Friday 29 August 2014

Independent report: Establishing food standards for NHS hospitals

Independent report: Establishing food standards for NHS hospitals

The report looks at standards relating to patient nutrition and hydration, healthier eating across hospitals and sutainable food and catering services.

NHS adoption of the recommended standards will be required through the NHS contract meaning that hospitals will have a legal duty to comply with the recommendations.

The panel, set up by Health Minister Dr Dan Poulter and led by Dianne Jeffrey from Age UK, examined existing food standards, advising on how they should be applied and monitored.

The NHS receives 480 written complaints per day

The NHS receives 480 written complaints per day

· Almost 175,000 reported complaints made in 2013-14. ICQOF

Data factsheets on weight, obesity and physical activity

Data factsheets on weight, obesity and physical activity


These factsheets compile up-to-date key information and data about obesity and its determinants in an easily readable format. The data factsheets will be a useful resource for policy makers, practitioners and anyone with an interest in obesity. Public Health England (PHE)
Factsheets

Spend and outcome tool (SPOT) for local authorities

Spend and outcome tool (SPOT) for local authorities


This tool gives local authorities an overview of spend and outcome across key areas of business for public health and its sub-programmes. The tool is an interactive spreadsheet and is also accompanied by factsheets for each local authority. Public Health England (PHE)
Tool
PHE news

Government told to invest in ambulance services as complaints soar

Government told to invest in ambulance services as complaints soar

Paramedics have called on the Government to urgently invest in ambulance services after new figures revealed complaints about delayed emergency responses have soared in the past year. Independent

Walk a mile a day to beat cancer

Walk a mile a day to beat cancer

Walking just one mile at a moderate pace every day could reduce the risk of death from breast and prostate cancer, Macmillan Cancer Support suggests. Telegraph

Empowering mental health service users to become more involved in decisions about their care: the DECIDE RCT

Empowering mental health service users to become more involved in decisions about their care: the DECIDE RCT

Laurence Palfreyman highlights an RCT of the DECIDE intervention, which aims to build awareness of the service user’s role in decisions about their care including how they can become more involved and seek information from independent sources. The Mental Elf

Electrical stimulation 'aids memory'

Electrical stimulation 'aids memory'

Electromagnetic stimulation of a specific part of the brain may improve the ability to remember certain facts, researchers say. BBC News

Tomato-rich diet 'reduces prostate cancer risk'

Tomato-rich diet 'reduces prostate cancer risk'

“Tomatoes ‘cut risk of prostate cancer by 20%’,” the Daily Mail reports, citing a study that found men who ate 10 or more portions a week had a reduced risk of the disease.

The study in question gathered a year’s dietary information from 1,806 men who were found to have prostate cancer and 12,005 who were clear after random prostate checks. The researchers compared the diets and adjusted the results to take into account factors such as age, family history of prostate cancer and ethnicity.

They found that men who ate more than 10 portions of tomatoes or tomato products per week have an 18% reduced risk of prostate cancer compared to men who ate less than 10.

As this was a case controlled study, and not a randomised controlled trial, it cannot prove that eating more tomatoes prevents prostate cancer. It can only show an association.

Depression therapy aids other cancer symptoms

Depression therapy aids other cancer symptoms

"Depression therapy could help cancer patients fight illness," reports The Daily Telegraph.

The headline follows a study of intensive treatment of clinical depression given to people who had both depression and cancer – delivered as part of their cancer care. It found that not only did people’s mood improve, but cancer-related symptoms such as pain and fatigue were also reduced compared to that seen with the usual care given.

The treatment programme, called Depression Care for People with Cancer (DCPC), involves a team of specially trained cancer nurses and psychiatrists who work closely with the patient’s cancer doctors and GP.

Thursday 28 August 2014

Cancer Drugs Fund gets £160m more for innovative treatments

Cancer Drugs Fund gets £160m more for innovative treatments

Fund that helps patients receive pioneering medicines not routinely funded by the NHS will be extended to 2016

Thousands more cancer patients in England will be offered vital treatments in a £160m boost to the Cancer Drugs Fund (CDF), the Department of Health said today.

The fund, which has helped more than 55,000 cancer patients since it was set up four years ago, will be increased from £200m a year to £280m a year. Guardian
Continue reading...



One in six hospital sites score 100 per cent on cleanliness in patient-led assessments

One in six hospital sites score 100 per cent on cleanliness in patient-led assessments


11 per cent increase in public involvement on 2013

*Regional data available from this report

218 hospital sites (16.1 per cent) scored 100 per cent for cleanliness3 in the latest Patient-Led Assessments of the Care Environment (PLACE)4report. The report released today by the Health and Social Care Information Centre (HSCIC) saw 1,356 hospital sites assessed.

PLACE results for 2014 show that the national average score for cleanliness has increased by 1.5 per cent on 2013. This improvement was across all site types5 except treatment centres; the largest increase was in the Community sector at 1.9 per cent.

PLACE is now in its second year and aims to give the public a chance to assess a range of non-clinical services within the NHS and the independent and private healthcare sector in England.

The assessment criteria used within PLACE represents aspects of the care environment which patients and the public have identified as important6.

PLACE covers four specific areas: cleanliness; food and hydration; privacy, dignity and wellbeing; and condition, appearance and maintenance7. IQOF

Depression in cancer 'overlooked'

Depression in cancer 'overlooked'

Three-quarters of cancer patients who are depressed are not getting the psychological therapy they need, researchers say. BBC News

Tomatoes linked with fighting cancer

Tomatoes linked with fighting cancer

Eating tomatoes may lower the risk of prostate cancer, research suggests. BBC News

The relationship between delayed discharge and care home bed supply

The relationship between delayed discharge and care home bed supply


It aims to answer two questions: Does the supply of care home beds in a local authority (LA) affect hospital discharge delays and does the supply of care home beds in neighbouring LAs affect delayed discharges ie are there spillovers?

