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Surgical waiting times in patients with high- and low-risk renal cell carcinoma in England.

OBJECTIVES: To assess to what extent hospitals meet the uniform English National Health Service 'timely' treatment standard, what happens after a breach, and determinants of delay for patients with high-risk renal cell carcinoma (RCC). PATIENT AND METHODS: Population-based study using linked data for 7030 patients with high-risk and 10 708 patients with low-risk RCC, 2019-2023. The probabilities of 'timely' treatment and prolonged delay (≤31 days or >62 days from decision-to-treat, respectively) were estimated using multilevel logistic regression. Daily treatment probabilities beyond 31 days

Accessibility to Primary Care Services for Immigrants Experiencing Homelessness in England: A Qualitative Exploratory Study.

Access to primary care services is essential for promoting mental health, yet immigrants experiencing homelessness face significant barriers to care. This study explores factors that influence access to primary care services in the UK. A qualitative design was employed, involving in-depth semi-structured interviews with 30 immigrants experiencing homelessness and 30 stakeholders across healthcare, voluntary, and local authority sectors. Data were analysed using thematic analysis, guided by the Levesque framework of healthcare access and an intersectionality lens. Findings reveal that access is

Increasing complexity in children with life-limiting conditions in England: an analysis of national routine data.

INTRODUCTION: The number of children with life-limiting conditions has risen in recent decades, partly due to medical advances enabling increased survival. It is unclear how the medical complexity of this population has changed. AIM: To use quantitative analyses of routinely collected healthcare and administrative data from 2003 to 2022 to assess the complexity of children with a life-limiting condition (0-19 years) over time. METHODS: National hospital data in England (Hospital Episode Statistics) were used to identify children aged 0-19 years with a life-limiting condition from 2003/2004 t…

Disability and intimate partner violence in England: Gender stratified analyses of a probability sample survey.

BACKGROUND: No prior random probability sample survey spans experience of all forms of intimate partner violence (IPV) among people with different types of impairment in England. This study aimed to compare the 12-month prevalence of four types of IPV (physical, sexual, psychological, and economic abuse) for people with and without four types of impairment (physical, sensory, learning impairments, and experiencing difficulties with activities of daily living (ADLs)), taking account of variations by gender. METHODS: This study used data from the 2014 Adult Psychiatric Morbidity Survey, a cross…

A comparative analysis of health technology assessment decision-making for cancer drugs in Germany and England.

IntroductionThe rising cost of cancer drugs places a heavy burden on patients and public healthcare systems, posing an ongoing challenge of balancing access with efficient resource allocation. Health technology assessment (HTA) serves as a critical basis for reimbursement decisions, evaluating both clinical and economic value. Although the Federal Joint Committee (G-BA) and the National Institute for Health and Care Excellence (NICE) have established standardized HTA frameworks, differences in their assessment methods and decision-making processes may lead to divergent outcomes. This study com

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… Germany and England have both established standardized HTA appraisal procedures ( 6 ), representing two distinct institutional models centered on additional benefit assessment and cost-effectiveness analysis, respectively. … Overall, both Germany and England operate HTA systems that are internally coherent within their respective healthcare systems and payment frameworks, reflecting distinct institutional contexts and decision-making logics. …

Evaluation of planning policy to regulate takeaway food outlets for improved health in England: Synopsis.

BACKGROUND: Takeaway food outlets ('takeaways') sell hot food for consumption off the premises. Takeaway management zones are areas around schools where new takeaways are not allowed to open. They are the most common planning intervention targeting takeaways across local authorities in England to date. We conducted an evaluation of these zones to: model their impact on adult health model their associated economic costs and benefits explore their acceptability and perceived effectiveness among young people investigate support and perceived effectiveness among adults explore barriers to and faci…

Changing trends and variation in service delivery for inpatient diabetes care in England: A national survey.

BACKGROUND: The Getting It Right First Time (GIRFT) programme national report was published in 2020 with recommendations on how inpatient diabetes care could be improved. To determine whether there have been changes in service provision of inpatient diabetes care since the GIRFT report and to gather feedback from staff on current diabetes care, we conducted a survey of NHS hospitals in England. METHODS: A national survey of inpatient diabetes service provision and diabetes staff opinion was conducted across NHS hospital trusts in England between 1 July 2024 and 31 March 2025. The survey asses…

Ethnic Disparities in Police Diversion and Criminalisation for Drug Possession in England: A Study of 32,758 Incidents.

INTRODUCTION: Police-led drug diversion schemes have expanded across England, yet little is known about whether their use reproduces established ethnic disparities in policing outcomes. METHODS: Using individual-level data from 32,758 incidents recorded by 15 police forces (covering 38% of England's population), we conducted a cohort study to estimate ethnic differences in the likelihood of: (i) being offered diversion for suspected drug possession; and (ii) receiving a criminal sanction. Mixed-effects logistic regression models were used to adjust for age, sex, suspected drug type and police…

Everyday social contexts influence fluctuations into and out of chronic pain: an ethnographic study in England.

OBJECTIVES: The research explored how individuals experience chronic pain within their everyday social contexts over a 12-month period. The … d 48 semistructured interviews (around 30 hours). SETTING: The study was carried out in South West England, UK. PARTICIPANTS: 19 participants were identified through the Avon Longitudinal Study of Parents, 12 women and 7 men, all identifying as white British, aged between 32 and 33 years. RESULTS: The analysis identified three key themes: (1) Social co …

Cost-effectiveness of emergency department opt-out testing for HIV in England: a modelling study.

