add_circle Create Playlist
Inside Health - - A World of Music

Inside Health



Dr Mark Porter demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice, with the help of regular contributor GP Margaret McCartney
124 Episodes Play All Episodes
access_time2 months ago
This is the remarkable story of how the UK’s Recovery Trial saved the lives of hundreds of thousands of Covid patients.

It was set up in nine days, after a conversation on the number 18 bus. Within 100 days it had found the first life-saving drug. This trial has united thousands of doctors, the NHS and 40,000 patients, at the scariest moments of their lives, changing the pandemic, and possibly medicine, forever.

We speak to Oxford professors Martin Landray and Peter Horby who devised the Recovery Trial, and to some of the doctors and patients who helped make it happen.

PRESENTER: James Gallagher
PRODUCERS: Geraldine Fitzgerald & Beth Eastwood
access_time2 months ago
I was floored for three days with side-effects after having my first Covid jab and many of you have been in touch about your side-effects too. Why do some of us feel awful after the vaccine, while others barely notice anything? What does this say about our immune systems and how protected we will be against covid? We put your questions to Eleanor Riley, a professor of immunology and infectious disease at Edinburgh University.

Our resident GP Margaret McCartney has been taking a look at the reports of blood clots after vaccination, and we speak to Victoria Male, a lecturer in reproductive immunology at Imperial College London, about the rules for vaccination in pregnant women.

PRESENTER: James Gallagher
PRODUCERS: Beth Eastwood & Geraldine Fitzgerald
access_time2 months ago
Covid-19 has changed how doctors and nurses communicate with their patients,
Graham Easton is Professor of Communication Skills at Barts and QMUL , and he tells James about how doctors and nurses can ensure they communicate effectively with their patients. Giving bad news is never easy but how do you explain to a relative about end of life decisions via an iPad?
Professor Monica Lakhanpaul reviews the latest evidence around BAME and Covid-19 and with Jo Hudson-Lett from Revoluton Arts looks at projects for young people adversely effected by Covid-19.
Plus Margaret McCartney on Covid passports - will they ever happen?
access_time2 months ago
I have become hooked on playing online chess during this lockdown and after watching the Queen’s Gambit. So we’ll find out if it is actually doing my brain any good and whether it and similar games can ward off dementia.

Margaret McCartney takes us on a fascinating tour through the history of deliberately infecting people with diseases, as the first “challenge trials” with coronavirus are about to start.

Listeners David and Barbara tell us about a treatable condition called normal pressure hydrocephalus that is often mistaken for dementia.

PRESENTER: James Gallagher
PRODUCER: Beth Eastwood

Clip from the Netflix series 'The Queen's Gambit', directed by Scott Frank.
Music copyright: ‘Training with Mr Schaibel’ by Carolos Rafael Rivera from the official soundtrack of The Queens Gambit
access_time2 months ago
A weekly quest to demystify health issues, bringing clarity to conflicting advice.
access_time3 months ago
Most people recover rapidly after catching coronavirus. But I chat to three people who were infected almost a year ago and are still feeling the impact, both on their bodies and their minds.

Doctors are having to rapidly grapple with how to treat patients with long Covid. We speak to one of them, Dr Manoj Sivan, the Research Lead for the Long Covid Service in Leeds, who warns that long Covid could be a “second pandemic”.

We also have GP Dr Navjoyt Ladher answering your questions on the Covid vaccines.

PRESENTER: James Gallagher
PRODUCER: Beth Eastwood
access_time3 months ago
A fever, cough or loss of smell and taste are criteria for a Covid-19 test, but what if you have different symptoms? James Gallagher discusses whether more symptoms should be added to the UK government's list with resident GP, Margaret McCartney and Dr Thomas Struyf of KU Leuven.

Cardiologist Dr Rohin Francis explains what symptoms he sees when patients with coronavirus arrive in hospital.

One of the most common symptoms of Covid-19 is the loss of the sense of smell. It returns after a few weeks in most people but a significant minority still can’t smell anything many months later. James Gallagher talks to Prof Carl Philpott of Norwich Medical School who has led an international panel of nose doctors, assessing the evidence for the best therapies to restore the olfactory sense to people who have lost it following respiratory infections. So-called smell training comes out top as the most evidence-based approach. Carl explains how it works and we hear from two people who are trying to regain their sense of smell.

And Dr Carly Welch from the British Geriatric Society says that delirium has emerged as another symptom of Covid-19, particularly in the elderly.
access_time3 months ago
One or our listeners, Katharine, asks whether mouthwash can help stop the spread of Coronavirus. We hunt down the answer with the help of biochemist Valerie O’Donnell, from the University of Cardiff, and our own Dr Margaret McCartney.

Then it’s our turn in the dentist’s chair. Dentistry is up close and personal with a fair amount of splatter, the perfect place for coronavirus to spread. So dentist Paul Woodhouse and University of Newcastle dentist and researcher, Paul Holliday, are on to explain how to make it safe.

PRESENTER: James Gallagher
PRODUCER: Beth Eastwood
access_time3 months ago
It’s an exercise special on Inside Health. This week Amanda wants to know how quickly she can get back to exercising after Covid. Dr David Salman has drawn up some advice and Dr Navjoyt Ladher explains why this virus means we should be taking it easy, as well as having a shocking confession of her own. We check in on George, Jen and Dr Helen Hawley-Hague to see how they are getting on with their physiotherapy in the height of lockdown. And we explore with Sport England’s Tim Hollingsworth what the pandemic can teach us about improving exercise levels. Oh and I think I nearly broke our resident GP Margaret McCartney talking about 'adaptogens'.
access_time4 months ago
In Covid, oxygen levels in the body can crash without noticeable symptoms - it’s known as “silent hypoxia”. This week we’ll be discussing whether letting people monitor their oxygen levels at home with a pulse oximeter could save lives. James talks to Chris Harris, who’s been using one, and two pioneers of the project - Dr Matt Inada-Kim, Consultant in Acute Medicine at Hampshire Hospitals NHS Trust, and Dr Caroline O'Keeffe who runs oximetry@home in North Hampshire.

