Family doctors are being prevented from prescribing drugs for conditions such as diabetes, heart disease and osteoporosis as NHS managers attempt to make drastic budget cuts, an investigation has found.
Primary care trusts are adding more medicines to their so-called “red lists” which means they can only be prescribed by a hospital consultant and not a GP.

The measure is designed to save money by restricting access to drugs that are often among the more expensive. It also means that many patients find it more difficult to obtain the most effective drugs free on the NHS, even though they have been approved by the medicines rationing watchdog Nice.

Patients’ groups described the disclosure as “outrageous” and “extremely worrying”.

Examples of medications moved to red lists include a class of diabetes drugs called gliptins; treatments for Parkinson’s disease; a drug that helps lower the risk of fractures in osteoporosis sufferers; and certain types of statins for those at greater risk of heart disease.

One health authority has added 32 drugs to its red list in the past year, while another said it intended to fine doctors who wrote letters requesting that such medicines be prescribed.

Last night, the Department of Health suggested that trusts should look to make savings elsewhere before trying to restrict access to drugs.

According to a survey carried out by Pulse, a magazine for GPs, 73 out of 134 primary care trusts which responded to Freedom of Information Act requests said they had put more drugs on red lists, or added new restrictions on GPs prescribing them, in the past year.

Drugs are prescribed using a “traffic lights” system. If a medication is deemed “green” then GPs are free to prescribe it; if it is “amber” they have to discuss prescription with a specialist; if it is “red” then only a specialist can do so.

Dr Bill Beeby, the chairman of the British Medical Association’s clinical and prescribing committee, said the status of drugs should be based solely on clinical grounds.

But he added: “There are lots of people who try to put drugs on these red lists on the basis of cost.”

With trusts under pressure to make savings estimated at £1.9 million each this year, the study suggests that increasing numbers are restricting access to drugs.

NHS Cambridgeshire has added 32 drugs to its red list over the past year, Pulse found, taking the total to more than 100.

NHS Warrington has added 25 “areas” of prescribing to its list, including the statins Crestor (also known as rosuvastatin) and Lipitor (atorvastatin).

The “areas” include drawing to a halt to “routine prescribing for longer than three months for patients who live abroad”.

NHS Derby City estimates that it will save £781,000 by “decommissioning” 13 drugs, including Intanza, a flu vaccine which uses a very short needle for those who dislike jabs, and Grazax, a grass allergy tablet.

Katherine Murphy, chief executive of the Patients Association, described the bans as “a real worry”. “What’s the point of Nice approving medicines if they are not being made available?” she said.

Barbara Young, chief executive of Diabetes UK, said: “People’s health must not be compromised with an attempt to cut costs. This would be a very short-sighted policy as complications of diabetes, such as kidney failure, are hugely expensive.”

Most drugs prescribed by GPs are so-called “generics”, meaning they are cheap versions of drugs that are no longer subject to a monopoly of production. However, there are no alternatives for some newer, more expensive drugs.

Dr Dermot Neely, an expert on statins at the charity Heart UK, said of the increased use of red lists: “It is an extremely indiscriminate and ill-advised policy, if it’s being used by PCTs to constrain costs.”

Studies show that switching from branded statins to generics results in more heart attacks and deaths, he added.

Richard Hoey, the editor of Pulse, said: “Many of the drugs approved by Nice or other national bodies are not only cost-effective, but are likely to recoup some of the price in the long-term by reducing rates of illness.

“These bans on prescribing drugs are therefore not only damaging to the care of patients, but quite possibly a false economy.” Although its budget has been protected, the NHS is committed to making efficiency savings of up to £20?billion a year by 2014.

Although the red list is only for guidance, GPs often feel pressured into following the advice because trusts hold the purse strings.

From: http://www.telegraph.co.uk/Patients-are-denied-high-cost-drugs-by-NHS-trusts

Commonly used painkillers increase the risk of heart attacks and strokes when taken at high doses or over the long term, according to research.
Experts analysed more than 30 clinical trials on more than 116,000 patients to examine the effects of painkillers on people’s health.

The fears relate to non-steroidal anti-inflammatory drugs as well as newer anti-inflammatory drugs known as Cox-2 inhibitors.

Doctors regularly prescribe such drugs to treat painful conditions, including osteoarthritis.

