The BMJ (British Medical Journal)

Hospitals are dealing with 41{degrees}C indoor temperatures http://www.bmj.com/content/394/bmj-2026-100584.short?rss=1 Hospital staff are dealing with indoor temperatures of more than 41°C as the NHS struggles to provide care during the current heatwave, it has been disclosed.Responses to a freedom of information (FOI) request by the Liberal Democrats found one hospital had recorded 41°C temperatures in June, with several others reaching the high 30s.1The FOI gathered responses from 33 NHS trusts in England that had been monitoring and recording room temperatures during recent warm spells in June and July. It found that most had breached the official NHS recommended maximum safety threshold of 28°C.The Lib Dems said these temperatures were creating a “dangerous” environment for staff and patients and have called on the government to create what they called a “NHS Rapid Adaptation Unit” to heatproof the hospitals and care homes most affected by the heatwave.All of England has been subject to an amber heat health alert this week, meaning “significant...

Scaling up malaria vaccines in Africa http://www.bmj.com/content/394/bmj-2026-100502.short?rss=1 Sustained investment in malaria control has more than halved the global malaria mortality rate over the past 25 years and reduced incidence by 19%. However, this falls short of global targets of a 75% reduction in both rates by 2025 compared with 2015 levels, hampered by increasing levels of drug and insecticide resistance.12As Sorgho et al highlight, incorporating malaria vaccines into an integrated malaria control strategy (encompassing vector control, chemoprevention, diagnosis, and treatment1) could significantly accelerate progress.3 WHO currently recommends two vaccines, RTS,S and R21/Matrix-M (R21), with more under development seeking to interrupt disease transmission or reduce disease burden through other mechanisms.3 However, developing and manufacturing vaccines is only a starting point; translating these breakthroughs into sustained population-level impact requires effective, efficient, and equitable delivery through countries’ health systems while engaging communities to build awareness and trust.4Since WHO’s recommendations, the introduction of these vaccines has been one of the most...

Medical schools risk conflating compliance with professionalism http://www.bmj.com/content/394/bmj-2026-100569.short?rss=1 “It sometimes feels like [what medical schools] should be taking seriously, sexual assault, racism and sexism … are often not taken seriously enough … while minor petty things are taken too seriously.” These are the words of a respondent to our recent BMA survey on students’ experience of medical school professionalism standards.1 They speak to a serious concern echoed throughout the survey—that professionalism is being reduced to a tick box exercise at the cost of its intended purpose.The medical profession relies on public trust, so there is a high bar for how doctors are expected to behave. We must always act with integrity and advocate for our patients’ wellbeing. This is why professionalism standards were built into training at medical school—so we act like doctors from the outset. But our new BMA report, based on a UK wide survey of 2573 medical students, shows the current approach to professionalism is...

Organ donation service that tried to take organs from “thrashing and crying” patient is decertified http://www.bmj.com/content/394/bmj-2026-100578.short?rss=1 A US service that tried to harvest the organs of a man despite him “thrashing on the bed” and showing key signs of life has been decertified.US health secretary Robert F Kennedy Jr stripped the Kentucky based organ donation service Network for Hope of its permission to operate because of the controversy.Kennedy announced the decertification, or firing, on 5 August,1 after a year long investigation that led to plans to reform the US organ procurement and donation system. He said that Network for Hope had endangered patients and had not fixed safety problems despite opportunities to improve.2 The organisation said it would appeal.Controversy surrounding the service erupted in 2021 when Anthony Thomas Hoover II was being treated in hospital after a drug overdose and his family was told he was brain dead and would not recover.The family then authorised donation of his organs. But as Hoover was being removed from...

RSV vaccination programme may have halved numbers of baby admissions to ICU http://www.bmj.com/content/394/bmj-2026-100576.short?rss=1 Respiratory syncytial virus (RSV) admissions of newborn infants to intensive care units (ICUs) in England seem to have halved after a national vaccination programme.UK Health Security Agency (UKHSA) figures from 2025-26 show a more than 50% fall in RSV related admissions of newborns in the first full year of the RSV maternal vaccine programme.1The programme began in September 2024 in England, Wales, and Northern Ireland (August 2024 in Scotland), but its full impact on reducing the number of cases and severity of RSV in infants was not expected to be seen until last winter (2025-26). This is because more pregnant women became eligible over the course of the past year.RSV causes bronchiolitis in babies, which can make it hard for them to breathe and feed, so some need life support in an ICU. The RSV vaccine is provided on the NHS to pregnant women and older adults through GP surgeries...

