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.

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.

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.

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.”

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.

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.

More than 660,000 people were brought back to hospital last year within 28 days of leaving, statistics show, sparking allegations that patients are being “hurried through the system” so the NHS can meet waiting-list targets.

The official figures show that some NHS trusts have seen their emergency readmission rate rise more than threefold over the past decade – while some hospitals have seen only a modest increase.

Last night, Andrew Lansley, the Health Secretary, said that the “hugely distressing” trend must stop.

“Patients have a right to expect that when they go in for treatment that they are looked after properly and that the treatment they are given helps them to recover,” he said.

“Having to be readmitted and treated all over again is hugely distressing. These figures show how Labour’s obsession with waiting time targets meant that patients were treated like parts on a production line to be hurried through the system rather than like people who need to be properly cared for.”

The Department of Health has released detailed information on the number of emergency readmissions in every area across Britain.

The figures show that 620,054 patients had to be readmitted in 2009-10 – compared to just 348,996 a decade before, a 78 per cent increase. Over the past five years, there has been a 31 per cent rise and a five per cent increase on the previous 12 months.

The data also highlights the widespread regional variations. The rate of readmission in the Kensington & Chelsea PCT area has risen by 287 per cent over the past decade to 1,582 people.

However, North Lincolnshire PCT has only experienced a 3.37 per cent rise over the same period.

Hospitals within the Hampshire PCT area readmitted 13,239 people last year. The nearby area covered by the Isle of Wight PCT only had to readmit 1,098 people.

The figures, do not include patients suffering from cancer or mental health problems or maternity patients.

Most of the areas with the highest increases in readmission numbers are in London and the south east, where pressure is greatest on the NHS. The Department of Health has analysed the social make-up of each area and concludes that the so-called “thriving London periphery” – the relatively wealthy commuter hinterland around the capital has suffered the biggest recent deterioration.

About 10 million people are admitted to hospital wards each year. Critics claim that government targets, such as the demand that patients be admitted to hospital for treatment within 18 weeks of seeing their GP, mean hospital managers are pressured into releasing patients early to make beds available.

Earlier this month, The Daily Telegraph disclosed that the Government is moving from a system of targets for hospitals based on waiting and treatment times – to a system of so-called “outcomes” which measures the success of treatment.

In a criticism of previous targets which he blames for the increase in emergency readmissions, Mr Lansley said: “Instead of focusing on the results which actually matter for patients, they focused on narrow processes to the detriment of patient care. That is why we have taken action to address these increases in emergency readmissions.

“One of the new goals we are setting the NHS is reducing emergency readmissions. In order to help achieve this we have created a re-ablement fund of £300 million and we have taken action to stop hospitals being paid when they readmit a patient after discharging them too early. These steps will turn Labour’s poor performance around.”

Under the Government scheme, hospitals will effectively be responsible for people’s care in the weeks after they return home and will be financially penalised for discharging patients too soon.

From:  http://www.telegraph.co.uk/Scandal-of-NHS-production-line-as-readmissions-soar

It comes after the Daily Telegraph revealed that 100 feotuses were aborted last year because they were part of a multiple pregnancy which carries greater risks of birth defects and complications.

The latest figures from the Human Fertilisation and Embryology Authority have shown that multiple pregnancies are reducing and are down from over one quarter in 2008 to one fifth last year.

Clinics have been told that women under 37 should be advised that it is normally best for them to have one embryo put back into the womb at a time.

However the HFEA data show that 64 per cent of women had two embryos put back in the womb last year.

Only one in six opted for a single embryo and a similar proportion had no choice because only one embryo was produced.

In 2010, 45,264 women had a total of 57,652 cycles, an increase of almost six per cent on the previous year.

This year clinics were set a target that no more than 15 per cent of their births be twins or triplets.

Tony Rutherford, chairman of the British Fertility Society, said the multiple pregnancy rate has dropped significantly as the number of single embryo transfers has increased from nine per cent to almost one in four now.

But he added: “There has been significant improvements but it is nowhere near enough to reach the 10 per cent multiple pregnancy rate target set by the HFEA in 2007.

“The targets are achievable, the philospohy behind it is absolutely correct and by doing so we will protect the health of mothers and their babies following IVF.”

Mr Rutherford said in Sweden the single embryo transfer rate was 70 per cent and the multiple pregnancy rate was five per cent.

