NHS hospitals had to be bailed out to the tune of almost £415 million last year after running out of cash according to Department of Health figures.

The payments have risen dramatically since 2009-10, when the department started collating full figures.

That year, they were £187.1 million, while in 2010-11 they rose slightly to £223.0 million, before jumping to £414.2 million.

The big rise coincided with a tighter budget settlement for the NHS as a whole,which has resulted in drops in referrals to hospitals and tighter restrictions on surgery for operations like hip and knee replacements.

Andrew Lansley said: “Labour left us a dismal legacy of challenged hospitals, burdening some of them with PFI deals they could not afford, huge debts, and poor financial governance.

“Even with the Government’s decision to protect NHS spending, the challenges of an ageing population and rising costs mean that these problems cannot be swept under the carpet any longer.

“For some hospital trusts, the challenges they face may be too great for them to take on alone.  That is why we are helping them overcome their problems, with short-term support if necessary, so that they become sustainable in the long-term.”

The largest single bailout was for South London Healthcare Trust, which received £79.2 million last year. Over three years it has been handed £168.7 million. Barking, Havering and Redbridge University Hospitals NHS Trust was the second biggest recipient in 2011-12, taking £57.7 million in total.

From: http://www.telegraph.co.uk/Hospital-bailouts-top-400m

This exporting is conducted by speculators and is legal under EU and UK law, the report noted.

Highly qualified pharmacists are having to spend time locating medicines in short supply, the MPs noted.

But in spite of the best efforts of pharmacists, the group said it had been told of cases involving vulnerable patients not receiving the medicine they need because of shortages.

These included patients with mental health problems, epilepsy sufferers, diabetics, and even pregnant women in need of medicine to stabilise their pregnancy.

“Evidence we received highlights the stress, anxiety and sometimes harm that patients suffer,” the MPs said in their report.

The group warned that the UK has been experiencing shortages of NHS prescription medicines for four years.

“We have no objection to the export of medicines in principle, so long as this practice does not harm patients,” they said.

“However, throughout this inquiry, we have seen evidence that patients are suffering and that pharmacists’ time and resources are being diverted away from patient care as a result of medicines being in short supply.”

In its report, the group calls for a “renewed sense of urgency” to deal with the problem by those organisations involved in the supply of medicine.

The Government must “unequivocally” state that the interests of UK patients must come first and not provisions concerning the free movement of goods, it said.

Katherine Murphy, chief executive of the Patients Association, said: “The very least patients should be able to expect is for prescribed medicines to be available to them when required.

“However, all too often this simple expectation is not being met and as a result patients, some of whom have serious medical conditions that require medicine to remain stable, are being put at risk.

“The Government needs to investigate this problem as a matter of urgency, using the findings of this report as a starting point.”

Over 26,000 nursing posts have been cut in the last two years and a further 61,000 are at risk, according to the RCN.

The college says that, despite government rhetoric claiming more care is being provided outside hospital, there has been less than a 1 per cent increase in the community nursing workforce in the last decade and community nursing is “stretched to breaking point”.

The figures come as Andrew Lansley, the Health Secretary, prepares to address the RCN congress today. In an interview with The Independent ahead of the speech, Mr Lansley denied there were mass reductions in nurse numbers.

He also said staffing numbers were not the only factor in providing good patient care. “In some hospitals the staffing ratios are exactly what we would expect, but some wards are really excellent and some are really bad. This is about leadership,” he said.

Mr Lansley added that a recent staff survey shows that, across the NHS, only 65 per cent of staff would recommend their hospital to friends or family.

A poll conducted for the college on the eve of its annual congress in Harrogate found 90 per cent of respondents agreed patients were being discharged sooner from hospital and with more complex needs than a year ago.

Dr Peter Carter, chief executive of the RCN, said: “Nurses are stretched too thin and many are approaching breaking point. Inevitably patients are going to suffer.” The RCN supported a shift from hospital to community care but nurses reported patients being discharged from hospital before social-care support was in place.

The Health minister Simon Burns said he did not recognise the RCN’s figures: “There are only 450 fewer qualified nursing staff in England than in 2009 and in 2011-12 we expect to train 2,300 community nurses and health visitors.”

From: http://www.independent.co.uk/government-is-cutting-nursing-numbers-by-stealth

At the same time, levels of MRSA and C. difficile infections in hospitals fell.

The government has since dropped the campaign, but said its ambition was to “wipe out” such infections.

Hospital superbugs were once a real fear for many patients. In response the Clean Your Hands campaign, funded by the Department of Health, was introduced in all hospitals by June 2005.

Alcohol gels were put by bedsides, posters reminded staff to wash their hands and there were regular checks to ensure hands were kept clean.

By 2008, the total amount of soap and alcohol gel being purchased by hospitals trebled, going from 22ml per patient per day to 60ml per patient per day.

Rates of MRSA more than halved in the same time period and C. diff infections fell by more than 40%.

One of the report’s authors, Dr Sheldon Stone from the Royal Free University College London Medical School, estimated that around 10,000 lives were saved because of the campaign.

He told the BBC: “It’s been a real British success story, we’ve gone from being the dirty man of Europe to being world leaders.

“What we need to do is keep up the momentum and stay at the forefront of world hand hygiene.”

A spokesman from the Department of Health said: “The Clean Your Hands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.

“The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection.

“We know real progress has been made in this area as MRSA bloodstream infections have dropped by 41% and C. difficile by 30% across the NHS in England since 2009/10.”

From:  http://www.bbc.co.uk/news/health-17942182

However the opposite was true in people who slept for nine hours or more.

Several genes have been found to be associated with obesity and this is thought to be the first study to examine how sleep interacts with them.

The genes affect how the body uses energy, how fat is stored, the feeling of being full after a meal and how quickly sugar is used up.

A team at the University of Washington studied 1,088 pairs of twins and found that the genetic influence on their body mass index was twice as great in those who slept for less than seven hours compared to those who slept for nine hours a night.

The findings were published in the journal, Sleep.  Lead author Dr Nathaniel Watson, said: “The results suggest that shorter sleep provides a more permissive environment for the expression of obesity related genes. Or it may be that extended sleep is protective by suppressing expression of obesity genes.”

Dr Watson said the results were preliminary but may suggest that weight loss measures would be most effective when the genetic influences on obesity were mitigated through sleep extension.

From: http://www.telegraph.co.uk/Sleeping-for-more-than-nine-hours-may-help-weight-loss-research

Typically, they had a state education and their university fees were paid by the state. Even those from middle class homes got a student grant.

They also took the first step on the property ladder in their twenties — years before the current first time buyers.

Their mortgages were comfortably less than three times their salary.

The analysis to find the perfect age was commissioned for the British Airways Business Life magazine, which asked the leading financial advisers Hargreaves Lansdown to examine the numbers and trends.

It found that 70 — or approaching it — was the best age to be. And 45 was the worst.

While someone in their sixties might be suffering thanks to a flat market and low savings growth, they also have the legacy of years of low taxation, good equity in their homes and a pension driven by a 20 year bull run in stock markets.

Those in their forties face high school and university fees for their children, and have few savings and low pensions.

At their time of maximum expenditure they may be in negative equity in their home and there’s little sign of good news on the horizon.

Figures show that life can also be tough for anyone in their twenties. Saddled with student debt, they are finding it difficult to get a job, can’t afford a house, have no savings, high costs and, if they are in work, a low salary.

When they do receive care at home, one in five have had some or all of it withdrawn despite no change in their condition, it was found.

A survey for the charity also found that health and social care services often do not communicate properly with each other leaving family and carers to coordinate between them.

Fewer than four in ten of those who received an assessment had been given a care plan outlining the services and treatments that would be put in place.

The National Stroke Strategy states that people should receive an assessment at six weeks of leaving hospital, again at six months and then annually.

Reports from the National Audit Office and the Public Accounts Committee have also recently criticised the care of stroke patients once they leave hospital.

The Stoke Association report entitled Struggling to recover, it based on a survey of 2,200 stroke survivors.

Around 150,000 people a year suffer a stroke and 53,000 die annually. It is one of the most common causes of disability with 450,000 stroke survivors left severely disabled in England.

Jon Barrick, chief executive at the Stroke Association said: “More people than ever are surviving a stroke and that’s a welcome improvement.

“But many stroke survivors tell us that after all the effort to save their lives they then feel abandoned when they return home.

“The NHS and local authorities are failing in their responsibilities to provide appropriate and timely support to stroke survivors and their families; and the growing evidence of cuts for people currently getting services is very worrying.”

Helping stroke survivors to make a full recovery makes economic sense Mr Barrick said because they are then less likely to be admitted to hospital as an emergency or end up in a care home.

Mr Barrick added: “Common sense aside, the evidence is clear. Appropriate assessment and provision of services at the right time improves quality of life for stroke survivors and their families.

“It also saves the tax payer money, as people are less likely to require acute or crisis interventions.

“Stroke survivors and their families must be properly supported immediately after leaving hospital and in the long term, so they can make better recoveries and get on with their lives.”

Researchers have identified a ‘genetic switch’, carried by one in five women, that doubles their risk of developing breast cancer.

Experts described the breakthrough by scientists at Imperial College London as “exciting” and said signs of the disease could be detected “many decades in advance”.

Dr James Flanagan, who led the new research, said the test could be available in five to ten years.

The ‘genetic switch’ is influenced by lifestyle factors such as alcohol, smoking, pollution, and hormones including HRT.

Carrying the genetic alterations increase a woman’s lifetime risk of developing breast cancer from one in eight in the general population to one in four.

These tiny genetic changes could be detected in blood samples years before symptoms of breast cancer developed.

Scientists analysed blood samples from 1,380 women of various ages, 640 of whom went on to develop breast cancer.

On average, the blood tests were carried out three years before diagnosis. In some cases they pre-dated the discovery of breast cancer by up to 11 years.

The results were especially clear in blood samples from women under the age of 60.

Around 49,000 people are diagnosed with breast cancer each year and almost 12,000 die annually in Britain.

The changes are also associated with lymphoma and leukaemia meaning the test could have implications in other cancers.

A strong association was found between molecular changes in a white blood cell gene called ATM and breast cancer risk.

Dr Flanagan said: ‘We are working towards prevention. If we can identify women at high risk of cancer we can work towards preventing it and could reduce the incidence of breast cancer quite dramatically.  We have found one marker, we need to work towards finding them all and then we will have a more useful test.”

The findings are published in the journal Cancer Research.

Baroness Delyth Morgan, chief executive of Breast Cancer Campaign, said: “Dr Flanagan’s research into epigenetics is so exciting because it suggests that there is every possibility the risk of developing breast cancer could be decided many decades in advance.

“By piecing together how this happens, we can look at ways of preventing the disease and detecting it earlier to give people the best possible chance of survival.”

Last month researchers announced that they had discovered that breast cancer was not a single disease but there were fact ten distinct genetic types.

This means that treatment can be tailored to the genetic profile of the specific type meaning drugs will work better, with fewer side effects.

From: http://www.telegraph.co.uk/Blood-test-could-detect-breast-cancer-years-in-advance

It allows foreign nationals who arrive in England on a six month visitors visa to begin receiving health care immediately.

But the pressure group Migration Watch UK says that it could also mean illegal immigrants getting NHS treatment.

Sir Andrew Green, chairman of the organisation, said: “What this means is that someone getting off a plane with a valid visitors visa, is, in effect, able to access the GP services of the NHS without ever having paid a penny into the system. Over one and a half million such visas were issued last year.”

“And once registered with a GP it is, in practice, an easy step to potentially highly expensive and long term treatment – all at the expense of the UK taxpayer with little or no prospect of the beneficiaries ever being charged for it.”

He went on: “‘It is clearly not the job of doctors to act as an arm of the immigration service but there are clear and substantial risks of abuse in such a lax system and controls must be put in place.”

“The present situation is outrageous. Everyone knows the pressure the NHS is under and its ever increasing cost to the taxpayer. To allow such easy and potentially hugely expensive access without any entitlement must be stopped at once, otherwise the NHS risks becoming the ‘World Health Service’.”

The “lax” rules were confirmed in response to a parliamentary written question asked by Frank Field, the veteran Labour MP.

From: http://www.migrationwatchuk.org/

The problem – often referred to as “bed blocking” – has increased 29 per cent when compared with figures from August 2010.

Patients are frequently delayed in hospital and cannot be discharged until suitable care has been arranged, either in a nursing home or in their own home, to aid their recovery.

Councils have faced significant cuts to their budgets and experts have previously warned there would be a knock-on effect on the NHS.

However, patients can also be delayed because they need to be transferred to other hospitals.

The figures show there were 71,450 delayed days in hospitals in March, up from 64,590 in February 2012 and 55,330 in August 2010. However, officials said it was not fair to compare summer figures with statistics from the winter period, when hospitals and councils are busier.

The cost of the delays to the taxpayer has now reached more than £18.5 million a month – around £600,000 every day. The total bill for delayed discharges since August 2010 is £324 million.

The Health Minister Simon Burns said: “No one should stay in hospital longer than they need to.  We know that there is always room for improvement when the NHS faces challenges from an ageing population and rising costs of new treatments.”

From: http://www.telegraph.co.uk/25pc-more-patients-forced-to-remain-in-hospital-beds

The NHS Employers organisation said it had “serious concerns” that health trusts were not being given sufficient opportunity to plan for the day of action.

Director Dean Royles said: “Employers are telling us they have not yet received written notification on which staff will be asked to withdraw their labour with action scheduled to take place in less than two weeks.

“Unions must by law do this no later than seven days before a strike, but this is healthcare we are talking about. Employers are having to rely on patchy information from local representatives but this is not enough on which to take significant decisions about patient care.

“Of course the NHS will work hard and cope but we could be so much clearer to patients and maximise safety with written information from Unite. Even in a well planned strike, there will be distress and disruption to patients.

“This is bad enough but problems will be exacerbated with every day that passes without reliable information.”

The May 10 walkout will be the biggest day of action since last November’s stoppage by more than 1.5 million public sector employees.

Unite has suspended its industrial action by health workers in Scotland after the Holyrood Government agreed to fresh talks on the NHS pension scheme.

The union, which has 100,000 members in the health service, including 15,000 in Scotland, urged the Westminster Government to follow suit.

Diabetes that is not controlled can cause many serious long-term problems

• Excess glucose (sugar) in the blood can damage the blood vessels, contributing to heart disease, strokes, kidney disease, impotence and nerve damage.
• Uncontrolled diabetes is the most common cause of blindness in people of working age.
• People with diabetes are also 15% more likely to have an amputation than people without the condition.

In Type 2 diabetes, not enough insulin is produced or the insulin that is made by the body does not work properly.

It tends to affect people as they get older and usually appears after the age of 40, but increasingly is seen in younger, overweight people. It accounts for 90% of all cases.

Type 1 diabetes, a condition which usually means insulin cannot be produced at all, is responsible for the other 10%.

Adrian Sanders, chair of the all-party parliamentary group for diabetes, claimed there was plenty of evidence out there to support Dr Rayman’s assessment.

He said the government was aware that a disproportionate number of people occupying hospital beds have diabetes, and their hospital stays are longer.

He said the government – and the last Labour administration – had encouraged more support for people with diabetes in primary care.

“That’s actually a very good policy for people whose condition doesn’t present complications or specialisms. And that’s why you need specialist care for those who present with specialist problems.”

Barbara Young, chief executive at Diabetes UK, said diabetes was a serious condition which could lead to devastating long term complications including blindness, kidney failure and amputations.

She said: “The tragedy is that for many people with diabetes, complications could have been avoided if the health checks were in place to spot any signs and if the appropriate care and treatment were applied.

“For example, up to 80% of amputation cases due to diabetes could be avoided if problems are identified early enough and treated appropriately.”

Life expectancy is going up all round, but the rates for men are increasing faster. Plummeting smoking rates in men are thought to explain a lot of the change.

Prof Mayhew, a professor of statistics at Cass Business School, analysed life expectancy data in England and Wales. He was working out how long 30-year-olds could expect to live.

His findings show men laguishing far behind for decades, but now starting to get closer to women. If current trends continue, Prof Mayhew predicts, both sexes could, on average, be living to the age of 87 in 2030.

He said: “What’s interesting at the moment is that in the last 20 years or so, male life expectancy at 30 has jumped by about six years and if it jumps by the same amount in the next 20 years it will converge with female life expectancy.”

The reason could be down to men living a healthier lifestyle. “One of the main reasons, I think, is the trend in the prevalence of smoking. Smoking took off after 1920 in the male population and at its high about 80% of males smoked.

“This was reflected in more divergence in the life expectancy, so by the time you get to about 1970 it was at its peak – the difference in life expectancy was about 5.7 years.”

Other factors are thought to be safer, more office-based, jobs. Millions of men used to work in hazardous occupations such as coal mining. Healthcare has meant more men live longer as well. People with heart disease, which is more common in men, can expect to live much longer than they did a few decades ago.

By contrast, women started smoking later than men. Rates of lung cancer are still increasing in women, but are falling fast in men.

