Podcasts about nhs england

In CI News this week: Work on NHS England's puberty blocker trial is paused due to safety concerns, a Christian fostering charity has opened a new adoption service in England, and MP Danny Kruger highlights the importance of marriage for a healthy society. You can download the video via this link. Featured stories Puberty blocker trial halted over safety concerns ‘Senedd's vote on Leadbeater Bill did not approve principle of assisted suicide' Christian charity opens new adoption service in ‘celebration of faith' MP: Marriage is good for society, while ‘cult of individualism' is ‘destructive'

Surgical quality is a term that is often thrown around in surgical practice. We have multiple quality improvement projects, metrics and benchmarks that motivate us to do better, and of course the ever expanding patient reviews to possibly “reflect” the type of surgical care provided. But what does quality actually mean? What metrics can we use to understand the type of care being provided by ourselves, our colleagues, and the health system at large. Today, we delve into these questions to understand how quality is currently understood within surgery and how we hope it to evolve in the future. Joining BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam are two fantastic guests - Dr. Mark Cheetham, joining us from the UK, has deep experience in national audits and system-level quality improvement. Dr. Cheetham is a colorectal surgeon and the National Clinical Lead for General Surgery at the Getting it Right First Time Programme in NHS England, or GIRFT. Dr. Alexander Perez is representing the US; he is a board-certified general surgeon and minimally invasive surgeon at Baylor St. Luke's Medical Center. He has worked extensively with institutional quality programs and is the current assistant Dean for patient safety, simulation, and process improvement at the Baylor College of Medicine. Resources: Institute for Healthcare Improvement: https://www.ihi.org/library/tools/quality-improvement-essentials-toolkit NSQIP: https://www.facs.org/quality-programs/data-and-registries/acs-nsqip/ Getting it right first time (UK): https://gettingitrightfirsttime.co.uk/ ***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

AI is transforming the world—but is it transforming privacy for better or for risk? We trust our GP with our deepest secrets, but can we extend that same trust to AI-powered systems and cloud-based suppliers? And if AI can re-identify people even in anonymized research data, is “anonymous” still real anymore? In this episode, Punit Bhatia and Tania Palmariellodiviney reveals how AI tools reshape confidentiality, integrity, availability, cloud sprawl, supplier risk, clinical transcription accuracy, re-identification, and even personal fears like voice-based deepfakes. The voice of experience rings clear: digital trust isn't a checkbox…it's engineered early with transparency, responsible data use, privacy by design, and safety by design. 

