Lewisham and Greenwich NHS Trust is an NHS trust which was formed on 1 October 2013 and is responsible for running two acute hospitals, Queen Elizabeth Hospital and University Hospital Lewisham, in addition to community health services in Lewisham.The trust was formed by the acquisition of the acquisition of Queen Elizabeth Hospital by Lewisham Healthcare NHS Trust upon the dissolution of South London Healthcare NHS Trust. Despite extensive local opposition and legal challenges in Lewisham, the merger was approved by Secretary of State for Health Jeremy Hunt on 26 September 2013.Both hospitals continue to operate emergency departments, acute medicine services and maternity units following the High Court decision which ruled that the plan to close services at Lewisham Hospital was unlawful, a judgement which was subsequently upheld in the Court of Appeal.
Introduction/Background: Since the pandemic started, studies on long COVID have expanded significantly. This bibliometric analysis maps the field’s evolution from January 2020 to March 2025, providing a macro-level understanding of research trends and informing clinical practice and health policy. Methods: We performed a systematic bibliometric review of 9729 publications indexed in the Scopus database. Utilising VOSviewer (version 1.6.20) and Biblioshiny (Bibliometrix R package, version 4.1), we analysed annual growth rates, country and institutional contributions, co-authorship networks, and thematic clusters. The study followed RIBA and GLOBAL reporting guidelines to ensure methodological transparency and clinical relevance. Results: We found 7867 articles and 1862 reviews, with an average document age of 2.13 years and 19.2 citations per document. Scientific output increased at an annual rate of 19.81%, reaching a definitive production peak in 2024, with 64,027 authors, 10.3 co-authors per document, and 24.97% international co-authorship. The United States, China, and the United Kingdom were the most significant contributors, with the University of California and Oxford University emerging as primary research hubs. Thematic mapping revealed 23,803 keywords plus and 13,991 author keywords. Key research gaps included limited interventional evidence, which represented less than 2% of the corpus; sparse paediatric-related research accounting for only 4.2%; and persistent geographic imbalance, particularly the underrepresentation of low- and middle-income countries. Conclusions: The long COVID research landscape is dynamic and collaborative but exhibits geographic and topical imbalances. To improve patient outcomes, stakeholders should pivot from observational mapping toward interventional trials. Priorities should include fostering inclusive international collaborations, addressing the paediatric research gap, and evaluating integrated service delivery models to manage this complex, multisystemic condition.
Abstract Background/Aims A comprehensive annual review including comorbidity assessment in patients with rheumatoid arthritis (RA) has been advocated by the National Institute for Clinical Excellence (NICE). Psoriatic arthritis (PsA) carries a similar, if not greater, burden; on meta-analysis, patients with PsA were 1.66 times more likely to have metabolic syndrome than those with RA, driving increased cardiovascular risk and mortality. Furthermore, depression in PsA (prevalence 9 to 22%) is common and linked to nociplastic pain. We describe the first year of a dedicated PsA annual review clinic (ARC), evaluating comorbidity prevalence and the utility of systematic screening. Methods A retrospective review was conducted of all patients attending a PsA ARC between May 2024 and April 2025 at University Hospital Lewisham in London, UK. Clinical and demographic data were collected, including metabolic risk factors, and results from structured assessments, including Fibrosis-4 Index (FIB-4), Fracture Risk Assessment Tool (FRAX), Patient Health Questionnaire-9 (PHQ-9), and Health Assessment Questionnaire-Disability Index (HAQ-DI). Results The cohort (n = 78) had a mean (SD) age of 50.8 (13.1) years, 51.3% were male, and 53.8% were from the two most deprived socioeconomic quintiles. Most patients had established disease, with 59% on conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and 50% on biologic (b) or targeted synthetic (ts)DMARDs. A high comorbidity burden was observed: 39.7% had at least one metabolic risk factor (hypertension 23.1%, diabetes 7.7%, ischaemic heart disease 2.6%). Over half the cohort were overweight (30.8%) or obese (33.3%). We identified that 65.4% had a low risk FIB-4 (<1.3) for liver fibrosis, and 20.5% had intermediate risk (FIB-4 1.3 to 3.25). Of 28 patients with a fibroscan completed, 82.1% had no significant fibrosis (<6.0 kPa) and 17.9% had mild-moderate fibrosis (6.0 to 12.0 kPa). FRAX assessment deemed 12.8% required Bone Mineral Density (BMD) measurement and 2.6% required treatment; subsequent bone density scans in 17 patients revealed osteoporosis in 23.5%. Mood screening found 17.9% had mild, 15.4% moderate and 2.6% severe depression. Functional assessment (HAQ-DI) showed 6.4% had moderate and 6.4% severe difficulty. Conclusion Our dedicated PsA ARC identified a profound comorbidity burden, with over one-third of patients having at least one metabolic risk factor and one-third living with obesity; this is likely a conservative estimate as we did not adjust for ethnicity. Overall, there was a low incidence of significant liver fibrosis within this cohort. It is important to note that patients attending this ARC may have represented a more stable group, and the overall PsA population likely carries an even greater disease burden. These findings support our PsA ARC model as an essential tool for proactive management in PsA, capable of identifying and addressing modifiable risks that can directly impact disease outcomes and long-term health. Disclosure N. Arumalla: Honoraria; Abbvie. Other; Conference fees from AbbVie, Accord Healthcare and Lilly. E. Sayson: None. D. Srikantharajah: None. L.C. Pollard: None. Y.L. Man: None.
Study objective: To assess current perceptions of training in adolescent and young adult healthcare among UK resident doctors and educational supervisors (ES), and to identify barriers and opportunities for improvement. Design: Cross-sectional national survey of resident doctors and ES, followed by qualitative focus group discussions. Setting: UK-wide, involving medical specialties participating in internal medicine training (IMT) and higher specialty training programmes. Participants: 670 resident doctors and 64 ES across 29 specialties. A subset of nine participants (four ES, five resident doctors) took part in focus groups. Main outcome measure(s): Exposure to training, confidence in managing adolescent medicine, awareness of transition care tools and policies, perceived barriers and suggestions for improvement. Results: 18% of resident doctors had attended transition clinics and 38% reported no formal training in adolescent medicine. 5% of respondents were aware of national training guidance. Confidence and preparedness were low, with significant variation across specialties. ES confirmed the importance of adolescent medicine training but noted systemic limitations. Key barriers included limited clinical opportunities, lack of curricular emphasis and poor interdepartmental coordination. Conclusions: Training in adolescent medicine remains inconsistent across UK specialties. System-wide reforms are needed to improve preparedness and care quality. This may include mandating adolescent care competencies, structured clinic access and integration into curricula.
Core Outcome Sets (COS) are used by researchers to enable synthesis and comparison of results from trials in similar patient groups and contexts. Around 50
