It has been revealed that the NHS paid almost £1bn over three years to private companies providing NHS services, mostly to help clear elective care backlogs.EveryDoctor, a grassroots advocacy group made up of UK doctors, published details of a Freedom of Information (FOI) request showing that 72 trusts had spent £993m since 2023 on “insourcing.”1Insourcing is when an NHS trust pays a private company to treat NHS patients, inside NHS buildings, usually run by NHS staff working extra shifts.The FOI request gathered responses from 72 of the 81 trusts contacted. Information requested covered the names of all insourcing providers used, the specific clinical specialties provided, and total expenditure per provider for the financial years 2023-24, 2024-25, and 2025-26.NHS England launched the Elective Recovery Fund in 2021 to help trusts clear the backlog left by the covid-19 pandemic. Under this approach, trusts were able to access more funding if they reached...

In this article by Myles and colleagues (BMJ 2026;394:e100407, doi:10.1136/bmj-2026-100407, published 19 August 2026), in the footnote to table 4, a P value was incorrectly reported as 0.001 when it should be 0.75. This section of the footnote should read “Comparison of difference between 25th and 10th centile was -2.9 (95% CI -9.3 to 15.2), P=0.75.” The article has been corrected.

A genetically modified kidney from a pig has worked in a patient with kidney failure for nine months—the longest period yet recorded—US doctors have reported.The transplant kept Tim Andrews, 66, free of dialysis for 271 days, and demonstrated for the first time that a pig kidney can be used as a temporary “bridge” until a human transplant becomes available, according to a case study report published in the Lancet.1Andrews had kidney failure caused by type 2 diabetes. He had just a 9% chance of receiving a human kidney within five years, against a more than 40% risk of dying or being removed from the waiting list for a transplant, the researchers noted.The pig kidney he received worked for nine months before it failed and was removed. After a short period of dialysis, he received another kidney from a deceased human donor.Researchers at Mass General Brigham hospital, Massachusetts—who carried out the...

The Royal College of General Practitioners (RCGP) has published its first dedicated research strategy, setting out a three year roadmap for 2026-29.1 It promises to strengthen research literacy; build and sustain academic careers and the evidence base in primary care; and support sustainable multidisciplinary research delivery, and it commits the RCGP to work with key stakeholders to achieve these objectives. The roadmap resonates with recent research strategies from the Royal Australian College of GPs,2 College of Family Physicians, Canada,3 and North American Primary Care Research Group,4 which provide similar recommendations to enhance primary care research.Research improves patient care56 and provides major economic benefits: for every £1 invested, research funded by the National Institute of Health and Care Research (NIHR) delivers over £13 in economic benefit in the UK.6 Historically, most research funding has been allocated to secondary care, despite most clinical contacts occurring in community settings.7 Only around 25% of...

An invasive species of mosquito that can transmit viral diseases such as dengue, Zika, and chikungunya has been discovered breeding in the UK for the first time.The UK Health Security Agency (UKHSA) has increased surveillance and trapping activities after invasive Aedes aegypti mosquitoes and larvae were detected at residential properties in east London.The agency said that the risk to the public remained low, as—despite recent heatwaves—the UK climate is too cold for the species to survive long term.It is the fourth time Aedes aegypti has been detected in the UK in recent years, but this is the first time that it has been identified breeding, health officials said.The species is typically found in tropical and subtropical regions and can transmit diseases including dengue, chikungunya, yellow fever, and Zika. It is not a vector for malaria.It has previously been known to “hitchhike” from its native range in vehicles, baggage, and imported...

A doctor in Guernsey revealed sensitive confidential medical information about one patient by taking a phone call while examining another patient, it has emerged.The breach of confidentiality was outlined in the latest report from Guernsey’s Office of the Data Protection Authority.1This case came to light after the healthcare provider that employed the doctor reported the breach to the data protection regulator.The doctor remained in the examination room throughout the conversation, where the identifying details of the patient on the phone and sensitive details of their health were heard by the patient being examined and by others in the room.“The information was heard by people who had no legitimate reason to receive it and who were unconnected to the care of the patient on the phone,” the Data Protection Authority’s report reads.“The breach involved the unauthorised disclosure of special category data and created a risk of distress and loss of privacy...

Global health is entering an era of financial retrenchment and fragmented leadership. Development assistance for health fell sharply in 2025, driven largely by cuts in US funding, and is at its lowest level since 2008.1 This has encouraged speculation that China might fill the financial gap. That illusion should be rejected. Such substitution would be financially implausible, politically inconsistent with China’s approach to development cooperation, and undesirable for regions seeking more national sovereignty, such as that envisioned in the Africa-led Accra reset to reform the global health architecture.2China nevertheless has compelling reasons to engage more deeply in global health and governance. The 2003 SARS outbreak exposed weaknesses in domestic surveillance, reporting, and emergency response, while disrupting trade, travel, and economic growth; covid-19 reinforced the lesson on an unprecedented scale.3 China’s engagement reflects overlapping motivations: national risk management, international commitments and responsibilities, south-south solidarity, and economic and technological interests.34 More importantly...

