GPs could limit appointments and cease non-contractual work as part of an escalation of collective action, the new chair of the BMA’s General Practitioners Committee for England (GPCE) says.Clare Bannon told The BMJ that she would like to see the options form part of the next phase of action, which GPCE is coordinating in response to BMA GP members overwhelmingly rejecting their contract for 2026-27 in March.1However, decisions about upcoming action are yet to be made, with Bannon only taking up the post as chair on 9 July.2 She takes over from outgoing chair Katie Bramall, who held the position since 2023.Bannon said one of her key priorities as GPCE chair would be to achieve a significant increase in core practice funding: “There’s no point negotiating a new General Medical Services contract without new funding.”In February, it was announced that the 2026-27 GP contract deal included a £485m uplift to...

NHS Resolution has published a report on misconduct hearings involving sexual misconduct,1 continuing the important work of raising awareness of this problem and showing commitment to the NHS England Sexual Safety Charter.We don’t find these figures “deeply alarming.” Instead, we “welcome” the increased number of reports, as it shows better awareness and shines more light on an endemic problem in healthcare. We remain appalled that anyone is subjected to these toxic behaviours, but an increased number of reports is a positive first step indicating increased psychological safety,2 as well as awareness and recognition of sexual misconduct. Crucially it also indicates that those reporting their concerns believe they will be heard and managed appropriately. Our research indicates that 90% of female respondents witnessed sexual harassment in 2017-22 and 30% experienced sexual assault by a colleague themselves in the same timeframe, so reported figures remain low, probably owing to lack of anonymised...

A new long term plan to rebuild “crumbling” NHS buildings and infrastructure will end “a decade of national decline in the NHS,” the government has vowed.1The NHS 10 year capital plan budget, announced on 9 July, will be £15bn by 2029-30 for improvements to provide NHS patients and staff with “modern buildings, reliable equipment, and services fit for the future,” said health minister Karin Smyth.The investment will help patients get faster appointments and bring more care closer to home for patients across the country, Smyth said.The budget will include a further £200m to help GP surgeries to expand and modernise as part of the primary care utilisation and modernisation fund (PCUMF).2 The fund, which amounted to £102m in 2025-26, has already funded 790 upgrades to individual practices.The upgrades, which largely involve converting unused space for clinical use, will create extra capacity and “help unlock nine million extra appointments,” the government...

An adult in England has died from measles, bringing the total number of fatalities from the disease so far this year to three.The fatality, which officials said occurred in an adult with an underlying immunological problem, follows the deaths of two children in June.Latest figures from the UK Health Security Agency show 883 confirmed measles cases reported in England so far this year, up to 6 July. In 2025 there were 959 confirmed measles cases across the whole calendar year.All regions of England have reported cases in 2026, the worst affected areas being London (52% of total cases), the West Midlands (17%), and the north west (10%). The UK lost its measles elimination certification in January, as the disease had circulated continuously for more than a year.1The current vaccination rate for both doses of measles, mumps, and rubella (MMR) at age 5 years in England is 84.1%, far lower than...

The health of Hussam Abu Safiya, a paediatrician who has been held by Israeli authorities for 18 months over unsubstantiated allegations of ties to Hamas, is rapidly deteriorating.In a statement to the media Safiya’s lawyer, Nasser Odeh, said that the doctor’s condition had begun to worsen in June, shortly after he was transferred to the high security Nitzan Prison and placed in solitary confinement.1Odeh said that Safiya, former director of Kamal Adwan Hospital in the Gaza Strip, told him during a meeting in early July, “This is the last time you’ll see me . . . They brought me here to kill me. This is the end.”The non-governmental organisation Physicians for Human Rights Israel said that in a meeting with his lawyer Safiya had appeared close to collapse, struggling to remain upright and having difficulty breathing and speaking.2 During the meeting he was escorted by masked prison officers and had...

A coalition of health campaigning groups and trade unions has urged the likely next prime minister to scrap the UK-UK trade deal after The BMJ exposed how it could lead to thousands of excess deaths.The SOS NHS Coalition has written an open letter to Andy Burnham warning that the deal prioritises pharmaceutical company profits over the lives of NHS patients.1The BMJ’s analysis estimated that the deal would divert an additional £44.7bn away from health services by the end of 2036 to pay for new drugs unless extra funding was made available. 2 The analysis, by academics from the University of York, the University of Liverpool, and Christchurch Hospital in New Zealand, concluded that reduced NHS spending on services as a result of the deal would have an adverse effect on population health and lead to an estimated 229 000 excess deaths.The letter calls on Burnham, who is expected to succeed...

