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

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.”


Payout for hospital chief after 90 superbug deaths after DoH bungle

A senior judge has delivered a stinging rebuke to the Department of Health over its treatment of a former head of an NHS trust that experienced the worst superbug outbreak in memory.
Payout for hospital chief after 90 superbug deaths after DoH bungleLord Justice Sedley gave his ruling as the Court of Appeal awarded more than £190,000 in damages to Rose Gibb, former chief executive of the Maidstone and Tunbridge Wells NHS Trust in Kent, where outbreaks of clostridium difficile from 2004 to 2006 infected more than 1,100 patients and led directly to 90 deaths.

Ms Gibb went to court after the Department of Health withheld a six-figure severance payment she had agreed in return for her resignation days before a report into the outbreak was published by the Healthcare Commission.

The judge said the trust had offered to compensate Ms Gibb, who was paid £150,000 a year, so it could “sacrifice on the altar of public relations a senior official who had done nothing wrong”. Its decision was one that “the Department [of Health] does not appear to have cavilled at,” he added.

But when the department later disallowed most of the payment, worth £250,000, it triggered the court action by Ms Gibb.

Lord Sedley said: “The effect of unwarranted departmental interference has been to trap the trust between a rock and a hard place and to expose it, in its attempt to escape, to heavy legal costs.” He added: “It seems that the making of a public sacrifice to deflect press and public obloquy, which is what happened to the appellant, remains an accepted expedient of public administration.”

The Healthcare Commission inquiry into the outbreak, published in October 2007, was highly critical of the trust’s leadership but pinned much of the blame on the Trust’s board – all of whom resigned following its publication.

The Commission’s report said the trust should review its leadership and the trust ordered its legal advisers to report on allegations against Ms Gibb. But no adverse findings were discovered and a decision was made not to remove her by the trust’s Remuneration Committee.

That decision was reversed at a meeting of the committee in September 2007, when it was decided to pay off Ms Gibb before publication of the Healthcare Commission report in October. It was agreed that she would receive £75,000 in lieu of notice and £175,000 compensation.

But the trust rescinded the agreement after being ordered by the director-general of NHS Finance, Performance and Operations to withhold the £175,000 compensation payment, which has since increased to £190,000 with interest.

The Court of Appeal yesterday ordered the trust to pay Ms Gibb the full amount of the compensation plus the costs of the court hearings.

Lord Sedley concluded: “Perhaps those responsible will now reflect that, since such blame as the report allocated was subsequently accepted by the trust’s board – all of whom resigned following publication of the report – there had been no good reason to dismiss the CEO; and that all this money, both compensation and costs, could have been spent on improving hygiene and patient care in the trust’s hospitals.”

Patients and relatives affected by the superbug reacted angrily. Former Bucks Fizz singer Cheryl Baker, whose mother-in-law Doreen Ford died at Maidstone Hospital in 2008 aged 77 after contracting clostridium difficile, called on Ms Gibb to give the money to the families whose loved ones died.


PFI- Private firms should share benefits of big hospital contracts with NHS

The NHS should be allowed to share the benefits of “efficiencies” made by private companies who have won lucrative contracts to build and manage hospitals under the private finance initiative, according to report from the National Audit Office.
PFI- Private firms should share benefits of big hospital contracts with NHSThe report into the performance of PFI in the health service praises the private sector for making savings but with the NHS being asked to find £20bn in efficiencies it recommends that the government looks to recoup some of the money by renegotiating contracts – a move that would be fiercely resisted by the private sector.

There are more than 70 operational PFI hospitals in England, costing around £900 million a year and with a capital value of more than £6bn.

PFI contracts are awarded and managed by local health trusts with the private company building new hospitals and in some cases providing ancillary services such as catering, cleaning and portering.

Amyas Morse, head of the National Audit Office, says that PFI hospital contracts are generally well-managed and achieving the value for money originally envisaged but calls on the department of health to ensure that “efficiencies are sought and that an appropriate share of benefit comes back to the public sector”.

There is also some concern over the expense associated with PFI contracts. The NAO says that while catering is on average slightly cheaper in PFI hospitals, hospitals with “PFI buildings spend more on maintenance annually to keep the buildings to a specified high standard”.

The idea of taking on the private sector over the costs of PFI has been rising up the political agenda. Last year management consultants McKinsey said that since NHS contracts were written at a time of high interest rates, by simply adjusting them to today’s lower rates the government could save £200m a year in running costs.

