The £12.7bn scheme to give every patient in England an electronic medical record will cease to be a centralised national programme, Simon Burns, the health minister, has announced.
Instead, the job will be devolved to the NHS, with hospitals allowed to introduce “smaller, more manageable change” using “a more plural, supplier base” than the two main contractors BT and CSC.

The moves will save another £700m on top of the £600m that the Labour government said it would cut from the cost of the programme, Mr Burns said in a written ministerial statement.

According to Christine Connelly, the health department’s director-general for informatics, the £1.3bn savings to reduce the programme’s overall estimated cost to £11.4bn will come from a variety of sources.

They include an anticipated – though still to be negotiated – £500m cut in the cost of CSC’s £3bn deal to supply systems to most of the north, east and west of the country; a £112m saving already booked from reducing the scope of BT’s deal in London; and £200m being taken out of the national programme’s own costs.

In addition, there will be an anticipated £500m reduction on an estimate that it would cost the NHS locally £3.5bn to install the systems.

The “core assumption” of the programme will now be one of “connecting all systems together rather than replacing all systems,” Mr Burns said, allowing NHS trusts to keep those that match modern standards while moving forward “in a way that best fits their own circumstances”.

The promise of a more devolved approach was welcomed by critics of the programme and the NHS Confederation. But both struggled to be clear about the implications.

Richard Bacon, a Conservative member of the Commons’ public accounts committee, said: “The big unanswered question is when it is all finished, what will we have got for all the money? There is still some £5bn in the programme to be spent, but it was meant to deliver something very special.”

Mr Burns said that in spite of “more plural” suppliers, the existing contracts with BT and CSC that have huge penalty break clauses “will be honoured”. Frances Blunden, the NHS Confederation’s IT specialist, said it was “a fair question” to ask “where will money come from for a wider choice of suppliers if the existing deals are to be honoured?”.

The statement does, however, represent something of a U-turn for the Conservatives, who had threatened ahead of the election to scrap all the programme’s central databases. The existing national infrastructure is to be kept, although a review of the national summary record is still underway, focusing on its contents and patient consent.

“The early indications [from the review] are that we are past the point of should we or shouldn’t we have one,” Ms Connelly said, “although that question will be asked”.

From: http://www.ft.com/cms/s/0/785e2f70-bc41-11df-8c02-00144feab49a.html

A political row has erupted after Andrew Lansley the health secretary was accused of making “a significant U-turn” over plans to scrap NHS Direct, in the face of widespread public anger.
Andrew Lansley said that NHS Direct would remain but that its telephone number would be replaced so that from 2013 people could call 111 for non-emergencies and 999 for emergencies.

“I have not announced plans to scrap NHS Direct. I have announced plans to phase out the NHS Direct number,” the health secretary said in a letter.

This appears to contradict statements from the Department of Health last month, including to the BBC, that said the service would be scrapped. The new 111 helpline is already being piloted in the north-east of England.

However, there are concerns that fewer medical staff will be employed by the new service. NHS Direct employs 3,400 people, 40% of whom are trained nurses. It was reported that the ratio for the new helpline would be lower.

The threat to the telephone service, which costs £123m a year to run, provoked an immediate backlash. In the fortnight since the story broke, more than 16,000 people have signed a petition to save NHS Direct, which provides general health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24-hour chemists.

Lord Prescott, the former deputy prime minister, played an active role in the campaign – including changing his Twitter picture to a “Save NHS Direct” badge.

Significantly, the Royal College of Nursing said it would be “shortsighted” of ministers to axe a service that had saved the NHS more than £200 million by dispensing advice over the phone.

Labour attacked Lansley for a “significant U-turn” that had seen the health secretary “rowing back” from previous statements. “It’s an incredible victory for the campaign to save NHS Direct,” said Andy Burnham, Labour’s leadership contender and spokesman for health.

A series of letters between Lansley and Burnham, the previous health secretary, reveals a combative exchange. Burnham accused his Tory counterpart of “misrepresenting his position” as Lansley claimed that the 111 number was Labour’s idea and he was “getting on with what you failed to do”.

