There has been an increase in neighbourhoods in north east London where fewer than 60% of children receive their first MMR vaccine on time following the pandemic, according to research from the Clinical Effectiveness Group at Queen Mary University of London. The study, published today in BMJ Open, found that only 75% of children are receiving the first dose of the MMR vaccine on time, compared to the 95% needed to prevent outbreaks of measles, a highly infectious disease. The poorest neighbourhoods were most affected, raising concerns about growing health inequalities after the pandemic.
CEG's work with the NHS in North East London is featured as a case study in a new report by The King’s Fund: Cardiovascular disease in England: Supporting leaders to take actions. The report calls for “urgent action by government, national and local leaders to tackle the large and unequal burden of disease and mortality associated with cardiovascular disease - much of which is potentially preventable through timely, evidence-based public health measures and health care.”
The Clinical Effectiveness Group (CEG) has launched a Cancer Toolkit to GP practices across North East London. It includes a clinical template, patient record searches, a data dashboard and a new Cancer Diagnosis Audit Tool. Together, the resources will support GP practice teams to address inequalities and deliver timely cancer diagnosis and care for everyone who needs it.
Using CEG’s software tools, GP practices across North East London reviewed the care of hundreds of people with type 1 diabetes to ensure they can access the treatment they need, regardless of gender, ethnicity, language, disability or wealth. The region has since seen an 11% increase in the numbers of patients re-engaging with diabetes specialists at local hospitals and community care centres. On 13 October, it was announced that the initiative won a Quality in Care (QiC) Diabetes Award, under the category: Patient Care Pathway, Secondary and Community.
Health Spot – a collaboration between Spotlight, Tower Hamlets GP Care Group, the Clinical Effectiveness Group (CEG), Docklands Outreach and Safe East – has been shortlisted for the Partnership Working Award at the London Youth Awards 2022. The Health Spot service offers friendly, confidential medical appointments with a doctor who is experienced in supporting young people with health needs.
Linking anonymised GP records to other datasets (for example, on housing or collected by schools) can reveal important insight into how circumstances interact and influence our health. At the International Population Data Linkage Network conference, between 7-9 September, CEG researchers presented three projects that use innovative data linkage methods to address important research questions that have broad implications for policy.
An observational study of people with the heart condition atrial fibrillation, published by a student of Queen Mary’s Wellcome Trust-funded PhD programme: Health Data in Practice, has found that almost 2 in 3 (65.9%) patients on dual-antithrombotic therapy (DAT) receive the treatment for more than 12 months. This is considered too long and puts the patient at increased risk of bleeding complications.
Queen Mary’s Clinical Effectiveness Group (CEG) is collaborating with the NHS in North East London, providing intelligence to inform the logistics of the immunisation campaign and software tools to ease the burden for GPs.
The software tool ‘APL-Imms’ was developed by Queen Mary’s Clinical Effectiveness Group (CEG) to help GP practices immunise more children against preventable illness. The timing of the updated tool will help GPs to protect more children against polio, which has recently been detected in north east London sewage.
Researchers at Queen Mary University of London found that only half of patients regularly see the same GP, despite increasing evidence that continuity of care between GPs and patients leads to better outcomes.
People who benefit the most from seeing the same GP are those with long-term health conditions and people who visit a practice frequently. With continuity of care in decline, these patients could be disproportionately affected, leading to suboptimal care and important issues being missed. The researchers are calling on policymakers to measure continuity of care as a marker of GP practice quality, with incentives to encourage improvement.
A collaborative project by Barts Health NHS Trust, CEG, UCLPartners and east London clinicians has been shortlisted for Best use of integrated care and partnership working in patient safety at the HSJ Patient Safety Awards 2022. The team worked to reduce strokes in people with the heart condition atrial fibrillation (AF) by increasing the use of life-saving anticoagulant medications. In the first 12 months, anticoagulant prescription rates in people with AF in the region reached 95% – well above the national target of 90%.
Researchers at Queen Mary University of London have found that more than a quarter of asthma patients are still over-using inhalers intended for rapid relief of symptoms. Overuse of these inhalers is linked to an increased risk of hospital admissions and severe asthma attacks. They also found that prescribing varies between GP practices, with some overprescribing rescue inhalers to 6% of their asthma patients and some to as many as 60%.
Researchers in the Clinical Effectiveness Group (CEG) have identified sub-groups of type 2 diabetes, which could inform a personalised approach to managing the condition. The study, published in the British Journal of General Practice, uses data from the multi-ethnic population of east London and analyses standard metrics that are routinely recorded by GPs.
The paper ‘Evaluation of the ASSIGN open-source deterministic address-matching algorithm for allocating Unique Property Reference Numbers to general practitioner-recorded patient addresses’ has been selected by the HDR UK Impact Committee as having significant impact and clearly demonstrating the value of uniting the UK’s health data to make discoveries that improve people’s lives. The committee meets monthly to select research outputs put forward by research directors, researchers, and other members of the HDR UK community.
In an article published in the BMJ: ‘Investigating hypertension in younger patients’, Doctors Stuart Rison, Chris Carvalho and John Robson of Queen Mary’s Clinical Effectiveness Group (CEG) argue that GPs should be mindful of the possibility of an underlying condition when treating patients with hypertension who are under 40 years old and investigate this as appropriate.
By Carol Dezateux, Professor of Clinical Epidemiology and Health Data Science at the Clinical Effectiveness Group (CEG), Queen Mary University of London
A recent study shows that optimising medicines for high blood pressure and cardiovascular disease patients living in East London could reduce lifetime hospital costs and prevent cardiovascular events such as heart attacks and strokes.
