Parents should not dose up children who have a simple fever on regular spoonfuls of paracetamol and ibuprofen, according to doctors who say that doing so could put them at risk.
The advice comes after a study indicated that children given paracetemol before 15 months were more than twice as likely to develop asthma by the age of six as those not given it

A misplaced “fever phobia” in society means parents too frequently use both medicines to bring down even quite slight temperatures, say the paediatricians, who warn that children often receive accidental overdoses as a result.

A high temperature is usually the body’s way of fighting an infection, according to advice issued today by the American Academy of Pediatrics, so to bring it down could actually lengthen the time a child suffers.

Doctors too readily advise parents to give the medicines, known collectively as “antipyretics”, according to the Academy.

The advice comes after a study indicated that children given paracetemol before 15 months were more than twice as likely to develop asthma by the age of six as those not given it.

Writing in a clinical report on fever and the use of paracetamol and ibuprofen in children, the authors warn: “Combination therapy with acetaminophen [paracetamol] and ibuprofen may place infants and children at increased risk because of dosing errors and adverse outcomes, and these potential risks must be carefully considered.”

Doctors, they write, should begin “by helping parents understand that fever, in and of itself, is not known to endanger a generally healthy child”.

They explain: “It should be emphasized that fever is not an illness but is, in fact, a physiologic mechanism that has beneficial effects in fighting infection.”

It slows the spread of bacteria and viruses, enhances white blood cell production, and “actually helps the body recover more quickly from viral infections”.

Despite this, they say: “Many parents administer antipyretics even though there is either minimal or no fever.”

Half consider it to be a fever even if their child’s temperature is not higher than 38C (101.4F), they report.

Many doctors are happy to advise parents to give paracetamol and ibuprofen alternately – known as combination therapy – believing side effects are very rare and minimal.

But the Academy warns: “Unfortunately as many as one half of parents administer incorrect doses.”

A frequent error is giving children adult-sized doses, while children who are small for their age can also receive doses that are too high even if their parents follow box instructions based on age alone.

In Britain, the National Institute for Health and Clinical Excellence (Nice) advises that the use of anti-pyretics “should be considered in children with fever who appear distressed or unwell”.

However, they “should not routinely to used with the sole aim of reducing body temperature in children with fever who are otherwise well”.

Similarly, “paracetamol and ibuprofen should not routinely be given alternately to children with a fever”, although it states this approach “may be considered if the child does not repsond to the first agent.”

The guidance also states: “The views and wishes of parents and carers should be taken into consideration.”.

Children’s paracetamol solutions like Calpol and ibuprofen solutions like Nurofen for Chilren are sold over the counter in chemists. Recommended dosage quantities vary by age.

There are different strength solutions for different ages, meaning it is possible for parents with different aged children to mix up which they are giving.

Rather than focusing on temperature alone, doctors should advise parents to look out for signs of serious illness, make sure their child is drinking enough, and “advocate a limited number” of doses of medication.

Dr Clare Gerada, chairman of the Royal College of GPs, said the two medications should be used “only to help a child be comfortable, and not to chase down a temperature.”

However, she said: “I don’t think we over-prescribe anti-pyretics and I don’t think parents give them too readily.”

She added: “I think they have their place. The younger the child the more cautious you have to be.”

She did not think that giving ibuprofen and paracetamol together was more likely to lead to increased dosing errors, saying: “In my experience of 20 years as a GP, parents are usually pretty careful.”

“I think the most important thing to be worried about is keeping medicines out of the reach of children, because some of them taste quite nice.”

They could also give “a false sense of security” in depressing a high temperature with a more serious underlying cause than a mild infection, she said.

From: http://www.telegraph.co.uk/Fever-medicines-given-to-children-too-readily

Too many NHS health trusts are still not responding to patient safety alerts in England, campaigners warn.
Alerts are issued when potentially harmful situations are identified in health settings, such as the risk of overdoses or using medical equipment.

Department of Health data showed there were over 650 cases of NHS trusts not complying with alerts within deadline.

This is a 50% fall from last year, but Action against Medical Accidents said there was no excuse for non-compliance.

The charity first highlighted the issue last year when it obtained the figures under a freedom of information request.

But now the government has started publishing the figures itself.