They are given at much higher doses than those found in over-the-counter remedies, which are used for occasional headaches, aches and pains.

The study, in the British Medical Journal, found that compared with a dummy drug lumiracoxib increased the risk of heart attacks, while ibuprofen was linked to the highest risk of stroke (more than treble the risk).

Diclofenac almost tripled the risk, while etoricoxib and diclofenac were associated with around a fourfold increased risk of suffering death from cardiovascular causes.

The authors, from the University of Bern in Switzerland, said: “Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms.”

In an accompanying editorial, Prof Wayne Ray, from the department of preventive medicine in Nashville, said: “Naproxen seemed least harmful.

“Cardiovascular risk needs to be taken into account when prescribing any non-steroidal anti-inflammatory drug.”

Overall, the number of heart attacks and strokes reported was low compared to the number of patients.

In 29 of the trials, there were a total of 554 heart attacks and in 26 trials there were 377 strokes. In 28 trials there were 676 deaths.

From: http://www.guardian.co.uk/high-doses-painkillers-stroke-risk

The first trial among the over 50s in the UK of the “polypill”, a daily tablet combining several low-dose drugs that could protect against heart attacks and strokes, is being launched this month.
The idea was proposed by two British professors in 2003. Prof Sir Nicholas Ward and Prof Malcolm Law, from the Wolfson Institute of Preventive Medicine at Queen Mary, University of London, suggested in a paper in the British Medical Journal that a pill combining low doses of several drugs to bring down cholesterol and blood pressure could save lives.

Ward and Law wrote in their paper: “The polypill strategy could largely prevent heart attacks and stroke if taken by everyone aged 55 and older and everyone with existing cardiovascular disease. It would be acceptably safe and with widespread use would have a greater impact on the prevention of disease in the western world than any other single intervention.” Richard Smith, then BMJ editor, said it was possibly “more than 50 years since we published something as important as these papers”.

The idea has gained currency and is being explored by more than one team of researchers. While some scientists are investigating a pill they christened the “red heart”, which they hope will cut heart disease deaths among those already known to be at risk in Asia, the Wolfson researchers continue to focus on the original concept.

They hope the trial, which begins this month, will pave the way for a pill which anybody over 50 in the UK will be able to obtain at low cost from a pharmacy within a couple of years.

One of the researchers conducting the trial at the Wolfson Institute, Dr David Wald, said: “The polypill has the potential to be a daily preventive method against heart attacks and strokes, just as the contraceptive pill is a daily preventive method to avoid an unwanted pregnancy. This trial is a step towards making access to the polypill a reality.”

The pill is being made by the Indian generics company Cipla. All components are out of patent and therefore can be copied and are cheap. It contains simvastatin to lower cholesterol and three drugs at half the standard dose to reduce blood pressure – losartan, hydrochlorthiazide and amlodopine.

Unlike the red heart, which is intended for people who have already suffered heart problems, the polypill does not contain aspirin as originally envisaged by Ward and Law in 2003. Aspirin is known to protect against heart attacks and stroke, and trials recently showed there were more than 20% fewer deaths from certain common cancers in people who took a daily low dose of aspirin.

But the Wolfson team want to minimise potential side-effects to make the pill safe for everyone to take, and aspirin has been shown to sometimes cause stomach bleeding.

Wald said: “By offering the polypill on the basis of age alone, prevention is greatly simplified and the population receiving the polypill are not medicalised, because they do not have to become patients to receive it.”

The trial will include 100 people, selected on the basis of age alone, who will take the pill for 12 weeks and a placebo for 12 weeks, without knowing which one is which. They will be monitored for the effects on their blood pressure and cholesterol levels. At the end of the 24 weeks, all will be given the polypill for a further two years to help assess the long-term benefits.

Because the drugs which make up the polypill are all well-known and are often taken together, even if not in a single tablet, there would not have to be the usual long licensing process to get the polypill on the market.

Within 18 months or two years, the researchers hope it may be universally available, although they still envisage that it may be prescribed by a pharmacist, rather than sold over the counter.

From: http://www.guardian.co.uk/heart-attack-stroke-polypill-trial-begins

The scale of the “postcode lottery” of care that patients can expect across England, and the different amounts of money health authorities spend on problems, has been highlighted for the first time in an NHS survey.
The NHS Atlas of Variation has found that some NHS trusts are failing in key areas including cancer, stroke, and diabetes care.