Healthcare must be built around patients, not profits http://www.bmj.com/content/394/bmj-2026-100570.short?rss=1 Patients are continually let down by health services that aren’t built around their needs. Inertia or the challenge of delivering change may mean that services are stuck in their old ways. For instance, patients in England face unnecessary risks because cosmetic surgery can still legally be performed by doctors without specialist surgical qualifications (doi:10.1136/bmj-2026-100528).1 Royal colleges, specialist surgical associations, and patient safety organisations have asked ministers to close this “serious regulatory gap,” a year after the government promised to take action.And clinicians working in orthopaedic services continue to overlook domestic violence injuries, despite training being available to help staff recognise indicators of abuse, even subtle ones. Improving the recognition and response to domestic violence would, Shady Hermena argues, require “minor structural adjustments to current service models” in orthopaedic centres (doi:10.1136/bmj-2026-100494).2Patients may be let down by services not shifting quickly enough to meet changing needs. James Parsonage and colleagues argue that...

General practice closes in heatwave as NHS staff faint amid soaring temperatures http://www.bmj.com/content/394/bmj-2026-100568.short?rss=1 A general practice says it will temporarily close as a result of soaring temperatures in the UK’s latest heatwave.The move comes amid reports that some NHS staff are fainting at work in the heat.The Mackworth Surgery in Derby announced that it was closing for a few days this week as temperatures were predicted to exceed 30°C as part of the fifth heatwave this summer.1NHS leaders have reminded staff to be prepared for high temperatures, as heat related illness and dehydration can worsen existing health conditions and increase demand for health services.The Derby surgery said that it was closing for four days because it had “concerns about the temperature within the Mackworth building and the safety and wellbeing of both patients and staff.”It said the decision had been made as a “precautionary health and safety measure” and because a member of staff recently became unwell and collapsed at the surgery during...

GMC: Doctors struggle to provide patients with sufficient care, owing to inadequate staffing and admin burden http://www.bmj.com/content/394/bmj-2026-100567.short?rss=1 Inadequate staffing and administrative burden are leaving many doctors struggling to provide patients with the care they need, a General Medical Council report has found.1The GMC’s Workplace Experiences 2026 report found that doctors’ overall satisfaction levels fell in 2025, after two years of small but steady improvements.The regulator’s report was based on a survey of 4606 doctors, 41% of whom reported finding it difficult to provide patients with sufficient care on a weekly basis. This figure was even higher among doctors in Wales (47%) and Scotland (46%).Among GPs specifically, 60% reported finding it difficult to provide sufficient levels of care.Qualitative research carried out by the GMC identified that the main barriers to good care were inadequate staffing, administrative burden, workload demands, patient flow problems, and delays.Just over half of respondents (55%) overall said that they were satisfied with their day to day work, but this was a decline from 59%...

US policies are making a resurgence of vaccine-preventable diseases inevitable http://www.bmj.com/content/394/bmj-2026-100562.short?rss=1 After being prompted in an interview on 2 August, US health secretary Robert F Kennedy Jr said that parents should vaccinate their children against measles and acknowledged that two doses of the measles, mumps, and rubella (MMR) vaccine are about 97% effective.1 Just days later, he accompanied US president Donald Trump as he signed an executive order that will require the MMR vaccine to be delivered in separate doses.2 This order has no scientific basis, will increase pressure on health providers, and by inconveniencing families and sowing doubt and confusion, will also certainly reduce vaccine coverage. Public confidence in vaccines cannot be turned on only when an outbreak becomes impossible to ignore, as it has with measles in the US.The US is experiencing a resurgence of measles after it was eliminated over 25 years ago. As of 6 August 2026, 2465 confirmed measles cases had been reported in the US...

Judge rules that details of doctor’s family court case can be referred to GMC http://www.bmj.com/content/394/bmj-2026-100565.short?rss=1 A family court judgment holding a doctor responsible for abusing his former partner and barring him from contact with his child may be disclosed to the General Medical Council, the judge overseeing the case has ruled.1Family court cases in England and Wales are heard in private and the parties are anonymised. Disclosure of information from private family law proceedings may be made only with the court’s express permission.Case law does not show any previous cases involving disclosure to the GMC, the doctors’ regulator. But in taking the decision at the family court in Cardiff to allow disclosure, Judge Adem Muzaffer reviewed earlier cases in which judgments or documents from family cases were allowed to be disclosed to police, the probation service, or the nursing regulator.“The common thread is the public interest in ensuring that those who work with vulnerable people, whether it is children or vulnerable adults, are fit to...