Four projects tackling some of London’s key health challenges have been awarded a total of £1 million to demonstrate how the use of data at scale can improve health outcomes, supporting delivery of the London Health Data Strategy. The Clinical Effectiveness Group at Queen Mary University of London leads one of the four successful projects: a primary care quality improvement system designed to address falling rates of routine childhood immunisations.
Researchers from Queen Mary’s Clinical Effectiveness Group have developed an address-matching algorithm to link patient health records to geospatial information.
Professor Carol Dezateux and Nicola Firman from Queen Mary's Clinical Effectiveness Group (CEG) have co-written a piece for The Conversation on a recent study published in The Lancet, which found that the HPV vaccine cuts cervical cancer cases by nearly 90 per cent, and their research on uptake.
Applications open for our PhD Health Data in Practice
27 October 2021
Our Wellcome Trust funded doctoral training programme, Health Data in Practice, is open for applications until Monday 10 January. We aim to develop future scientific leaders who are able to apply interdisciplinary perspectives to research and realise the potential of innovations in health data research for the benefit of patients, the public, health care systems and society.
Dr Milena Marszalek, NIHR Academic Clinical Fellow in General Practice and member of Queen Mary University of London’s Clinical Effectiveness Group (CEG), has been awarded £7,000 from Barts Charity to investigate the impacts of ethnicity and deprivation on timely uptake of the Measles, Mumps and Rubella (MMR) vaccine in children.
The Clinical Effectiveness Group (CEG) at Queen Mary University of London is supporting a programme to prevent 200 heart attacks and strokes in the London borough of Redbridge over five years. The team have built a data-driven tool for GP practices, to increase prescribing of statin medication and identify patients for a new ground-breaking drug that reduces cholesterol.
CEG’s risk stratification searches form an integral part of the Proactive Care Frameworks developed by UCL Partners. These resources have now been adopted into a national NHS programme ‘Proactive Care @home’, to be used in 12 Integrated Care Systems across England. This covers around one third of the adult population.
Queen Mary University of London has received funding for three fellowships in primary care as part of our membership in the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR). Two of the fellows – Dr Meredith Hawking and Dr Chris Carvalho – are members of the university’s Clinical Effectiveness Group (CEG) who use primary care data to improve population health in north east London.
HPV vaccination prevents several serious diseases caused by the Human papillomavirus, including cervical cancer. The UK has been vaccinating young women, aged 12-13 years, against HPV since 2008 through a school-based programme. Uptake is high – around 84% of young women are fully immunised through the programme*, but new research published in Vaccine reveals some groups are less likely to be vaccinated than others.
Press release: According to a seven year study led by researchers in the Clinical Effectiveness Group at Queen Mary University of London, involving more than three million people, only 8 per cent of those at greater risk of heart disease who would benefit from taking statins, were prescribed them.
Press release: Researchers in the Clinical Effectiveness Group at Queen Mary University of London have tested an algorithm on 700,000 patient records in east London, to find out if the data routinely collected by GPs can reveal cases of Familial Hypercholesterolemia – a leading cause of heart attack in young people.
CEG research makes BJGP's top ten most read papers of 2020
25 January 2021
Update: Research by CEG made the top ten list for the most read articles in the British Journal of General Practice in 2020. We used data from GP records across east London to demonstrate there were three times as many suspected Covid-19 cases presented to GPs during the peak of the first wave than shown in official Covid-19 test results, and twice the risk for ethnic minorities. Read the full research paper here, or find out more about our work on Covid inequalities in our online case study.
Barts Life Sciences – a partnership between Queen Mary University of London and Barts Health NHS Trust – has been awarded £6.7m by Barts Charity to research new ways to improve the prevention, diagnosis and treatment of a variety of diseases. The diseases to be studied include Covid-19, cancer, heart disease and diabetes, which affect many in the East London population.
Practice support webinars
2 November 2020
Update: We supported GP practices across north east London with a recent series of webinars on QOF, Learning Disabilities, Structured Medication Review and Seasonal Flu. Thank you to everyone who joined us and shared such positive feedback. All of our recent webinars are available to watch online via the Resources page.
UCLP Proactive Care Frameworks
25 September 2020
Update: CEG is collaborating with UCL Partners on their Proactive Care Frameworks. The programme will help primary care practices deliver proactive care to patients with long-term conditions post-Covid, where as much as possible needs to be delivered remotely.
Supporting primary care through the pandemic
14 September 2020
Update: Covid-19 has created an urgent need to deliver routine care more efficiently, particularly for patients with long-term conditions. There has been an increased need to prioritise at-risk groups, enable virtual reviews and self-management, and assess needs that can be met by a variety of professionals such as healthcare assistants, pharmacists and nurses. Here’s how we are supporting these activities and where to find our resources.
Press release: There were three times as many suspected Covid-19 cases presented to GPs during the peak of the pandemic than shown in official Covid-19 test results, according to research led by the Clinical Effectiveness Group at Queen Mary University of London.
CEG is working remotely
16 March 2020
Update: In light of Covid-19, the CEG team will be working from home from Thursday 19th March.
Conference: The Scottish Deep End Project, University of Glasgow
14 February 2019
Dr John Robson presented at The Scottish Deep End Project: The Exceptional Potential of General Practice. His presentation, and those of the other speakers, are now available online.
Update: The NHS Long Term Plan was launched today. It is an ambitious vision to improve NHS care with an increased focus on prevention and digital solutions. The Community Kidney Service, developed jointly by CEG, three east London Clinical Commissioning Groups and St. Bartholomew's Hospital is featured as a case study in the opening chapter 'A new service model for the 21st century'.