One in eight calls to the NHS’s new non emergency health direct phone number are going unanswered, amid reports people are having to wait over half an hour.Ministers want 111 to be the only number people need to call in England, “if you urgently need medical help or advice but it’s not a life threatening situation”.

But a pilot in four areas – Luton, County Durham and Darlington, Lincolnshire, and Nottingham – is highlighting worrying problems.

Official statistics show that in September, 12 per cent of calls went unanswered.

Across the four areas there were 33,707 calls to the service.

The Department of Health expects 12 million calls a year to the free 111 number in England, based on scaling up that figure.

Writing on the NHS’s own web page about the 111 number, one caller expressed frustration at being unable to get through despite waiting 35 minutes.

“All I wanted was a bit of advice. I now need to go to work and have had no help from anyone,” the caller wrote. “I had the sense to take pain killers myself, hope this new service gets better.”

A month ago Andrew Lansley, the Health Secretary, announced that 111 would be rolled out nationwide by April 2013, abolishing the concept of “out-of-hours” care. It is also meant to encompass NHS Direct.

The Department of Health claimed the September statistics showed an “encouraging picture”.

A spokesman said: “Lessons learned from the pilots will ensure that when the service is rolled out nationally it will provide people with a first class service.”

He added: “We know that unanswered calls are usually callers who get through to the NHS 111 message and hang up. This could be because they wanted to speak to their GP practice, but it was still in the ‘out of hours’ period and they were therefore transferred to NHS 111.

“This figure does not mean patients are receiving a poor service.”

A spokesman for NHS Direct echoed this, saying the vast majority of the 12 per cent of unanswered calls were of people who chose to hang up, after learning they were being put through to the 111 service when they wanted to speak directly to their GP.

From:  http://www.telegraph.co.uk/NHS-111-number-1-in-8-calls-unanswered

‘Nudging’ people to lose weight by thinking about their lifestyle shows little evidence of success, an analysis of published data suggests.It showed the step by step “nanny state” behavioural approach used in hospitals and clinics led to an average weight loss of 2kg or less.

The report, by The Cochrane Library, looked at studies involving nearly 4,000 people around the world.

The method, known as the transtheoretical model (TTM) stages of change, is used to encourage people to move towards more healthy forms of behaviour.

The five step process encourages people to see the need to change and then give it a go.

It has been shown to be successful in helping people quit smoking, and has also been used in alcohol and drug addiction.

The analysis looked at five trials – in the UK, US, Netherlands, Canada, and Australia – involving 1,834 overweight or obese patients, and 2,076 people of normal weight.

The authors, led by Professor Azeem Majeed and Dr Nik Tuah of Imperial College London, found no convincing evidence of any sustained or significant weight loss.

Professor Majeed: “Changing people’s dietary patterns is very difficult – that’s why we’ve got such a problem with obesity.”

Dr Tuah added: “This review does not necessarily challenge the notion that diet and exercise are effective weight loss strategies, but instead raises questions about how to approach lifestyle changes for individuals who want to adopt them.”

The report concluded: ” The use of TTM SOC resulted in minimal weight loss (about 2 kg or less) and there was no conclusive evidence for sustainable weight loss amongst participants.”

The report’s abstract is at: Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults

A massive recruitment drive is under way to match up thousands of diabetic patients with diabetes research projects aimed at finding a cure for the disease.The scheme is being likened to a kind of “dating agency” that puts researchers and patients in contact.

Researchers say about 30% of cancer patients may be taking part in clinical trials, but for diabetes that figure is less than 1%.

About 2.8 million people in the UK are known to have diabetes.

But the charity Diabetes UK believes another 800,000 people may not know they already have the disease.

Part of the reason researchers have found it hard to find diabetes patients is that most only see their GP.

But three regions in England have been chosen to pilot a scheme which aims to offer 25,000 patients, with any form of diabetes, the chance to take part in clinical trials or other forms of research.

A recruitment drive is taking place in north east London, the south west and the north west of England.

Prof Martin Gibson, from the Diabetes Research Network at Salford Royal NHS Foundation Trust, says clinical trials are essential in order to find better treatments for diabetes – or even a cure.

“Pretty much everyone I talk to with diabetes is interested in research but they don’t get the opportunity.  It’s not like cancer where people are increasingly offered the chance to take part in research projects.”

“Part of the problem is that people with diabetes are very often out in the community, which is not where the researchers are.  So what we’re trying to create is a dating agency so we can bring the two groups together, because both are very interested in trying to find a cure for diabetes.”