The latest data, from January, showed that there were 654 instances of patient safety alerts not having been complied with – half the figure from August.

In total there were 203 trusts which had failed to comply with at least one alert, while five trusts had not complied with 10 or more alerts.

Peter Walsh, chief executive of Action against Medical Accidents, said: “There can be no excuse for not implementing these alerts. Each alert not complied with means patients are being put at unnecessary risk. Lives are being lost as a result.”

But he added: “We welcome the fact that as a result of the pressure we have brought to bear, there has been a significant improvement in compliance.”

A Department of Health spokesman said: “Although progress has been made, much more needs to be done across the system. We expect trusts to comply with safety alerts.”

From: http://www.bbc.co.uk/news/health-12527071

A hospital trust will save £14million after becoming the first in the country to buy its way out of a Private Finance Initiative (PFI) deal.
The NHS body was due to pay £2m a year for the next two decades to the private firm that built West Park Hospital in Darlington, County Durham.

But after reviewing the costs, Tees, Esk and Wear Valleys Mental Health Foundation Trust decided to take advantage of a break clause in the deal.

It paid £18m upfront to get out of the PFI contract 23 years early, but it now owns the hospital outright and expects to save £14m over the course of the deal once maintenance and inflation is taken into account.

The move, disclosed in the Health Service Journal, comes after The Daily Telegraph uncovered evidence that hospitals are closing accident and emergency departments in order to pay the interest on PFI deals for new buildings.

Some PFI hospitals – built and run by private firms and effectively rented back to the state – will end up costing taxpayers more than 10 times their capital value.

“We concluded that the best option was to exercise what exists in the PFI projects, which is a clause called ‘voluntary termination’,” said Colin Martin, Director of Finance at the Tees, Esk and Wear Valleys trust.

“It effectively means we pay off the mortgage early.”

However he added that the trust – which runs mental health services in County Durham, the Tees Valley and along the North Yorkshire coast – did not regret the original deal and was committed to two other PFI deals.

“We wouldn’t have had the hospital if we’d waited for the traditional financing route,” Mr Martin said.

PFI deals became the preferred way of paying for public sector infrastructure projects under Labour, as they allowed new buildings to be constructed while avoiding large initial outlays of money.

Under the complex deals, private contractors carry out the building work then own the structure for up to 35 years, while the public sector body gives them annual interest and repays the capital sum as well as paying for maintenance.

However because of the length of the deals and the amount of interest involved, taxpayers end up paying several times the original value of the project.

In the first known example of an NHS hospital buying its way out of a PFI deal, the North-East mental health trust decided to purchase West Park Hospital outright.

It had agreed a 32-year deal with Norwich Union Public Private Partnership Fund to build the 116-bed facility, which opened its doors in 2004.

The hospital – which is also home to the trust’s headquarters – cost £16m to build but under the deal, the trust was paying the contractors £1.4m a year in interest payments and a further £600,000 in maintenance and paying back the principal.

In 2009, the trust reviewed its PFI deals and decided it had enough cash in the bank to pay the £18m break clause and so buy West Park outright. It gave the project company the required statutory notice and after the legal process was completed, the deal ended in December.

Treasury figures suggest it would have the remainder of the deal would have cost a further £32m, so it has saved £14m by getting out of it.

However it is unlikely the pioneering move will be copied by many other trusts, as most PFI deals are so large as to make early repayment impractical.

Aviva, the company that now runs the PFI firm that built West Park, was unavailable for comment.

From: http://www.telegraph.co.uk/Hospital-saves-14m-by-getting-out-of-PFI-deal

The doctor parents of a three year old girl who died from swine flu have called for all children to be vaccinated against the virus.
Lana Ameen, who had no underlying health problems, died in hospital on Boxing Day, two days after apparently catching a cold and developing a high temperature.

Her parents, a doctor and nurse, have described how they were “shocked” at losing their daughter and said it was wrong that not all children were given the swine flu jab this winter. During the 2009 swine flu outbreak, it was recommended that all under-fives be vaccinated.

In the past fortnight, the Government has come under fire for restricting use of the seasonal flu jab, which protects against swine flu and two other strains, to under-fives who suffer from health problems, such as neurological disorders or asthma.

Ministers insist they are legally bound to follow the recommendation of the Joint Committee on Vaccination and Immunisation, which last July decided against vaccinating all children against this winter’s flu strains, a position they reaffirmed over Christmas.

