NHS advice, news, information, spin on the NHS

NHS advice, news, information, spin on the NHS.
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Huge rise in number of 11 year olds on the pill

August 10, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The number of 11 and 12-year-old girls prescribed the pill by a family doctor has soared five fold in the past decade, according to new figures.
Huge rise in 11 year olds on the pillMore than 1,000 girls in the first year of secondary school have been given prescriptions for the pill, according to figures from GPs, while a further 200 have long-term injectable or implanted contraceptive devices.

The disclosure prompted warnings that Britain was “facilitating the sexualisation of young people at an every younger age”.

It follows the publication of guidance by the nanny state’s National Institute for Curbing Expenditue (NICE)  that sex education should be introduced from the age of five.

Trevor Stammers, chairman of the Christian Medical Fellowship and a GP in south London, told The Sunday Times: “If sex education is introduced in primary schools in the way being proposed, we will see many more 11-year-old girls seeking contraception without pointing out the risks…. We are going to make matters worse.”

He added: “These figures illustrate the fact that the UK is facilitating the sexualisation of young people at an ever younger age.”

The latest figures came from the General Practice Research Database, which collects information on medical records from 500 GP practices.

The data also shows that at least 58,000 15-year-olds were on the pill last year – more than double the number in 1999.

By law, doctors are bound by a duty of confidentiality towards children – even if they are under the legal age of consent – unless they suspect abuse.

From: http://www.telegraph.co.uk/Huge-rise-in-11-year-olds-on-the-pill

Only scientist in Commons alarmed at MPs’ ignorance

August 09, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The only scientist in the House of Commons has called for all MPs to be required to take a crash course in basic scientific techniques.
Only scientist in Commons alarmed at MPs' ignoranceJulian Huppert, a research biochemist who became the Liberal Democrat MP for Cambridge at the last election, said he was alarmed at the lack of scientific knowledge among colleagues.

In an interview with The Independent, he also accused political leaders of paying “lip service” to the importance of scientific proof and warned that looming cuts to university research budgets could provoke a “brain drain” from Britain.

Although there are other backbenchers with scientific backgrounds, Dr Huppert is the sole MP to have practised past PhD level, specialising most recently on DNA structures.

He said it was a real concern that the Commons – which is full of career politicians, lawyers and economists – lacked scientific expertise. Dr Huppert, a fellow of Clare College, Cambridge, argued that all MPs should be obliged to take a short science training course, covering areas such as how research is conducted, numeracy and the use of statistics.

“It would be really important for all MPs to have some exposure, because some of them will not have studied any science since they were 15 and it’s important to understand how to engage with it,” he said. “You would then have a lot of MPs who were able to understand the information they were being presented with.”

Accusing some MPs of being “anti-science”, he said: “They have a set of beliefs and they will argue that regardless of the science.”

Dr Huppert said political leaders tended to come up with a stance and then tried to make the evidence fit it, rather than being driven by the science. He cited the previous government’s decision to make the drug mephedrone a banned substance after claims about the role it played in the deaths of several young people.

“What we saw was a policy based on media reports, rather than based on evidence, and that does happen too much, ” he said. “As a researcher I will come up with a hypothesis, which I may talk about to people, I’ll then do some experiments and test it and will then change my hypothesis based on what I find. If you do that in politics, that’s a U-turn and a defeat.”

Although he absolved the Science minister, David Willetts, from criticism, he said a “tricky” relationship had developed between MPs and scientists. “Generally, they are two separate camps who do not communicate,” he said.

Dr Huppert gained a seat on Cambridgeshire County Council when he was 22 – the same age at which he gained his PhD. He pursued the two careers in parallel until the election in May, when he succeeded fellow Liberal Democrat David Howarth, who stood down as the MP for Cambridge to return to academia.

Dr Huppert said: “Science in some senses is what I am good at, but politics is what I care about.” He also hit out at suggestions that university research budgets could fall victim to the public spending squeeze being undertaken by the Government.