Other experts have questioned whether enough risk is being borne by the private sector or if the end users of the buildings are best served by the contracts.


Potential of genome medicine could be lost warn scientists

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.”


MS sufferers welcome first licensed cannabis based drug

The first licensed medical drug containing whole cannabis plant extracts has been launched to treat symptoms of multiple sclerosis (MS).
MS sufferers welcome first licensed cannabis based drugSativex will be made widely available after it was approved by the medicines regulator last week.

Taken as a mouth spray, it is used to help alleviate symptoms of spasticity – involuntary muscle stiffness and spasms – associated with MS and is said to be the first symptom relief drug specifically for those with the condition.

It is the first cannabinoid medicine derived from whole plant extracts of the cannabis sativa plant, and is only the second cannabinoid drug to be licensed by the Medicines and Health care products Regulatory Agency (MHRA).

Cannabis is a Class B drug and using it for medicinal purposes remains illegal in the UK.

But doctors can prescribe Sativex to MS patients experiencing the spasms and cramping associated with spasticity.

MS charities welcomed the regulator’s approval of the drug, which was developed by UK-based GW Pharmaceuticals.

Pam Macfarlane, chief executive of the MS Trust, described today’s launch as a milestone.

She said: “We have been aware for a long time, based on comments from people with MS, that cannabis-based medicines can significantly improve spasticity, which is a common, complex symptom of MS.

“For this reason, the MS Trust has campaigned for the availability of a licensed medicine that can be properly controlled and prescribed.”

She added: “The launch of Sativex is a milestone for the NHS and the MS Trust and we are delighted. It will now be down to specialist professionals to assess people and we hope that this can happen quickly.”

Ed Holloway, head of care and services research at the Multiple Sclerosis Society, said: “Sativex can help alleviate one of the most distressing symptoms of MS and its licensing is good news for people with progressive forms of the condition, for whom drugs and therapies are sparse.

“We’d like to see it made available to anybody who might benefit.”

Doctors have been able to prescribe the drug to named individuals at their own risk since 2006, the Home Office said.

About 2,000 people in the UK are already prescribed it on this basis but any MS patient will now be able to request a prescription for the drug from their doctor, meaning many more will be able to obtain it.

About 100,000 people in the UK have MS, a condition of the central nervous system.

It is most often diagnosed in those aged between 20 and 40, with women nearly twice as likely to develop it as men.

It can cause a wide range of symptoms besides spasticity, including fatigue, visual problems, cognitive problems and mood changes.

The only other MHRA-approved drug containing cannabinoid – a compound found in cannabis – is Nabilone, which was licensed in February 1995 for the treatment of nausea and vomiting suffered by cancer patients undergoing chemotherapy.

Unlike Sativex, the cannabinoid’s it contains are synthetic.


Dozens of teenage girls have had three abortions or more

Dozens of teenage girls have had three abortions or more, according to figures that campaigners say paint a profoundly depressing picture of modern Britain.
Dozens of teenage girls have had three abortions or moreThese statistics follow controversy last month over the UK’s first ever television advertisement for abortion services.

Government data have disclosed that 89 girls aged 17 or under who terminated a pregnancy last year had had at least two abortions previously.

The head of Britain’s largest abortion provider said many young women were living chaotic lives that meant they could not organise contraception.

Christian doctors said the statistics demonstrated the failure of liberal sex education policies and nanny state edicts.

The Department of Health figures for 2009 show that, for the first time, more than a third (34 per cent) of abortions were performed on women who had already ended one or more pregnancies.

Across all ages, more than 1,000 women or girls were on at least their fifth termination, including 214 on their sixth, 70 on their seventh and 48 who underwent the procedure for at least the eighth time.

Ann Furedi, the chief executive of the British Pregnancy Advisory Service, said repeated pregnancies among teenage girls were often caused by chaotic lifestyles and difficulties they had in using contraception.

She said: “With teenage girls, often they feel able to handle sex, emotionally and physically, yet aren’t able to handle the planning that comes with contraception.”

Dr Peter Saunders, from the Christian Medical Fellowship, which represents Christian doctors, said that the figures were profoundly depressing. “It is increasingly clear that abortion is simply being used as a form of contraception by a growing percentage of girls and women, and that tired policies of values-free sex education, condoms and morning-after pills are not working,” he said.

The total number of abortions in England and Wales last year, 189,100, fell slightly on the previous year. Of those, 63,390 involved women who had previously ended a pregnancy, compared with 51,987 a decade ago — a rise of 22 per cent.