But Gemma and Zana Ameen from Quinton, Birmingham, said the “price was too high” not to vaccinate children against the potentially deadly swine flu (H1N1) virus.

Mrs Ameen, 28, who is 12 weeks pregnant, said: “I want to say to people, to parents, ‘If you can get the vaccine don’t hesitate’. The risk of not having it and the price you might pay is just too high.

“We have been so shocked by what has happened and we feel very strongly that everyone, particularly children, should have the vaccine. The Government has made the swine flu vaccine from last year available now — we should all be having it.

“Even financially, surely it makes sense. The swine flu vaccine is inexpensive and has already been bought — it cost £1,700 just to care for Lana in intensive care for one day.”

The Ameen family were visiting relatives in Stockport, Greater Manchester, when Lana became ill on Christmas Eve. At about 2am on Christmas Day, her parents took her to Stepping Hill Hospital, where they had formerly worked, where she was diagnosed with an infection and her temperature stabilised before being sent home.

When she woke she seemed slightly better, opening Christmas presents and eating a little lunch. But after falling asleep that afternoon, she started having fits and was taken in an ambulance back to the hospital. She was eventually transferred to Alder Hey Hospital in Liverpool and died the next day.

Since October, five of the 50 patients known to have died of flu have been under-fives.

From: http://www.telegraph.co.uk/Doctor-whose-three-year-old-daughter-died-of-swine-flu-calls-for-all-children-to-be-vaccinated

NHS trusts are closing accident and emergency departments to help pay for hospitals built under Labour’s Private Finance Initiative (PFI) an investigation by The Daily Telegraph has found.
Since 2007, more than a fifth of England’s hospital trusts with active PFI hospitals have closed casualty departments, or published proposals to do so. In the same period, only four per cent of trusts without PFI hospitals have closed, or proposed to close, A&E units.

Fewer than a quarter of England’s 168 NHS hospital trusts have significant PFI hospitals in operation. But these trusts account for almost two-thirds of A&E closures or proposed closures.

Health campaigners said there was a “clear connection” between the “inflated” costs of the PFI and the cuts in A&E.

Most trusts insisted there was no connection — not all A&E closures are necessarily done on financial grounds and some are supported by local clinicians.

In recent days, The Daily Telegraph has disclosed how some PFI hospitals – built and operated by the private sector, and effectively rented back to the taxpayer – will end up costing the public purse more than 10 times their capital value.

The new Princess Royal University Hospital in Bromley, south London, cost £118million to build. It will end up costing taxpayers £1.2billion, including facilities management. South London Healthcare, the NHS trust responsible for the Princess Royal, has a second PFI hospital, the Queen Elizabeth in Woolwich.

The trust’s annual deficit was raised to £100million by the two deals. It has closed the A&E unit at one of its non-PFI hospitals, Queen Mary’s in Sidcup.

In internal documents seen by The Daily Telegraph, the trust stated that the “occupation costs” of the PFI hospitals were roughly double those of its non-PFI hospital.

A spokesman admitted that its PFI contracts placed “some undeniable restrictions on our flexibility”. But she insisted that the decision to close A&E at Sidcup was “entirely unrelated” to PFI.

Other trusts closing A&E units include Coventry and Warwickshire NHS Trust, which recently opened a new PFI hospital and plans to shut the full A&E unit at its non-PFI hospital in Rugby.

Barking, Havering and Redbridge Trust, which opened a new PFI hospital in Romford, wants to close the A&E unit King George’s Hospital in Ilford.

East Lancashire Trust has closed A&E at its Burnley hospital to help pay for a new PFI hospital at Blackburn. In Nottinghamshire, Sherwood Forest NHS Trust has downgraded A&E services at Newark after opening a new PFI hospital in Mansfield. At least four other trusts with PFI hospitals have similar plans.

Under its PFI contract, Queen Elizabeth Hospital, Woolwich, must have 64 visits a year from pest controllers, even when there are no pests to control. When there are pests, the hospital must pay for further visits, which it did 10 times last year.

Food served at the Queen Alexandra PFI hospital in Portsmouth is cooked in south Wales, then driven 100 miles to Hampshire.