Blood cancers are the fifth most common group of cancers in the UK. But for a small number of people, the condition may have an inherited genetic cause.  In this episode of Behind the Genes, we explore the role of genetics in blood cancer, and what an inherited risk means for patients and their families. Our guests explain what blood cancer is, how inherited factors can increase risk, and why multidisciplinary teamwork is key to supporting families. They also look ahead to future advances, from whole genome sequencing to prevention trials.  Our host Amanda Pichini, Clinical Director at Genomics England, is joined by:  Dr Katie Snape, Principal Clinician at Genomics England and Consultant Cancer Geneticist  Bev Speight, Principal Genetic Counsellor Dr Sarah Westbury, Consultant Haematologist “By doing whole genome sequencing we get all of the information about all of the changes that might have happened, we know whether any are inherited, but importantly, we're certain of the ones that have just occurred in the cancer cells and can help guide us with their treatment.”  You can download the transcript or read it below. Amanda: Hello, and welcome to Behind the Genes.  Sarah: When we think about blood cancers, it's a whole range of different conditions and when you talk to patients who are affected with blood cancers or are living with them, their experiences are often really different from one another, depending in part on what kind of blood cancer they have.  We also know that blood cancers affect not just the cell numbers but also the way that those cells function, and so the range of symptoms that people can get is really variable.  Amanda: I am your host, Amanda Pichini, clinical director at Genomics England and genetic counsellor.  Today I'll be joined by Dr Katie Snape, principal clinician at Genomics England and a consultant cancer geneticist in London, Bev Speight, a principal genetic counsellor in Cambridge, and Dr Sarah Westbury, and haematologist from Bristol.  They'll be talking about blood cancers and the inherited factors that increase blood cancer risk.  If you enjoy this episode, we'd love your support, so please subscribe, rate and share on your favourite podcast app.  Let's get started.  Thanks to everyone for joining us today on this podcast, we're delighted to have so many experts in the room to talk to us about blood cancer.  I'd love to start with each of you introducing yourself and telling us and the listeners a little bit about your role, so, Sarah, could we start with you?  Sarah: Sure.  It's great to be here.  My name's Sarah Westbury, and I'm a consultant haematologist who works down in Bristol.  And my interest in this area is I'm a diagnostic haematologist so I work in the laboratories here in the hospitals, helping to make a diagnosis of blood cancer for people who are affected with these conditions.  And I also look after patients in clinic who have different forms of blood cancer, but particularly looking after families who have an inherited predisposition to developing blood cancer.  And in the other half of my job, I work as a researcher at the University of Bristol.  And in that part of my job, I'm interested in understanding the genetic basis of how blood counts are controlled and some of the factors that lead to loss of control of those normal blood counts and how the bone marrow functions and works.  Amanda: Thank you.  That's really interesting, we'll be looking forward to hearing more about your experience.  Bev, we'll come to you next.  Bev: Thank you.  Hello everyone, I'm Bev Speight, I'm a genetic counsellor, and I work at Addenbrooke's Hospital in Cambridge.  I work with families with hereditary cancers in the clinical genetic service, and for the last six years or so have been focused on hereditary blood cancers.  So we've been helping our haematologists across the region to do genetic tests and interpret the results, and then in my clinic seeing some of the onward referrals that come to clinical genetics after a hereditary cause for blood cancer is found.  I'm also part of the Council for the UK Cancer Genetics Group.  Amanda: Thank you, Bev.  And Katie, over to you.  Katie: Hello, I'm Katie Snape.  I'm a genetics doctor and I am a specialist in inherited cancer.  So we look after anyone who might have an increased chance of developing cancer in their lifetime due to genetic factors.  I am the chair of the UK Cancer Genetics Group, so that's a national organisation to try and improve the quality of care and care pathways for people with inherited cancer risk in the UK.  And I have a special interest in inherited blood cancers through my work at King's College Hospital, I work in the haematology medicine service there seeing individuals who might have or have been diagnosed as having an inherited component to their blood cancers.  So it's great to be here.  Amanda: Excellent, thank you for those introductions.  I'd like to then dive right in and understand a little bit more about blood cancers.  So, Sarah, could you tell us a little bit more about what blood cancer is?  Sarah: Yes, sure.  The term blood cancer is used to describe a whole range of different kinds of cancer, all of which affect some part of the blood or sometimes parts of the immune system that kind of gets represented as part of the blood.  So it's really describing a big group of conditions rather than one single kind of condition or entity itself.  But like any form of cancer, we understand blood cancers as being conditions where because cells as part of the blood system are rapidly dividing and normally doing so under really well controlled circumstances to produce just the right balance of blood cells and just the right number of those cells.  In a cancer affecting those cells, we see that that loss of control results in either too many of one type of blood cell being produced or too few, or that balance being lost.  And like any form of cancer, this is because of genetic changes that happen in individual cells that then go on to grow in a way that is not controlled and well regulated.    And because when we talk about blood cancer we're talking about such a wide range of different kinds of cancer affecting different cells within that blood system, there's a really wide range of different conditions.  From conditions that we might think of as being like a form of acute leukaemia, so something that produces often symptoms and signs in patients very quickly and they can often feel quite unwell quite soon and then get picked up with having this condition because they present feeling unwell.  All the way to chronic and slow growing cancers that can be found completely by chance and serendipity when blood tests are done for other reasons.  So when we think about blood cancers, it's a whole range of different conditions.  And when you talk to patients who are affected with blood cancers or are living with them, their experiences are often really different from one another, depending in part on what kind of blood cancer they have.  We also know that blood cancers affect not just the cell numbers, but also the way that those cells function.  And so the range of symptoms that people can get is really variable, again depending on which of the blood cells are really affected by that.  And it may be that during the course of some of the conversations we have today in this podcast, we'll perhaps focus on particular kinds of blood cancer.  But like any cancer, it's that disruption of the normal growth and development of cells that means that the number and function of those blood cells has been disrupted in some way.  Amanda: Thank you so much for explaining that, Sarah, that's really helpful.  In terms of across the range of blood cancers, is that something that people can get at any age, and how common is it?  Sarah: It does depend, as we were sort of talking about that really wide range of different disorders that make up that group of blood cancers.  And individually each of those blood cancers is reasonably uncommon compared to cancers that we might typically think of, like breast cancer or colon cancer.  But actually, if you group blood cancers together, they make up quite a sizeable proportion, and they're actually as a group the fifth most common form of cancer that's diagnosed in people in the UK.  In adults in particular we think that perhaps people diagnosed with leukaemia would make up about 3% of the new diagnosis of cancer made in any year.  Amanda: So coming to you, Bev, when we talk about inherited blood cancers, what are the differences between those and blood cancers more generally?    Bev: So at point of diagnosis, it may not be obvious that somebody with a new blood cancer diagnosis is one of the minority of people in that big group as Sarah has described, who has an inherited cause.  So it may not be immediately obvious.  However, in the last few years certainly, it's become more and more routine to do quite broad genetic testing.  Often on a bone marrow sample or blood, because that is done looking for genetic changes, which are part of all cancer and we find within cancer cells, that can help with treatment planning.  It can also find that there is an inherited cause to that new blood cancer diagnosis.  Sometimes that might not be clear cut, sometimes that might be inferred from the genetic tests that are done on the blood or the bone marrow. And the proportion of blood cancers in that huge group which do have an inherited cause is fairly small, the actual proportion will depend a bit on the age of the patient and the specific subtype of blood cancer.  Amanda: Okay, and could you talk us through how some of those inherited genetic factors can increase the chance of a person developing blood cancer, how does that work?  Bev: Yes, so if we know that there is an inherited cause for blood cancer, then what we mean by that most of the time is that a change in a single gene has been found.  And that there is enough research evidence and enough known about that specific change in that gene to say to the person who's been diagnosed, there is at least in part or perhaps a full explanation for why that blood cancer has developed and this could be shared in the family.  So at that point it's information that not only has implications for the person in treatment, but also their relatives.  Depending on what sort of gene alteration it is and which gene it's found in, there are different inheritance patterns, and that changes the sorts of information that we give about risks for relatives.  So for lots of the genetic tests that detect an inherited cause in adults when they're diagnosed, that's most often what we would call an autosomal dominant inheritance pattern.  Essentially that means you only need to have one gene alteration which is in that person's normal non-cancerous DNA inherited from a parent and can be passed onto a child.  And for people in the family who have inherited this one genetic change, then they are likely to be at increased risk of developing blood cancer.  Sometimes with particularly the children's blood cancers, if an inherited cause is found, it can be a different pattern, which we call autosomal recessive.  And that's where two gene changes are found and one has been inherited from each parent.  So parents might be what we call carriers and have one each just by chance, both have been passed onto a child who has developed blood cancer either in childhood or possibly later on, and that's the pattern we call autosomal recessive.  There are other inheritance patterns too.  The third one that we come across being X-linked, and so that has a gender component.  That's where there's a change on the X chromosome, women have two X's, and men have one X and one Y.  So sometimes with the X-linked conditions we're more likely to see the clinical signs of a condition in boys and men because they've only got that one X chromosome.  But those are less common in the context of talking about hereditary blood cancers.  Amanda: Thank you.  That's really helpful to understand.  So it sounds like you're saying that these forms of blood cancers that are caused by a single gene are relatively rare.  And also by having one of these changes, it's not a given that that person will develop a blood cancer, but it makes them more likely, and how likely that is might depend on the inheritance pattern or the type of condition.  Bev: That's right.  So what we're saying is it can give either part of full explanation for the blood cancer diagnosis, and it could confer a risk to family members, but that doesn't mean they definitely will develop it.  We're talking about an increased risk compared to the population risk.  Amanda: Right.  I can imagine for those families to some extent it might be helpful to know the underlying reason why they had that blood cancer, but again, that's just a small proportion.  So, Katie, could I come to you next?  What about the rest of all the blood cancers, how do they occur?  Katie: Yes, thanks, Amanda.  So most blood cancers will occur just by chance.  We also know that there are some environmental factors that can increase the risk of blood cancers, so, for example, serious radiation exposure, something like that.  What Bev has described is where there is this sort of quite rare condition where there is a kind of single gene that's really important for the blood cells in terms of keeping those control mechanisms that Sarah described.  And that's not working properly, which has increased the risk of a blood cancer.  But we also sometimes see some families where there is more blood cancer, or the same type of blood cancer in that family than we might expect by chance.  We think that's probably not due to a single high risk genetic factor, but might be due to kind of multiple lower risk genetic factors that are sort of shared by close family members and can add up together to increase the risk a little bit.  And we call that familial risk or polygenic risk.  We don't have a test for that at the moment.  We wouldn't offer usually any extra screening or testing to those families, but we would just suggest obviously family members are aware of any signs of symptoms of blood cancers and seek any advice if they're concerned.  But, you know, the majority of blood cancers are not due to genetic factors, and it's sort of environmental or chance or bad luck. Amanda: Okay, so it's clear that obviously blood cancer is almost an oversimplification, within that category there's so many different types, so many ways that it could happen in a person.  So, Bev, if we're dealing with that type of blood cancer that is inherited or has some heritability, can you tell us more about what that means for the family?  What kind of impacts do you see that having for them?  Bev: Yes, of course.  So clearly this is another layer of information that's often coming at a family during a time where somebody is often recently diagnosed with blood cancer of one sort or another and is having to take in a lot of information about treatment and all of the uncertainty and anxiety that goes with that.  So for this minority of patients and families where there is new information about an inherited cause, that needs conveying in a timely but sensitive way, bearing in mind what else is happening.  And for some people it can come as a major shock and really an additional burden at that time.  I think the reaction to that will of course depend on lots of factors.  And what we also see is that this question about a new cancer diagnosis of any sort, including blood cancers, can generate the question in people's mind, particularly if they've got children, about does this change the risk for relatives?  So sometimes this new information that, actually, there is an inherited cause is an answer to a question that families have already got.  And that might be because of what Katie's described as familial clustering, there might already have been this known history in the family. So sometimes this information can feed into that and actually be quite a helpful answer.  But it's quite normal for families to feel quite mixed about this and for different family members to have a different approach to it.  When there's the offer of what we would call predictive testing, if we found a change in a single gene in somebody with blood cancer which we're saying is a hereditary cause for that, that might open the door for relatives to access predictive testing.  I.e., the opportunity to discuss and possibly take up a genetic test for themselves when they haven't had cancer themselves, but there's an opportunity to try and quantify whether or not they're at increased risk.  We know in families the uptake of those kinds of tests is different, and a lot of it is to do with timing and the way people respond to this in families might depend on their response to the cancer diagnosis in their relative, and of course what else is going on in their life at the time.  This aspect for the family is where clinical genetic services come in, because these initial tests in the person with blood cancer are done in their haematology/oncology setting, and normally the results about an inherited cause has been found are conveyed through that service.  That's when a referral to clinical genetics happens.  And in our specialist service we're addressing those additional concerns for the family which arise because of this diagnosis. Amanda: Thanks, Bev, for explaining that.  Sarah, coming back to you.  Could you tell me then if someone has an inherited blood cancer does it also change the way that the patient is treated? Sarah: Well, it certainly can do, and again, it does depend a little bit on the specific circumstances of that particular person and the form of inherited blood cancer predisposition that they have.  But certainly if we think about treatment as a whole, then for a lot of people it does affect the way that we might recommend treatments or look after them and their families.  So, for example, for some patients who have a diagnosis of an inherited form of blood cancer, we know that some treatments might be more or less effective for their particular set of circumstances.  And so that can sometimes influence the specific treatment recommendations that we would make, particularly thinking about, for example, the risks that the cancer might come back again after it's been treated.  Or thinking about whether or not some of the typical drug regimes that might be used might be perhaps more likely to cause them side effects or problems with tolerating that treatment.  So it can certainly make some changes in that respect. For some people, to be fair a minority of people with blood cancers, they may need a stem cell transplant as part of their treatment to hopefully cure them of their blood cancer.  And this as I say is a treatment that's required for a minority of patients as a whole who have a diagnosis of a blood cancer.  But for those people who have got an inherited predisposition and who might be recommended a stem cell transplant as part of their treatment, then knowing about a familial risk for this condition can also be really important.  For making sure that if a family member is being considered as a donor for example that we're being really careful to make sure that we're not choosing a donor that might also be affected by the same underlying blood cancer predisposition.  Because this can obviously cause problems for the person that's receiving the stem cells if it turns out that the person they're receiving them from actually has the same inherited condition as them.  So in that respect knowing about the underlying predisposition and genetic cause for their cancer can be helpful.  But in a more sort of general sense, yes, the other thing that it can have a big difference for is that some of these inherited cancer predispositions and syndromes also have other health conditions associated with them.  So it might be that that genetic diagnosis predisposes somebody not only to a form of blood cancer but to other health conditions as well.  And so actually knowing about that diagnosis can help their haematologist then make sure that they're linked in with the right other medical teams to make sure that those other health conditions are identified if they're present and taken care of.  And then I think really coming back to what Bev has already touched on, there's the sort of bigger picture of just how people are looked after in their own right but also as part of their family unit.  And making sure that they're given the right information and advice about their health, but also thinking about other family members.  And particularly for younger patients who perhaps either are just starting their own families or for whom that's not yet a consideration, making sure that they've got the information to understand what might be relevant for future family members, if that makes sense.  So it's not necessarily true to say that for every individual patient knowing that there's an inherited blood cancer present will necessarily directly affect the way that the treatment is offered.  But you can see that as a part of a bigger picture for a lot of patients, it will make a difference to their care as a whole.  Amanda: And you can really see how the impact is very sort of multigenerational and is going to affect people at all ages and stages of their life, so that's really interesting.  Katie, Bev spoke a little earlier about the fact that there are genetic tests that can help tell us if blood cancer is inherited.  Could you tell us more about what the tests involve, and some of your experience taking families through this?  Katie: There's sort of two main different ways that we might identify somebody has an inherited cause for their blood cancer through testing.  So traditionally what has happened, as Bev and Sarah sort of discussed before, is that when a person is diagnosed with a blood cancer, we either take a sample of their blood or bone marrow.  To try and look at what are the changes within those cells that have driven that cell to become a cancer cell and have driven this blood cancer to develop.  And a lot of the time, as we've said, it's not inherited, it's not genetic, so they're what we call acquired changes, they're changes that have just happened in the bone marrow or to the blood cells that have caused that kind of particular cell to become a cancer cell.  And it's really important that we look at those because that can help both diagnose the blood cancer, it can give us information about how serious that blood cancer might be, and it can also help us guide our treatments and therapies.  And so if we do those testings, they're primarily done within haematology for those sort of diagnostic or prognostic or treatment purposes.  We do sometimes see then a change that looks a bit suspicious that it might be inherited for various reason.  And if we see something that is in the cancer and it looks like there's a potential it could be inherited, we would go on and do a second test.  So usually because we can't do a blood test because the cancer's in the blood, we would take a skin biopsy.  And then we would look and see, well, is this change also present in the skin?  And if it is, then that indicates that that change is in all of the cells of the body, because it's in both the blood cancer and it's in the skin, and therefore it's likely to be inherited.  So that's one thing that we do.  And I think that that can be quite challenging for patients.  Because they go in to have a test for their blood cancer and then suddenly were being told, “Well, actually, we've also found something that might be inherited,” and it is something then that other members of the family might have.  And as Sarah said, potentially that means that even if your relative was offering to be a bone marrow donor for you, they might not be able to if they also carry the same thing.  And so that can be quite tricky just in terms of making sure that we're guiding the patient and their family members through that process.  And then thinking about the work that Genomics England does, particularly with whole genome sequencing, and this is particularly offered for children and young adults in the paediatric setting.  But I think we're also increasingly, as we progress we'll perhaps talk about this a bit, moving towards whole genome sequencing for adult blood cancers more routinely as well, that that is offered as a sort of standard of care.  And what whole genome sequencing is, is it is looking at the entire genetic instruction manual in both the blood cancer cells and in the cells that we're born with, to look at the inherited or germline genome as well.  And the reason that we look at both the cancer cells and the inherited or germline genome is because what we're trying to understand is firstly, are there any inherited changes that have led to the blood cancer developing?  But also, what are the changes that have just occurred in the cancer cells that are going to help us to diagnose and treat that blood cancer?  So by doing whole genome sequencing we get all of the information about all of the changes that might have happened, we know whether any are inherited, but importantly, we're certain of the ones that have just occurred in the cancer cells and can help guide us with their treatment.  And so, again, when we're talking to patients, we have to explain to them that we're going to be looking at their entire genetic information.  And what's interesting about that is it might find things that are not only relevant to blood cancer, but very rarely other findings, incidental findings as well, or we might find things that we don't know about.  But I think certainly that's something that patients often feel very comfortable with having because it gives them the maximum amount of information.  Amanda: Thanks, Katie.  So it really sounds like there's a lot of advancements that are being made in genetic technology which potentially brings a lot of new things for you and Bev as genetic specialists, but also for you, Sarah, as a haematology specialist.  What does that kind of change for you, and I assume it's really important then for you all to be working together as a multidisciplinary team?  Katie: Yes, I mean, I think for clinical genetics, we were not involved in sort of haematology pathways for a really long time, and the haematologists are absolute experts in the genomic factors that drive blood cancers.  And certainly in my practice, it's really only been as the technology advanced that we really started finding more and more of these inherited factors, particularly in the adult setting.  Because I think in the paediatric and childhood setting, the haematologists again have been managing those conditions very well for years.  And I think there's places that we really interface and we really need to work together as a multidisciplinary team, understanding the genetic information, really understanding when something that we've seen in the blood cancer or the bone marrow could be inherited.  Do we need to check that?  What should that pathway look like?  But I think as you've said, a lot of these are actually really quite new conditions, particularly in the adult setting.  And we don't yet 100% know why do some people get blood cancer and some people don't when they have the same inherited factor.  What's the actual risk?  Are there any other factors modifying it?  What makes some people progress to develop a blood cancer and some people not?  And for that we really need to work together to try and gather the data and sort of capture people that have these inherited changes.  And hopefully develop a system and an infrastructure that we can follow it long-term and get a lot of information about long-term outcomes, both for individuals with cancer but also their families.  And also from looking at doing population studies.  Because I think we know that lots of people in the general population might carry some of these inherited changes and never develop a blood cancer as a result of this, certainly ones that seem a bit lower risk.  So we really need to work together to understand all of that.  But I'd be really interested in Sarah's views on that as well.  Sarah: Yes, sure.  So I think, as you say, Katie, haematologists have got a long history of understanding and interpreting genetic findings in the sort of acquired or somatic changes that we know are what occurs in some blood cells to drive the cancer forming in the first place. But this kind of newer integration of that with the germline testing is something that is becoming much more mainstream in haematology now, and I think something that people have had to sort of acquire new skills in this area to interpret that alongside.  I think as you say, that multidisciplinary working, where we're able to benefit from both sides of our expertise and knowledge and put that together is so valuable, particularly in those circumstances where there is some uncertainty.  And I think as a haematologist, one of the things that I really find a benefit both personally and professionally to help me navigate these tricky questions but that I also think patients benefit from is your expertise and ability to have those really quite tricky conversations with people who are not haematology patients, if that makes sense.  So they may be the relatives of patients who have a haematological diagnosis for example.  Who at the moment are entirely well and were just going about their daily business, and they're now told that they may or may not potentially have this inherited predisposition.  And I think that as haematologists, we're very used to dealing with potentially quite poorly patients, potentially quite scared patients who find themselves, you know, the recipient of all this quite difficult information.  But we're not necessarily so skilled and experienced at holding conversations with people who don't yet have that diagnosis.  And I think that that's a really rich area of mutual aid to one another as haematologists and genetic doctors, if that makes sense.  And I think your points about understanding actually the real risks and the nature history, as we would call it, of what happens to people who carry these variants that predispose them to blood cancers is something that we can probably only work out by working together.  And of course, working with the patients and families that are affected by these conditions so that hopefully for both sides in the future we'll be able to give much better advice to patients and their families.  Amanda: So, Bev, from your experience and as a genetic counsellor, what do you feel are the important things that patients and their families should know as they're going through this testing and diagnosis process?  Bev: The things I think families where there is a hereditary cause found should know is that with this new information comes a whole new referral to a dedicated service.  Who want to help patients and their family members at risk to navigate this, to adjust the information, and to make decisions that fit with them, about whether to have testing and the timing of that.  As we already said, where there is a hereditary blood cancer risk, that risk in family members is rarely 100%.  Depending on what the hereditary predisposition is in the family, we may be able to quantify that risk, sometimes we can't always.  And the other thing to know which links to that is that there is growing interest in research in this area.  That will really help us to improve care in terms of, for example, being able to quantify the risk of developing a blood cancer in relatives who are perfectly well that may have inherited these predisposition gene changes.  Or, for example, the other obvious place where we want to make improvements in terms of some sort of evidence-based surveillance for those people who want to find out that they have inherited the genetic change and are at increased risk.  Amanda: Thank you.  And overall there's been a lot I think we've been covering today that's probably going to be very new to many people.  Why do you think it's important to raise public awareness of inherited blood cancers?  Bev: There have been lots of public awareness campaigns about other cancers, as listeners probably can think about, in terms of for women checking their breasts and breast cancer awareness.  And perhaps there's been a bit less of that in general for blood cancers.  As we've already talked about, clinical genetics were not so involved in all of the genetic testing happening in blood cancers.  Because it wasn't so long ago in the history of how we think about inherited cancers in general that our suspicion of inherited causes in leukaemia was much lower than it is now.  So I think that awareness in the public probably will take a bit more effort to bring up.  But clearly public awareness about blood cancers in general, symptom awareness, and the fact that occasionally it can be something that is running in the family, clearly better public awareness of that means that people are empowered to ask the right questions.  And the questions that might already be in some way going through their minds of their haematology doctors or perhaps of their GP, if they've got a family history but are not affected themselves.  Amanda: Wonderful.  So, looking now to the future, Katie, what genomic advancements are we seeing or are we likely to see that could impact on the care of people with an increased genetic risk of blood cancer?  Katie: We touched a little bit, I think that whole genome sequencing is expanding.  And as we can turn that test around and get it back more quickly that might become more commonplace.  And I know Genomics England and the UK Haemato-oncology Network of Excellence have been doing a lot of work in that area.  We are very lucky now we have a national inherited cancer predisposition register that NHS England have set up with the National Disease Registration Service.  So that will enable us to capture individuals that have these sort of rarer but single gene disorders or conditions that increase the chance of developing blood cancers.  And that will enable us to do that sort of longer-term follow-up and get really more information.  We've touched on this already but I think there's really amazing research happening, why do some people develop blood cancers and some people don't, even though everyone carries the same underlying change that increases the risk?  And then I think really importantly, we're seeing now in some conditions, clinical trials of certain medications to see if that can actually prevent people who carry these inherited changes from progressing to developing blood cancers.  So I think all of those things are really exciting and will give us lots more information that we can then help patients and their families, particularly the sort of treatment and trials aspects.  Amanda: And, Sarah, on treatment and trials, how do think genomics might improve the treatment, but also the diagnosis of people with inherited blood cancers in the future?  Sarah: I think, you know, hopefully when we are able to accrue more information about these underlying genetic predispositions and how they actually then affect people's likelihood of developing blood cancer, we'll be able to build on what we have so far to make that just feel much more robust and evidence based.  And it feels like at the moment there are many of us struggling to bring together small threads of evidence that have been accrued in the UK but in other centres around the world that are also interested in understanding this inherited blood cancer risk.  In such a way that we can actually give patients and their families more clear information and advice about what that means to them.  And I think that in terms of the diagnosis of blood cancer, I think this is something that Bev alluded to.  If we could better understand who might benefit for example from having regular screening or monitoring blood tests performed to see whether we can detect an emerging blood cancer.  Versus identifying those people who actually, the chances of them developing a blood cancer are so small that doing those tests is likely to do them more harm than good.  Perhaps by just causing them to be anxious or have other sort of unintended consequences of that kind of testing.  So understanding something more about that natural history, as we've already alluded to, will hopefully improve our ability to go from the diagnosis of the predisposition condition to working out how to then diagnose the blood cancer on the back of that.  And with time, I think as Katie has alluded to, thinking about more specific treatments and more tailored treatments to the individual predisposition condition and the blood cancer.  So whether it's that you're intervening before the blood cancer has developed to try and reduce that happening, or whether it's that you're then treating the blood cancer after it's developed.  Understanding the genetic basis and what it is that causes that transition would be really helpful and I think that is something that will come but will take time.  And I think on a sort of national level what I would really hope to see over time is that we're able to use that improvement in evidence base to then be able to bring together perhaps more defined patient pathways.  So that if you're diagnosed with a particular condition, one of these leukaemia predisposition syndromes or another form of blood cancer predisposition, there's a recognised strategy and set of steps that should be taken for all of those patients.  To make sure that they're getting equity of care and make sure that everything is being done in a way that feels safe, sensible and appropriate across the country.  While still then enabling us to give really personalised treatment to that individual person and what that diagnosis means for them.  But I think until we've gathered more information and more evidence we are just in the process of trying to do that to then bring about those changes.   Amanda: If you enjoyed today's episode, we'd love your support.  So please subscribe, share and rate us on wherever you listen to your podcasts.  I've been your host, Amanda Pichini.  This podcast was produced by Deanna Barac and edited by Bill Griffin at Ventoux Digital.  Thank you for listening. 