In a statement the health secretary said: “This is the latest political stunt from [Burnham]. He seems more concerned with trying to boost his leadership campaign than discussing our policies accurately.”

Unions warned that the future of medical staffing levels in the new service would remain an issue. Dave Prentis, general secretary of Unison, said: “Staff will still be confused and worried the government may have another change of heart. I would like a guarantee from the health minister that the 1,300 nurses working for NHS Direct will still have a job there this time next year.”

Despite its popularity, the medical establishment has been divided over the benefits of phone line. Earlier this summer British Medical Association chairman Dr Laurence Buckman said that getting rid of NHS Direct could be one way of cutting back on spending — adding that the “expensive” phoneline delayed healthcare reaching patients.

From: http://www.guardian.co.uk/nhs-direct-closure-Andrew Lansley backtracks

The researchers say that movements associated with good dancing may be indicative of good health and reproductive potential.  Their findings are published in the Royal Society journal Biology Letters.
“When you go out to clubs people have an intuitive understanding of what makes a good and bad dancer,” said co-author Dr Nick Neave, an evolutionary psychologist at Northumbria University, UK.

“What we’ve done for the very first time is put those things together with a biometric analysis so we can actually calculate very precisely the kinds of movements people focus on and associate them with women’s ratings of male dancers.”

Dr Neave asked young men who were not professional dancers, to dance in a laboratory to a very basic drum rhythm and their movements with 12 cameras.

These movements were then converted into a computer-generated cartoon – an avatar – which women rated on a scale of one to seven. He was surprised by the results.

“We thought that people’s arms and legs would be really important. The kind of expressive gestures the hands [make], for example. But in fact this was not the case,” he said.

We found that (women paid more attention to) the core body region: the torso, the neck, the head”

“We found that (women paid more attention to) the core body region: the torso, the neck, the head. It was not just the speed of the movements, it was also the variability of the movement. So someone who is twisting, bending, moving, nodding.”

Movements that went down terribly were twitchy and repetitive – so called “Dad dancing”.

Dr Neave’s aim was to establish whether young men exhibited the same courtship movement rituals in night clubs as animals do in the wild. In the case of animals, these movements give information about their health, age, their reproductive potential and their hormone status.

“People go to night clubs to show off and attract the opposite sex so I think it’s a valid way of doing this,” Dr Neave explained.

“In animals, the male has to be in good physical quality to carry out these movements. We think the same is happening in humans and certainly the guys that can put these movements together are going to be young and fit and healthy.”

Dr Neave also took blood samples from the volunteers. Early indications from biochemical tests suggest that the men who were better dancers were also more healthy.

From: http://www.bbc.co.uk/good dancing sign of a healthy male

An NHS manager unfairly dismissed “as a whistle blower” over plans to relocate cancer services out of his county has been awarded £1.2m in compensation.
John Watkinson, the chief executive of the Royal Cornwall Hospital Trust (RCHT) from January 2007 until April 2009, claimed he was fired because he was about to blow the whistle on legal advice suggesting the transfer of services to neighbouring Devon may have been unlawful without a full public inquiry.

A tribunal earlier this year ruled the 55-year-old had been unfairly ousted from his £148,000 a year post and should receive £67,250 after the trust failed to follow proper procedures in his dismissal.

On Friday it ruled Mr Watkinson should also receive £1.2 million for the whistle-blowing part of this claim. That award is now subject to an appeal by both the RCHT and Strategic Health Authority (SHA).

A 37-page judgement by the Exeter employment tribunal levels severe criticism at the RCHT and the SHA, saying witnesses for the trust appeared to be “unable or unwilling to give straightforward answers to simple questions”.

The panel criticised the fact that key witnesses from the SHA including chief executive Sir Ian Carruthers and Chairman Michael Pitt were not called to give live evidence.

Mr Watkinson, from Truro, described the latest ruling as “bittersweet”, adding:”Although the award is substantial it cannot replace the 35 year long NHS career which I expected to last another 12 years to my retirement.