And the hotly debated topic of rapid, or lateral flow, testing. Local councils are rolling them out for people who can't work from home, and the hope is that they could help us keep on top of the virus by picking out people with Covid. Could it be a way out of the pandemic or could it cause more harm than good? Prof Irene Petersen and our own Dr Margaret McCartney are on the case.

Dr Navjoyt Ladher answers some of the most common questions about vaccines.

PRESENTER: James Gallagher
PRODUCER: Beth Eastwood
access_time4 months ago
Should you take vitamin D pills to ward off coronavirus? Our own Dr Margaret McCartney has been sifting through the evidence in search of answers.
Also clinical trials expert Dr David Collier of Queen Mary University London tells us about new treatments for Covid-19 that are in the pipeline. And is the mysterious “nocebo effect” causing most of the side-effects from statins? Janice Richardson from Hebden Bridge shares her experience on the pills and we chat to researcher and Dr James Howard of Imperial College and cardiologist Dr Rohin Francis.

Presenter: James Gallagher
Producer: Geraldine Fitzgerald
access_time4 months ago
2020 was awful. So what about 2021?

I chat with Prof Neil Ferguson to see how this year could play out and when life might return to normal. Cardiologist Dr Rohin Francis and cancer nurse Aly Foyle are both back to share their experiences of coping during Covid.

I promise you, it’s not all bad news.

And our own Dr Margaret McCartney, alongside Cancer Research UK’s Jodie Moffat, scrutinises a new blood test that promises to find cancer early.

It's a good programme, James.

PRESENTER: James Gallagher
PRODUCER: Beth Eastwood
access_time6 months ago
Saleyha Ahsan reports from Ysbyty Gwynedd, her own hospital in Bangor, North Wales about how the Intensive Care Unit is preparing for winter. Saleyha meets Val and the Critical Care team who have looked after her since the pandemic began. Val was admitted to the unit in March and has become part of the intensive care family.

Producer, Erika Wright
access_time7 months ago
Covid-19 damages the lungs, leaving people struggling to get enough oxygen into their body. In the early stages of the pandemic many patients needed a lot of support in intensive care - including artificial ventilation. But there are other ways of boosting oxygen levels in the body - which are being studied in the Recovery-RS trial. Professor Gavin Perkins from the University of Warwick is comparing oxygen delivered by a mask called CPAP with both regular and high-flow oxygen to see which works best.

Physiotherapy is one of the hands-on therapies which has been disrupted by the lockdown. Patients who need to do bespoke exercises following a fall or a heart attack might have been offered online sessions instead. But Manchester University researcher Dr Helen Hawley-Hague says these don't suit everyone - including people who don't have access to the internet or a smartphone. We hear from Jennifer and George - both of them have taken part in Helen's studies and have accessed physiotherapy either face-to-face or via a phone app.

An Inside Health listener wanted to know if live vaccines like the polio vaccine could protect us against Covid. Oxford University's Andy Pollard explains about the theory behind this idea and how it might help.

Dr Margaret McCartney looks at whether it makes a difference if you do a Covid throat and nose yourself - or if it's carried out by a healthcare professional.
access_time7 months ago
Margaret McCartney on National Test and Trace and why households are receiving multiple calls. Beth tells of being contacted many times when her child tested positive and began to think all the family had been separately in contact with different cases, until the penny dropped that the calls were all about the same contact - her daughter. Professor Kate Ardern, director of Public Health in Wigan explains why these calls from the national system aren't joined up. And is there time in a pandemic to do trials for non-drug interventions like pub curfews or social distancing? Professor Paul Glaziou explains that there are currently just 8 such trials globally, while Professor Martin McKee highlights the problems involved. And Margaret hears from Professor Atle Fretheim who is trying to set up a trial in Norway into the impact of school closures on infection control.
access_time7 months ago
The Radio 4 Touch Test included questions about touch in health care. Dr Natalie Bowling who's a psychologist from the University of Greenwich helped to create the test with colleagues at Goldsmith's University. Analysing the data revealed that a positive attitude towards touch in treatment settings increases as we get older. Surprisingly men reported being more likely to feel comfortable with touch in treatment settings - despite women preferring tactile treatments more than men.

GPs Margaret McCartney and Ann Robinson agree on the importance of touch in their consulting rooms - both to help tell the difference between constipation and a ruptured appendix - and to place a comforting hand on the shoulder of a distressed patient.

Chemotherapy cannot cure 82 year old Anne Townsend who was given a diagnosis of ovarian cancer a year ago - but it's hoped it will help to relieve her symptoms. One side effect has been a loss of her sense of touch - devastating because she loves to sew quilts. She found that reflexology sessions helped - though they stopped because of lockdown and she now uses acupressure techniques which she was taught online by therapists at St Christopher's hospice.

Deborah Bowman, Professor of Bioethics at St George's University, also felt calmer and better-prepared for medical procedures when she was having cancer treatment. She explains how she trains medical students to approach their patients in a sensitive way and use touch with care.
access_time7 months ago
The story of one child's recovery from PIMS-TS, the rare new condition that caught doctors by surprise in April. James Gallagher visits specialists at the Evelina London Children's Hospital to hear how they coped with identifying and treating a condition they'd never seen before. Dr Jenni Handforth and Dr Sara Hanna explain how 'they had to reinvent and tweak the rule book' to manage PIMS-TS, where 'the immune system has gone a bit crazy' and treatments worked 'like a fire blanket to dampen down the immune system'. And scientists at the Francis Crick Institute have discovered that children can have Coronavirus-fighting antibodies from before the pandemic started. Dr George Kassiotis explains how kids could have them and what this might mean. And Dr Margaret McCartney unpicks the tricky issue of spotting Covid and cold symptoms in children.
access_time8 months ago
Thromboses - blood clots that form in the circulation - are easily the biggest single killer of British men and women. They affects people of all ages, races and ethnicities. Most strokes and heart attacks are caused by thromboses forming in the arteries supplying the heart or brain. But clots in the veins can be just as lethal, particularly when part of the clot breaks off and travels around the circulation and lodges in the lungs. Recently, the appearance of abnormal micro-clots in the lungs of severely affected Covid patients has highlighted the huge impact even tiny clots can have on our long term health and mortality. What more should be done to protect people from this misunderstood condition?