In the latest episode of Digital Health Unplugged, Marcus Baw calls for a rethink of NHS technology strategy, arguing that the service has drifted away from open source and in-house capability. Baw, a GP, clinical safety officer, clinical informatician and software engineer, criticises NHS England's quiet removal of its open source policy webpages, dismissing the explanation that this was part of a routine website clean-up and that the NHS is now following government service standards. He also makes a strong case for in-sourcing software development, claiming that outsourcing increases costs and weakens the NHS's technical capability. Baw also tells host Jordan Sollof, that the federated data platform is not delivering against its original ambitions and while adoption is growing, and expressed scepticism that changes at the top of NHS England would automatically lead to reform. Looking ahead, he says the NHS should consider building its own cloud infrastructure through NHS-based data centres to reduce reliance on commercial providers, lower compliance burdens and reuse waste heat to power hospital estates. Guest: Marcus Baw, GP, clinical safety officer, clinical informatician, and software engineer  

The four-year Cass Review, carried out for NHS England recommends limiting the use of puberty blockers to research settings. 

In CI News this week: Northern Ireland pauses its participation in NHS England's controversial puberty blocker trial, Holyrood legislates to weaken parental opt-out protections in schools, and the CI launches its brand new Faith in Action podcast. You can download the video via this link. Featured stories NI puts puberty-blocker trial participation on hold Holyrood passes controversial Bill to weaken parental opt-out in schools Tribunal told to reconsider case of Christian social worker denied job Faith in Action: a new CI podcast

AI is transforming the world—but is it transforming privacy for better or for risk? We trust our GP with our deepest secrets, but can we extend that same trust to AI-powered systems and cloud-based suppliers? And if AI can re-identify people even in anonymized research data, is “anonymous” still real anymore? In this episode, Punit Bhatia and Tania Palmariellodiviney reveals how AI tools reshape confidentiality, integrity, availability, cloud sprawl, supplier risk, clinical transcription accuracy, re-identification, and even personal fears like voice-based deepfakes. The voice of experience rings clear: digital trust isn't a checkbox…it's engineered early with transparency, responsible data use, privacy by design, and safety by design. 

Hospitals are being told by NHS England to focus on easy wins to hit this financial year's A&E targets, so on this episode we unpick what trusts are being ask to do and whether this will get them over the line by the end of March.NHSE also finally published guidance on its “model emergency department”, which will see under-performing trusts required to open new treatment areas. But, as ever, big questions remain about funding. And we get under the skin of a recent HSJ analysis that showed the health service has been haemorrhaging non-clinical staff.

Emma speaks to Professor Bola Owolabi, a practising GP in the Midlands and the chief inspector of primary care and community services at the CQC. Before this she director of the National Healthcare Inequalities Improvement Programme at NHS England, where she led the Core20PLUS5 approach to tackling healthcare inequalities.Bola took on her role at the CQC in July last year at a particularly turbulent time for the regulator.In this conversation, she discusses how the CQC is working to turn things around after facing significant criticism about its work, the development of a new sector-specific assessment framework for primary care, and how she hopes inspections will become a less stressful experience for GPs, practice managers and the rest of the practice team.Bola also talks about her own experience of leading the turnaround of a GP practice in a deprived area that was rated inadequate, the role of the CQC in improving care and tackling health inequalities, and how the regulator views the move towards neighbourhood health and the use of AI in general practice.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Useful linksCQC regulators pioneers' fund informationLack of investment in community services will hit plans to shift care out of hospitals, says CQCCQC mythbuster on AI in general practice Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Business of Healthcare Podcast – How It Got Commissioned, Tara is joined by Rukshana Kapasi, Director of Health at Barnardo's, the UK's largest children's charity.   Rukshana shares the story behind a short-term pilot that placed family support workers in A&E to reduce avoidable and repeat attendances by children and young people. What began as a three month, winter-pressures pilot went on to generate compelling evidence, and ultimately informed a national NHS England rollout across seven regions.   This conversation is a practical, honest look at commissioning outside the usual tendering routes, the power of VCSE partnerships, and why looking beyond traditional NHS funding streams matters more than ever.   In this episode, we explore: The risks and realities of short term pilots, and when they're worth taking Why evidence, outcomes, and confidence data mattered more than access alone The importance of commissioner relationships and senior sponsorship Why starting small, testing, and learning can lead to scalable change   Rukshana also shares practical advice for anyone trying to get an idea commissioned that doesn't neatly fit an existing pathway, including why you shouldn't wait for "perfect" data before starting conversations.   Connect with Rukshana Kapasi here.

In this episode of Prevention is the New Cure, former Health Ministers Steve Brine and James Bethell sit down with Sir Jim Mackey, Chief Executive of NHS England, for a wide-ranging and candid discussion about the future of the NHS.Sir Jim addresses the crisis facing NHS demand, the limits of hospital-centric care, and why prevention, neighbourhood health systems, and disruptive reform are essential if the NHS is to survive the next decade.

This week we cover a mysterious update to the “model ICB” blueprint that hasn't been formally published or endorsed by NHS England, but instead passed in whispers. We also talk about the full timetable for merging NHS England and the Department of Health and Social Care and one of the biggest stories this week: the unexpected resignation of Ming Tang, NHSE's chief data and analytics officer. We discuss her legacy, most notably the federated data platform, and why some of the biggest trusts are yet to start using it.  

In an era where “there's an app for that” is increasingly the answer, we turn our attention to what digital transformation really means for medicines. Not just convenience and clicks, but safety, understanding, and how people actually experience care.In this episode, hosted by Jamie Hayes, STC, and Gimmo, we're joined by Rahul Singal, Senior Responsible Officer for the Digital Medicines Programme at NHS England. Rahul offers a clear-eyed view of the digitisation of the medicines pathway — from prescribing and dispensing to how patients interact with their medicines through tools like the NHS App.Together, we explore the promise and the pitfalls of digital pharmacy: innovations in community pharmacy, the realities of electronic health records, and the tensions between national ambition and local delivery. This is a conversation about progress — but also about complexity, equity, and what it really takes to make digital healthcare work in practice.Rahul Singal is the Senior Responsible Officer for the Digital Medicines Programme within the Transformation Directorate at NHS England. He leads work to digitise the medicines pathway across the NHS, including e-prescribing, automation, transfer of medicines information, and prescription ordering via the NHS App. He is also Senior Advisor for digital pharmacy and medicines, and Professional Lead for pharmacy in clinical informatics. He has held senior leadership roles across the NHS, including Chief Pharmacist in a London NHS Trust, and was the first Clinical Fellow to the Chief Pharmaceutical Officer, where he led national work on seven-day pharmacy services. Like Gimmo, he holds a Master's in Leadership (Quality Improvement) from Ashridge Executive Education and is a Generation Q Fellow.For our micro-discussion we discuss the paper “Qualitative evaluation of the implementation and national roll-out of the NHS App in England” which examines how the NHS App was implemented during the pandemic and beyond; https://pubmed.ncbi.nlm.nih.gov/39838384/.As with all of our guests, Rahul shares with us his Memory Evoking Medicine, a career anthem and book that has influenced his life. From Prescription to Ocean — A TEDx Talk by Jamie HayesWe're incredibly proud to share that Aural Apothecary co-host Jamie Hayes has taken to the TEDx stage with a thought-provoking talk:  Prescription to Ocean: The Hidden Impact of Medicineshttps://www.youtube.com/watch?v=swCLNaAG5qYJamie explores a fascinating and urgent question: What happens to our medicines once they leave the prescription pad — and how do they impact the world beyond the patient? It's a journey that connects healthcare, the environment, and our shared responsibility for the future. You'll never think about prescribing (or taking) medicines in quite the same way again.Please take a few minutes to watch, reflect, and share — this is a conversation worth having.Please follow us on LinkedIn!Let us know what you think of the show. https://www.linkedin.com/company/auralapothecary/You can listen to the Aural Apothecary playlist here; https://open.spotify.com/playlist/3OsWj4w8sxsvuwR9zMXgn5?si=tiHXrQI7QsGtSQwPyz1KBg You can view the Aural Apothecary Library here;  https://litalist.com/shelf/view-bookcase?publicId=KN6E3OOur website is https://www.theauralapothecary.com/To get in touch follow us on LinkedIn, Bluesky and X @auralapothecary or email us at auralapothecarypod@gmail.com. Don't forget to rate us and comment wherever you have got this podcast from.

On 13 March 2025, Keir Starmer announced the abolition of NHS England, the arm's-length body responsible for overseeing, planning, funding and delivering the health service – with its functions to be merged back into the Department of Health and Social Care. Work on the transition is underway but key decisions are still to be made. What are the risks and opportunities associated with abolishing NHS England? How much progress has been made to date? What can be learnt from previous structural changes to the NHS and other parts of government? How can the government get the reform process right? To answer these questions and more, this webinar from the IfG and the Nuffield Trust brought together an expert panel featuring: Mark Dayan, Policy Analyst and Head of Public Affairs at the Nuffield Trust Stuart Hoddinott, Associate Director at the Institute for Government Sarah Reed, Senior Fellow at the Nuffield Trust The webinar was chaired by Nick Davies, Programme Director at the Institute for Government. This webinar was kindly supported by the Nuffield Trust.

On 13 March 2025, Keir Starmer announced the abolition of NHS England, the arm's-length body responsible for overseeing, planning, funding and delivering the health service – with its functions to be merged back into the Department of Health and Social Care. Work on the transition is underway but key decisions are still to be made. What are the risks and opportunities associated with abolishing NHS England? How much progress has been made to date? What can be learnt from previous structural changes to the NHS and other parts of government? How can the government get the reform process right? To answer these questions and more, this webinar from the IfG and the Nuffield Trust brought together an expert panel featuring: Mark Dayan, Policy Analyst and Head of Public Affairs at the Nuffield Trust Stuart Hoddinott, Associate Director at the Institute for Government Sarah Reed, Senior Fellow at the Nuffield Trust The webinar was chaired by Nick Davies, Programme Director at the Institute for Government. This webinar was kindly supported by the Nuffield Trust. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Steve & James return with episode 82 of the health and politics podcast, Prevention is the new cure.This week, to mark Stroke Prevention Day on Thursday, the guys talk to Juliet Bouverie from the Stroke Association about signs, symptoms and red flags.And they look ahead to the long-awaited National Cancer Plan which is expected to be published next week. What can we expect from the first plan since 2018?Also on this episode; the WHO confirms the UK has lost its measles elimination status, James speaking at the counter-fraud conference next month and NHS England is set to significantly enhance its bowel cancer screening programme, aiming to detect thousands more cases at an earlier, more treatable stage.You can access the archive via Podfollow and find us on all social at our LinkTree page.You can email the team - preventionisthenewcurepodcast@gmail.comThanks for listening! Hosted on Acast. See acast.com/privacy for more information.