A boy and a girl born on the same day will still not have the same life expectancies, as the study looked only at people who had already reached 30. Boys are more likely to die in their first year of life and are more likely to take up dangerous sports or be involved in fatal accidents.

Prostate cancer symptoms are unfortunately difficult to spot in the early stages of growth.

If you experience any of the following symptoms, you must see a medical professional immediately:

• the prescence of blood in urine and/ or semen
• pain or burning sensation when urinating
• erectile dysfunction (inability to have or sustain an erection)
• uncomfortable or painful ejaculation
• in the upper thighs, hips, or lower back, a frequent pain or stiffness
• a general pain in the prostate area
• a need to urinate frequently, especially at nighttime
• difficulty in urinating, both in starting or holding back
• interrupted or weak flow of urine

There are several Risk Factors associated with Prostate Cancer:

• Age – For men with over fifty years of age, prostate cancer is most common.
• Family history – It is also an important indicator. If you have a close male relative who has suffered or is suffering from the disease, you are twice as probable to be diagnosed with prostate cancer yourself.
• Nationality – Your nationality and racial genetics may also play a part. Studies show, for example, that African-Americans are most at risk, followed by Americans and Europeans. Asians (particularly those that live in the East and Southeast portions of the continent) are the least at risk.
• Lifestyle – Even though, the evidence in often conflicting, in the development of prostate cancer, an individual’s lifestyle, and diet may also play an important part.

At present, while prostate cancer is not an avoidable disease, it can be mitigated by alterations in a person’s food consumption and general way of life.

The most commonly employed method of testing for prostate cancer is a basic prostate exam.

It involves a physician inserting a gloved, lubricated finger into the rectum so that the physician can feel the prostate, which is located a few inches up from the rectum. A healthy prostate feels firm; if prostate cancer is present, the prostate may have hard spots on it.

For those who are squeamish towards this type of testing, an alternative method is sometimes used.

Known as a prostate cancer PSA level test, blood is taken from the patient and screened for prostate-specific-antigen levels.

Prostate-specific-antigens are present in all men, but those with prostate cancer often have a heightened level of the antigen.

Alternatively men with the BRCA1 gene have a one in 11 chance of developing prostate cancer by the age of 65, it was found.

Other tests such as X-rays and bone scans may also be useful in detecting the cancer and determining the extent to which it has spread.

Outbreaks in Africa and delays in vaccination programmes in India have stalled progress, researchers say.

A new campaign to tackle the disease has been launched, which will combine measles and rubella jabs.

In 2000 there were 535,300 deaths from measles. This fell to 139,300 deaths in 2010, according to the analysis.

The Measles and Rubella Initiative, a collaboration of international organisations including the WHO, said the decline in measles deaths was strong up to 2007, but measures “faltered” in 2008 and 2009.

This lead to outbreaks in Africa, Asia and even Europe.

Africa and India accounted for a combined total 79% of all deaths from measles between 2000 and 2010.

Measles is a highly infectious viral illness:

• Causes a fever, coughing and distinctive red-brown spots on the skin
• Contracted by breathing in tiny droplets created when an infected person coughs or sneezes
• Possible complications include pneumonia, ear and eye infections, and croup
• Serious complications include inflammation of the brain (encephalitis), which can be fatal
• Infection during pregnancy can cause miscarriage, premature labour or low birth weights

The next target is a 95% drop in deaths from their 2000 levels by 2015.

The new campaign will see the introduction of a vaccine for both measles and rubella.

They have bought the wrong medication after misdiagnosing themselves on the internet and one in ten has suffered unpleasant side effects as a result, research suggests.

Half of women have diagnosed themselves online and bought a treatment without checking with pharmacists if it is the correct product.

A similar proportion said they would seek to treat medical problems themselves before consulting doctors.

A quarter said they “dread” speaking to doctors.

The online world is just as bad as the offline world for misleading people with snakeoil potions.

The moral of the story is to make sure that you only deal with professionals who you can trust.

For medical news we suggest only using websites such as Health Direct which are regularly reviewed by independent experts:
This site complies with the HONcode standard for trustworthy health information: verify here.
Remember that Dr Google can’t do anything for you, except make you feel bad and paranoid

Dr Google can’t write prescriptions- nor even examine you verbally or in person.

Also, search engines can’t actually think- though they may be programmed very cleverly.

Common sense should prevail online as well as offline.

If your symptoms are bothering you that much, you should go to a qualified practitioner which in the case of medical issues is a GP.

Dermatologists told the British Medical Journal the move could cause problems for people who have nickel allergies, including some people with eczema.

But the Royal Mint said the change would not have an adverse impact.

The new coins, which come into circulation in the next few months, are being introduced because of the rising cost of copper.

The Treasury believes it could save £10 million a year, although millions more have been spent changing vending machines and parking meters as the new coins are slightly thicker, causing anger among councils and industry.

Up to 10% of the population, predominantly women, are thought to be affected by nickel allergy.

The latest controversy has been raised by dermatologists from St John’s Institute of Dermatology in London and the Royal Hallamshire Hospital in Sheffield.

The authors warned that there had been no health assessment of the new coinage.

In comparison in Sweden its central bank, the Swedish Riksbank, has recently concluded that nickel-plated coins “pose unacceptable risks to health”, the BMJ reported.

In a letter to the BMJ, the dermatologists said there was the potential for more skin problems, which could have financial implications for the NHS.

They said: “Considerable evidence supports these concerns, which have not been assessed by the Treasury or Royal Mint.”

They have called for Sir John Beddington, the government’s chief scientific adviser, to look into the matter.

More than 60,000 low-risk women in England were studied over two years.

The Royal College of Midwives says all women should receive one-to-one care.

For women having their first baby, however, planned home birth was more risky for the baby but still the most cost effective option.

The study used data from the Birthplace in England national study to calculate the cost, and health effects, of women at low-risk of complications giving birth.

It looked at planned births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units not in a hospital and at home.

The study takes into account all NHS costs associated with the birth itself – such as midwifery care during labour and immediately after the birth, the cost of pain relief in hospital, and the cost of any stay in hospital or neonatal unit immediately after the birth, either by the mother or the baby.

The costs for planned home and midwifery unit births take account of any hospital care a woman may receive if she is transferred into hospital during labour or after the birth.

But the costs do not include any longer term costs, for example the life-long cost of caring for babies who suffer serious birth injuries.

The study found that the average cost per low-risk woman planning birth at the start of labour was £1,631 for an obstetric unit, compared with £1,067 at home.

When the researchers analysed women who had already given birth or who had no complicating conditions, the cost differences between planned places of birth narrowed.

The authors of the study conclude that giving women the opportunity to give birth at home or in a midwifery unit saves the NHS money and is safe for baby and mother, resulting in fewer expensive interventions.

AVERAGE COST OF BIRTH

• £1,066 – births planned at home
• £1,435 – births in freestanding midwifery units
• £1,461 – births in midwifery units alongside hospitals
• £1,631 – births in hospital obstetric unitsSource: BMJ study

The study found that individual care at home is cheaper than a planned hospital birth because hospital overheads tend to be higher and women who plan birth in an obstetric unit tend to have more interventions, such as caesarean section, which are expensive.

Men with the BRCA1 gene have a one in 11 chance of developing prostate cancer by the age of 65, it was found.

The faulty gene seemed to be linked to a particularly agressive form of cancer making early detection and treatment vital.

The study was conducted by the The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust and published in the British Journal of Cancer.

In breast cancer BRCA1 increases the chances of developing the disease by five fold, giving them a six in ten chance of breast cancer compared with a one in eight chance for healthy women.

It has led some women with faulty genes to have preemptive mastectomies rather than live with high risk of breast cancer.  BRCA1 is also associated with ovarian cancer.

In the study 913 men underwent genetic screening, with results obtained from 886 and four men were found to have alterations in BRCA1. Three out of those four men were diagnosed with prostate cancer before the age of 65.

As well as detecting BRCA1 in men with a history of cancer in their families to identify those at greater risk, genetic screening of men who already have the disease could improve their treatment, the researchers said.

There are already drugs in use that target BRCA1.

The findings come after other research showed that HIFU (high intensity focused ultrasound) can provide the ‘perfect’ outcome for nine out of ten men with early stage prostate cancer. The majority of men treated were continent, had good sexual function and were free of cancer after 12 months where as traditional surgery or radiotherapy could only offer that in half of cases.

Prostate cancer is the most common cancers affecting men in Britain with 37,000 men diagnosed each year. It claims 10,000 lives every year.

Other faulty genes have been implicated in prostate cancer including a mutation in HOXB13 which increased the risk of the disease 20 fold. It is relatively rare, occuring in less than two per cent of men with prostate cancer.

It was known that stress and depression increase the chances of being unwell and is harmful for the heart but less was known about how positive emotions affect health.

In the first review of its kind, a team at Harvard School of Public Health, in Boston, America, examined 200 separate research studies which looked as psychological wellbeing and cardiovascular health.

The findings were published online in Psychological Bulletin.

Lead author Julia Boehm, research fellow in the Department of Society, Human Development, and Health at HSPH said: “The absence of the negative is not the same thing as the presence of the positive. We found that factors such as optimism, life satisfaction, and happiness are associated with reduced risk of cardiovascular disease regardless of such factors as a person’s age, socioeconomic status, smoking status, or body weight.

“For example, the most optimistic individuals had an approximately 50 per cent reduced risk of experiencing an initial cardiovascular event compared to their less optimistic peers.”

Each of the 200 research papers studied slightly different emotional states using questionnaires and assessments to score individuals’ characteristics and outlooks.

They measured the extent to which individuals consider themselves a happy or unhappy person, satisfaction with their life and the extent to which they experience pleasurable feelings.

Some also looked at optimism and hope, the extent to which individuals have expectancies for positive outcomes in the future and enthusiasm for life.

Senior author Laura Kubzansky, associate professor of society, human development, and health at Harvard, said there are psychological assets, like optimism and positive emotion, that afford protection against cardiovascular disease.

These factors protected people against heart attacks and strokes and also slowed the progression of heart disease and other diseases in patients who had already developed them, it was found.

The research showed that people with a positive outlook on life and who were optimistic about the future tended to lead healthier lives overall.

They were more likely to exercise, eat a good balanced diet, and get enough sleep. Yet even when these factors were accounted for, the happier people were still less likely to develop cardiovascular disease.

It is thought that a positive attitude to life makes people more resilient to stress and helps them recover more quickly after things like preparing for a speech, the researchers said.

In one study that was examined, involving 300 men and women having bypass surgery, those with an optimistic outlook were also 50 per cent less likely to be admitted to hospital for heart problems or surgery complications six months later.

Prof Kubzansky said if future research continued to indicate that higher levels of satisfaction, optimism, and happiness proceeded good cardiovascular health, it would have strong implications for the design of prevention and treatment of heart disease and stroke.

The review found that one study of nearly 2,500 men and women showed that emotional wellbeing, as rated on a depression scale, was linked with a 26 per cent reduced risk of stroke six years later, even after accounting for traditional risk factors and negative mood.

There were similar results on scores of vitality, even after accounting for factors that cause heart disease such as smoking and obesity, it was found emotional vitality was associated with a 28 per cent reduced risk of coronary heart disease.

From: http://www.telegraph.co.uk/Positive-outlook-on-life-linked-to-lower-risk-of-heart-attacks-research

NHS Hartlepool spent £764 per patient in 2009-10, but NHS Peterborough only £275.

Examples of treatments they offer include physiotherapy, drugs, and pain management clinics.

The figures are detailed in a new report by ARMA, called Joint Delivery?

Professor David Marsh, chairman of the organisation, said: “Joint Delivery? shows that progress in delivering improved musculoskeletal care in the NHS has gone into reverse since ARMA’s previous audit in 2008.

“Urgent action is now needed to address variations in service provision and improve the quality of musculoskeletal services in the NHS.

“ARMA and its members are taking a lead by developing a musculoskeletal clinical network to improve services but we need national action to make musculoskeletal conditions a priority in the new NHS.

“That is why we are today calling for a national outcomes strategy for musculoskeletal conditions to ensure services deliver better outcomes for patients.”

At the moment about five per cent of the total NHS budget, some £4.76 billion, is spent on musculoskeletal conditions, making it the fourth highest area of programme budget spend.

Although spend had “risen rapdily in recent years”, according to ARMA, it warned that the area was at risk of being downgraded, with two-thirds of PCTs saying they had reduced the number of specialist commissioners who decide on care

The drugs trade has spread to Africa and Eastern Europe in recent decades and entrenched its standing in its traditional strongholds of Asia and the Americas.

Nigel Inkster, the former assistant chief of MI6 and author of the study, said there was a growing revolt against the cost of the fight in developing countries.

Only “vested interests” in countries where illegal drugs are consumed stood in the way of a change in approach, he said.

Research indicated that the authorities would need to stop 70 per cent of all drugs shipments to disrupt the trade. While no figures for the proportion of the trade stopped are available, the figure is almost certainly far below that threshold.

Therefore ramping up the security services fight against drugs is almost certainly doomed to failure.

“As any doctor is told on his first day, you should not just double the dose,” said Mr Inkster, who is the most senior figure to have worked within the fight against narcotics to openly call for a review. “If your initial diagnosis doesn’t work don’t just double the dose.”

The corrosive effects on security of the narco-economy also weighs as an argument for ending the war. “You can’t do counter-insurgency and counter-narcotics simultaneously,” he said. “Our investigation has shown us that the so-called war on drugs fundamentally undermines international security.”

The report, Drugs, Insecurity and Failed States, highlights two alternative systems.

Either decriminalisation of all personal possession, as Portugal instituted a decade ago- or a licensing scheme such as that which brought the gin trade under control in London in the 1700s.

Licensing would also allow states to begin to apply the lessons of antismoking campaigns which have curtailed tobacco use.

Taxation, public health messages and social legislation could marginalise drug use.

A study has found that focal HIFU, high-intensity focused ultrasound, provides the ‘perfect’ outcome of no major side effects and free of cancer 12 months after treatment in nine out of ten cases.

Traditional surgery or radiotherapy can only provide the perfect outcome in half of cases currently.

Experts have said the results are ‘very encouraging’ and were a ‘paradigm’ shift in treatment of the disease.

It is hoped that large scale trials can now begin so the treatment could be offered routinely on the NHS within five years.

A larger trial is already recruiting patients and men interested in the treatment should speak to their cancer doctor or GP about being referrred, experts said.

Prostate cancer is the commonest cancer in men with more than 37,000 diagnoses each year contributing to approximately 10,000 deaths.

Current treatments include surgery to remove the whole prostate or radiotherapy. Both of which can effectively treat the cancer but often cause side effects such as incontinence and impotence.

However in many men prostate cancer will not progress to a life threatening disease meaning that radical treatment risks side effects unnecessarily. For this reason, research is now focused on reducing side effects.

Focal HIFU involves careful selection of tumours, as small as a grain of rice, within the prostate gland and targeting them with highly focused ultrasound to heat them and destroy them.

The advantage over previous HIFU and other treatments is that damage to surrounding tissue is minimised, meaning there are far fewer side effects.

In the study Focal therapy for localised unifocal and multifocal prostate cancer published in the journal Lancet Oncology, 41 men were treated with focal HIFU. After 12 months, none were incontinent and one in ten suffered impotence.

The majority, 95 per cent, were free of cancer after 12 months.

Dr Hashim Ahmed, who led the study at University College London Hospitals NHS Foundation Trust andUniversity College London, said: “This changes the paradigm. By focusing just on the areas of cancer we reduce the collateral damage to surrounding tissue.

“Our results are very encouraging. We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side-effects. That could mean a significant improvement in their quality of life.

“This study provides the proof-of-concept we need to develop a much larger trial to look at whether focal therapy is as effective as the current standard treatment in protecting the health of the men treated for prostate cancer in the medium and long term.”

The research programme is led by Professor Mark Emberton, of UCL and UCLH. He said: “Focal therapy offers harm reduction – it is a strategy that attempts to redress the balance of harms and benefits by offering men who place high utility on genito-urinary function an alternative to standard care.

“In fact, the concept is not new – tissue preserving strategies have been used successfully in all other solid organ cancers such as breast cancer by offering women a lumpectomy rather than mastectomy.”

Professor Gillies McKenna, director of the Medical Research Council and Cancer Research UK Gray Institute for Radiation Oncology and Biology, said: “Clinical trials, like this one supported by the MRC, are a fantastic tool for telling us whether experimental new treatments are likely to be effective in the clinic.

“If these promising results can be confirmed in a randomised controlled trial, focal therapy could soon become a reasonable treatment choice for prostate cancer alongside other proven effective therapies.”

NHS medical director Prof Sir Bruce Keogh said people should be sent home only when it was appropriate and safe.

The paper had contacted 170 NHS trusts in England but only 100 responded.

However, the rates of those discharged varied widely between different hospitals.

The paper reported that some 3.5% of all hospital discharges took place between those hours and this rate had steadily held for the past five years.

On the face of it, it seems shocking that any patients are being discharged at night. The data obtained by The Times suggests this may be happening in 3.5% of cases.

But that needs putting into context. It seems some hospitals are including patients who have died in their figures, while some patients, such as women who have had a baby, may choose to leave at night.