Diabetes UK estimates that about 10% of the total NHS budget across the UK is spent on illnesses related to the disease.

The charity calculates this works out at about £173m a week – or £1m an hour.

Dr Iain Frame, director of research at Diabetes UK, said: “This is a huge opportunity for people with diabetes to play their part in crucial research that is piecing together the gaps in our knowledge and in our understanding of the condition.

“This exciting campaign will help future generations of people diagnosed with this serious, life-long condition and help us take a step further to a future without diabetes.”

If you would like to be involved in the diabetes research project please click here now.

A new health lottery is launched today with the aim of generating up to £50 million a year for health causes.The Health Lottery – run by Northern & Shell, which owns Channel 5 and Express newspapers – offers a £100,000 top prize for matching five numbers from 50.

The launch was hosted by television presenter Eamonn Holmes, who will also front the live draw to be shown on ITV1 and Channel 5 each Saturday from October 8.

He said: “It’s such a great idea, I am really excited about being part of something that not only makes people smile every week, but also has the ability to change lives in the longer term.

“In these difficult economic times, the Health Lottery will inject a sizeable amount of new money into that local network, and the projects that are supported will help people live longer, healthier lives.”

Twenty pence from tickets, which cost £1, will go towards health-related good causes.

Matching three numbers wins £50 and four numbers £500.

No matter how many people win, everyone will get the advertised prize, the Health Lottery said.

John Hume, chief executive of the People’s Health Trust, said: “We will be working directly with communities to identify practical and sustainable ways in which funding from the Health Lottery can have real impacts on health and well-being in communities experiencing significant disadvantages.”

Martin Hall, chief executive of the Health Lottery said: “The Health Lottery game is a fresh new alternative which has one single good cause at its heart – health.

“We will be offering people the opportunity to win a life-changing amount of money while at the same time contributing to tackling real health issues in their own communities.

“It is an exciting new launch which will benefit every community in Great Britain.”

But the launch attracted criticism from Sir Stephen Bubb, of the Association of Chief Executives of Voluntary Organisations, who dubbed it a “disgraceful new development”.

He wrote on his blog: “He (Northern & Shell owner Richard Desmond) intends to only give 20p in the pound to health, whereas the National Lottery is giving 28p to good causes.

“So if people switch to Desmond from the National Lottery charities will lose out.”

Health Direct also notes that the marketing and admin charges are higher for the new lottery than the national Camelot lottery.

NHS Hospitals are breaking the law by failing to report incidents that result in severe harm to patients a charity has warned.Peter Walsh, chief executive of the charity Action Against Medical Accidents (AvMA), said many were failing to own up to such incidents despite a law that had been in force since April 2010, requiring them to do so.

He was commenting on National Patient Safety Agency (NPSA) figures, showing an 8.5 per cent increase in the total number of reported incidents in the NHS in England, between April to September 2010 and October to March 2011.

The vast majority of such incidents result in “no harm” (69 per cent), “low harm” (24), or “moderate harm” (six).

However, one per cent result in “death or severe harm”. Since April 2010, health trusts have had to report these incidents.

Between the two most recent six-monthly periods for which data are available, the number of such reported incidents rose by 13 per cent – from 4,358 to 5,012.

While significant, Mr Walsh believed if all trusts were reporting as they should, the rise would be larger still.

He said: “Given that there was a new set of rules that came in, in April 2010, that made it a statutory requirement for trusts to report incidents that cause severe harm or death, we would have expected a bigger increase.

“So we think some trusts might be holding back on reporting incidents that caused severe harm.”

He added: “We think work is needed looking at why trusts do not seem to be reporting at a rate we would expect.”

Individual cases that were known through clinical negligence claims should be checked back, to see if trusts had reported them to the NPSA, he recommended.

A spokesman for the NPSA said that overall new figures reflected an improving culture of reporting incidents in NHS trusts.

Sarndrah Horsfall, chief executive of the NPSA, said: “Identifying patient safety incidents and ensuring they are reported and analysed is at the heart of reducing risk in healthcare.

“NHS organisations should use the data and review the tools, guidance and support available to them. This will ensure patient safety incidents continue to be reported and learned from, strengthening the patient safety culture across all levels of the NHS.”