The report uses data that is only recently available on delays for hospital patients in 147 LAs between 2010-2012, distinguishing between those delays caused by social care and those due to hospitals. NHS Networks

Can giving addicts access to medical records aid recovery?

Can giving addicts access to medical records aid recovery?


Putting people with substance misuse problems in control could help with treatment and save NHS resources
Could bedside TVs be used to give patients access to medical records?

As a clinical psychologist whos spent many years helping people recover from drug and alcohol problems, I know that the substance misuse sector can be a minefield for both service users and practitioners.

While much has improved, someone recovering from a drug and alcohol addiction is still cared for by an often bewildering array of organisations. This is something that can cause stress in the individual and the system. I believe that giving individuals more control over their lives and treatment can lead to huge benefits all round.
Guardian

Continue reading...

Patient-led dosing for hypertension improves BP control

Patient-led dosing for hypertension improves BP control

Allowing hypertensive patients to monitor and adjust drug doses under a programme devised by their GP can improve BP control in high-risk patients, a study has found. GP Online

Motivational interviewing does not prevent alcohol misuse in young people

Motivational interviewing does not prevent alcohol misuse in young people

This new Cochrane systematic review finds that motivational interviewing has no effect on reducing alcohol-related problems or risky behaviours such as drunk driving in young people. Mental Elf

A national review of choices in end-of-life care

A national review of choices in end-of-life care

The review focuses on end-of-life care for adults of 18 years of age and over, and within the current legal framework. It does not look at assisted dying or anything that would involve changes to mental capacity legislation. The deadline for responses to the review is 30 September 2014. NHS Networks

Drug hope for Crohn's patients: New treatment is first to work in the gut to target symptoms on the disease

Drug hope for Crohn's patients: New treatment is first to work in the gut to target symptoms on the disease

Vedolizumab is the first to work directly in the gut lining, targeting the inflammation that causes chronic symptoms such as diarrhoea, bleeding and fatigue. Daily Mail

Will polystyrene cancer concerns prompt brands to change?

Will polystyrene cancer concerns prompt brands to change?


The National Research Council has affirmed that styrene, often used in food packaging and foam coffee cups, is linked to cancer. Whats the industrys reaction?

Polystyrene foam packaging has been a topic of environmental debate for decades, and several international brands have made moves to phase it out. This slow trend may have been accelerated last month when the National Research Council (NRC) affirmed the National Toxicology Programs 2011 finding that the organic compound styrene can reasonably be anticipated to be a human carcinogen.

In terms of consumer hazards, the biggest styrene concern is with food packaging, as studies have shown that this substance can leech out of polystyrene takeout food and drink containers, says Mike Schade of Safer Chemicals. If you drink coffee or soup or eat Chinese food from a polystyrene foam container you can potentially be exposed to this chemical, which government agencies consider reasonably anticipated to be a human carcinogen.

We remain committed to finding a long-term alternative to Dunkin Donuts foam cup that meets our guests expectations, is affordable for our franchisees and reduces our environmental impacts. Guardian

Continue reading...

Does weight loss surgery affect dementia risk?

Does weight loss surgery affect dementia risk?

"Weight loss surgery 'reduces chance of Alzheimer's disease'," reports The Daily Telegraph. This misleading headline reports on a small Brazilian study of severely obese women before and after weight loss surgery. None of the women had any signs or symptoms of Alzheimer's.

Seventeen women with an average body mass index (BMI) of 50kg/m² had neuropsychological tests, blood tests and a brain scan before surgery and again six months later, when their average BMI had reduced to 37kg/m². Their results were compared with those of 16 women of a normal weight – the "controls".

All of the women had normal neuropsychological tests. The obese women performed one of the tests more quickly after weight loss surgery, but it cannot be assumed this is a direct result of their weight loss. It could be they were faster simply because this was the second time they had done the test. The control group of women did not repeat the test, so we do not know if they also would have performed better.

Wednesday 27 August 2014

New computer systems to speed up x-ray scans at Northampton hospital

New computer systems to speed up x-ray scans at Northampton hospital

Patients at Northampton General Hospital (NGH) will have the chance to benefit from faster turnaround times on x-ray tests as a new computer system is introduced to deliver scans to doctors in other parts of the hospital. Northampton Chronicle

Smoker numbers in Northamptonshire down two per cent

Smoker numbers in Northamptonshire down two per cent

The number of smokers has decreased by two per cent in 12 months, latest statistics for Northamptonshire show. Northampton Chronicle

Trust hunts disk holding 42,000 records

Trust hunts disk holding 42,000 records

East Midlands Ambulance Service NHS Trust has admitted to losing a disc containing the confidential information of 42,000 patients. EHI News

Mindfulness therapy comes at a high price for some, say experts

Mindfulness therapy comes at a high price for some, say experts


Much-hyped therapy can reduce relapses into depression but it can have troubling side effects

In a first floor room above a gridlocked London street, 20 strangers shuffle on to mats and cushions. There's an advertising executive, a personnel manager, a student and a pensioner. A gong sounds softly and a session of sitting meditation begins. This is one of more than 1,000 mindfulness courses proliferating across the UK as more and more people struggling with anxiety, depression and stress turn towards a practice adapted from a 2,400-year-old Buddhist tradition.

Enthusiasm is booming for such mindfulness-based cognitive therapy (MBCT) courses, which anOxford University study has found can reduce relapses into depression by 44%. It is, say the researchers, as effective as taking antidepressants. It involves sitting still, focusing on your breath, noticing when your attention drifts and bringing it back to your breath and it is surprisingly challenging. Guardian

Continue reading...

Self-harm by mental health patients in NHS has risen by 56%, figures show

Self-harm by mental health patients in NHS has risen by 56%, figures show


Labour links rise in self-harm and suicide attempts to 'intolerable' pressure from staff and budget cutbacks

Growing numbers of people being treated in mental health units are harming themselves and trying to take their own lives, new NHS figures suggest.

The number of such incidents at 29 of England's 52 NHS mental health trusts rose from 14,815 in 2010 to 23,053 last year, an increase of 56% over four years. Guardian

Continue reading...