Nonetheless, it is clear there are also many cases of inappropriate discharges.

This reflects the pressure hospitals are under. Admissions to A&E units have been rising for years – and if more people are coming in, more have to leave.

The problem is compounded by the fact hospitals have very little wriggle room. They are supposed to operate at only 85% capacity, but all too often they are closer to 100%.

It means when there is a surge in patients, there is no leeway in the system – and something has to give.

If the remaining 70 trusts discharged their patients at similar rates, this would add up to 400,000 such discharges a year and almost 8,000 a week, the paper added.

Derby Hospitals Foundation Trust sent 8.7% of its patients home overnight but the trust told the Times there may have been a problem with its records.

Others with rates above 7% include the Heart of England NHS Foundation Trust in Birmingham and Countess of Chester and University Hospitals of Leicester trusts.

Newcastle Hospitals Foundation Trust and Southend University Hospital Foundation Trust both said they did not discharge patients during the night.

The Times does state that the data is variable and while some hospitals admitted to keeping detailed records, others said they could not guarantee the accuracy of the figures as details were not necessarily recorded accurately.

The paper also adds that some hospitals categorise deaths as “discharges” while others do not.

Time spent on planning and inspecting equated to 1,100 days, it said.

The department said the inspections had been agreed between the CQC and the health secretary.

It added that if the regulator had said more money was needed, it would have been provided.

The inspectors visited nearly 300 abortion providers in England over three days in March, and found about 50 were not complying with laws or regulations.

Several doctors were referred to the General Medical Council, and police have been investigating too, to establish whether criminal offences have been committed.

In a letter to the Department of Health, CQC chairwoman Dame Jo Williams said the urgent inspections have had “a considerable impact on our capacity to deliver our annual targets”.

“Such a request at short notice entails Operations management time in planning the visits, cancelling pre-planned inspections as well as the compliance inspector time in carrying out the visits and drafting the reports.”

Dame Jo outlined the impact on scheduled activity in the letter, saying that 320 locations would require visits, with the total number of days required – including for planning and management – being 1,100.

“This equates to a total of 580 inspections foregone and a total of 16 inspectors being utilised on a full year basis at an estimated cost of £1.0 million,” she wrote.

She also asked that the department take into account such an impact on planned work “when considering future requests and delivery within a time limited period”.

The work of abortion clinics first came under the spotlight in February when the Daily Telegraph secretly filmed doctors and alleged some were agreeing to terminate foetuses when women did not want their baby because of its gender.

Police are investigating the allegations.

It said it “continues to hold the view that the private healthcare market could work better for patients”.

The market is of growing importance due to an ageing population and improved medical outcomes, according to the OFT.

Among the concerns raised by the OFT are:

• a lack of information about the pricing and quality of services that would enable patients to compare healthcare providers
• the small number of healthcare providers and insurers nationally, which limits choice and competition
• practices that make it harder for new competitors to break into the market, such as loyalty payments to consultants.

The Competition Commission has the power to demand that firms change business practices and spin off specific business interests, if it deems these to be harmful to market competition.

The investigation could take up to two years to complete.

Staff cuts and a lack of cover when people are on leave or sick is to blame, a union said.

The 2011 NHS Staff Survey, of more than 135,000 health service workers in England, found some were struggling with heavy workloads.

The official NHS staff survey comes after the Royal College of Nursing warned that one in three nurses working on older people’s wards are too busy to help patients with eating or going to the lavatory.

However when hospital staff were asked if a friend or relative needed treatment in their organisation, they would be happy with the standards of care, the proportion answering ‘yes’ varied from just one in three at Croydon Health Services NHS Trust to 96 per cent at Clatterbridge Centre for Oncology NHS Foundation Trust.

Health Secretary Andrew Lansley said: “This survey shows that NHS staff remain committed to providing the highest quality of care to their patients.

“The number of staff happy with the standard of care remains stable, with some foundation trusts performing to a very high standard. Too many trusts continue to have less favourable levels of recommendation to family and friends.”

“The NHS should use this as a basis for seeing improvement in the services we deliver for patients in the future.”

Christina McAnea, Unison head of health, said: “The staff survey reflects some of the pressures felt by staff, but our own survey painted a much bleaker picture.

“Unison’s survey showed that 85% experienced an increase in workload and 83% suffered an increase in stress over the past year. The increase in workload is not a coincidence, it is down to cuts in staffing and to a lack of cover for staff on sick or on leave.”

The NHS survey also found that a fifth of staff said they cannot do their job to a standard they are personally pleased with and half would not recommend their trust as a good place to work.

Almost nine out of ten staff who deal with patients said they were satisfied with the quality of care they provided.

From: http://www.telegraph.co.uk/NHS-staff-overworked-survey-finds

Other parts of the UK are planning similar action to drive down smoking rates.

Andrew Lansley Health Secretary said: “Firstly, it reduces the visibility of tobacco and smoking to young people. And, of course two thirds of smokers started smoking before they were eighteen.

“So, if we can, literally, arrive at a place where young people just don’t think about smoking and they don’t see tobacco and they don’t see cigarettes – then I hope we can make a big difference.”

He said the government recognised the pressures on retailers to comply with the ban but added: “We want to arrive at a place where we no longer see smoking as a normal part of life. We’re doing it by stages with constant active pressure.”

A fifth of adults smoke – a figure which has remained steady in recent years after decades of rapid falls.

A plan to force manufacturers to put cigarettes into plain packets is also expected to be put out to consultation later this year.

The display ban will apply to shops of more than 280 sq m (3,014 sq ft).

Public health minister Anne Milton cited evidence from Ireland which suggested the measure could play an important role in discouraging young people in particular from smoking.

“We cannot ignore the fact that young people are recruited into smoking by colourful, eye-catching, cigarette displays.  Most adult smokers started smoking as teenagers and we need to stop this trend.”

Jo Butcher, of the National Children’s Bureau, agreed: “It’s essential that we create a culture that promotes and protects public health and tobacco legislation is a significant factor in making this happen.”

Jean King, of charity Cancer Research UK, said the ban would help stop children who are attracted to brightly coloured tobacco packaging from taking up smoking but further action was still needed.

“Of course we want to see the pack branding taken away as well. This is not a normal consumer product, it kills people. We want to protect the next generation of children,” she said.

Andrew Opie, from the British Retail Consortium, said it was wrong to believe the legislation would have a major effect on young people and it was supermarkets and other shops which were bearing the brunt of the costs needed to comply with the ban.

He said the organisation had calculated that it cost more than £15 million to ensure everything was sorted out before the ban came into place.

He said: “Children are more likely to smoke when they’re in a household where parents smoke and also they tend to get their cigarettes from either parents, or older peers, not directly from supermarkets.

The display ban was announced by the government last year as part of its tobacco control strategy.

Although the legislation allowing it to happen was actually put in place by the Labour government before it lost power in 2010.

A number of countries, including Canada, Ireland, Iceland and Finland, have already introduced similar bans.

Prof David Hammond from the University of Waterloo in Ontario, said the ban led to a decline in smoking – especially among the young – in Canada.

“The declines were greatest in the provinces where the ban had been implemented the longest. And that’s consistent with the idea that when you remove something like marketing, it takes some time for the residual marketing to wear out.”

From: http://www.bbc.co.uk/news/health-17626133

An estimated 270 patients in England and Wales have had them fitted.

Surgeons are being advised to closely monitor all affected patients. The implants are no longer being manufactured or distributed.

Hip implants are made up of an artificial cup and head, replacing the original hip joint. They can be made entirely of metal, of ceramic, or of a combination of metal and plastic.

The implants in question are a particular combination of metal cup and metal head- with the brand names Mitch TRC and Accolade.

Surgeons are being advised to stop using them because the National Joint Registry for England and Wales shows a revision rate of 10.7% after four years of implantation, much higher than average.

The advice follows a recent study warning that metal-on-metal total hip replacements fail more frequently than other options.

The Medicines and Healthcare Products Regulatory Agency has already recommended annual checks for people with large head metal-on-metal implants.

It is thought tiny pieces of metal break off implants and leak into the blood. This might cause muscle and bone damage as well as neurological issues.

The clinical director of the MHRA, Dr Susanne Ludgate, said the revision rate for this particular combination of hip implant was unacceptably high.

“That is why we have advised surgeons to stop using this combination and to monitor their patients closely,” she said.  “We have previously taken prompt action in February to investigate safety concerns and provided advice on patient management to relevant healthcare professionals.”

From: http://www.bbc.co.uk/news/health-17590832

People who still maintain the treatments are effective are “ignoring or misrepresenting the best evidence available”, he added.

Homeopathy could even be dangerous because it is sometimes used instead of scientifically proven medical procedures such as immunisations, he added.

Prof Ernst, a former homeopathist, is an outspoken critic of unproven treatments provided on the NHS. He once labelled the Prince of Wales a “snake-oil salesman” because of his support for “unproven and disproved” medicine.

The NHS spends about £4 million a year on homeopathy, which is based on the theory that patients can be cured through exposure to a diluted form of the substance that caused their symptoms.

Writing in The Biologist magazine Prof Ernst, now a professor of complementary medicine, said this belief “Is in contrast with the laws of physics, chemistry and pharmacology. Homeopathy is thus biologically implausible.”

He said: “Homeopathy could be (and often is) used as an alternative to effective interventions. For example, the advice from homeopaths not to immunise has become a major cause of low vaccination rates.”

The strategy of using homeopathy as a placebo can only work if doctors hide the truth from their patients, he added.

Homeopathists insist that the form of treatment is not suited to the design of conventional clinical trials because they do not take into account the benefit that many patients have been shown to experience in observational studies.

They say that the method of administering extremely diluted substances works by triggering the body’s natural healing systems, which can lessen symptoms and lead to eventual cures.

Dr Mark Downs, Chief Executive of the Society of Biology, said: “The UK spends billions of pounds every year ensuring that the new and existing conventional medicines we take are effective, safe and fit for purpose.

“It makes no sense to allow other treatments available through public expenditure to be made available without application of the same rigorous standards. That is what is happening with homeopathic treatments. It needs to stop.”

Síle Lane of the Sense About Science campaign group added: “When a treatment like homeopathy is offered by the NHS, people will think the evidence for it has undergone the same level of scrutiny as conventional medicine.

“It misleads people into thinking there is something in it when there isn’t.”

From: http://www.telegraph.co.uk/Homeopathy-biologically-implausible

He said the current system ‘lacks compassion’ because patients are forced to wait for investigations or take time off work or arrange childcare in order to be seen.

Studies have shown that patients are around 16 per cent per cent more likely to die if they are admitted to hospital at the weekend due to a lack of senior staff.

His comments come as a survey revealed that four in ten doctors are opposed to hospitals operating a seven-day service saying they would need extra pay to work unsocial hours.

Sir Bruce is attempting to reform NHS hospital working hours by talking to hospital chief executives around the country to identify which services can be opened at the weekend first.

He said: “What other industry shuts down for two and half days a week? People get sick seven days a week, they need help seven days a week.

“I want to get to a position where the NHS is indistinguishable on a Saturday from a Wednesday but we won’t get there overnight.

“Twenty years ago there was a debate about Sunday trading and the situation has changed quite substantially. Now in a secular world, the prime occupation on a Sunday is shopping.

“There is a really powerful moral and professional argument for seven day routine services. It would contribute to people’s lives, to the economy and bring a bit of convenience into healthcare.”

In London alone it is estimated that 500 lives a year could be saved if mortality rates at the weekend matched those in the week.

A poll conducted by the website, Doctors.net, has found that four in ten doctors are opposed to such a move.

A seven day working week would mean senior doctors would have to be paid more for working at the weekend and that services would be reduced in the week when staff needed days off in lieu, they said.

Some claimed the NHS is unable to afford proper staffing for a five-day working week, let alone seven days. Childcare issues were also raised as a major stumbling block to doctors working all week.

Currently hospital wards are staffed mostly by nurses and junior doctors often covering hundreds of patients each with consultants and other senior staff on call from home.

Research commissioned by Sir Bruce found that NHS patients were ten per cent more likely to die if they were admitted on a Saturday compared with a Wednesday and 16 per cent more likely to die if they were admitted on a Sunday.

Not all of the deaths were emergency cases, showing that patients seen routinely were at greater risk too.

Chairman of the British Medical Association’s Consultants Committee, Dr Mark Porter, said: “This snapshot poll reflects consultants’ abiding concern for the quality of patient care. Some patients clearly need acute specialist care on a 24/7 basis with appropriate diagnostic and support teams.

“It may be appropriate for other departments to have an on-call consultant available out-of-hours, rather than having a senior doctor present at all times. Hospitals have to be flexible to patients’ needs.

“This is a complex issue and we need to look at the evidence and determine what works best for different areas of medicine.

“The ongoing cuts in NHS resources at present make a consultant-based service more difficult as the NHS is often at full tilt just covering emergencies at weekends.”

Sir Richard Thompson, president of the Royal College of Physicians, which has called for weekend working said: “It is good news that doctors are recognising and supporting the need for seven-day working.

“In December 2010, the Royal College of Physicians called for consultant physicians to be available to care for very sick patients at least 12 hours a day, seven days a week.

“I am worried that patients are still not getting the best care that they deserve at night and at weekends. Too many junior doctors are covering too many very ill patients, and this has to change.

“To support this change, consultants will need diagnostic and other support services, such as radiography and support from junior doctors. We will also need changes to workforce planning and working patterns.

President of the Royal College of Surgeons, Norman Williams, said: “The evidence continues to mount that we need to rethink how surgical care is delivered for patients’ seven-days-a-week. In particular, mortality and complication rates vary widely for patients admitted as emergencies at the weekend.

“In order to address this, clinicians and managers must work together to reconfigure hospital services in a way that strengthens the quality of care given to patients regardless of when they are admitted.”

From: http://www.telegraph.co.uk/Hospitals-should-operate-seven-days-a-week-NHS-top-doctor

A third of older people are at an increased risk of dying because they do not fully understand the instructions on medicine labels, a study has found.

It comprised of four simple comprehension-style questions, such as ‘What is the maximum number of days you may take this medicine?’ and ‘List three situations for which you should consult a doctor’. The answers were on the bottle’s label.

A third failed to answer all four questions correctly. One in eight got two or more answers wrong.

The academics then followed the health of the volunteers for five years, all of whom were part of the English Longitudinal Study of Ageing project. Over that period 621 died.

They found those with poorer literacy – who got more answers wrong – were more likely to have died, the research published in the British Medical Journal found.

Specifically, 16 per cent of those who got two or more answers wrong died, nine per cent of those who got one wrong died, while only six per cent of those who answered all questions correctly did so.

Sophie Bostock, a research associate at UCL’s Department of Epidemiology and Public Health, said: “You can’t say the higher death rates are due to these people not reading medicines labels – the reasons for them dying early are complex – but poor literacy is certainly an indicator that they are more vulnerable.

“We do think there’s something specific about underlying literacy that has an impact on mortality.”

She noted that failing eyesight and dementia were not reasons for people being unable to read or comprehend the labels, and that the study was designed to examine fundamental literacy.

Despite poor literacy usually being a lifelong, intractable problem, she said there were ways to ensure such people lived longer, by targeting them with campaigns to make them understand their health problems better.

The team’s research chimes with recommendations made by Sir Michael Marmot, a Government advisor on health inequalities. He has said that improving children’s literacy is one of the most powerful ways of bettering public health.

Poor underlying literacy has long been known to be related with premature death, partly because those who fail to develop their reading skills at school are more likely to take up unhealthy habits like smoking and over-eating as adults.

However, there have been few attempts to quantify the scale of the problem or how it impacts on life expectancy.

From: http://www.telegraph.co.uk/Misreading-medicine-labels-puts-elderly-at-risk-of-dying

Those who start taking low dose (75mg) aspirin daily in their 60s appear to benefit just as much as those who start taking it earlier.

The study Effect of daily aspirin on risk of cancer metastasis published in The Lancet, add to the argument that low dose aspirin should be taken widely from middle-age, said the lead author, Professor Peter Rothwell, of Oxford University’s Stroke Prevention Research Unit.

His team found that taking low dose daily aspirin for between three and five years reduced the chance of being diagnosed with cancer at that time by 19 per cent. Five years or more after starting taking aspirin, the reduction rose to 30 per cent.

He said: “These data do push the argument in favour of taking daily low-dose aspirin, particularly if you have a family history of heart disease or cancer.

“We showed previously that daily aspirin substantially reduces the long-term risk of some cancers, particularly colorectal cancer and oesophageal cancer, but that these effects don’t appear until about eight to 10 years after starting treatment.

“The delay is because aspirin is preventing the very early development of cancers and there is a long delay between this early stage and the eventual clinical presentation with a cancer.

“What we have now shown is that aspirin also has short-term effects, which are manifest after only two to three years.”

The effect was just as marked in those who started taking it after they had turned 60.

The short-term effect appeared to be caused by aspirin slowing the progression of cancer. Another new study showed aspirin almost halved the chances of diagnosed cancer spreading to other organs, over 6.5 years.