From: http://www.independent.co.uk/only-scientist-in-commons-alarmed-at-mps-ignorance

Kidney cancer patients denied drug that can extend their lives by killer quango NICE

July 14, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Having wasted a few reports recently on extending the nanny state by battering voters into not eating fat food the killer quango NICE has now decided to prematurely kill cancer patients.
Kidney cancer patients denied drug that can extend their lives by killer quango NICEKidney cancer patients will not be allowed a new drug that could extend their lives by up to three months because it is too expensive, the NHS drug rationing body has said.

The National Institute for Curbing Expenditure has turned down the drug called everolimus, also known as Afinitor, saying it does not offer enough benefit to patients to justify the cost.

Each pack of the drug costs £2,822 and the manufacturer, Novartis, had offered the first pack free to the NHS and a five per cent discount on following ones.

But even with this, and taking into account new guidance on end of life drugs which allows Nice to approve more expensive drugs that extend life for patients with rare diseases, the treatment was still too expensive, the panel decided.

An estimated eight week cycle of treatment would cost £5,264 per patient.

The cost per quality adjusted life year gained, a complex calculation taking into account improvement in quality of life as well as extra length of life versus the cost of the new drug over and above existing treatments, is almost double what Nice would normally allow.

Around 4,000 people a year in England and Wales are diagnosed with advanced kidney cancer and those who would be eligible for treatment because they had already tried the other drug, called Sutent, and were still fit enough to attempt another drug, would be much fewer, Nice said in a statement.

Patient groups hit out at the draft guidance saying people with rare cancers were being penalised.

Last year patients with advanced kidney cancer campaigned after four drugs including Sutent were turned down. Nice partially reversed the decision and Sutent is now available.

Mike Hobday, Head of Policy at Macmillan Cancer Support, said: “We are disappointed by Nice’s decision not to make everolimus available on the NHS for people living with advanced kidney cancer, who already have limited treatment options following the rejection of three clinically effective drugs last year.”

“It’s unfair that patients suffering from rarer cancers are repeatedly denied treatments that could extend their lives. Drugs like everolimus can dramatically improve people’s quality of life. They can mean the difference between patients being given a few weeks to live and a few months – valuable time that can be spent with family and friends, which means a lot to cancer patients.”

Nick Turkentine, Chief Operating Officer for the James Whale Fund for Kidney Cancer said: “Once again Nice has disappointed the thousands of kidney cancer sufferers in the UK by not approving everolimus, a drug which gives terminal kidney cancer patients and their families some hope.”

From: http://www.telegraph.co.uk/Kidney-cancer-patients-denied-drug-that-can-extend-their-lives

New NHS quality standards set out by Andrew Lansley

July 01, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

NHS hospitals could lose their right to carry out certain procedures if they fail to meet a new set of NHS ”quality standards” set out by Andrew Lansley, the Health Secretary.
New NHS quality standards set out by Andrew LansleySome 150 clinical areas will eventually have their own set of quality standards, with the first three published today covering dementia, blood clots and stroke.

The standards set out the type of care patients can expect and some timeframes for treatment.

Mr Lansley, who has scrapped several of Labour’s key targets, including the guarantee of a GP appointment within 48 hours, insisted the new standards were not just another set of targets.

Speaking at the launch of the standards, which have been developed by the National Institute for Health and Clinical Excellence (Nice), Mr Lansley said they were not mini-targets as they were ”evidence-based” measures identified by the NHS itself.

”These are standards, not diktats. It is not politicians establishing these, I am not picking them out. ‘If I started doing that, I would be distorting clinical standards.”

The latest standards from Nice are drawn from various sources, including existing Nice guidelines, and reports from the Royal Colleges, the Department of Health and the National Audit Office.

It will be up to local managers – or possibly GPs in the future – to check if the NHS is meeting them.

If trusts fail to reach the standards, they could face losing contracts to carry out services, such as stroke care, which could be commissioned from other hospitals instead.

It is unclear how data will be collected nationally so patients can assess whether standards are being met.

Dr Tim Kendall, who led development of the dementia standard, said it would help transform the experience of dementia patients but also support carers.