Overseas nurses 'face shorter tests'

Overseas nurses 'face shorter tests'

New rules mean nurses and midwives who have completed their training outside Europe will face shorter tests to check they are fit to work in the UK. BBC News

Survival rates for all common cancers improve across England

Survival rates for all common cancers improve across England

Survival rates for five common cancers in England have increased 'radically' over recent years, figures show, as officials suggest earlier diagnosis is behind the improvement. GP Online

Private hospitals should be put under the same scrutiny as NHS services

Private hospitals should be put under the same scrutiny as NHS services


Private hospitals must offer the same transparency on patient safety that the public demands from the NHS
Patient safety: How local NHS leaders can best use data

Earlier this week a report published by the Centre for Health and the Public Interest (CHPI) called for much greater transparency about the quality of healthcare in the private sector.

The health thinktank claimed that patients undergoing operations in private hospitals are sometimes exposed to risk from inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record keeping. Guardian
Continue reading...

London mental health web service planned

London mental health web service planned

London Councils and Public Health England are planning to establish an open access digital mental health service to help Londoners with untreated mental disorders. EHI News

Spine2 is alive

Spine2 is alive

The replacement for the NHS data spine, Spine2, went live over the bank holiday weekend. EHI News

Policy alert: NHS patient, visitor and staff car parking principles

Policy alert: NHS patient, visitor and staff car parking principles


These car parking principles suggest the provision of concessions to groups that need them such as disabled people, frequent outpatient attenders or visitors with relatives who are gravely ill. Department of Health
Document
Further information

'Ban E-cig use indoors,' says WHO

'Ban E-cig use indoors,' says WHO

The World Health Organization says there should be regulations preventing the use of electronic cigarettes indoors in public and work places. BBC News

Weight loss surgery 'reduces chance of Alzheimer's Disease'

Weight loss surgery 'reduces chance of Alzheimer's Disease'

Stomach stapling and gastric bands could reduce the chance of dementia, research sugggests. Telegraph

Friday 22 August 2014

NHS sickness absence rates fall further

NHS sickness absence rates fall further The latest NHS staff sickness absence rates released by the Health and Social Care Information Centre (HSCIC) show a decrease in overall sickness absence, falling to 3.95 per cent in April 2014 from 3.98 percent in April 2013. NHS Employers

Doctors may face 'tougher sanctions'

Doctors may face 'tougher sanctions' Failing doctors could be forced to apologise to patients under measures being considered by the medical regulator. BBC News

See also:

US Ebola patients out of hospital

US Ebola patients out of hospital One of the US aid workers who recovered from the Ebola virus says he is "thrilled to be alive" as he and another patient are discharged from hospital. BBC News

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Health experts' food poverty warning

Health experts' food poverty warning More people are suffering from malnutrition as a result of worsening food poverty, health experts warn. BBC News

'Fat and 30' link to dementia is inconclusive

'Fat and 30' link to dementia is inconclusive “People as young as 30 who are obese may be at greater risk [of dementia],” The Independent reports.

This UK study examined a set 14-year period (1998 to 2011) and looked at whether NHS hospital records documenting obesity in adults above the age of 30 were associated with subsequent hospital or mortality records documenting dementia in the remaining years of the study.

Overall there was actually no significant association between obesity and dementia in later life.

When the researchers broke down the data into 10-year age bands (30s, 40s, 50s and 60s) they found that people in these age groups had increased risk of dementia. However, it must be remembered that the researchers were not looking at lifetime dementia diagnoses, but only looking at diagnoses in the remaining years of the study. Very few people in the younger age groups would have developed dementia over the following few years.

For example, the study found more than a trebled risk of dementia for people with obesity in their 30s, but this was based on only 19 people who developed dementia during the remaining years of the study. Calculations based on small numbers may be less reliable and should be given less "weight".

As expected the greatest number of subsequent dementia diagnoses occurred in people who were 70 or above when obesity was assessed, and obesity did not increase dementia risk in these people.

Aside from any dementia link or not, overweight and obesity are well established to be associated with a variety of chronic diseases and a healthy weight should be the aim.

New drive to make GP information more accessible

New drive to make GP information more accessible NHS England consults on ‘accessible information standard’. OnMedica

NHS patients to be seen by 'doctors on the cheap'

NHS patients to be seen by  'doctors on the cheap' Patients will increasingly be seen by “physician associates” rather than doctors under Government plans despite fears they are “doctors on the cheap”, according to a report. The Independent

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All three parties must tackle mental health crisis now, says Alastair Campbell

All three parties must tackle mental health crisis now, says Alastair Campbell Britain “cannot wait another generation” to tackle the mounting crisis in the nation’s mental health, Alastair Campbell has said, in a challenge to all three political parties to put the issue at the heart of their election manifestos. The Independent

Thursday 21 August 2014

Can we ignore NHS charges any longer?

Can we ignore NHS charges any longer? This is the second in a series of guest blogs that we’ll be publishing in the run-up to the launch of the final report from the Commission on the Future of Health and Social Care in England.

Each blog will focus on one of the possible options for funding future health and social care considered in the commission’s interim report. Here, Andrew Haldenby and Cathy Corrie of independent think-tank Reform discuss why new NHS charges are necessary and why no political party wants to talk about them.

The commission will make its final recommendations on 4 September.

Guidance: Ebola: infection control and prevention for acute trust staff

Guidance: Ebola: infection control and prevention for acute trust staff Guidance is also available on the risk assessment and management of viral haemorrhagic fevers (VHF), including Ebola, from the VHF algorithm page. Public Health England

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Superbug measures 'lack evidence'

Superbug measures 'lack evidence' Researchers suggest some standard methods to reduce the spread of MRSA infections need to be re-evaluated as they may do more harm than good. BBC News

Keeping knowledgeable: how NHS chief executive officers mobilise knowledge and information in their daily work

Keeping knowledgeable: how NHS chief executive officers mobilise knowledge and information in their daily work This study aimed to investigate how chief executive officers of NHS trusts make decisions and mobilise particular knowledge and ‘evidence’ in the course of their day-to-day activities. National Institute for Health Research

Sepsis: Antibiotics 'not working'

Sepsis: Antibiotics 'not working' Patients are dying from sepsis because of a lack of effective antibiotics, an expert is warning. BBC News

Urgent care change pilots started

Urgent care change pilots started NHS England has established a series of pilots for a "system-wide transformation" of emergency services, including restructuring A&Es and enhancing the NHS 111 service. E-Health Insider

Could failure to breastfeed cause depression?