Prof Rothwell said: “This is important because it is this process of spread of cancer, or ‘metastasis’, which most commonly kills people with cancer.”

After five years, the chance of having died from cancer if on aspirin was 37 per cent lower.

The findings also raised “the distinct possibility that aspirin will be effective as an additional treatment for cancer – to prevent distant spread of the disease”, he said.

Aspirin has long been hailed for its blood-thinning properties, leading some to argue that it should be prescribed to those who are at a higher risk of heart attack or stroke, even if they have never had one.

However, researchers have been increasingly worried that the benefits of reduced heart attacks and strokes are cancelled out by the raised risk of stomach bleeds, which are occasionally fatal.

But Prof Rothwell said the new research showed that aspirin had a far greater effect on reducing cancer than reducing heart attacks and strokes. Nine out of 10 deaths it prevented were “non-vascular”, according to one of the studies.

Critics of widespread aspirin use point out that it triggers stomach bleeding in some people, which can occasionally be fatal. Even advocates concede it should be used with caution in over 75s.

Prof Rothwell said their studies showed that while aspiring doubled the risk of bleeds in the first three years, after that the risk fell so there was no difference to not taking it. Aspirin also did not increase the risk of fatal bleeds, he said.

The technique – which can involve introducing cold saline solution into the veins, and putting ice-packs on the body – is already used for patients with traumatic head injuries and for some babies hurt during birth.

Now academics across Europe are setting up a £9 million study, funded largely by the EU, to test the theory in 1,500 volunteers.

Dr Malcolm Macleod, head of experimental neuroscience at the Centre for Clinical Brain Sciences at Edinburgh University, said: “Our estimates are that hypothermia might improve the outcome for more than 40,000 Europeans every year.”

Pilot studies indicate at least seven or eight per cent of stroke patients will benefit from the cooling therapy, he said- similar to the proportion helped by thrombolysis.

Dr Macleod noted cooling appeared to work for up to six hours after the stroke, compared to about 4.5 hours for thrombolysism. He also said it could also be used in the vast majority of stroke patients, which is not the case for clot-busting drugs, which can only be used for about one in five.

He continued: “It’s a treatment that might in time be available to give in the back of ambulances.”

The larger study is needed to verify the pilot study results, he said.

Dr Clare Walton from The Stroke Association said: “Cooling is a particularly promising area of stroke research because we know body temperature often increases following a stroke and patients with very high temperatures tend to make poorer recoveries.

“We already know that cooling is effective in reducing the amount of brain damage in patients who have acquired brain injuries from accidents. We look forward to finding out whether it has the same positive effect in stroke patients.”

And it called for minimum staffing levels to ensure standards improved, arguing one nurse for every seven patients was needed.

The intervention by the Royal College of Nursing (RCN) comes after a series of damning reports about the services the elderly are receiving.

The Patients Association and Care Quality Commission have both recently published studies detailing “shocking” levels of care.

Ministers have promised to give more powers to nurses as well as improving monitoring to drive up standards.

But the union said it was now time to insist on strict staffing levels and stop relying on health care assistants to fill the gaps.

It polled nearly 1,700 nurses – 240 of whom were working on wards with older patients.

The survey showed that while older people’s wards only had one nurse for every nine patients on average, general wards, at 6.7 patients per nurse, and children’s wards, at 4.2, were much better staffed.

Respondents said low staffing meant care suffered in a variety of ways.

Eight in 10 said basic support, such as talking and comforting patients, was compromised, while a third said they did not have time to help people properly with eating and drinking.

Nearly one in five also said care for dying patients was neglected.

The research looked at the use of guaranteed staffing rules in places such as Australia and the US and concluded they were needed in the UK.

It recommended there should be one registered nurse for every five to seven patients in the NHS.

Peter Carter, the RCN’s general secretary, said: “Patients on older people’s wards are being let down by systemic failings in our hospitals.

“Despite working tirelessly to provide patients with high quality care, nurses in these settings have repeatedly told us that they are unable to do this because of pressures caused by short staffing.”

Nor do these findings suggest that the EU Working Time Directive, limiting doctors’ working hours, is operating to good effect.

Although there were strong objections from the medical profession when this directive was imposed, there was also a recognition that doctors’ hours needed to be regulated to some degree: there is an obvious risk to patients being seen by an exhausted doctor, panda-eyed from lack of sleep.

The revelation, however, that in the two years since the directive came into force, NHS hospitals have spent more than £2 billion on temporary clinical staff makes it clear that something is very wrong.

One problem has been highlighted by Professor Norman Williams, President of the Royal College of Surgeons, who has expressed concern about hospitals attempting to economise by leaving vacant the posts of retired consultants, only to spend large sums employing locum staff.

That is sheer incompetence and evidence of the urgent need to rationalise NHS bureaucracy.

Doctors perform a vital service; but it is neither reasonable nor necessary to pay rates of £20,000 a week (equivalent to £1 million a year), especially when many of the payments to on-call doctors include hours when they are asleep.

This scandalous situation has all the classic ingredients: European diktat, bureaucratic incoherence and abuse of taxpayers’ money.

The public agency on which taxpayers least begrudge their involuntary contributions being spent is the NHS; but that generosity is predicated on the money being spent at the “sharp end” of patient care, not dissipated in the black hole of public sector paper-shuffling.

Doctors must not work excessive hours, but both the directive and NHS administration should be searchingly reappraised.

From: http://www.telegraph.co.uk/A-scandalous-waste-of-money-in-the-health-service

The NHS shake-up has threatened to drive a wedge between the coalition partners ever since it was unveiled by Tory Health Secretary Andrew Lansley.

It is intended to give GPs greater control over NHS budgets, reduce bureaucracy, and increase patient choice.

But while there was jubilation among Tory and Liberal Democrat ministers, opponents have warned that the problems are only just beginning.

RCN chief executive and general secretary Dr Peter Carter described the reforms as “deeply flawed”.

He said: “We have achieved some concessions which make the Bill a different piece of legislation from that which first appeared, but our real concerns about the future of the NHS have not been heeded.

“It is now our responsibility to patients to do everything we can to ensure that the health service runs as best as it can despite the massive upheaval that this Bill will bring.

“We intend to work with trusts, regulators and other bodies but our fear is that in the fullness of time this Bill will be a cause of significant regret.

“Perhaps most importantly we will be supporting nurses who are going to have to pick up the pieces and still deliver the best care they can for patients through this extremely difficult time of change.”

Furious opposition from professional bodies and Lib Dem activists led David Cameron and Nick Clegg to take the highly unusual step of “pausing” the legislation last year.

Despite accepting more than a thousand amendments – including limits on competition and private sector involvement – the Government has failed to win over many health workers.

Lib Dems embarrassed Mr Clegg at the party’s spring conference this month by again refusing to back the measures in a vote.

And there is speculation that the controversy could yet cost Mr Lansley his job in a reshuffle expected over the coming months.

When the Cabinet met yesterday, ministers from both parties banged the table to celebrate news that the reforms had finally cleared the House of Lords.

An emergency debate called by Labour had the potential to delay the Bill until an internal assessment of risks had been published.

Shadow health secretary Andy Burnham demanded that the Government publish the risk register, insisting: “People outside will struggle to understand how Members of this House could make such momentous decisions without having carefully considered all of the facts and all of the evidence.”

But Mr Lansley accused Labour of “political opportunism”, saying civil servants needed “safe space” in which to advise ministers.

The Commons defeated the motion by 328 to 246 – a majority of 82. No Lib Dem MPs sided with the opposition, with the most vocal critics choosing to abstain.

After the House agreed more than 370 amendments to formally pass the Bill later, Mr Burnham insisted the “fight will go on” and promised to repeal the measures if Labour returned to power.

“We have given this fight everything that we had,” he said. “All I can say is our fight will go on to protect and restore this party’s finest achievement.”

From: http://www.independent.co.uk/nhs-reforms-approved-by-parliament

MS is a neurological condition that can cause symptoms from dizziness and fatigue to tremors, memory and speech problems. Some patients lose mobility and are wheelchair-bound.

It is often characterised by periods of stability followed be relapses.

Nice has recommended in new draft guidance that people with highly active relapsing remitting MS be treated with fingolimod, also known as Gilenya, made by Novartis.

Studies have shown it can reduce relapses by between 50 and 60 per cent.

It costs around £20,000 per patient per year and thousands of people may benefit.

The qualify patients will have to have unchanged or increased relapse rate or ongoing severe relapses compared to the previous year, despite them taking other drugs such as beta interferons.

Professor Carole Longson, Director of the Health Technology Evaluation Centre at NICE said: “The latest draft guidance from our committee recommends the NHS-use of fingolimod for a specific group of adults who have highly active relapsing-remitting multiple sclerosis.

“Following new information provided during the consultation, the analyses show that for these people, treatment with fingolimod will be a cost effective option for the NHS in this group of people with multiple sclerosis, if Novartis provides the drug at a discounted price, as proposed in its patient access scheme.

“We have published the latest version of our draft guidance on our website so that interested parties can highlight any factual errors or appeal against our final draft recommendations.”

In MS the body’s own immune system attacks the protective coating around nerve fibres which carry signals between the brain and the rest of the body.

The drug prevents the immune cells from attacking the nerve coating.

The Scottish equivalent of Nice, the Scottish Medicines Consortium has not approved the drug.

Nick Rijke, Director of Policy & Research at the MS Society, said: “We are delighted; this decision signifies a major step forward in the treatment of this devastating condition.

“Gilenya has been found to be highly effective in trials and taking a daily tablet will come as welcome relief from frequent, often unpleasant, injections.

“Making this new treatment available will increase patient choice for thousands of people with MS across England and Wales, but we’re deeply disappointed by the SMC’s decision in Scotland – and urge them to reconsider.”

From: http://www.telegraph.co.uk/New-drug-hope-for-thousands-of-MS-sufferers

Worries about the breast implants made by PIP have emerged since news of a major investigation into the France firm.

The French implants caused global concern after it was revealed they contained industrial silicone rather than medical-grade fillers and that they may be more prone to rupture and leakage.

Initially reports also linked the implants to a rare form of cancer known as ALCL. This cancer link has been now been firmly discounted by medical experts here and in Europe.

It isn’t currently known whether the rupture rate for PIPs is higher than for other types of implant.

From the implants that have been tested, there appears to be no risk of dangerous toxic effects in the event of a rupture.

The implants involved are called Poly Implant Prosthèse (PIP) and were made by a French company of the same name.

In a Medical Device Alert in March 2010, the Medical and Healthcare products Regulatory Agency (MHRA) said: ” … most breast implants manufactured by the company since 2001 have been filled with a silicone gel with a composition different from that approved”.

That alert was based on advice from French regulators. However, after an investigation by the MHRA, the French authorities reported in March 2012 that PIP implants made before 2001 may also contain unauthorised silicone gel.

PIP gained approval to market its silicone implants in 1997 but it is not clear when it began using a cheap type of silicone gel intended for making mattresses.

The marketing, distribution and use of the PIP implants was suspended in March 2010.

About one breast implant in five needs replacing within 10 years, whatever the make, so it is unlikely that all the 7,000 women who had PIP implants before 2001 still have the same implants.

An expert committee was set up recently to examine the specific risks associated with PIP implants. It concluded that there was not enough evidence to recommend their early removal. That advice has not changed.

However, the committee said the NHS would remove and replace the implants without charge if patients that the NHS had operated on remained concerned. The government expects the private sector to follow suit.

Women who received a PIP implant from the NHS will be contacted to let them know they have one. If you are worried, you should book a consultation with your specialist or GP.

Some private clinics have said they will replace PIP implants free if clinically necessary.

The expert committee has commissioned further work on the health risks and will meet again in May 2012 to review the findings and update its earlier advice as needed.

Also, the Department of Health has set up two reviews to look at how the PIP situation occurred and the issue of regulating the cosmetic surgery industry as a whole.

The first report is due to be submitted to the health secretary by the end of March 2012.

Advanced Alzheimer’s is marked by the progressive loss of cognitive skills and physical control and leaves individuals stripped of their dignity and personality.

The finding could double the number of patients currently on treatment from 50,000 to over 100,000 in the UK and extend treatment to millions more worldwide.

Only one in five of the 500,000 patients with Alzheimer’s in the UK, a third of whom have advanced disease, are currently receiving drug treatment because of a shortage of clinics to diagnose them.

Professor Robert Howard of the Institute of Psychiatry, Kings College, London, who led the study published in the New England Journal of Medicine, said: “For the first time we have robust and compelling evidence that treatment with these drugs can continue to help patients at the later, more severe stages of disease. Patients were better able to remember, understand, communicate and perform daily tasks for at least a year longer than those who stopped taking the drugs.”

The National Institute for Curbing Expenditure (NICE) came under fire when it initially refused to approve Donepezil, the commonest drug whose brand name is Aricept, and associated drugs on the ground that they were not cost effective. It said the drugs worked in 40 per cent of those treated. Later they were forced to review its decision and recommended the drugs in the early and moderate stages of the disease but not in the late stages.

Although Its current advice says the drugs should only be withdrawn when doctors consider they are no longer of benefit, the latest findings mean its default position – that the drugs do not work in the late stages of the disease – may now have to be reviewed.

Researchers led by Professor Howard  studied 295 patients with  severe Alzheimers over a year and found continued use of donepezil slowed the deterioration characteristic of the disease by one third, equivalent to four months of improved quality of life.

Those who took a second drug, memantine, in combination, did even better.

Professor Clive Ballard, director of research at the Alzheimer’s Society, which funded the study with the Medical Research Council, said the drug was not a cure but significantly relieved the symptoms: “If I had Alzheimers disease or my relative did I would want them to have [the combination].”

Donepezil came off patent in February and its cost has  plummeted. It is now priced at around 80 pence a day compared with £2.50 a day for the patented drug, Professor Ballard said. The next stage of the research would be to examine the cost effectiveness of the drug based on the reduced cost.

Professor Nick Fox of the Institute of Neurology, University College, London, said dementia cost Britain £20 billion a year and one third of the population would be affected at some point in their lives.

“We desperately need therapies that will slow the disease at a stage when we have most to retain. This is a savage disease with a self sustaining momentum of its own.”

http://www.independent.co.uk/life-style/health-and-families/health-news/alzheimers-treatment-in-late-stages-of-disease-does-slow-progression-7544408.html

A team co-led by Prof Jeroen Raes of the Flemish Institute of Biotechnology has discovered that we all have one of three basic ecosystems of bugs in our guts – but strangely, the type for each person is unrelated to their race, native country or diet.

They label these “enterotypes” the “bacteriodes”, “prevotella” and “ruminococcus”, to reflect the species of bug that dominate in each.

People with a bacteriodes ecosystem, for example, have a bias towards bacteria that get most of their energy from carbohydrates and proteins.

This revelation has prompted much interest, because it could explain differences in our ability to digest food.

A few years ago, Prof Jeffrey Gordon’s team at Washington University School of Medicine found that the intestines of obese people contain a slightly different repertoire of microbes when compared with slim people. In the Flemish study, researchers found a similar correlation between obesity and the abundance of bacteria that extract energy rapidly from food.

Prof Jeremy Nicholson, of Imperial College London, doubts that the latest find is of huge biological significance, since the three enterotypes probably have similar roles and capabilities. Yet he believes that one day, it might be possible to engineer enterotypes, which could be used (for example) to boost the number of calories extracted from poor diets by children in developing countries.

The human gut contains about 1,500 bacterial species, so tinkering with their ecology in a controlled way may be tricky. Although there are products that claim to manipulate bacteria, such as prebiotics, which fuel certain microbes, and probiotics (such as yogurts) that contain live bacteria, we still understand too little to do this reliably.

Yet recognition of the importance of the microbiome is growing.

It has already been linked to our understanding of obesity, allergies, diabetes and cancer – and in the past few days, a study has appeared by Prof John Baker at the Medical College of Wisconsin in Milwaukee that suggests that the types and levels of bacteria in a person’s gut may be used to predict the likelihood of their having a heart attack, too.

The find, Prof Baker believes, “is a revolutionary milestone” in the prevention and treatment of such attacks.

As part of his experiments, he and his colleagues induced heart attacks in three separate groups of rats.

The first was fed a standard diet. The second was given the antibiotic vancomycin and the third fed a probiotic supplement containing Lactobacillus plantarum, a bacterium that suppresses the production of a hormone called leptin, which is linked to appetite and metabolism.

It turned out that the group treated with the antibiotic also showed decreased levels of leptin – and that the two groups with lower leptin levels suffered less serious heart attacks, and recovered from them better. “We may not be ready to prescribe yogurt to prevent heart attacks, but this research does give us a much better understanding of how the microbiome affects our response to injury,” says Dr Gerald Weissmann, editor-in-chief of the journal in which the study appeared.

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, stresses that more research will be required to show whether the dramatic changes in inflammatory molecules seen in the rats would apply to humans, too. But few doubt that, in the not too distant future, we will get dramatic new insights into our health by studying the shadow world of our microbial passengers.

Roger Highfield is the director of external affairs at the National Museum of Science and Industry

From: http://www.telegraph.co.uk/Yogurt-that-might-stop-a-heart-attack

The findings coincide with an NHS report putting the annual cost of diabetes-related amputations at £120m.

