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ESA benefit payments- retests axed for chronically ill claimants

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Work and Pensions Secretary Damian Green said it was pointless to re-test recipients of Employment and Support Allowance (ESA) with severe conditions and no prospect of getting better.

More than two million people receive ESA, which is worth up to £109 a week. The move has been welcomed by charities supporting those with severe illness.

Shadow work and pensions secretary Debbie Abrahams said it was “a welcome U-turn” by the government, but “the devil was in the detail”. What about mental health conditions, conditions that are fluctuating, conditions that may not necessarily have a physical manifestation?” she said.

Applicants for ESA have to undergo a work capability assessment to find out if they are eligible and they are re-tested to ensure their condition has not changed. Some are re-tested every three months and others up to two years later.

Under the government’s change, those who are deemed unfit for work and with conditions that will not improve will no longer face re-testing.

Illnesses such as severe Huntington’s, autism or a congenital heart condition are among those that are likely to qualify for continuous payments without reassessment. The criteria will be drawn up with health professionals.

Mr Green said a “key part” of making sure those who were unable to work received “full and proper support” included “sweeping away any unnecessary stress and bureaucracy”.

Currently, those in the “work-related activity group” – deemed unable to work at the moment but capable of making some effort to find employment – receive up to £102.15 a week in ESA payments.

Those in the “support group” – deemed unable to work and not obliged to do anything to improve their chances of finding work – receive up to £109.30 a week.

From April 2017, payments will fall to £73 for new claimants in the “work-related activity” category as ministers argue that too few people in the category are moving into work.

Former Work and Pensions Secretary Iain Duncan Smith, welcomed the “progressive” reform to the re-testing regime, which he had set up when in office.

“I hope that the government will… move on to the fuller reform… where we lock together with the health department much more to be able to get a better health assessment of people, rather than a just strictly work assessment.”

Tim Nicholls, policy manager at the National Autistic Society, said ESA was a vital benefit for those unable to work, covering basic daily living costs such as food, heating and clothes.

“The flawed assessment process can be highly stressful for autistic people who can experience high levels of anxiety meeting new people or when their routine is broken, particularly when the stakes are so high,” he said. “We will be looking out for more details from the government.”

The smoking ban has led to a sharp fall in heart attacks

Major research suggests that the introduction of a smoking ban has resulted in a 40 per cent fall in the number of people suffering from heart attacks as the result of passive smoking.

Major research suggests that the introduction of a smoking ban has resulted in a 40 per cent fall in the number of people suffering from heart attacks as the result of passive smoking
Heart attack rates in the UK have fallen by up to 42 per cent since the 2007 smoking ban, major research suggests.

A review of 77 studies found that reduced exposure to passive smoking has caused a “significant reduction” in heart problems across the population.

Several of the studies found that non smokers and ex-smokers gained most the benefits.

The Cochrane study examined a range of health outcomes in 21 countries, including the UK, which have introduced bans in recent years.

Researchers concluded that there was strong evidence that reduced exposure to passive smoking reduced the number of people suffering from cardiac problems.

The studies examined included a Liverpool study of 57,000 hospital patients. This found admissions for heart attacks fell by 42 per cent among men and 43 per cent among women in the five years since the ban was introduced in 2007.

And US research reviewed found a 14 per cent reduction in strokes in counties which introduced a ban, compared with those which did not.

Some 33 out of the 44 studies reviewed on heart disease found a “significant reduction” following the introduction of smoking bans.

Researchers said the studies took account of other trends over the period – such as a large increase in rates of statin prescribing, to protect against heart disease.

Review author, Professor Cecily Kelleher, from University College, Dublin, said: “The current evidence provides more robust support for the previous conclusions that the introduction of national legislative smoking bans does lead to improved health outcomes through a reduction in second hand smoke exposure for countries and their populations.”

Professor Peter Weissberg, medical director of the British Heart Foundation, said: “This review strengthens previous evidence that banning smoking in public places leads to fewer deaths from heart disease and that this effect is greatest in the non-smoking population.

He said the studies were observational and all had their limitations, but it would be difficult to study the effects of passive smoking in a more robust scientific way.

