Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, analysis by the polling firm Gallup has found.Overweight and obese workers with no chronic problems take twice as many days off as comparable workers of a healthy weight, found the survey of almost 9,000 people.

Those who were overweight or obese and had three or more chronic health problems took 12 times as many sick days as healthy weight individuals with no health problems, or 18 compared to 1.5.

The survey was conducted by Gallup and Healthways, a firm that runs fitness centres.

It also found obesity alone counts for six lost work days per worker each year – or over £1,200 in lost productivity.

Ben Leedle, president and chief executive of Healthways, said it showed that the level of chronic disease in the UK workforce was at “alarming levels”.

He said: “Employers who recognize the importance of improving well-being at the workplace are most likely to gain a competitive advantage.”

From: http://www.telegraph.co.uk/Obesity-and-chronic-disease-cost-UK-PLC-20bn-a-year

Fair skinned people who are prone to sunburn may need to take health supplements to ensure they get enough vitamin D, say experts.It appears that those with pale skin, while not deficient, may still be lacking in the essential vitamin that the body makes from sunlight.

The Cancer Research UK charity say that even with a lot of sun exposure, those with fair skin may not be able to make enough vitamin D.

And too much sun causes skin cancer.

Clearly, for this reason, increasing sun exposure is not the way to achieve higher vitamin D levels in the fair-skinned population, say the researchers. But taking supplements could be.

Their work examined 1,200 people.

Of these, 730 were found to have “lower than optimal” vitamin D levels – and many of these were people with very pale, freckled skin.

Supplements are already recommended for groups at higher risk of deficiency. This includes people with dark skin, such as people of African-Caribbean and South Asian origin, and people who wear full-body coverings, as well as the elderly, young children, pregnant and breastfeeding women and people who avoid the sun.

Based on the latest findings, it appears that pale-skinned people should be added to this list.

Vitamin D is important for healthy bones and teeth.

A level less than 25nmol/L in the blood is a deficiency, but experts increasingly believe that lower than 60nmol/L are suboptimal and can also be damaging to health.

Most people get enough vitamin D with short exposures to the sun (10 to 15 minutes a day). A small amount also comes from the diet in foods like oily fish and dairy products.

But people with fair skin do not seem to be able to get enough, according to Prof Julia Newton-Bishop and her team at the University of Leeds.

Part of the reason might be that people who burn easily are more likely to cover up and avoid the sun.

But some fair-skinned individuals also appear to be less able to make and process vitamin D in the body, regardless of how long they sit in the sun for.

Hazel Nunn, of Cancer Research UK, explains how to increase vitamin D levels if you’re pale

Prof Newton-Bishop said: “It’s very difficult to give easy advice that everyone can follow. There’s no one-size-fits-all.  However, fair-skinned individuals who burn easily are not able to make enough vitamin D from sunlight and so may need to take vitamin D supplements.”

Hazel Nunn, of Cancer Research UK, said: “It is about striking a balance between the benefits and harms of sun exposure.

“People with fair skin are at higher risk of developing skin cancer and should take care to avoid over-exposure to the sun’s rays.  If people are concerned about their vitamin D levels, they should see their doctor who may recommend a vitamin D test.”

From:  http://www.bbc.co.uk/news/health-15151930

Foreign doctors who cannot speak English are to be banned from working in NHS hospitals and clinics, the Health Secretary will announce today.The NHS will introduce mandatory language tests for doctors moving to Britain after training elsewhere in the European Union.

The decision follows a series of cases in which patients have died or suffered poor care as a result of doctors speaking sub-standard English.

The issue was brought to national attention three years ago when Dr Daniel Ubani, a German-trained GP on his first out-of-hours shift in Britain, killed David Gray, 70, by giving him 10 times the normal dose of diamorphine.

In his speech to the Conservative Party conference today, Andrew Lansley will say that the Medical Act will be amended so that doctors must speak good English to practise in Britain.

“I am determined that doctors who come from overseas to work here in our NHS must not only have the right qualifications, but also the language skills to practise here,” the Health Secretary is expected to say. “We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients. This is not about discriminating; we’ve always appreciated how much overseas doctors and nurses give to our NHS. It is simply about our absolute commitment to put patients’ safety first.”

There are more than 88,000 foreign-trained doctors registered to work in Britain, including 22,758 from Europe. They account for almost a third of the total.