For the first time geographical differences have been drawn together into a series of 34 maps that the public can view online to see how well their region is performing.

It shows a 14-fold difference in spend on broken hips between best and worst areas; a four-fold variation in the proportion of stroke patients who spend almost all their hospital time in a dedicated stroke unit; and a 38-fold difference in rates of obesity surgery.

Some health authorities spent more than two-and-a-half times as much on mental health services, while there were similar differences in spend on inpatient cancer care.

Lord Howe, the Health Minister, welcomed publication of the atlas, saying: “In order to improve unwarranted variations in services, it is vital to expose existing flaws in the system.”

Charities said the move demonstrated greater openness but warned the variations showed patients were being let down in many areas.

Prof Chris Ham, chief executive of The King’s Fund, a health think-tank, said the atlas “brings into sharp relief variations in the quality and cost of care across the NHS”.

He said: “With the NHS needing to find £20 billion a year in productivity improvements, reducing unwarranted variation is no longer an option – it is a necessity.”

Many of the maps are standardised to take account of differences in age, sex and prevalence of the condition – some of the major reasons typically cited for variations in care.

The report therefore reveals that practices between NHS trusts vary in ways that cannot always be explained by social or patient factors.

The amount spent on broken hips by primary care trusts (PCTs) ranged from little over £500 per 1,000 people to more than £8,000 – even after differences in local population need were taken into account.

Rates of obesity surgery ranged from just 1.1 operation per 100,000 population to 38.9, with higher rates tending to be in poorer areas.

On cancer, some PCTs spent more than £40,000 per 1,000 population on inpatient care while others spent less than £20,000. Devon, Suffolk and Cambridgeshire were among the higher spenders and parts of London towards the lower end.

However, Mike Hobday of Macmillan Cancer Care said this was one area when higher spend was not necessarily a good thing.

He said: “We think spending less money on inpatient cancer care is better, because that means people are being supported more effectively.”

Shorter hospital stays – and hence lower inpatient costs – indicated better cancer therapies and back-up-treatment were being used, he explained.

Regarding variations as a whole, he added: “What this shows is that the NHS still isn’t very good at sharing good practice from one hospital to another.”

However, he welcomed publication, saying it demonstrated greater “openness”.

The percentage of patients receiving nine key checks on their diabetes control – including for kidney damage, cholesterol and weight – varied from 60 to 70 per cent in Norfolk and parts of Yorkshire to zero to around 40 per cent in places like Cornwall, Lincolnshire and Northamptonshire.

Barbara Young, chief executive of Diabetes UK, said the charity was “seriously concerned”.

“This demonstrates that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery,” she said.

Everyone aged over 45 should consider a small daily dose of aspirin to help protect themselves against heart disease and cancer, a panel of experts have suggested.Evidence is building that the benefits of taking aspirin for many healthy middle aged and older people “far outweigh” the side effects, according to the academics.

In particular, individuals at higher risk from the country’s two biggest killers would be helped by taking the painkiller as a preventive medicine, they added.

The experts were speaking at the Royal Society of Medicine a month after research from Oxford University published in The Lancet showed that taking 75mg of aspirin daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third.

A 75mg dose is a quarter of the standard over the counter pill.

Earlier studies had already shown that a low daily dose could reduce the risk of developing heart disease.

Members of the panel said that the recent research was potentially of “enormous importance” to public health.

Bowel, or colorectal, cancer is the third most common form of the disease in Britain, with 39,000 diagnoses annually and 16,000 deaths.

The Lancet study suggests greater aspirin use could potentially save thousands of lives a year in relation to this one cancer alone.

But research is also looking into whether aspirin could have a preventive effect on other types of cancer as well.

Combined, all cancers claim more than 150,000 lives in Britain every year, while cardiovascular disease accounts for some 200,000 deaths.

Prof Peter Rothwell, the Oxford neurologist who led the bowel cancer study and was part of yesterday’s panel, has started taking a daily dose of aspirin himself. He said: “I suspect that in five to 10 years’ time we will be prescribing aspirin to middle-aged people, not only for the known vascular benefits.”

But members of the public might take matters into their own hands before then, he predicted.