James Gallagher unravels the risks and causes for blood clots, from deep vein thrombosis to clots in the lungs. As he hears from patients, the surprise of a DVT diagnosis and debilitation can be profound. Treating clots is a delicate process with a need to get the balance right between thinning the blood but preventing bleeding. James examines the effectiveness of the latest range of anticoagulants that have a more predictable blood thinning effect, without the need for regular checks to make sure the blood’s not too thick or too thin.

The psychological effects of being diagnosed with thrombosis are often under reported. but in up to half the cases severe anxiety, depression and PTSD can arise. We hear of a major new study following the experiences of patients from their diagnosis to follow ups after treatment that explores how effectively they overcame the impact on their mental health of knowing they carried a blood clot.

And James Gallagher reports on the newly emerging relationship between Covid and clotting. It was back in April when the alarm was first sounded about abnormal blood clots in severe Covid cases. Research is shedding new light on the causes of the problem - sticky blood. In turn, this knowledge is offering up new ways to treat some of the major complications thrown up by the virus.

Presenter: James Gallagher
Producer Adrian Washbourne
access_time9 months ago
How will this year's expanded flu vaccine programme be delivered? In addition to usual groups the flu vaccine will be offered to all eleven year olds, any household contacts of vulnerable people told to shield, more health and social care workers and - the biggest change - everyone over 50! Dr Margaret McCartney discusses the difficult logistics for GP practices and pharmacies trying to work out how to immunise around half the population, whilst managing PPE, social distancing and infection control. Dentistry and Covid - Eddie Crouch, Vice Chair of the British Dental Association discusses how practices open since lockdown are coping. And a good news story of how the pandemic has instigated change in the diagnosis of coeliac disease. Dr Hugo Penny, one of the authors of new interim guidance, explains while Radhika tells of her personal experience of coeliac disease. Plus NHS preparations for winter. Trevor Smith, Divisional Director of Medicine at Southampton General Hospital, and Professor Neil Mortensen, President of the Royal College of Surgeons in England, both share their forecasts..
access_time9 months ago
Dr Mark Porter on a new bedside test that differentiates between Covid-19 and other infectious diseases including flu in under an hour. Mark meets Dr Tristan Clark who has already been using the test as part of a trial. And the world's largest study into 'Long Covid' recruiting 10.000 people from 50 different hospitals across the UK who've been hospitalised for Covid to assess their long term recovery. Lead author Professor Chris Brightling discusses the long term symptoms seen in many people recovering from the virus and how research can answer difficult questions such as how long will these continue and what's the best way to help people. And Mark hears from Roz, still recovering from Covid after being admitted to intensive care on May 26th and from physiotherapists Matt and Gemma about how early and long term rehab can help. Plus Professor Sally Singh on the new NHS online rehab service 'Your Covid Recovery'.
access_time9 months ago
As the Government announces GPs should start to prescribe cycling Margaret McCartney examines the evidence for exercise referrals with Harry Rutter, Professor of Global Health at the University of Bath. Temperature checks are popping up in bars, restaurants and receptions but do they work or are they giving false reassurance? Plus while the pandemic progresses Professor Carl Heneghan explains another type of false result, that the chance of false positive tests go up. Navjoyt Ladher, Head of Education at the BMJ, talks us through two highly topical terms - specificity and sensitivity. Amateur choirs have been closed due to Covid-19. Margaret talks to Professor Jackie Cassell who is currently researching what aspect of choirs congregating is particularly dangerous and whether the singing is actually a red herring.

Producer: Erika Wright
Studio Manager: John Boland
access_time10 months ago
Public health doctors don't dash around hospitals wearing white coats brandishing stethoscopes. The work of this medical specialty is mainly outside of hospitals and it has a very long history. It has a local, national and global reach, an international skeleton charged with the care of populations. And in this pandemic, it is public health which is doing the heavy lifting.

In this special edition of Inside Health Dr Margaret McCartney investigates the serious questions being raised about the UK's public health response to trying to stop the spread of the virus, and how tension, over the performance of the government's Test and Trace programme, has spilled out into the open.

Margaret hears from Directors of Public Health who feel that their role and expertise in local communities working closely with local Public Health England teams has been overlooked. Instead a new national Test and Trace system has been set up using private companies outside the traditional public health infrastructure. The DPH for Wigan and lead director of public health for the Greater Manchester Combined Authority, Professor Kate Ardern, tells Margaret she believes government didn't understand the role and the experience of local public health teams and so instead of empowering them to oversee test, trace and isolate services, set up a new national system, from scratch, using private companies without public health experience. And the data needed locally to identify and deal with Covid cases, she tells Margaret, just hasn't come through. This is despite the fact that the law is clear; Covid is a notifiable disease and local directors of public health should receive the information.

Margaret explores the history of public health with Professor Martin Gorsky from the London School of Hygiene and Tropical Medicine and hears from Professor of Global Health at Queen Mary, University of London, David McCoy, who believes the very structure of public health institutions after the 2012 Health and Social Care fragmented the service, leaving the country vulnerable (as he and 400 other experts warned at the time) to a pandemic.

Public Health England's Medical Director, Professor Yvonne Doyle, rejects suggestions that PHE is insufficiently independent from government and insists that both national and local public health teams have pulled together in these unprecedented times.

Producer: Fiona Hill
access_time10 months ago
One of the most striking features of the coronavirus pandemic is the disproportionate toll it’s taken on some groups in society. Research by the Office for National Statistics shows black people are nearly twice as likely to have died from coronavirus than white people. And you see a similar pattern of elevated risk in other ethnicities too. Why is this? And to what extent is Covid 19 shedding light on approaches being taken in medicine more generally when assessing and treating people from Black, Asian and Minority ethnic groups?

We hear from GP Dr Navjoyt Ladher who’s been navigating the language of race for the British Medical Journal; Dr Rohin Francis, cardiologist and host of the Medlife Crisis podcast, and Prof Kamlish Khunti who’s establishing a detailed Covid risk score to establish exactly who’s at most risk of infection.