Under the proposals, local NHS trusts would have a duty to check the language skills of foreign-trained doctors before they can be employed. In addition, the General Medical Council would be given powers to take action against doctors when there were concerns about their ability to speak English. At present, only doctors from outside the European Economic Area are routinely scrutinised for their language skills before being registered by the GMC.

This means that doctors from Canada or Australia are routinely tested for their language skills while those from countries such as Poland and France are not.

It had previously been thought that European Union laws ensuring the freedom of movement of labour prevented language testing. However, the European Commission has recently stated that the language tests would be legal.

Dr Ubani, who admitted he had never heard of the drug he gave to Mr Gray, was struck off by the GMC in June last year but still practises in Germany. His poor English meant he was refused work by the NHS in West Yorkshire but was accepted in Cornwall and Camb-ridgeshire, where he saw Mr Gray.

Since the case, the GMC and other NHS leaders have repeatedly warned that some foreign doctors’ language skills are so poor that patients are being put at risk.

Compulsory language tests for foreign doctors will raise concerns that the NHS could be left short-staffed, such is its reliance on overseas medics. Ministers believe that the majority will reach the necessary standard of English.

Mr Lansley will today deliver a robust defence of the Government’s health policy, saying that money is being diverted from cutting bureaucracy to front-line services.

“Unlike Labour, we will make sure that every penny of our investment goes right to the patients who matter, not the huge Labour bureaucracy which we inherited,” he will say. “And all that is why, since the election, we now have 1,500 more doctors and 5,000 fewer managers in the NHS.”

He will also claim that hospital infection rates have fallen and the number of people being treated in mixed-sex wards has fallen by more than 90 per cent over the past eight months.

From: http://www.telegraph.co.uk/Conservative-Party-Conference-2011-doctors-from-overseas-must-speak-English-or-be-banned

Eating lots of fruit and vegetables with white flesh may help to protect against strokes, says a study in the journal Stroke.But Dutch researchers say they do not know why people with a high intake of apples, pears, bananas or cauliflower reduce their risk of stroke by 52%.

The study followed more than 20,000 adults over 10 years.

Stroke experts said people should not be put off eating other colours of fruit and veg.

At the start of the study, carried out in The Netherlands, participants were asked to fill in a detailed questionnaire on diet and lifestyle for the previous year.

By using this information and tracking the health of participants over the next decade, researchers were able to examine the link between the colour of fruit and vegetables consumed and stroke risk.

The study found that a 25g per day increase in white fruits and vegetables was linked to a 9% lower risk of stroke.

Of the white fruit and veg eaten, over half was apples and pears. An average apple weighs 120g.

But no link was found between stroke incidence and green (dark leafy vegetables, cabbages and lettuces) orange/yellow (mostly citrus fruits) or red/purple fruits and vegetables.

Linda Oude Griep, lead author of the study and postdoctoral fellow in human nutrition at Wageningen University in The Netherlands, said more research was needed to find out why white flesh was important.

“It is difficult to say which nutrients are responsible in white fruits and vegetables. We know that apples and pears are high in dietary fibre, but there may be other explanations.”

She said it might be useful to consume considerable amounts of white-flesh fruit and veg to prevent strokes.

“Eating one apple a day is an easy way to increase white fruits and vegetable intake.”

Dr Sharlin Ahmed from The Stroke Association said the findings should not deter people from eating other colours of fruit and vegetables.

“All fruit and vegetables have health benefits and remain an important part of a stable diet. A lot more research is needed before the colour of our groceries alone is used to determine what health benefits they may have.”

“Everyone can reduce their risk of stroke by eating a healthy balanced diet that is low in saturated fat and salt, exercising regularly and ensuring that your blood pressure is checked and kept under control.”

From: http://www.bbc.co.uk/news/health-14931634

The General Medical Council (GMC) says some overseas doctors come to the NHS with ‘little or no preparation’ for working in the UK.Along with the Nursing and Midwifery Council, it wants the right to test the English language skills of applicants from within the EU in the same way they test applicants from outside of Europe.

But an EU red tape Directive prevents any systematic testing of language skills of doctors from the European Economic Area (EEA).

The GMC says UK legislation – the Medical Act 1983 – ‘gold plates’ the directive and prevents the GMC from doing any language-testing of doctors from the EEA at all.