Researchers said the evidence was less clear about whether the introduction of bans had actually helped people to give up smoking.

Nonetheless, smokers seemed to benefit from some reduction in exposure to passive smoke.

One Scottish study, which found no fall in smoking rates after a ban was introduced in 2006, found a 14 per cent reduction in hospital admissions for heart problems among smokers, and a 21 per cent reduction in admissions among non-smokers.

The research found the impact of the ban on respiratory health, and conditions such as asthma, was less clear cut, though seven of 12 studies on asthma found reduced hospitalisations since the ban.

Overseas nurses denied NHS jobs

Thousands of overseas nurses were denied permission to work in England last year, despite hospitals facing staff shortages.

The Royal College of Nursing (RCN) has found that the refusals have hit high profile hospitals in Cambridge, Newcastle and Manchester.

A Freedom of Information request to the Migration Advisory Committee (MAC) found more than 2,341 refusals.

The RCN asked for the number of applications to allow overseas (non-European Union) nurses to work in England between April and November 2015 and the number refused.

It found that East Lancashire Hospitals NHS had the highest number of refusals with 300 out of 300 applications.

The research found that Brighton and Sussex University Hospitals and North Cumbria University Hospitals both had about 240 refusals.

Nursing was temporarily placed on the MAC shortage occupation list (allowing more overseas nurses) in December.

Janet Davies, chief executive of the RCN, said: “These figures show that when nursing is not on the list, many trusts are unable to recruit enough nurses, which could have an impact on patient care.”

Catherine Morgan, director of nursing at The Queen Elizabeth Hospital in King’s Lynn, said that she had been prevented from recruiting a number of overseas nurses.

“It is frustrating because we are running a hospital and do want it to be safe, and we had the opportunity to recruit from India and the Philippines and we had nurses keen to come over but haven’t been able to bring them over,” she said.

A Department of Health spokesman said: “The MAC is currently reviewing the shortage occupation list. Staffing is a priority and there are already more than 8,500 more nurses on our wards since 2010 and 50,000 more nurses in training.

“We want more home-grown staff in the NHS and our recent changes to student funding will create up to 10,000 more nursing, midwifery and allied health professional training places by 2020.”

Dementia patients face Russian roulette in hospital

Dementia patients admitted to hospital in England play “Russian roulette” with their health, a charity is warning.

Dementia patients admitted to hospital in England play "Russian roulette" with their health, a charity is warning.

The Alzheimer’s Society said it had found “shocking” evidence of poor and variable care during its review.

The report, based on Freedom of Information (FOI) requests, found problems with falls, night-time discharges and readmissions, and said standards needed to improve urgently.

The Department of Health said the disease was a key priority as one in four hospital beds is believed to be occupied by a person with dementia.

The Alzheimer’s Society called for all hospitals to publish an annual statement of dementia care, to include information on satisfaction, falls, readmissions and staff training as part of its campaign to improve standards.

The charity received responses to their FOI request from half of the 163 hospital trusts in England; however, for some of the questions the figures were based on a fifth of trusts as not all hospitals could provide answers to all the questions.

Its report showed:

  • more than one in four people over the age of 65 who fell had dementia, but in some trusts it topped 70%
  • people with dementia stay five to seven times longer than other patients over the age of 65 in the worst-performing hospitals
  • one in 10 people over 65 who were discharged overnight had dementia – with the numbers rising to nearly four in 10 in the worst trusts
  • more than half of over-65s readmitted within 30 days – a sign of inappropriate care – had dementia in the worst-performing trust.

The Alzheimer’s Society also carried out a survey of dementia patients. It found examples of patients being treated with excessive force, not being given enough help with meals and drinks and being left in wet or soiled sheets.

Nine in 10 said hospitals were frightening and only 2% felt all staff understood the needs of people with dementia.

The charity described these findings as unacceptable and a sign that dementia patients were not getting the standard of care they should.

Alzheimer’s Society chief executive Jeremy Hughes said: “In the worst cases, hospital care for people with dementia is like Russian roulette. People with dementia and their carers have no way of knowing what’s going to happen to them when they are admitted.