A major review has found women’s lives have been ruined and babies have been harmed in the womb and yet concerns were dismissed for years as simply “women’s problems”. Those are the findings of the Independent Medicines and Medical Devices Safety Review. It looked at the hormonal pregnancy test Primodos, the epilepsy drug sodium valproate and vaginal mesh implants which are used to treat prolapse and incontinence. Inside Health’s resident GP Margaret McCartney. discusses what needs to change.

Presenter: James Gallagher
Producer: Adrian Washbourne
access_time10 months ago
Coronavirus has turned the NHS upside down and inside out and by re-organising to treat people with the virus, other potentially fatal diseases like cancer have taken a backseat. At University Hospital Southampton NHS Foundation Trust, which Inside Health visited weekly as the pandemic unfolded, cancer diagnoses fell by half in March and April and of the 50% who were asked to come in for follow up, only 25% actually did. The virus was more frightening than a potential cancer diagnosis. Divisional Director for Medicine at Southampton, Dr Trevor Smith, tells James Gallagher, the BBC's health and science correspondent. that patients are coming back, but it will take a long time to tackle the backlog.

For those with cancer caught up in the pandemic, they have experienced disruption, cancellations, altered treatments and they have had to cope with consultations and even surgery by themselves, without loved ones to support them. Charly from Wiltshire was diagnosed with breast cancer in February and her treatment was changed as lockdown happened. Instead of chemotherapy then surgery, she had surgery first. And a mastectomy instead of a lumpectomy. But despite the disruption to her care, she still considers herself one of the lucky ones because she did get treatment.

Others weren't so lucky and across the country, lives have been lost. The focus now is on Covid-proofing cancer care and tackling the backlog in screening, diagnosis and treatment. And it's an enormous backlog.

Professor Charlie Swanton, chief clinician of Cancer Research UK tells James Gallagher, the BBC's health and science correspondent, that 2.7 million people have missed out on cervical, breast and colorectal screening and 300,000 fewer people than normal have been referred under the urgent 2 week cancer pathway. The creation of Covid-free cancer hubs, he says, safe zones for cancer treatment, are vital, but it will still take a long time to recover and of course there's the spectre of a second wave of coronavirus which would disrupt services all over again.

Confidence building includes rapid Covid-19 testing for staff and Dr Trevor Smith from Southampton tells James about the saliva test pilot for key workers in the city. The new test just involves putting saliva in a sample pot, much easier than the normal "have you got it" swab test which involves wiping the back of the throat and deep inside the nose. Dr Navjoyt Ladher, GP and Head of Education at the British Medical Journal gives a simple guide to the "have you got it" tests: PCR, antigen and perhaps if the trial is a success, the new saliva test as well as the "have you had it tests"; the antibody tests.

And finally in the week that in England at least, guidance for those who are "clinically vulnerable" and shielding on the advice of the government changes, Inside Health's Dr Margaret McCartney reviews the new advice for those in all four nations of the UK.

Producer: Fiona Hill
access_time12 months ago
Tanya has rheumatoid arthritis, a compromised immune system and heart problems. Getting the virus is a risk she cannot take and this is the tenth week that she's been isolating at home with her husband and teenage daughter. But how long will this last and will she have to self isolate in her own home away from her family for the foreseeable future, if her daughter goes back to school? Tanya talks to Claudia about the impact of the pandemic on her life and says why those in the shielding group must not be forgotten.

The arrival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the human population has popularised vocabulary that was previously the preserve of scientists and medics. In just a matter of weeks, phrases like the R Number, Herd Immunity, Case Fatality Rate and All Cause Mortality have become part of everyday language. A new pandemic lexicon has emerged. Inside Health regular Dr Margaret McCartney and Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine at the University of Oxford, discuss the meanings of these very precise descriptions and reveal their personal bugbears, the misuse of such terms.

And in her final visit for this series to University Hospital Southampton, Inside Health's Erika Wright, talks again to Trevor Smith, Divisional Director for Medicine, about the enormous challenges ahead as the hospital adapts to living with Covid-19. And she talks about the Banksy art work currently hanging at the hospital which reveals a Super Nurse displacing the traditional comic book superheroes, Batman and Spiderman.

Healthcare workers have been lionised as heroes, putting themselves on the front line, risking their own lives, to save others. It's a sentiment which troubles some. Dr Michael FitzPatrick, a gastroenterologist in Oxford and Co-chair of the Royal College of Physicians Trainees Committee, describes why heroes are almost entirely the wrong comparators for healthcare workers.

Producer: Fiona Hill
access_time12 months ago
Claudia Hammond on the longest known stay for a Briton with COVID-19 in intensive care. A month ago Respiratory Physiotherapist Gemma Bartlett at University Hospital Southampton highlighted the case to Inside Health. At that stage the patient was at day 28: now Erika Wright catches up with Gemma again for a good news update on the patient who is at a staggering 58 days on a ventilator and has been speaking for 3 weeks. There are many unknowns about COVID-19 but one aspect that is not disputed is how the virus has laid bare pre-existing health inequalities. It does not effect us all in the same way and those with underlying health conditions such as heart disease, obesity and diabetes are at a higher risk of poorer outcomes if they get the virus. Linda Bauld from Edinburgh University and Chair in Behavioural Research at Cancer Research UK says this is the time to reset the health inequalities clock. And Laura Bartley, who began having severe symptoms of agoraphobia five years ago, explains her experience of lockdown. Plus resident sceptic GP Margaret McCartney explains her concerns about the current Covid-19 testing strategy.
access_time12 months ago
There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid.

Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation against the virus in the US, and from James Gill, Honorary Clinical Lecturer at Warwick Medical School, who’s been following the latest game-changing refinement of this therapy.

Just as the rest of us have been getting better at zoom meetings and remembering to unmute ourselves when we want to speak, so have GPs who are now getting rather good at having online consultations. Will this change the way we “go to the doctor” forever or is there sometimes no substitute for face to face contact? Dr Margaret McCartney gives a GP’s insights.