Employers are allowed to assess the language skills of applicants from the EEA, but it is thought many do not.

A spokesperson from the GMC said: “Doctors who come to work in the UK make a vital contribution to our healthcare system, but we must make sure they receive the support they need to practise safely and to conform to UK standards.”

“It is unacceptable that the current system enables doctors to practise in the UK without a sufficient grasp of English.”

The GMC says some overseas doctors come to the NHS with “little or no preparation” for working in the UK and those trained under different cultural and professional standards need more support.

The GMC is planning a basic induction programme for all doctors – including those who qualify in the UK – to help understand how healthcare is practised in the UK.

A spokesperson from the Department of Health said: “This government is determined to make sure that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language skills.”

“We do think the Directive needs updating and we are in the process of responding to the EU proposals, but we can’t pre-empt that response.

“We have already taken steps to strengthen the current system by introducing a duty for responsible officers to check the qualifications, experience and references of all doctors, including foreign doctors.”

But poor English language standards are not just an issue among some European NHS staff, for whom English is not their first language.

Asian nurses said they found it difficult to understand European colleagues – particularly those from Eastern Europe.

But when one was asked what a patient meant if they said they wanted to ‘spend a penny’ – slang for go to the lavatory – she replied “they want to spend money”.

A spokesperson from Imperial College Healthcare NHS Trust, said: “We take patient experience and patient complaints very seriously.”

“We care for a diverse patient population and employ a diverse workforce, and understand the importance of staff being able to talk to patients and their families in an appropriate way.”

From: http://www.bbc.co.uk/news/health-14921565

Nurses and midwives are being urged to get their flu jabs after figures reveal less than a third did last year.All front line healthcare workers are meant to be vaccinated to stop them going off sick with influenza and spreading the virus to patients.

Last year only 30% of hospital nursing staff in England got immunised compared with 43% of GP practice nurses, 38% of GPs and 37% of other doctors.

Nursing and midwifery groups say having the jab is a “professional duty”.

This is the first time the figures have given broken down by occupation.

The number of healthcare workers getting the vaccine had increased from 26.4% in the 2009 winter to 34.7% in 2010.

However, the majority of nurses who work with the most critically ill over the winter months and midwives who work with pregnant women, were left vulnerable to flu, its potentially life-threatening complications and passing it on to patients and family, says the Department of Health which released the figures.

The data also shows that only 25.2% of youngsters aged six months to two years in at-risk groups were vaccinated last winter, compared with 51.7% of those aged 16 to 65.

Those at risk include people with conditions such as asthma, diabetes, heart disease and liver disease, as well as the over-65s and pregnant women.

Last winter people in at-risk groups were 11 times more likely to die from seasonal flu than people with no underlying health problems.

Chief Medical Officer Dame Sally Davies said: “It is never too early to start thinking about flu. So as NHS staff return from their holidays, I urge them to plan ahead and get vaccinated.”

Dr Peter Carter, of the Royal College of Nursing, said while NHS staff should not be forced to get immunised, they had a professional duty to do so: “Patients and healthcare staff suffer when nurses are off sick.

“It is vital that nurses do all they can to take responsibility for their own health and of those around them. The RCN will be working with our members to ensure they have access to all of the relevant information to enable them to make the right decision about the uptake of the vaccine.”

Louise Silverton, of the Royal College of Midwives, said: “Midwives are strongly advised to encourage all pregnant women to be vaccinated against seasonal flu.

“In addition midwives as key health workers should themselves seriously consider being vaccinated to prevent transmission of influenza to the women for whom they care and also to their own families.”

A National NHS Staff Seasonal Flu Vaccination Campaign launches later this month and will use resources like Twitter and Facebook, as well as leaflets, to encourage more healthcare professionals to get vaccinated.

From: http://www.bbc.co.uk/news/health-14792570

NHS managers are trying to restrict access to crucial tests and scans in a move that could mean diseases being diagnosed later. 

An investigation has found that a quarter of Primary Care Trusts are either investigating how many patients individual GP practices send for examinations or looking for ways to reduce the numbers.

In addition, a handful are identifying “excessive” use of the tests or setting upper targets while others have completely stopped letting doctors have direct access to the scans.

Experts said the tactics could lead to patients being diagnosed later with diseases such as cancer, which research shows lowers survival chances.