In this special episode, recorded live at the 2025 Genomics England Research Summit, host Adam Clatworthy is joined by parents, clinicians and researchers to explore the long, uncertain and often emotional journey to a genetic diagnosis. Together, they go behind the science to share what it means to live with uncertainty, how results like variants of uncertain significance (VUS) are experienced by families, and why communication and support matter just as much as genomic testing and research. The panel discuss the challenges families face when a diagnosis remains out of reach, the role of research in refining and revisiting results over time, and how collaboration between researchers, clinicians and participants could help shorten diagnostic journeys in the future. Joining Adam Clatworthy, Vice-Chair for the Participant Panel, on this episode are: Emma Baple – Clinical geneticist and Medical Director, South West Genomic Laboratory Hub  Jamie Ellingford – Lead genomic data scientist, Genomics England  Jo Wright – Member of the Participant Panel and Parent Representative for SWAN UK  Lisa Beaton - Member of the Participant Panel and Parent Representative for SWAN UK  Linked below are the episodes mentioned in the episode:  What is the diagnostic odyssey?  What is a Variant of Uncertain Significance?  Visit the Genomics England Research Summit website, to get your ticket to this years event. You can download the transcript, or read it below. Sharon: Hello, and welcome to Behind the Genes. My name is Sharon Jones and today we're bringing you a special episode recorded live from our Research Summit held in June this year. The episode features a panel conversation hosted by Adam Clatworthy, Vice-Chair of the Participant Panel. Our guests explore navigating the diagnostic odyssey, the often-complex journey to reaching a genetic diagnosis. If you'd like to know more about what the diagnostic odyssey is, check our bitesize explainer episode, ‘What is the Diagnostic Odyssey?' linked in the episode description. In today's episode you may hear our guests refer to ‘VUS' which stands for a variant of uncertain significance. This is when a genetic variant is identified, but its precise impact is not yet known. You can learn more about these in another one of our explainer episodes, “What is a Variant of Uncertain Significance?” And now over to Adam. -- Adam: Welcome, everyone, thanks for joining this session. I'm always really humbled by the lived experiences and the journeys behind the stories that we talk about at these conferences, so I'm really delighted to be hosting this panel session. It's taking us behind the science, it's really focusing on the people behind the data and the lived experiences of all the individuals and the families who are really navigating this system, trying to find answers and really aiming to get a diagnosis – that has to be the end goal. We know it's not the silver bullet, but it has to be the goal so that everyone can get that diagnosis and get that clarity and what this means for their medical care moving forwards.    So, today we're really going to aim to demystify what this diagnostic odyssey is, challenging the way researchers and clinicians often discuss long diagnostic journeys, and we'll really talk about the vital importance of research in improving diagnoses, discussing the challenges that limit the impact of emerging research for families on this odyssey and the opportunities for progress. So, we've got an amazing panel here. Rather than me trying to introduce you, I think it's great if you could just introduce yourselves, and Lisa, I'll start with you. Lisa: Hi, I'm Lisa Beaton and I am the parent of a child with an unknown, thought to be neuromuscular, disease. I joined the patient Participant Panel 2 years ago now and I'm also a Parent Representative for SWAN UK, which stands of Syndromes Without A Name. I have 4 children who have all come with unique and wonderful bits and pieces, but it's our daughter who's the most complicated. Adam:  Thank you. Over to you, Jo. Jo:  Hi, I'm Jo Wright, I am the parent of a child with an undiagnosed genetic condition.  So I've got an 11-year-old daughter. 100,000 Genomes gave us a VUS, which we're still trying to find the research for and sort of what I'll talk about in a bit.  And I've also got a younger daughter. I joined the Participant Panel just back in December. I'm also a Parent Rep for SWAN UK, so Lisa and I have known each other for quite a while through that. Adam:  Thank you, Jo.  And, Jamie, you're going to be covering both the research and the clinician side and you kind of wear 2 hats, so, yeah, over to you. Jamie:  Hi, everyone, so I'm Jamie Ellingford and, as Adam alluded to, I'm fortunate and I get to wear 2 hats. So, one of those hats is that I'm Lead Genomic Data Scientist for Rare Disease at Genomics England and so work as part of a really talented team of scientists and engineers to help develop our bioinformatic pipelines, so computational processes. I work as part of a team of scientists and software engineers to develop the computation pipelines that we apply at Genomics England as part of the National Health Service, so the Genomic Medicine Service that families get referred to and recruited to, and we try to develop and improve those. So that's one of my hats. And the second of those is I am a researcher, I'm an academic at the University of Manchester, and there I work really closely with some of the clinical teams in the North West to try and understand a little bit more about the functional impact of genomic variants on kind of how things happen in a cell. So, we can explore a little bit more about that but essentially, it's to provide a little bit more colour as to the impact that that genomic variant is having. Adam: Great, thank you, Jamie. Over to you, Emma. Emma: My name's Emma Baple, I'm an academic clinical geneticist in Exeter but I'm also the Medical Director of the South West genomic laboratory hub, so that's the Exeter and Bristol Genomics Laboratory. And I wear several other hats, including helping NHS England as the National Specialty Advisor for Genomics. Adam: Thank you all for being here. I think it's really important before we get into the questions just to ground ourselves in like those lived experiences that yourself and Jo and going through. So, Lisa, I'm going to start with you. The term ‘diagnostic odyssey' gets bandied around a lot, we hear about it so many times, but how does that reflect your experience that you've been through and what would you like researchers and clinicians to understand about this journey that you're on, essentially? Lisa: So I think ours is less an odyssey and more of a roller-coaster, and I say that because we sort of first started on a genetic journey, as it were, when my daughter was 9 weeks of age and she's now 16½ – the half's very important – and we still have no answers. And we've sort of come a bit backwards to this because when she was 6 months old Great Ormond Street Hospital felt very strongly that they knew exactly what was wrong with her and it was just a case of kind of confirmation by genetics. And then they sent off for a lot of different myasthenia panel genes, all of which came back negative, and so having been told, “Yes, it's definitely a myasthenia, we just need to know which one it is,” at 4 years of age that was removed and it was all of a sudden like, “Yeah, thanks, sorry.” And that was really hard actually because we felt we'd had somewhere to hang our hat and a cohort of people with very similar issues with their children, and then all of a sudden we were told, “No, no, that's not where you belong” and that was a really isolating experience. I can remember sort of saying to the neuromuscular team, “Well is it still neuromuscular in that case?” and there was a lot of shrugging of shoulders, and it just…  We felt like not only had we only just got on board the life raft, then we'd been chucked out, and we didn't even have a floaty. And in many ways I think I have made peace with the fact that we don't have a genetic diagnosis for our daughter but it doesn't get easier in that she has her own questions and my older children – one getting married in August who's already sort of said to me, you know, “Does this have implications for when we have children?”  And those are all questions I can't answer so that's really hard. Adam:  Thank you, Lisa. Yourself, Jo, how would you describe the odyssey that you're currently experiencing? Jo: So my daughter was about one when I started really noticing that she was having regressions. They were kind of there beforehand but, I really noticed them when she was one, and that's when I went to the GP and then got referred to the paediatrician. So initially we had genetic tests for things like Rett syndrome and Angelman syndrome, which they were all negative, and then we got referred on to the tertiary hospital and then went into 100,000 Genomes. So we enrolled in 100,000 Genomes at the beginning of 2017, and we got our results in April of 2020, so obviously that was quite a fraught time. Getting our results was probably not as you would want to do it because it was kind of over the phone and then a random letter. So, what I was told in that letter was that a variant of uncertain significance had been identified and they wanted to do further research to see if it might be more significant. So we were to be enrolled into another research project called Splicing and Disease, which wasn't active at the time because everything had been put on hold for COVID, but eventually we went into that. So, I didn't know what the gene was at that point, when I eventually got the form for going to get her bloods done…  So that went off and then that came back and the geneticist said, “That gives us some indication that it is significant.” So, since that point it's been trying to find more information and research to be able to make it a diagnosis. There have been 2 sort of key things that have happened towards that but we're still not there. So one of the things is that a research paper came out earlier this year so that's kind of a little bit more evidence, it's not going to give us a diagnosis but it kind of, you know, sits there. And the other thing is that my geneticist said, “Actually, yeah, it looks like it's an important change.”  That's as far as we've got. So we've still got work to do to make it a diagnosis or not.  Obviously if it is a diagnosis, it is still a one-of-a-kind diagnosis, so it doesn't give me a group to join or that kind of thing. But now I've got that research paper that I've read and read, and asked ChatGPT to verify that I've understood it right in some places, you know, with the faith that we put into ChatGPT (laughs), I've got a better understanding and I've got something now that I can look back on, the things that happened when my daughter was one, 2, 3, 4 and her development was all over the place and people thought that I was slightly crazy for the things I was saying, that “Actually, no, I can see what's happening.” So, it's like the picture's starting to come into focus but there's work to do. I haven't got a timeframe on that, I don't know when it's going to come together. And I always say that I'm a prolific stalker of the postman; ever since our first genetic tests you're just constantly waiting for the letters to drop through the door. So a diagnostic odyssey to me is just waiting for random events. Adam: I think what you've both kind of really clearly elaborated on is how you're the ones that are having to navigate this journey, you're the ones that are trying to piece this puzzle together, and the amount of time you're investing, all whilst navigating and looking after your child and trying to cope with the daily lived experience as well. And something you've both touched on that I'd love to draw out more is about how exactly was the information shared with you about the lack of diagnosis or the VUS or what's going on, because in our case you get this bit of paper through the post that has all these numbers and it's written in clinical speak and we had no conversation with the geneticist or the doctors. You see this bit of paper and you're reading it, scared for what the future will hold for your child, but I'd love to know like how were you communicated whilst all this is going on, how did you actually find out the next steps or any kind of future guidance. Lisa: So I think in our case we kept sort of going onto neuromuscular appointments, and I think for probably the first 5 years of my daughter's life I kind of had this very naïve thought that every time we turned up to an appointment it would be ‘the one' and then…   I think it would've been really helpful actually in those initial stages if they had said to us, “Actually, we don't know when this is going to happen, if it's even going to happen, you need to kind of prepare yourself for that.” It sounds fairly obvious to say but you don't know what you don't know. And in some ways we were getting genetic test results back for some really quite horrible things and they would tell us, “Oh it's good news, this mitochondrial disorder hasn't come up,” and so part of you is like, “Yay!” but then another part of you is thinking, “Well if it's not that what is it?” And we've very much kind of danced around and still don't really have an answer to whether it's life-limiting. We know it's potentially life-threatening and we have certain protocols, but even that is tricky. We live in North Yorkshire, and our local hospital are amazing. Every time we go in, if it's anything gastro-related, they say to me, “What's the protocol from Great Ormond Street?” and I say, “We don't have one” (laughs) and that always causes some fun. We try to stay out of hospitals as much as we absolutely can and do what we can at home but, equally, there's a point where, you know, we have to be guided by where we're going with her, with the path, and lots of phone calls backwards and forwards, and then is it going to be a transfer down to Great Ormond Street to manage it. And actually the way I found out that nothing had been found from 100,000 Genomes was in a passing conversation when we had been transferred down to Great Ormond Street and we'd been an inpatient for about 6 weeks and the geneticist said to me, “So obviously with you not having a diagnosis from the 100,000 Genomes…” and I said, “Sorry?  Sorry, what was that?  You've had the information back?”  And she said, “Well, yes, did nobody write to you?” and I said, “No, and clearly by my shock and surprise.” And she was a bit taken aback by that, but it happened yet again 2 years later (laughs) when she said, “Well you know everything's been reanalysed” and I said, “No.”  (Laughs)  And, so that's very much, it still feels an awful lot like I'm doing the heavy lifting because we're under lots of different teams and even when they're working at the same hospital they don't talk to each other. And I do understand that they're specialists within their own right, but nobody is really looking at my daughter holistically, and there are things that kind of interrelate across.    And at one of the talks I attended this morning they were talking about the importance of quality of life, and I think that is something that has to be so much more focused on because it's hard enough living without a diagnosis, but when you're living with a bunch of symptoms that, I think the best way I can describe it is at the moment we've got the spokes of the umbrella but we don't have the wrapper, and we don't know where we're going with it. We can't answer her questions, we can't even necessarily know that we're using the most effective treatments and therapies for her, and she's frustrated by that now, being 16, in her own right, as well as we are. And I'm panicking about the navigation towards Adult Services as well because at the minute at least we have a clinical lead in our amazing local paediatrician but of course once we hit and move into that we won't even have him and that's a really scary place to be, I think. Adam: Jo, is there anything you wanted to add on that in terms of how you've been communicated to whilst all this is going on? Jo: Yeah, so I think part of what makes it difficult is if you're across different hospitals because they're not necessarily going to see the same information. So obviously it was a bit of a different time when I got our results, but I got our results on a virtual appointment with a neurologist in one hospital, in the tertiary hospital, and because he could see the screen because it was the same hospital as genetics, and he said, “Oh you've got this” and then the letter came through later. When I had my next appointment with the neurologist in our primary hospital, or secondary care, whatever it's called, in that hospital, he hadn't seen that, so I'm telling him the results, which isn't ideal, but it happens quite a lot. What I think is quite significant to me is the reaction to that VUS.  I have to give it, the doctors that look after my daughter are brilliant, and I'm not criticising them in any way but their reaction to a VUS is “I'm so grateful for the persistence to get to a diagnosis.” Neurologists are a bit more like “Oh it's a VUS so it might be significant, it might be nothing.” Actually, as a patient, as in a parent, you actually want to know is it significant or not, “Do I look at it or not?” And, I mean, like I said, there were no research papers to look at before anyway until a few months ago so I didn't have anything to look at, but I didn't want to look at it either because you don't want to send yourself off down a path. But I think that collective sort of idea that once someone gets a VUS we need a pathway for it, “What do we do with it, what expectation do we set the patients up with and what is the pathway for actually researching further?” because this is where we really need the research. Adam:  Thank you, Jo. So, Emma, over to you in terms of how best do you think clinicians can actually support patients at navigating this odyssey and what's the difference between an initial diagnosis and a final diagnosis and how do you then communicate that effectively to the patients and their family?   Emma: So I think a key thing for me, and it's come up just now again, is that you need to remember as a doctor that the things you say at critical times in a patient's or parent's journeys they will remember – they'll remember it word for word even though you won't – and thinking about how to do that in the most sensitive, empathetic, calm, not rushed way is absolutely key.   And there are some difficulties with that when you're in a very high-pressure environment but it is absolutely crucial, that when you are communicating information about test results, when you're talking about doing the test in the first place, you're consenting the family, you're explaining what you're trying to do and those conditions, you balance how much information you give people.    So, you were talking earlier about “So you haven't got this diagnosis, you haven't got that diagnosis,” I often think it's…  We're often testing for numerous different conditions at the same time, I couldn't even list them all to the parents of the children or the patient that I'm testing. It's key to try and provide enough information without overwhelming people with so much information and information on specific conditions you are just thinking about as a potential.  Sometimes very low down your list actually but you can test for them.    Because people go home and they use the internet and they look things up and they get very, very worried about things. So, for me it's trying to provide bite-sized amounts of information, give it the time it deserves, and support people through that journey, tell them honestly what you think the chance of finding a diagnosis is. If you think it's unlikely or you think you know, sharing that information with family is helpful.   Around uncertainty, I find that a particular challenge. So, I think we've moved from a time when we used to, in this country, declare every variant we identified with an uncertain significance. Now, if we remember that we've all got 5 million variants in our genome, we've all got hundreds and hundreds… thousands and thousands, in fact, of variants of uncertain significance in our genetic code. And actually, unless you think a variant of uncertain significance genuinely does have a probability of being the cause of a child's or a patient's condition, sharing that information can be quite harmful to people.    We did a really interesting survey once when we were writing the guidelines for reporting variants of uncertain significance a few years ago. We asked the laboratories about their view of variants of uncertain significance and we asked the clinicians, and the scientists said, “We report variants of uncertain significance because the clinicians want them” and the clinicians said, “If the labs put the variant of uncertain significance on the report it must be important.” And of course, if you're a parent, if the doctor's told you the variant is a variant of uncertain significance of course you think it's important.    So, we should only be sharing that information, in my opinion, if it genuinely does have a high likelihood of being important and there are things that we can do. And taking people through that journey with you, with the degree of likelihood, the additional tests you need to do and explaining to them whether or not you think you will ever clarify that, is really, really key because it's very often that they become the diagnosis for the family.  Did I cover everything you think's important, both of you?  Lisa: I think the one thing I would say is that when you are patient- or parent-facing, the first time that you deliver that news to the parent… you may have delivered that piece of news multiple times and none of us sit there expecting you to kind of be overcome with emotion or anything like that but, in the same way that perhaps you would've had some nerves when, particularly if it was a diagnosis of something that was unpleasant, you know, to hold onto that kind of humanity and humility. Because for those patients and parents hearing that news, that is the only time they're ever hearing that, and the impact of that, and also, they're going on about with their day, you don't know what else they're doing, what they're juggling.    We're not asking you all to be responsible for kind of, you know, parcelling us up and whatnot but the way information is imparted to us is literally that thing we are all hanging our hats on, and when we're in this kind of uncertainty, from my personal experience I'm uncomfortable, I like to be able to plan, I'm a planner, I'm a researcher, I like to sort of look it up to the nth degree and that, and sitting in a place without any of that is, it's quite a difficult place to be. And it's not necessarily good news for those parents when a test comes back negative, because if it's not that then what is it, and that also leaves you feeling floundering and very isolated at times.  Adam: Yeah, and you touched upon the danger of like giving too much information or pushing families down a particular route, and then you have to pull them out of it when it's not that.   You talked about the experience you had, you felt like you'd found your home and then it's like, “Well, no, no, sorry, actually we don't think it's that.” And you've invested all of your time and your emotion into being part of that group and then you're kind of taken away again. So it's to the point where you have to be really sure before you then communicate to the families, and obviously in the meantime the families are like, “We just need to know something, we need to know,” and it's that real fine line, isn't it?    But, Jamie, over to you. Just thinking about the evolving nature of genomic diagnosis, what role does research play in refining or confirming a diagnosis over time?  Jamie: So it's really, really difficult actually to be able to kind of pinpoint one or 2 things that we could do as a community of researchers to help that journey, but perhaps I could reflect on a couple of things that I've seen happen over time which we think will improve things. And one of that's going back to the discussion that we've just had about how we classify genetic variants. And so, behind that kind of variant of uncertain significance there is a huge amount of effort and emotion from a scientist's side as well because I think many of the scientists, if not all, realise what impact that's going to have on the families.   And what we've tried to do as a community is to make sure that we are reproducible, and if you were to have your data analysed in the North West of England versus the South West that actually you'd come out with the same answer. And in order to do that we need guidance, we need recommendations, we need things that assist the scientists to actually classify those variants.  And so, what we have at the moment is a 5 point scale which ranges from benign to likely benign, variant of uncertain significance, unlikely pathogenic variant and pathogenic variant. It's objective as to how we classify a variant into one of those groups and so it's not just a gut feeling from a scientist, it's kind of recordable measurable evidence that they can provide to assist that classification.   So in many instances what that does is provide some uncertainty, as we've just heard, because it falls into that zone of variant of uncertain significance but what that also does is provide a framework in which we can generate more evidence to be able to classify it in one direction or another to become likely pathogenic or to become likely benign. And as a research community we're equipped with that understanding –– and not always with the tools but that's a developing area – to be able to do more about it.   What that doesn't mean is that if we generate that evidence that it can translate back into the clinic, and actually that's perhaps an area that we should discuss more. But kind of just generating that evidence isn't always enough and being able to have those routes to be able to translate back that into the hands of the clinicians, the clinical scientists, etc, is another challenge. Adam:  And how do you think we can drive progress in research to deliver these answers faster, to really try and shorten those diagnostic journeys, like what are the recommendations that you would say there? Jamie:  So being able to use the Genomics England data that's in the National Genomic Reference Library, as well as kind of other resources, has really transformed what we can do as researchers because it enables teams across the UK, across the world to work with data that otherwise they wouldn't be able to work with.   Behind that there's an infrastructure where if researchers find something which they think is of interest that can be reported back, it can be curated and analysed by teams at Genomics England and, where appropriate, kind of transferred to the clinical teams that have referred that family. And so having that pathway is great but there's still more that we can do about this. You know, it's reliant on things going through a very kind of fixed system and making sure that clinicians don't lose contact with families – you know, people move, they move locations, etc. And so, I think a lot of it is logistical and making sure that the right information can get to the right people, but it all falls under this kind of umbrella of being able to translate those research findings, where appropriate, into clinical reporting.   Adam:  Thank you. And, Emma, is there anything you would add in terms of like any key challenges that you think need to be overcome just to try and shorten the journeys as much as possible and find the answers to get a diagnosis?  Emma: I think trying to bridge that gap between some of the new technologies and new approaches that we've got that we can access in a research context and bringing those into diagnostics is a key area to try to reduce that diagnostic odyssey, so I really want to see the NHS continuing to support those sorts of initiatives.   We're very lucky, as Jamie said, the National Genomic Research Library has been fundamental for being able to reduce the diagnostic odyssey for large numbers of patients, not just in this country but around the world, and so trying to kind of look at how we might add additional data into the NGRL, use other research opportunities that we have in a more synergistic way with diagnostics I think is probably key to being able to do that.    We are very lucky in this country with the infrastructure that we've got and the fact that everything is so joined up. We're able to provide different opportunities in genomics for patients with rare conditions that aren't so available elsewhere in the world.  Adam: Great, thank you. I think we're it for time, so thank you very much to the panel. And I'd just say that if you do have any further questions for ourselves as participants then we're only too happy to pick those up. Thank you for lasting with us ‘til the end of the day and hope to see you soon.  -- Sharon: A huge thank you to our panel, Adam Clatworthy, Emma Baple, Jo Wright, Lisa Beaton and Jamie Ellingford, for sharing their insights and experiences. Each year at the summit, the Behind the Genes stage hosts podcast style conversations, bringing together researchers, clinicians and participants to discuss key topics in genomics.  If you're interested in attending a future Genomics England Research Summit, keep an eye out on our socials. If you'd like to hear more conversations like this, please like and subscribe to Behind the Genes on your favourite podcast app. Thank you for listening.    I've been your host, Sharon Jones. The podcast was edited by Bill Griffin at Ventoux Digital and produced by Deanna Barac.