The potential benefits of sharing clinical trial data are broadly recognised by researchers, policy makers, and the public. Notably, US clinical trial participants express high levels of support for secondary use of their individual participant data (IPD), especially by academic scientists.1 The US National Institutes of Health and other research sponsors have adopted policies to expand IPD sharing among investigators they fund.23 However, as a result of uneven data sharing practices, the vision of a scientific commons in which data are accessible to all qualified researchers to accelerate discovery remains elusive.4A linked special paper by Taherifard and colleagues (doi:10.1136/bmj-2026-100460) illuminates a strategy that could overcome some barriers to data sharing: repositories.5 So that data requestors need not beg other investigators to spend time and resources preparing datasets and metadata, repositories provide a mechanism for deposition of clinical trial artefacts in a centralised structure staffed by people who evaluate requests, secure...

AbstractObjectiveTo assess the number, timing, characteristics, and scholarly impact of secondary publications generated using individual participant level data (IPD) from a portfolio of clinical trials shared with external investigators through a data sharing platform.DesignCross sectional study.SettingYale University Open Data Access (YODA) Project platform.ParticipantsJohnson 91%), most obtained access through data sharing platforms (n=161; 85%), primarily the YODA Project (n=157; 83%). Over time, the proportion of external publications increased steadily, exceeding 50% of all secondary publications by year 11 and thereafter. Compared with internal publications, external publications were more frequently pooled analyses (151/209 (72%) v 534/958 (55.7%); P<0.001) and involved predictive or prognostic modelling (108/209 (51.7%) v 322/958 (33.6%); P<0.001), development of statistical models or algorithms (60/209 (29%) v 114/958 (11.9%); P<0.001), and validation of existing methods, models, or risk scores (32/209 (15%) v 66/958 (6.9%); P<0.001). Compared with internal publications, external publications were published in journals with higher impact factors (median 6.7 (interquartile range 3.4-16.6) v 4.6 (2.9-10.2); P=0.002) and had higher annual Altmetric Attention Scores (median 2.1 (0.7-7.1) v 0.6 (0.3-2.3); P<0.001) but had lower annual citation counts (median 2.7 (1.1-5.6) v 3.4 (1.6-7.5); P<0.001) and were less likely to be cited in clinical guidelines (21/184 (11%) v 235/805 (29.2%); P<0.001) or policy documents (14/184 (8%) v 206/805 (25.6%); P<0.001).ConclusionsMost trials in this portfolio of clinical trials, for which IPD were available through a data sharing platform, generated secondary research by both original trial investigators and external investigators. External investigators most often accessed data through the data sharing platform, and their publications accounted for an increasingly larger proportion of secondary publications over time. These findings suggest that structured data sharing mechanisms may support additional secondary use of clinical trial data and further enhance the scientific value of clinical trials.

The General Medical Council (GMC), like many institutions today, faces a clash of values. Doctors’ freedom of speech must be protected from punitive or bad faith referrals1: if doctors fear that ethical, humanitarian, or political speech about Israel, Palestine, or Gaza will trigger regulatory scrutiny, professional witness will be constrained at the very moment moral clarity is most needed.Yet a second trust problem must be held alongside the first. If the debate is framed only as “antisemitism is being used to silence doctors,” we should not be surprised when Jewish staff and patients hear something else: that their recognition of antisemitism is itself suspect or politically motivated. That too damages trust.The task for medical institutions is not to choose between protecting speech and recognising antisemitism, but to build processes that differentiate between legitimate criticism of Israeli policy, humanitarian advocacy for Palestinians, offensive but lawful speech, professional misconduct, discrimination, and hostility...

Neurosurgeons in London have successfully carried out a live artificial intelligence assisted operation to remove a brain tumour, described as a world first for such surgery.Rhys Hibbert, a 48 year old patient, could have lost his sight without the surgery at the National Hospital for Neurology and Neurosurgery (NHNN) in London earlier this year.During the operation the AI system analysed the live surgical video feed in real time, rather than using presurgery scans. The surgeons remained in full control, but the technology helped the team make more precise decisions by highlighting critical structures at the base of the brain.The procedure represented the first time the technology has been used on a patient this way.Because blood vessels and nerves controlling vision are so tightly packed together in the pituitary gland, and going a millimetre wrong can make a critical difference leading to death, blindness, or stroke, the surgical team used AI...