Early PFI hospitals had on average 20 per cent fewer beds than the hospitals they replaced, according to research. Because of high service charges, several PFI hospitals cannot afford to keep even these reduced numbers of beds fully open.

In an effort to disguise their private ownership, a number of PFI hospitals have changed their names to include a royal connection. Greenwich District Hospital became Queen Elizabeth Hospital. Salford Hope Hospital is now Salford Royal. Oldchurch Hospital, Romford, became Queen’s Hospital. Farnborough Hospital, in Bromley, was renamed after Princess Anne.

From: http://www.telegraph.co.uk/Casualty-units-shut-to-pay-for-private-finance-hospital-contracts

The NHS is in “gridlock”, with hospitals across the country being forced to declare that they have reached the highest level of emergency because of flu and other winter viruses.
Britain’s most senior accident and emergency doctor said that four weeks of intense pressures had left casualty departments “overwhelmed” with patients.

He said desperately sick people had been left for hours waiting on trolleys, with even those requiring intensive care enduring long delays.

Dozens of NHS units have cancelled surgery and clinics for outpatients.

At least 10 major centres issued “black alerts” — the highest emergency warning — meaning they were at breaking point, forcing patients to be sent elsewhere.

Scores of hospital wards closed due to norovirus, the winter vomiting bug, which put more than 1,200 beds out of use in one week as nurses attempted to isolate the disease.

Hospitals in Cambridge and Norfolk were on “black alert” for more than two weeks. In the past 10 days, major hospitals in London, Liverpool, Surrey, Southampton, Peterborough, Derby, King’s Lynn and Great Yarmouth issued the same warning.

While many hospitals did not schedule non-emergency surgery during the Christmas and New Year period, in the past week dozens cancelled thousands of planned operations.

Routine surgery was stopped at hospitals in Leicester, Sheffield, Macclesfield, Middlesbrough, Northallerton, Durham, Darlington, Bassetlaw, Belfast, Portsmouth, south Wales and many parts of London.

Last night it was disclosed that two boys, aged two and 10 months, had died from swine flu in Northern Ireland.

John Heyworth, the president of the College of Emergency Medicine, said: “We have seen A&Es absolutely overwhelmed, with people queuing on trolleys and long delays even for those being admitted to intensive care. The hospitals are gridlocked.”

He expressed anger about the failure of Government and the NHS to develop sufficient contingency plans, given that a flu outbreak was widely anticipated following the swine flu pandemic in 2009. “My frustration is that so much of this is predictable. This did not come out of the blue and yet the planning is inadequate — as though there is a sense of denial about it. The planning this winter has been far less effective than last year.”

Mr Heyworth claimed that casualty units had been hit by a “dramatic surge” in demand not just because of an increase in the number of very sick patients suffering flu complications, but also because less serious cases went to A&E because they could not see a GP at evenings or weekends.

“In many parts of the country out-of-hours services are absolutely inadequate, so what we get is people turning up at A&E simply because they do not know where else to go, or else they delay and only seek help when their condition is serious,” said Mr Heyworth. It is not good enough. We are failing the public.”

Across the country, hospitals were struggling to cope. Southampton General Hospital spent more than three weeks on “black alert”, closing 10 wards as norovirus swept through the centre. It was forced to stop all non-emergency surgery and cancel most appointments for outpatients during the period. The crisis warning was finally lifted on Thursday.

Because of the same bug, four wards were closed at Royal Cornwall Hospital last week and cancer and surgery wards in Poole, Dorset, were closed to new admissions. Three wards were closed at West Suffolk hospital.

On Thursday, it was disclosed that the number of deaths from flu had almost doubled, with 110 deaths this winter.

Hospitals were already struggling to cope with an increased number of elderly patients needing surgery following falls during the big freeze when they were hit by rising influenza admissions and cases of norovirus.

The latest figures for England showed that in the week ending last Sunday, 23 casualty units were filled to capacity, forcing ambulances carrying emergency patients to take desperately sick people miles further for treatment.

The Government was criticised by influenza experts for failing to introduce a national public advertising campaign about the perils of swine flu until Jan 1, by which time the outbreak was on course to hit epidemic levels.

Katherine Murphy, of the Patients Association, said: “It is really worrying that the NHS is not prepared to deal with these sorts of pressures. The system is on a knife-edge, and it does not have enough slack in it to cope once we have an outbreak of flu and cases of norovirus.”

