A&E departments across the UK struggling to cope this winter

Doctors across the UK have expressed significant concerns over the pressures the A&E departments are facing this winter, which is, unfortunately, leading to a compromise in patient safety, and opposing the NHS standards. They have called for urgent action to be taken to ease the pressure, which includes a call for an increase in the NHS budget.

A warning has been issued in letter form, signed by 68 senior A&E doctors highlighting the danger patients are facing this winter under intolerable conditions. Patient safety is being compromised, and doctors urged for action as patients are dying in corridors due to the substantial shortage in the number of beds available.

New reports have emerged; which show the concerning scale of the problem. Patients are being left for hours on trolleys in corridors and in ambulances due to a significant shortage of beds. On a daily basis, doctors are forced to treat more than 120 patients in corridors due to lack of space, which has led to some cases of premature death. Last week, the NHS records have shown that 133 out of the 137 hospital trusts in England had an unsafe number of patients on their wards. These conditions are degrading for patients. The patient’s safety, dignity and confidentiality has to be maintained under the NHS constitutional standards.

In December alone, over 300,000 patients had to wait over 4 hours for A&E, with just over 85% of the patients being seen on time, which is significantly below the 95% target set by the NHS. These statistics are also worse than last year’s winter period, which presents an urgent need of action. Chris Hopson, of NHS Providers, has said; ‘hospitals were short of 10,000 to 15,000 beds and it was time for the government to decide how to fund the NHS in the long term.’

The pressure has even been more intense due to the highest flu levels since 2011, however shouldn’t the NHS be prepared to cope with event like these? Despite these worrying statistics, doctors, nurses, and all other NHS staff are doing the best they can to cope with the pressure, and it has, for a long time now, reached the point where the government has to intervene; either by significantly increasing the NHS budget, or by other means to support the NHS on the long run.

What are your opinions on the pressure the A&E departments are currently facing, and what do you think should be done to handle it?


Mazyad Atassi.

The Charlie Gard Case

Charlie Gard was born on the 4th of August last year. Only a month after, his parents realised that he was struggling in supporting himself, and was transferred to the Great Ormond Street Hospital. The doctors identified his rare condition which was Infantile Onset Encephalomyopathic Mitochondrial DNA Depletion Syndrome (MDDS). This condition caused Charlie to suffer a severe organ failure, leaving him to survive for only 11 months – with life support.

There were many legal and ethical issues surrounding the case of Charlie Gard, causing it to be highly controversial. After many attempts and efforts made by doctors to treat Charlie Gard, it was still unsuccessful. Dr. Michio Hirano offered Nucleoside Bypass Therapy treatment in the USA, which would cost around £1.3 million due to the significant costs of the intensive care, however, despite the large sum, the money was raised by Charlie’s parents.

Unfortunately, the NHS doctors’ final decision was to remove the life support, and this was later recommended by the High Court ruling after the parents objected the decision of the doctors. The High Court made their decision as they concluded that the chances of success were too low to justify the trauma Charlie would experience as part of the process. In addition, the High Court found that even if the treatment did happen in the USA, Charlie’s life expectancy would later be much lower than average, and he would live with severe disabilities. Despite this, the parents, again, were determined and appealed to the European Court of Human Rights. The result was still to remove the life support as it was seen to be in the patient’s bests interests to avoid further suffering with no strong justification.

Many, including Dr. Hirano argued that a small chance of survival post-treatment was better than none. The conflicting views of this situation raises further questions on where the line or threshold should be drawn on whether a certain treatment should be pursued, or to stop the treatment, ending the life of a patient. Unfortunately, in this case, as it was seen being in Charlie’s best interest, his life support was withdrawn on the 28th of July 2017.


Mazyad Atassi.

NHS Mental Health Services

Our mental health services are responsible for dealing with conditions such as; anxiety, depression, eating disorders, obsessive compulsive disorders and psychosis. Recently research has shown that one in three people in employment, experience mental health issues. As a result, the NHS has been working more and more with the Mental Health Services, increasing funding to help ease some pressure on NHS hospitals and GP surgeries.

Despite the increased funding provided for the Mental Health Services over the last few years, great challenges are still being faced as over 6000 patients had to be sent far from their local area to receive necessary treatment. This represents a 40% increase over the course of two years only.

According to health secretary Jeremy hunt, England is currently witnessing the ‘biggest expansion of mental health services in Europe’, and he has announced an additional £1.3 billion in yearly funding by 2021. This extra funding will improve mental health for children in particular, and significantly reduce the distance patients have to travel in order to be seen at their nearest mental health hospital.