“In many cases they are well looked after but, as our investigation shows, too often people with dementia fall and injure themselves, get discharged at night or are marooned in hospital despite their medical treatment having finished.”

A Department of Health spokesman said the disease was a key priority and in recent years £50m had been spent on making hospitals and care homes more “dementia friendly”, while 500,000 staff had received extra training.

“People with dementia and their carers deserve the very best support,” he added.

Suicide gene therapy kills prostate cancer cells

A new gene therapy technique is able to modify prostate cancer cells so that a patient’s body attacks and kills them, US scientists have discovered.

A new gene therapy technique is able to modify prostate cancer cells so that a patient's body attacks and kills them, US scientists have discovered.

The technique causes the tumour cells in the body to self destruct, giving it the name ‘suicide gene therapy’.

Their research found a 20% improvement in survival in patients with prostate cancer five years after treatment.

Prostate cancer is the most common cancer in men in the UK with more than 41,000 diagnosed each year.

The study, led by researchers from Houston Methodist Hospital in Texas, appears to show that this ‘suicide gene therapy’, when combined with radiotherapy, could be a promising treatment for prostate cancer in the future.

The technique involves the cancer cells being genetically modified so that they signal a patient’s immune system to attack them.

Usually, the body does not recognise cancer cells as the enemy because they have evolved from normal healthy cells. Unlike an infection, which the body reacts against, the immune system does not react to kill off the offending cancer cells.

Using a virus to carry the gene therapy into the tumour cells, the result is that the cells self destruct, alerting the patient’s immune system that it is time to launch a massive attack.

In two groups of 62 patients, one group received the gene therapy twice and the other group – who all had more aggressive prostate cancer – received the treatment three times. Both groups also received radiotherapy.

Survival rates after five years were 97% and 94%. Although there was no control group in this study, the researchers said the results showed a five to 20% improvement on previous studies of prostate cancer treatment.

And cancer biopsy tests performed two years after the trial were found to be negative in 83% and 79% of the patients in the two groups.

Dr Brian Butler, from Houston Methodist Hospital in Texas, said it could change the way that cancer is treated. “We may be able to inject the agent straight into the tumour and let the body kill the cancer cells. Once the immune system has knowledge of the bad tumour cells, if they pop up again, the body will know to kill them.”

Kevin Harrington, professor of biological cancer therapies at The Institute of Cancer Research, London, said the results were “very interesting” but more research was needed. We would need a randomised trial to tell if this treatment is better than radiotherapy alone.”

“The viruses used in this study cannot reproduce. Next generation viral therapies for cancer can selectively replicate in cancer cells, something that can kill the cancer cell directly, and also help spread the virus to neighbouring cancer cells.”

“It would be interesting to see this approach used with viruses that could reproduce to see if it makes for a more effective treatment.”

NHS trust failed to investigate hundreds of deaths

The NHS has failed to investigate the unexpected deaths of more than 1,000 people since 2011 according to a new report.

The NHS has failed to investigate the unexpected deaths of more than 1,000 people since 2011 according to a new report.

It blames a “failure of leadership” at Southern Health NHS Foundation Trust and that the deaths of mental health and learning disability patients were not properly examined.

Southern Health said it “fully accepted” the quality of processes for investigating and reporting a death needed to be better, but had improved.

The trust is one of the country’s largest mental health trusts, covering Hampshire, Dorset, Wiltshire, Oxfordshire and Buckinghamshire and providing services to about 45,000 people.

The investigation, commissioned by NHS England and carried out by Mazars, a large audit firm, looked at all deaths at the trust between April 2011 and March 2015.

During that period, it found 10,306 people had died. Most were expected. However, 1,454 did not.

Of those, 272 were treated as critical incidents, of which just 195 – 13% – were treated by the trust as a serious incident requiring investigation (SIRI).

The likelihood of an unexpected death being investigated depended hugely on the type of patient.

The most likely group to see an investigation was adults with mental health problems, where 30% were investigated. For those with learning disability the figure was 1%, and among over-65s with mental health problems it was just 0.3%.

The average age at death of those with a learning disability was 56 – over seven years younger than the national average.

Even when investigations were carried out, they were of a poor quality and often extremely late, the NHS England report says.

