The unrest over physician assistants continues to drag on, more than a year after Gillian Leng’s independent review was published. On 17 July 2026 the High Court dismissed a legal challenge to the Leng review’s recommendations brought by the physician assistants’ trade union, United Medical Associate Professionals. Importantly, the judge dismissed the unfounded claim that Leng had produced the review to appease certain quarters of the medical profession, including the BMA.The handling of the controversy around physician assistants has been damaging to the health system—including the royal colleges, the General Medical Council (GMC), and NHS England. Many concerns about physician assistants raised by frontline staff were dismissed by leaders as “social media noise.” Doctors were accused of elitism and being protective of their role. Delayed and soft touch regulation of physician assistants by the GMC added to the problems around undefined scope of practice and patient safety risks.The former health...

Thousands of people with multiple sclerosis (MS) in England will be offered a new drug on the NHS to help them walk more easily.Fampridine (Fampyra)—the first medicine to help improve walking for adults with MS—will be routinely available on the NHS in England from today.The twice daily pill acts as a “signalled booster” for nerves damaged by MS, helping electrical messages to travel to muscles more effectively. This will make it easier for some patients to walk, which could make everyday tasks easier and help them maintain their independence, said NHS England (NHSE).MS is a lifelong neurological condition caused by damage to nerves in the brain and spinal cord. Symptoms can include weakness, fatigue, loss of sensation, problems with balance and coordination, and difficulty walking.Existing treatment options for helping people with MS to walk include physiotherapy and exercises, walking aids, devices to support the feet, and treatments to manage muscle...

This editorial by Lei (BMJ 2026;392:s236, doi:10.1136/bmj.s236, published 6 February 2026) was corrected after publication. The academic position of the author was incorrectly listed as “senior research fellow.” This has been amended to “student” to accurately reflect their position at the time of publication.

This editorial by Lei (BMJ 2025;390:r1268, doi:10.1136/bmj.r1268, published 2 July 2025) was corrected after publication. The academic position of the author was incorrectly listed as “senior research fellow.” This has been amended to “student” to accurately reflect their position at the time of publication.

A challenge to the government’s refusal to release an impact assessment of a controversial pharmaceutical trade deal with the US has been denied.The UK’s transparency regulator, the Information Commissioner’s Office (ICO), released a response to a complaint made by health think tank the Nuffield Trust, saying that the government’s decision not to make it public was acceptable.The UK agreed a drug trade deal with the US in December last year to soften the impact of tariffs put in place by US president Donald Trump.1Under the agreement, the UK became the only country in the world to have a 0% tariff on pharmaceuticals exported to the US and secured preferential terms for the UK’s medical technology exports.However, to secure the deal ministers agreed to a 25% rise in the cost effectiveness thresholds used by the National Institute for Health and Care Excellence (NICE). These thresholds will rise from £20 000-£30 000...

Atopic dermatitis in school childrenItching, sleep disturbance, and psychological distress might all be expected to interfere with schoolwork. But two large cohort studies from Denmark and England find that atopic dermatitis doesn’t impair academic performance (JAMA Dermatol doi:10.1001/jamadermatol.2026.0425). Among 780 000 children, examination results at age 16 were much the same in those with atopic dermatitis as they were in those without, with little to suggest that disease phenotype or socioeconomic background altered the picture.Hyperemesis gravidarumA retrospective analysis of 2.5 million singleton live births in California focused on the outcomes of 50 000 women who had experienced hyperemesis gravidarum severe enough to require hospital admission or emergency department care (Am J Epidemiol doi:10.1093/aje/kwag134). Not surprisingly, perhaps, these women had increased risks of many adverse pregnancy outcomes including pre-eclampsia, gestational hypertension, preterm birth, small for gestational age infants, placental abruption, and anaemia. But the size of any increase in risk was...

A new pill for patients whose cholesterol remains high despite treatment has been approved by the US Food and Drug Administration (FDA).Called Lipfendra, the daily pill can be taken alone or in conjunction with statins.When trialled in patients whose low density lipoprotein cholesterol (LDL-C) remained high despite already receiving treatment, Lipfendra reduced LDL-C levels by as much as 59%.1Dhruv Kazi, a cardiologist at Beth Israel Deaconess Medical Centre in Boston and associate professor at Harvard Medical School, commented that the approval would make a critical difference to patients. “This is an important step forward for patients who need additional therapies for lowering lipids,” he said.High LDL-C levels are a major risk factor for atherosclerotic cardiovascular disease, including coronary heart disease—which the American Heart Association said caused 349 470 US deaths in 20232—as well as stroke and other forms of cardiovascular disease.Although Lipfendra must be taken on an empty stomach, some...

Restoring the health of the UK population to 2014 levels would boost GDP by 2% and unlock £72bn in public finances , an analysis indicates.The report, from the Health Foundation, argues for an overhaul of government thinking on health.1Analysts say that, rather than treating ill health as a cost, good health should be seen as a national economic asset.It comes as a new prime minister, Andy Burnham, enters Downing Street and faces economic challenges such as weak growth, stagnant productivity, a sluggish labour market, and pressure on the public finances.The think tank argues that improving health should be treated as core to the government’s economic strategy.“Good health enables people to live well for longer and contribute to their communities, helping to build a stronger society,” the report’s authors say. “A healthy labour force is also the engine that powers our economy—it determines whether people can participate in employment, how effectively...