“It seems I can hold out little or no hope of a senior role in the service to which I have dedicated my professional life.”

He began his career as a hospital porter in 1974 and said the judgement had “restored my good name and reputation”.

The RCHT refused to comment because of the whistle-blowing appeal although it accepted it had unfairly dismissed its former chief.

From:  http://www.telegraph.co.uk/Hospital-whistle-blower-awarded-1.2m-compensation-over-sacking

Health Direct asks if you had a good weekend- as hospital admissions due to alcohol have risen by 825 a day in five years to almost a million. There were 945,469 admissions to hospital for alcohol-related harm in England in 2008/09.A survey by the North West Public Health Observatory also revealed that more than a quarter of drinkers exceed healthy limits every week, making us a nation of irresponsible boozers.

The findings came as experts recommended a UK-wide price limit on drink should be brought in to try to curb alcohol misuse.

The Alcohol Commission, which was set up by the Labour Party in Scotland, has recommended a ban on selling drink at below the “floor price” of the cost of production, plus the cost of duty and VAT.

In the study, northerners were found to be the hardest drinkers but the most alcohol-related crimes were committed in London.

The academics, based at Liverpool John Moores University’s Centre for Public Health, published their Local Alcohol Profiles for England (Lape 2010) report.

Professor Mark Bellis, the observatory’s director, said: “The price we pay for turning a blind eye to the real extent of alcohol abuse across England is reflected in the new Local Alcohol Profiles for England and it is a price that is paid especially by the poorest communities.

“The English death toll from alcohol now exceeds fifteen-and-a-half thousand people every year.

“It is time to recognise that we are not a population of responsible drinkers with just a handful of irresponsible individuals ruining it for others.

“Over one in four drinkers exceed weekly limits according to national surveys and alcohol sales figures suggest the number is much higher.

“At weekends, by the early morning hours our city centres do not have just a few drunk individuals in them – actually most people are drunk yet continue to be able to buy alcohol despite such sales being illegal.

“We need to see the real cost of alcohol reflected in the price it is sold at and the warnings about the dangers that alcohol represents not relegated to a tiny corner in alcohol adverts, but written large enough for people to recognise the seriousness of the risks.”

Key indicators such as healthcare, criminal justice, benefits claimants, drinking patterns and deaths were considered in mapping the nation’s booze breakdown.

Researchers also found:
:: Two thirds (65%) of all local authorities suffering the highest levels of overall harm are in England’s North West and North East.

:: The 10 local authority areas with the highest levels of combined alcohol-related harm, in descending order, are: Manchester, Salford, Liverpool, Rochdale, Tameside, Islington, Middlesbrough, Halton, Oldham and Blackpool.

:: By comparison the East and South East contained two thirds (65%) of all the local authorities with the lowest overall harm. The 10 local authorities with the lowest levels of alcohol-related harm, in ascending order, are: Broadland, East Dorset, South Northamptonshire, Babergh, Three Rivers, South Norfolk, Hart, Sevenoaks, Wokingham and North Kesteven.

:: Across England, there were 415,059 recorded crimes attributable to alcohol in 2009/10; equivalent to 8.1 crimes per 1,000 population. The highest rates of alcohol-attributable crime occur in the London region where there were 12.2 crimes per 1,000 residents, although this has decreased by 2.1% from the previous year. The lowest rate is in the North East region at 6.2 crimes per 1,000 which also showed the largest decrease (13.5%) from the previous year.

Dr Ruth Hussey, regional director of public health for the North West, said: “We are once again reminded of the terrible burden that the abuse of alcohol causes to residents of the North West through its affects of ill health and crime.

“The North West alone saw over 100,000 individuals admitted into hospital for alcohol related reasons in 2008/09.

“Parts of the North West have already pioneered new ways to educate the public about alcohol and improve access to care for those requiring support. Alcohol costs people their jobs, their health and their lives.”