As more people begin to wear face masks what kind of impact does it have on communication when a person’s mouth is covered up and it’s hard to tell whether someone is happy or cross? Claudia discusses this question with George Hu, a clinical psychologist in Shanghai where masks have now become ubiquitous, and Alexander Todorov, Professor of Psychology at Princeton University and author of the book “Face Value : The Irresistible Influence of First Impressions”. Are we more versatile in interpreting a masked person’s mood or intentions than we think?

Producer: Adrian Washbourne
access_time1 year ago
Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 infection.

Erika Wright is back at University Hospital Southampton NHS Foundation Trust. Clinical lead and consultant in critical care, Dr Sanjay Gupta, talks about success giving critically ill patients oxygen using non-invasive ventilation: CPAP - continuous positive airway pressure. He also describes patients reorganising the hospital's critical care into four sections: patients positive for Covid, negative for Covid, those waiting for test results and those who test negative but are symptoms positive. Nationally, he tells Erika, those who falsely test negative, is between 5-10%.

And Inside Health contributor Dr Margaret McCartney delves into the accuracy of antigen swab tests (the test that tells you whether you have the virus or not). False negatives, test results that report the person doesn't have the virus when in fact they do, have serious implications for health care professionals, who might return to work on the basis of a mistaken result. Caution is advised, Dr McCartney advises, when symptoms contradict the test result.

A cytokine storm is a variant on a hyperactive immune reaction, where the body thinks its own tissues are invaders. Cytokines are small proteins that trigger more immune activity or less. In a cytokine storm the cytokines rage through the bloodstream, throwing our immune system out of balance and leading to severe illness and even death. This hyper inflammation has been seen in Covid-19 patients and Dr Jessica Manson, consultant rheumatologist at University College London Hospitals and co-chair of the national group of hyper inflammation doctors, tells Claudia what is and isn't known about how to treat cytokine storms in patients with coronavirus.

Producer: Fiona Hill
access_time1 year ago
It's well established that the best thing smokers can do for their health is to quit. Smoking contributes to many of the underlying conditions that undermine recovery from coronavirus and it is pretty clear that a coronavirus patient who smokes will likely have a worse outcome than one who doesn't. The FDA in the US recently went so far as to suggest smoking might increase the risk of contracting the virus at all. Nevertheless, existing data coming from various studies of patients around the world appear to show smaller numbers of smokers amongst the hospitalized cases than might be expected from local smoking populations. There are fewer smokers than there should be in the data. But why?

As the University of Edinburgh and CRUK's Prof Linda Bauld tells Claudia, there may be several simple reasons for this, such as data gathering - that patients' smoking status is going unrecorded or unverified. But a study last week from France goes so far as to suggest that nicotine itself, know to disrupt some of the receptors viruses use to enter cells, may be conferring some kind of a protection. It is just a hypothesis, but while the dangers of smoking tobacco still stand, studies on covid-19 patients using nicotine patches might be worthwhile. And if you are trying to quit, nicotine replacement therapy might be an even better idea just now than was thought.

Inside Health's resident GP Dr Margaret McCartney talks of her concerns for NHS non-urgent treatments being side-lined under the current virus squeeze, and some of her hope for the future. Professor Pamela Qualter and Dr Margarita Panayioutou describe why lockdown is an important time to do more psychological research into the effects of loneliness and other responses while we have the chance.

And in this week's update from Southampton General, where Inside Science's Erika Wright has been speaking to frontline health workers every week, Mr Robert Wheeler, a surgeon and clinical law expert muses on some of the legal aspects of our coronavirus response.
access_time1 year ago
Every week we’re heading to Southampton General Hospital, where we’ve heard a lot about the doctors and nurses doing amazing work. But this week Erika Wright has been talking to Gemma Blanchett who does a job you might not even associate with the virus or with intensive care – and that’s physiotherapy. Gemma is a respiratory physiotherapist who has the joy of watching some recover with her extraordinary help.

Recovery is going to be a long haul for some and can even take time for those who’ve had the virus with mild symptoms at home. So what do we know about how long a complete recovery takes? James Gill GP and Honorary Clinical Lecturer at Warwick Medical School discusses the latest insights.

For people who have already found themselves worrying excessively about their health or who have an obsessive compulsive disorder related to hand washing, this is a particularly difficult time. With all of us now on the look-out for symptoms, Claudia Hammond speaks to Jo Daniels, a Senior Lecturer in Clinical Psychology at Bath University who specialises in health anxiety, and David Adam, author of the Man Who Couldn’t Stop – an intimate account of the power of obsessional thoughts.

There’s been a lot of discussion about how to get accurate numbers for the people who have died from the virus outside hospital and one issue that’s been raised is whether doctors are wary of putting Covid-19 on a death certificate, when there’s been so little testing in the community. GP Margaret McCartney examines the current dilemmas.

Amidst a host of trials to find effective treatments against Covid19, are there existing drugs which no one has thought of yet? We hear from Dr Lindsay Broadbent whose team at Queens University are testing more than a thousand drugs on human lung cells infected with Covid19 in the lab, to see what might work for both mild and more severe infection.

Producer Adrian Washbourne
access_time1 year ago
A range of potential treatments have been suggested for Covid-19 but nobody knows if any of them will turn out to be more effective in helping people recover than the usual standard hospital care which all patients will receive. Inside Health regular Dr Margaret McCartney talks to Claudia about how the first randomised trials are now setting out to test some of these suggested treatments with unprecedented speed and adaptability as potential new drug candidates emerge.

During lockdown some find their mental health is put at higher risk. Katie Connebear is a mental health campaigner and blogger who was diagnosed with bipolar disorder eight years ago. She has experienced psychotic episodes and has coping strategies in place for when she feels her mental health deteriorating. She offers her thoughts on how to make small progressive steps in the absence of family and friends who she normally relies on when times are difficult.

We’ve the latest in Inside Health’s regular visits to test the temperature at Southampton General Hospital. During the current pandemic maternity wards have to make sure that the birth of babies happens in a way that keeps expectant mothers, their birth partners and staff safe from the virus. Government advice includes pregnant women in the “vulnerable group" who need to take extra steps to socially distance, with extra attention after 28 weeks. Consultant obstetrician Jo Mountfield is keen to allay pregnant women’s concerns.

