GENETICS AND GENOME

Genetics is the study of single genes and their roles in inheritance; genetics focus on how specific traits or conditions are passed genetically from parents to offspring. Genome is an organism's complete set of all of a person’s genetic material; genomics is the broader study of all genes together, including how they interact with each other and the environment.

GENETICS	GENOME
the science of inheritance	analysing the entire genome and how these genes interact with each other and with environmental factors
study of single genes and their variations as a cause of inherited single-gene (Mendelian) disorders	research the causes of common diseases with complex aetiology, which have multifactorial determinants including genes, lifestyle behaviours  environment.

Dr Martin Harris Private GP in London Health Blog The National Genomic Test Directory specifies which genomic tests are commissioned by the NHS in England and sets out test eligibility criteria to provide guidance on which patients may benefit from genomic testing.

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POTS Postural Orthostatic Tachycardia Syndrome

POTS is Postural Orthostatic Tachycardia Syndrome). The definition is that on standing, then there is a rise in heart rate (pulse rate).

https://www.potsuk.org/

The diagnosis is made on the evidence that the Pulse rate (heart rate)  must increase by ≥30 beats per minute (or ≥40 bpm for ages 12–19) within 10 minutes of standing, while your blood pressure remains stable without a significant drop in blood pressure.

Normal heart rate in a healthy person, then when standing it is the autonomic nervous system which automatically constricts blood vessels and slightly raises heart rate.

POTS patients the constriction of  the blood vessels do not constrict properly, so that the effect causes blood to pool in the lower half of the body. To compensate and push blood to the brain, the heart beats excessively fast, known as tachycardia and the INCREASE in heart rate will rise more than 30 beats per minute.

It is important to note the essential diagnostic criterion is theabsence of a large, simultaneous drop in blood pressure known as orthostatic hypotension, and so distinguished from POTS diagnosis. In orthostatic hypotension there is  both a high heart rate and a sharp fall in blood pressure when vertical.

www.private-gp-in-london.co.uk/health-blog

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Long COVID trial Over-the-counter antihistamines and the anti-inflammatory agent colchicine produced a small additional reduction in fatigue among adults with long COVID attending specialist clinics, but the benefit did not persist once treatment stopped, according to a randomised trial led by University College London (UCL) and University College London Hospitals (UCLH). Meanwhile, the anticoagulant rivaroxaban conferred no fatigue benefit.

Published in The Lancet Infectious Diseases and funded by the National Institute for Health and Care Research, the trial evaluated repurposed medicines alongside usual specialist care to identify pragmatic options for symptom relief in a condition that still lacks approved treatments.

The study enrolled nearly 800 non-hospitalised adults with long COVID across 12 clinics in England and Scotland, ranging from Hull and the Highlands to Leicester and London. Participants were randomly assigned to usual care alone or to 1 of 3 drug approaches: a combination of antihistamines, colchicine, or rivaroxaban. Fatigue was measured with a questionnaire at baseline, 12 weeks, and 24 weeks.

Across all arms, self-reported fatigue improved by an average of 4.3 points on a 40-point scale over 12 weeks. Participants receiving antihistamines or colchicine had an additional 1.5-point improvement at 12 weeks, but this advantage was no longer evident at 24 weeks — 12 weeks after stopping treatment. Rivaroxaban conferred no measurable benefit.

Amitava Banerjee, MD, UCL Institute of Health Informatics, London, said: “our findings suggest these drugs alone are unlikely to be the answer to long COVID fatigue.” Professor Banerjee added: “both antihistamines and colchicine affect the immune system and it may be that they address the immune dysregulation that long COVID has been linked to, but further research is needed to understand the possible mechanism,” and noted that the results “do not support the use of anti-coagulation medicine for long COVID.”

Melissa Heightman, MD, UCLH, London, said: “this level of improvement shows the importance of specialist long COVID care,” pointing to integrated, community-based rehabilitation as central to the gains observed across all trial arms.

The trial was open-label, with no placebo in the usual-care group, and the researchers could not fully exclude a placebo effect, although they noted that no benefit was observed in the rivaroxaban arm. Further trials are needed to clarify the underlying immune and inflammatory mechanisms and to develop better-targeted therapies.

Dr Martin Harris

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In 2025 the number of deaths reported to coroners as a proportion of registered deaths varied widely across coroner areas, from 13% in Rutland and North Leicestershire to 54% in Inner North London

Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025.

 https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

In this section we have provided further analysis using data published by ONS.

The number of deaths reported to coroners in 2025 varied markedly by coroner area – from 222 in City of London to 4,897 in Kent and Medway. The number of deaths reported in each area will be affected by its size, resident population, demographic breakdown and profile, so comparisons of the number of deaths reported to coroners across coroner areas should be treated with caution.