Health minister Lord Howe said: “Levels of alcohol-related hospital admissions, crime, ill-health and deaths are unacceptable and we have already outlined our commitment to tackling the problem by taking action to stop the sale of alcohol below cost, to review alcohol taxation and price, and introducing a tougher licensing regime.

“Supply and price are not the only factors fuelling misuse though, attitudes are crucial. We need to understand better the psychology behind why different groups of people drink too much. Legislation or initiatives will not work unless we have a better understanding of what drives people’s decisions.

“We will work across Government, society, communities and families to challenge negative social norms that cause social problems and promote the positives.”

From: http://www.independent.co.uk/alcohol-related-hospital-admissions-soar

Tests suggest daily vitamin B supplements can dramatically slow the onset of Alzheimer’s and similar diseases.
Researchers from the University of Oxford have found that taking tablets of three B vitamins every day slows the brain shrinkage that happens with age, causing early signs of dementia such as memory loss.

In a two-year trial, the vitamin supplement delayed the rate of brain atrophy by up to half in a group of elderly people, with a more than 30 per cent reduction overall. Cognitive tests show those with the least shrinkage perform best.

A vitamin pill that curbed the mental decline associated with ageing would have colossal implications. About 1.5 million people in the UK, 14 million in Europe and five million in the US have problems with memory, language or other mental functions known as Mild Cognitive Impairment (MCI), half of whom go on to develop Alzheimer’s or another form of dementia within five years.

Even a slight slowing of this process would have immense human and economic benefits. However, the researchers said it was too soon to recommend elderly people suffering memory lapses should take B vitamin supplements, until further studies had confirmed the benefits and risks.

Large doses of around 300 times the daily recommended intake of B12 and four times the recommended levels of folic acid were used in the trial. The researchers said this meant they acted like a pharmaceutical drug rather than a nutritional supplement and would require further safety tests. They are now seeking funding for another trial.

The best sources of vitamin B are fresh dairy products and meats. The word fresh is key, as the nutritional value of foods can decline when they are frozen, overcooked, or combined with different additives.

Dark-green leafy vegetables such as spinach, arugula, kale, collard greens, chicory, dandelion greens and Swiss chard, are a great source of folic acid. By steaming these vegetables as opposed to frying or simmering, you reap the greatest benefits because their vitamin content remains intact.

The Oxford research, carried out in association with colleagues in Norway, involved 168 people with MCI, half of whom were given daily doses of vitamin B12, B6 and folic acid (B9).

After two years, MRI scans showed the brains of those who had taken the vitamins had shrunk less – by 0.76 per cent a year – than those given placebo (1.08 per cent) – a 31 per cent difference. In the quarter of elderly people who responded best, the reduction in the rate of shrinkage was 53 per cent.

Brain shrinkage is known to occur more rapidly in people with MCI or Alzheimer’s and high levels of the amino acid homocysteine are linked to an increased risk of the conditions. The researchers believe that the B vitamins slowed the brain atrophy seen in MCI and Alzheimer’s by reducing the levels of homocysteine. People with the highest levels of homocysteine in their blood benefited most.

Although the trial was not designed to measure thinking ability, the researchers found that individuals with the lowest rates of shrinkage had the highest mental test scores.

The findings are published in the journal PLoS [Public Library of Science] One.

Professor David Smith of the Department of Pharmacology, Oxford University, and co-leader of the trial, said: “This is a very striking, dramatic result. It is our hope that this simple and safe treatment will delay the development of Alzheimer’s disease in many people who suffer from mild memory problems.

“These are immensely promising results but we do need to do more trials to conclude whether these particular B vitamins can slow or prevent development of Alzheimer’s. So I wouldn’t yet recommend that anyone getting a bit older and beginning to be worried about memory lapses should rush out and buy vitamin B supplements without seeing a doctor.”

Professor Smith said the key question was whether MCI was a mild manifestation of the more extreme Alzheimer’s disease. “Is this a continuum? Are we seeing a disease that begins a long time ago and gets worse and worse? I personally think so.”