Repeated criticisms from coroners about the timeliness and usefulness of reports provided for inquests by Southern Health failed to improve performance, while there was often little effort to engage with the families of the deceased.

Key findings from the report

  • The trust could not demonstrate a comprehensive systematic approach to learning from deaths
  • Despite the trust having comprehensive data on deaths, it failed to use it effectively
  • Too few deaths among those with learning disability and over-65s with mental health problems were investigated, and some cases should have been investigated further
  • In nearly two thirds of investigations, there was no family involvement

The reasons for the failures, says the report, lie squarely with senior executives and the trust board.

There was no “effective” management of deaths or investigations or “effective focus or leadership from the board”, it says.

Even when the board did ask relevant questions, the report says, they were constantly reassured by executives that processes were robust and investigations thorough.

The culture of Southern Health, which has been led by Katrina Percy since it was created in 2011, “results in lost learning, a lack of transparency when care problems occur, as well as lack of assurance to families that a death was not avoidable and has been properly investigated,” the report says.

UK pays less for cancer drugs than some countries

The UK is paying less for new cancer drugs than a number of other high income countries, according to a report in The Lancet Oncology.

The UK is paying less for new cancer drugs than a number of other high income countries, according to a report in The Lancet Oncology

While the UK, Greece, Spain and Portugal pay the least, on average, for the drugs they use, Germany, Sweden and Switzerland pay the most.

The authors said more transparency was needed because some countries risked overpaying for drugs. The pharmaceutical industry said the UK was getting a fair deal on medicines.

Prices of cancer drugs have risen steeply in recent years, placing major stress on many healthcare systems, including the NHS.

The report said drugs had accounted for nearly a third of the EU’s £37 billion cancer healthcare spending in 2009.

And the researchers then compared the 2013 price of 31 cancer drugs in 18 high-income countries, including the UK, Australia, New Zealand, France, Greece, Switzerland, Sweden and Portugal.

Prices in Greece were the lowest for 14 out of the 24 cancer drugs available there.

The price of drugs in the UK was also low.

Prices of drugs in Switzerland, Germany and Sweden were frequently the highest – and for some drugs, such as interferon alfa 2b to treat leukaemia and skin cancer, were twice as high.

The price figures come from the Pharma Price Information service in Austria, which details what manufacturers charge per unit – a single tablet or vial of a drug, for example.

But although the official list prices published in this report are freely available, any further discounts – which are often negotiated by organisations in different countries – remain confidential.

David Watson, director of pricing and reimbursement at the Association of the British Pharmaceutical Industry, said the report was evidence that newer medicines “are affordable in the UK”.

He said the UK was “getting a fair deal with regards to medicines pricing” and the NHS was “getting good value for money”.

Antibiotic resistance- world on cusp of post antibiotic era

The world is on the cusp of a “post-antibiotic era”, scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed.

The world is on the cusp of a "post-antibiotic era", scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed

They identified bacteria able to shrug off the drug of last resort – colistin – in patients and livestock in China.

They said that resistance would spread around the world and raised the spectre of untreatable infections. It is likely resistance emerged after colistin was overused in farm animals.

Bacteria becoming completely resistant to treatment – also known as the antibiotic apocalypse – could plunge medicine back into the dark ages.

Common infections would kill once again, while surgery and cancer therapies, which are reliant on antibiotics, would be under threat.

Chinese scientists identified a new mutation, dubbed the MCR-1 gene, that prevented colistin from killing bacteria.

The report in the Lancet Infectious Diseases showed resistance in a fifth of animals tested, 15% of raw meat samples and in 16 patients.

And the resistance had spread between a range of bacterial strains and species, including E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.

There is also evidence that it has spread to Laos and Malaysia.

Resistance to colistin has emerged before. However, the crucial difference this time is the mutation has arisen in a way that is very easily shared between bacteria.

The concern is that the new resistance gene will hook up with others plaguing hospitals, leading to bacteria resistant to all treatment – what is known as pan-resistance.

Early indications suggest the Chinese government is moving swiftly to address the problem.

New drugs are in development, such as teixobactin, which might delay the apocalypse, but are not yet ready for medical use.