Almost 18,000 abortions were carried out on girls aged under 18, including more than 1,000 on girls aged 14 or under. The statistics follow controversy last month about Britain’s first television advertisement for abortion services.


NHS waiting times targets relaxed and abandoned

NHS Hospital waiting times have been relaxed or scrapped as part of a drive by the new Government to rid the NHS of Labour’s ‘target culture’.

Nursing and doctors’ leaders welcomed the greater flexibility they have been given to treat patients according to clinical need rather than being forced to stick to strict central guidelines.

But patients’ groups expressed concern that the reforms could result in a “free-for-all,” and that without targets long waiting times could return to the NHS.

GPs will no longer be forced to see patients within 48 hours of them seeking an appointment.

The requirement for 98 per cent of patients attending Accident and Emergency wards to be seen within four hours has been relaxed to 95 per cent.

And the target for patients to be given a hospital appointment within 18 weeks of being referred by their GP has been abandoned altogether.

Andrew Lansley, the Health Secretary, insisted that people would still have the right to demand high levels of service from the NHS, but that this would be done locally rather than dictated from the centre.

“I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes,” he added.

“Doctors will be free to focus on the outcomes that matter – providing quality patient care.”

Katherine Murphy, director of the Patients Association, said: “The targets focused minds in the NHS, made people start realising services had to get better.”

But Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, welcomed the relaxation in targets.

He said: “Patients should have good access to GPs. However, while this target may have been intended to improve access it has in fact had adverse consequences.

“At the moment practices need to have enough appointments available on the day or the following day to meet the target, so those who want to book in advance find there are fewer appointments available.”

Under the changes to the NHS Operating Framework, Mr Lansley has also ordered health bodies to reduce management costs from £1.85 billion to £1 billion by 2013.

While spending on the health service will continue at current levels, he said it was crucial to make “immediate” savings which could be reinvested in patient care.


One in 10 brain tumour sufferers see their GP eight times before referred to specialist

One in ten brain tumour sufferers see their GP eight times before they are referred to a specialist with a quarter visiting their family doctor four times.

The Samantha Dickson Brain Tumour Trust, which carried out the research, warned that it had heard of patients being forced to buy their own brain scans, at a cost of hundreds of pounds, to prove to their GPs that they had the disease.

Almost one in three of those surveyed waited more than three months before they were diagnosed.

The charity warns that early diagnosis is crucial in the condition, which is often deadly.

Even if a patient’s life cannot be saved, early diagnosis and treatment can give them longer to spend with their loved ones.

And for those who do survive speedy treatment can cut their chances of suffering long-term disability.

In one of the largest surveys of its kind, the Trust asked 350 brain tumour patients how they had been diagnosed.

Brain tumours can be difficult to identify because the common symptoms, which include headaches, fits and vomiting, could be indicative of a number of other conditions.

The charity is calling for an end to the “gate keeping” approach to carrying out brain scans.

Patients with persistent symptoms that could suggest that they have a brain tumour should be given the scan to offer “positive reassurance” that they do not have the disease, said Paul Carbury, chief executive of the trust.

The charity is also drawing up a guide to symptoms for GPs which they plan to launch later this year.

Mr Carbury added: “These results confirm that we still need to educate the public and the primary health care professionals about this devastating illness and make them aware of the recurring warning signs.”

He added: “If ‘red-flag’ symptoms persist for around two weeks … then individuals should be referred for a scan as only this will confirm the presence of a brain tumour.

“Early diagnosis is critical as the quicker a tumour is identified, the more readily treatment can be administered which can then have a positive effect on the prognosis, quality of life and likelihood and burden of disability.

“Early diagnosis would also reduce the chance of emergency admissions where people are presenting at accident and emergency departments, for example, in a critical condition.”

An estimated 6,500 people a year in Britain are diagnosed with a primary brain tumour, that is a cancer that starts in the brain rather than one that begins in another part of the body and spreads.

Brain cancer are extremely deadly and around 3,400 lives a year are lost to the disease in Britain.

Brain tumours are the leading cause of cancer deaths in children and also cause more deaths in the under 40s than any other type of cancer.

While other cancer survival rates have increased in recent years, those of brain cancer, often described as the “forgotten cancer”, have barely changed over the past three decades.

Around 8,000 people a year in Britain suffer from cancer which spreads to their brain.


Thousands of hospital patients dying because too few senior staff work weekends

Health Direct warns that with the weekend coming up, patients are much more likely to die if they are rushed to hospital at weekends than during the week, because too few senior staff are working.
Thousands of hospital patients dying because too few senior staff work weekendsHigher deaths rates at weekends mean thousands of patients every year are dying unnecessarily, according to the findings.