This is the first of a series of four podcasts (and associated blogs) about how we can integrate more physical activity across the NHS and what key actions health and care professionals can do to support the strategic shift from ‘Sickness to Prevention' and from ‘Hospital to Community'. The first podcast kicks off with an introductory episode, by Sarah Price, Director of Public Health for NHS England and Sasha Karikusevic, Director, NHS Horizons, who outline how we can harness the true potential of physical activity across the NHS to help to prevent ill-health and help people to live healthier, longer, and more independent lives, with best-practice examples across England to illustrate the benefits. A full transcript of this episode is available on our website - https://www.england.nhs.uk/long-read/four-ways-forward-podcast/ Please get in touch if you have any questions regarding this episode - england.medicalcomms@nhs.net

The government is making major changes to the structure of the NHS. NHS England is being abolished, with its functions merged into the Department of Health and Social Care (DHSC). At the same time, the number of Integrated Care Boards (ICBs) is set to be reduced, with many expected to merge. Changes proposed by the 10 Year Health Plan, including contracts for single and multi-neighbourhood providers, will also create changes in local delivery structures. How can the government ensure that the new national structure works effectively? Should any current NHSE functions remain independent of DHSC? How should the reformed DHSC work regionally, and with ICBs, strategic authorities and trusts? How can the government make a success of the emerging ICB structure? How should local delivery structures be reformed? To discuss these questions and more, we were joined by an expert panel including: Dr Penelope Dash, Chair of NHS England Dame Patricia Hewitt, former Secretary of State for Health and author of the Hewitt Review of ICSs Samantha Jones, Permanent Secretary at the Department of Health and Social Care Johan Kahlström, President and Managing Director, UK and Ireland at Novartis Pharmaceuticals UK This event was chaired by Nick Davies, Programme Director at the Institute for Government. We would like to thank Novartis Pharmaceuticals UK for kindly supporting this event.

The government is making major changes to the structure of the NHS. NHS England is being abolished, with its functions merged into the Department of Health and Social Care (DHSC). At the same time, the number of Integrated Care Boards (ICBs) is set to be reduced, with many expected to merge. Changes proposed by the 10 Year Health Plan, including contracts for single and multi-neighbourhood providers, will also create changes in local delivery structures. How can the government ensure that the new national structure works effectively? Should any current NHSE functions remain independent of DHSC? How should the reformed DHSC work regionally, and with ICBs, strategic authorities and trusts? How can the government make a success of the emerging ICB structure? How should local delivery structures be reformed? To discuss these questions and more, we were joined by an expert panel including: Dr Penelope Dash, Chair of NHS England Dame Patricia Hewitt, former Secretary of State for Health and author of the Hewitt Review of ICSs Samantha Jones, Permanent Secretary at the Department of Health and Social Care Johan Kahlström, President and Managing Director, UK and Ireland at Novartis Pharmaceuticals UK This event was chaired by Nick Davies, Programme Director at the Institute for Government. We would like to thank Novartis Pharmaceuticals UK for kindly supporting this event. Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, we explore something a little different, but deeply connected to everything we do in medicine, leadership, and human connection: the power of storytelling. Whether it's patient handover, clinician-to-clinician stories, or the messroom chat, stories fill our everyday lives. My guest today is Clare Murphy, a world-renowned storyteller who has been bringing the ancient art of story firmly into the modern world since 2006. Clare has performed across the globe, sharing stories with audiences as diverse as the All-Blacks coaches, Mission Critical Teams, scientists, schoolchildren, and even Irish President Mary Robinson. Her work also transcends entertainment. Clare teaches storytelling as a tool for connection, communication, and meaning-making, working with diverse communities that include asylum seekers, climate scientists, social entrepreneurs, firefighters, and veterans who have lost limbs.Her client list speaks volumes: NASA, the All-Blacks, the Mission Critical Team Institute, The Drive Project, Social Entrepreneurs Ireland, Routes Collective, and NHS England. Together, we'll unpack how story shapes the way we understand the world, how it can help us connect with our teams, our patients, and ourselves in the moments that matter most. You can find Clare's work here: https://claremurphy.org/Empirical research suggests that Paramedics routinely recount emergency calls during downtime to make sense of their work. This storytelling functions as a form of tactical resilience to managers, other services, patients, bystanders, and each other, and often involves strong language. The paper can be found here:https://www.researchgate.net/publication/251772924_Heroes_and_Lies_Storytelling_Tactics_among_ParamedicsThis Podcast is sponsored by World Extreme Medicine.World Extreme Medicine provides internationally recognised education for clinicians and operators working in pre-hospital, remote, expedition, humanitarian, and high-risk environments. Their programmes focus on practical, experience-led learning, equipping professionals with the skills to make sound clinical and operational decisions when resources are limited, evacuation is delayed, and conditions are extreme.With courses covering expedition and wilderness medicine, hostile environments, dive medicine, human performance, leadership, and austere care, World Extreme Medicine brings together a global faculty with real-world experience from some of the most challenging settings on earth. To explore courses, free educational resources, and upcoming webinars, visit:www.worldextrememedicine.com