BACKGROUND: In England, up to 5% of people living with HIV are undiagnosed and the proportion of late diagnoses remains high. Opt-out testing could help to identify people living with undiagnosed HIV who might not access testing in other settings. We aimed to evaluate the cost-effectiveness of the first phase of UK National Health Service (NHS)-funded opt-out testing for HIV in emergency departments, which scaled up from 2022. METHODS: We adapted a previously developed deterministic model of HIV diagnosis, progression, and transmission to simulate the impact of the first 33 months of the opt-…

Meat, milk, wool and grain: The animal economy of medieval England (CE 400 to 1400).

Much has been written about the animal economy of medieval England (CE 450-1500) but interpretation of the zooarchaeological record has been held back by reliance on artificial periodisation. This study reduces that reliance via a novel approach to data synthesis. A substantial zooarchaeological dataset compiled for the 'Feeding Anglo-Saxon England' project was investigated allowing a more detailed understanding of when change took place and in what form. Key patterns include: a continuation of Roman husbandry practices at some sites throughout the fifth century; an increase in wool production…

Diagnostic intervals and imaging use in lung cancer: a national real-world study in England.

BACKGROUND: Timely diagnosis is critical for improving lung cancer outcomes, yet diagnostic pathways in England remain complex and variable. Real-world evidence examining imaging use, delays and emergency care during the diagnostic interval is limited. METHODS: We conducted a national retrospective cohort study using linked Hospital Episode Statistics and Diagnostic Imaging Dataset for adults newly diagnosed with lung cancer between April 2018 and March 2019. Diagnostic intervals were defined from first chest imaging to diagnosis. We assessed imaging utilisation, diagnostic pathways and A&E a…

Variation in paediatric splenic trauma management in adult and combined major trauma centres in England.

AIM: Treatment options for paediatric splenic injuries include conservative management, splenic embolisation, and splenectomy. Within the UK, in addition to standalone paediatric trauma centres, adult and combined (adult and paediatric) major trauma centres (MTCs) receive traumatically injured children. We describe the treatment of paediatric splenic injuries between 2017 and 2021 in the United Kingdom adult and combined MTCs. MATERIALS AND METHODS: Data were extracted from the Trauma Audit and Research Network (TARN) for all patients <18 years old with splenic injuries admitted between 01/01

Supervised toothbrushing programmes in England: a national survey of current provision and factors influencing their implementation.

Introduction Supervised toothbrushing programmes (STPs) in nurseries and schools are effective at reducing inequalities in caries when targeted to areas of dental disease. Recent changes to government education and health policy have increased interest in STPs in England. This study aimed to establish the current level of provision of STPs in England, describe changes over time, understand associations with predictor variables, and summarise key barriers and facilitators to their implementation.Methods A national survey was conducted at upper tier local authority level about the extent of a ST…

Hemodialysis Nonattendance: Patient Characteristics and Outcomes in a Single Renal Center in North West England.

INTRODUCTION: Nonattendance for prescribed hemodialysis (HD) sessions is a form of nonadherence that compromises the delivery of life-sustaining HD therapy and is associated with severe morbidity and mortality. In this study, we aimed to assess the characteristics and outcomes of HD nonattenders in a single renal center in the North West of England. METHODS: HD patients followed by the renal team at our unit between December 2020 and September 2022 were included in this study. Dialysis nonattendance data were retrieved from the incident reports (DATIX) between December 2020 and November 2022,…

Two decades of spatial and temporal pesticide risk to non-target invertebrates in England farmlands.

Pesticide impact assessment methods provide relevant approaches to quantifying risks to non-target terrestrial biodiversity in agricultural systems. Here we develop such an approach through combined analysis of pesticide usage, cropping patterns and ecotoxicological hazard datasets to generate a temporal series of maps (1994-2016) of the spatial risk of pesticides for invertebrates in England. Using data for 179 insecticides, fungicides and herbicides applied on arable crops, we assessed how pesticide risk for bees, earthworms, springtails, parasitic wasps and lacewings varied in space and tim…

Evaluating the effectiveness of the human papillomavirus vaccination programme in England, using a regression discontinuity design.

BACKGROUND: In England, the national human papillomavirus (HPV) immunization programme was introduced in 2008 to prevent cervical cancer. Girls aged 12-13 years were offered routine vaccination and those aged 14-18 years in 2008 were offered 'catch-up' vaccination. We evaluate the effect of the HPV catch-up vaccination programmes on cervical cancer and cervical dysplasia diagnoses, and provide an estimate of the vaccine effectiveness. METHODS: Using the 2011 Census, Hospital Episode Statistics, and mortality data for the population of England, we exploit the cut-off in eligibility and apply a…

Intraoperative and postprocedural respiratory disorders admissions profile: An ecological longitudinal study in England and Wales.

Postoperative respiratory complications are widespread and associated with several healthcare systems and financial burdens. Studying admissions due to these complications may aid in developing preventive measures and approaches. However, such studies are lacking in England and Wales. Therefore, this study aims to study the admissions related to intraoperative and postprocedural respiratory disorders (IPPRDs). This was an ecological study using publicly available data extracted from the Hospital Episode Statistics database in England. The diagnostic code (J95) was used to identify all hospital…