The long-term effects of taking big doses of the vitamins were not known, and there was some evidence that high folate intake could be linked to cancer, he said. However, asked if he would try the vitamin treatment if he was diagnosed with MCI he said: “Yes, no hesitation. I would take it.”

Chris Kennard, chair of the Medical Research Council’s Neurosciences and Mental Health Board which co-funded the study, said: “This trial brings us a step closer to unravelling the complex neurobiology of ageing and cognitive decline.”

From: http://www.independent.co.uk/daily-vitamin-pill-could-reduce-dementias-effects-by-up-to-50-per-cent

Foreign nurses are receiving a crash course in euphemism after bewildered patients expressing the wish to “spend a penny” found themselves being escorted to a hospital shop.
Norfolk’s Queen Elizabeth hospital has organised special “adapting to life in Norfolk” sessions for Portuguese staff whose otherwise excellent English results in too-literal translations of everyday expressions.

Patients, particularly the elderly, face being met with incomprehension when complaining of “feeling under the weather”, suffering “pin and needles” or experiencing problems with their “back passage”.

Local expressions such as “blar”, meaning to cry, and “mawther”, meaning “young woman”, are also likely to see mystified nurses flicking in vain through conventional phrasebooks. The distinct Norfolk brogue provides another linguistic obstacle for the recruits hired by the Queen Elizabeth Hospital King’s Lynn NHS trust.

“One of the things people from overseas had difficulty with was our euphemisms such as ‘spend a penny’,” said a hospital spokesman. “In the past some of the new recruits from abroad, when patients used the expression, were taking people to the hospital shop.”

“They all speak exceptional English, but that doesn’t necessarily cover the type of English spoken in Norfolk. We have many different phrases and sayings in this part of the world. A lot of patients are elderly and use what can only be described as quaint phrases and descriptions, especially for body parts and common illnesses.

” The hospital has organised two-hour induction courses in dialect, idiom and colloquialism, covering phrases such as “spick and span”, “higgledy-piggledy”, “la-di-dah” and “tickled pink”. Other useful terms on the agenda are “jim jams”, “a cuppa” and “elbow grease”. Nurses are being asked to write down any confusing phrases they hear on the wards so they can be discussed in follow-up meetings.

Katherine Murphy, chief executive of the Patients’ Association, said the training would ensure “safe service” in hospitals. “Anyone working for the NHS – nurse, doctor, other healthcare professional, healthcare assistant – must be able to be understood by the patient and must demonstrate that they are safe to treat patients,” she said.

But Fiona McEvoy, of the Taxpayers’ Alliance, resorting to idiom herself, said it was “using a sledgehammer to crack a nut”. It made more financial sense for foreign nurses to pick up local phrases “from hearing them used and being advised by peers”, she said.

From: http://www.guardian.co.uk/foreign-nurses-taught-english-euphemisms

The Government’s drive to switch patients to cheaper statins could put lives at risk, new research has shown.
A study indicated that one third of patients who were switched from a branded statin to a cheaper generic one received a less powerful equivalent.

Those switched from Lipitor, known as atorvastatin, to a generic simvastatin would see their levels of dangerous “bad” cholesterol rise by between five and six per cent.

This could increase their risk of suffering a heart attack or stoke by about three per cent, said experts from the University of Melbourne.

In Britain, about five million people are on statins, which combat cardiovascular diseases. The Government has encouraged doctors to switch patients to generic drugs for several years. It means hundreds of patients could be at greater risk because they have been put on a less potent drug.

“This is a warning not just to look at the cost of medicines. You might be saving money but you could be losing a life,” said Lieven Annemans, a professor of health economics, at the European Society of Cardiology Congress in Stockholm.

The NHS spends twice as much on Lipitor than it does on simvastatin, despite fewer people taking the branded drug. A month’s supply of tablets of Lipitor costs about £26 per patient, whereas the equivalent cost of simvastatin is £2.