The study Variation in the recorded incidence of amputation of the lower limb in England, published in the journal Diabetologia, compared lower leg amputation rates for local health trusts (PCTs) across England over three years.

The paper concluded that, compared with the general population, people with diabetes were over 20 times more likely to have an amputation.

It reports a huge variation in the rates of both major (above the ankle) and minor amputations for patients with diabetes – including Types 1 and 2.

For major amputations these range from just over two each year for every 10,000 patients to 22.

In England every year there are about 6,000 diabetes-related amputations.

One of the main authors, Prof William Jeffcoate, a consultant diabetologist at Nottingham City Hospital, is wary of pinning blame on the areas with the highest amputation rates, though he says the variations are “shocking”.

He thinks the problem lies in the way services are organised.

“Foot disease is very complicated and a single professional hasn’t necessarily got the skills to manage every aspect of it.

“And that’s why I believe that only if you can gather a multi-disciplinary team and make sure that people have rapid access to assessment by such a team, it’s only in that way that we think you can provide the best service.”

Many hospitals in England still do not have these teams – which also include podiatrists, surgeons and specialist nurses.

Prof Jeffcoate says a lot of health staff are not trained to recognise the risks of foot disease.

“Maybe it’s just that people don’t like feet. Maybe it’s related to the fact that footcare tends to occur in an older population. But for whatever reason doctors and nurses have also never had specialist training in foot disease and so it means that they don’t necessarily have the skills to assess a new condition when it arises.”

The findings complement previous research suggesting that up to 80% of diabetes-related amputations could be avoided.

They also coincide with new figures on the annual cost of foot ulcers and amputations in England, published in a report by NHS Diabetes.

Its overall estimate is £650 million per year, including £120 million per year for amputations. The paper also highlights additional costs to patients and carers through lost working days and reduced mobility.

The report author, Marion Kerr, says the savings from specialist footcare teams – by reducing amputations – are six or seven times greater than the costs of setting them up.

“We believe that if the NHS were to spend to save – to introduce teams of this kind – not only would they transform the lives of many patients, but actually save money in the process.”

The study caused a fall in vaccination rates, but was later discredited.

The judge quashed a GMC finding of professional misconduct.

Mr Justice Mitting called for changes in the way General Medical Council fitness to practise panel hearings are conducted in the future saying: “It would be a misfortune if this were to happen again.”

Prof Walker-Smith, who retired in 2001, said: “I am extremely pleased with the outcome of my appeal.

“There has been a great burden on me and my family since the allegations were first made in 2004 and throughout the hearing that ran from 2007 to 2010. I am relieved that this matter is now over.”

The former head of department at the Royal Free Hospital in north London lost his licence to practice in May 2010, along with Dr Andrew Wakefield.

A GMC panel found both guilty of misconduct over the way research into autism and bowel disease was conducted.

A third doctor, Prof Simon Murch, then a junior consultant in the department, was cleared.

The disciplinary case against the doctors centred on how they conducted their work.

The judge said the GMC panel failed to address whether Prof Walker-Smith had been doing research or simply investigating symptoms to help treat children. There had been “inadequate and superficial reasoning and, in a number of instances, a wrong conclusion”, he said.

The GMC said reforms to disciplinary hearings were being considered.

Chief executive Niall Dickson added: “Today’s ruling does not however reopen the debate about the MMR vaccine and autism.

“As Mr Justice Mitting observed in his judgement, ‘There is now no respectable body of opinion which supports (Dr Wakefield’s) hypothesis, that MMR vaccine and autism/enterocolitis are causally linked’.

Overseas visitors to Britain are to be offered free HIV treatment on the NHS for the first time.

Foreign students, workers and victims of human trafficking are among those expected to benefit.

The Department of Health said that safeguards would be introduced to prevent “health tourism”.

Currently treatment for HIV is only available to people officially resident in Britain, excluding migrants.

But Lord Fowler, a former Conservative Cabinet minister who has campaigned on Aids, has called for free treatment to be extended to those who have been in Britain for six months.

The proposal, contained in an amendment to the Health and Social Care Bill currently before the Lords, will be accepted by the Government but introduced in a Statutory Instrument rather than as part of the legislation.

The move comes amid concerns about rising levels of HIV infection and the cost to the NHS of not treating it early. Foreigners are thought to be dissuaded from seeking help because of the cost of treatment.

Public Health Minister Anne Milton said: “This measure will protect the public and brings HIV treatment in to line with all other infectious diseases. Treating people with HIV means they are very unlikely to pass the infection on to others.

“Tough guidance will ensure this measure is not abused.”

Chief Medical Officer Professor Dame Sally Davies said that effective treatment of HIV reduced its spread by up to 96%.

“This change is in line with the UK Chief Medical Officers’ Expert Advisory Group’s advice, and offering NHS treatment will encourage testing, resulting in fewer undiagnosed HIV infections and therefore ensuring that there is less chance of passing on infection to the wider population.”

Yusef Azad, the director of policy at the National Aids Trust, said: “If someone is tested and treated early, it is much cheaper than them presenting themselves in hospital with a much more serious, complex condition that can cost tens of thousands of pounds to treat.”

He is now calling on the World Health Organisation to add dementia to their list of top priority diseases to fund research and treatment across the globe.

He said: “It’s not adding years to your life, but life to your years.”

Despite his calls to improve diagnosis, Prof Piot admitted it may not always be ethical to diagnose the condition, in parts of the world where treatment is not yet available.

He told BBC Radio4’s Today programme that developing countries in Asia and Latin America were seeing the greatest rise in dementia sufferers, as better healthcare led to people living longer.

Prof Piot, director of the London School of Hygiene and Tropical Medicine, said: “The figures speak for themselves. We are really going into the next global health time bomb.

“I have worked for the last 30 years on AIDs. That was a time bomb several decades ago and it’s still not over.

“But the figures are there. Today 36 million people are living with dementia. Every seven seconds there is a new case and we will see a doubling in the number of people by 2020.

“People in the emerging economies, like Asia and Latin America, are living longer and dementia is progressing fastest there in terms of the numbers.

“It’s affecting, families, communities and of course the people themselves.”

He added that the idea dementia was an inevitable part of aging is a “myth” and that early diagnosis would allow sufferers to make legal, financial and care arrangements.

The World Health Organisation list of priorities currently comprises of cancer, lung disease, diabetes and chronic heart disease.

From: http://www.telegraph.co.uk/Dementia-is-next-global-health-time-bomb

It reveals that people are being denied IVF treatment, breast reductions and fat-loss operations based on their weight and whether they smoke.

In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.

The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations.

Freedom of Information responses from 91 PCTs, obtained by Pulse the  doctors’ magazine, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011.

Dr Clare Gerada, head of the Royal College of GPs, said some of the restrictions, particularly for IVF, were “dreadful”.

She added: “It’s becoming the deserving and the undeserving. I think it’s discriminatory and I find it astonishing.  The Government should determine what should be applied universally.”

The figures showed that the Peninsula health technology commissioning group, covering Cornwall, Devon, Torbay and Plymouth, is now banning both men and women from undergoing IVF treatment unless they have been non-smokers for at least six months.

Men and women must also have a BMI of between 19 and 29.9 before they will be given certain fertility drugs.

The two PCTs covering County Durham and Darlington will not treat people for varicose veins unless they have a BMI of 30 or under, the figures also show.

The figures also showed that the three PCTs covering North Essex must not accept referrals for joint replacement surgery from people with a BMI of 40 or over.

Furthermore, all patients who smoke in the region must be referred to stop-smoking services before they will be considered for stomach surgery, breast reconstruction, breast reduction, scar revision surgery or nipple inversion treatment.

In Lincolnshire, as of June last year, patients must have had a stable BMI of 18 to 25 for at least a year before they will be considered for breast reductions.

Meanwhile, hip and knee replacements will not be given to patients who have a BMI greater than 35, or current smokers.

In Bedfordshire, access to hip and knee replacements is denied to patients with a BMI of 35 or over until after they have lost 10% of their initial body weight or moved below a BMI of 35.

Before July last year, there was no BMI cut-off in the region.

Steve Nowottny, deputy editor of Pulse, said: “Rationing in the NHS is nothing new – but PCTs and clinical commissioning groups are increasingly taking the decision to ration care based on patients’ lifestyle choices.

“In some cases there may be genuine clinical justification for rationing treatment on these grounds. But there is a growing suspicion that some PCTs are now blocking access to surgery for smokers and the obese simply to help achieve ever greater efficiency savings.

“Such a policy has disturbing implications – and GPs are increasingly uneasy about the NHS providing a second-class service to patients with less healthy lifestyles.”

A quarter were not given a choice of male or female staff to help them use the lavatory and more than a third of care homes surveyed admitted delays in getting medication to residents.

Campaigners blamed NHS bureaucrats showing a “lack of interest” and failing to provide expert assessments for conditions as basic as incontinence.

The findings emerged after almost 1,000 elderly people yesterday descended on Parliament to lobby their MPs calling for a radical overhaul of the social care system.

Paul Burstow, the care minister, signalled that a widely anticipated white paper of the future of social care had been delayed until next month insisting: “Getting it right is better than rushing it out and getting it wrong.”

Among those who addressed the crowd was the actor Tony Robinson, an ambassador for the Alzheimer’s Society, who said it was an “undeniable fact” that the system of social care is now in crisis with millions of people faced with paying large sums for care unlikely to meet their needs in old age.

The Archbishop of York also threw his support behind the lobby. Speaking during a visit to a care home he called for an overhaul of the care system to provide “dignity and peace of mind” to older people.

Fresh evidence of the failings in the system was detailed as a raft of previously unpublished data gathered by the health care regulator the Care Quality Commission (CQC) was released.

It was drawn from the first ever nationwide review of how the needs of needs of care home residents across England are met.

The CQC report discloses that people suffering from incontinence have to wait more than two weeks for an assessment of their condition in almost 40 per cent of homes for the elderly surveyed.

But a separate detailed analysis of the CQC data carried out by the British Geriatrics Society, also found that more than 40 per cent specialist providers set themselves a target as long as 90 days to carry out such assessments.

Such delays have led to elderly people being denied the treatment they need or forced to wear incontinence clothing when they do not need it.

The CQC research also says that 30 per cent of nursing homes investigated had no clear policy on when to attempt to resuscitate patients who suffer a serious deterioration in their health.

In a quarter of homes, staff admitted they were unsure about the health care needs of those in their care.

The Geriatrics Society study showed that only 57 per cent of Primary care trusts ensure that all elderly people under their responsibility have access to key services including continence assessments, physiotherapy, pressure sore checks and mental health services.

In 40 per cent of cases trusts set no specific targets to ensure the services were being delivered.

The society concluded that this showed the PCTs had “limited interest” in services for care homes.

Its president, Prof Finbarr Martin, said: “What it shows is that there is a massive disconnect between what the NHS aspires to and what it actually delivers to people in care homes and they are the most vulnerable group of people.

“The issue is there is a negative about people in care homes. There is a nihilism about care homes that is completely unreasonable and unjustified.”

Michelle Mitchell, director of Age UK, said: “The majority of people living in care homes have profound and complex health care needs.

“The British Geriatrics Society’s CQC data analysis reveals that many thousands of residents are failing to receive basic geriatric and community health care from the NHS.  Older people who live in care homes should have the same rights to NHS care as anyone else.”

In a letter to The Daily Telegraph today, the heads of a string of charities including Age UK voice their support for a move in the House of Lords to protect the human rights of all elderly people receiving care.

The Daily Telegrpah publishes a free Guide to Long and Short Term Health Care, you can order one here.

The drug was also found to reduce the need for patients to be treated in hospital for heart failure, which affects about 900,000 people in Britain, by 30 per cent.

The drug has been approved by European regulators but has yet to be assessed for widespread use on the NHS as the killer quango NICE has yet to approve it.

It costs £1.40 a day and is already prescribed for patients in this country with angina.

It could reduce the risk of death from all types of cardiovascular disease by 17 per cent and the risk of death from all causes by 17 per cent.

In addition, the drug, which slows down the heart rate, was found to cut the risk of heart failure patients requiring treatment by 30 per cent. The study involved 6,505 people in 37 countries, including Britain.

Heart failure occurs when the organ becomes too weak to pump blood efficiently round the body, leading to fatigue, breathlessness, a higher heart rate and other problems.

Prof Martin Cowie, a consultant cardiologist and specialist in heart failure at the Royal Brompton Hospital in central London, and the British lead investigator for the study, said: “Heart failure is a very common problem, affecting approximately 1 per cent of the population.

“The decision to approve this new indication for ivabradine is great news for both doctors and patients, and is a significant step forward in the management of heart failure.”

Prof Cowie added: “While Ace inhibitors and beta-blockers remain very important in the treatment of this condition, the results of the trial demonstrate the value that a reduction in heart rate with ivabradine can bring both in terms of improving symptoms and preventing disease progression, but also in helping patients return to normal daily activities and increasing their enjoyment of life.”

Computer Sciences Corporation, (CSC) an American IT firm, previously had a £1.9 billion contract for the national NHS system which was scrapped by Andrew Lansley, the Health Secretary, last year.

The firm is understood to have threatened legal action against the Government and is now thought to have agreed to continue with up to £900 million of NHS work in return for dropping any legal action.

It will run computer systems for the NHS across the north, midlands and eastern England under the deal which is expected to be agreed in the coming days.

Ministers are expected to herald the “compromise deal” as a success which will save the taxpayer about £1 billion. However, it underlines the difficulties faced by the Coalition in extricating itself from previous contracts agreed by the last Government.

It will also add to growing allegations that despite the high profile announcement that the beleaguered national NHS database is being scrapped – it is simply being replaced by a series of similar regional systems which will perform the same function.The NHS database attracted widespread criticism following a series of damning official reports. Last year, the House of Commons Public Accounts committee described the programme as “unworkable”.

When he announced the “acceleration” of the dismantling of the system last year, the Health Secretary said: “Labour’s IT programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Computer Sciences Corporation had previously largely written off the value of the NHS contract in its accounts, leading to a reduction in the company’s share price. Last May, David Cameron said the Government would not sign any new contracts with the firm until a review of its work on the NHS IT programme was complete.

However, the firm announced yesterday that it had entered into a non-binding letter of intent with the British Government. The letter “defines a way forward for CSC to deliver healthcare solutions and services, primarily across the North, the Midlands and east of England.”

The company’s share price rose yesterday after falling by more than a third over the past year.

A Department of Health spokesman said: “The Department of Health has secured agreement to an approach which will involve a hugely improved settlement for the NHS with CSC, the company responsible for introducing Lorenzo software in the North, Midlands and East.

“A Letter of Intent has been negotiated which makes clear that a new contract, to be signed this Spring, will ensure that the local NHS has control over whether to introduce Lorenzo. The agreement we have negotiated gives choice to Trusts about taking this software, rather than imposing the decision on NHS organisations.”

From: http://www.telegraph.co.uk/IT-firm-behind-unworkable-NHS-database-keeps-IT-deal

It marks a move from the BMA opposing the Health and Social Care Bill to advising members to do something about it, if it receives Royal Assent.

The letter, by Dr Laurance Buckman, chair of the BMA’s GPs’ committee, describes the Bill as “complex, incoherent and not fit for purpose”.

It warns the legislation will be “almost impossible to implement successfully, given widespread opposition across the NHS workforce”.

Dr Buckman argued the reforms “will be irreversibly damaging to the NHS as a public service, converting it into a competitive marketplace that will widen health inequalities and be detrimental to patient care”, and “could cause irreparable damage to the relationship between GPs and their patients”.

Although stronger in tone than previous criticisms the BMA has made, the statements in the letter do not change the union’s position. It moved to a position of total opposition last November.

However, Dr Buckman also called for GPs to act if the Bill becomes law.

Doctors have become increasingly concerned about the role of private firms in running clinical commissioning groups (CCGs), which will be responsible for buying services for the NHS. These will control about two-thirds of the service’s £100+ billion budget.

The Bill contains provisions for private firms to become involved in CCGs, with the Government arguing they will just provide back-office support.

But Dr Buckman wrote: “Unless GPs take an active stand, the day-to-day running of the CCG, and especially its commissioning function, is likely to be outsourced to the hands of organisations providing commissioning support services (CSSs).

“These bodies will initially do some or all of the “back office” functions, but we fear that, in time, they could become the de facto CCG management.”

He continued: “We believe this will lead to the privatisation of commissioning, destroy the public health dimension to commissioning, with a loss of local accountability to local populations, and is likely to exacerbate health inequalities.”

This point is central to much opposition to the Bill, which opponents argue is a poorly-disguised Trojan horse for privatisation of the NHS.

Many GPs favour some sort of clinically-led commissioning – putting doctors in charge of buying health services – but Dr Buckman said the Bill was not necessary to achieve this.

The authors, whose piece was published in the Journal of Medical Ethics, have received death threats for suggesting that “what we call after-birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled”.

Many believe such possibilities should never be raised – even within the confines of an ethics journal.