From:  http://www.telegraph.co.uk/Hospitals-failing-to-report-serious-safety-incidents

Patients have been left at risk as the country’s main health watchdog quango carried out 70 per cent fewer inspections in order to focus on bureaucracy MPs find.The Care Quality Commission was guilty of a “significant distortion” in its priorities as it concentrated on red tape rather than checking that hospitals and care homes were safe, according to the Health Select Committee.

The situation was made worse by the fact that almost 300 posts were unfilled at the regulator and it failed to make Government understand the difficulties it was facing in adding dentists to the professions it monitors.

A damning report accuses the CQC of responding “woefully” to a whistleblower who uncovered abuse of people with learning disabilities at a private hospital, and of only offering “out of date and unhelpful” information to the public.

The MPs also call on the watchdog to focus on the broader culture at hospitals and care homes, rather than individual failings in treatment, to make sure that complaints are not being suppressed.

Stephen Dorrell, the Health Secretary under John Major who now chairs the select committee, said: “In its review of the CQC, the Committee concluded that the organisation’s priorities became distorted by a statutory deadline for the registration of dentists and that this distortion led directly to a drop of 70 per cent in inspection activity during the second half of 2010-11 compared with the same period in the previous year.

“The primary causes of this distortion, which resulted in increased risk to patients, were the unrealistic statutory obligations imposed on the CQC.”

Rosie Cooper, a Labour member of the committee, said: “I was really disappointed that the CQC allowed itself to get trapped in the regulatory profess and that restricted its ability to carry out inspections, which left vulnerable people at risk.”

The CQC, which has a budget of more than £160 million, was formed in 2009 in a merger of three separate watchdogs for healthcare, mental health and social care, and set about registering thousands of NHS hospitals and care homes.

But it missed its target of registering 8,000 dentists by April because of its complex process and the deadline for putting GP practices on its books has been postponed for a year so it can catch up.

As a result of this focus on administration, the select committee says that CQC inspections to see if patients are being looked after safely fell by 70 per cent, from 6,840 between October 2009 and March 2010 to 2,008 in the following six months.

Meanwhile its number of job vacancies rose from 148 in June 2010 to 297 a year later, “a further cause for concern”, almost half of whom were the inspectors and registration assessors it needed the most.

The MPs said the watchdog should have argued its case to Government more persuasively and far sooner.

Caseloads for the CQC’s inspectors have risen from 50 to 62 organisations over the past year, and so many assessments are mere “box-ticking” exercises carried out from its offices.

After a nurse contacted the CQC to complain about abuse at Winterbourne View, its response was “woefully inadequate”. Calls from whistleblowers elsewhere increased after the scandal was exposed by Panorama but this could be “only the tip of the iceberg”.

The CQC has a website where patients and relatives can read reports on hospitals and care homes but in many cases they are “several years old” and contain “limited” information.

The MPs say that inspectors should visit hospitals and nursing homes every year and speak to staff, patients and visitors to get a true picture of the quality of care being provided, rather than just relying on easily met targets.

From: http://www.telegraph.co.uk/Patients-left-at-risk-by-watchdogs-focus-on-red-tape

Scientists found that small amounts of dark chocolate may improve health in a similar way to exercise.The researchers focused on the mitochondria, the tiny powerhouses in cells that generate energy, and discovered that a plant compound found in chocolate, called epicatechin, appeared to stimulate  the same muscle response as vigorous activity.

Dr Moh Malek, from Wayne State University in Detroit, who led the US study on mice, said: ”Mitochondria produce energy which is used by the cells in the body. More mitochondria mean more energy is  produced the more work can be performed.

”Aerobic exercise, such as running or cycling, is known to increase the number of mitochondria in muscle cells. Our study has found that epicatechin seems to bring about the same response –  particularly in the heart and skeletal muscles.”

A specific type of epicatechin from cocoa was given to mice twice a day for 15 days.

At the same time, the animals underwent 30 minutes of treadmill training each day.

Researchers found that mice only fed epicatechin had the same exercise performance as those running on the treadmill.

The findings were published today in the Journal of Physiology.

The scientists hope their research will lead to better ways of combating age-related muscle wasting.

”The number of mitochondria decreases in skeletal muscle as we age, and this affects us physically in terms of both muscle energy production and endurance,” said Dr Malek. ”Applying what we know  about epicatechin’s ability to boost mitochondria numbers may provide an approach to reduce the effects of muscle ageing.”

Middle aged mice who both exercised and ate epicatechin showed an even greater benefit.

”It appears epicatechin treatment combined with exercised could be a viable means to offset muscle ageing,” said Dr Malek.