From: http://www.telegraph.co.uk/IVF-women-still-receiving-two-embryos-despite-twin-risk

Children with low vitamin D levels are more likely to be at risk of developing Type 2 diabetes, according to a study suggesting a deficiency could help trigger the disease.

Dr Micah Olson, lead author of the study Diabetes & Metabolic Syndrome: Clinical Research & Reviews , published in the Journal of Clinical Endocrinology and Metabolism, said: “Although our study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of Type 2 diabetes.”

He added: “Future studies are needed to determine the clinical significance of lower vitamin D levels in obese children, the amount and duration of treatment necessary to replenish vitamin D levels in these children and whether treatment with vitamin D can improve primary clinical endpoints such as insulin resistance.”

The skin helps manufacture vitamin D, but only when exposed to strong sunlight. In the winter and early spring the body’s reserves can drop to low levels, particularly if a person has had insufficient exposure in the summer months.

Vitamin D can also be derived from certain foods, such as oily fish, eggs and fortified breakfast cereals.

Therefore, lack of vitamin D could simply be a sign of a generally unhealthy lifestyle: not getting out for enough exercise in the fresh air, and not eating a good diet.

Children who sit in front of the television for most of the day, snacking on fatty foods, are therefore likely to have lower vitamin D levels and be overweight as well. The two factors might not be biologically related.

Nonetheless, Dr Iain Frame, director of the charity Diabetes UK, said the study “adds to growing evidence of a link between low levels of vitamin D and an increased risk of Type 2 diabetes.”

He went on: “However, as the authors note, the exact causes of vitamin D deficiency and its role in the development of Type 2 diabetes are still unclear.

“Diabetes UK is currently funding research at the University of Glasgow to help establish if people with Type 2 diabetes might benefit from vitamin D supplementation.

“Until we know more, it is not possible to recommend vitamin D supplements to reduce the risk of Type 2 diabetes and people should not see this as an easy fix.

“Maintaining a healthy weight by keeping to a healthy diet and undertaking regular physical activity is still the best way to reduce your risk of developing Type 2 diabetes.”

Two thirds of parents who have children fighting cancer are being forced into debt due to the costs of caring for them, according to research.

Many such parents also take extensive unpaid leave, so the families have to get by on reduced incomes.

The survey of 245 parents found 66 per cent were having to borrow money to make ends meet, while 76 per cent said extra costs were having a major impact on family finances.

More than two in five (42 per cent) were borrowing on a credit card, while 20 per cent had taken out a loan.

More than one in 20 (6 per cent) had turned to high interest, short-term loans to cope with additional costs.

Of those in debt, 41 per cent had been forced to borrow more than £1,000 to fund extra costs while 27 per cent borrowed more than £2,000.

More than half (55 per cent) had taken unpaid leave – many more than three months – while 13 per cent said they felt they had been demoted as a result.

Cancer-related expenses every month amounted to more than £360 on average.

Lorraine Clifton, chief executive of CLIC Sargent, said: “Everyone is suffering in this economic climate but parents of children with cancer are amongst the hardest hit. The extra costs can be significant.

“It’s shocking to hear that some families felt driven to debt in order to get through financially. Unpaid leave from work, travel costs and care for siblings are some of the additional costs that families face once cancer treatment begins.

“CLIC Sargent is concerned that Government reforms will restrict families’ options to financial support through the benefits system.

“Which is why we want to work with the Government and other organisations to ensure young people and children with cancer, and their families, have the financial support they need.”

In the study half of women were given a multivitamin and mineral tablet to take each day and half were given folic acid, recommended by government to prevent abnormalities in the baby.

Four weeks later they then had a fertility drug treatment.

Women on the vitamins were more likely to conceive and 60 per cent were still pregnant three months later compared to 25 per cent on folic acid.

They were also likely to fall pregnant after fewer fertility treatments with three quarters conceiving on their first cycle, compared with less than one in five of those on folic acid, it was found.

The study conducted by researchers at Warwick University involving 56 women attending University College London and the Royal Free Hospital fertility units.

The women, who were mostly from an affluent background, all had healthy diets at the beginning of the study and later blood tests showed those on the multivitamin had higher levels of micronutrients than those only taking folic acid.

Lead author Dr Rina Agrawal, consultant obstetrician and gynaecologist and Associate Professor in Reproductive Medicine, said: “All women considering pregnancy should take a specifically formulated prenatal micronutrient supplement to optimise their chances of conception.”

