NHS 10 year plan without providing an embargoed copy of the plan for scrutiny. This behaviour became standard practice under the previous UK government. Whether intentional or not, the result is a free pass for political spin. However, the truth will out. The last notable example was the government’s long awaited workforce plan, which ended up being heavily criticised (doi:10.1136/bmj-2024-079474).1 When the new NHS plan finally arrived it was missing detail on how the ambitions, many of them noble, would be delivered.Speaking at a conference earlier this year (doi:10.1136/bmj.r990), Michael Marmot advised, “There’s enough in the world to make one despair. But, to quote Raymond Williams: ‘To be truly radical is to make hope possible, rather than despair convincing.’ We know what needs to be done....

Sleeping in?Safety concerns have been raised about doses of the sleep-wake hormone melatonin in over-the-counter supplements that are often marketed to parents as gummies that they can give to their children.1Nightmare tablets?A large US study has found that doses in over-the-counter products can differ significantly from those stated on the label.2 Researchers at the US Food and Drug Administration analysed 110 melatonin products marketed at children and found that doses varied from 0% to 667% of the amount stated. The dose was deemed accurate in only half of the products (76-126% of the stated dose).Is this only an American dream?Not exclusively. While use of the drug is more common in the US with one in five US children under 14 reported to be taking it,3 a recent investigation by the Guardian newspaper reported evidence of a UK black market for melatonin.4Are we talking backstreet deals?Not exactly, but in the UK...

AbstractObjectiveTo quantify and identify the main causes of increased disease burden due to coronavirus disease 2019 (covid-19) pandemic.DesignTime-series modelling study.Data sourceGlobal Burden of Disease Study 2021.Main outcome measuresAbsolute and relative rate differences were calculated, along with their 95% confidence intervals (95% CIs), between the observed and expected rates for 174 causes of increases in incidence, prevalence, disability adjusted life years (DALYs) and deaths in 2020-2021. A statistically significant increase was indicated if the 95% CIs of the rate differences were above 0.ResultsGlobally, the rate of age standardised DALYs increased in absolute difference per 100?000 and relative rate difference by 97.9 (95% CI 46.9 to 148.9) and 12.2% (95% CI 5.8% to 18.5%) for malaria, 83.0 (79.2 to 86.8) and 12.2% (11.7% to 12.8%) for depressive disorders, and 73.8 (72.2 to 75.4) and 14.3% (14.0% to 14.7%) for anxiety disorders, which were prominent and statistically significant, followed by stroke, tuberculosis, and ischaemic heart disease. Additionally, the age standardised incidence and prevalence per 100?000 significantly increased for depressive disorders (618.0 (95% CI 589.3 to 646.8) and 414.2 (394.6 to 433.9)) and anxiety disorders (102.4 (101.3 to 103.6) and 628.1 (614.5 to 641.7)), as well as notable rises in age standardised prevalence for ischaemic heart disease (11.3 (5.8 to 16.7)) and stroke (3.0 (1.1 to 4.8)). Furthermore, age standardised mortality due to malaria significantly increased (1.3 (0.5 to 2.1) per 100?000). Depressive and anxiety disorders were the most predominant causes of increased DALY burden globally, especially among females; while malaria had the most severe increased DALY burden in the African region, typically affecting children younger than five years; and stroke and ischaemic heart disease in the European region and in individuals aged 70 and older.ConclusionThe covid-19 pandemic significantly increased the burden of several non-covid conditions, particularly mental health disorders, malaria in young children in the African region, and stroke and ischaemic heart disease in older adults, with notable disparities across age and sex. These findings underscore the urgent need to strengthen health system resilience, enhance integrated surveillance, and adopt syndemic-informed strategies to support equitable preparedness for future public health emergencies.

A group of medical researchers has urged the UK government to act decisively to end the “horror” that continues to unfold in Gaza, including ensuring aid can safely be delivered to the territory.In an open letter published in The BMJ, researchers from the London School of Hygiene and Tropical Medicine noted that Israel’s military bombardment of Gaza had resulted in the deaths of more than 56 000 people, a third of them children aged under 18.1 More than 1200 families have been killed, and 470 000 people are now at risk of famine, the letter said.On 18 June the United Nations reported that more than 400 Gazans had been killed by Israeli forces while trying to obtain food and other humanitarian aid since the US and Israel backed Gaza Humanitarian Foundation started distributing food.2In their letter the academics wrote, “What is unfolding in Gaza bears historical and global significance beyond...

F. Gordo Vidal
Med Intensiva. 2023;47:191-2

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Francisco Álvarez-Lerma, Mercedes Catalán-González, Joaquín Álvarez, Miguel Sánchez-García, Mercedes Palomar-Martínez, Inmaculada Fernández-Moreno, José Garnacho-Montero, Fernando Barcenilla-Gaite, Rosa García, Jesús Aranaz-Andrés, Francisco J. Lozano-García, Paula Ramírez-Galleymore, Montserrat Martínez-Alonso
Med Intensiva. 2023;47:193-202

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P. Perelló, J. Gómez, J. Mariné, M.T. Cabas, A. Arasa, Z. Ramos, D. Moya, I. Reynals, M. Bodí, M. Magret
Med Intensiva. 2023;47:203-11

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E.P. Gomes, M.M. Reboredo, G.B. Costa, F.S. Barros, E.V. Carvalho, B.V. Pinheiro
Med Intensiva. 2023;47:212-20

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L. Zapata, C. Guía, R. Gómez, T. García-Paredes, L. Colinas, E. Portugal-Rodriguez, I. Rodado, I. Leache, A. Fernández-Ferreira, I.A. Hermosilla-Semikina, F. Roche-Campo
Med Intensiva. 2023;47:221-31

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I. Astola Hidalgo, A. Fernández Rodríguez, E. Martínez Revuelta, M. Martínez Revuelta, A.M. Ojea, P. Herrero Puente, D. Escudero Augusto
Med Intensiva. 2023;47:232-4

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F.J. Casadiego Monachello, M.C. de la Torre Terron, J.A. Mendez Barraza, S. Casals Vila
Med Intensiva. 2023;47:235-7

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M.V.F. Garcia, R. Souza, P. Caruso
Med Intensiva. 2023;47:237-9

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J.M. Pérez Villares, L. Alarcón Martínez, P. Fernández Florido
Med Intensiva. 2023;47:239-41

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A. González-Castro, E. Cuenca Fito, C. González
Med Intensiva. 2023;47:242

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M. Cuervas-Mons Tejedor, J.D. López Castilla, E. Sánchez Valderrábanos
Med Intensiva. 2023;47:243

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L.I. Perez-Sanchez, N. Mamolar Herrera, J.J. Velasco Gómez
Med Intensiva. 2023;47:244-5

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M.C. Martínez-Ávila, C.I. Herrera-Arrieta, Z.M. Mondol-Almeida
Med Intensiva. 2023;47:246-7

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I. Keituqwa Yáñez, J. Navarro Martínez, M. García Valiente
Med Intensiva. 2023;47:248-9

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