NHS hospitals in England have been told to “urgently review” the safety of their home birth services following a coroner’s report into the deaths of a mother and baby in Manchester.The recommendation from NHS England comes after the senior coroner for Manchester North published a prevention of future deaths report in November 2025 after the deaths of Jennifer Cahill and her baby daughter Agnes following a home birth.1Jennifer died after a haemorrhage during labour and Agnes had the umbilical cord wrapped around her neck and was not breathing when she was delivered.The coroner, Joanne Kearsley, said Cahill had not made an informed decision to have a home birth and was not given all the relevant information about her risks.Kearsley found that Cahill wrongly believed she was low risk when she should have been classed as high risk as she had had a postpartum haemorrhage after her first delivery in hospital.The...

Medical and public concern about a controversial UK trial of puberty blockers is on the rise, as are efforts to derail it.The clinical Pathways trial is due to begin recruiting children and adolescents with gender incongruence this month to measure the impact of puberty blockers on their quality of life and emotional wellbeing.But disquiet about the study and its potential long term effects on children prompted a special meeting of clinicians, academics, and medical ethics experts at the House of Lords on 15 January. They called for the trial to be paused to allow alternative research studies to take place before considering puberty suppression in children.A clinical trial of puberty blockers was one of 32 recommendations in the landmark Cass review on gender identity services for young people,1 and research teams at King’s College London and the South London and Maudsley NHS Foundation Trust were granted approval last November to...

Mafi’s commentary suggests that reform of exception reporting risks reducing doctors to “shift workers paid by the minute.”1 As a resident doctor, I think this misrepresents the reforms and the reality of working in the NHS.Over the years, I have seen professionalism repeatedly conflated with unpaid labour. Foundation year 1 doctors are paid as little as £18.62 an hour to deliver safety critical care,2 and resident doctors’ pay has fallen by a fifth in real terms since 2008.3 Expecting doctors to work beyond contracted hours without recognition is not a mark of vocation, but of a system that relies heavily on goodwill. Exception reporting ensures that additional work is visible and acknowledged. This does not erode professionalism; it supports it by ensuring fair pay and attention to wellbeing.The reforms are described as offering a “small financial benefit,” but they represent a major contractual change. Employers must now provide access to...

Former neonatal nurse Lucy Letby will face no further charges of murder or attempted murder, the Crown Prosecution Service (CPS) has announced.The move has come as a surprise to the police force which had been investigating her.Letby is serving life in prison after being convicted for the murder of seven babies and the attempted murder of another seven at the Countess of Chester Hospital between June 2015 and June 2016.1She had been under investigation by police over further deaths and collapses of babies at the Countess of Chester and one death at the Liverpool Women’s Hospital, where she trained.In a rare move, Cheshire Constabulary revealed that it disagreed with the CPS decision not to charge Letby and believed that the evidence it submitted met the service’s charging standard.In a statement, the police force said, “We submitted files for charging decisions in relation to nine babies. We believed the evidence submitted...

????Indeed. Emoji use is rising in medical records, a new study says. US researchers found that by the final quarter of 2025, emojis were present in more than 10 notes in every 100 000, compared with fewer than two notes in every 100 000 between 2020 and 2024, the study published in JAMA Network Open reported.1????Is this allowed?!At Michigan Medicine—where 218.1 million notes from 1.6 million patients were scrutinised—clinicians aren’t supposed to use symbols in medical records. But it seems that some can’t resist using those little emotional cues.????What forms of communication were included?The study focused exclusively on emojis in medical records, not clinician texts. Overall, it identified 372 distinct emojis used in 4162 clinical notes. Portal messages to patients were the most common form of notes containing emojis (1477 notes (35.5%)), followed by phone call notes (1185 (28.5%)), encounter summaries (637 (15.3%)), progress notes (579 (13.9%)), patient instructions (265...

Online gambling has grown rapidly worldwide over the past 10 years. Discreetly accessible and available 24 hours a day, online products are taking the place of familiar gambling formats such as slot machines, casino table games, and in-person sports betting. Newer products such as cryptocurrency speculation, virtual betting, and daily fantasy sports, together with online analogues of established gambling products, have quickly expanded in both established and emerging gambling markets.1 As a result, the size of the globalonline gambling market rose from £20bn in 2017 to £65bn in 2024.2 Governments that legalise online gambling typically seek to balance the benefits of generating tax revenue against the risks for population harm. However, in many jurisdictions, including the UK, most US states, and Canada, governments often ask gambling providers to devise harm prevention strategies to comply with overly broad regulation. 3 Typically this requires “responsible gambling” to be promoted without explaining...