“If it becomes clear that there are benefits for other cancers, then the balance of risk and benefit will become so clear that people may take the decision to take it for themselves,” he said. “It seems implausible that this effect on colorectal cancer is going to be a completely isolated phenomenon in relation to other cancers, given that we know that there are similarities between how cancers develop.”

Prof Rothwell said that he thought it would be “sensible” for people to start taking aspirin at about 45, when the chance of developing bowel and other cancers began to rise. “The risk of cancer goes up substantially between the age of 40 and 55,” he said.

As aspirin had a preventive effect, it was advisable to start taking it daily towards the beginning of that period, he explained. However, he said it was ultimately up to individuals to decide whether to take the drug, “rather than us making definitive statements”.

Prof Peter Elwood, of Cardiff University’s School of Medicine, who conducted the first trial into the effect of aspirin on heart disease in the 1970s, said: “I think we are on the brink of another breakthrough of enormous importance to the community in general.”

Prof Gordon McVie, a leading cancer specialist, from the European Institute of Oncology, said the discussion among the experts was whether this was metaphorically a “put-it-in-the-water moment”.

Opinion on the subject varies however. Experts are divided particularly over the question of to whom aspirin should be recommended as a daily preventive medicine.

The drug was formulated as a painkiller more than a century ago but researchers are finding that it can help in diseases ranging from heart disease to dementia.

Advocates believe that its active ingredient is akin to a vitamin that almost everybody should take, as our modern diet does not provide it. Others point out that taking the drug is known to double the incidence of intestinal bleeding, from about one in 1,000 people per year to about two.

The question is how much of the population – in terms of their age and their risk of developing serious diseases – should be recommended to take aspirin on a daily basis.

Prof McVie said: “I think there’s a frankly conservative feeling in this group, that for [colorectal] cancer, it should be targeted for people at higher risk.”

Prof Sir John Burn, a geneticist at Newcastle University, said: “The problem is, if we recommend something to the whole population, then we will see side effects.

“We know aspirin can cause gastrointestinal bleeding. That is to some extent holding back the situation.” Prof Dion Morton, a colorectal surgeon at University Hospital Birmingham, was another of those attending yesterday’s meeting, which was convened by the Aspirin Foundation.

He said that medicine was increasingly using a “stratified approach, where we target the right drugs at the right patients”.

He thought regulatory approval should be sought for doctors to prescribe aspirin as a preventive medicine for those at a higher risk of bowel cancer. “If they have not been told in writing they should be advocating it, they won’t advocate it,” Prof Morton said.

While intestinal bleeding was serious, research suggested that aspirin increased the risk only of less serious cases, said Prof Elwood. He said there was some evidence that the intestines adjusted to aspirin over the long term.

From: http://www.telegraph.co.uk/Daily-aspirin-dose-for-everyone-over-45-to-protect-from-cancer-heart-disease

Nineteen hospital trusts were exposed as having alarmingly high death rates in a major report that also reveals how hundreds of people are dying needlessly because of substandard NHS care.
The Dr Foster hospital guide, which the Observer published exclusively yesterday, disclosed that tens of thousands of patients were harmed in hospital last year when they developed avoidable blood clots, suffered from obstetric tears during childbirth, had objects left inside them after operations or were not given immediate treatment after a stroke.

The authoritative study also identifies four hospital trusts where an unexpectedly high number of patients died after developing complications following routine operations. It names Hull and East Yorkshire Hospitals NHS Trust as the place where patients have the highest risk of dying in these circumstances – 66% above the average.

Last year that equated to 33 deaths more than expected there, although it is not possible to say how many of these deaths could have been prevented. Dr Foster says the mortality rate is too high to occur by chance and is a warning sign of potential issues in the quality of care provided.

The Care Quality Commission – the NHS watchdog for England – will now investigate the trust.

Andrew Lansley, the health secretary, welcomed the report last night and increased the pressure on the NHS to improve patient safety by warning that lax procedures were costing lives.

He wrotes in the Observer: “Safe care saves lives and saves money. Adverse events like high levels of infection, blood clots or falls in hospital, emergency readmissions and pressure sores cost the NHS billions of pounds a year. There is a serious human cost, too, with patients ending up injured, or even killed. Most are avoidable with the right care.”

The minister sets out plans to eliminate what he calls a “culture of blame and secrecy in the NHS that can compound the initial mistake and stop lessons being learned”.