She said the charity was “inundated” with calls from elderly people who had their operations cancelled and had not been given a date for the surgery to go ahead.

“What concerns me even more is that this is happening at a time when the health service is gearing up to make major savings, and massive reforms,” said Ms Murphy.

A spokesman for the Department of Health said there was always more pressure on the NHS at this time of year and insisted that the service had been prepared and was coping well.

“This year’s flu has resulted in greater than usual numbers of patients requiring critical care,” he said.

“Where necessary, local NHS organisations have increased their critical care capacity, in part by delaying routine operations requiring critical care back-up. This is a normal operational process which is initiated by NHS organisations at the local level.”

From: http://www.telegraph.co.uk/Swine-flu-hospitals-gridlocked

The number of cancer patients being admitted to hospital through accident and emergency has doubled in less than a decade amid claims they are being “abandoned” after receiving treatment.
Such admissions are meant to be “the exception” but the number has increased from 70,000 in 2000/01 to 140,000 in 2008/09, according to the National Audit Office (NAO).

Macmillan Cancer Support said that showed too many patients were not being cared for properly after being given treatment like chemotherapy and radiotherapy.

According to the NAO’s report, which examines how well the NHS has managed to deliver the last government’s five year Cancer Reform Strategy so far, waiting times have fallen and the number of days cancer patients spend in hospital has dropped.

The strategy, launched in 2007, was meant to make NHS cancer services “among the best in the world” by 2012.

But the NAO report said there was “limited assurance” as to whether the £6.3 billion spent on cancer care annually was money well spent, because such poor information linking spend and outcomes was available.

In particular it illuminated problems caring for cancer outpatients.

Ciaran Devane, chief executive of Macmillan Cancer Support, said: “English cancer services have improved but there is still an incredibly long way to go for the UK to be a world leader.”

She warned: “The NHS won’t be able to support the growing number of cancer patients unless it seriously ups its game.

“The whole NHS needs to realise that cancer is a long term condition for many. If the NHS does not provide appropriate services after patients leave hospital, they can expect to see a massive increase in costs as cancer patients are forced to use emergency services.

“Abandoning cancer patients after treatment is no longer acceptable, nor does it make any financial sense.”

The previous government had pledged to cut the total number of emergency cancer admissions – not just via A&E but also for example by doctors making emergency referrals – but instead the number has been rising steadily.

It has risen from 231,000 in 2000/01 to 300,000 in 2008/09. However, the rate of annual increase has almost halved. Four in five have an existing diagnosis.

Karen Taylor, from the NAO, said there was “poor understanding” of the issue while primary care trusts “don’t appear to be aware of it’s extent”.

Mike Hobday, head of policy at Macmillan, said the reason was clear.

“The traditional NHS approach at the end of cancer treatment has been to say, ‘Go away, you are cured.’ ”

But he explained: “While treatment is in most cases extremely good, people with cancer have ongoing problems. Chemotherapy is toxic – you can’t do it without impacting people’s health.

“Patients aren’t being given the support to manage themselves, so they turn up at A&E.”

A “small investment” in things like better information and dedicated helplines for cancer patients would reap large savings by lowering emergency admissions, he predicted.

With growing numbers of cancer survivors and stretched budgets “the NHS has to do this smarter”, he said.

Dr Jodie Moffatt of Cancer Research UK said the increase could partly be explained by the tripling of cancer patients receiving chemotherapy since 2000. The government was trying to tackle the problem, she argued.

Paul Burstow, the Health Minister responsible for care services, said: “This report is a damning indictment of Labour’s failure to deliver on their promises to improve the quality of cancer care.

“The shocking levels of emergency admissions are the legacy of Labour’s obsession with hitting targets instead of helping patients.

“Under Labour, NHS spending rose to European levels of funding, but they have failed to deliver European levels of quality cancer care. If the NHS was performing at the level of the best in Europe, an extra 10,000 lives could be saved each year.”

Jo Webber, deputy director of policy at the NHS Confederation, which represents health trusts, said: “It is difficult to attribute a rise in emergency re-admissions to any one factor.

“Commissioning appropriate after-care services and providing patients with access to specialist services and home support services all play their part in bringing numbers of re-admissions down.