Prof Danny Liew, of Melbourne University, who led the latest study, said some research suggested that a triple dose of simvastatin was needed to be equivalent to Lipitor. “We must be careful about non-equivalent switching because of the potential for increasing cardiovascular disease risk and patients need to be aware of the difference in potency of different statins,” he said.

Branded drugs can be made only by the company that holds the patent and Pfizer makes Lipitor. After the patent has expired, the drug becomes “generic” and can be made by any manufacturer, meaning the price drops substantially. About eight in every 10 drugs prescribed by GPs in England are generics and statins, in particular, have been targeted by policy-makers to reduce costs.

A 10mg daily dose of Lipitor produces a 38 per cent reduction in bad cholesterol, whereas 10mg of simvastatin produces a 28 per cent drop.

Many British doctors are reluctant merely to increase the dose of a generic drug because of the risk of side effects. Statins can induce muscle aches, dizziness and headaches, and have been linked to kidney and liver problems.

Prof Liew studied data from almost 40,000 patients in Holland who were switched from Lipitor to simvastatin in the first three months of 2009. One third of patients ended up with a lower equivalent dose of simvastatin. The study was funded by Pfizer.

Dr Jeremy Pearson of the British Heart Foundation said: “It is clear that GPs need to be informed that you cannot switch 20mg of one for 20mg of another.

“Switching cannot be done thoughtlessly, otherwise you are at risk of doing something that is not advantageous to your patient at all.”

From: http://www.telegraph.co.uk/Heart-patients-lives-at-risk-in-switch-to-cheaper-drugs

More than 10,000 cases of breast and bowel cancer could be prevented each year if people took more exercise, such as going for brisk walks.
Just 45 minutes a day of activity at a moderate level could prevent about 5,500 cases of breast cancer in the UK.

At least 4,600 bowel cancer cases could also be stopped if people were moderately active for at least 30 minutes a day, five days a week, research showed.

Moderate activity is described as any type of exertion which gets the heart beating faster and makes people breathe more deeply.

Shorter bouts of exercise are also just as effective as longer sessions – it is the total time spent on activity that is important.

The calculations, from the World Cancer Research Fund (WCRF), show the importance of diet and exercise in lowering the risk of developing cancer.

Alongside brisk walking, other activities that would count include cycling at a leisurely pace, dancing, swimming at a leisurely pace, gardening and vacuuming combined with other housework.

According to the WCRF, exercise also cuts the risk of women developing womb cancer.

And because people who exercise tend to be more likely to keep a healthy weight, their risk of dozens of other cancers is lower than people who are overweight or obese.

Health experts warned last week that obesity was placing an “overwhelming” burden on the NHS as figures showed a 785% rise in weight-loss surgery.

Some doctors are “skirting around the rules” and not insisting on months of lifestyle change and pharmaceutical treatment before allowing patients to undergo surgery, specialists said.

Operations carried out for the most obese people in England have soared over the past five years, according to the NHS Information Centre.

Data for 2003/04 showed there were 480 procedures, rising to 4,246 in 2008/09.

Dr Rachel Thompson, deputy head of science at the WCRF, said people should aim to be physically active for at least half an hour every day.

“There is now very strong evidence that being physically active is important for cancer prevention,” she said. “Even relatively modest increases in activity levels could prevent thousands of cancer cases in the UK every year.

“These figures also show you do not have to go to the gym every day to benefit.

“You can reduce your cancer risk just by making small changes and this is highlighted by the fact that so many cancer cases could be prevented through something as simple as brisk walking.

“By taking up walking as a hobby or even walking to the shops instead of taking the bus or car, people can make a real difference to their health.”

Henry Scowcroft, science information manager at Cancer Research UK, said: “You don’t have to be an athlete to reduce your cancer risk.

“There’s solid evidence that certain cancers – including breast and bowel cancer – are less common in people who do regular, moderate exercise such as brisk walking.”