In just 16 years, a handful of food banks in the UK have proliferated into thousands of community-run food parcel distribution centres. In 2024, Labour’s election manifesto rightly referred to the need for these as a “moral scar on our society.” The party committed to ending mass dependence on emergency food parcels in the UK.1Two years later, the Labour government has made some steps towards this by scrapping the poverty inducing two child benefit limit and introducing new funding through the Crisis and Resilience Fund (CRF). This fund paves the way for people in England to build long term financial resilience through cash first crisis payments and wraparound support through local community networks.2Against a backdrop of stubbornly high levels of food insecurity, emergency food parcel distribution figures in the UK are still 45% higher than before the covid pandemic.34 The cost of living crisis continues to ring alarm bells, so...

Commonly used weight loss drugs may help to reduce symptoms of binge eating disorder, the largest review of the evidence to date has suggested.1But the researchers acknowledged that the evidence remains limited on the benefits of glucagon-like peptide-1 (GLP-1) receptor agonists for people with binge eating disorder who live with obesity.“It is certainly plausible that for some individuals with binge eating disorder these medications facilitate a healthier relationship with food whereas for others they could contribute to more rigid eating patterns,” said Ilaria Costantini, senior author and research fellow in psychiatric epidemiology at the UCL Division of Psychiatry.Binge eating disorder—when people regularly eat an excessive amount of food while feeling they have lost control—affects 17 million people worldwide, two thirds of whom live with overweight or obesity.2 The disorder is common among people seeking weight loss treatment.3There remains “a need for better ways to help people living with this condition,...

A story about the Tour de France?Afraid not. It’s about a large outbreak of cyclosporiasis in the United States—an intestinal illness caused by a microscopic parasite called Cyclospora, which causes “watery, explosive diarrhoea.”Kack-atoa? A poo-nami?It’s certainly a large outbreak, with reports of cases in 34 states. Up to 14 July, there had been at least 1645 laboratory confirmed cases of Cyclospora since 1 May, and 145 people had been admitted to hospital. The US Centers for Disease Control and Prevention (CDC) has a further 5100 reports under investigation, but the true number is “likely higher.”1Doesn’t this explode every year?Cyclospora activity does tend to increase in the spring and summer, but the number of confirmed cases is already six times higher than last year, and if the possible cases are confirmed, this year’s total is 27 times higher. Gwen Biggerstaff, deputy director of CDC’s division of foodborne, waterborne, and environmental diseases...

A legal challenge to a review that recommended limiting the scope of physician assistants (PA) and anaesthesia assistants (AA) has been dismissed on all grounds in the High Court.Brought by the PA/AA union, United Medical Associate Professionals (UMAPs), the challenge claimed that Gillian Leng’s review was unlawful and that its recommendations had been designed to appease the BMA. But Mr Justice MacDonald ruled that this allegation was baseless and that the review had been lawfully produced.1The BMA welcomed the decision and urged ministers to swiftly act on Leng’s recommendations for protecting patient safety, many of which have still not been implemented2 a full year after the review was published.Leng’s review, which assessed the safety and scope of what were then called physician associates and anaesthesia associates, made a total of 18 recommendations, all of which the government accepted. These included that PAs and AAs should be renamed as “‘assistants” rather...

Pakistani police have arrested an Afghan resident doctor mid-operation amid rising political tensions in the country.Pakistan recently decided to expel all Afghans in its borders without a valid visa, as a row deepens with the Taliban in Kabul. The move has now started to affect Afghan health professionals working and learning in the country.A number of young Afghans training or studying medicine or other healthcare subjects in Pakistan have been barred from attending their institutions despite having submitted renewal applications and their visas not having expired yet. Ironically, many of these had been recipients of a long running scholarship programme from the Pakistani government intended to improve relations with Afghanistan.Tensions between the countries have been brewing for years. Islamabad has accused Afghanistan of sponsoring terrorism in border areas—a charge denied by the Afghan government. As a result, Pakistan has closed its border with Afghanistan several times, most recently on 9...

Ministers plan to radically reduce the appeal of vapes to stop children being drawn to experiment with them and into possible addiction.They propose that vapes should be put in plain packages and placed out of sight in shops, with strict curbs on enticing brand imagery and flavour descriptions.Child health experts and antismoking campaigners have welcomed the 12 week consultation—which includes a ban on the use of vape names linked to sweets and alcohol—announced by the government on 10 July as part of wider action to tackle vaping among young people.Evidence indicates that colourful packaging, prominent retail displays, and appealing flavours are among the factors leading young people to take up vaping, ministers say.Steve Turner, president of the Royal College of Paediatrics and Child Health (RCPCH), said, ”As paediatricians, we are deeply concerned by the insidious marketing practices used by tobacco and vaping companies to target our future generations.“It is clear...

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...