“Providing patients with access to quality treatment in or close to home, as well as information on local support services, is just as important as the early detection and treatment of the disease when planning an effective cancer strategy.”

From: http://www.telegraph.co.uk/Cancer-patients-abandoned-after-treatment

Emergency patients are being let down by the health service because managers are more concerned with meeting targets by treating those with appointments, the heads of Royal Colleges warn.

In a letter to The Daily Telegraph, some of the country’s most senior doctors say they are “deeply frustrated” at the low priority given to Accident and Emergency.

Targets concerning waiting times and cancelled operations, introduced under Labour, result in managers pushing doctors to operate on patients whose care has been pre-planned, in order to avoid financial penalties. But they can also mean that those who come in as emergency cases are stabilised and admitted but then left to wait for surgery.

Studies have shown that elderly people with fractured hips who do not undergo surgery within 48 hours are less likely to regain full mobility. Younger patients with shattered pelvises, from motorcycle or horse-riding accidents, are less likely to walk again if their operations are delayed.

A report published on Thursday criticised care for the elderly, finding that two thirds of those who died within a month of surgery had not received proper care and that they had often been left in pain.

Most of those patients were being treated for bowel conditions or broken hips, which are usually admitted as emergency cases.

John Black, president of the Royal College of Surgeons, said the report echoed concerns that surgeons had been raising for some time.

In the letter, Mr Black said: “It is a source of deep frustration to our members that hospitals have become organised to deal quickly with elective operations at the cost of properly managing emergency care.”

The Coalition’s reforms of the NHS could help by making hospitals more accountable to GPs for the care they provide, he said.

The letter was signed by Peter Nightingale, president of the Royal College of Anaesthetists; Peter Kay, president of the British Orthopaedic Association; Finbarr Martin, president of the British Geriatric Society; Mike Horrocks, president of the Association of Surgeons; and Clare Marx, the Royal College of Surgeons’ lead representative in matters of patient safety.

Mr Horrocks said: “In recent years, the NHS has been set targets for elective operations to bring down waiting lists.

“This has been fantastic for patients with non-emergency conditions, but came at the detriment of those who require urgent treatment as hospitals focused on hitting those targets.

“The new government has committed to moving away from targets and towards measuring and rewarding hospitals who deliver good outcomes and this report should provide further evidence that this approach is correct.”

Under Labour, patients had to be treated within 18 weeks of a referral by their family doctor.

Surgeons have told the Telegraph that this resulted in extreme pressure to operate on any patients in danger of failing to meet that target, ahead of cases that came in as emergencies.

Any pre-planned operation that was cancelled was recorded and the data published. The patient then had to be rescheduled within 28 days, adding to the pressure to give elective operations priority, doctors have said.

Mr Black added: “Surgeons have been saying for some time that emergency surgery is a Cinderella service in the modern NHS.

“We will only solve these problems if focusing on emergency care becomes a priority in the boardroom as well as the ward.”

Katherine Murphy, director of the Patients Association, said: “It can be so debilitating for someone who has a fracture to be left for a couple of days or longer, waiting for an operation when the trust is focused yet again on meeting these pernicious targets. It is an appalling way to determine who gets care. An emergency should be an emergency.

“The financial rewards for elective surgery are more lucrative for the trust than for emergencies and that is why trusts continue to focus on elective treatment. We cannot make savings by putting patients through unnecessary pain and suffering.”

From: http://www.telegraph.co.uk/Emergency-patients-let-down-by-targets-say-surgeons

More than half of sufferers with brain tumours or acute leukaemia are diagnosed only in an emergency.
The National Cancer Intelligence Network said 23 per cent of all cancer cases went undetected until the emergency admission stage.

Pensioners and the poor were most at risk of being diagnosed late. The detection rate is even worse among sufferers of brain tumours or acute leukaemia, with more than half of these cancers diagnosed only in an emergency.

The figures were described as “shocking” by leading cancer charities. Spokesmen said a lack of awareness of symptoms among the general population and a failure by doctors to identify the early warning signs were largely to blame.

They called for new screening programmes as quickly as possible and for public awareness campaigns to highlight the symptoms of cancer.

Patients whose cancers are diagnosed only when they reach A&E departments are more likely to have advanced forms of the disease, making it often impossible to treat.