However, some anti-abortionists have welcomed its publication, saying it casts a bright light on what abortion actually is.

Anthony Ozimic, from the Society for the Protection of Unborn Children (SPUC), said the article, which he described as a “chilling promotion of infanticide”, showed how abortion was “creating a culture of death”.

While he was appalled at the suggestion that newborns should be killed for their parents’ convenience, he nevertheless said it showed the logical framework behind infanticide and abortion was the same.

He said: “The paper proves what pro-lifers have long been arguing: that the common arguments for abortion also justify infanticide.

“There is no difference in moral status between a child one day before birth and a child one day after birth.  Birth is merely a change of location, not a change from non-personhood to personhood.”

He continued: “All human beings, regardless of age, location or capacities, are regarded in international law as equal members of the human family and thus as having an equal right to life.”

The authors, ethicists Dr Alberto Giubilini and Dr Francesca Minerva, argued: “The moral status of an infant is equivalent to that of a foetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.”

Rather than being “actual persons”, newborns were “potential persons”. They explained: “Both a foetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’.

“We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her.”

As such they argued it was “not possible to damage a newborn by preventing her from developing the potentiality to become a person in the morally relevant sense”.

“Actual persons” could be harmed by being killed, in that they were prevented from accomplishing “aims”.

But they argued: “Now, hardly can a newborn be said to have aims as the future we imagine for it is merely a projection of our own minds.”

Parents should be able to have the baby killed if it turned out to be disabled without their knowing before birth, they said, citing the example that only 64 per cent of Down’s syndrome cases in Europe were diagnosed by prenatal testing.

Once such children were born there was “no choice for the parents but to keep the child”, they wrote.

“To bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care.”

However, they did not argue that some baby killings were more justifiable than others – their fundamental point was that, morally, there was no difference to abortion as already practised.

They preferred to use the phrase “after-birth abortion” rather than “infanticide” to “emphasise that the moral status of the individual killed is comparable with that of a fetus”.

The authors argued: “The alleged right of individuals (such as foetuses and newborns) to develop their potentiality … is over-ridden by the interests of actual people (parents, family, society) to pursue their own well-being because, as we have just argued, merely potential people cannot be harmed by not being brought into existence.”

“Actual people’s well-being could be threatened by the new (even if healthy) child requiring energy, money and care which the family might happen to be in short supply of.

“Sometimes this situation can be prevented through abortion, but in some cases this is not possible. In these cases, since non-persons have no moral rights to life, there are no reasons for banning after-birth abortions.”

While accepting that many people would disagree with their arguments, Prof Savulescu commented: “The goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises.”

Speaking to The Daily Telegraph, he added: “This “debate” has been an example of “witch ethics” – a group of people know who the witch is and seek to burn her. It is one of the most dangerous human tendencies we have. It leads to lynching and genocide.

“Rather than argue and engage, there is a drive is to silence and, in the extreme, kill, based on their own moral certainty. That is not the sort of society we should live in.”

He said the journal would consider publishing an article positing that, if there was no moral difference between abortion and killing newborns, then abortion too should be illegal.

From: http://www.telegraph.co.uk/Killing-babies-article-reveals-the-truth-of-abortion-say-pro-lifers

Trusts will have to show they have improved efficiency and provide good care in order to access the money.

The seven trusts are: Barking, Havering and Redbridge, St Helens and Knowsley, South London, Peterborough and Stamford, North Cumbria, Dartford and Gravesham and Maidstone and Tunbridge Wells.

There are 100 plus PFI schemes, where private firms pay to build hospitals, leaving the NHS to pay an annual fee or “mortgage”.

Coalition ministers have attacked Labour over its deals, but the National Audit Office recently reported that for most trusts with financial difficulties PFI was just part of the problem.

The Department of Health says without the funding, services at the hospitals would be put at risk.

Health Secretary Andrew Lansley said: “We need to balance the accountability of the NHS at local level to live within its means on one hand, with recognising that there is a legacy of debt for some trusts with PFI schemes.”

They are mainly from China and being bought by UK users over the internet.

The official figure is set to be confirmed later in the year by the EU drugs agency, the EMCDDA.

Because the substances haven’t been tested yet the long term effects are unknown.

Katy MacLeod from Edinburgh Crew 2000, a charity that helps young people with substance issues, said legal highs were difficult to deal with.

“We already know quite a lot about cocaine, ecstasy and ketamine,” she said.

“It’s probably easier to treat people with those kind of drugs, because we have much more pieces of research done. With legal highs, the same knowledge base isn’t there yet.”

In just a couple of weeks, they treated 34 people who had all been poisoned by Ivory Wave, which has now been banned.

The government says it will use powers that came in in November to ban all potentially dangerous new substances while they’re being tested.

But Dr Stephen Potts, who works at the Edinburgh Royal Infirmary, says he’s worried about new legal highs emerging as soon as others are banned.

“The people who take them don’t know what’s in them,” he explains. “The people who sell them don’t know what’s in them, and we as the doctors certainly don’t know what’s in them.”

Dr John Ramsey tests new legal highs in his laboratory at St George’s medical school in London.

He told Newsbeat that some of the new substances he comes across are potentially very dangerous: “We’ve got a compound we found a couple of days ago which is potent at 100 micrograms – that’s a tiny amount.

“Most drugs are active at about 100 milligrams. This one is about a 1000 times more potent.  The risks people are taking are just not worth it.”

From: http://www.bbc.co.uk/newsbeat/16866929

Research finds that patients are more likely to die if they are admitted to hospital at the weekend.

The review looked at all admissions to NHS hospitals in England in one year.

The NHS medical director has called for weekend services to be extended.

The research was carried out at University College London and the universities of Birmingham and East Anglia, and covered more than 14 million hospital admissions – both emergency and planned.

The study looked at more than 187,300 patients who died within 30 days of being admitted to hospital during 2009-10.

The researchers found higher death rates if patients went in at the weekend, but a slightly lower death rate if people were already in hospital at the weekend.

For every 100 deaths following admissions on a Wednesday, 116 occurred for admissions on a Sunday – a “significant increased risk”, the researchers said.

These results confirm previous reports of increased 30-day mortality risk for patients admitted to hospital with emergency conditions at the weekend”

Prof Domenico Pagano University Hospital Birmingham Foundation Trust

They added: “We identified a significantly higher risk of subsequent in-hospital death during the 30-day follow-up period associated with admission during the weekend (Saturday or Sunday), compared to mid-week days.

“Admission on Tuesday through Friday was associated with the lowest risk of in-hospital death, while admission on Sunday was associated with the highest risk.

“Admission on Saturday was associated with a marked increased mortality (death) risk and admission on Monday was associated with a less, but statistically significant, increased risk.”

Researchers said the results were consistent with data from 254 not-for-profit hospitals in the United States, which they also analysed.

Lead researcher Professor Domenico Pagano, from the University Hospital Birmingham Foundation Trust, said the results offered conclusive evidence.

Prof Pagano also said reduced staffing and fewer senior doctors on duty, as well as poor access to diagnostic tests at weekends, could have an effect.

His team said seven-day access to “all aspects of care” could improve the outcomes for higher-risk patients currently admitted at weekends.

The medical conditions resulting in the biggest number of in-hospital deaths included pneumonia, congestive heart failure, heart attack, septicaemia, acute renal failure, urinary tract infection and neck or hip fracture.

“We’ve tried to take account of the severity of illness and we’re not clear yet whether it’s the severity of illness or the way we deliver services that are the key thing.”

He also said he thought the research added weight to the argument to extend NHS services through the weekend.

“It’s about our NHS catching up with other service industries and offering a routine six- or seven-day week where people can see consultants or experts on a Saturday and maybe even a Sunday, where people can have routine operations over the weekend – more at their convenience than the convenience of the service – and also people who are worried on a Friday have access to expert advice – and that’ll put the compassion back into the NHS.”

The trust had accepted it was not strong enough to survive on its own and agreed the takeover.

The move affects the Cumberland Infirmary in Carlisle and the West Cumberland Hospital in Whitehaven.

In November 2011 it emerged from a leaked email by the trust’s chief executive that its financial position had worsened and urgent action was needed, which could include ward closures.

Some staff later talked about being “at breaking point”, with morale at an “all time low”.

However, the Cumbria trust had always denied that patient safety was at risk.

Two organisations were in the running for the takeover, with Northumbria Healthcare NHS Foundation Trust beating off competition from a partnership between the trusts that run Cumbria’s community health services, and Newcastle’s hospitals.

Jim Mackey, chief executive of Northumbria Healthcare NHS Foundation Trust, said: “Our focus for the coming months will be on working with all stakeholders to ensure hospital-based care is fit for the future and on a sound financial footing.

“Whilst we recognise that there are many challenges ahead, we are optimistic and confident in being able to deliver real benefits to patients.”

The move was also welcomed by the joint health unions, Royal colleges and professional associations.

They said in a joint statement: “We believe the appointment should represent a fresh start, and we therefore call on the new management of the trust to work in partnership with us to ensure that the interests of the patient are now given the priority they deserve.

“The patients, families and staff of North Cumbria deserve a trust that is well run, well managed, and that focuses on delivering high quality patient care.”

Trans fats found in fast foods were linked to lower scores in tests and more shrinkage typical of Alzheimer’s.

The research looked at nutrients in blood, rather than relying on questionnaires to assess a person’s diet.

US experts analysed blood samples from 104 healthy people with an average age of 87 who had few known risk factors for Alzheimer’s.

They found those who had more vitamin B, C, D and E in their blood performed better in tests of memory and thinking skills. People with high levels of omega 3 fatty acids – found mainly in fish – also had high scores. The poorest scores were found in people who had more trans fats in their blood.

Trans fats are common in processed foods, including cakes, biscuits and fried foods.

The researchers, from Oregon Health and Science University, Portland; Portland VA Medical Center; and Oregon State University, Corvallis, then carried out brain scans on 42 of the participants.

They found individuals with high levels of vitamins and omega 3 in their blood were more likely to have a large brain volume; while those with high levels of trans fat had a smaller total brain volume.

Study author Gene Bowman of Oregon Health and Science University said: “These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet.”

Co-author Maret Traber of the Linus Pauling Institute at Oregon State University said: “The vitamins and nutrients you get from eating a wide range of fruits, vegetables and fish can be measured in blood biomarkers.

Alzheimer’s disease is the most common cause of dementia

Symptoms include loss of memory, mood changes, and problems with communication and reasoning

No one single factor has been identified as a cause for Alzheimer’s disease although a combination of factors, including age, genes, environment, lifestyle and general health are implicated.

Half of care home residents are at risk of harm from mistakes made in giving out their medication, research suggests.

Researchers at the University of West England Bristol and the University of Warwick found that 52 per cent of those in the study were exposed to “more serious” problems, such as untrained staff trying to give them another patient’s medicine.

Experts say that many people have to be taken to hospital every year because of mistakes in medication administration, and so the NHS could save millions if these trips were avoided.

Some trusts have tried to stop nurses being distracted on drug rounds by making them wear bright red tabards printed with the message “do not disturb”, but these led to fears that they could leave other patients feeling ignored.

Prof Ala Szczepura of Warwick University said: “Older people in long-term residential care are clearly at increased risk of medication errors.”

Deidre Wild, a visiting research fellow at UWE Bristol, added: “The majority of residents are cared for in a residential home with no onsite nursing staff. In such homes the management of prescribed medication is undertaken by social care staff who may have had no formal training in safe practice.”

The study protocol of a cluster-randomised controlled trial of family-mediated personalised activities for nursing home residents with dementia was published online in the journal BMC Geriatrics, looked at 13 care homes in the south west, midlands and north west of England, and analysed 188,249 attempts to administer drugs by staff.

Each resident received nine different drugs on average and were given medication 206 times a month. Each resident experienced 6.6 potential errors, with the most common being an attempt to give drugs at the wrong time.

However experts say many of the problems could be avoided with new technology which uses a barcode system to alert staff to potential errors. Staff scan each patient’s barcode identifier then scan the drugs sent out by the pharmacy to check they are being given the right dose at the correct time.

Overall the number of reports of “adverse incidents” involving devices received by the Medicines and Healthcare products Regulatory Agency rose by 13 per cent in 2010, to reach 10,280.

Of these, 301 cases were fatalities – a 50 per cent rise on the previous year – while 2,382 involved serious injuries.

Investigations by the MHRA showed that about a third of the incidents were down to the “healthcare establishment or user responsibility”, while a similar proportion were the fault of the manufacturer.

About a quarter of the cases involved “active and inactive implants” such as pacemakers, replacement hips, gastric bands and even contact lenses.

But the report also highlights the problems raised by French authorities over the safety of silicone breast implants made by Poly Implant Prosthese (PIP), which has led to a row between the Department of Health and private cosmetic surgery clinics over who should pay for their removal and replacement.

About 15 per cent of the incident reports involved problems with surgical equipment and a similar proportion was concerned with life support machines and incubators.

Other patients suffered problems with wheelchairs, artificial limbs, syringes and beds or hoists.

From: http://www.telegraph.co.uk/Deaths-and-serious-injuries-involving-medical-devices-up-29

Scientists showed that after a significant person’s death, heart attack risks increased to 21 times higher than normal within the first day, and were almost six times higher than normal within the first week.

Doctor Murray Mittleman, a preventive cardiologist and epidemiologist at Harvard Medical School in the United States, said: “Caretakers, healthcare providers, and the bereaved themselves need to recognise they are in a period of heightened risk in the days and weeks after hearing of someone close dying.”

The researchers also found that the increased risk of heart attack within the first week after the loss of a significant person ranges from one per 320 people with a high heart attack risk to one per 1,394 people with a low heart attack risk.

The study is the first to focus on heart attack risk during the first few days and weeks after someone close died.

Grieving spouses have higher long-term risks of dying, with heart disease and strokes accounting for up to 53 per cent of deaths, according to previous research.

As part of the Determinants of MI Onset Study, researchers reviewed charts and interviewed patients while in the hospital after a confirmed heart attack between 1989 and 1994.

Patients answered questions about circumstances surrounding their heart attack, as well as whether they recently lost someone significant in their lives over the past year, when the death happened and the importance of their relationship.

The researchers estimated the relative risk of a heart attack by comparing the number of patients who had someone close to them die in the week before their heart attack to the number of deaths of significant people in their lives from one to six months before their heart attack.

Psychological stress such as that caused by intense grief can increase heart rate, blood pressure and blood clotting, which can raise chances of a heart attack.

At the beginning of the grieving process, people are more likely to experience less sleep, low appetite and higher cortisol levels, which can also increase heart attack risks.

Elizabeth Mostofsky, lead author of the research, said grieving people also sometimes neglect regular medications, possibly leading to adverse heart events,

She added: “Friends and family of bereaved people should provide close support to help prevent such incidents, especially near the beginning of the grieving process.  Similarly, medical professionals should be aware that the bereaved are at much higher risk for heart attacks than usual.”

Dr Mittleman added: “During situations of extreme grief and psychological distress, you still need to take care of yourself and seek medical attention for symptoms associated with a heart attack.”

Heart attack symptoms include chest discomfort, upper body or stomach pain, shortness of breath, breaking into a cold sweat, nausea or light-headedness.

However, Dr Mittleman said future studies are needed to make more specific recommendations based on the study which was published in Circulation: Journal of the American Heart Association.

From: http://newsroom.heart.org/pr/aha/grief-over-losing-loved-one-linked-221451.aspx

The rights of carers are expected to be put on the same legal footing as those of the people they look after.

There are estimated to be about six million people caring for husbands, wives, children, parents or neighbours, but the Government admits that “many do not get the emotional, financial and practical support they need”.

Paul Burstow, the care services minister, said: “Without the support of relatives and friends, many people who aren’t able to look after themselves would not be able to stay at home. Carers should have their needs looked after as much as the person they are caring for.

“A carer’s health often suffers because they don’t have time to look after themselves. Some often don’t have time to eat properly. So it’s vital we support them to look after their health and well-being.

He added: “None of this is rocket science. It is about the NHS seeing beyond the patient to support family carers. Carer stress is one of the biggest triggers for admission to care homes. That’s why we’ve given the NHS the clearest ever direction to make carers a priority.”

The details of the new rights for carers will be set out in the spring when the Government publishes its plans for reforming the social care system.

They are expected to include safeguards to ensure carers can work flexible hours and are not discriminated against in the workplace. Carers who are studying are likely to be able to ensure they receive state help at school or college.

A scheme that allows carers to take a break is also likely to be strengthened to protect leisure time.

“Caring is for many a full-time job,” said the Department of Health, “but many carers don’t realise they can get help and support from their community.”

A simple programme of assessing carers’ needs and providing tailored help to address them is expected to be introduced.

Ministers have promised to publish a white paper on elderly care reform in April next year.

From:  http://www.telegraph.co.uk/Carers-to-get-legal-rights-and-support-in-reforms

Dr Samit Joshi of Yale University School of Medicine found changes in bacteria in the mouth preceded the development of pneumonia.

He concluded that this process “suggests that changes in oral bacteria play a role in the risk for developing pneumonia”.