However, additional funding isn’t always the most effective solution, as we have witnessed the success of the Sheffield NHS Health and Social Care Foundation Trust which has been able to treat all acute mental health patients within its own district for the past three years, simply by rearranging existing budgets into different sectors of the trust, and reforming the services provided to patients.

With no doubt, the Mental Health Services play a key role in helping patients with mental issues, and these services need to be improved significantly to continue supporting more patients. In my opinion, the best approach to improve the quality of the Mental Health Services is not by only increasing the budget to aid the development of the services, but also to reform current budgets accordingly.


Mazyad Atassi.

Seven day NHS

The seven day NHS topic has been highly controversial, and been discussed since the 1990s, more recently, significant research has emerged regarding the seven day NHS, and it has become a very important subject for the government to consider.

The idea of a seven day NHS, essentially is; providing quality, equal healthcare, regardless of the day of the week. It mainly focuses on improving the quality of care on weekends, to meet the quality of care provided on weekdays.  The government is pushing to opening local GP surgeries on weekends, and extending their hours.

Research has shown that the quality of care provided by the NHS is not evenly spread over the week, and an investigation has provided evidence that a patient is 15% more likely to die if they are admitted on the weekend rather than if they are admitted mid-week.

In theory, it may seem like the sensible option would be to increase weekly working hours for current medical staff, or increase the number of medical staff on the weekend. However, it is critically important to consider, the morale of medical staff, pay, and the funding required. Currently the NHS is already struggling with its limited yearly budget, and if the idea of a seven day NHS were to be implemented then additional funding would be required. If the government chooses to go with the route of increasing the number of medical staff, then this will mean the budget has to be increased significantly. However, this option doesn’t look likely for now as the predicted increase in the NHS budget of £8 billion by 2020 is meant to be allocated to continue running current services. The other option of extending working hours of current medical staff is possible, however it is important to consider the stress medical staff would face, and as a result this can lead to a reduction in the quality of care provided. On the long-term, if medical staff continue to work for very long hours, without sufficient remuneration, then many will struggle in creating a work-life balance, which would directly lead to a decrease in the number of medical applicants, possibly leading to a major shortage of staff on the long term.

The NHS should ensure that the quality of care provided is at its highest all days of the week, however the NHS also needs to consider the workload of medical staff, and ensure they aren’t under stress to a point where the quality of care may actually deteriorate. We have also seen that the British Medical Association doesn’t currently support this scheme, therefore the NHS needs to find an alternative to improving the quality of care provided to patients on the weekend, while ensuring medical staff aren’t vulnerable in the process.


Mazyad Atassi

Brexit and the NHS

Brexit has been a highly controversial referendum, and inevitably, has had consequences on the NHS. The most significant effects the Brexit decision has had on the NHS are impacts on; funding, staffing, and research. This has created uncertainty, especially among European healthcare staff.

Currently 150,000 of the NHS staff are European, and over 10% of the doctors have graduated with medical degrees from European countries outside the UK. However, these numbers are decreasing rapidly as over 10,000 EU nationals have left the NHS just over a one year period, and many more continue to leave. Furthermore, the number of EU nurses applying to work for the NHS has dropped significantly by 96%, which undoubtedly, has had a detrimental effect on NHS staffing, as there is currently a shortage of over 40,000 nurses.

One of the important, yet far-fetched claims made at the time of voting for Brexit was that voting to leave the EU can bring an additional £350 million per week of funding for the NHS. However, a more realistic possibility is that an additional £100 million may be allocated per week instead. That brings an increase of 4% from the previous year, however it’s also important to consider the losses we would face from Brexit, to cover for the lack of European healthcare staff. There is still large uncertainty with how the NHS budget will be allocated after the UK leaves the EU on the 9th of March 2019.

Between 2007-2013 the UK received €3.4Bn more than what it has contributed to the EU science research budget. This shows the significant value of funding the NHS receives from the European Union, which is unlikely to remain after Brexit. The free movement between EU countries has also, up to now, allowed European medical researchers, doctors, nurses, and other healthcare staff to easily work in the UK, however Brexit will no longer make it as easy. Therefore, we may start to see a decrease in research, and additional funding will likely be required from the UK to support research.

Everyone will have their own personal opinion on Brexit, however, whatever it is, there is no doubt that Brexit will have a direct effect on the NHS. Let me know what your personal opinions are on Brexit and the NHS. Will it improve our NHS, or negatively impact it?


Mazyad Atassi.

Choosing the ideal university to study medicine

After completing my UCAS application earlier this year, I have experienced many important aspects in applying to the ideal medical universities, and I would like to share my experiences with you.