She said it is not known what components of the vitamin tablet had the effects on pregnancy but the Pregnacare Conception product used contained a range of vitamins, minerals, antioxidants and substances linked to ovarian function and blood flow to the reproductive organs.

The findings are being published in the Reproductive BioMedicine Online journal.

Dr Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield said “The influence of nutrition on our fertility is of general interest to the public and professionals, but there are relatively few studies which have examined this systematically and few which have shown direct benefits of taking supplements to enhance things.”

“Therefore, on the face of it, this study is interesting but we should acknowledge that this is a relatively small number of patients and the study would need to be repeated in a larger trial before we could be certain of the results.

“I can’t help but thinking that for most people, just general dietary advice would achieve the same effect and a good basket of fresh fruit and vegetables from the greengrocer each week would have much the same effect if their diet was poor.”

Glenys Jones, a Nutritionist at the Medical Research Council’s Human Nutrition Research said: “This is an interesting study and supports the body of evidence that diet plays an important role in supporting women’s health and their fertility.

“However this study alone cannot result in the general recommendation that all women undergoing fertility treatment should take a preconception multivitamin as it is a very small single study and further large-scale research is required to investigate if this is reproducible in a larger more diverse group of women.”

Catherine Collins, Principal Dietician, St Georges Hospital NHS Trust said: “Although the researchers claimed their diets were nutritionally adequate no robust data was provided to confirm this – a major concern for any trial making nutritional claims.

“We know that broad-spectrum supplements can correct dietary deficiencies and boost blood levels of iron, B12, folic acid and vitamin D – as was shown in this study which suggests these women had low intakes pre-conception.

“As this study was of women with conception problems there’s no evidence to suggest every woman considering pregnancy should take them.

“Similarly, n-acetyl cysteine and arginine have been shown to improve the efficacy of IVF treatments in a small number of studies, but there’s no evidence to support their use in natural conception. However, the nutritional advice for women contemplating pregnancy remains unchanged – take folic acid supplements until 12 weeks of pregnancy and if you decide on a multi-nutrient supplement for nutritional insurance make sure it’s one suitable for pregnancy, as the vitamin A content is lowered to ensure safety of the developing baby.

From: http://www.telegraph.co.uk/Women-trying-to-conceive-should-take-vitamins-researchers

The annual study carried out across England is a detailed survey of the “postcode lottery” in NHS treatment.

Ministers say the results will help identify “unjustified” disparities and drive up standards resulting in “consistently high quality care”.

The report shows a stark contrast in the rate of prescribing anti-dementia drugs.

Patients in north Lancashire are being described 25 times as many treatments and tablets to help “temporarily improve or stabilise symptoms” than in Kent.

The report suggests that one possible reason is the lack of awareness some GPs have about how to spot early symptoms of Alzheimer’s disease – a concern shared by campaigners for those living with the illness.

It also highlights worries that some breast cancer patients are staying in hospital too long in some parts of the country as compared with others.

The survey notes that most patients undergoing breast cancer surgery can be “safely managed as day cases or with a single overnight stay” but that currently more than 20 primary care trusts have average lengths of stay “in excess of three days”.

For example, the same surgery carried out in parts of south Wales resulted in patients staying in hospital for a few days where in Hertfordshire they stayed only one night.

Access to care homes – paid for by the NHS for those receiving end-of-life care or round-the-clock intensive care – also varied considerably.

In Devon and Cornwall, with its high elderly population, the admission rate for those aged over 74 to care homes funded by the NHS was just under three per 100,000 of the population. The figure in Northumberland was 190.

Meanwhile the rate of angioplasty operations – which tackle blocked and narrowed arteries – was three times higher in Peterborough than County Durham.

The report measures 71 key indicators, including hospital admission rates, what treatments health trusts choose to fund, and how children are managed in the NHS.

It attempts to map the “utilisation of healthcare services that cannot be explained by variation in patient illness or patient preferences”.

Health minister Lord Howe said: “The Atlas of Variation lets us look at how the local NHS is meeting the clinical needs of their local population.

“This will help commissioners to identify unjustified variations and drive up standards so patients are receiving consistently high quality care throughout the NHS.

“We are committed to improving results for patients and our new NHS Outcomes Framework will hold the NHS to account for this. Commissioners will be able to apply contractual penalties if any organisation is failing to deliver improvements for patients.”