Join us as Nuha Yassin sits down with Sue Clark, Terri McVeigh and Frank McDermott to discuss genomics and molecular surgery. Genomics and molecular surgery have the potential to change our approaches to healthcare and surgical practice. These exciting advancements in genomics and molecular surgery are allowing us to better personalise treatments and improve patient outcomes. This includes the use of next generation sequencing, circulating tumour DNA, polygenic risk scores, pharmacogenomics and personalised drug treatments such as cancer vaccines. Join us for the Future of Surgery Festival this April for a celebration of surgery, where innovation meets inspiration. Host: Nuha Yassin Nuha Yassin is a Consultant Colorectal Surgeon at University Hospitals Birmingham and an Associate Clinical Professor at the University of Birmingham. Her clinical and research interests focus on technology, minimally invasive, and robotic surgical techniques for colorectal cancer and IBD. She is the Lead for robotic colorectal surgery at her trust and the first female national proctor for robotic colorectal surgery in the UK. Guest: Sue Clark Professor Sue Clark MD FRCS (Gen Surg) EBSQ (Coloproctology) is a Consultant Colorectal Surgeon at St Mark's Hospital, and Professor of Practice (Colorectal Surgery) at Imperial College, London, UK. Additional roles include Chair of the UK-wide Hereditary Gastrointestinal Polyposis Syndromes Rare Disease Collaborative Network, Administrative Officer of the International Society for Gastrointestinal Hereditary Tumours (InSiGHT) and Chair of the Bowel Research UK Grants Committee. She was previously Director of the St Mark's Hospital Polyposis Registry, RCS(England) Genomics Champion, member of the RCS(England) Commission on the Future of Surgery, Editor in Chief of Colorectal Disease and member of InSiGHT Council. Guest: Terri McVeigh Terri McVeigh is a Consultant Clinical Geneticist in the Royal Marsden NHS Foundation Trust in London, with clinician–scientist training that includes international research and clinical fellowships. Her work spans genomic medicine, education and national service development. She works with NHS England's Genomics Education Programme, supporting curriculum development, faculty training and the creation of learning resources for both specialist and mainstream clinicians. As a Professional Lead within the Genomics Training Academy, she helps shape educational strategy, assessment approaches and faculty development, and co‑chairs the Oncology and Malignant Haematology GeNotes working groups.  Guest: Frank McDermott Frank McDermott is Lead for Genomics and Molecular Surgery at the Royal College of Surgeons of England, Consultant Colorectal Surgeon at the Royal Devon University Healthcare NHS Foundation Trust, and Associate Professor at the University of Exeter. His clinical and academic interests include colorectal cancer, complex decision-making, and the integration of genomics into routine surgical practice. He is Clinical Director of the South West Genomic Medicine Service Alliance and Editor of BJS Open and is involved in national and international collaborative research focused on improving personalised cancer care.Produced by: Andrea Pearson References GeNotes: GeNotes: Genomic notes for clinicians | GEP | NHS England GTAC: GTAC: The Genomics Training Academy - Genomics Education Programme UKCGG one-page clinical guidelines: UKCGG leaflets and guidelines - Cancer Genetics Group RCS Genomics e-learning module: https://vle.rcseng.ac.uk/enrol/index.php?id=730 Current and future genomic applications for surgeons: https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2024.0031  The impact of cancer genomics across the surgical pathway: https://www.sciencedirect.com/science/article/abs/pii/S0263931925000225 Precision surgery: harnessing the power of genomics: https://publishing.rcseng.ac.uk/doi/10.1308/rcsbull.2026.1

Risky Business returns for 2026! Patrick Gray and Adam Boileau talk through the week's cybersecurity news, including: Santa brings hackers MongoDB memory leaks for Christmas Vercel pays out a million bucks to improve its React2Shell WAF defences 39C3 delivers; the pink Power Ranger deletes nazis, while a catgirl ruins GnuPG Cambodian scam compound kingpin gets extradited to China, and we don't think it'll go well for him Krebs picks apart the Kimwolf botnet and residential proxy networks So many healthcare data leaks that we have a roundup section This week's episode is sponsored by Airlock Digital. The founders of the application allow-listing vendor, David Cottingham and Daniel Schell, discuss Microsoft's ClickOnce .NET app packaging, and how attackers have been abusing it to load code. Airlock hates it when you load code! This episode is also available on Youtube. Show notes US, Australia say ‘MongoBleed' bug being exploited | The Record from Recorded Future News Merry Christmas Day! Have a MongoDB security incident. | by Kevin Beaumont | Dec, 2025 | DoublePulsar Inside Vercel's sleep-deprived race to contain React2Shell | CyberScoop gpg.fail Hacktivist deletes white supremacist websites live onstage during hacker conference | TechCrunch Chinese attackers exploiting zero-day to target Cisco email security products | The Record from Recorded Future News Ni8mare  -  Unauthenticated Remote Code Execution in n8n (CVE-2026-21858) | Cyera Research Labs ServiceNow patches critical AI platform flaw that could allow user impersonation | CyberScoop Alleged cyber scam kingpin arrested, extradited to China | The Record from Recorded Future News FCC IoT labeling program loses lead company after China probe | Cybersecurity Dive Trump picks Lt. Gen. Joshua Rudd to lead NSA spy agency - The Washington Post NSA cyber directorate gets new acting leadership | The Record from Recorded Future News Dutch court sentences hacker who used port systems to smuggle cocaine to 7 years | The Record from Recorded Future News ECLI:NL:GHAMS:2026:22, Amsterdam Court of Appeal, 23-003218-22 The Kimwolf Botnet is Stalking Your Local Network – Krebs on Security Who Benefited from the Aisuru and Kimwolf Botnets? – Krebs on Security Coupang recovers smashed laptop that alleged data leaker threw into river | The Record from Recorded Future News Ransomware responders plead guilty to using ALPHV in attacks on US organizations | The Record from Recorded Future News Nearly 480,000 impacted by Covenant Health data breach | The Record from Recorded Future News Illinois health department exposed over 700,000 residents' personal data for years | TechCrunch Tech provider for NHS England confirms data breach | TechCrunch Hacker claiming to be behind ManageMyHealth breach: ‘I do it for the money and I'm in negotiations to get it' - NZ Herald

If you have perhaps eaten a bit too much over the holidays and maybe feeling a little bit heavier than before.  Well don't worry as for the first check in of 2026 with Glasgow based Pharmacist Elizabeth Roddick it is all about weight loss. Elizabeth began by explaining to RNIB Connect Radio's Toby Davey about the current position around weight loss injections such as Mounjaro and whether you can get the injections on the NHS.Then to why it is not only a good idea but important to try and avoid processed foods.Ending with some good advice from Elizabeth about eating well and exercising regularly too.You will find more information around weight loss injections by visiting the NHS England website - https://www.england.nhs.uk/ourwork/prevention/obesity/medicines-for-obesity/weight-management-injections/#:~:text=From%2023%20March%202025%2C%20you,the%20right%20treatment%20for%20you.To get in touch with Elizabeth you can email info@elizabethroddick.com or for more information visit -https://elizabethroddick.comImage: Picture showing Elizabeth standing in her pharmacy, dressed in her white pharmacist coat and a colourful bandana around her neck, she's smiling warmly at the camera with her hands slightly raised.

The government has announced a new NHS online hospital service is being launched in England next year. It will focus on nine health conditions, including glaucoma, age-related macular degeneration and cataracts.Amelia spoke to RNIB Head of Policy, Mike Wordingham, to learn about what this means for blind and partially sighted people in England.Image shows the RNIB Connect Radio logo. On a white background ‘RNIB' written in bold black capital letters and underline with a bold pink line. Underneath the line: ‘Connect Radio' is written in black in a smaller font. Learn more on the NHS England website - NHS England » Menopause and prostate conditions prioritised for NHS's new online hospital

In today's Tech and Science Daily from The Standard, NHS England sets out priority conditions for its upcoming NHS Online hospital, and CES 2026 kicks off with Intel's new Panther Lake-era laptop chips and fresh Acer ultrabooks. Plus, Arc Raiders confirms “aggression-based matchmaking” that groups PvP-heavy players together. Hosted on Acast. See acast.com/privacy for more information.

In the latest episode of the Transforming Primary Care podcast, Dr Sarah Zaidi, GP and NHS England regional lead for frailty in the East of England and a panel of North-East and Yorkshire based GPs, geriatricians and other health and care professionals discuss how to help the most vulnerable people in our communities. They explore how the identification and successful management of frailty is key to the aims of the 10 Year Plan and the medium-term planning framework, as well as its role within neighbourhood working. For more information on neighbourhood health visit: https://www.england.nhs.uk/long-read/neighbourhood-health-guidelines-2025-26/ A full transcript of this episode is available on our website - https://www.england.nhs.uk/long-read/transforming-primary-care-podcast-2/ Please get in touch if you have any questions regarding this episode - england.ney.pctransformation@nhs.net

In this episode of the Clinical Update podcast, MIMS Learning deputy editor Rhiannon looks back at a year of thought-provoking clinical education from the podcast. The episode begins with a focus on cancer diagnosis, revisiting a conversation with NHS England's Professor Peter Johnson on the success of the Lung Cancer Screening Programme. We also hear from pancreatic cancer specialist nurse Rachel Richardson about the potential for new tests to revolutionise early detection in primary care. Dr Toni Hazell provides advice on one of the most talked-about clinical areas in 2025 – weight-loss medications – highlighting specific considerations for women using these drugs. Look out for more content on obesity as part of MIMS Learning's 2026 editorial campaign.Consultant nephrologist Dr Andrew Frankel outlines the ‘three actions in 3 months' initiative — a structured approach to medicines optimisation in chronic kidney disease (CKD). Also, Dr Steve Brinksman discusses how best to identify alcohol use disorder, noting ‘we're in the harm reduction business – anything we can do to stop people developing diseases, to stop people having to go to hospital; that's worthwhile.' Finally, Dr Farnaaz Sharief shares practical resilience frameworks to help clinicians recharge at this busy time of year. Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Describe the impact of targeted lung cancer screening Recall specific advice regarding oral contraception for patients using GLP-1 agonists for weight loss Outline the ‘three actions in 3 months' approach to optimising medication in CKDUse screening tools to effectively assess alcohol consumption in primary care Apply practical techniques to manage your energy levels and maintain resilience in clinical practice You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser. Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events. MIMS Learning[Subscribe to MIMS Learning] Patient, Presentation, Pathway for Cancer campaignNHS England's Professor Peter Johnson on optimising early cancer diagnosisNurse specialist Rachel Richardson on pancreatic cancer risk factors and new developments in earlier detectionDr Toni Hazell on weight loss injections and women's healthPodcourse: part 2 - monitoring and management of CKD with Dr Andrew FrankelDr Steve Brinksman on supporting people with alcohol misuse in primary careDr Farnaaz Sharief on finding balance in a pressured systemFrom MIMSObesity treatments Hosted on Acast. See acast.com/privacy for more information.

The Cybercrime Wire, hosted by Scott Schober, provides boardroom and C-suite executives, CIOs, CSOs, CISOs, IT executives and cybersecurity professionals with a breaking news story we're following. If there's a cyberattack, hack, or data breach you should know about, then we're on it. Listen to the podcast daily and hear it every hour on WCYB. The Cybercrime Wire is brought to you Cybercrime Magazine, Page ONE for Cybersecurity at https://cybercrimemagazine.com. • For more breaking news, visit https://cybercrimewire.com

Professor Tony Avery,  National Clinical Director for Prescribing for NHS England, discusses safer prescribing of medicines. He highlights the changes he would like to see to enable patients to make genuinely informed decisions, which may also sometimes mean that they decide not to go ahead with a treatment. Tony describes how he believes doctors and patients can work together on initial prescribing decisions,  so that patients can be confident that the benefits of the selected approach outweigh the risks. You can find out more about this podcast on its website and if you would like to support it you can do so via Patreon at or via PayPal. The host of the podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director.  You can follow Liz on X and read further information about the podcast on her Substack newsletter. Medical Evidence Matters with Liz Tucker has been selected by Feedspot as one of the top 15 UK Medical Podcasts https://blog.feedspot.com/uk_medical_podcasts/

Send us a textIn our update this month Derek Munn, Director of Policy and Public Affairs at the RCSLT covers:Big news from 2025, including RCSLT successes such as the Invest in SLT debate, Voicebox competition in Scotland, Language Launchpad and launch of AHPF Cymru in Wales; the budget in England.Lots happening in Scotland around children and young people. RCSLT particularly welcomes the 'Early years speech, language and communication action plan': https://www.gov.scot/publications/speech-language-communication-action-plan/Best Start Family Hubs in England to be a one-stop shop for parents of children with SEND.Publication of the 'Getting it right first time' head and neck cancer report: https://gettingitrightfirsttime.co.uk/medical_specialties/head-and-neck-cancer/The House of Lords committee on the Autism Act has highlighted speech, language, and communication, the role of speech and language therapy, and the barriers too many autistic people, of all ages, and their families face accessing it, across education, employment, health, justice, and social care The Office of the Chief Allied Health Professions Officer (CAHPO) at NHS England has commissioned NHS Elect to co-produce  a Transformation Toolkit for NHS community speech and language therapy services for children and young people https://www.rcslt.org/news/toolkit-to-support-nhs-services-to-reduce-waiting-times-for-children-and-young-people/ Please be aware that the views expressed are those of the guests and not the RCSLT.Please do take a few moments to respond to our podcast survey: uk.surveymonkey.com/r/LG5HC3R

Dr Taz Aldawoud is a GP, NHS Innovation Accelerator Fellow and founding CEO of Doc Abode, a nationally recognised digital health company enabling the NHS to deliver faster, safer care closer to home. With over 20 years' clinical experience and an MBA specialising in Strategic Healthcare Management, he combines frontline insight with a strong record in digital transformation.He spent more than a decade as Director of Clinical Innovation at West Yorkshire's urgent care provider, where he pioneered one of the NHS's first award-winning telehealth services. Taz is currently Chief Clinical Information Officer for the West Yorkshire Integrated Care Board and previously served as a Digital Clinical Adviser for NHS England, contributing to national digital policy and innovation.Through Doc Abode, he works with Integrated Care Systems and provider Trusts across the UK to increase workforce capacity, improve responsiveness and enhance patient outcomes through dynamic care coordination and real-time visibility of clinical resources.

