Gay couples and women over 40 will be entitled to the same free IVF treatment as heterosexual couples on the NHS for the first time under new guidelines published today.Same sex couples will be given the same rights as heterosexual couples under guidance issued by the killer quango National Institute for Curbing Expenditure (NICE).

The NHS will also extend the upper age limit for IVF by three years to 42, following advice that suggests many women in their late 30s and early 40s could conceive after treatment.

Fertility experts questioned whether health authorities could afford to widen eligibility criteria, when only a quarter currently fund three cycles of IVF for infertile couples, as recommended by Nice.

Gedis Grudzinskas, emeritus professor of obstetrics and gynaecology at Barts and the Royal London Hospital, said that while the new guidance reflects “social changes” there were questions over whether NHS trusts could afford it.

“How do we reconcile the changes in society and equality of access to healthcare, with the economic predicament?” he said.

The new guidelines call on health authorities in England and Wales to fund fertility treatment known as intra-uterine insemination (IUI), using donor sperm, for people in same-sex relationships.

The move follows a relaxation in the law, made under Labour in 2008, to put same sex parenting on an equal legal footing.

The recommendation follows implementation of the Human Fertilisation and Embryology Act 2008. It abolished requirement for fertility clinics to take into account a child’s need for a father or a male role model before agreeing to treatment. Gay couples or single women now need only show they can provide “supportive parenting”.

Demand from gay couples paying privately for fertility services has subsequently boomed, say clinics. Official figures show the number of lesbian couples undergoing IVF rose from 178 in 2007 to 417 in 2010.

One cycle of IVF can cost up to £8,000 privately. Because success rates are low – typically 20 per cent for a 38-year-old – couples can spend tens of thousands on treatment.

Meanwhile Josephine Quintavalle, founder of Comment on Reproductive Ethics, described the same-sex move as “absurd”.

She said: “We are not prepared to accept what constitutes fertility from a biological perspective. Fertility treatment is very important but in this case what we are trying to do is rewrite biology.”

Under the Nice guidelines, women aged 40 to 42 deemed to have no chance of conceiving naturally should be offered one full IVF cycle. In this age group one in eight will give birth after one cycle.

From: http://www.telegraph.co.uk/Gay-couples-and-women-over-40-to-get-free-IVF-treatment-on-NHS

One in six cancers – two million a year globally – are caused by largely treatable or preventable infections according to new research.The Lancet Infectious Diseases review, which looked at incidence rates for 27 cancers in 184 countries, found four main infections are responsible.

These four – human papillomaviruses, Helicobacter pylori and hepatitis B and C viruses – account for 1.9m cases of cervical, gut and liver cancers.

The team from the International Agency for Research on Cancer in France says more efforts are needed to tackle these avoidable cases and recognise cancer as a communicable disease.

Most cases are in the developing world. The proportion of cancers related to infection is about three times higher in parts of the developing world, such as east Asia, than in developed countries like the UK – 22.9% versus 7.4%, respectively.

Nearly a third of cases occur in people younger than 50 years.

Among women, cancer of the cervix accounted for about half of the infection-related cancers. In men, more than 80% were liver and gastric cancers.

Drs Catherine de Martel and Martyn Plummer, who led the research, said: “Infections with certain viruses, bacteria, and parasites are some of the biggest and preventable causes of cancer worldwide

“Application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.”

Vaccines are available to protect against human papillomavirus (HPV) – which is linked to cancer of the cervix – and hepatitis B virus – an established cause of liver cancer.

And experts know that stomach cancer can be avoided by clearing the bacterial infection H. pylori from the gut using a course of antibiotics.

Commenting on the work, Dr Goodarz Danaei from Harvard School of Public Medicine in Boston, the US, said: “Since effective and relatively low-cost vaccines for HPV and HBV are available, increasing coverage should be a priority for health systems in high-burden countries.”

Jessica Harris of Cancer Research UK said: “It’s important that authorities worldwide make every effort to reduce the number of infection-related cancers, especially when many of these infections can be prevented. In the UK, infections are thought to be responsible for 3% of cancers, or around 9,700 cases each year.

“Vaccination against HPV, which causes cervical cancer, should go a long way towards reducing rates of this disease in the UK. But it’s important that uptake of the vaccination remains high. At a global level, if the vaccine were available in more countries, many thousands more cases could be prevented.”

Everyone over the age of 50 should be given statins because they reduce the risk of a heart attack even in healthy people, a study has found.The risk of a heart attack or stroke is cut by a fifth in those who have no sign of heart disease, shows research by scientists at Oxford University.