”Some carers suffer far more than they should. People with dementia effectively die while the person caring for them watches them disappear,” he said.

The stroke standard sets out how patients can expect to receive a minimum of 45 minutes, five days a week, of therapies to help them improve, such as speech therapy or help with movement.

From: http://www.telegraph.co.uk/NHS-quality-standards-set-out-by-Andrew-Lansley

Ban bad fats and cut salt to save 40,000 lives a year- killer quango Nice demands

June 30, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Cutting the average consumption of salt from eight grams a day to three would save up to 20,000 lives year and reducing fat would save even more, new guidelines  from the killer quango pontificates.Ban bad fats and cut salt to save 40,000 lives a year- killer quango Nice demandsSweeping changes in food production, government policy and lifestyle could prevent tens of thousands of unnecessary deaths each year in Britain and save billions for the economy, the National Institute for Curbing Expenditure has said in new guidance.

Food producers should cut the amount of saturated fat in food and eliminate all ‘toxic’ artificial fats, called trans fats, completely.

Trans fats are added to food to prolong shelf life, have no nutritional value and have been linked to heart disease.

Ministers should consider introducing legislation if action is not forthcoming by manufacturers, the guidance said.

The average person in Britain consumes more than eight grams of salt a day where as the body only requires one gram to function. Targets are already in place to reduce consumption to six grams by 2015 and this should be extended to three grams by 2050, the guidance said.

Children should consume considerably less salt than adults and because the bulk of salt in the diet comes from prepared food, such as bread, cereal, soups, meat and cheese products, manufacturers have a key part to play, the guidance said.

The guidance, drawn from evidence of beneficial measures, was commissioned by the Department of Health and covers population based measures rather than advice for individuals. It calls for action from a range of public bodies, business and Europe, but is not binding.

There are around five million people living with the effects of cardiovascular disease, which includes heart attacks, heart disease and stroke. There are around 150,000 deaths each year and while mortality rates have fallen, there are 300,000 new cases diagnosed each year in Britain.

The Nice panel has calculated that 40,000 deaths a year could be prevented by significant reductions in salt and saturated fat consumption and if all trans fats were eliminated from prepared foods.

The guidance has called for a wide range of measures including:

– Low salt and fat foods should be sold more cheaply than their unhealthy counterparts, through the use of subsidies if necessary, although the guidance stopped short of calling for a ‘fat tax’ on high salt and fat foods saying this was difficult to implement.

– Advertising of unhealthy foods to children should be banned until after 9pm and planning laws should be used to restrict the numbers of fast food outlets, especially near schools.

– The Common Agricultural Policy should focus more on public health with farmers paid to produce healthier foods.

– Action should also be taken to introduce a traffic light food labelling system, the Nice panel said, even though the European Parliament recently voted this down.

– Local authorities must also act to encourage walking and cycling in their areas and public sector caterers must provide healthier meals as has already been seen in schools, the guidance said.

– All lobbying of government and its agencies by the food and drink industry should be fully disclosed.

Professor Klim McPherson, Chairman of the Nice Guidance Development Group and professor of epidemiology at Oxford University, said: “The guidance sets out a range of evidence-based recommendations for effective action to help reduce CVD levels.

“Where food is concerned, we want the healthy choice to be the easy choice. Going even further, we want the healthy choice to be the less expensive, more attractive choice. Just one of the recommendations is reducing saturated fats and removing trans fats from the diet – this can save over 20,000 lives every year.

“Put simply, this guidance can help the Government and the food industry to take action to prevent huge numbers of unnecessary deaths and illnesses caused by heart disease and stroke.”

From:
http://www.telegraph.co.uk/Ban-bad-fats-and-cut-salt-to-save-40000-lives-a-year-says-Nice

Potential of genome medicine could be lost warn scientists

June 25, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The NHS needs a new body for evaluating diagnostic tests if it is to make the most of advances in genomic medicine, says a report.
Potential of genome medicine could be lost warn scientistsThe PHG Foundation and the Centre for Science and Policy at the University of Cambridge say that the potential of genetic testing to deliver better treatments at lower cost will be delayed unless there is a system to establish the benefits.