Last week, there was an average of 2660 people a day with flu in England's hospital beds, a 55% increase on the week before. A more virulent, mutated strain is being blamed for the spike in cases. Also: President Zelensky insists Ukraine must have a vote before ceding any territory to Russia. And: ticket prices for next year's football World Cup are revealed.

 Merry Christmas! This month for the December 2025 episode of the RCEM Learning Podcast Andy and Dave are talking about higher MAP targets in sepsis and the routine use of antibiotics for max-fax fractures. Rob attempts a festive round up of the most impactful guidelines of the year. We'll then end with New Online. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (03:19) New in EM - Higher MAP targets in Sepsis Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised controlled trial (Endo et al., 2025) (15:19) Most Impactful Guidelines of the Year European Resucitation Guidelines - Guidelines on Cardiopulmonary Resuscitation (ERC, 2025) NHS England - Urgent and emergency care plan 2025/26 (NHS England, 2025) NHS England - Guidance to support the commissioning and delivery of ambulance services in 2025/26(NHS England, 2025) NICE - NG246 Overweight and obesity management (NICE, 2025) NICE - NG253 - Suspected sepsis in people aged 16 or over: recognition, assessment and early management (NICE, 2025) NICE - NG254 - Suspected sepsis in under 16s: recognition, diagnosis and early management (NICE, 2025) NICE - NG255 - Suspected sepsis in pregnant or recently pregnant people: recognition, diagnosis and early management (NICE, 2025) RCPCH - Facing the Future - standards for children and young people in emergency care settings (RCPCH, 2025) RCEM - GPEMS(RCEM, 2025) (38:07) New in EM - Routine use of antibiotics in facial fractures Prophylactic antibiotic use in trauma patients with non-operative facial fractures: A prospective AAST multicenter trial (Mian et al., 2025) (47:10) New Online – new articles on RCEMLearning for your CPD Is Normalisation of Deviance the "Standard" in Medicine? - Neel Bhandani Mental Illness in Children by Jidhin Davis Rest, sleep, and our breaks - the conversation we cant tire of - Amar Mashru

In this week's episode of the Full of Beans podcast, Han is joined by Dr Tomos Williams. Tom has worked in the CWP Eating Disorder Service since May 2022. He works across community and specialist inpatient settings. He is the Psychiatric lead in the regional Type 1 Diabetes and Disordered Eating Clinic, the local MEED lead, and also works with patients with complex presentations, acting as a link person for local acute trusts. He is a member of the Royal College of Psychiatry Eating Disorder Faculty Executive Committee.This week, we discuss:What T1DE is, and why “diabulimia” is an outdated termThe life-threatening risks of insulin omissionHow eating disorders and diabetes treatment often conflictWhy T1DE clinics are essential, but underfundedThe role of eating disorder and diabetes professionalsWhat joined-up, trauma-informed care looks likeThe outcomes and success of T1DE pilotsThe urgent need for political support to save these servicesTimestamps:01:30 – What is Type 1 Diabetes and Disordered Eating (T1DE)04:00 – Medical risks associated with insulin omission08:50 – Building the T1DE clinic & lack of national funding13:10 – The power of a multi-disciplinary team18:40 – Early signs of T1DE and what clinicians should look for22:10 – Impact of trauma & perfectionism in diabetes25:00 – Outcomes & HbA1c improvements29:00 – Barriers to insulin pump access33:20 – Can you recover from EDs while managing diabetes?Resources & Links:The Compassion Project (Wessex & London T1DE Pilot)Parliamentary Inquiry into T1DE (2023)Diabetes UK on T1DEWant to help save T1DE services?Write to your local MP and demand continued funding. Mention the NHS England pilot outcomes and the need for integrated care for patients with type 1 diabetes and eating disorders.Connect with Us:Subscribe to the Full of Beans Podcast hereFollow Full of Beans on Instagram hereCheck out our website here⚠️ Trigger Warning: This episode discusses lived experiences of eating disorders, restrictive behaviours, and mentions of specific foods. Please take care when listening.If you enjoyed this episode, don't forget to subscribe, rate, and share the podcast to help us spread awareness.Sending positive beans your way, Han

Earlier this week, RNIB have marked two years since the launch of the Eye Care Support Pathway, with an event in Manchester which brought together optometrists, sector leaders and other partners. The framework was developed by the charity with leading organisations across the eye care and sight loss sectors, to ensure patients have timely access to information, advice and support throughout their eye care journey. RNIB Connect Radio's David Hogg was there and spoke to James Palmer from NHS England.   Find our full coverage of the event here: Audioboom / Reporting From Eye Care Support Pathway 2 Years On Event   Image shows the RNIB Connect Radio logo. On a white background ‘RNIB' written in bold black capital letters and underline with a bold pink line. Underneath the line: ‘Connect Radio' is written in black in a smaller font. 

Contact us and share your opinionJoin eGPlearning as we take a look at the NHS Medium Term Planning Framework. This document was published by NHS England on 24 October 25 and provides more detail on how DoH and NHSE will deliver on the aspirations outlined in the NHS 10 year plan.This summary will help you understand where your ICB, Place, PCN and Practice are being asked to focus over the next 4 years.The document covers how responsibilities for delivery will be distributed across different levels of within the system from the centre down to neighbourhoods and the layers in between, how aspirations will align with the three darzi shifts, and describes specific targets in the areas of; elective care, cancer and diagnostics, urgent and emergency care, primary care, community health services, mental health, learning disabilities and workforce.Boost your triage skills with our dynamic 5-session live webinar course, tailored for primary care clinicians. Led by Dr. Gandalf and Dr. Ed Pooley, this comprehensive training covers all facets of remote patient triage—digital, on-call, and more. Gain practical knowledge, exclusive tips, and direct access to our experts through open Q&A sessions. Elevate your ability to manage primary care challenges effec Subscribe and hear the latest EPIC episode. Join Dr Mike as he shares how to get started and fly using EMIS to make your life easier with this clinical systembit.ly/EMIScourse

Doctors Sara and Lisa speak to Dr Chris Nortcliff who is a GP and Chief Clinical Information Officer for Greater Manchester Primary Care Provider Board. The discussion is focussed around all things digital in primary care. We start with an overview of how the digital environment is set up within Greater Manchester. We then spend some time talking about digital inclusion - covering how to find people, how to help upskill them to be more digitally literate, and how to support better access to digital services. We also explore what is available in the digital space to help in primary care, and touch on AI and large language models. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: Greater Manchester Care Record: https://gmwearebettertogether.com/ Health Innovation Manchester: https://healthinnovationmanchester.com/ Greater Manchester Digital First Primary Care: https://healthinnovationmanchester.com/our-work/gm-digital-first-primary-care/ Digital Skills Map: https://greatermanchester-ca.gov.uk/what-we-do/digital/get-online-greater-manchester/greater-manchester-wide-support/get-online-greater-manchester-digital-skills-map/ National Databank: https://www.goodthingsfoundation.org/our-services/national-databank The Good Things Foundation: https://www.goodthingsfoundation.org/ NHS App: https://www.nhs.uk/nhs-app/ Digital Facilitator Team: https://gmpcb.org.uk/general-practice/digital-transformation/dfpc-programme-explained/meet-the-team/ Greater Manchester Primary Care Provider Board Website: https://gmpcb.org.uk/general-practice/digital-transformation/ Clinical safety standards - DCB 0129: https://digital.nhs.uk/data-and-information/information-standards/governance/latest-activity/standards-and-collections/dcb0129-clinical-risk-management-its-application-in-the-manufacture-of-health-it-systems/ Clinical safety standards - DCB0160: https://digital.nhs.uk/data-and-information/information-standards/governance/latest-activity/standards-and-collections/dcb0160-clinical-risk-management-its-application-in-the-deployment-and-use-of-health-it-systems/ Digital Inclusion Framework by NHS England: https://www.england.nhs.uk/long-read/inclusive-digital-healthcare-a-framework-for-nhs-action-on-digital-inclusion/ Digital Inclusion Heat Map: https://www.thrivebydesign.org.uk/digital-exclusion-heatmap ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

In this episode of the RCP Medicine Podcast, Dr Vincent Simpson, diabetes and endocrine registrar based in Derriford, Plymouth joins Dr Bryony Alderman, palliative medicine consultant and RCP Education Fellow in Sustainability. Together, they explore the intersection of diabetes care and environmental sustainability, focusing on Vincent's pioneering work around reusable cartridge insulin pens.From the initial spark of curiosity during a training session to national-level conversations with NHS England, Vincent shares his journey of uncovering the environmental impact of diabetes devices and advocating for change. The discussion covers practical steps clinicians can take, the importance of behavioural change, and how small interventions can lead to significant improvements in both patient care and environmental outcomes.Whether you're a physician, policymaker, or someone living with diabetes, this episode offers valuable insights into how sustainability can be seamlessly integrated into clinical practice.Dr Vincent Simpson and team recently won an RCP Excellence in Patient Care award for Sustainability – reducing the environmental impact of healthcare ResourcesPaper: https://onlinelibrary.wiley.com/doi/10.1111/dme.15409Local guidelines: https://sustainablediabetes.short.gy/guidelinesWebsite: https://sustainablediabetescare.comLinkedin: https://uk.linkedin.com/in/dr-vincent-simpsonBluesky:https://bsky.app/profile/drvsimpson.bsky.socialCreditsDr Bryony Alderman, consultant in palliative medicine, is the RCP Sustainability Fellow. Financial support for this clinical fellowship was provided as an Independent Medical Education Grant from Pfizer Limited. Pfizer Limited had no involvement in candidate selection, and no influence on the work of the clinical fellowship.RCP Links Education Events Membership Improving care Policy and campaigns RCP Social Media Instagram LinkedIn Facebook X Bluesky Music: Episode 50 onward - Bensound.com Episodes 1 - 49 'Impressive Deals' - Nicolai Heidlas

This week on Hospitality Meets, I sit down with the brilliant Phil Shelley — Senior Operational Manager at NHS England and Chair of the NHS Food Review. Phil is an exceptional hospitality leader and human being and was crowned Outstanding Achievement Award winner at the 2025 Foodservice Cateys, only last Friday.Phil's career is a masterclass in purpose driven leadership. From his early days in hotel kitchens to shaping the future of hospital food, he's proof that hospitality is about so much more than service, it's about care.We talk about how hospitality thinking is transforming the NHS, the power of teamwork in driving real change, and why good food and kindness go hand in hand.It's an episode packed with humour, heart, and hope and a well deserved celebration of a man who's spent his life making food matter.Key TakeawaysFood Is Care: The NHS Food Review isn't just about meals — it's about dignity, wellbeing, and recovery.Hospitality Belongs Everywhere: Empathy, teamwork, and kindness are as crucial in hospitals as in hotels.Leadership Through Listening: Real change comes from empowering others, not instructing them.Progress Beats Perfection: Keep moving forward — the impact compounds.Celebrate the Wins: Recognition matters, especially when it shines a light on meaningful work.Memorable Quotes“I've got to say, Phil, I love my job”“Always has time for people. And isn't that the secret of success?”“Sometimes those challenges or the times where you really kind of hit a wall, they are the biggest learning areas”“You will find a solution, you will find a way together. And sometimes if you do it together, my goodness me, that is powerful”“I was thinking it must be Number 10 just down the road from me... and as the call went on, I suddenly realised, oh my gosh"Final ThoughtsPhil is a living reminder that hospitality is everywhere and when it's done with purpose, it can transform lives.This conversation is equal parts inspiring and grounding, showing how leadership, food, and humanity can come together to make a real difference, one plate at a time.Show PartnersA big shout out to Today's show partner, RotaCloud, the people management platform for shift-based teams.RotaCloud lets managers create and share rotas, record attendance, and manage annual leave in minutes — all from a single, web-based app.It makes work simple for your team, too, allowing them to check their rotas, request holiday, and even pick up extra shifts straight from their phones.Try RotaCloud's time-saving tools today by heading to https://rotacloud.com/philThis podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy

In Episode 46, of Season 5 of Driven by Data: The Podcast, Kyle Winterbottom was joined by Ming Tang, Chief Data & Analytics Officer & Chief Digital & Information Officer at NHS England where they discuss the the governments 10-year strategy for the future of healthcare and the role that data and digital will play, which includes; From pharmacist to Chief Data and Analytics Officer at NHS England.The reason for trialling a dual role of CDAO and CDIO leading both digital and data strategies across the NHS.How the government's ten-year plan is driving a major shift in how digital and data support healthcare delivery.Why a single patient record is a cornerstone of the NHS's strategy.What the future of healthcare may look like in ten years.How digital transformation is already improving patient outcomes.How patients engage with the NHS will change dramatically. The impact the strategy will have on Staff of the NHS. The data challenges associated with building a single patient record.Why AI is delivering real impact in areas like diagnostics, software development, and operational efficiency.Why Digital inclusion remains a key focus, with efforts to support both patients and staff across varying levels of digital confidence.The challenges of building digital and data literacy at scale across different audiences.Why patient-centred design, multidisciplinary collaboration, and reimagining workflows are critical to success.Moving from treatment to prevention is a top priority.Moving from siloed data to real-time, person-centred, interoperable data flows.How AI is supporting clinicians by tools such as ambient voice technology. How proposed legislation could support seamless data sharing across NHS, suppliers, and public...