From: http://www.independent.co.uk/moderate-exercise-could-prevent-cancer

More than 3 million doctors have downloaded a 59p application – invented by Prof Peter Bentley, a researcher from University College London – which turns an Apple iPhone into a stethoscope.Last week, Bentley introduced a free version of the app, which is being downloaded by more than 500 users a day. Experts say the software, a major advance in medical technology, has saved lives and enabled doctors in remote areas to access specialist expertise.

“Everybody is very excited about the potential of the adoption of mobile phone technology into the medical workplace, and rightly so,” said Bentley, who initially developed the app “as a fun toy”.

“Smartphones are incredibly powerful devices packed full of sensors, cameras, high-quality microphones with amazing displays,” he said. “They are capable of saving lives, saving money and improving healthcare in a dramatic fashion – and we carry these massively powerful computers in our pockets.”

Bentley’s iStethoscope Pro application is not the only mobile phone programme lightening doctors’ bags and transforming their practices: there are nearly 6,000 applications related to health in the Apple App Store. The uptake has been rapid. In late 2009, two-thirds of doctors and 42% of the public were using smartphones – in effect inexpensive handheld computers – for personal and professional reasons. More than 80% of doctors said they expected to own a smartphone by 2012.

The trend looks likely to gain pace as younger doctors enter the workplace. Some medical schools issue students with smartphones. In America, Georgetown University, the University of Louisville and Ohio State University are among those requiring undergraduates to use one.

However, experts say they are being prevented from exploiting the technology’s opportunities. Bentley says that he is unable to launch a new range of applications because of out-of-date regulations.

“It’s much easier to develop technology than it is to get permission to use it,” he said. “I could create a mobile ultrasound scanner and an application to measure the oxygen content in blood, but the regulations stop me. We’re not allowed to turn the phone itself into a medical device, and what that precisely means is currently a grey area in terms of regulation. That’s the only reason we’re not seeing a flood of these devices yet.”

Professor Ian Wells, head of the scientific computing section in the department of medical physics at the Royal Surrey County hospital in Guildford, agrees that innovation is being hindered by regulations that are “still in their infancy”.

He said: “The approach of the regulators is not well worked out yet. There’s a wonderful new world out there but we need to find a way for regulators to protect patients and doctors, while not impeding innovation, research and development.”

The Medicines and Healthcare products Regulatory Agency (MHRA) – the government body with responsibility for standards of safety, quality and performance in healthcare – recently set up the Medical Device Technology Forum, a group of industry representatives, regulators, users and scientists, to help establish how to regulate novel technologies.

“This is such a complex area that we are currently looking at every application on a case-by-case basis,” said an MHRA spokesman. “We want to ensure that these new technologies are effectively regulated – thereby protecting health and avoiding unnecessary deterrents – while at the same time removing any unnecessary obstacles to manufacturers who wish to exploit new technologies for the benefit of patients.”

European regulators are also striving to bring their guidelines up to date. A group of regulators from Austria, Belgium, Denmark, France, Ireland, Sweden and the UK was set up last December to develop guidance for software under the European Medical Device Regulations. They are expected to report at the end of the year.

• Star Analytical Services has developed an app that allows patients to cough into their phone, and tells them whether they have a cold, flu, pneumonia or other respiratory diseases.

• OsiriX lets doctors look at x-rays, ultrasounds, CT and MRI images on handheld devices or mobile phones with special software, enabling radiologists, for example, to diagnose acute appendicitis from remote locations.

• ERoentgen Radiology Dx helps radiologists identify the most appropriate radiology exam for a patient by searching a large database of signs, symptoms and diagnoses to help them make quick assessments.

• Instant ECG is just one app that analyses the most common ECG results. It distinguishes the difference in various myocardial ischemia or injury patterns. Using the iPhone’s interactive touch screen, the app offers “real-time” films to make rhythm analysis similar to the clinical setting.

• AirStrip OB, an iPhone app, gives obstetricians real-time remote access to foetal heart tracings, contraction patterns, nursing notes, and vital signs. Obstetricians can monitor different stages of labour even when they are not by a patient’s side.

From: http://www.guardian.co.uk/technology/2010/aug/30/iphone-replace-stethoscope