Could failure to breastfeed cause depression? Mothers who plan, but are unable, to breastfeed their babies are more likely to suffer from postnatal depression, report BBC News and The Independent.

A study of 14,000 women in England found that those who planned to breastfeed but had not managed to were two-and-a-half times more likely to develop postnatal depression, compared to women who had no intention of breastfeeding.

Around 1 in 10 women develop postnatal depression, which is not the same as the “baby blues”, but a serious illness that can affect a mother’s ability to bond with her baby. It can also affect the baby’s longer-term development.

It can develop within the first six weeks of giving birth, but is often not apparent until around six months. It’s important to get professional help if you think you may be suffering from this illness.

The study had several limitations. For example, both antenatal and postnatal depression were self-reported rather than clinically diagnosed, which may make the results less reliable.

Due to the nature of the study’s design, it cannot prove that not breastfeeding raises the risk of postnatal depression. However, it highlights the need to support new mothers who want to breastfeed but are unable to do so.

Common antibiotic linked to 'tiny' rise in heart deaths

Common antibiotic linked to 'tiny' rise in heart deaths An antibiotic given to millions of people in the UK to treat chest infections has been linked to an increased risk of heart death, report The Daily Telegraph and The Independent.

A Danish study of three antibiotics found the risk of death from any heart condition while taking the antibiotic clarithromycin is slightly higher than with penicillin V.

Clarithromycin is used for respiratory infections, and 2.2 million doses were prescribed in England in 2013. However, it is not recommended for people with abnormal heart rhythms.

Researchers compared the number of people who had a heart-related death after being put on a course of either clarithromycin, roxithromycin (not used in the UK) or penicillin.

The study, published online in the British Medical Journal, found there were an extra 37 cardiac deaths per 1 million courses of clarithromycin compared with penicillin.

But the risk was still very low. As this was a cohort study, it cannot prove that any of these deaths were as a result of taking clarithromycin, as it did not account for all of the other factors that could have influenced the results.

CCGs urged to fund epilepsy GPSI service to replace 'failed' QOF indicators

CCGs urged to fund epilepsy GPSI service to replace 'failed' QOF indicators Commissioners should fund additional GPSI-run epilepsy services in the community to address shortcomings in care following the scrapping of QOF indicators for the condition, according to a GP expert. GP Online

Emergency admissions for typical primary care conditions drop

Emergency admissions for typical primary care conditions drop Asthma admissions rise sharply from August to September. OnMedica

How the NHS can deal with soaring drugs prices

How the NHS can deal with soaring drugs prices National Institute of Clinical Excellence decisions have sparked debate over funding the spiraling cost of medication

Last week the National Institute of Clinical Excellence (Nice) ruled that offering abiraterone, demonstrated to extend life by up to four months in advanced prostate cancer, was not cost effective as a treatment when given before chemotherapy. Described as a kick in the teeth by Prostate Cancer UK, the decision comes after a similar Nice ruling the week before on kadcyla, shown to prolong life for a certain group of breast cancer patients. Blockbuster drugs with ever increasing benefit are expensive, and there are lots on the way.

To allow room for financing such drugs, first, doctors need to get back to the principle of prescribing drugs from the current arsenal of pharmaceuticals that they can be confident will offer benefit. A study from University College London and Public Health England suggests that inappropriate antibiotic prescriptions for viral coughs and colds is on the rise, raising the spectre of resistant strains of bacteria. For such common ailments, simple bed rest is often the best prescription. The lengthy appointment and explanation needed to justify the absence of a prescription requires time that todays NHS doctors have less of. All too often, I fear, a prescription playing on the dogma of taking a medicine being a solution to an ailment, is just easier.A far more sinister trend, leading to doctors switching to newer, more expensive drugs over older, cheaper ones, is a growing feeling that in some cases we are being misled by drug manufacturers. To make the right choices for their patients, doctors need to be able to trust the evidence of patient benefit. Randomised controlled trials, considered the gold standard for testing the efficacy of a new drug against conventional treatment or placebo, are expensive and time consuming to run, requiring extensive drug manufacturer sponsorship to coordinate results across continents and thousands of patients. Continue reading... The Guardian

The 'suicide tourists': 126 Brits opt for assisted death in Switzerland since 2008

The 'suicide tourists': 126 Brits opt for assisted death in Switzerland since 2008 British people are the second biggest group of “suicide tourists”, according to a new study, which shows that the number of people travelling to assisted dying clinics in Switzerland has doubled in three years. The Independent

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Wednesday 20 August 2014

NHS Nene in Northamptonshire brings strict cost controls - BBC News

NHS Nene in Northamptonshire brings strict cost controls Better control of costs for people in Northamptonshire needing continuing care helped a clinical commissioning group (CCG) avoid a £39.9m overspend, according to its first annual report. BBC Northamptonshire

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Patient safety in private hospitals - the known and the unknown risks

Patient safety in private hospitals - the known and the unknown risks Patients undergoing operations in private hospitals may be put at risk from inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record-keeping according to a new report from the Centre for Health and the Public Interest.

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Update on Urgent and Emergency Care Review

Update on Urgent and Emergency Care Review Today NHS England has published an update on the Urgent and Emergency Care Review, which builds on NHS England’s future vision for urgent and emergency care in Transforming urgent and emergency care services in England. Urgent and Emergency Care Review End of Phase 1 Report.