The absence of such a system means that hospitals and GPs may waste money on new tests that do not have clear benefits for patients, while ignoring others that can lead to better clinical outcomes. Just as the National Institute for Health and Clinical Excellence (NICE) currently recommends which treatments are cost-effective for NHS use, new genetic diagnostic techniques must be examined in a methodical way.

“The Department of Health should establish an evaluation and decision-making body, as a matter of urgency, to direct research funding towards important strategic questions and ensure evidence-based implementation of both new diagnostic techniques and informatics systems within the NHS,” the report says.

The recommendation comes in response to a House of Lords inquiry into genomic medicine published last summer, which found that the NHS was not ready to take advantage of genetic advances in healthcare.

The falling costs of reading DNA mean that it is likely to be possible to sequence any person’s entire genome for less than £1,000 within a year or two.

Scientists have also started to identify how variations in DNA affect responses to drugs or susceptibility to disease, raising the prospect of personalised medicine based on individuals’ genetic profiles.

Doctors could potentially use genetic information to select the best drugs for treating particular patients, or to calibrate doses of medicines with potentially dangerous side-effects, such as the blood-thinning drug warfarin. Companies such as 23andMe and Pathway Genomics are already selling genetic tests directly to consumers that provide some of this information.

Little research, however, has so far shown that knowing details of a patient’s genome is helpful to doctors, and leads to better medical outcomes when it is used in prescribing drugs.

The new report, which was compiled following four seminars attended by more than 50 doctors, scientists, ethicists and patient representatives, says that this needs to be addressed as new genetic tests are offered to the NHS.

NICE recently established a diagnostics assessment programme to start this, and is currently conducting a pilot project, but a more comprehensive system is needed. New commissioning structures are also required to ensure that validated tests are accessible everywhere.

Caroline Wright, head of science at the PHG Foundation, said: “The heart of the problem is that we do not have enough data on whether these tests actually help patient care. We desperately need the equivalent of clinical trials for diagnostics.

“There’s an implicit assumption that testing is good, that knowledge is power, but the key question is does a test result helpfully change the management of a patient? If not, it is a waste of money.

“When public money is being spent, it must be spent sensibly to get better care outcomes. It’s really important that anything funded by health systems has evidence behind it.”

From: http://www.timesonline.co.uk/tol/news/science/genetics/article7128357.ece

Nanny state cash bribes for good health fail three quarters of patients

June 10, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The first NHS nanny state scheme to offer cash rewards for losing weight has helped more than 100 obese people shed nearly two stone each in a year.

Cash payments of up to £425 were offered by an NHS primary care trust in Kent to 402 volunteers who signed up for the year-long “Pounds for pounds” trial in January 2009.

Among the 100 who completed the course, the average weight loss over the year was 25lb. However, they represented only a quarter of the total. In all, two-thirds of the volunteers failed to reach their weight loss target.

The mixed results are a disappointment to advocates of the use of financial incentives to change unhealthy behaviour. A growing body of experts say cash rewards may offer the best hope of persuading people to alter their lifestyles and head off the epidemic of chronic disease associated with smoking, drinking and overeating which threatens Western nations.

Last month, the National Institute for Clinical Excellence (NICE) held a two-day hearing to discuss the use of cash incentives in health. In addition to helping people lose weight and give up smoking, other schemes have offered rewards to addicts to stay off drugs and £10 record vouchers to young people who agree to have a test for chlamydia.

An independent evaluation of the Kent weight loss scheme by the University of Sheffield concluded that financial incentives worked for some people, but the high drop-out rate meant the true impact was unclear.

Claire Martin, acting assistant director of public health for NHS Eastern and Coastal Kent PCT, said: “Very often people lose weight, but when they stop their diet the weight returns. We need to invest in programmes that return a sustained weight loss and produce long-term health benefits.

“There were high drop-out rates and so it is very difficult to interpret the results to show how successful this would be across our population.”