Dr Clare Gerada, head of the Royal College of GPs, said: “This is about money and finances driving behaviour by the PCT – not about putting patients first.”

Cancer Research UK’s director of policy, Sarah Woolnough, added: “It is very worrying to hear of PCTs setting referral targets and decommissioning direct access to tests that could speed up a cancer diagnosis.”

Meanwhile, official figures show that even patients who are being referred to hospitals for tests are being forced to wait longer than a year ago.

Department of Health statistics show that 10,700 patients were waiting more than six weeks for any one of 15 key diagnostic tests at the end of July, a rise of 7,000 on the figure for the previous year.

The Government has told health service managers to improve direct access to diagnostic scans such as MRI, CT and ultrasound in order to improve early diagnosis of cancer and heart disease.

But an investigation by GP magazine suggests that many trusts want to reduce the number of patients sent directly to tests at specialist centres in order to save money.

Of the 116 Primary Care Trusts contacted, 28 per cent said they had either started looking into how many referrals GPs carried out across their area, or were planning to do so. A quarter are helping practices reduce inappropriate access.

Nine trusts said they had found surgeries that either sent too many or too few patients for tests while two are considering introducing upper and lower targets.

Five PCTs have scrapped direct access altogether to at least one type of test.

Dr Chaand Nagpaul, a leading member of the British Medical Association, said restricting access to scans risks “turning back the clock” on plans to diagnose disease early.

“An intelligent approach would be to have guidelines for appropriate use of diagnostics and incorporate them into the pathway.”

The moves are the latest example of how managers are rationing patient care in an attempt to make unprecedented efficiency savings totalling £20billion across the NHS by 2015.

From: http://www.telegraph.co.uk/NHS-managers-restricting-access-to-crucial-scans-and-tests

Drinks industry lobbyists now make up almost half the members of a key body tasked with advising ministers on alcohol policy, research papers show.
Seven out of 16 members of the Government and Partners Alcohol Working Group are from industry, up from just a couple last autumn.

Critics believe it is evidence that the Coalition is pandering to the interests of the drinks industry, potentially at the expense of the nation’s health.

Some nine million people in Britain suffer from the harms of alcohol in some, either directly or indirectly, while the cost to the NHS stands at £2.7 billion a year.

Don Shenker, chief executive of the charity Alcohol Concern, believed companies were being allowed a bigger say in “setting the agenda” under the Coalition.

Speaking of the changes to the working group “I can only imagine it’s because this government believes that the drinks industry has a big role to play in shaping policy, in setting the agenda.

“And so they have extended the invitations to a larger set of people from the drinks industry.”

However, Anne Milton, the Public Health Minister, claimed ignorance of the body.

She said: “I think we have a communications problem in Whitehall because you know something that I have never heard of before.”

In opposition David Cameron talked tough on alcohol abuse, and the Conservatives’ manifesto said the party would ban off-licences and supermarkets from selling alcohol below cost price.

In January the Coalition announced that retailers would be banned from selling drinks for less than the value of duty and VAT.

But they will not have to take into account the cost of producing the drinks, meaning they will still be able to sell drinks at a net loss.

The Coalition has pursued an approach of working with industry, arguing it will be more effective than legislation.

However, in March eight organisations pulled out of the Coalition’s Public Health Responsibility Deal – including Alcohol Concern, the Institute of Alcohol Studies and the British Liver Trust.

They wrote to Andrew Lansley, the Health Secretary, saying the deal on alcohol – which includes voluntary agreements with industry – would not help reduce illness or deaths.

At the time Mr Lansley said imposing laws was often “costly” and they could “take years” to implement.

A spokesman for the Department of Health yesterday re-iterated that argument.

She did not deny that changes to the working group had been made.

The spokesman said: “We are committed to challenging the assumption that the only way to change people’s behaviour is through adding to rules and regulations.

From: http://www.telegraph.co.uk/Alcohol-advisory-body-stacked-with-drinks-industry-lobbyists

Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.
Two thirds of health trusts in England are rationing treatments for “non-urgent” conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.

Examples of the rationing now being used include:

• Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
• Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.
• Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.
• Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
• Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.
• Funding has also been cut in some areas for IVF treatment on the NHS.

The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.

Doctors are known to be concerned about how the new rationing is working – and how it will affect their relationships with patients.