This work will make it easier for patients to get the right care, in the right place, first time. The vision is simple: firstly, for those people with urgent but non-life threatening needs we must provide highly responsive, effective and personalised services outside of hospital - as close to people’s homes as possible, minimising disruption and inconvenience for patients and their families. Secondly, for those people with life threatening needs we should ensure they are treated in centres with the very best expertise and facilities.

This update sets out what the Review has been doing since we last reported in November 2013. It reports on progress with NHS England’s work with local commissioners and the development of their five year strategic and two year operational plans as well as updates on planning to develop demonstrator sites to trial new models, including the new NHS 111 service specification.

To underpin these changes, a new approach to reimbursing providers of health and care services is essential. Today NHS England and Monitor have therefore also published a discussion documentsetting out the options for payment to kick off discussion.

Numbers using NHS Stop Smoking Services in decline for the second year

Numbers using NHS Stop Smoking Services in decline for the second year Success rate remains stable with over 50 per cent giving up smoking. Health & Social Care Information Centre

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Mental health care 'in dark ages'

Mental health care 'in dark ages' Mental health services for young people in England are "stuck in the dark ages" and "not fit for purpose", according to a government minister. BBC News

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Income from private patients soars at NHS hospital trusts

Income from private patients soars at NHS hospital trusts NHS trusts accused of exploiting raised limit on numbers of paying patients amid health service's 'creeping privatisation'

Some of Britain's leading hospitals stand accused of exploiting the coalition's controversial lifting of the cap on the number of private patients they can treat to increase their income as part of a "creeping privatisation" of the NHS.

As new figures show that some hospitals have seen a big increase of up to 40% in their private income since the cap was lifted, Labour accused ministers of presiding over a scandal of declining standards for NHS patients while allowing paying patients to enjoy high standards of care. Continue reading... The Guardian

Life on Ebola front line

Learning disabled not being discharged into the community

Learning disabled not being discharged into the community In spite of the Winterbourne View scandal too many patients still face hospital rather than community treatment. OnMedica

Guidelines to ensure safe staffing levels in the NHS fall short

Guidelines to ensure safe staffing levels in the NHS fall short The Nice guidelines omit recommendations for minimum nurse staffing levels and much more is needed.

In July the National Institute for Health and Care Excellence (Nice) issued guidance on safe nurse staffing for hospitals in England. This work was commissioned by the government in response to recommendations in the Francis inquiry into the mid-Staffordshire NHS trust. Nice recommended a systematic approach to matching nurse staffing to patient need, using red-flag indicators to detect staffing shortfalls. A ratio of 1:8 is cited as a high-risk level that should trigger urgent review. But it did not offer guidance on the minimum nurse staffing levels needed to deliver safe or high quality patient care.

Writing in the Guardian, economist Graham Cookson says that to do so would have been a mistake. In contrast Roy Lilley, an experienced NHS manager describes Nices failure to do so as ridiculous. Legally binding minimum levels, adjusted for specialty, that can be flexed up (but never down) are essential, he argues; we have minimum ratios for airlines, crèches, and football grounds, so why not hospital wards? Certainly the call for minimum nurse-to-patient ratios in the UK is getting louder. The Royal College of Nursing congress has voted for mandated minimums, and a Unison survey found 92% supported minimum staffing levels. A new law on minimum nurse staffing levels is now proposed in Wales. So did Nice get it right in not setting minimums for England, or is their guidance, as Roy Lilley puts it, as useful as a chocolate tea-pot? Continue reading... The Guardian

Stroke patients are more likely to die if fewer nurses at weekends

Heart disease rates fall across Europe

Heart disease rates fall across Europe Deaths from heart disease and strokes are declining across Europe, thanks to falling smoking rates and the use of preventative statins, according to a major new report. The Independent

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Revealed: The most devastating failures by public services

Revealed: The most devastating failures by public services A woman whose husband died hours after one of England’s biggest NHS hospitals missed several chances to diagnose his fatal condition was given just £2,000 in compensation, according to files published today, that highlight “devastating” failures by public services. The Independent

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Tuesday 19 August 2014

Lost days due to stress rise by 70%

Lost days due to stress rise by 70% Sickness caused by stress rises by 70% among East of England public sector workers over five years, the BBC finds. BBC Northamptonshire

Nice one NICE: developing the policy narrative on preventing disability, frailty and dementia in later life

Nice one NICE: developing the policy narrative on preventing disability, frailty and dementia in later life As we commemorate the 100th anniversary of the outbreak of the First World War, it is easy to forget that in 1914, UK life expectancy at birth was only 49 for men and 53 for women. Advances in societal wealth, nutrition, employment, environmental health, housing, perinatal care and preventative and curative medical treatment mean that the era in which those servicemen and their families lived is almost unrecognisable. Life-expectancy is now 79 for men and 83 for women, and when we reach the age of 65 we can expect to live another two decades on average.

Living longer lives is a cause for celebration but there are still major inequalities in life expectancy and healthy life expectancy at birth, in rates of premature deaths, and in life expectancy at 65 between different socioeconomic groups. We also face a rising prevalence of long-term conditions, dementia, disability and frailty related to rapid population ageing, which has big implications both for individuals and for health and social care systems.

Guidance: Who to screen for MRSA

Guidance: Who to screen for MRSA The guidance, from the Expert Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI), recommends a more efficient and effective method for identifying and managing high-risk patients who have tested positive for MRSA. However, NHS Trusts need to take into account local risks as well as the recommendations so they can get the best results in their hospitals.

This guidance draws on the outputs of the National One Week (NOW) study and could be used to inform policy making decisions should the prevalence of MRSA increase. Department of Health

VIDEO: The debate over competition in the NHS

VIDEO: The debate over competition in the NHS Recent large contracts are fuelling the debate over competition for services within the NHS. BBC News

VIDEO: Inside Liberia Ebola treatment centre

VIDEO: Inside Liberia Ebola treatment centre Following earlier denials, Liberia has admitted that 17 suspected Ebola patients are "missing" after a health centre in the capital was looted. BBC News

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Records access may reduce GP pressures

Records access may reduce GP pressures Giving patients access to their GP records can reduce demand for traditional appointments and telephone calls to practices, a research study has suggested. E-Health Insider

Bone marrow drug could treat alopecia

Bone marrow drug could treat alopecia “Alopecia sufferers given new treatment hope with repurposed drug,” The Guardian reports.