Pneumonia is thought to affect more than 620,000 people in the UK and claims the lives of around five per cent of those who contract the disease. Which means that it kills more than ten times the number of people who die in the UK from road accidents.

Although further research is required to determine the exact relationship between oral health and pneumonia, it is not the first time the two diseases have been linked.

Poor oral health has been associated with respiratory diseases for a number of years, as bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs.

This can cause infections, such as pneumonia, or could worsen an existing condition.

Studies have even suggested a higher mortality rate from pneumonia in people with higher numbers of gum problems.

The findings of the study present further evidence that there’s a significant health risk to the elderly and the young, according to Chief Executive of the British Dental Health Foundation, Dr Nigel Carter.

Dr Carter said: “During the winter months we’re all susceptible to colds, coughs and chesty viruses due to the drop in temperature. What people must remember, particularly those highlighted as vulnerable, is that prevention can be very basic.

“Systemic links between gum disease and overall health have been well documented, and at this time of year keeping up good oral health can really help stave off illness.

“Simply brushing your teeth for two minutes twice a day using a fluoride toothpaste, cleaning in between teeth daily with interdental brushes or floss, cutting down on how often you have sugary foods and drinks and visiting the dentist regularly, as often as they recommend will be a great starting point.

“If you have swollen gums that bleed regularly when brushing, bad breath, loose teeth or regular mouth infections appear, it is likely you have gum disease.

“If any of these symptoms persist, or signs of pneumonia develop, visit your dentist and GP immediately.”

The research was presented at the Infectious Diseases Society of America annual meeting in Boston looked at 37 subjects for a one month period.

People with the condition have abnormally inflexible ventricles, the heart’s major pumping chambers, that do not fill sufficiently with blood.

This leads to blood ”backing up” in the lungs and breathing difficulties.

Scientists found that Viagra activates an enzyme that causes a protein in heart muscle cells to relax.

The effect was seen in dogs with diastolic heart failure within minutes of the drug being administered.

Study leader Professor Wolfgang Linke, from the Ruhr Universitat Bochum (RUB) in Germany, said: ”We have developed a therapy in an animal model that, for the first time, also raises hopes for the successful treatment of patients.”

Viagra has a similar effect on blood vessels, which is why it was originally developed as a treatment for high blood pressure and heart disease.

The drug’s active ingredient, sildenafil, inhibits an enzyme involved in the mechanism that regulates blood flow.  However, the enzyme is slightly different in different parts of the body.

The British scientists behind Viagra found to their initial disappointment that it was not a great help to patients with high blood pressure. But it had a miraculous effect on men with erectile dysfunctin.

The drug successfully suppressed the enzyme phosphodiesterase (PDE) in the penis, increasing blood flow to the organ.

Prof Linke’s team found that it worked on the same enzyme in heart cells. This had the effect of causing a cardiac muscle protein called titin to become more elastic.

”The titin molecules are similar to rubber bands,” said the professor. ”They contribute decisively to the stiffness of cardiac walls.”

The research was initially published in the journal Circulation of the American Heart Association.

Almost half of emergency patients admitted to hospital with heart failure have a diastolic condition.

Various medical conditions can cause the ventricles to become ”stiff”. They include high blood pressure, blocked arteries, and cardiomyopathy heart disorders.

Sildenafil is already being tested on heart failure patients taking part in the Relax trial in the US.

Both doctors believe their findings merit further investigation and research.

The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.

Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly tell tale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.

In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.

Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had rib fractures.

In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.

Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.

Dame Sally Davies Chief Medical Officer was quoted as “We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.

“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”

Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.

Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.

“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.

“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.

“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”

Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.

“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.

“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.

From: http://multi-vitamins.eu/vitamin-d-deficiencies-linked-to-cot-deaths-sids

But experts argue that the dose a child needs is determined by their weight – and the average weight of children has increased.

It means that children may not be receiving a big enough dose of antibiotics to combat their infection.

Giving inadequate doses also encourages bacteria to become resistant to antibiotics making them harder to treat in future, it was warned.

The average weight today of a five-year-old is 21kg and a 37kg for a 10-year-old – up to 20% higher than in 1963, researchers at King’s College London sad.

The study, led by a team at King’s College London and St George’s, University of London, said they were “surprised at the lack of recent evidence” to support current dosing recommendations for penicillins.

Writing in the British Medical Journal (BMJ), they said ‘fractions’ of adult doses are calculated instead of basing the dose on the weight of the child who needs treatment.

The article said: “The widely used doses are still based on the original dosing principle of a big child = half an adult, small child = half a big child, baby half a small child.”

The team analysed the actual dose that would be received today based on age bands recommended in the 2010/11 British National Formulary for Children and the current weights of children based on 2009 Health Survey for England data.

The results showed doses could be strikingly low.

The authors also pointed out that many infections do not need treatment with antibiotics.

“Many of the five million children in England who receive oral penicillins each year may not need them, but those who do should receive them in an effective dose.”

Dr Paul Long, senior lecturer in pharmacognosy at King’s College London, said: “We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for children, as it is such a commonly used drug.

“Children’s average size and weight are slowly but significantly changing, so what may have been adequate doses of penicillin 50 years ago are potentially not enough today.

“It is important to point out that this study does not provide any clinical evidence that children are receiving suboptimal penicillin doses that lead to harm, and we want to reassure parents of that.

“But what we are saying is that we should ensure that children with severe infections who need these antibiotics the most are still receiving an effective dose.”

The first ever National Audit of Dementia found a “shocking” lack of care delivery.

Data from 210 hospitals in England and Wales was used in the report along with ward level data from a sample of 145 wards, over 2,000 staff questionnaires and observations of care on the wards.

Professor Peter Crome, the co-author of the report and Chairman of the National Audit of Dementia Steering Group, said that the report had “found problems across practically every aspect of care for patients admitted to hospitals with dementia.”

He added: “There were deficiencies in the assessment of people and there were deficiencies in the interaction betweem staff and patients.”

Hannah Clack from the Alzheimer’s Society called the report “shocking” and stressed the need for “a huge and radical shake-up of the way the NHS deals with people with dementia.”

She added: “People are going into hospital and they’re coming out worse in terms of their dementia and in terms of their physical health.”

The report recommended that all staff should have basic training in dementia, and that all hospitals should have Dementia Champions on every ward.

Up to 24,000 people with diabetes are dying unnecessarily every year, according to a new report.

The report into death rates, from the National Diabetes Audit for England, found that women with diabetes are nine times more likely to die young than those without the condition.

Among women aged 15 to 34 with diabetes, death rates are up to nine times higher than the average for this age group.

And the report also found that two young people of both sexes aged 15 to 34 may be suffering an avoidable death every week.

An estimated 70,000 to 75,000 people with diabetes die in England every year – accounting for about 15% of all deaths.

Most deaths are related to the actual condition – diabetes can cause serious heart and kidney problems, as well as amputation of limbs and loss of eyesight.

The report said people are dying too early due to poor management of their condition.

This includes not receiving basic diabetic health checks on the NHS, having unhealthy lifestyles and not taking medication properly or understanding how to take it.

It argues that educating people in managing their condition reduces the risk that they will suffer dangerously high or low blood sugar, which increases the risk of complications but can also lead directly to death.

The gap in death rates between people with diabetes and those without become more extreme in younger age groups.

About one in 3,300 of all women will die between the ages of 15 and 34, but this risk increases nine-fold among women with Type 1 diabetes to one in 360.

Type 1 diabetes usually develops in childhood and patients need to take insulin injections.

Among women with Type 2 diabetes – linked to unhealthy lifestyles and obesity – the risk increases six fold to one in 520.

Men aged 15 to 34 in the general population have a risk of dying of one in 1,530, but this risk increases four-fold for those with Type 1 diabetes to one in 360, and by just under four-fold among those with Type 2 to one in 430.

Earlier this year the National Diabetes Audit found almost 450,000 children and younger adults (aged up to 54) with diabetes have high-risk blood sugar levels that could lead to severe complications.

The audit is managed by the NHS Information Centre and commissioned by the Healthcare Quality Improvement Partnership (HQIP).

The report also found a strong link between deprivation and increased mortality rates.

Among under-65s with diabetes, those from deprived backgrounds are twice as likely to die as those from more affluent areas.

Diabetes UK has compiled a list of 15 essential health checks and services and there are nine checks recommended on the NHS by the National Institute for Curbing Excpenditure (Nice).

These nine checks include blood sugar control, cholesterol, blood pressure, body mass index (BMI) and eye and foot examinations to check for diabetic complications.

The National Diabetes Audit has found that only around half of people (53%) with Type 2 diabetes and less than a third (32%) with Type 1 diabetes receive all nine checks.

Some 290,000 people in the UK have Type 1 diabetes and another 2.6 million are diagnosed with Type 2.

It is also estimated there are 850,000 other people with undiagnosed Type 2 diabetes.

The study, lead by Dr Michelle Harvie, and presented at the San Antonio Breast Cancer Symposium, found that women who followed a diet for just two days of the week lost more weight than those practising a full time diet.

The researchers put 100 overweight female volunteers on one of three diets.

The first diet consisted of consuming just 650 calories a day for several days of the week, with carbohydrates such as potatoes and bread cut out. For the remaining five days of the week the participants, whilst encouraged to eat healthily, could consumer whatever they liked.

Although volunteers on the second diet were also banned from eating carbohydrates for two days in a week, they were not set a specific calorie limit.

They were also allowed to eat as much as they wanted for the remainder of the week. The third and final group followed a more conventional diet, which included avoiding high-fat foods, alcohol and sticking to approximately 1,500 calories every day.

The results of the study showed that after three months the women on the two day diets had lost an average of nine pounds, compared to five pounds of those on the full time diet.

Volunteers who had followed the two day diet had lost nearly twice the amount of weight of those on the more traditional full time diet, and recorded significant improvements in three key areas linked to breast cancer. Their levels of hormone leptin dropped by 40 per cent.

Research professor Gillian Haddock, who also took part in the study herself, has said she would recommend the diet to friends and that she found it an easier diet option.

Mrs Haddock said: “I used to follow the 650 calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

The research, conducted at the Genesis Breast Cancer Prevention Centre at UHSM, was published in the International Journal of Obesity.

Pamela Goldberg, chief executive of the Breast Cancer Campaign said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

The diet that the women followed for only two days a week:

• Breakfast: Fruit tea and a banana, or mug of milky coffee.
• Mid-morning: Can of diet cola, or cup of tea and plum.
• Lunch: Carrot and coriander soup and half pint of milk, or salad, glass of squash and half pint of milk.
• Mid afternoon: Glass of squash, or glass of sparkling water and Satsuma.
• Dinner: Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two vegetables, half pint of milk and cup of tea.
• Supper: Pint of milk, or hot milk with cinnamon and sweeteners.

Patients with hypertension, or chronic high blood pressure, are often given drugs to lower their risk of heart disease and stroke but the medication could also benefit a wider group of patients.

An analysis of 16 studies, covering 70,664 patients, found that treating 169 prehypertensive people with blood pressure-lowering medication for 4.3 years would prevent one stroke from happening.

High blood pressure is the biggest risk factor for stroke, and an estimated 40 per cent of strokes could be prevented if people took steps to control their blood pressure levels.

US data shows that about 10 per cent of Americans have prehypertension, with a blood pressure between 120/80mm Hg and 139/89mm Hg – higher than the upper boundary of “normal” but below the lower limit of hypertension.

Ilke Sipahi of the Harrington-McLaughlin Heart and Vascular Institute in Cleveland, Ohio, who led the study, published in the Stroke journal, said patients would be better off trying to lower their blood pressure through a healthy diet and physical activity than by taking pills.

He said: “We do not think that giving blood pressure medicine instead of implementing the lifestyle changes is the way to go … however, the clear-cut reduction in the risk of stroke with blood pressure pills is important and may be complementary to lifestyle changes.”

Dr Sharlin Ahmed of The Stroke Association said: “Making a few simple lifestyle choices, such as eating a healthy diet low in salt, giving up smoking, and exercising regularly can help to keep your blood pressure under control and can reduce your risk of stroke.

“As highlighted in this study, it may also be beneficial for some people with borderline high blood pressure to take blood pressure lowering medication, however this needs to be discussed with your GP.”

Professor Rawlins, the chairman of NICE said the economic pressure on trusts meant that “completely illegal” decisions were being made to limit the use of expensive drugs.

He told the Financial Times: “I just wish a patient organisation would take a Trust to court for failing to comply.”

Nice has been criticised for ruling against the prescription of expensive new drugs on the grounds that they are not cost-effective.

But Sir Michael told the paper that most of Nice’s recommendations were in favour of prescription and that it was other bodies that blocked the drugs’ use.

Sir Michael criticised the local lists of approved medicines drawn up across the NHS which “second-guess” and sometimes ignore Nice recommendations.

While patient groups for particular diseases – often helped by pharmaceutical companies – have attacked Nice for advising against the use of some expensive new medicines, Sir Michael said they should be directing more criticism instead to the drug companies for charging high prices.

The government’s own innovation review recognised the problem by pledging a Nice “compliance regime” to reduce regional variation – the so-called “postcode lottery” – and to improve adherence to the agency’s guidelines.

It cautioned that local decisions should not act as a barrier to the medicines that Nice had approved.

Taxpayers are now facing an estimated £2 billion bill, despite the company already failing to deliver a fully functional version of its software, The Times reported.

The £11.4 billion National Programme for IT, set up in 2002 by bliar, was at the time spun as the world’s biggest civilian computerisation project.

It aimed to give doctors instant access to patient records wherever they were being treated and CSC had signed a deal to computerise records in most of England.

Digitising the medical records of the country’s 62 million people was the core objective of the National Programme for IT in the NHS, accounting for £7 billion of the total estimated cost.

Andrew Lansley, the Health Secretary, announced in September that he was abandoning the scheme to create a national patient database because it had “let down” the health service.

He made the decision to “urgently dismantle” the failed project after criticism it was not value for taxpayers’ money.

Yet the company stated in official US papers that it was in talks with the British Government for its contract to be extended until 2017, at a cost of up to £2 billion.

Computer applications installed as part of the scheme have also failed or been scrapped.

However, £250,000 in bonuses has been paid by the DoH to 80 people involved in the scheme as a reward for “an exceptional contribution to delivery”.

CSC, one of the world’s biggest IT providers, had been contracted to provide patient record software, known as the Lorenzo system, to 166 NHS hospitals. But it has delivered on 10 projects. None of those systems is fully functional.

CSC has signed deals worth hundreds of millions of pounds with Royal Mail, Identity and Passport Service and UK Atomic Energy Authority.

The Coalition’s Major Projects Authority, established to review Labour’s financial commitments, found the scheme was not fit to provide services to the NHS.

A cross-party committee of MPs concluded the programme had proved “beyond the capacity of the DoH to deliver”.

Katherine Murphy, of the Patients Association, said it was “shameful” to pour more money into a failed initiative.

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

The Government is trying to reassure women fitted with PIP implants to prevent a rush for NHS surgery to remove faulty breast implants.

Almost £135,000 is being spent by the Department of Health on the campaign, which will also run in social media sites. Posters will appear in GPs’ surgeries and hospitals as well.

The advert reads: “The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

“There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.”

However, it also states, in large-type at the top of the advert: “The NHS will support women with PiP breast implants.”

Clarifying the situation for those who received implants as part of private breast enlargement operations, it states: “”The NHS will remove your implants if your doctor agrees, but the NHS will not replace implants unless it is clinically necessary.”

It advises those worried about whether they have implants made by Poly Implant Prothese (PIP), which contain industrial-grade silicone, to find out if they have them, to speak to their specialist or GP, and “agree what’s best for you”.

Despite the campaign, Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the organisation’s stance remained that all 40,000 women fitted with them in Britain should have them removed.

He said: “We remain steadfast in our recommendation to the public of precautionary removal of these defective devices. Although there is no immediate health risk, the gel within these implants is simply not meant to be inside the human body.”

A survey of its 230 members found 95 per cent agreed that “it should be the clinics and hospitals that should pay for the replacement surgery, rather than burden the taxpayer with these costs”.

Women given the PIP implants are due to protest in London on Saturday at the reluctance of private firms like Harley Medical Group, The Hospital Group and Transform Cosmetic Surgery to fund removal and replacement surgery.

Explaining the rationale for the campaign, Andrew Lansley, the Health Secretary, said: “The refusal of some clinics to help their patients has left some of those women worried and confused.

“That’s why we are running this ad campaign, to give women clear, definitive advice about what course of action they should take. I hope it helps women decide what is best for them. We have made it very clear to private companies what we expect of them – to provide their patients with the aftercare that they need and deserve.”

“I do not think it is fair to the taxpayer or other NHS patients for the NHS to foot the bill.  We will pursue private clinics with all means at our disposal to avoid this.”

Professor Sir Bruce Keogh, NHS medical director and leader of an expert group on PIP implants convened by Mr Lansley, said: “At present there is insufficient evidence to recommend routine removal of these implants.

“But I know women will be worried. That’s why the expert group supports the NHS offer and believes the private industry should do the same.”