In this episode of our new digital clinical safety podcast series, originally recorded in Autumn 2024, we are joined by Liz Barfield, who brings over 20 years of experience in this vital area. Liz's extensive background includes roles in emergency care, implementation, and her most recent position as a Clinical Safety Officer (CSO) at NHS England, where she contributed to numerous national programmes. In 2019, she completed an MSc in Patient Safety, focusing her dissertation on the DCB safety standards. Throughout the podcast, Liz shares valuable insights and practical hints and tips for those working in digital clinical safety roles. Further resources: • Digital Clinical Safety – Essentials e-learning training module https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-training#essentials-training • Digital Clinical Safety – Intermediate e-learning training module https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-training#intermediate-training • Digital Clinical Safety – Practitioner training https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-training#practitioner-training • Digital Safety in Practice course - https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-training#digital-safety-in-practice • Digital Clinical Safety – Refresher training https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-training#refresher-training The digital clinical risk management standards: • DCB0129: Clinical Risk Management: its Application in the Manufacture of Health IT Systems https://digital.nhs.uk/data-and-information/information-standards/governance/latest-activity/standards-and-collections/dcb0129-clinical-risk-management-its-application-in-the-manufacture-of-health-it-systems/ • DCB0160: Clinical Risk Management: its Application in the Deployment and Use of Health IT Systems - NHS England Digital https://digital.nhs.uk/data-and-information/information-standards/governance/latest-activity/standards-and-collections/dcb0160-clinical-risk-management-its-application-in-the-deployment-and-use-of-health-it-systems/ A full transcript of this episode is available on our website - https://www.england.nhs.uk/long-read/insights-from-a-national-clinical-safety-officer-podcast-transcript/ Please get in touch if you have any questions regarding this episode - Tengland.clinical.safety@nhs.net

The atmosphere of the emergency department can be a hard thing to put into words, with intense emotions washing over patients and staff alike. This month we feature a poem, powerfully illustrating the drama and stress inside the ED bubble. One of the recurring sources of uncertainty for patients is the question, “How long until I'm seen, doc?”, and there's a paper following up on that issue with a personalised approach. A framework that has been employed by NHS England, aimed at dealing with the problem, is Same Day Emergency Care (SDEC). The next paper finds there is a limited evidence on the impact of SDECs, as well as confusion around their definition. Another paper on the subject of patient flow shows that while digital solutions are promising, you can't replace a streaming nurse for critical decisions. To finish the episode is a 10-year retrospective review on the use of blood in paediatric trauma, drawing on the data of the Trauma Audit Research Network. Read the highlights: October 2025 primary survey Whose turn is it? Poetry: the art of expression “How long until I am seen, doc?” Modelling paediatric emergency department waiting times to make personalised predictions Impact of same day emergency care services on urgent and emergency care delivery outcomes: a systematic review Blood product use in paediatric trauma: lessons from the TARN data The EMJ podcast is hosted by: Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Senior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

This episode of the Transforming Primary Care podcast, chaired by Liz Spice head of primary care in the cross-sector area in the North East and Yorkshire region, covers the development of Acute Respiratory Infection (ARI) hubs in our local communities, their importance during periods of high demand and the considerations involved when setting them up. The panel including Dr Cath Monaghan, Medical Director of the North East and North Cumbria Integrated Care Board, also explores the role of ARI hubs in the NHS response to winter, their impacts in previous winters and how they align with the key shift from hospital to community outlined within the 10-year plan. With neighbourhood health being firmly on the horizon, what can we learn from those who have been pioneering respiratory care closer to home? For more information about ARI hubs visit NHS England https://www.england.nhs.uk/long-read/combined-adult-and-paediatric-acute-respiratory-infection-ari-hubs/ For a transcript of this episode, visit https://www.england.nhs.uk/long-read/same-day-urgent-respiratory-care-in-the-community-a-breath-of-fresh-air/ Please get in touch if you have any questions regarding this episode - england.ney.pctransformation@nhs.net.

In the first of our new series of digital clinical safety podcasts, we are joined by Chris Day, NHS England Clinical Lead for Cyber Operations and Robyn Dennis, NHS England Cyber Security Tiger Team Lead, as we explore how cyber threats directly impact patient care and what healthcare organisations and their staff can do to prevent them and minimise impact. Key insights include: • How cybersecurity incidents directly impact clinical safety and patient care • The most common cyber threats facing healthcare organisations, including ransomware and new AI-enabled risks • Why ""cyber is a team sport"" and everyone has a role to play in healthcare security • Practical strategies for preventing cyber incidents and protecting patient data • The importance of planning for business continuity and disaster recovery • How to integrate cybersecurity considerations throughout the digital product lifecycle The podcast provides essential listening for those working in digital clinical safety, patient safety and cyber security roles, but will also be of interest to anyone in healthcare who wants to understand how cybersecurity and patient safety work together to protect patients from harm. Further resources: • Data Security and Protection Toolkit (DSPT) - https://www.dsptoolkit.nhs.uk/ • Digital Technology Assessment Criteria (CDTAC) - https://transform.england.nhs.uk/key-tools-and-info/digital-technology-assessment-criteria-dtac/ • Chris's blog on multi-factor authentication (MFA): https://digital.nhs.uk/blog/transformation-blog/2023/multi-factor-authentication-a-silver-cyber-bullet • NHS multi-factor authentication (MFA) Policy - https://digital.nhs.uk/cyber-and-data-security/guidance-and-assurance/multi-factor-authentication-mfa-policy/nhs-england-multi-factor-authentication-policy • Cyber operations website - https://digital.nhs.uk/cyber • National Cyber Security Centre's (NCSC) Cyber Aware campaign on top tips for all of us - https://www.ncsc.gov.uk/cyberaware/home • Network and Information Systems (NIS) regulations - https://www.gov.uk/government/publications/network-and-information-systems-regulations-2018-health-sector-guide/the-network-and-information-systems-regulations-2018-guide-for-the-health-sector-in-england#introduction • Health and Adult Social Care Cyber Security Strategy for 2030 - https://www.gov.uk/government/publications/cyber-security-strategy-for-health-and-social-care-2023-to-2030/a-cyber-resilient-health-and-adult-social-care-system-in-england-cyber-security-strategy-to-2030#approach-the-5-pillars# • NHS cyber and data security services and resources - https://digital.nhs.uk/cyber-and-data-security/services • Resources published for Cyber Awareness Month 2024 - including the Cyber Sessions podcasts - https://digital.nhs.uk/cyber-and-data-security/campaigns/cyber-security-awareness-month If you have any questions or would like to know more about what NHS England cyber operations does, email cybersecurity@nhs.net. A full transcript of this episode is available on our website - https://www.england.nhs.uk/long-read/patient-safety-through-cybersecurity-preventing-harm-from-digital-threats/ Please get in touch if you have any questions regarding this episode - cybersecurity@nhs.net

Scientists say they have created an AI tool that could predict a patient's risk of hundreds of diseases years before they develop symptoms.The technology, if it works, could help revolutionise a health service which is always looking for ways to reduce costs and offer better patient care.However, with many people feeling the NHS can often struggle to implement new technologies - how ready is the health service for such a potentially groundbreaking tool?Who will be accountable if it gives a wrong diagnosis? And should people be scared AI is about to replace the human touch of their local GP?Niall is joined by Sky's science and medical correspondent Thomas Moore, who explains how the technology works and how prepared the NHS might be to introduce it. Dr Ben Maruthappu, founder of healthtech company Cera and former innovation adviser to NHS England, also reveals what other AI tools are on the horizon.Producers: Emily Hulme and Natalie KtenaEditor: Mike Bovill

Andy Cumpstey is joined by three experts from NHS England; Mindy Dawes, Deputy Divisional Director of Nursing for Surgery at Walsall Healthcare NHS Trust; Maria Oyston, Head of Nursing Service Transformation & Resilience at NHS England; and Jane Murkin, Deputy Director for Safety & Improvement - Nursing at NHS England, to discuss the Dreaming Project and Toolkit. The conversation delves into the origins and implementation of the Dreaming Collaborative, which aims to prevent patient deconditioning post-surgery by promoting early drinking, eating, and mobilizing. They discuss the contributions of various stakeholders, the importance of a multi-disciplinary approach, and the toolkit which was designed to help healthcare providers implement these strategies effectively. The episode highlights the significant improvements in patient outcomes and reduced length of stay achieved through this project, as well as the importance of engaging patients and healthcare staff at all levels. Further reading: We mention this paper: https://www.bjanaesthesia.org/article/S0007-0912(22)00146-5/fulltext Our guest, Mindy Dawes, provides this paper: https://www.bjanaesthesia.org.uk/article/S0007-0912(25)00162-X/abstract

In this episode of the RCP Medicine podcast, Professor Mark Harber, nephrologist, and RCP sustainability advisor, is joined by Chris Gormley, Chief Sustainability Officer at NHS England, to explore the NHS's groundbreaking journey toward net zero.Together, they discuss the origins of the NHS's green strategy, the global health implications of climate change, and the ambitious targets set for 2040 and 2045. Chris shares insights into the NHS's leadership on sustainability, the economic and health drivers behind the movement, and the practical steps being taken - from decarbonising the supply chain to rolling out solar energy across NHS estates.Listeners will gain a deeper understanding of the challenges and opportunities in embedding sustainability into clinical practice, the importance of international collaboration, and how clinicians and staff can get involved through green plans and toolkits.ResourcesGreener NHS plan website - https://www.england.nhs.uk/greenernhs/Greener NHS – case studies https://www.england.nhs.uk/greenernhs/whats-already-happening/12 things we can do as individuals to become greenerRCP view on healthcare sustainability and climate changeCSH Courses Courses | Centre for Sustainable Healthcaree-learning for Health – Environmentally Sustainable Healthcare Environmentally Sustainable Healthcare - elearning for healthcare (e-lfh.org.uk)SusQI.org (step by step guide) Step-by-step guide | Centre for Sustainab (susqi.org)Greener NHS Greener NHS (england.nhs.uk)CSH Resource Library Resource library | Sustainable Healthcare Networks HubCSH Networks Networks | Sustainable Healthcare Networks HubRCP Links Education Events Membership Improving care Policy and campaigns RCP Social Media Instagram LinkedIn Facebook X Bluesky Music: Episode 50 onward - Bensound.com Episodes 1 - 49 'Impressive Deals' - Nicolai Heidlas

Two deeply disturbing cases in France have reignited national debate about how the justice system handles sexual violence. In December last year, Dominique Pelicot was found guilty of repeatedly drugging and raping his wife while she was unconscious and inviting other men to do the same. This week, Joël Le Scouarnec, a retired surgeon, was sentenced to a maximum of 20 years in jail for sexually abusing almost 300 people, mostly children. His victims have spoken out against this sentence and lawyers have called for a change in the law. Jessica Creighton is joined by Blandine Deverlanges, a feminist activist and the Founder of Les Amazones d'Avignon, and BBC correspondent Hugh Schofield to discuss the situation. Three-time Oscar nominee Carey Mulligan, known for roles in films such as Maestro, Promising Young Woman and Suffragette, returns to our cinema screens in the comedy drama The Ballad of Wallis Island. She talks about playing ex-folk singer Nell, working on a film set with a young baby, and how she feels about turning 40. The Secret Intelligence Service, known as MI6, is about to appoint a new chief and it's looking very likely that it will be a woman for the first time in the organisation's 115-year history. Former BBC defence correspondent Gordon Corera and spy novelist Ava Glass tell Jessica who's in the running and how significant it is that this organisation could be run by a woman.A new blood test which will help develop personalised cancer treatment is going to be rolled out across the NHS. The technique, known as a 'liquid biopsy' will be offered as a standard for lung cancer patients, and the NHS is now planning on expanding this testing to advanced breast cancer patients. Jessica is joined by Peter Johnson, national clinical director for cancer at NHS England, to discuss how this works and the impact it could have.Earlier this week, goalkeeper Mary Earps, one of England's most high profile footballers, announced her retirement from the international game. Her decision comes just five weeks before the Lionesses go to the European Championships to defend their title. Joining Jessica to discuss her decision is football writer for the Guardian Suzy Wrack, and sports lecturer at the University of Worcester and professional goalkeeping coach, Dr Julia West. Presenter: Jessica Creighton Producer: Andrea Kidd