And with isolation set to continue, we can also learn from people who have lived in a different kind of lockdown – and one that was in many ways more extreme. Beth Healey is an intensive care doctor currently working in Switzerland who spent 14 months at Concordia research station in the Antarctic, investigating how the team coped with living in such an isolated environment She reveals the similarities in life there and life under lockdown here.

Producer Adrian Washbourne
access_time1 year ago
Claudia Hammond reports on Covid-19 and "moral injury" - when the virus peaks, some healthcare staff will find themselves in a situation never faced before, forced to make decisions they would never normally have to make. This puts them at risk of a so-called “moral injury” which might harm their mental health. It’s more often associated with life in the armed services and Neil Greenberg, Professor of Defence Mental Health at Kings College London, explains how he's applying lessons from research in the military to support staff starting work at the new Nightingale Hospital in London. And some of the million recipients of letters saying they should shield themselves by not going out at all for 12 weeks are people who have asthma. Margaret McCartney examines the evidence for how those with asthma receiving letters were selected. Plus the latest dispatch from University Hospital Southampton: consultant Chris Hill explains that the emergency department has been split into Red and Blue areas based on the probability of arrivals having Covid-19. And what’s happening to mental health services during this time of crisis when seeing someone face-to-face needs to be avoided as much as possible? Claudia finds out from psychiatrist Dr Sri Kalidindi.

Producer: Erika Wright
access_time1 year ago
When hospitals are full of patients, they're said to be "hot". The coronavirus crisis will push up the temperature of hospitals across the UK and in the first in a special series of weekly dispatches from the medical front line, producer Erika Wright will be taking the temperature of University Hospital Southampton - or The General - in Hampshire (which services almost two million people in the south of England) as they cope with the influx of Covid-19 patients. In this first dispatch, Erika talks to the Divisional Director for Medicine, Dr Trevor Smith, who says as patients have been moved out of this large teaching hospital to make space for coronavirus patients, the hospital's current temperature reading is "cold", but all staff know that this will soon change.

This virus is deeply frightening for everybody, but often for older people and those with underlying health conditions it is even worse. The fear is that if hospitals are overflowing, then crude cut-offs by, for example, age, might determine who does or doesn't, get a a bed in intensive care. But Dr Mark Roberts, consultant in acute and geriatric medicine and chair of the British Geriatric Society in Northern Ireland, tells Claudia that health care professionals don't and wouldn't make such arbitrary decisions based on age. Instead, he says, decisions about access to intensive care beds (or in-patient care) will continue to be made at the bedside, with compassion, and with a focus on who has the greatest capacity to benefit.

Some people have already decided that they won't go to hospital if NHS services are overwhelmed but they do want reassurance that they would get urgent care at home should they become seriously ill. Retired GP Dr Lyn Jenkins has written to the Prime Minister calling for this to be addressed as a priority. He's in good health, only 69 years old, but believes that he has a moral obligation not to use up scarce hospital resources if critical care beds can be given to younger people. For those who need it, he wants a quick response team to bring pain relief and supplementary oxygen and importantly, the presence of another person, a carer, so people who were very sick wouldn't be alone.

GP and Inside Health regular Dr Margaret McCartney talks to Claudia about supplies of personal protective equipment and whether long-promised supplies are finally arriving and she delves into the evidence to find out whether the loss of a sense of smell or taste could be a symptom of coronavirus. Listener Rachel says she can't smell cheese, garlic or lavender oil and she's worried that she could have the virus.

Producer: Fiona Hill
access_time1 year ago
Margaret McCartney on COVID-19 and how the military has been deployed to get protective equipment supplies to critical care staff. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard tells of the difficult ethical decisions staff are facing. And Professor Carl Heneghan - suffering from COVID-19 symptoms himself - explains the importance of fast action when treating secondary pneumonia in the elderly; while Deirdre Hollingsworth explains the term "Viral Load". Plus Margaret McCartney visits the famous Belford Hospital in Fort William - specialising in hostile environment trauma - and hears a story of intense mountain rescue.
access_time1 year ago
The UK has one of the lowest numbers of critical care beds in Europe but as the coronavirus threatens to engulf us, drastic measures are being taken to increase capacity. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard, tells Saleyha that the NHS has been asked to plan for doubling, trebling and then quadrupling the number of critical care beds. So far, health authorities in England, Northern Ireland, Scotland and Wales have identified how they can increase the number of beds from just under 5,000 to around 10,000 but as Nicki Credland, Chair of the British Association of Critical Care Nurses says, increased beds mean more specialist intensive care nurses in numbers that can't be invented overnight. Additional non-specialist staff are being earmarked to help fully qualified intensive care nurses in the current virus crisis.

Dr Margaret McCartney addresses the confusion around two medications: ibuprofen for viral symptoms and the potential risks to Covid-19 patients who are using ACE inhibitors for their high blood pressure or heart failure.

Meanwhile away from coronavirus, Saleyha reports on new advances for the treatment of glaucoma, a condition which involves increased pressure to the eye and damage to the optic nerve. It's usually treated using eye drops, but laser treatment could be coming to a hospital near you. Saleyha watches as Gus Gazzard, Professor of Ophthalmology at University College London, uses a laser to treat the high pressure in Veenay Shah's right eye. Evidence from the LiGHT trial, which showed the laser works for newly diagnosed glaucoma patients, is likely to lead to new NICE guidelines which could give patients the choice: eye drops or laser.

Faecal incontinence is one of the most debilitating conditions and patients can go for years without even seeking help. But at Sandwell General Hospital in West Bromwich, a revolutionary non-surgical approach is transforming lives. Called the FINCH service, Lead Nurse Kelly Stackhouse, colorectal consultant Rajeev Peravali and patients 21 year old Lara and 74 year old John, tell Saleyha how the new approach works.

Producer: Fiona Hill
access_time1 year ago
Inside Health gets exclusive access into Ysbyty Gwynedd, the Bangor emergency department, to see how they are preparing staff to deal with coronavirus patients arriving at the front door. Although advice is for patients to stay at home and call 111, some will be sick enough to need hospital admission. For that outcome, staff need to be properly fitted for face masks and trained in putting on personal protection equipment or PPE. Saleyha works in the department and Inside Health follows her getting kitted out with the help of Tim Hamilton Jones, an ED staff nurse tasked with the job of getting everyone ‘fit tested’.