From: http://www.telegraph.co.uk/Breast-implant-scandal-Government-campaign-to-reassure-women

Dr Guthrie, a member of the Faculty of Sexual and Reproductive Health, was concerned that women could take the pill during these days and wrongly think they would avoid pregnancy.

She said: “There’s very clear evidence showing that it’s not effective in the couple of days running up to ovulation, and probably not very effective in the 36 hours afterwards.”

The aim of the bpas scheme is to cut the number of women seeking abortions over the festive season.

The idea is that women will be able to pop the pill on the morning after accidentally having unprotected sex, rather than having to get an appointment, which can be difficult over the Christmas break.

Part of the rationale is, as bpas puts it, “the sooner the morning after pill is taken after unprotected sex, the more effective it is.”

Dr Guthrie, who works in East Yorkshire, agreed with that, saying that Levonelle should always be taken within 72 hours of sex.

However, she was concerned that women would not be sufficiently informed of Levonelle’s limitations.

While she welcomed immediate access to emergency contraception, she said: “You have to know how effective or ineffective it is.”

Guidance from the faculty, published this August, states that Levonelle “has been shown to be no better than placebo at suppressing ovulation when given immediately prior to ovulation, and is not thought to be effective once the process of fertilisation has occurred”.

Dr Guthrie said that, if a woman has had unprotected sex at this time of the menstrual cycle, she should see a doctor about obtaining another form of emergency contraception.

In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.

The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.

Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.

In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors.

The findings of the research The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK were published in the British Journal of Cancer.

Smoking was the biggest factor, causing nearly one in five of all cancers.

But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.

He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”

Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.

The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.

Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.

Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.

Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.

The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.

Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.

“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”

It wants the Department of Health in England to carry out the first proper review of drinking guidance in more than 15 years, which should follow the example of Scotland in recommending two “dry” days a week.

The MPs also want new rules on what would count as a dangerous night of “binge-drinking”, new lower safe levels for older people and a website where people can work out individual intake based on their age, weight and family history.

They say few people understand what constitutes an alcoholic unit, the basis of the drinking advice, and tell ministers that the guidelines do not seem to change behaviour.

Although the Committee’s report concedes that the drinks industry is needed to help improve labelling on bottles and glasses, it warns of potential conflicts of interest if the Government works too closely with brewers and shops.

Andrew Miller, the Committee’s chairman, said: “Alcohol guidelines are a crucial tool for Government in its effort to combat excessive and problematic drinking. It is vital that they are up-to date and that people know how to use them.

“Unfortunately, public understanding of how to use the guidelines and what an alcohol unit looks like is poor, although improving.

“While we urge the UK Health Departments to re-evaluate the guidelines more thoroughly, the evidence we received suggests that the guidelines should not be increased and that people should be advised to take at least two drink-free days a week.”

The MPs’ report, published on Monday following public hearings and written submissions last year, states that the first Government health advice on sensible drinking was not published until the 1980s.

Originally, the public were told that men could safely have 18 “standard drinks” a week and women half that number, while in 1987 this was revised in favour of weekly “sensible limits” of 21 units for men and 14 for women.

Medical research later suggested that moderate daily alcohol intake could be good for the health, by lowering levels of bad cholesterol in the blood, while giving weekly limits could “mask episodes of heavy drinking”. In 1995, therefore, daily limits were introduced that recommended men should not drink more than three to four units a day, and women two to three.

Some experts, however, raised concerns that this switch from weekly to daily limits appeared to increase the weekly “allowance” of alcohol while also appearing to “endorse daily drinking”.

The MPs say more recent studies have cast doubt on the health benefits of regular drinking, and recommend that England follows Scotland’s lead in urging “at least two alcohol-free days a week”.

They back current specific advice for children and pregnant women, and say “there could be merit” in producing new rules for older people as well as limits for “individual drinking episodes”, but find no evidence for increasing current general safe limits.

The Committee says an expert group, including civil servants as well as scientists, should review current evidence on the health effects of alcohol in order to “increase public confidence”.

They say people should be made aware of the difference between the short-term effects of binge drinking and the long term harm caused by alcoholism, and should be helped to understand how many units are in different drinks.

Officials say the implants – thought to have been fitted in some 52,000 women who wanted larger breasts for cosmetic reasons or after cancer surgery – only need to be replaced if they have ruptured but will also carry out the procedure if the patients are worried about them.

Most independent providers have agreed to provide free surgery for their patients who received implants made by the now-defunct Poly Implant Prothèse (PIP) – which were filled with non-medical grade silicone intended for use in mattresses – at least one is holding out while another has so far refused to reveal its policy.

Transform Cosmetic Surgery said the Government needed to “accept its responsibility” for the problem as the implants had been approved for use by a watchdog, the Medicines and Healthcare products Regulatory Agency.

Transform carries out 6,000 breast augmentation procedures a year, and estimates it has fitted some 4,000 women with PIP implants in recent years.

The clinic is currently refusing to pay for them to be removed and replaced and is charging women £2,800 per procedure, although it insists most implants are not at risk of malfunctioning. Some patients have already been booked in for the operation.

It said it would review its stance this week, but if it remains unchanged it could mean the Government has to step in and pay for these women’s operations, at a cost of up to £11.2m.

Nigel Robertson, the chief executive of Transform Cosmetic Surgery, said in a statement: “Transform is fully committed to supporting the Department of Health in its efforts to end the uncertainty and anxiety of British women affected by the PIP situation and awaits a response to its request for an urgent meeting to discuss the way forward.

“It is important to recognise that this crisis is the result of failed regulation of breast implants, which were approved for use. The Government needs to accept its responsibility for this situation and work constructively with us to find a workable solution.”

The other major clinic yet to announce its decision is The Hospital Group.

It is telling patients there is “no evidence to suggest routine removal” of PIP implants but will replace those that have already ruptured “free of charge”.

Other leading providers including BMI Healthcare, Nuffield Health and Spire have agreed to offer free removal of the PIP implants.

Michelle Victor, a solicitor at Leigh Day & Co, said the firm had already been contacted by women seeking help to make private clinics pay for the replacement of their PIP implants.

She said that although the clinics themselves were not responsible for making them, the implants were “not fit for purpose” and so cosmetic surgery groups should remove them.

From: http://www.telegraph.co.uk/Leading-cosmetic-surgery-group-refusing-to-fund-new-breast-implants

Interpol, which is based in France, issued a so-called red notice for Mr Mas, who ran Poly Implant Protheses (PIP), which is in liquidation.

France on Friday offered to pay for 30,000 women to have their PIP implants removed because of the risk the products could rupture and leak industrial-grade silicone.

But the Department of Health said it was not echoing the French advice as there was no evidence to support it. However they are reviewing the data and more information will be made this afternoon.

The Medicines and Healthcare products Regulatory Agency (MHRA) pointed out that there was no evidence of any disproportionate rupture rates other than in France.

A spokesman said: “We therefore do not believe that the associated risks of surgery from breast implant removal can be justified without further evidence.

“We will continue liaising with the French medicines and medical devices regulator and we are awaiting the evidence to support the decision made in France. This will be evaluated as a matter of priority by our clinical and toxicological experts and we will issue further advice if necessary.

Tens of thousands of women in France, Britain, Italy, Spain, Portugal and other countries in Europe and South America have had implants made by PIP, which has now closed.

The implants are filled with an unapproved non-medical grade silicone believed to be made for mattresses and there have been reports that the protective barriers are faulty.

The British Association of Aesthetic Plastic Surgeons (BAAPS) took a different stance from the Government and said it considered the French advice “not unreasonable”.

BAAPS president Fazel Fatah said: “If women are concerned or experience adverse symptoms they should see their surgeon, to discuss options such as having a scan to determine whether there is any weakening or rupture. If there is, we reiterate our previous recommendations – to have both implants removed.”

Figures from the MHRA suggest 84,300 PIP implants have been sold in the UK since 2001.

Based on the assumption that each woman has two implants, at least 42,000 women in the UK could be affected, according to the regulator.

But the figure could be higher because women undergoing breast reconstructive surgery following cancer may only have had one implant.

Their discovery that oxyntomodulin reduces appetite offers a potential new treatment for obesity.

Prof Bloom said he was delighted by his knighthood.

“This is a testament to the efforts of a great many colleagues with whom I have worked over the years. This is a unique period in the history of scientific research when we are at last able to work out the details of how the body functions and therefore contribute to the prevention of disease. I am proud that the units are helping patients. I get letters from them all the time.”

Professor Sir Keith O’Nions, rector of Imperial College London, said Prof Bloom’s research was “pioneering” and had changed the approach to treating obesity, for the benefit of everyone in society.

A large variety of vocations are also honoured in health and medicine.

They include MBEs for six GPs, five nurses, a physiotherapist, two pharmacists, a dentist and a volunteer ambulance driver.

John Wallwork, professor of cardiothoracic surgery and director of transplantation at Papworth Hospital in Cambridge, is the recipient of a CBE.

Julie Moore, chief executive of University Hospital Birmingham NHS Foundation Trust becomes a Dame. Her personal involvement in the development and staffing of the military managed ward concept at Selly Oak Hospital has been recognised.

Christine Mills, founder of Hope for Tomorrow charity, receives an MBE for launching the first UK mobile chemotherapy unit.

She founded the charity after her husband died from cancer of the spine and wanted to alleviate the suffering of people travelling long distances to and from hospital to receive chemotherapy treatment.

She raised enough money to build the world’s first mobile chemotherapy unit, which can treat 12 to 20 cancer patients a day on the road, complete with two dedicated nurses.

There are a host of challenges looming for the NHS in the next 12 months.

The inquiry has been looking at what happened at Stafford Hospital from 2005 to 2008 during which hundreds of patients died needlessly and why it went undetected for so long. In particular, the findings promise to have major implications for regulation of the health service.

In recent months, the Care Quality Commission, which now regulates quality in the NHS after taking on responsibility for it from the Healthcare Commission in 2009, has come under criticism from the House of Commons health committee for losing sight of what it should be doing. Ominously for the quango, the prime minister was quick to give his backing to the findings.

What is more, during the inquiry the culture and vision of the regulator came under attack from its own officials, prompting the health secretary to order an investigation himself. It seems unlikely that the CQC will survive unchanged.

Politically, the government’s reform of the NHS in England may be over the worst hurdles, but that does not mean it will be an easy ride from now until the big bang in 2013 when GPs finally get control over the purse strings.

There is growing frustration among doctors who are getting involved in the new clinical commission groups. In many ways, they should be the greatest advocates of the plans as they are supposed to be getting more power than ever before.

But the Clinical Commissioning Coalition, which represents the GPs who are piloting the new arrangements, has started reporting that they are being bullied by senior managers in the health service. They say they are interfering with their structures and decision-making process – and this in turn is threatening the whole project. Expect another 12 months of arguments and controversy.

Although it is not part of the NHS, the social care system is closely linked to the fortunes of the health service. Whether it is arranging discharge from hospital or preventing falls in the home, when social services are not working as they should, the effect is felt in the NHS.

When Tony Blair came to power in 1997 he talked about improving social care. But at the end of Labour’s 13 years in power, ministers were still arguing about the best way forward.

After 13 years of labour’s dithering the system is suffering from chronic under funding.

While the NHS enjoys a budget in excess of £100 billion, adult social care has to get by on about £14 billion.

This is topped up by individual contributions – the system is means-tested – but nonetheless councils across the country are cutting back on what they can offer. And so reform will require extra money – something which is of course in short supply at the moment.

It is also likely to require cross-party consensus, but there is still some bad blood between the health secretary and his Labour opponent Andy Burnham over the death tax row which effectively scuppered the shadow health secretary’s plans to reform social care when he was in power.

The budget is increasing by an average of 0.1%, but as inflation in the health service is rising at a much quicker rate to cover costs associated with the ageing population and rising levels of obesity, savings are having to be made.

The NHS has a target of £20 billion by 2015, the equivalent of about 4% a year. That means there is pressure on jobs – unions say tens of thousands are being lost – and front-line services.

In particular, hospitals are coming under pressure. Advances in medicine and the nature of illnesses in the 21st century – many more people are suffering from chronic conditions like diabetes – means more and more can be done in the community.

It has meant an increasing number of hospitals are piling up debts because they are not getting enough patients through the door.

This in turn means managers and ministers are having to make difficult decisions about closing departments and even whole centres. The process will continue in 2012, particularly in and around London which was recently described as being in a “shocking” state by a committee of MPs.

Under Labour, an 18-week waiting time target was set for non-emergency hospital treatment, such as knee and hip operations. Within months of the coalition being formed, ministers said it was being relaxed to move away from the tick-box culture that they say had developed.

But when the government was knee-deep in criticism over its reforms the prime minister made the specific pledge that waiting times would not be allowed to slip. This has resulted in more attention than ever being given to waiting times.

And signs are emerging that hospitals are beginning to struggle to keep up with the 18-week goal. Overall, the NHS is still meeting the target – they only have to achieve it for 90% of patients to reflect the fact there are valid reasons why some wait longer.

But that masks the fact that there is a rising number of places where it is being breached, leaving the best-performers to bring the national figure up.

It means there could be growing dissatisfaction with the waits patients are facing, although it must be remembered a return to the 1990s when waits of six months and even a year were the norm for many patients is still a long, long way off.

Positive changes have a domino effect meaning people who don’t smoke tend to eat less fatty food and those who quit cigarettes find that they eat more fruit and vegetables.

The study was carried out by the social research experts at the National Centre for Social Research (NatCen) for the Department of Health.

While healthy habits breed more healthy habits, the same was also found with unhealthy habits.

People who regularly ate fried food were more likely to eat too much salt and people who consumed too much alcohol also ate fewer fruit and vegetables.

Chief Medical Officer, Professor Dame Sally Davies said: “The New Year is a great time to renew efforts and give up unhealthy habits, such as smoking, and take up healthier ones, such as regular physical activity, improving our diet and drinking less.

“This NatCen research shows that if you make one healthy resolution this New Year you might get double the benefits as you are more likely to make other positive healthier changes too. So, start thinking about other areas where you can improve your health and set yourself up for a healthier life, for 2012.”

So if you have made a promise to improve your wellbeing in 2012- you now have a double reason to stick to your new lifestyle. Good Luck!

Health Direct wishes you a healthy, happy and prosperous New Year.

We would also like to take the opportunity to thank and support all of those hard working professionals within the NHS- without whom we would all be paddleless.

A large proportion of the patients involved were aged over 75, the figures from the NHS Information Centre show. Illnesses related to such infections led to average stays in hospital last year of 31.1 days.

Experts blamed poor hygiene for the dramatic rise in infections, including superbugs MRSA and Clostridium difficile (C. diff) as well as norovirus and E.coli.

But the Department of Health dismissed the “misleading” figures, published online, saying that officials have “got better and better at tackling hospital infections”.

According to the new figures, supplied by NHS hospitals, the number of patients found by consultants to have hospital acquired infections rose last year reached a record 42,712.

That figure increased from the 31,447 recorded in the previous year and almost double the 22,448 documented in 2008/09.

Last year’s figures were the highest levels recorded in the 13 years in which the records have been publicly available. In 1998/99 there were just 335 such cases. The Centre did not provide a breakdown of illnesses.

It came as the Health Protection Agency said that there were 46 suspected outbreaks of norovirus in hospitals over the past two weeks, with more than half leading to ward closures or admissions restrictions.

The agency said the levels were within seasonal norms.

Commenting on the overall infection levels Joyce Robins, co-director of Patient Concern, said the figures were a “terrifying prospect for vulnerable elderly people who think they are going into hospital to get better”.

“It contrasts sharply with the happy propaganda that has been telling us that infection rates had dropped sharply,” she said.

A DoH spokesman said: “The NHS has got better and better at tackling hospital infections, demonstrated by the record lows we have seen this year.

“Because we are not complacent, we have introduced mandatory reporting of more hospital infections. That means that we have shone a light on the problems previously swept under the carpet.  But patients should be confident that the measures we have taken will continue the downward trend in hospital infections.”

The figures for last year represent an 11 per cent increase on the previous 12 months, when alcohol-related admissions stood at 1,056,962.

Separate information published by Anne Milton, the public health minister, showed that since January an estimated 7,074 under-18s have been admitted to hospital due to alcohol abuse.

A recent report predicted that binge drinking will cost the NHS £3.8 billion by 2015, with 1.5 million A&E admissions a year.

Andrew Lansley, the Health Secretary, blamed Labour’s 24-hour drinking policy and accused the last government of “taking their eye of the ball” on the issue of binge drinking.

He said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge-drinking and long-term excessive alcohol abuse in a minority of people.

“Our alcohol strategy, which we will set out in the new year, will outline what further steps we are taking to tackle this growing problem.”

Recent Local Alcohol Profiles for England figures also show that the number of hospital admissions for conditions attributable to alcohol are rising at a similar rate.

The number of admissions has more than doubled since 2002/03 and increased by nine per cent last year.

In 2002/03 there were 926 admissions per 100,000 people for conditions caused by alcohol, rising to 1,743 per 100,000 in 2009/10 and 1,898 last year.

The biggest increase over the past 12 months was in London, with a jump in admissions of 14 per cent, followed by the East of England with 10 per cent.