Alopecia is a type of autoimmune condition where the body’s own immune cells start to attack the hair follicles for an unknown reason, leading to hair loss.

This new research actually involved two phases, one involving mice and one involving humans.

The researchers identified the specific type of immune cell (CD8+NKG2D+ T cells) that is involved in this autoimmune process, and identified the signalling pathways that stimulate the activity of these cells.

The researchers then demonstrated that using molecular treatments to block these signalling pathways was effective in preventing and reversing the disease process in mice genetically engineered to develop alopecia.

These findings in mice were followed by promising results in three people with moderate to severe alopecia. These people were treated with ruxolitinib, which is currently licensed in the UK to treat certain bone marrow disorders. All three patients demonstrated “near-complete hair regrowth” after three to five months of treatment.

Child mental health bed boost

Child mental health bed boost NHS England to make more beds available following sustained criticism of child mental health services. OnMedica

Antibiotics wrongly prescribed by many GPs, survey finds

Antibiotics wrongly prescribed by many GPs, survey finds Doctors giving out antibacterial medication, even when unnecessary, to satisfy patients or cover uncertain diagnosis

Almost half of British GPs have admitted prescribing antibiotics even though they know they will not treat the patients condition, a survey shows.

Ninety per cent of doctors who responded to a recent questionnaire said they felt pressure from patients to hand out the antibacterial medication. Continue reading... The Guardian

Monday 18 August 2014

'Red flag' death symptom missed

'Red flag' death symptom missed A doctor missed a "red flag symptom" as he assessed a toddler who died three days later, a disciplinary panel finds. BBC Northamptonshire

Compensation payouts to Northampton General Hospital patients total almost £24m

Compensation payouts to Northampton General Hospital patients total almost £24m Compensation payments to Northampton General Hospital patients totalled £23.9 million over five years, latest figures showed. Northampton Chronicle and Echo

One in five arriving at Northampton General Hospital’s A&E could not see a GP

One in five arriving at Northampton General Hospital’s A&E could not see a GP One in five people who arrive at Northampton General Hospital’s A&E do so because they cannot see a GP, an independent survey suggests. Northampton Chronicle and Echo

Work underway on two more A&E units at Northampton General Hospital

Work underway on two more A&E units at Northampton General Hospital Work has started on more improvements to Northampton General Hospital’s emergency department as the new dedicated children’s treatment rooms are completed. Northampton Chronicle and Echo

New model process flowchart for raising concerns

New model process flowchart for raising concerns We have developed a model process flowchart for raising concerns which you can freely download and adopt to reflect your local policy and process. NHS Employers

Developing a high-performance support workforce in acute care: innovation, evaluation and engagement

Developing a high-performance support workforce in acute care: innovation, evaluation and engagement This study aimed to identify and facilitate the development of innovative practice as it relates to support worker roles in an acute health-care setting; evaluate various acute trust policies and practices designed to improve the efficiency and effectiveness of stakeholder interaction with support worker roles; and to secure the engagement of various stakeholders in sharing knowledge, practice and learning on support worker roles. National Institute for Health Research

Salmonella outbreak investigated

Salmonella outbreak investigated Public Health England is investigating a Salmonella outbreak which has affected more than 150 people in England over the past few months. BBC News

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GP trainees shun traditional employment

GP trainees shun traditional employment Survey shows just 15% interested in a conventional partnership work. OnMedica

Half of voters happy to pay more tax to fund NHS poll

Half of voters happy to pay more tax to fund NHS poll Public's willingness to pay extra tax to help the NHS reaches highest level in over a decade.

Almost half of voters say they would be happy to pay more income tax as long as the money went directly to the NHS, which is facing a £30bn gap in its finances by 2020.

Polling firm ComRes found that 49% of people would be prepared to pay more tax to help fund the health service, one in three (33%) people said they would not be ready to do so, and 18% did not know either way. Continue reading... The Guardian

Cancer death rates drop by a third

Cancer death rates drop by a third Combined death rates for breast, bowel, lung and prostate cancer, which account for half of all cancer deaths in UK, have dropped. The Daily Telegraph

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Millions needlessly clogging up A&E

Millions needlessly clogging up A&E Millions of people are needlessly attending overstretched A&E units, investigation finds, as new figures reveal 70 per cent of people who attend hospital casualty units in many areas leave with just advice. The Daily Telegraph

Ebola outbreak: College campuses on alert as new term begins

Ebola outbreak: College campuses on alert as new term begins Universities in the UK have been put on alert to be ready for a potential outbreak of the Ebola virus when the new term starts in September. The Independent

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Friday 15 August 2014

Can CCGs become accountable care organisations?

Can CCGs become accountable care organisations? 'We need clinical commissioning groups to become accountable care organisations' – that’s what Jeremy Hunt said recently in parliament and during a speech at the Commissioning Show.

Jeremy Hunt is not the only one saying this kind of thing. I’ve heard representatives from acute hospitals, GP federations and CCGs all make the same claim: they want to become an accountable care organisation (ACO).

But what does this really mean? The basic concept of an ACO is that a group of providers agrees to take responsibility for all care for a given population for a defined period of time under a contractual arrangement with a commissioner.

Essentially accountable care organisations, which have emerged from the United States over the past few years, are the next generation of managed care, but with a fundamental difference. While managed care initiatives in the 1980s and 1990s handed over a capitated contract to a network of providers to manage a defined population, they were not accountable for improving care, or even delivering care (networks quickly realised they could save money by restricting access). Learning from the scars of this legacy, these more recent managed care initiatives have included a stipulation to improve quality.