GP Dr Margaret McCartney talks about the evidence on face masks and the different types that are out there and gives the latest information on the incubation period for COVID19.

It’s estimated that 80% of cases will be able to recover at home but 20% may need hospital care. Reports coming from Italy describe the demand on intensive care beds for patients with coronavirus because of the disease’s potential impact on the lungs. Dr Alison Pittard, Dean of the Faculty of Intensive Care and herself a practising ITU consultant in Leeds tells Inside Health about plans for increasing critical care bed capacity, in the NHS. The service is however already stretched before the disease has even taken hold here.

As the government works out a plan of action to support the NHS to cope at this time, Inside Health talks to the British Red Cross, already working in hospitals across Wales, about supporting staff during the normal pressures, even before coronavirus struck. We hear from support workers within the Emergency Department and get an insight into what they do.

Producer, Erika Wright
access_time1 year ago
Inside Health hears from two patients, Surinder Biant and Sam Begum who went for a free eye check up with Optical Express. Both were surprised by a diagnosis of cataracts when previous eye tests hadn't uncovered these. Both felt that they were given a hard sell and felt pressurised to have cataract surgery and both had independent second opinions which brought the diagnosis and proposed treatment into question. And the President of the Royal College of Ophthalmologists, Mike Burden, explains what cataracts are and how doctor and patient can decide together when surgery is required.

GP and regular Inside Health contributor, Dr Margaret McCartney talks about the language we use in healthcare which blames both patients and doctors unfairly. Words and phrases like "compliance", "bed-blocker" and "unnecessary admissions" are singled out as particular culprits.

The travel clinic at The Hospital for Tropical Diseases in London aims to help people with complex medical conditions get to where they need or want to go for work, family or just some winter sun. We meet Elisabeth, who is partially sighted and wants to travel to East Africa with her grandson; Robert who has lymphoma but is far more concerned that he won't be able to fly to a country he loves, Japan, and to Robin, who wants to start a career in Uganda but is allergic to some of the components of essential vaccines. Dr Nicky Longley, consultant in infectious disease and travel medicine runs the clinic.

Producer: Fiona Hill
access_time1 year ago
Chris van Tulleken examines cigarette filters - the tobacco industry's hidden marketing tool. He talks to historian Robert Proctor, author of The Golden Holocaust and May van Schalkwyk explains why she wrote her paper 'No More Butts'. Plus Margaret McCartney discusses whether the media portrays a balanced view of Sepsis.
access_time1 year ago
Evidence is building about the impact of air pollution on health, but the relationship between the cocktail of chemicals, gases and particles in the air we breathe and the direct effect on an individual's health is a tricky one to prove. Dr Farrah Jarral cycles to Kings College London to hear about a new study by researcher in respiratory toxicology, Dr Ian Mudway, which revealed, to the surprise of Ian and his colleagues, that particles from brake dust had the same damaging impact on our lung immune system as that familiar culprit, diesel exhaust. It's a result that demonstrates that the toxic risk to our health doesn't just come out of the exhaust pipe and suggests the concept of a zero emissions vehicle might need further work.

COPD or Chronic Obstructive Pulmonary Disease is an umbrella term for a range of respiratory conditions that used to be known by names like emphysema or chronic bronchitis. COPD flare ups or exacerbations are the second largest cause of emergency hospital admissions in the UK. Dr Jennifer Quint, consultant physician in respiratory medicine at the Royal Brompton Hospital tells Dr Farrah Jarral about a world-first study where the individual air pollution exposure of COPD patients was tracked in real time to find out how toxic air can make their condition worse.

What's it like for healthcare professionals working on the front line of infectious disease outbreaks? Dr Michael Kiuber, a consultant in emergency medicine at University Hospital Southampton NHS Foundation Trust, volunteered to treat patients with the deadly infection, Ebola, in Sierra Leone and he describes the challenges to Farrah of caring for very sick adults and children while taking every safety step to avoid contracting the Ebola virus himself. And Inside Health regular contributor, Dr Margaret McCartney outlines the challenges for the NHS in planning how to protect staff as the UK grapples with the global outbreak of Covid-19.

There's a growing trade in female cosmetic genital surgery including hymenoplasty, which claims to the restore the hymen to its virginal state. Scores of private clinics in the UK are offering the procedure with advertising claims like "Get your virginity back!" and "Restore your innocence within one hour!". Dr Leila Frodsham, consultant gynaecologist, specialist in psychosexual medicine and spokesperson for the Royal College of Obstetricians and Gynaecologists discusses the ethics of the procedure.

Producer: Fiona Hill
access_time1 year ago
Farrah Jarral on Coronavirus transmission and the difference between a cough and a sneeze. Why is health research and media coverage about Breakfast often contradictory? Farrah meets senior lecturer Javier Gonzalez and Professor James Betts from the department for health at the University of Bath. And Margaret McCartney discusses the complex issue of inequalities between men and women when diagnosing heart attacks. Plus Farrah talks to Dr Ruth Chambers, clinical lead for a project in Stoke on Trent that assesses the benefits of personal digital assistants in the home.
access_time1 year ago
It's not a household name but RSV or Respiratory Syncytial Virus is responsible for 30,000 children under five ending up in hospital every year in the UK. The virus can cause serious infections of the lungs and airways (like pneumonia and bronchiolitis). Hannah and Sean from Oxfordshire had baby girls, Millie and Freya, born prematurely in October last year. Just weeks later, the twins spent 12 days in intensive care and then 3 days in the high dependency unit at the John Radcliffe Hospital in Oxford with bronchiolitis caused by RSV. Andrew Pollard, Professor of Paediatric Infection and Immunity at the University of Oxford tells James, the BBC's Science and Health Correspondent, about the dangers of RSV in lower income settings where the virus claims more babies' lives under 12 months old than any other disease apart from malaria. Hopes are that a vaccine for RSV to protect children during the vulnerable first years is imminent.