The NHS is on the brink of something important. The federated data platform (FDP), combined with the accelerating use of artificial intelligence (AI), offers the possibility of a health system that’s more coordinated, predictive, and efficient. Although this is the right direction of travel, one question isn’t receiving enough attention: who ultimately controls the data?That question matters because of a little-known piece of US legislation: the CLOUD Act. The Clarifying Lawful Overseas Use of Data Act allows US authorities to compel US companies such as Palantir, the technology company currently contracted to deliver the FDP, to provide data within their “possession, custody, or control.” This is required regardless of where the data are physically stored.This means that data held on UK servers may still fall under US legal jurisdiction if controlled by a US company. This doesn’t mean arbitrary access to NHS patient records, but it does establish a lawful...

I received a diagnosis of type 1 diabetes at the age of 5. I vividly remember hearing my mom being told that type 1 diabetes would be cured by the time I was 30. Because of these conversations, I spent much of my childhood believing that a cure was on the horizon. The idea was reassuring at first, but gradually diabetes became my everyday life, and at age 10, when I got my first insulin pump, I stopped anticipating a cure. Getting the pump made my diabetes feel permanent. Before that, insulin injections had happened in a single moment. Wearing a medical device attached to my body at all times made diabetes feel more real and no longer intermittent. I now carried it with me everywhere.Building knowledge and trustAs a child, I managed my diabetes only because my mom made me or did it for me. Often I heard only...

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.

In this narrative medicine essay an infectious diseases physician shares the sense of forgiveness she brings to anyone possibly involved in COVID-19 transmission, having learned as a child the healing power of family absolution after she witnessed the death of a cousin.

I will work. I will work without a mask. I will mask the work of courage. I will say there is a reason, bury my aunt, and say it again. I will walk on any street without a graveyard without a mask. I will let our children play there. I will see them share the sand. I will let them touch each other. I will see them slip in soil. I will remember I played dead. I will forget two hundred thousand bodies. I will sift anything but ash.

This randomized trial compares the effects of blinatumomab, an antibody construct that links CD3+ T cells to CD19+ leukemia cells, vs consolidation chemotherapy as a third consolidation block before allogeneic hematopoietic stem cell transplant (HST) on event-free survival in children with high-risk first-relapse B-cell acute lymphoblastic leukemia (B-ALL).

This randomized trial compares the effects of postreinduction therapy consolidation using blinatumomab, an antibody construct that links CD3+ T cells to CD19+ leukemia cells, vs chemotherapy on disease-free survival among children, adolescents, and young adults with first relapse of B-cell acute lymphoblastic leukemia (ALL).

In Reply Dr Kim and colleagues state that the results of our study are not comparable with those of PLATO and suggest that our findings may differ because patients enrolled in PLATO had a higher proportion of prior myocardial infarction. First, as we mention in our article, PLATO failed to show benefit in North America and included few Asian patients. It did show that ticagrelor reduced ischemic events and increased the rate of nonprocedural bleeding. However, several studies have demonstrated that high-risk patients with ACS do not have a net benefit with ticagrelor. For example, the SWEDEHEART registry showed that ticagrelor was associated with higher rates of bleeding and increased mortality in patents with ACS who were aged 80 years or older. A reduction in ischemic outcomes from ticagrelor was also not observed in this study. The open-label randomized clinical trial POPular AGE demonstrated that clopidogrel is favored for older patients with non–ST-elevation ACS, a high-risk subgroup. The TICA-KOREA trial showed that ticagrelor use was not associated with fewer ischemic events but was associated with increased risk of bleeding in Korean patients with ACS treated with PCI.

In Reply Our recommendations for initial antiretroviral therapy are based on evidence from randomized clinical trials demonstrating superiority of InSTI-based therapy vs comparators that included boosted protease inhibitors or efavirenz. Additional benefits of dolutegravir-based and bictegravir-based therapies include a low risk of treatment-emergent resistance, lack of need for pretreatment genotype results, few significant drug interactions, and a highly favorable tolerability profile, along with a very low rate of discontinuation due to adverse effects.

In Reply We agree with Dr Donzelli that reforming health care payment is an essential step in reducing the delivery of low-value services. This is core to our argument around the economic forces that guide the de-adoption of low-value care. Within this realm of economic levers, Donzelli makes an important distinction between pay-for-performance and pay-for-health models, noting some inconsistent results from the former. Although there is evidence that targeted payment policies can reduce the provision of low-value care, we agree that more holistic value-based payment models are needed. Our understanding of how to best pay for health continues to evolve and requires precise measurement of and alignment around the definition of health. One approach raised by Donzelli is to move toward risk-adjusted capitated payments, an approach already used at scale within the Medicare Advantage program. There is also some evidence to suggest that other global payment structures influence the provision of low-value services. As the adoption of value-based payment continues to grow, it will be important to rigorously evaluate the impact on low-value care.

To the Editor A recent retrospective cohort analysis by Dr You and colleagues demonstrated that compared with clopidogrel, ticagrelor was not associated with better outcomes in patients from the US and South Korea with acute coronary syndrome (ACS) undergoing percutaneous intervention (PCI). However, there are several important discrepancies between this cohort analysis and the randomized Platelet Inhibition and Patient Outcomes (PLATO) trial.