When looking at the number of deaths reported to coroners in 2025 as a proportion of registered deaths, which allow for some differences in population characteristics, there is still a wide variation across coroner areas, with a minimum of 13% in Rutland and North Leicestershire compared with the maximum of 54% in Inner North London. However, caution should be taken when using these figures as local area factors can influence these proportions. For example, large hospitals can impact the proportion, due to the difference between the coroners’ figures being based on the place of death and the ONS figures being based on the place of residence.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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There was a 19% increase in Treasure finds reported in 2025 and a 27% increase in inquest conclusions on finds

Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025. https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

1,621 finds were reported to coroners in 2025, an increase of 258 on 2024. 635 inquests were concluded into finds. Of these, 97% (614) returned a conclusion of treasure, a decrease in proportion by two percentage points when compared with 2024.

The Government introduced a new and expanded definition of treasure from July 2023 which includes a “significance-based” class of treasure, rather than being based solely on material composition and age.

In 2025, 1,621 finds were reported and 635 inquests were concluded. Separately, there were no inquests held into Treasure Trove in 2025 (Tresure Trove relates to finds made before the Treasure Act 1996 came into force).

The number of finds reported has been steadily increasing since the commencement of the 1996 Act in September 1997, from 54 finds in 1997 to 1,059 in 2017. Between 2018 and 2020, however, the number was more volatile. Since 2021, the number has been rising again. In 2025, the number of finds rose to the highest level in the time series at 1,621, from 1,363 in 2024 (up 19%). The number of treasure inquest conclusions increased by 27% (from 500 in 2024 to 635 in 2025).

Of the 635 inquests concluded in 2025, 97% (614) returned a conclusion of treasure, a decrease in proportion by two percentage points compared to 2024.

The number of finds and inquests held varies greatly across the country, which is likely due to geographical and historical differences between areas. In 2025, 12 coroner areas had no treasure finds reported to them, whilst Hampshire, Portsmouth and Southampton had the highest number of treasure finds at 172.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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There were 654 PFD reports issued by coroners in 2025, down 8% compared with 2024.

Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025. https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

A Prevention of Future Deaths (PFD) report is issued by a coroner if there is a concern (arising from the investigation) that action should be taken to reduce or prevent the risk of other deaths occurring in the future. A PFD report is issued to people or organisations whom the coroner believes are in a position to take action.

Collection of data on PFD reports for these statistics started in 2021 (partial year collection). In 2025, there were 654 PFD reports issued – this represents 2% of all inquests concluded and a decrease of 8% in the number of PFDs issued compared with 2024.

All the coroner region issued PFDs in 2025. The London region issued 108, the highest number as a proportion of inquests concluded (3%). London also issued the highest proportion in 2024 (3%). The East Midlands region issued the lowest number of reports (41) as a proportion of inquests concluded (1%). The North East region issued the lowest proportion in 2024 (1%). A further breakdown shows 3 coroner areas issued no PFDs in 2025. PFD reports and the responses to them must be copied to the Chief Coroner, who may publish them on the Judiciary website

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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Time taken to process a coroner inquest overall the average time taken to process an inquest remained stable

Time taken to process a coroner inquest the estimated average time taken to process an inquest remained stable at 31.3 weeks in 2025.

Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025. 

https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

Time taken to process a coroner inquest the estimated average time taken to process an inquest in 2025 (defined as being from the date the death was reported until the conclusion of the inquest) was 31.3 weeks stable compared with 2024.

The average time taken to process an inquest in 2025 ranges from 11.2 weeks to 77.4 weeks. This disparity between regions is mainly due to differences that exist from one coroner area to another. Some of these differences are:

• Availability of resource, including staff and judicial resources
• Local complexity, including the presence of facilities like hospitals and prisons
• Socio-economic make up of regions

Therefore, a direct comparison between coroner areas is not advised.

More information about how the average time taken has been estimated can be found in the Guide to coroner statistics published alongside this report.

In 2025, 29% of inquests were completed in less than 3 months, 56% in less than 6 months, 81% took up to a year and 19% took over a year, compared to 29%, 55%, 82% and 18% respectively in 2024, and 29%, 54%, 82% and 18% respectively in 2023.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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Coroners Inquest Conclusions by Age Of the inquests completed in 2025, 55% related to persons who were aged 65 years or over at the time of death compared with 5% relating to persons under 25 years of age.

Dr Martin Harris

The number of inquests opened in 2025 decreased by 672 (down 2%) to 35,989.