He added: ”At the moment it would be a leap of faith to say the same effects would be seen in humans. But it is something we hope to identify in future studies.”

From:  http://www.telegraph.co.uk/Chocolate-as-good-for-you-as-exercise

England’s NHS hospitals needed at least £200 million in bailouts and loans as they struggled to balance their books while also meeting tough savings targets, according to a spending watchdog.The Audit Commission said nine NHS trusts “failed to achieve financial balance” and many more applied for extra funding from managers and the Government, although overall performance “continues to be good”.

Health bodies spent £289m on redundancy payments but the number of staff employed in hospitals actually rose by almost 8,000.

Dozens were found at fault with the “value for money” they offer and a fifth of all NHS bodies failed to meet their savings targets despite cutting back on staff and the number of patients they treat.

The Audit Commission, the public spending watchdog that is being scrapped, warned that health service providers face even tougher times ahead as savings become harder to find and Government spending increases dry up.

Andy McKeon, managing director for health at the Audit Commission, said: “It is impressive that the NHS overall performed so well financially last year, even if some organisations struggled.

“But there is no room for complacency. Tighter funding, and the need to continue to improve services and implement reforms, will make the next three years much tougher.  NHS organisations will need to make a determined effort to find further recurrent savings while continuing to deliver high quality services.”

The watchdog looked at the 2010-11 accounts for Primary Care Trusts, which pay for treatment; hospitals not including the semi-independent Foundation Trusts; and the regional Strategic Health Authorities.

It found that they were running a £1.5 billion surplus and had actually underspent by £272 millon on the £2.95 billion in capital expenditure they were given by the Department of Health, twice as much as recorded the previous year.

But seven hospitals and two PCTs failed to break even, one fewer than in 2009-10, with the biggest deficit of £41m recorded by South London Healthcare NHS Trust.

At least 16 NHS organisations needed additional financial support from PCTs which is never paid back “thereby obscuring their real financial health”.

Managers gave out £90 million to hospitals, while the Department of Health issued loans totalling £34 million to four hospitals and also gave £76 million to two trusts which did not even have enough money to pay back loans.

Ministers want to cut management costs by 45 per cent at SHAs and PCTs, which are being restructured, and they did let 5,713 people go with average pay-offs of £40,000 each.

But the headcount at hospitals actually rose by 7,616 and only fell by 27 in the 10 SHAs.

The Audit Commission did not find any NHS body’s accounts were not “true and fair”, but it did issue “qualified Value For Money conclusions” for 27 hospitals and 18 PCTs, suggesting they had problems with “financial resilience” or “economy, efficiency and effectiveness”.

The Audit Commission warns next year will be “a more financially challenging year” as there will be no “significant real-terms increase” in the central budget, so trusts will require “determined effort and strong leadership”.

From:  http://www.telegraph.co.uk/NHS-hospitals-needed-200m-in-bailouts-and-loans

Deprived areas in England will lose out to affluent parts of the country under health spending reforms Labour has claimed- despite repeatedly creating those same postcode lotteries when they were in power.
Changes to funding formulas means poor health rates will be given less consideration when cash is allocated, the party said.

It suggested areas like Manchester and the London borough of Tower Hamlets would lose out to parts of the wealthy south east, such as Surrey and Hampshire.

Labour based the claims on an assessment of funding reforms by public health bodies in Manchester.

But the government has disputed the allegations and claimed Labour’s figures were misleading.

Department of Health officials said primary care budgets in Surrey and Tower Hamlets would go up by a similar amount this year.

The Conservatives claimed every area would have suffered health funding cuts under Labour.

A Conservative party spokesman said: “This is yet another own goal from Labour. If they had won the last election, the NHS would now be being cut by £28 billion across the country. Every area would have seen spending on the NHS cut – as it is in Labour-run Wales.

“This Government is increasing spending on the NHS in real terms over this parliament, and every region of the country will receive more money as a result of this investment.”