Making the decisions of applying to the most suitable universities for you is a key step of your UCAS application. A lot of research must go behind it, in order to shortlist the university choices into 5 universities (4 of which for studying medicine). The first thing to do is to research all universities, and note down up to 10 universities which are suited for your predicted grades. I’d also recommend researching at least a couple of universities which have higher grade requirements than your predicted.

Secondly, you need to decide which medicine admission exams you’ll be doing (UKCAT or BMAT) or both. Based on this you can further cut down on your list of universities based on your needs. Please remember that if you are an Oxbridge applicant, you can only apply to either Oxford or Cambridge.

Thirdly, research your remaining university choices in detail, looking at the type of course, type of learning (e.g Problem based learning, or a more traditional learning style), practical work, theory, coursework, and if you prefer early patient contact then do look at the universities which offer this – not all do!  Important factors to consider would also be whether the university is a campus, or a city university, its location, how far away from home it is and therefore practicality of transport, and whether the city/town the university is based in offers activities, sport, cultural attractions or nightlife suited for you. All this research can be done by going on the university website, and looking at the university prospectus.

Finally, make sure you visit the universities! I would highly recommend this, as it might turn out as something you didn’t really expect, or it might turn out to be much better than you thought. Furthermore, visiting the university will also make you aware of the type of accommodation offered, things to do around the city, and the atmosphere of the university itself, especially the medicine school block.

This should hopefully leave you with your final choices, which you may need to adjust closer to the UCAS deadline as you start receiving your medicine admission exam results, and get a clearer view of where your heading with your academic work.

Good luck with all your choices, and please get in touch with me if you require any help.

Mazyad Atassi.



Top tips for future medical applicants

This years UCAS cycle for medical applicants has recently concluded. With fierce competition every year for medicine, I will highlight some top tips for applicants seriously considering medicine.

If you’re reading this then you’ll probably already be considering medicine seriously as a course to study. You have passed one of the most important stages of choosing medicine, which is making sure medicine is the right course for you!  You can be successful with any degree you wish to study as long as you have true desire and interest in studying it.

I have submitted my UCAS application recently, and I am now focusing on preparing for my A level exams at the end of the year. I have been confident with my decision to study medicine since my GCSE’s and my interest strengthened last year after completing several placements at hospitals. If you are still not 100% sure what you would like to do, don’t worry! You will realise your potential and passion a few months into your first year of A levels when the intensity and challenging work really starts to build up.

In order to strengthen and prove your passion for studying medicine, doing some work experience at a  hospital is highly recommended. I understand that some applicants may not be lucky enough in getting a placement, however I have found that sometimes the process of getting one may take a while but if you start looking early and applying to several hospitals, then you are very likely to get one. I can not stress enough how valuable the experience is. I have gained valuable insight of what type of work I would be facing as a medical student, and later on, as a doctor. For most people, the experience will allow the applicant to become more confident in his choice of studying medicine, and for some it will show them that maybe medicine isn’t really the ideal course for them. Either way, this will be highly useful, so you can really start thinking about the right fit course for you.  Hopefully, once your accepted for a work experience placement, another top tip would be to write down your experience at the hospital everyday. This is useful as it will allow you to recall what work you did, and the experiences you went through later on, especially when you start to write up your personal statement.

Another top tip is volunteering. All of you should know by now that most medical schools highly recommend this, wether it’s at an old peoples care home, or any other place that shows your commitment to caring for the vulnerable. Again, I would recommend looking for volunteering placements early on, and applying to as many as possible. This is because many of them may not require volunteers at the present time, so make sure to widen your search. I’ve been volunteering weekly and still am at a old peoples care home, helping to improve their quality of life. I have realised from my work, that even the smallest things you do to help them is very rewarding as they appreciate all the help you provide them. It is important that you volunteer on a long-term basis to really show your commitment in providing care, preparing yourself to become a successful medical applicant. The work will also give you an insight of how vulnerable some people can be, and will show you how rewarding caring for people is.

Other tips would be to always keep up to date with issues concerning medicine. You can do this in many different ways such as reading news concerning medicine on a regular. I have chosen to set up this blog in order to  do this while keeping other like-minded people updates as well.

I have not covered tips concerning revision for A levels, as you should probably already know now how challenging the work can get sometimes, and therefore a logical thing to do is to start revising early for any exams, including mocks. This will show you how well (or bad) your progressing through the year, and can help you place realistic targets.

If you would like to share your own tips, please don’t hesitate to do so by commenting below.


Mazyad Atassi.

New NHS guidelines: patients to be asked about their sexuality

The NHS has introduced some new controversial guidelines which will mean doctors, nurses and other healthcare professionals will ask patients who are aged 16 or over about their sexual orientation.