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025. 

https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

Coroners Inquest Conclusions by AgeThe profile of the age of the deceased in inquests has changed slightly from 2024 to 2025. The percentage of inquests completed relating to persons aged 65 or over has decreased by less than one percentage point to 55%. By contrast, 5% of inquests concluded related to persons under 25 years of age, unchanged compared to 2024, while the percentage of those between 25 and 65 years remained stable at 39% (see Table 8).

Over the last 10 years from 2015 to 2025, the percentage of inquests completed for persons aged 65 or over decreased from 61% to 55%. Inquests concluded for those under 25 years of age remained stable at 5% and for those aged between 25 and 65 years the percentage rose from 34% to 39% over the same period.

Although an age breakdown of registered deaths in England and Wales in 2025 is not yet available, ONS figures for 2024 show that 84% of registered deaths in England and Wales were persons aged 65 or over, with only 1% aged under 25 years old.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025. https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

Conclusions recorded at inquests by sex

Male deaths accounted for 64% of all conclusions recorded in 2025 while female deaths accounted for 36%. In 2024, the percentages were 63% and 37% respectively.

The pattern of conclusions recorded differs between males and females. Males accounted for 61% of deaths reported but 64% of all conclusions recorded in 2025. Correspondingly, female deaths accounted for 36% of all conclusions recorded in 2025 (and 39% of all deaths reported).

Figure 6 shows the variation in the sex proportions, depending on the type of inquest conclusion. Industrial disease had the highest proportion of inquests relating to males, at 93%; lack of care or self-neglect had the highest proportion of inquests relating to females, at 50%.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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Dr Martin Harris

The annual publication presents statistics of deaths reported to Coroners in England and Wales in 2025.

 https://www.gov.uk/government/statistics/coroners-statistics-2025/coroners-statistics-2025-england-and-wales

1% decrease in inquest conclusions recorded, with the largest decrease seen in natural causes.

In 2025, 39,118 inquest conclusions were recorded, down 1% on 2024. Inquest conclusions of natural causes had the largest decrease, down 24% on 2024, to 3,729, and, excluding unclassified conclusions, road traffic collision had the largest increase, up 3% on 2024, to 978.

There were 39,118 inquest conclusions recorded in 2025, down 468 (1%) from 2024, in part reflecting the decrease in the number of inquests opened. This is the lowest level since 2022. The decrease was driven by conclusions for female deaths (down 4%). Conclusions for male deaths remained stable. Of the inquests concluded 6,448 were inquests in writing, up 2,060 (47%) from 2024, and 18,048 were rule 23 inquests (when written evidence is admitted at an inquest hearing in lieu of oral evidence).

Conclusions are recorded at the culmination of the inquest. This means that the conclusions recorded in a certain year may relate to deaths that occurred in the same year or in earlier years.

In 2025, the most common short form conclusions (by order of frequency) were death by misadventure (9,724 or 25% of all conclusions), suicide (5,298 or 14%) and drugs and alcohol (4,659 or 12%).

The number of suicide conclusions increased by 1% compared to 2024. The increase was driven by male suicides (up 3% compared with 2024), while female suicides decreased (down 4% compared with 2024). The proportion of conclusions recorded as suicide has remained broadly constant over the past eight years, with an increase from 13% of all conclusions in 2024 to 14% in 2025. This proportion varies from 3% in City of London to 36% in Ceredigion.

Industrial disease conclusions fell by 5% in the last year (to 1,828 cases), the lowest level since 1996.

In 2025, natural cause conclusions decreased by 24% to 3,729, possibly due to the effect of the statutory medical examiner system introduced in September 2024, which is designed to ensure that deaths are scrutinsed, certified and where necessary investigated in the appropriate part of the death management system.

In 2025, the number of unclassified conclusions increased by 848 cases (up 8%) to 11,686. Unclassified conclusions made up 30% of all inquest conclusions in 2025, an increase in proportion by two percentage points compared with the 2024 amount. The term “unclassified” is a way of recording an outcome where the coroner or jury do not rely on just one of the short-form conclusions, or where a narrative conclusion or rider (which may or may not be accompanied by a short-form conclusion) is returned by the coroner or jury. Self-Induced Abortion, Want of Attention at Birth and Disaster conclusions are included in the Unclassified conclusions figure.

For the remaining short-form conclusion types, alcohol/drugs related deaths decreased by 32 cases (down 1%) to 4,659, ending the rising trend seen since the conclusion type was introduced in 2014. Road traffic collisions increased by 25 cases (up 3%) to 978.

Open conclusions have decreased over the last decade – they accounted for 3% of all inquests concluded in 2025 compared with 5% in 2015. Year on year, open conclusions decreased by 5% compared with 2024.

Dr Martin Harris

Private GP in London and expert for medical legal reports and qualified Medical Examiner RCPathME

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