Experts say England’s poor detection rates could explain why the country has much lower survival rates than other countries in Europe. They believe that many hundreds of lives could be saved each year if more early diagnoses were made.

The study comes after the Office for National Statistics disclosed that the cancer death rate among British women was higher than in countries such as France, Italy and Portugal.

Britain has national screening programmes for only three types of cancer: cervical, bowel and breast cancer.

Harpal Kumar, the chief executive of Cancer Research UK, said: “The figure for diagnoses via emergency presentations is way too high.

“This statistic helps explain why we have lower survival rates than we would hope to have, lower than the best countries in Europe.

“We need screening programmes to be rolled out as early as possible and GPs given rapid access to the tests that will enable patients to be moved quickly through the system.” Mr Kumar said people should be better educated about the possible signs and symptoms of different types of cancer.

Prof Sir Mike Richards, the National Cancer Director, who acted as clinical director to the project, said the overall figure of 23 per cent had been “quite a surprise”.

“We need to look at this group of patients and see what we can do to reduce the proportion coming in as emergencies,” he said.

The NCIN, part of the NHS-run National Cancer Programme which coordinates national information on cancer, looked at all English patients diagnosed in 2007 and worked through their files to find when their disease was diagnosed.

The proportion of cancers identified during an emergency varied widely between different types, depending on how easy they are to identify and on general awareness.

Only a small number of skin and breast cancers – 3 and 4 per cent respectively — were diagnosed at emergency, with most identified by doctors or screening programmes.

Overall, 23 per cent of cancer cases were diagnosed during an “emergency presentation” by the patient, most often to A&E departments. Of those with brain or central nervous system cancer, 58 per cent were not picked up until they were seen in hospital, along with 57 per cent with acute leukaemia and 47 per cent with pancreatic cancer.

Patients under 25 and over 75 were the most likely to present as emergencies, as well as poorer ones. These patients were less likely to survive for a year than those whose illness was detected in the doctor’s surgery.

The authors of the study said: “One-year relative survival rates were lower for patients presenting as emergencies than for those presenting via other routes.”

From: http://www.telegraph.co.uk/Cancer-detected-late-in-quarter-of-cases

Britain’s armed forces serving in Iraq show less signs of psychological distress than  doctors in emergency departments.
Psychologists discovered that just over one in five servicemen on deployment showed signs of psychological distress and less than four per cent showed signs of post-traumatic stress disorder (PTSD).

These levels of mental health are the same as soldiers, sailors and airmen in training and less than those in other high-stress occupations, such as police officers, doctors in emergency departments and disaster workers.

Focusing on the mental health of UK armed forces while on deployment, the study by researchers at the Institute of Psychiatry, King’s College London, included servicemen and women at eight locations across Iraq in January and February 2009.

Of the 611 surveyed, 20.5 per cent demonstrated symptoms of psychological distress, while 3.4% showed signs of PTSD.

Respondents were more likely to report good health if they were of officer rank, if they felt their unit was very cohesive and had supportive leadership, and if they had taken a period of rest and recuperation in an area outside an operational theatre.

Those who reported psychological distress were most likely to be young, female, in the Army, and of junior rank.

Personnel belonging to junior ranks were also more likely to show symptoms of PTSD, along with those who felt they were in danger of being killed.

The report showed that sickness levels were very low with only 1.6 per cent of personnel taking more than three days off during their six month deployment.

While a lot of research on the mental health of UK armed forces personnel has been conducted either before or after deployment, very little is known about their mental health during employment, Professor Neil Greenberg from the Academic Centre for Defence Mental Health said.

“Interestingly, those who told us they remembered having a pre-deployment stress briefing reported significantly better mental health than those who did not,” he said.

Although most units had medical support, Prof Neil said training for medical staff had only recently begun to be standardised to ensure it covered mental health disorders.

“Improving training, as well as raising awareness among staff of the link between these personnel reporting sick and having poorer mental health, may help identify those in most need of psychological help,” he said.

Those who took part in the survey, published in the British Journal of Psychiatry, represented about 15 per cent of personnel deployed in Iraq at the time.

From: http://www.telegraph.co.uk/Servicemen-in-Iraq-less-stressed-than-emergency-services-in-Britain