The cost of the Kent scheme, run by a private company, Weight Wins, is around £180 per head. A spokeswoman for the Department of Health said the cost to the NHS of treating obesity-related conditions was £4.2bn.

Winton Rossiter, chief executive of Weight Wins, said 745 people had joined the scheme, more than half through the NHS Kent scheme and the remainder as private customers, paying a monthly fee. The average weight loss after one year was 15.8lb.

“These results suggest that long-term financial incentives could be the best single weapon in the war on obesity,” he said. Weight Wins is now offering a maximum payout of £3,000 to private customers who lose 150lb over 21 months and keep it off for three months. Customers pay £135 to join the scheme and £30 a month.

Healthy dividends

* In Essex, pregnant women who smoke have been offered up to £60 in food vouchers if they give up.
* In Hammersmith, west London, and in Bournemouth, the NHS has offered those under the age of 25 a £10 HMV voucher to have a chlamydia test.
* Weight Wins, a private company, charges a £10-£30 monthly fee and offers £150 to clients who lose 50lb and up to £3,000 for people who lose 150lb.
* In the US, employees of General Electric were paid up to $750 (£500) if they gave up smoking for at least 12 months.
* Several companies in the US offer a similar service, including Virgin Health Miles, StickK and HealthyWage.

From: http://www.independent.co.uk/pounds-for-pounds-scheme-helps-obese-people-shed-stones

Killer quango NICE in new nanny state drive against alcohol

June 07, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The National Institute for Curbing Expenditure (NICE) wants to set a minimum price for a unit of alcohol in its latest wheeze to crack down on problem drinking.
Killer quango NICE in new nanny state drive against alcoholThe public health quango, which labour set up as the Government’s drugs rationing body, has spent two years looking at how to reduce alcohol-related health problems.

One in four people drink at levels that could be putting their physical and mental health at risk, according to official figures.

The move will reignite debate about how best to deal with the problem.

Deaths from alcohol abuse have more than doubled in the last 16 years, with almost 9,000 a year now succumbing to conditions such as alcohol poisoning and liver cirrhosis

More than 860,000 people a year are also admitted to hospital because of alcohol and the cost to the nation of excessive drinking is put at an estimated £27 billion a year.

Health experts and charities have all backed calls for a minimum price per unit to curb Britain’s binge drinking culture.

But many in the drinks and retail industries are strongly opposed to such a move and believe a minimum price would disproportionately hit responsible drinkers.

The move has already been backed by the British Medical Association (BMA) and the Royal College of Physicians.

Analysis by Sheffield University found that setting a minimum price of 50p a unit would save up to 3,400 lives a year without hitting moderate drinkers.

A draft of the Nice guidance, published in October last year, recommended the introduction of a minimum price per unit and said there was “sufficient evidence … to justify the introduction of a minimum price per unit.”

As well as overall consumption levels, a minimum price would also help to reduce binge and underage drinking, advocates believe.

Minimum pricing is expected to have a much harder impact on supermarkets and off licenses than pubs and restaurants, which sell alcohol at higher prices.

Supermarkets in particular have been criticised for selling alcohol at very low prices, including cans of beer for as little as 22p each.

The Wine and Spirit Trade Association said that minimum pricing “would punish millions of innocent consumers” without solving the problem of alcohol misuse.

From: http://www.telegraph.co.uk/Minimum-price-for-alcohol-to-be-backed-by-Nice

Dying cancer patients are denied approved drugs

April 30, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Hundreds of cancer patients may have been left to die without access to life prolonging medication, despite the drugs being approved by the labour government.

A postcode lottery means hundreds of people are missing out on life-prolonging care

Now figures obtained under the Freedom of Information Act show that a cancer patient’s chances of overruling health authorities who deny them access to drugs depends on where they live.

Some NHS trusts, such as Torbay in Devon and Salford in Manchester, granted all appeals while in others, such as Kingston in southwest London, only 7% were granted. In about one-third of trusts, fewer than half of the requests for drugs that can cost thousands of pounds a month were approved.