William WitheringMy list of medically related anniversaries for 2026 includes the 250th anniversary of the publication in 1776 of William Withering’s book The botanical arrangement of all the vegetables naturally growing in Great Britain.William Withering was born on 17 March 1741, in the town of Wellington in Shropshire, the second child of Edmund Witherings [sic] and Sarah Hector.Withering’s father was described in his will as an “Apothecary and Surgeon,” or just as “the apothecary of Wellington,”1 and there were also several physicians on his mother’s side of the family. His maternal grandfather was George Hector, who delivered Samuel Johnson, according to Johnson’s own account in his autobiography of his first 11 years.2 His maternal uncle, Brooke Hector, was a well known physician at Lichfield; and another uncle, George, and a cousin, Edmund, were surgeons. It is no surprise, therefore, that Withering’s father wanted him to train in the medical profession.The...

Surging norovirus cases are piling more pressure on NHS hospitals, with at least 10 trusts now declaring critical incidents owing to high demands and capacity issues.Norovirus cases in NHS hospitals in England increased by 57% to 567 in the week ending 11 January, up from 361 the previous week, NHS England reported.Separate surveillance data from the UK Health Security Agency (UKHSA) also show that norovirus cases are on the rise with cases increasing by 47% in the first two weeks of 2026, compared with the previous fortnight ending 28 December.1However, NHS England figures show that hospital admissions for flu have fallen again after a festive bounce back the week before.An average of 2725 patients were in a hospital bed with flu last week, a fall of 7% from 2924 the previous week.2Latest UKHSA prevalence data also show that flu cases in England continued to decrease last week—with the positivity rate...

bmj;392/jan16_13/s89/FAF1faHelen (née Carson) was born in Belfast. At an early age the family left Northern Ireland for South Africa and then a remote corner of northern Kenya, where her father ran a mission hospital. Helen always wanted to be a doctor. She spent her A level biology project analysing placental weights in the maternity unit her father had built.She was educated in Kenya before moving to Cambridge in the UK for sixth form, living independently from the age of 16 as the family remained overseas. At medical school in London she threw herself into student life. She was a keen sportswoman who enjoyed the camaraderie and teamwork of hockey—elements she prized throughout her career. A knee injury from netball cut short her sporting exploits, however.Her first house job was at St Mary’s and she started her ophthalmology career with a masters at Moorfields. She was appointed to the Cambridge senior...

Child poverty is a fundamental driver of ill health that has been rising in recent years. Across the UK, 4.5 million children—more than a third of all children—were living in poverty in 2024.1 Two million children live in deep poverty, unable to afford essentials such as heating, clothing, and food.1Poverty affects children’s homes,2 the safety and stability of their families,34 and the expected freedoms of childhood.5 It results in a lifetime of consequences, across education, employment, and physical and mental health.6 Increasing poverty in the UK has been associated with rises in infant mortality7 and a widening gap in healthy life expectancy—currently around two decades—between people living in the most and least deprived areas,689 which the government has pledged to halve.10Alongside others, the Faculty of Public Health has long called for meaningful action on poverty.11 The UK government’s child poverty strategy is welcome.12 The strategy’s flagship change is the removal...

A UK government target to rebuild seven hospitals constructed mostly using unsafe concrete is likely to be missed, a report says.The public spending watchdog the National Audit Office (NAO) predicted that the government’s target to deal with unsafe construction would slip by a couple of years, from 2030 to 2032. But it also found that the government’s New Hospital Programme overall was now on a “firmer footing.”The NAO’s Update on the New Hospital Programme,1 published on 16 January, said that the government’s “reset” of the programme unveiled in January last year2 had created a more realistic timetable than that posed by the previous government when it first launched the programme in 2020.The initiative covers 41 hospital schemes, including new buildings and major refurbishments being carried out in four waves over the next 20 years. An additional five schemes were already complete and open when the programme was updated in January...

Human health will no longer be factored into US Environmental Protection Agency (EPA) cost-benefit calculations of air pollution.Instead, costs to industry will be the EPA’s focus when assessing the impact of regulations surrounding PM2.5 and ozone, two major forms of air pollution.Previously the agency calculated the financial benefit to human health from cutting down on air pollution versus the cost of implementation.Experts told The BMJ the change will bias decisions towards “weaker protections and dirtier air.”The EPA—detailing the change in a regulatory impact analysis published on 9 January—said the decision was made because of uncertainty surrounding the science of the benefits. “Historically, the EPA’s analytical practices often provided the public with a false sense of precision and more confidence regarding the monetised impacts of fine particulate matter (PM2.5) and ozone than the underlying science could fully support,” the document says.1EPA spokeswoman Carolyn Holran said that the agency would still consider...