Dr Foster’s report reveals that, despite recent improvements, in 2009-10:
¦ Almost 10,000 patients suffered an accidental puncture or laceration.
¦ More than 2,000 had post-operative intestinal bleeding.
¦ More than 13,000 mothers suffered an obstetric tear while giving birth.
¦ Some 30,500 patients developed a blood clot.
¦ 1,300 patients contracted blood poisoning after surgery.

Naren Patel, who chaired the National Patient Safety Agency (NPSA) until June, said some patients were dying because – as the report confirms – the NHS was still failing to provide high enough quality care in key areas, despite many initiatives from influential bodies.

“It [the report] identifies three or four key areas, such as with strokes, blood clots and prostate care, where there’s evidence that optimum care is still not being delivered,” said Patel. “Therefore some people do die unnecessarily because they haven’t received the best possible care.”

The NHS Confederation, which represents hospitals, conceded more action was needed. “There are still parts of our health system where particular services are having problems, and for the hospitals concerned this report presents an opportunity to learn and improve,” said acting chief executive Nigel Edwards. “There will always be variations in any nationwide system but the golden principle must be that our NHS is safe for the patients who rely on it. This report shows where we can do better.”

Peter Walsh, of patient safety charity Action against Medical Accidents, said: “This report confirms that far too little progress has been made on patient safety. Our system of regulation is failing to deliver consistently good quality care across the country or pick up on unacceptable variations and intervene.”

He also accused ministers of recently backtracking on a pledge to require hospitals to always tell a patient or relatives when a blunder occurs, which could let mistakes be covered up. “Mr Lansley and the coalition government say almost all the right things about patient safety, but now is the time to see them put their money where their mouth is. The worry is that political correctness about not regulating and the financial cutbacks will mean patient safety loses out,” Walsh warned.

John Healey, Labour’s shadow health secretary, welcomed Dr Foster’s disclosure that 30% fewer hospitals than in 2008-09 have unexpectedly high death rates. But he claimed the coalition’s NHS reforms would worsen the problem. “The health secretary should make patient safety and care top of his in-tray, instead of forcing the health service through a £3bn internal reorganisation.

“Andrew Lansley has to drop his hands-off attitude to problems in the NHS and tell people in Hull [and other areas] what he’s going to do to make their hospitals safer and better.”

From: http://www.guardian.co.uk/hospital-death-rates-nhs-dr-foster

Raising the dose of cholesterol lowering statin drugs could prevent many more heart attacks and strokes, say researchers.
UK and Australian teams compared a standard statin treatment with a more intensive therapy, publishing results in the Lancet medical journal.

They concluded that higher doses cut heart attacks and deaths by 13%.

Experts warned that a bigger dose of the most popular statin could produce many more cases of side effects.

Statins cut levels of so-called “bad” LDL cholesterol, and the risk of heart attacks and strokes in higher risk patients.

Almost two million people in the UK are prescribed them, and one type is even available over the counter at pharmacies to patients assessed as at “moderate” cardiovascular risk.

The two studies in the Lancet were carried out at the universities of Oxford and Sydney, and pooled the results of dozens of other trials to give a more reliable verdict on the likely benefits and risks of doing this.

In the first study, when a standard statin regime was compared to an “intensive” regime, further drops in LDL cholesterol levels were produced.

In turn, there was a 15% further reduction in “major vascular events” – which included a 13% drop in heart deaths and non-fatal heart attacks, 19% fewer operations to treat heart disease, and a fall of 16% in the number of strokes.

The other study also revealed falls in LDL cholesterol and “vascular events”.

Commenting on the study, two academics, Professor Bernard Cheung and Professor Karen Lam, from the University of Hong Kong, said that people with a “substantial” heart or stroke risk should have intensive statin treatment.

Even those with apparently low LDL cholesterol could benefit, they said.

They added: “At the population level, statins are underused, so the urgent priority is to identify people who would benefit most from statin therapy and to lower their LDL cholesterol aggressively, with the more potent statins if necessary.”

However, the study authors warned that simply raising the dose of the most commonly-used statin in the UK, simvastatin, the version available direct from pharmacies, might be counterproductive.

A rare side-effect of low-dose simvastatin is muscle weakness, known as myopathy. In some cases this can lead to more serious muscle damage.