Pennsylvania has recorded the first two deaths from measles in the US state for more than three decades.These are also the first fatalities from measles recorded in the US this year. In 2025 there were three deaths from measles, which were the first measles associated fatalities in the country since 2015.The most recent fatalities occurred in Lancaster County, where 185 of Pennsylvania’s 393 cases this year have been recorded.No further details about the two individuals were released by health officials owing to privacy concerns, though the Pennsylvania Department of Health confirmed that they were unvaccinated.Jeffrey Martin, a GP at Penn Medicine Lancaster General Health, told a press briefing, “These tragic deaths remind us that measles is not a harmless illness. It’s appropriate that we’re having this press conference at our Women and Babies Hospital. Pregnant women and children are vulnerable to measles if they are not vaccinated.”The US Centers for...

Women in southwest England have voiced alarm that the temporary closure of a town’s maternity unit means riskier, longer journeys to give birth.But media reports that expectant women are now being coached on “how to give birth in the back of a car” have led to clarification and pushback.1Royal Devon University Healthcare NHS Foundation Trust, which suspended births at North Devon District Hospital in Barnstaple because of a lack of medical cover, confirmed that the birthing advice discussed in the media was not theirs.Rather, it had come from Devon Antenatal Family Centre. The centre’s founder and chief executive, Catherine Mchomvu, told The BMJ that press reports of the advice to women, which she had updated to enhance their safety and wellbeing, had produced “sensationalist” headlines.Births at North Devon District Hospital were controversially suspended earlier this month owing to shortages of consultants and obstetricians.23 But safety concerns were raised over the...

Taking the shingles vaccine Shingrix could reduce the risk of cardiovascular events including heart disease, heart failure, and stroke, a study has suggested.1Shingles, a viral infection that can lead to a painful rash, is caused when the varicella zoster virus (which causes chickenpox) reactivates, often decades after initial infection. It typically lasts two to four weeks.An estimated one in five people develop the condition in their lifetime.2Shingrix, a recombinant vaccine targeting the infection, has been available widely on the NHS since 2023 and is now offered to people aged 65-79 and immunosuppressed people aged over 18.Previously, the live attenuated Zostavax vaccine against shingles was used in many parts of the world, including the UK from 2006. But many countries, including the US and the UK, switched to Shingrix, which is more effective and—unlike the live vaccine—is suitable for people with weakened immune systems. The US switched from Zostavax to Shingrix...

In January 2021 Anthony Fauci, then director of the US National Institute of Allergy and Infectious Diseases, sent a text message stating that the second dose of covid vaccine “theoretically could be associated with miscarriage in the 1st trimester.”1This was one of a chain of messages, later in which he highlighted the risks of covid infection in pregnancy and stated that no issues had arisen in more than 10 000 pregnant women who had been vaccinated. But, hot on the heels of President Donald Trump’s latest executive order advising a reduction in childhood vaccines, antivaccination Republicans in the US have seized on the first statement, along with misinterpretation of data from an early study, to falsely assert that vaccination against covid-19 causes miscarriage.That early study, published soon after the mass rollout of the vaccine began, used data from a small number of pregnant women who had received the vaccine.2 The...

Just before noon local time on 21 October 2013,1 a car entering an intersection in Nashville, Tennessee, crashed into an SUV. Sitting in the passenger seat of that SUV was Dolly Parton.2 Thankfully, no one was seriously hurt, and the legendary country singer experienced only minor injuries.What happened next arguably changed the course of her life and, quite likely, helped to save the lives of many others. Because it was later that day, during treatment for her injuries at Vanderbilt University Medical Centre (VUMC), that Parton met the surgeon Naji Abumrad. They became friends, and when the covid-19 pandemic erupted roughly seven years later, Parton donated $1m towards the development of Moderna’s mRNA based vaccine, in honour of her medical pal.3 VUMC researchers were involved in the jab’s development.4Parton died this week at the age of 80, after a cancer diagnosis.5 She leaves a broad legacy in music and the...

This Viewpoint discusses policies the Biden administration can enact to reduce costs, including benchmarking Medicare Part B drug payments to the lowest price paid in similar countries, preventing Part D plans from negotiating confidential rebates with manufacturers, and patent reform to promote generic drug use.

This Viewpoint reviews evidence that higher hospital prices reflect greater market power more than higher-quality services and proposes that backstop price caps can mitigate harms from the most excessive prices without constraining or distorting competitive health care markets.

This narrative review summarizes the epidemiology, pathophysiology, diagnosis, management, and prognosis of irritable bowel syndrome.