Birmingham is looking at reducing operations in gastroenterology, gynaecology, dermatology and orthopaedics. Parts of east London were among the first to introduce rationing, where some patients are being referred for homeopathic treatments instead of conventional treatment.

Medway had deferred treatment for non-urgent procedures this year while Dorset is “looking at reducing the levels of limited effectiveness procedures”.

Chris Naylor, a senior researcher at the health think tank the King’s Fund, said the rationing decisions being made by PCTs were a consequence of the savings the NHS was being asked to find.

“Blunt approaches like seeking an overall reduction in local referral rates may backfire, by reducing necessary referrals – which is not good for patients and may fail to save money in the long run,” he said. “There are always rationing decisions that have to go on in any health service. But at the moment healthcare organisations are under more pressure than they have been for a long time and this is a sign of what is happening across many areas of the NHS.”

According to responses from the 111 trusts to freedom-of-information requests, 64 per cent of them have now introduced rationing policies for non-urgent treatments and those of limited clinical value. Of those PCTs that have not introduced restrictions, a third are working with GPs to reduce referrals or have put in place peer-review systems to assess referrals.

In the last year, 35 per cent of PCTs have added procedures to lists of treatments they no longer fund because they deem them to be non-urgent or of limited clinical value.

Some trusts expect to save over £1m by restricting referrals from GPs.

Chaand Nagpaul, a member of the British Medical Association’s GPs committee, said he was concerned about PCTs applying different low-priority thresholds and rationing access to treatments on the basis of local policies.

He said the Government needed to decide on a consistent set of national standards of “low priority” treatments to help remove post-code lotteries in provision. “Patients and the public recognise that with limited resources we need to make the maximum health gains and so there needs to be prioritisation. What is inequitable is that different PCTs are applying different thresholds and criteria,” he said.

A Department of Health spokesman said: “Decisions on the appropriate treatments should be made by clinicians in the local NHS in line with the best available clinical evidence and Nice [National Institute for Health and Clinical Excellence] guidance. There should be no blanket bans because what is suitable for one patient may not be suitable for another.”

From: http://www.independent.co.uk/cataracts-hips-knees-and-tonsils-nhs-begins-rationing-operations

Maternity services across the UK need a radical rethink, the Royal College of Obstetricians and Gynaecologists says.
It wants the number of hospital units cut to ensure 24-hour access to care from senior doctors and says more midwife-led units are needed for women with low-risk pregnancies.

The National Childbirth Trust welcomed the report but says the proposals do not go far enough.

NHS managers said maternity care desperately needed to be reorganised.

Too many babies are born in traditional hospital units, says the college, which also warns the current system is neither acceptable nor sustainable in its report on maternity care.

The college estimates there are about 1,000 too few consultants to provide adequate round-the-clock cover for hospital units.

Dr Falconer said: “There is no doubt if you look at the worst scenario of serious complications, you need the right person, a senior person, there immediately.”

Previous attempts to re-organise maternity care around a smaller number of hospital units have proved controversial, but Dr Falconer said if women could be convinced of the greater safety they would be prepared to travel to have their babies.

The need for change would be largely in cities or large towns, because in rural areas it might be more important to support smaller units.

The report estimates that across the UK there are 56 units with fewer than 2,500 deliveries of babies a year.

In order to take the pressure off busy hospitals, the college is also calling for an increase in the number of midwife-led units.

Midwives have welcomed the report, saying it could improve the experience for about a third of women who have straightforward deliveries.

The proposals for maternity are part of a wider vision of delivering all women’s gynaecology and obstetrics care in networks, similar to the model which has helped improve cancer treatments in England.

The National Childbirth Trust said the idea of having a network to provide joined-up care for women was one it could support but it would prefer care during pregnancy and maternity to be concentrated in one NHS organisation in each area.

The NHS confederation, which speaks for managers, described maternity care as a classic example of a service which desperately needed to be reorganised.

Chief executive Mike Farrar said politicians needed to be prepared to speak up for change.

“Where the case for change is clear, politicians should stand shoulder-to-shoulder with managers and clinicians to provide confidence to their constituents that quality and care will improve as a consequence of this change.”

Although Scotland has reorganised some of its maternity services, there are likely to be pressures for change elsewhere in the UK.

In North Wales maternity care across three hospitals is expected to change after an initial review recently concluded improvement was needed.

From: http://www.bbc.co.uk/news/health-14145862