At a low dose, three in 10,000 (0.03%) patients developed myopathy, but when a higher dose of simvastatin was prescribed, this jumped to nine in a 1,000 (0.9%).

Dr Louise Bowman, one of the researchers, said: “It may be safer to lower cholesterol using low doses of the more potent statins rather than increasing the dose of simvastatin.”

This advice was echoed by the British Heart Foundation, which part-funded the study.

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said that simply “ramping up the dose” of simvastatin might not be the best option.

He said: “We know that cholesterol is a major risk factor for heart disease – cutting it cuts your risk of a heart attack. However it’s been unclear whether going the extra mile to lower cholesterol even further, pays off.”
From: http://www.bbc.co.uk/news/health-11712569

Poor kidney function could be an early warning of heart disease and stroke, two studies have found.
In the first study, researchers from Taiwan and the US found that a low fluid rate through the kidneys was linked to a higher risk of stroke in later life.

By analysing 33 studies involving more than 280,000 people they found that those with a glomerular filtration rate of about half the normal level, had a 43 per cent higher risk of suffering a stroke in the future. Asian people with a low filtration rate were at a higher risk than non-Asians.

The academics, led by Bruce Ovbiagele, a stroke expert at the University of California, Los Angeles, recommended that treatments to lower the risk of strokes should be given to those with poor kidney function, such as taking cholesterol-lowering drugs like statins.

The second study, by British and Icelandic researchers, found that even people with the earliest stages of kidney disease were at an increased risk of developing coronary heart disease. Their study tracked almost 17,000 people living in Iceland over a 24 year period.

The presence of chronic kidney disease could be used as a predictor of heart disease, although only a “modest” one, they found.

It provided about half as much predictive gain as did history of diabetes or about a sixth as much as did history of smoking.

Both were published in the British Medical Journal last week.
From: http://www.telegraph.co.uk/Poor-kidney-function-related-to-strokes-and-heart-disease

Taking a quarter of an aspirin pill every day can help prevent bowel cancer, with the benefits growing the longer it is taken, scientists claim.
A daily 75mg dose – lower than the recommended dose for a child – can provide significant protective effects after just one year, researchers said.

Even people not considered to be at high risk of the disease could benefit from taking the painkiller, they said, regardless of their diet or lifestyle.

According to the study, taking 75mg of aspirin every day for between one and three years cut the chances of developing bowel cancer by 19 per cent.

After three to five years the risk decreased by 24 per cent, and after five to ten years of taking the drug the chance of bowel cancer was down by 31 per cent.

There was no noticeable benefit in taking aspirin or any other non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for people who already had bowel cancer.

The disease, which is the second most common cause of cancer death in the world, kills more than 16,000 people in Britain every year, with 38,500 cases diagnosed in annually.

Previous research had indicated that aspirin protects against bowel cancer, but it was unclear what the most effective dose was, and how often it should be taken.

The usual aspirin dose for an adult, when used for pain relief, is between 300mg and 900mg.

NSAIDs have previously been linked to an increased risk of internal bleeding.

But the study of 2,800 people with bowel cancer and 3,000 healthy people, published in the journal Gut, showed that a much smaller dose of just 75mg could provide significant protection against the disease.

The same dose is sometimes recommended for people recovering from heart attacks and stroke.

Some 18 per cent of healthy people studied said they were taking a low dose of aspirin, or other NSAIDs, at least four times a month, along with 16 per cent of those who had bowel cancer.

While there was no evidence taking NSAIDs influenced the risk of death in bowel cancer patients, it did have a significant protective effect for those who did not have the disease at the start of the trial.

Steve Williamson, Consultant Pharmacist in Cancer at the Royal Pharmaceutical Society, said: “This study adds to the weight of evidence already around that daily low dose aspirin can reduce risk of developing bowel cancer.

“However people must remember that aspirin even at its lowest dose isn’t suitable for everyone, and patients should always talk to their doctor or pharmacist about the potential benefits of taking aspirin.”

Mark Flannagan, chief executive of Beating Bowel Cancer, said: “These findings are encouraging, particularly as, unlike previous studies, this shows that even the lowest daily dose can have an effect on risk reduction after just one year.”

From: http://www.telegraph.co.uk/Small-dose-of-aspirin-can-ward-off-bowel-cancer

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.
Some 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