And as one of the world's leading experts on vaccinations (and chair of the UK's Joint Committee on Vaccination and Immunisation) Professor Pollard tells James that he is confident that a vaccine for the coronavirus, which some experts have suggested could become a pandemic, could be developed by the end of this year.

Inside Health regular contributor Dr Margaret McCartney raises the issue of unnecessary vaginal examinations. A new American study in JAMA Internal Medicine suggests that more than half of the bimanual pelvic examinations performed on girls and women aged 15 to 20 in the USA are potentially unnecessary and could cause harm. The fact this is still routine for many American women contradicts clear guidance which states there is no evidence for such internal examinations to be carried out in healthy girls and women who don't have symptoms. It doesn't happen in the NHS, Margaret reports, but they are carried out in the private sector under the banner of "well women checks".

Could you tell somebody that they were going to die? Could you comfort family members after their loved one has passed away? Crucially could you do this as part of your job, day in, day out, without it affecting you? James talks to nurses at the Royal Marsden Hospital in Surrey which has been raising "compassion fatigue" as an occupational hazard within the profession.

Producer: Fiona Hill
access_time1 year ago
James Gallagher, the BBC's health and science correspondent discusses the Coronavirus and how GP's have been advised to manage a patient at risk. He meets listener's Rich and Lucy who have asked about Probiotics and gut health in early life after one of their twins had a vaginal delivery while the other a C-section. They want to know whether the different types of birth might impact on the good bacteria passed from mother to child, evidence for the potential impact on long term health and whether probiotics can help. Plus Pill Organisers and whether arranging medicines into one single packet is always a good idea. And a life changing treatment for Haemophilia A.
access_time1 year ago
Nigel Edwards, Chief Executive of the health think tank the Nuffield Trust, joins Dr Margaret McCartney for this special programme about the challenges of remote and rural healthcare.
Margaret travels by boat from Mallaig to the Hebridean islands of Eigg, Muck, Rum and Canna off the north west coast of Scotland where, after 100 years the islanders lost their resident doctor. When it was clear there wouldn't be a replacement, the islanders and NHS Highland instead opted for a radical new healthcare model.
Taking inspiration from indigenous tribes in Alaska, the NUKA model has been adapted for the Small Isles and it is very different, with a high level of community engagement. The idea is that local people own their own healthcare rather than having healthcare delivered to them, as passive recipients.
Local people are trained up in first aid and become salaried Rural Health and Social Care Workers. They are the eyes and ears of healthcare professionals. Volunteers also act as First Responders coordinating helicopter and lifeboat rescues in emergencies.
Dr Margaret McCartney joins GP Dr Geoff Boyes on his weekly visit to Eigg and discovers how the community has adapted to this new way of delivering care. She hears from Gill McVicar, former NHS Highland Director of Transformation and Camille Dressler, chair of the Small Isles Community Council, about how the reorganisation was managed; from Julie McFadzean about the new health and rural health and social care worker role; from Sheena Kean, the Eigg healthcare practice manager who makes sure everything runs smoothly and to Eigg residents about how they think their new healthcare model is working.

Producer: Fiona Hill
Credit Photo of Margaret McCartney: Paul Clarke
access_time2 years ago
When is the best time of day to take blood pressure pills? A new study from Spain has hit the headlines, with dramatic results that could change practice but are the findings too good to be true? And why is getting help for ADHD or other behavioural conditions such a struggle for parents, schools and doctors? Plus recurrent fevers - a rare genetic condition that feels like flu every day. And evidence for the best way to get rid of headlice!
access_time2 years ago
Dr Mark Porter demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice, with the help of regular contributor GP Margaret McCartney
access_time2 years ago
Zantac alert over concerns that the branded reflux treatment is contaminated with a carcinogenic impurity, so what are the risks? And a new device helping to identify Newborn brain injury earlier. An Inside Health Guide to Over the Counter choices and evidence for those that work best - this week Warts and Veruccas; Plus surgery for reflux as an alternative to pills.
access_time2 years ago
There are plans to make high dose statins available over-the-counter without a prescription to improve uptake. Currently around two thirds of people likely to benefit most don't take them, but will these plans make a difference? Amyloidosis is a debilitating rare disease that is often missed: Pam tells her amazing story of recovery and Mark meets the specialists helping her. And news about new gene silencing treatments that could transform the outlook for people with other rare conditions too.
access_time2 years ago
Mark Porter reports on shortages of Heparin, a drug to treat blood clots, due to swine fever in Chinese pigs! And staying with anticoagulants Margaret McCartney discusses concerns about taking these drugs along with common pain killers like ibuprofen. Why is this a risky combination? And Alice tells her story of opting for ovarian freezing, the latest technique to preserve fertility when undergoing cancer treatment. Plus a pioneering new type of surgery for arthritis of the thumb.
access_time2 years ago
Why aren't prescription charges free across the whole of the UK? Acute Kidney Injury has shot up the NHS agenda in the last decade. Mark Porter visits Derby Royal Hospital to find out why kidney problems are so common and discovers what's been done to prevent damage to an organ many of us take for granted. Plus the World Health Organisation has removed the UK's measles free status because too few children are being immunised. Could making the vaccine mandatory be the answer? Margaret McCartney examines the evidence. And as the academic term gets underway Inside Health learns of a novel method to help with the prevention of meningitis amongst university students who are at risk of the disease.
access_time2 years ago
Dr Mark Porter finds out about 'singing for lung health', an evidence based therapy for helping people with breathlessness arising from conditions like Chronic Obstructive Pulmonary Disease. He hears from the choir based at Charing Cross Hospital in London and talks to respiratory physiologist, Adam Lound, to find out how the breathing and singing techniques being taught there, as well as the camaraderie, improve people's quality of life and confidence. Does exercise increase the risk of worsening an aortic aneurysm? Consultant vascular surgeon, Rachel Bell talks about the benefits of cardio vascular exercise for people with aneurysms. Dr Margaret McCartney reviews the evidence on sunscreens. Also in the programme, Saiju Jacob discusses myasthenia gravis, an auto-immune condition that causes muscle weakening. He explains what causes it and how it's treated.