A commentary in the Lancet concluded the “implications [of this study] are enormous” and unless something significant changes, doctors would “face increasing numbers of patients for whom we will need to say, ‘Sorry, there is nothing I can do to cure your infection.'”

NHS health data sharing project scrapped

The Department of Health in England is scrapping its controversial data sharing project – known as Care.data.

The Department of Health in England is scrapping its controversial data sharing project - known as Care.data.The programme, which was due to launch in 2014, faced widespread criticism – including fears the public had been left in the dark about it.

The announcement comes as Dame Fiona Caldicott and the Care Quality Commission published two reviews on data security in English healthcare.

Their reports put forward a series of proposals to safeguard data in the NHS:

  • They call for stronger government sanctions for malicious or intentional data breaches, together with tougher criminal sanctions against those who use any anonymised data to re-identify individuals.
  • Meanwhile, out of date computer software and hardware should be replaced urgently, they say.
  • The reviews recommend an opt-out system so patients can say no to confidential or personal health data being used for anything beyond their direct care.
  • But this could be overridden for mandatory requirements such as fraud investigations or situations of public interest such as epidemics, they suggest.
  • And patients could give explicit consent for specific research studies, even if they had opted-out.

Responding in a written statement to Parliament, the Department of Health said it has launched a public consultation on the option of opt-outs, alongside 10 security standards that Dame Fiona suggests NHS organisations must meet.

Officials also say they support stronger criminal sanctions for misuse of anonymised data and are working with suppliers to ensure IT systems are up-to-date.

Meanwhile, the Department of Health said though it had taken the decision to close the Care.data programme it was “committed to realising the benefits of sharing information”.

The Care.data project, led NHS England, together with the Health and Social Care Information Centre, was designed to bring health and social care information from different settings together to see what was working well and what could be done better.

It was due to launch two years ago, but was paused after concerns a public information campaign explaining its use was not clear enough and did not reach everyone.

Whilst Health Direct is pleased that this discredited IT system is being closed, one wonders with the Chilcott enquiry and Wales football game dominating the news agenda whether yesterday was a good day to bury bad news.

Healthier lifestyles could cut cancer cases by a third

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research.

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research
Exercise is an important way of keeping fit and cutting body fat, which is linked to the risk of developing cancer.

Data from the World Cancer Research Fund suggests that 20,000 cases of breast cancer and about 19,000 cases of bowel cancer could be stopped each year with small changes in lifestyle.

In 2013, there were more than 351,000 new cases of cancer in the UK. The WCRF said 84,000 could have been prevented.

Head of research Dr Rachel Thompson said simple changes to diet and lifestyle could make “a huge difference” in the battle against cancer.

“Even minor adjustments, like 10 to 15 extra minutes of physical activity each day, cutting down on alcohol, or limiting your intake of high calorie foods and sugary drinks, will help decrease your cancer risk,” she said.

She said that after cutting out smoking, being a healthy body weight was the most important thing people could do to cut their risk of getting cancer.

“There is strong evidence that being overweight or obese increases the risk of 10 cancers,” she said.

The link between a healthy lifestyle and the risk of developing cancer is well known, and this new data looks at preventable cases in 13 of the UK’s most common cancers.

For example, among men, 9% of cases of advanced prostate cancer could be prevented every year if men were not overweight or obese.

Lung cancer cases could be cut by 15,000 (33%) by getting people to stop smoking.

And 38% of breast cancer cases could be prevented, particularly in postmenopausal women, by increasing physical exercise and reducing body fat.

The WCRF also said that 2,200 cases of kidney cancer and 1,400 cases of pancreatic cancer could be prevented if people adopted a healthier lifestyle.

Prof Kevin Fenton, director of health and wellbeing at Public Health England, said the UK was currently behind on cancer survival rates compared with other European countries.

He said one major factor was that cancer prevention was not in the public consciousness.

“The link between tobacco and cancer is widely known and readily accepted by the public, but many are not yet fully convinced that healthy eating, regular exercise and not drinking alcohol, can lower your cancer risk.”

From: https://www.fithealthylives.com/2016/06/healthier-lifestyles-could-cut-cancer-cases-by-a-third-2/