Health Direct has repeatedly tracked Labour’s proud boast when it was in power of creating postcode lotteries based on it’s voting constituencies:

Friday, April 13, 2007 Labour voting areas get most PFI NHS cash
http://www.healthdirect.co.uk/2007/04/labour-voting-areas-get-most-pfi-nhs.html

Wednesday, November 22, 2006 Hewitt defends NHS cash for Labour voting areas
http://www.healthdirect.co.uk/2006/11/hewitt-defends-nhs-cash-for-labour.html

Tuesday, October 24, 2006 NHS cuts twice as likely in Tory and Lib Dem areas
http://www.healthdirect.co.uk/2006/10/nhs-cuts-twice-as-likely-in-tory-and.html

Monday, September 25, 2006 NHS closures rigged in Labour voting constituencies
http://www.healthdirect.co.uk/2006/09/nhs-closures-rigged-in-labour-voting.html

Friday, September 15, 2006 Labour accused over hospital cuts in marginal constituencies
http://www.healthdirect.co.uk/2006/09/labour-accused-over-hospital-cuts-in.html

Drugs used to stimulate the ovaries of older women undergoing IVF treatment may be causing genetic defects in the embryo which have until now gone undetected.
Scientists have discovered abnormalities in the chromosomes of eggs from women over 35 years of age who had been treated with synthetic hormones to stimulate their ovaries prior to IVF.

The researchers said they were surprised to find the chromosome defects which appeared to have occurred during the second stage of the specialised process of cell division that leads to the creation of the human egg cell.

Chromosome defects in eggs were previously considered to have resulted in the first stage of cell division, which occurs when a woman was herself a foetus in the womb. Finding them during the second stage, which occurs at ovulation, therefore suggests they may have resulted from the hyperstimulation of the ovaries during IVF treatment.

The defects included abnormal variations from the usual number of 23 pairs of chromosomes. Three copies of chromosome 21 instead of the normal two, for instance, leads to babies with Down’s syndrome. As women get older it becomes increasingly difficult for them to produce enough viable eggs for IVF treatment. It is common practice for older women to have their ovaries stimulated with stronger doses of drugs than is the case for younger women.

The results of the study are to be presented at a fertility conference in Stockholm this week but the scientists behind the research said that they wanted to reassure older women considering IVF treatment. They said further work needs to be done fully to explain the findings and there is no evidence to suggest that IVF babies of older women are at any higher risk of birth defects than babies conceived naturally by women of the same age.

“We found that some IVF eggs have up to seven chromosome abnormalities. This suggests the possibility that ovarian stimulation during the treatment may have caused some of these defects,” said Professor Alan Handyside, director of the London Bridge Fertility, Gynaecology and Genetics Centre, who led the study.

“These defects are unexpected and it may be that this is just an undiscovered aspect of biology. At the moment all we can say is that this is part of the natural process as women get older.”

The study, which will be presented at the European Society of Human Reproduction and Embryology, analysed more than 100 egg cells from 34 couples undergoing IVF treatment. The average maternal age was 40.

Scientists screened the chromosomes of the eggs and structures known as “polar bodies” that result from a type of cell division known as meiosis. Meiosis is a specialised form of division that results in eggs with half the normal complement of chromosomes – crucial to ensuring that the fertilised egg has the full complement of 46 chromosomes when it fuses with a sperm cell.

The first stage of meiosis occurs when the woman’s ovary is developing in the foetus before birth, when the dividing chromosomes are held together by a kind of cellular “glue” ready for the second stage of division at ovulation.

However, when the ovary of an older women is stimulated with synthetic hormones it is possible that this dislodges the glue prematurely. This might result in abnormal numbers of chromosomes to segregate into the resulting egg cell.

“Our evidence demonstrates that, following IVF, there are multiple chromosome errors in meiotic divisions, suggesting more premature separation of single chromosomes resulting in more random segregation,” Professor Hanyside said.

Stuart Lavery, a consultant gynaecologist at Hammersmith Hospital in London, said “This provides evidence that there is a problem, but it does not prove that it’s treatment related,” Mr Lavery said.

The most important conclusion to be reached from this research isn’t so much the “why” but that the screening process for eggs to be used in IVF must be improved.

It is possible to screen the chromosomes of so-called First Polar Body eggs, at least as part of research. This paper stresses the importance of also screening Second Polar Body eggs, those that have been fertilised.

Doing so will, we can now see, allow us to better identify eggs that have developed abnormalities that result in conditions like Down’s Syndrome.

The issue of whether drugs used to stimulate ovulation are having a role is two-fold. Are the drugs damaging the eggs or simply releasing those that would otherwise be discarded naturally because of abnormalities? Or it could be the drugs have no role at all? We don’t know.

One intriguing point is that if the drugs are a factor we would have anticipated having seen more cases of Down’s Syndrome among older mothers. They may be there but we haven’t detected any such increased risk yet – it means we need to research the possibility.

From:  http://www.independent.co.uk/ivf-drugs-may-be-linked-to-genetic-defects-discovered-in-embryos