One in three NHS staff say they are not enough people in their department to get their work done, according to the annual health service survey.And almost half of NHS staff said they do not have time to complete their tasks, it was warned.

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

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

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

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

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

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

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

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

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

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

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

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

A ban on tobacco displays is coming into force in England today – with ministers promising it will help curb the number of young people taking up smoking.Cigarettes and other products will have to be kept below the counter in large shops and supermarkets, while small outlets are exempt until 2015.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Surgeons have been warned to stop using a particular type of metal hip implant because it has an “unacceptably” high failure rate.The UK health regulator, the MHRA, said after four years, over 10 percent of the implants needed to be replaced.

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

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

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

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

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

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

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

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

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

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

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

Homeopathic treatments funded by the NHS are “biologically implausible” and risk damaging patients’ health by discouraging them from getting proper treatment, a leading researcher has claimed.Edzard Ernst, Professor of Complementary Medicine at Exeter University, said homeopathic remedies had not been proven to work in clinical trials.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The most senior doctor in the NHS is demanding that hospitals have a full complement of doctors at weekends to make the health service more convenient to access as “people get sick seven days a week”.Sir Bruce Keogh, Medical Director of the NHS, criticised the culture in hospitals of only treating emergency cases at the weekend with little or no routine surgery or diagnostic testing done outside normal office hours.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A third of older people are at an increased risk of dying because they do not fully understand the instructions on medicine labels, a study has found.Researchers at University of College London asked almost 8,000 adults over 52 to take part in a test of how well they could read and understand a basic medicines label, for a mocked-up aspirin product.

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

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

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

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

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

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

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

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

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

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

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

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

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

People can significantly reduce their chances of being diagnosed with cancer by taking an aspirin a day for as little as three years, according to new research.The cheap drug not only appears to stop cancers developing in the first place, but also prevents them from spreading to other parts of the body, the new work shows.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cooling the brains of people who have just had a stroke could have as dramatic effect on reducing deaths and long term disability as ‘clot-busting’ drugs new reserach has found.Reducing a patient’s body temperature to 35C induces a kind of hibernation in the brain that helps protect it from damage, pilot studies indicate.

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

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

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

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

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

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

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

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

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

The first pill for MS sufferers is set to be approved for use on the NHS.The National Institute for Curbing Expendtiture (NICE) has overturned previous draft guidance on the drug Fingolimod after the price was discounted and has now ruled that a proportion of people with multiple sclerosis should be treated with it.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Worries about the breast implants made by PIP have emerged since news of a major investigation into the France firm.Initially it was thought that around 40,000 women in the UK had the implants but yesterday the Department of Health said new evidence meant a further 7,000 women in the UK might have them. About 95% of the implants were provided privately for purely cosmetic reasons.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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