Whilst the new guidelines applies to everyone aged 16 or over, patients will have the right not to answer the question. The NHS says that by choosing to provide any information regarding sexual orientation, it will not affect any care the patient receives, and  “no patient is discriminated”. However some may argue, why should this information provided by the patient matter, if in the end, the care the patient receives is not affected.

Previously, doctors would already know about the sexual orientation of some patients, especially those who were facing a medical condition where sexuality is relevant to it. However, under the newly introduced guidelines, questions about sexuality can be asked by the doctor even if its completely irrelevant to the condition.

The options patients will be able to choose from, regarding their sexual orientation are the following: heterosexual or straight, gay or lesbian, bisexual, other sexual orientation, not sure, not stated and not known.

The new guidelines have had very different responses and opinions from the population, making it a highly controversial topic. Many have been in support of the guidelines, as it will ensure that doctors are aware of other information the patient provides, which can prove to be useful in some situations – particularly regarding mental health conditions a patient faces. This means that if the patient is found later with any medical condition where sexuality is related to it, the information on sexual orientation previously provided by the patient would readily be available on the system, allowing for a more efficient and faster diagnosis and treatment.

On the other hand, many have argued that the question asked can be intrusive. Whilst the option to not state sexuality is still provided, some may be uncomfortable with the whole process of having to choose a particular option.

I see the new guidelines being helpful in particular situations to allow for a more efficient NHS, but is the introduction of these guidelines really that useful and important for the NHS to know?

Let me know what you think by posting your personal opinions in the comments section below, or by emailing me if you have any questions.

Mazyad Atassi.


Will machines in healthcare make surgeons obsolete?

After spending weeks researching, drafting, and discussing this topic with my peers and doctors, today marks my first publicly released article on this topic and on my blog.

I have chosen to investigate this question after seeing myself how sophisticated machinery are being used in hospitals, and this has made me, patients, prospective surgeons and doctors curious whether these machines are able to take over the major roles of a surgeon or a doctor in the future. Moreover, this idea of machines in healthcare making surgeons obsolete is trending currently as we are witnessing significant progression in technology, many of which applied to medicine.

The idea of machines making surgeons obsolete is already striking debate between different groups of people; some of who agree that this is very likely to happen in the future due to the frequent breakthroughs in the world of technology, and medicine – and others who disagree, predominantly due to the nature of machines never being able to reach the same complex and intelligent level as a human being. Today, we are lucky to have sophisticated machinery used in medicine to help assist through complicated procedures and operations. However up to now, there is no medical machine used in operations that can operate without the supervision of a surgeon or medical staff – so will we ever be able to develop a machine sophisticated enough to take over a surgeon’s position? The question targets medicine on a global scale and focuses on the revolution of medicine over the years to come. This is because the influence of the advancements in medical machinery will have a global effect on working surgeons; including whether the machines will make them obsolete or not. Naturally, More Economically Developed Countries (MEDC’s) countries are likely to adapt to the technological breakthroughs in medicine much faster than Less Economically Developed Countries (LEDC’s). This means, surgeons’ positions in work in relation to the development of medical machinery is likely to differ depending on the status of the country – however eventually it will have an effect on all surgeons, irrespective of the place of work.

With the recent boom in technological developments, the healthcare sector has been impacted positively allowing technology today to be heavily integrated into medicine. However up to now, there is no medical machine used in operations that can function without the supervision of a surgeon or medical staff, which strikes debate with the question. Evidence for the dominance of machines in surgical operations is growing, and the healthcare workforce patterns today are different from what they used to be over the previous years; this is predominately due to the introduction of numerous sophisticated surgical machinery, which have reduced the number of medical staff required for a given procedure. Spending on robotics is sharply increasing, as the demand for medical machinery is surging. Incorporating medical and surgical machinery today has improved treatment for patients, and created new methods for surgeons to perform operations. The Da Vinci surgical system is at the forefront of today’s technological medicine and is a prime example of what machines are capable of achieving; it demonstrates multiple features such as several robotic arms which enable it to function in several ways a surgeon wouldn’t be able to otherwise.

It is particularly important to recall that since the question raised focuses on future trends of healthcare, we are often using an inductive argument to advocate what may happen, however generalising from experience doesn’t necessarily suggest what can happen. We should recognise and appreciate the potential in machines, however machines, in the end, are no more than artificial intelligence created by humans. Therefore, after in depth research, it has become explicit that machines replicating the highly sophisticated system of the human mind, soul, and body and eventually making surgeons obsolete is almost virtually unfeasible.