Access to cancer drugs has become an election issue, with the Conservatives saying they will ensure the National Health Service directs £200m more into supplying new drugs. The money will come from what the health service would otherwise have had to pay to meet Labour’s hike in National Insurance, which the Tories have said they would partially reverse.

The drugs concerned have all been approved by the labour government’s National Institute for Curbing Expenditure (Nice). However, each of 152 primary care trusts (PCTs) in England is allowed to use its own interpretation of Nice’s regulations.

In some cases patients who have already had two courses of chemotherapy are not allowed the drugs; in other cases they must have tried cheaper alternatives before being eligible. Those who do not meet the conditions must appeal to an “exceptional case” panel.

Widespread variation in attitudes between health trusts emerged in research to be published in Health Insurance magazine. It asked how many “exceptional-case funding requests” for cancer were received by trusts in 2009.

It named five drugs, including Rituxan for leukaemia; Tarceva for lung cancer treatment and Revamid for blood cancer.

All such appeals were granted by 17 healthcare trusts, with the areas benefiting ranging from Walsall and Manchester, to Torbay and Suffolk. However, Kingston and Northamptonshire refused most of the appeals made to them.

Forty one of 122 primary care trusts that responded granted fewer than half requests. The figures present an incomplete picture because some trusts may prescribe medicines without the need for patients to appeal. Critics, however, say they still show unacceptably wide variations in practice.

Specialists also complain that the NHS trust officials who decide whether or not to grant the appeals are rarely experts in the disease, so they help to create the wide discrepancies.

Karol Sikora, a cancer specialist at Hammersmith hospital, west London, said his department has a wallchart that marks both sympathetic and unhelpful PCTs. “You find yourself talking to office temps and all sorts of unlikely people who are apparently making these life-or-death decisions,” said Sikora.

NHS watchdog NICE acting against government advice, says cancer group

March 26, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Patients are being denied access to drugs for rarer cancers because the NHS treatment watchdog is acting contrary to the recommendations of a government inquiry, a report claims today.

Analysis by the Rarer Cancers Forum (RCF) suggests that the National Institute for Curbing Expenditure (NICE) is “failing to follow the spirit” of guidelines designed to improve access to end-of-life cancer treatments.

It claims that as many as 16,000 patients have been denied access to drugs because the watchdog had concluded unfairly that they did not meet the criteria for consideration, or they were deemed too expensive — without proper negotiation with pharmaceutical companies.

The report, Exceptional Progress?, looks at improvements to treatment access for people with rarer cancers following a review carried out by Sir Mike Richards, the Government’s national clinical director for cancer.

Sir Mike’s review was prompted by complaints from patients who were denied NHS care after having paid privately for treatment. The Government subsequently lifted the ban on so-called “top-up payments” and said that cancer drugs that were more expensive than NICE normally allowed, but which could offer patients a few more months of life, should be considered.

Andrew Wilson, chief executive of the RCF, said that although progress had been made in improving access to treatments since the publication of the review, there were still serious shortfalls which required urgent review.

“It is unacceptable that many thousands of patients are still missing out on the treatment they need, and which their doctors want to give them, because NICE has decided that their treatment does not meet some arbitrary criteria,” Mr Wilson said.

He added that NICE was failing to assess drugs quickly enough — taking 21 months to appraise new cancer drugs, rather than the six months promised by ministers by 2010.

Until the Richards review, NICE would not approve drugs that cost more than £30,000 to £40,000 for a year of good quality life. The ceiling has since been raised to £80,000.

Sir Andrew Dillon, NICE chief executive, said the watchdog had, in conjunction with the Department of Health, introduced “significant additional latitude in its appraisal of treatments, particularly where they are designed to extend life, at the end of life. NICE and the Department of Health are working together to assess ‘patient access schemes’ – proposals from companies for ways of managing the entry of expensive new treatments into the NHS by sharing some of the costs, and the Innovation Pass – a scheme to support a small number of promising new drugs with funding at a national level.”

From: http://www.timesonline.co.uk/tol/news/uk/health/article7061769.ece