Patients should be given greater access and control over their medical information, the consultation said.

However, there are worries over the security of the system and that the information will be passed on or sold in so called ‘technology and data markets’.

Patients could be pressured into giving third parties, such as insurers access, to their record or to disclose details contained in it, it was warned.

In documents released with the Autumn Statement, it said: “All patients in the NHS will have online access – where they wish it – to their personal GP records by the end of this Parliament.

“GP practices that can already provide online access are encouraged to do so as soon as possible.

“These measures will help to position UK companies in the development of a personal information market, which is likely to be the next stage of development on from the growth of social networks.

“Online access to one’s own personal data enhances personal control and participation in public services. It also fuels innovation and growth in the supporting technology and data markets.”

Concerns were raised last year that the Summary Care Record was being rolled out too fast with patient records being uploaded to the national system unless people directly opted out.

The roll-out was halted but it now appears that it is to be restarted again and all patients who have already been contacted will have an online record by 2013.

The summary care record is part of a wider online medical records database to allow NHS staff to access brief medical records of patients they may treat outside their home area. However, in pilots, it was found that staff were passing access ‘key cards’ to each other breaching security rules.

Guy Herbet, general secretary of the campaign group No2ID, said: “The problem is this is a Trojan horse for the continuation of the Department of Health’s continuing centralisation of all medical records, and its seeming desire to share them with its friends in the pharmaceutical and medical technology industries.

“That’s a real threat to privacy and medical confidentiality. And the government has continued the previous administration’s work of taking records out of the hands of clinicians who have a direct duty to you.”

Gus Hosein, Executive Director of Privacy International, said: “In theory, this system is a positive development; everyone should have access to their own information.

“The problem is that the NHS is insisting on building a multi billion pound computer system to store records containing our most intimate and potentially compromising information.

“At best, it will fail, as large government IT systems have historically tended to do. At worst, it will create a data protection nightmare. The benefit of giving patients access to their medical records is vastly outweighed by the huge expense of the system and the significant threat to privacy.”

Chaand Nagpaul, the British Medical Association’s GP IT lead, said: “The BMA does believe that patients should be given the option of accessing more information online so that they can make informed decisions about their care.

“However, take-up has been very slow in those areas where patients have been offered access to their records online.

“It is essential that further work is undertaken to assess the level of demand amongst the public before further investment is made. With the NHS being asked to make efficiency savings of £20 billion, we must not waste money on expensive systems that patients will not use. It is also important any electronic system has built in confidentiality and data security safeguards.

“The UK’s research base and wider NHS could benefit from plans to publish datasets more widely and open up new channels of communication between different parts of the health service. It is important though that confidential data is not inadvertently disclosed. Proper safeguards must be put in place to stop this from happening. “

From:  http://www.telegraph.co.uk/All-patients-to-be-given-online-access-to-medical-records

Studies show that up to 10 per cent of women in Britain suffer from a serious fear of natural childbirth, called tokophobia.

Now the National Institute for Curbing Expenditure (NICE) is recommending that women should always have the right to a caesarean, even if they have no physical or mental health need.

The guidelines, state: “For women requesting a CS [caesarean section], if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.”

Malcolm Griffiths, a consultant obstetrician and gynaecologist at Luton and Dunstable Hospital, who chaired the guidelines development group, said most women were not interested in having a caesarean.

“It is a major operation, about as major as a hysterectomy,” he said.

Nonetheless, 25 per cent of births in Britain are now by caesarean. Between a third and a half of them are pre-planned.

Figures show that rates in Nordic countries are much lower, at about 15 per cent.

Many obstetricians want the UK rate to come down, but believe that is impossible without better midwifery services.

Mr Griffiths said: “I think probably key to the difference is support during labour, with one-to-one midwifery care and support in Nordic countries.”

Better midwifery care was “key to reducing the caesarean rate”, he added.

Nina Khazaezadeh, a consultant midwife at St Thomas’ Hospital in London and a member of the guidelines panel, said some women opted for caesareans because they feared childbirth after a “traumatic” first experience in an understaffed ward – a condition known as “secondary tokophobia”.

She said: “We might see a rise in secondary tokophobia where women have already had a birth that they have found very traumatic, and the perceived lack of support will have had an impact on their decisions for the next pregnancy.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “There is very clear evidence that one-to-one support in labour reduces caesarean rates”.