India’s heatwaves expose the gendered harms of the climate crisis http://www.bmj.com/content/394/bmj-2026-100556.short?rss=1 Flashbacks of summers spent in the stifling heat of India, watching the women of my household (IS) toiling over open flames in a poorly ventilated kitchen, are strong. They would be drenched in sweat, cooking in the midday heat, dressed modestly from head to toe. In stark contrast, the men of the house could be found lounging under the fan in their tank tops, lungis, or boxer shorts.The climate crisis amplifies existing gender inequalities. In India, where temperatures regularly climb to 105°F (40-41°C) between March and June, gender norms determine who can cool themselves, who works in the hottest environments, and who bears the greatest burden of heat related illness.1 If we fail to recognise this, action plans for mitigating heat will protect only half the population.During the hottest months of the year, my mother-in-law (CRK) always remained fully covered, even while sleeping, because that was considered modest in a...

NHS email controversy: Changes paused after complaints from doctors http://www.bmj.com/content/394/bmj-2026-100559.short?rss=1 A planned overhaul that would have seen NHS doctors lose access to the content of their NHS emails has been paused after a backlash from doctors.The controversy began on 6 August when NHS.net Connect, part of NHS England, sent an email advising that “when a user leaves an organisation to join another, and transfers their account in NHS.net, then they will only take their email address.1“All data, permissions, and access will be archived with the organisation the user is leaving, and will no longer be available to that user, in line with accepted information governance standards.”This would mean that when resident doctors rotate to a new organisation, their NHS email address moves with them but the content, years of emails, folders, and other account data would remain with their previous organisation.These changes were intended to come into effect on 17 August.Doctors were quick to condemn the move. One of those...

GLP-1 deaths: Are weight loss drugs linked to hundreds of fatalities? http://www.bmj.com/content/394/bmj-2026-100557.short?rss=1 Stories linking glucagon-like peptide-1 (GLP-1) weight loss drugs to hundreds of deaths and thousands of adverse events have appeared in the UK media in the past few weeks.The Times reported on 5 August that patients taking weight loss medication in the UK had filed about 150 000 reports of adverse side effects to the Medicines and Healthcare Products Regulatory Agency (MHRA), with more than 100 deaths potentially linked to the drugs.1The Independent stated that more than 150 deaths had been linked to weight loss jabs,2 whereas Sky News put the figure at more than 200 deaths.3Just last month a coroner said that a GLP-1 agonist had contributed to the death of Paula Owen, aged 66, in Plymouth on 23 July.4 The Devon and Plymouth coroner, Philip Spinney, said that a GLP agonist that Owen was taking for weight loss had contributed to her death from acute pancreatitis. A full inquest...

Regulatory decisions: benefit-harm balance of new drugs takes time to emerge http://www.bmj.com/content/394/bmj-2026-100519.short?rss=1 Barjesteh van Waalwijk van Doorn-Khosrovani and Olivier draw attention to the potential harms caused by pressures on regulatory agencies to approve drugs more quickly than they necessarily merit.1 To the examples that they cite, lorcaserin can be added.Lorcaserin, a selective 5-HT2c receptor agonist, was approved by the US Food and Drug Administration for the management of obesity in June 2012, despite a previous rejection and some reservations (the vote of the advisory committee was 18 to 4 in favour). In August 2019, after publication of a large randomised clinical trial, Onakpoya and I analysed the evidence.2 We concluded that lorcaserin caused minimal weight loss, that its harms profile was incompletely understood, and that it was unlikely to be a cost effective intervention. We were especially concerned about the possibility of serious long term adverse effects. Lorcaserin was withdrawn from the market in February 2020 because of an increased risk of...

GLP-1s: New daily weight loss pill Foundayo approved by UK regulator http://www.bmj.com/content/394/bmj-2026-100547.short?rss=1 A new daily GLP-1 pill, orforglipron (marketed as Foundayo), has been approved by the UK’s drug regulator for weight management and type 2 diabetes.The UK is the first country in Europe to approve this glucagon-like peptide-1 receptor agonist developed by Eli Lilly.The Medicines and Healthcare Products Regulatory Agency (MHRA) authorised orforglipron for weight loss and weight maintenance in adults in the UK with a BMI of 30 or above or a BMI of between 27 and 30 and at least one weight related comorbidity.1The drug is also authorised to improve glycaemic control in patients with insufficiently controlled type 2 diabetes.The decision means orforglipron will be available with a private prescription in the UK, but the National Institute for Health and Care Excellence (NICE) will still need to recommend it before it can be prescribed on the NHS. NICE is currently evaluating its clinical and cost effectiveness, with a decision expected...