Treatment guidelines should be reviewed in light of the findings, the experts said, and the NHS should impose a blanket policy of prescribing up to 20 million people statins at a potential cost of £240million a year.

Currently, the only people considered at high risk, those with a one in five chance of having a heart attack in the next 10 years, are given the cholesterol-lowering drugs.

Half of men aged 50 or over and almost a third of women qualify for statin treatment. About five million people are thought to take them.

National guidelines should be amended to lower the threshold for treatment to those with a one-in-10 risk over a decade, the experts said.

As the majority of people in their fifties would qualify for statins under this criteria, it would be cheaper and easier to implement a blanket policy to save money on screening tests — which cost up to £700 per patient — to identify them, it was argued.

The cost of statins, which can cost as little as £1 for a month’s course, would also be offset by the savings they would bring to the NHS in preventing costly operations, rehabilitation and by freeing ward space and places in care homes. A total of £1.3billion is spent annually on cardiovascular drugs alone.

The proposed statins programme would be controversial, as many believe it is unnecessary to medicate otherwise healthy people, and it is not clear how many would take the tablets if they were not experiencing symptoms.

Prof Colin Baigent, co-author of the study, said: “If we want to prevent heart attacks and strokes that come out of the blue in people with no previous evidence of problems — and about half of such events happen in the absence of any prior history of disease — then we have to identify and treat people who are currently healthy but are known to be at increased risk of developing heart disease. Such treatment should, of course, be in addition to obvious things like encouraging better diet, more exercise and avoidance of cigarette smoking.”

A National Institute for Curbing Expenditure (NICE) spokesman said the study findings will be included in the ongoing review of the clinical guidelines on cardiovascular risk assessment and treatment.

The study analysed data from 175,000 people in 27 random trials which compared people on statins with those on a dummy pill.

Researchers found that for every one point reduction in levels of bad cholesterol in the blood, there was a 21 per cent reduction in the risk of serious events, including heart attacks, strokes or surgery for blocked arteries among those with no symptoms of heart disease.

The risk of dying from a heart attack or stroke among those at lowest risk was cut by 15 per cent.

For every 1,000 people in the low-risk group treated with statins for five years there would be 11 fewer major heart attacks or strokes. “A benefit that greatly exceeds any known hazards of statin therapy,” the authors wrote.

Side effects of statins can include muscle aches, stomach disturbances, and altered liver function. Patients have also reported sleep and memory problems, depression and headaches.

From: http://www.telegraph.co.uk/All-over-50s-should-be-taking-statins

Medicine shortages are having an “adverse” impact on patients, including vulnerable groups such as those with mental health problems, the House of Commons All Party Pharmacy Group said.In a report detailing its inquiry into medicine shortages, the group said the shortages had been mainly caused by the export of medicines intended for the UK market to other EU countries.

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.”

The campaign to improve hand hygiene in hospitals in England and Wales is contributing to a significant fall in the rates of superbug infections, according to a report.The study published on the BMJ website showed the amount of soap and hand gel being used tripled during the campaign.

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

Sleeping for more than nine hours a night may help those with a genetic predisposition to being overweight stay healthy, a study suggests. A study of twins has found that sleeping for less than seven hours a night was linked to higher bodyweights and a greater susceptibility to genetic factors that influence weight.

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

Stroke patients are ‘abandoned’ when they leave hospital leaving carers to shoulder burden due to lack of joined up care, a charity has warned.Stroke patients need support and care at home in order to make a full recovery however many do not even have their needs assessed, the Stroke Association has warned.

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.”

A blood test that can detect breast cancer decades before the disease develops could be available in five years, scientists have announced.The test could help doctors to identify women at high risk of the disease allowing them to take preventive medicines and switch to healthier lifestyles.

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

Strike action by health workers against the Government’s controversial public sector pension reforms could lead to delays in hospital tests and discharging of patients, employers have warned.Members of the Unite union working in the NHS are planning to join civil servants, Ministry of Defence civilian staff and Royal Fleet Auxiliary employees in strikes and other forms of action on May 10.

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.

NHS diabetes care is ‘inadequate’ and some patients come to further harm due to poor care in hospital, a leading specialist says.Dr Gerry Rayman, national clinical lead for inpatient diabetes, warned many hospitals had no specialist diabetes nurse. He said many hospital patients had diabetes, and called the situation ‘quite alarming’.

Diabetes accounts for 11% of all NHS inpatient expenditure, and costs the service around £23.7 billion last year, a figure projected to increase to just under £40 billion by 2035.

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.”