However, she welcomed the new Nice guidelines, saying it was “absolutely acceptable” that a woman who feared childbirth should be offered a caesarean.

Coincidentally, the RCM publishes a new report today claiming that England faces “massive midwife shortages” and needs another 5,000 of them.

Even though numbers have increased since 2001, they have “failed to keep pace with the rocketing number and increasing complexity of births”, it warns.

The number of births has risen by 22 per cent in a decade, with midwives having to deal with 120,000 more in 2010 than in 2001.

Mothers also tend to be older and heavier than in the past, which both raise the chance of complications.

Belinda Phipps, chief executive of NCT, said: “Most women want a straightforward birth, some need a caesarean. When women are treated with respect, and are offered support and information tailored to their concerns, very few of them will choose a caesarean birth unless there are clear health reasons.

“However, our services fail women badly at the moment, with midwifery numbers well below the level required to guarantee safe and satisfying care.”

She went on: “If caesarean rates go up following the change to the guidelines, it will be evidence that women are not getting the quality of midwifery support they need.”

The guidelines do recommend that a woman requesting a caesarean should be made to talk about her fear of childbirth before an operation is granted.

From: http://www.telegraph.co.uk/Caesareans-to-be-offered-to-all-amid-fears-over-midwife-shortages

Mothers have traditionally been told to “mollycoddle” their youngsters by avoiding high risk foods during pregnancy and while breastfeeding to protect them from potentially dangerous reactions.

But now there is a growing belief that the best way to avoid allergic reactions is to meet the problem head on and expose children to foods like peanuts in infancy.

Three large studies are under way at King’s College London, Cambridge University and Duke University in North Carolina to determine once and for all the best way of protecting against harmful reactions to food.

Prof Gideon Lack, of King’s College, said that until recently the nanny state had told mothers to breastfeed for up to six months before introducing their babies to other food, and keep them away from possible allergens until the age of two or three.

The idea, he said, was to “wrap the infant up in a sort of immunological cocoon and not expose them to proteins that could launch allergic reactions.

“There is a possibility that we were achieving the reverse of our intentions through this avoidance policy,” he told the Nature journal.

A 2008 study which Prof Lack co-authored suggested exactly the opposite, showing that Jewish children in Britain are ten times more likely to have a peanut allergy than those living in Israel, who eat more foods containing peanuts.

The following year the Department of Health revised its guidelines on allergies to clarify that there is not enough evidence to prove a benefit of restricting the diet of either mother or child from pregnancy to infancy.

The study into peanut allergy being conducted by Prof Lack, along with those in Cambridge and North Carolina, could help explain whether giving children controlled but increasing amounts of peanut-containing foods over time could desensitise them.

Starting in 2006, researchers began following 640 babies, half of whom are judged to be at high risk of food allergies, to see if exposing them to traces of peanuts in their early years causes them to develop adverse reactions.

Previous research at Cambridge has suggested that feeding small doses of peanut flour to allergic children every day for 30 weeks could raise their tolerance to safe levels, enabling most of the group to eat 32 peanuts with no reaction by the end of the trial.

Diagnostic tests and outpatient appointments will also be delayed, but hospitals insist emergency and critical care will not be affected.

Managers say they are preparing as they would for Christmas or bank holidays.

An estimated 400,000 nurses and healthcare assistants, as well as paramedics, physiotherapists, and support staff like cleaners and administrators have said they will join the action on 30 November over changes to public sector pensions.

However, the main medical unions – the Royal College of Nursing, the Royal College of Midwives and the British Medical Association are not taking part.

The Department of Health in England said it was expecting at least 5,500 non-emergency procedures like hip and knee operations to be rearranged.

More than 12,000 patients are likely to have diagnostic tests postponed, and 40,000 outpatient appointments are expected to be rescheduled.

On an average day, 28,000 patients have planned treatments or operations in England and there are 60,000 diagnostic tests.

However, managers say they are putting plans in place to make sure people can still get emergency or urgent care, in the way they do on bank holidays or at Christmas.
999 calls

Patients needing urgent treatment like chemotherapy and kidney dialysis will still be able to get it, and maternity units will remain open.

Calls to 999 will still be answered, but patients are being urged to think hard and only call if it is a genuine emergency.

The Health Secretary, Andrew Lansley, said health service workers should not take action that harms the interests of patients.

“I would ask staff to consider carefully whether going on strike is the right thing to do,” he said.