James Friend: respiratory specialist who helped usher in smoke-free legislation http://www.bmj.com/content/394/bmj-2026-100397.short?rss=1 bmj;394/aug11_9/e100397/VS1F1vs1On 1 July 2007 England joined Scotland, Wales, and Northern Ireland and outlawed smoking in public places, becoming one of only a handful of nations to implement such a ban. This was the culmination of a hard fought public health battle, one of whose foot soldiers was James Friend, a mild mannered chest specialist from Edinburgh.Friend was chair of the UK Scientific Committee on Tobacco and Health (SCOTH), whose 2004 report laid out the risks of secondhand smoke to non-smokers.1 The committee amassed evidence to show how non-smokers who were exposed to secondhand smoke had a high risk of lung and heart disease. It also found that exposure to secondhand smoke was strongly linked to a higher risk of pneumonia, bronchitis, asthma, middle ear infection, poor lung function in children, and sudden infant death syndrome.A 1998 SCOTH publication2 had previously warned of the harms of secondhand smoke and called for...

Epidural analgesia in labour and neonatal and childhood outcomes: national population based cohort study http://www.bmj.com/content/394/bmj-2026-100486.short?rss=1 Two errors have been identified in this paper by Kearns and colleagues (BMJ 2026;394:e343320, doi:10.1136/bmj-2026-343320, published 15 July 2026). Firstly, the study period was 13 years (2007-19), not 15 years as stated in the strengths and limitations section of the discussion. This was a typographical error. Secondly, the analytical cohort was restricted to singleton births. Therefore, the statements that women receiving epidural analgesia were more likely to have a multiple birth and that multiple pregnancy formed part of the definition of high risk pregnancy were incorrect. The relevant sentences have been corrected in the confounders and other variables section of the methods and in the study population and baseline characteristics section of the results. The supplementary file has also been updated to reflect these changes. These errors do not affect the study cohort, analyses, results, interpretation, or conclusions. The article has been corrected.

Regulatory gaps in period tracking apps http://www.bmj.com/content/394/bmj-2026-100515.short?rss=1 Publications in early 2026 on the women’s health strategies for England and Scotland highlight increasing recognition of women’s reproductive health.12 However, neither strategy engages substantively with the widespread turn towards “femtech” and the rise of menstrual cycles and fertility tracking using smartphone applications. These apps are largely unregulated, with direct consequences for user safety and public health.Over half of UK women younger than 45 use an app to track their menstrual cycles,3 and three of the most popular period tracking apps alone account for 250 million downloads worldwide (data gathered between April and December 2021).4 This matters because many period tracking apps generate ovulation predictions and display “fertile windows”—outputs that users may rely on to avoid pregnancy as a digital form of the fertility awareness method of natural family planning.56 According to the NHS, the effectiveness of this natural method ranges from 99% with “perfect use,” to as low as...

Pitfalls of announcing regulatory policy in medical journals http://www.bmj.com/content/394/bmj-2026-100438.short?rss=1 In June 2025, senior officials at the US Food and Drug Administration (FDA) used a medical journal editorial to announce the adoption of a new covid-19 vaccination framework under which annual boosters would generally be supported only for adults aged 65 years and older and people at high risk of severe covid-19.1 Although the framework had not been through the formal rulemaking processes, the editorial stated that “the views expressed in this article represent the policy position of the Food and Drug Administration.”1 Similar journal editorials announced a novel “plausible mechanism” FDA approval pathway,2 changes to labelling for specific drugs,3 and a new default approach to drug evaluation in the US that would allow a single pivotal clinical trial4 to be sufficient to support approval.These and other articles by senior FDA officials—many of whom had joined the agency during the second Trump administration without any previous regulatory experience or expertise—were...

The physician getting patients fit for surgery http://www.bmj.com/content/394/bmj-2026-100503.short?rss=1 For Sasi Pathmanathan, whenever a patient has a good surgical outcome and goes home to enjoy a good quality of life “it’s like winning the lottery.”Pathmanathan is a consultant vascular perioperative physician at Hull University Teaching Hospitals NHS Trust. She is thought to be the first consultant perioperative physician in the country to be directly employed by a vascular surgical department.She is involved in the patient’s whole surgical pathway, from contemplating surgery right up to and beyond discharge. She enjoys being part of this journey—which could last anything from a few days to more than a year—getting to know the patient and their family, winning their trust, and working in partnership for successful outcomes.Knowing a patient’s life story and understanding what motivates them, “helps to think creatively about lifestyle changes,” Pathmanathan says.Empowered to make the role her own, she has pioneered an individualised prehabilitation programme and established home visits to...