Progress has been made in reducing the “collective shame” of disproportionate employer referrals of doctors from ethnic minority backgrounds or who qualified outside the UK, the doctors’ regulator says.1The General Medical Council says the proportion of employers with excess referrals in relation to a doctor’s ethnicity or place of qualification has now reduced by 48%—from 5.6% between 2016 and 2020 to 2.9% from 2020 to 2024.The difference in employer referral rates between ethnic minority and white doctors has also fallen by 61%—from 0.28% (0.58% ethnic minority doctors v 0.3% white doctors) to 0.11% (0.26% v 0.15%).For non-UK versus UK graduates, the difference in referral rates has dropped by 69%—from 0.42% (0.28% UK v 0.7% non-UK) to 0.13% (0.15% v 0.28%).The regulator says it is now on track to hit its target of eliminating disproportionate employer fitness to practise referrals by the end of 2026, a goal it set in 2021.Progress...

Industrial action has become a regular part of NHS life. Since March 2023, repeated junior doctor strikes have affected how hospitals run and, in turn, how medical students are trained. For those of us in clinical years, this has meant dealing with ongoing uncertainty around placements, often with little warning and limited clarity.As a final year medical student at Lancaster, I have had several placements disrupted by strike action in different ways. Sometimes this has meant placements being cancelled altogether. Other times, placements have technically gone ahead, but in a form that looks very different from what was originally planned. By this stage of training, placements are meant to be hands on and confidence building. When they are disrupted, the impact is not just logistical, but educational as well.One example that stands out happened at the start of a paediatrics placement in my third year. Just before 10 pm the...

A doctor who posted or reposted a series of racist, antisemitic, and sexist comments on social media over 20 months has been struck off the UK medical register.Asif Munaf failed to turn up to the Medical Practitioners Tribunal Service hearing, which decided his misconduct was so serious that he should be barred from practice.The tribunal found that on 36 occasions between October 2023 and July 2025 he posted or reposted material that was objectively antisemitic, racist, seriously offensive, or motivated by racial or religious hostility or prejudice.His comments included, “Jews have no limits to their depravity. Sick in the head,” and, ‘Jews are born with the inherent ability to deceive.”In another post he wrote, “You only have to go to North London to see the Jewish love for a bakery . . . Does the obsession with baking and ovens explain the uncontested and unproven claims of 6 million Jews...

Health and social care workers in Northern Ireland have been verbally or physically attacked more than 72 000 times during the past five years, new figures show. The vast majority of recorded attacks (60 000) were physical.The data emerged in response to a written question asked in Northern Ireland’s legislative assembly by Diane Dodds of the Democratic Unionist Party.1 She described the figures as “utterly appalling.”When averaged out, the numbers equate to 32 physical attacks on staff every day between 2020-21 and 2024-25.In 2023 Northern Ireland’s Department of Health revealed that 50 000 reported attacks on healthcare staff had occurred between 2018-19 to 2022-23.2 This suggests that, while there is some crossover in the time periods, the more recent five year period between 2020-21 and 2024-25 had a 40% higher number of attacks. However, the full picture remains unclear, as the data did not include records of attacks on GPs...

Many people argue that creating security by ensuring peace and preventing war is the most important duty of a state. Tedros Ghebreyesus, the director of the World Health Organization, is not alone in asserting that peace is a key determinant of health.1 Peace, security, and health are closely intertwined. Most states equate security with the need for armed forces and respond by training military personnel and growing their arsenal of weapons. Instead, burgeoning military spending is driving global conflict and instability. Investment must be redirected towards tackling the root causes of insecurity.A few countries, including the United Kingdom, have a substantial arms industry that flourishes on exporting weapons to numerous countries. The UK’s exports of arms were valued at £14.5bn in 2023.2 In 2023-24 the Ministry of Defence spent £25bn on military equipment compared with only £2.6bn spent on operations and peace keeping.3 The UK’s spending is trivial when compared...

The government has now made explicit its intention to prioritise UK graduates for NHS training posts.12 The bill, introduced by the health secretary, Wes Streeting, represents a decisive shift in workforce policy, responding to growing frustration over competition for posts, alongside ongoing industrial disputes.3 While its stated aim—aligning medical training with national workforce needs—is understandable, the practical consequences may prove more problematic than anticipated.There’s a strong argument that the system needed reform. The rapid expansion of UK medical school places without a commensurate increase in postgraduate training numbers has left many domestic graduates facing career bottlenecks.4 Prioritising UK trained doctors for publicly funded training is not inherently unreasonable. What’s harder to defend is the lack of advance planning and communication for the international medical graduates (IMGs) already in the system.From this year IMGs will be deprioritised for foundation training, effectively turning this stage into a choke point. For specialty training...