Research and analysis: Review of radiation dose issues from the use of CT in the UK

Research and analysis: Review of radiation dose issues from the use of CT in the UK In this report, COMARE presents a comprehensive review of the radiation dose issues associated with CT scans in the UK. The implications of the increase in the numbers of CT scans in the UK are considered in the report, with focus on the number of younger patients undergoing CT scans, who have greater sensitivity to x-rays. The report provides an update on the radiation protection aspects of justification (balancing risk and benefit) and optimisation (balancing the risk from the radiation dose with the quality of the image). Department of Health

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Prostate drug ruling 'a fiasco'

The front line of the UK's Ebola prevention efforts

The front line of the UK's Ebola prevention efforts Hugh Pym on how Porton Down is helping the UK get ready. BBC News

Failing GPs: A Pandora's Box?

Is UK obesity fuelling an increase in 10 cancers?

Is UK obesity fuelling an increase in 10 cancers? “Being overweight and obese puts people at greater risk of developing 10 of the most common cancers,” reports BBC News.

The news is based on research using information in UK GP records for more than 5 million people, to see whether body mass index (BMI) was associated with 22 types of common cancers.

The researchers found that increasing BMI was associated with increased risk of several types of cancer. Some of these associations weren’t linear, meaning that there wasn’t always a steady increase in cancer risk with increased BMI. Additionally, some of the links seemed to be dependent on individual patient characteristics, such as gender and menopausal status.

The researchers estimated that 41% of uterine and 10% or more of gallbladder, kidney, liver and colon cancers could be attributable to excess weight.

However, increasing BMI was also found to decrease the risk of some types of cancer (such as prostate and premenopausal breast cancer).

The researchers suggest that BMI affects cancer risk through a number of different processes. However, the study was not able to demonstrate that being overweight or obese directly increase or decrease risk of these cancers, nor is it able to show the biological reasons for any of the associations found.

It is also not able to account for all possible factors that contribute to cancer risk, such as genetics and lifestyle factors.

Cancer patients: best and worst places to live for survival revealed

Cancer patients: best and worst places to live for survival revealed Up to 6,000 patients could be dying of cancer early because of variations in care around the country, charity warns. The Daily Telegraph

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900,000 elderly needing care left to fend for themselves

900,000 elderly needing care left to fend for themselves Age UK estimates that one in three older people in England and Wales who struggle with tasks as basic as washing and dressing get no care. The Daily Telegraph

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NHS faces huge bill over private provider’s botched eye operations

NHS faces huge bill over private provider’s botched eye operations Dozens of NHS patients have been left with damage to their eyes, including partial loss of sight, after undergoing routine cataract operations which had been outsourced to a private provider. The Independent

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Thursday 14 August 2014

Widespread support for electronic health record data sharing

Widespread support for electronic health record data sharing Most think it will improve care and curb medical errors, poll indicates. OnMedica

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New data show rates of common NHS operations and resulting patient benefit

New data show rates of common NHS operations and resulting patient benefit The Health and Social Care Information Centre has published information about four common NHS operations, and patient feedback about the health outcomes of these operations.

Guidance: Mutuals in health: Pathfinder Programme

Guidance: Mutuals in health: Pathfinder Programme Chris Ham, Chief Executive of the King’s Fund, recently published an independent review of staff engagement and empowerment in the NHS. The review recommended that government support a pathfinder programme to help NHS trusts and foundation trusts explore the benefits of the mutual model.

In response to the review’s recommendation, Department of Health and Cabinet Office launched a joint initiative on 15 July 2014 to support health and care organisations explore the potential advantages of mutualising their services. The Pathfinder Programme is designed to support a small number of pioneering trusts, either individually or in partnership. It is open to all foundation trusts and NHS trusts.

Expressions of Interest (EOI) are open until 4 September 2014. To participate, send your expression of interest form to mutualsinhealth@cabinet-office.gsi.gov.uk.

Drawing on a £1 million fund, trusts participating in the programme will have technical, legal and consultancy support to help them:

  • understand what mutualisation means for them
  • find solutions to practical barriers to becoming mutual organisations
The details of this support will be developed in partnership with each trust.

If you have any questions about the Pathfinder Programme, contact: mutualsinhealth@cabinet-office.gsi.gov.uk. Department of Health

The engagement cycle

The engagement cycle This model was developed by InHealth Associates to support commissioners aiming to engage with patients and the public throughout the commissioning cycle. It has been updated to align with current statutory guidance, new commissioning arrangements and current healthcare challenges.

Failing GP practices face closure

Failing GP practices face closure Failing GP practices will face closure under plans being unveiled in England by the Care Quality Commission. BBC News

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Two-thirds of Britons with depression get no treatment

Two-thirds of Britons with depression get no treatment If these figures related to cancer patients the nation would be in uproar, says new president of Royal College of Psychiatrists

Less than a third of people with common mental health problems get any treatment at all a situation the nation would not tolerate if they had cancer, according to the incoming president of the Royal College of Psychiatrists.

While the health secretary, Jeremy Hunt, has pledged to deliver "parity of esteem" for mental and physical health services, the treatment gap is now so huge that it may prove impossible to bridge in the current financial climate, said Professor Simon Wessely of King's College London in his first interview since election to the post. Continue reading... The Guardian

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Worst-hit GP surgeries to gain bailout as NHS admits reforms strike poor hardest

Worst-hit GP surgeries to gain bailout as NHS admits reforms strike poor hardest The NHS in England has admitted that its new system for funding GP practices may discriminate against poorer patients, as it announced a bailout fund to save surgeries in some of the most deprived parts of the country. The Independent

Ebola outbreak: Graphics reveal how deadly virus spread from two-year-old in Guinea to be international ‘public health emergency’

Wednesday 13 August 2014

Crisis response falls team: reducing admissions and repeat falls

Crisis response falls team: reducing admissions and repeat falls A case study looks at how EMAS is tackling demand on hospitals and the potential negative outcomes associated with hospital admission in Northamptonshire. NICE Evidence Services

Staff Friends and Family Test early experiences

Staff Friends and Family Test early experiences A new briefing document has been created following discussions with HR Directors who shared their ideas and emerging lessons about the Staff Friends and Family Test. NHS Employers

2.2 million pounds spent every day on diabetes drugs in primary care

Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?

Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges? Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for long-term care. This paper investigates the extent to which higher supply of nursing home beds or lower prices can reduce hospital bed blocking. It uses new local authority level administrative data from England on hospital delayed discharges in 2010-13. The results suggest that delayed discharges do respond to the availability of care-home beds but the effect is modest: an increase in care-homes bed by 10% (250 additional beds per local authority) would reduce delayed discharges by about 4%-7%. It also finds strong evidence of spillover effects across local authorities: higher availability of care-homes or fewer patients aged over 65 in nearby local authorities are associated with fewer delayed discharges. Centre for Health Economics

Canada to give WHO Ebola vaccine

Canada to give WHO Ebola vaccine Canada says it will donate up to 1,000 doses of an experimental Ebola vaccine to help battle the disease's outbreak in West Africa. BBC News

Council leaders call for overhaul of children's mental health services

Council leaders call for overhaul of children's mental health services Local Government Association says young are falling through gaps caused by funding cuts.

Services for children with mental health problems need a complete overhaul so youngsters and their families are not forced to deal with a complex system at such a difficult time in their lives, council leaders have said.

The current "fragmented" system means children are forced to navigate myriad different mental health organisations to access care, the Local Government Association (LGA) said. Continue reading... The Guardian

NHS cancels 16,000 operations at the last minute in just three months: Total postponed for non-medical reasons is highest for nine years

NHS cancels 16,000 operations at the last minute in just three months: Total postponed for non-medical reasons is highest for nine years A staggering 15,661 scheduled operations were cancelled at the last minute for non-medical reasons between April and June, according to official figures. Daily Mail 

Heart patients to be given placebo by paramedics in controversial trial

Heart patients to be given placebo by paramedics in controversial trial Patients whose hearts stop will be given a placebo instead of adrenalin by paramedics during attempts to save their lives in a study branded 'ethically questionable' The Daily Telegraph

Philip Morris International threatens to sue Government if plain packaging introduced

Philip Morris International threatens to sue Government if plain packaging introduced One of the world’s largest tobacco companies is threatening to sue the Government for billions of pounds in compensation if it makes plain cigarette packaging compulsory. The Independent 

Essex GP surgery tells patients not to post critical comments on Facebook and Twitter

Essex GP surgery tells patients not to post critical comments on Facebook and Twitter A GP surgery in Essex has told its patients not to use social media to complain about service on Facebook and Twitter, warning of a “zero tolerance policy”. The Independent

Tuesday 12 August 2014

Public invited to have their say on Northamptonshire hospital ahead of inspection

Public invited to have their say on Northamptonshire hospital ahead of inspection Patients are being asked to tell a watchdog their views on Kettering General Hospital ahead of an inspection. Northampton Chronicle and Echo

Volunteer groups to get £2m for vulnerable patients this winter

Volunteer groups to get £2m for vulnerable patients this winter The groups, including Age UK, British Red Cross and Royal Voluntary Service, will run local projects that target those people most at risk of admission to hospital and who need extra support when they are discharged, such as older people living alone without a support network. More .... NHS England

Hooper inquiry into how the GMC treats whistleblowers

Hooper inquiry into how the GMC treats whistleblowers Information about the GMC's inquiry into whistleblowing lead by Sir Anthony Hooper NHS Employers

Liberia to receive Ebola trial drug

Liberia to receive Ebola trial drug Liberia will receive an untested experimental drug, Zmapp, to treat people infected with Ebola, the government says following a request to the US. BBC News

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Exercise may cut breast cancer risk, study finds

Exercise may cut breast cancer risk, study finds "Exercise lowers risk of breast cancer after menopause," reports The Independent. This and similar headlines were sparked by a large study of postmenopausal teachers that found increased recreational activity was associated with a 10% decrease in the risk of breast cancer.

The risk reduction eroded among some women who became less active over the years, suggesting keeping up a certain level of activity might be important in maintaining the benefits.

The study used questionnaires to estimate the levels of walking, cycling and sport the women did outside of work.

It found women who did the equivalent of walking at least four hours a week or doing sport for two hours a week had a reduced risk of breast cancer. Factors such as body mass index (BMI) did not change the results.

However, the majority of women in the study had a healthy BMI and were teachers, so the results may not be applicable to all postmenopausal women.

Lack of physical activity and excess body fat have been linked to an increased risk of many cancers, including breast, colon, endometrial (lining of the womb) and prostate cancer, as well as heart disease, stroke and diabetes.

How technology could help monitor and treat mental health conditions

How technology could help monitor and treat mental health conditions Technology has the potential to make significant and cost-effective contributions to mental healthcare

Could digital treatments meet mental health service users' needs?

Mental health care is often described as the Cinderella of medicine overlooked, disparaged, and generally neglected. In the UK, mental healthcare is the single biggest item on the NHS budget (£12.16bn in 2010/11), but in practice this means that only about 11% of the overall spend is allocated to deal with 23% of the disease burden. Recent cuts have also hit mental health care significantly harder than acute hospitals, creating a combination of falling capacity and rising demand. Mental healthcare appears to suffer from the same stigma in policy circles as individuals with schizophrenia and bipolar disorder experience in private life. And just as stigma leads to worse outcomes for individuals with mental health problems, the underfunding of mental health care leads to higher long-term costs for the NHS.

If things look bad at home, they're a lot worse elsewhere. High-income countries such as Britain and America spend an average of £26.71per capita on mental healthcare; by contrast, low-income countries manage only 12p, and spend most of that on inpatient beds rather than more effective community care. Wealthy nations have one psychiatrist for every 11,640 people; the poorest countries barely have one for every two million. Undertreatment of mental health problems is a problem everywhere, but it reaches epic proportions in the poorest countries, where as few as one in 10 sufferers receive treatment. Continue reading... The Guardian