Patients were seven per cent more likely to die if they were admitted as an emergency case on a Saturday or Sunday, the largest study of its kind shows.

The higher rates were equivalent to 3,369 extra deaths a year, more than the total number who die every year on Britain’s roads.

Conditions including heart attacks, heart failure, stroke and some cancers all had higher deaths rates at weekends than Monday to Friday.

The team behind the findings warned that a lack of senior staff, such as consultants, working weekends and reduced access to specialist services could be behind the higher death rates.

Hospitals should look closely at weekend staffing rotas and other potential problem areas, according to researchers.

Dr Paul Aylin, from Imperial College London, who led the study, said: “We estimate that there were over 3,000 more deaths than expected at weekends in 2005/06 compared to weekdays – more than the number of people dying in road accidents in 2006.

“Clearly this is a significant number of people and we need to get to the bottom of what this means. Staffing levels are often lower at weekends, with fewer senior medical staff around, and some specialist services are less available.

“We believe this may be contributing to the increase in mortality rates on Saturdays and Sundays but we would like to see more research.”

The study looked at all emergency patients admitted to 163 hospital trusts across England between 2005 and 2006.

The findings are published in the journal Quality & Safety in Health Care.

The study, supported by Dr Foster Intelligence, the independent research company, reviewed more than four million admissions and 215,000 deaths.


Huge disparity in NHS hospital death rates found

Patients less likely to die in some hospitals finds Guardian investigation which suggests that vascular surgery patients are less likely to die in bigger, busier hospital units. huge disparity found in nhs hospital death ratesDoctors in the NHS do not know how well they are performing and whether they are more likely than their colleagues to kill or cure their patients, because of a widespread failure to collect the information, a Guardian investigation reveals.

The results of a major exercise looking at one particular procedure – vascular surgery – show a massive variation in death rates among patients admitted for planned operations and reveal that some hospitals have unacceptably high mortality.

The investigation reveals the hollowness of patient choice, which the coalition, like Labour before it, has made the centrepiece of NHS policy. The data amassed by the Guardian from surgeons at 116 hospital trusts after an extensive freedom of information trawl is not publicly available – and is at odds with what appears on the NHS Choices website, set up to help patients choose where to be treated.

The Guardian investigation focused on vascular surgery, where there is a significant risk of dying in planned operations, but the conclusions apply to every other branch of medicine – with the exception of heart surgery, where doctors collect and publish their individual results.

They embraced transparency following the Bristol babies scandal in the late 1990s, when doctors were struck off the medical register over the deaths of babies who underwent operations for heart defects that they might have survived at other hospitals.

The investigation reveals that:

• More than a decade on from Bristol, doctors are failing to collect and publish data that would tell them and their patients how well or badly they are doing and allow patients to chose a hospital where their risks are lowest.

• Death rates in planned vascular surgery for abdominal aortic aneurysm (AAA – to prevent a burst artery) vary from under 2% in some hospitals to at least 10% in 10 of them. More than 5,000 of the operations are carried out each year – most of them planned admissions in which the patient decides where to go for surgery.

• Patients are less likely to die in the bigger, busier hospital units where surgical teams are more skilled because they do more of the operations. The results strongly suggest that smaller units should close. This presents a major challenge to the health secretary, Andrew Lansley, who has stopped all hospital reorganisation.

The most worrying death rates were at Scarborough hospital in Yorkshire, where 29% of patients scheduled in advance for AAA surgery died in the three-year period from 2006 to 2008. The national average was just over 4%. Scarborough says it has now stopped offering the operation.

Results for planned surgery at several other hospitals also gave cause for concern, including Gateshead on 12.9%, Hull on 9%, Pennine Acute Trust on 8.4% and Leeds on 7.1%. Gateshead and Hull blamed a high number of difficult cases, Pennine argued there had been an issue around the way transferred cases were recorded, which is now resolved. Leeds pointed out that it takes difficult cases and has brought its death rates steadily down.

The data also shows the UK lagging in Europe. The second Vascunet report, on vascular surgery across 10 European countries in 2008, found the average death rate was just 2.8%.

Professor Sir Bruce Keogh, medical director of the NHS and a former heart surgeon, who was involved in successful efforts to publish mortality data in cardiac surgery said: “Surgeons have a moral and professional duty to know what they are doing, how well they are doing it and to use that information to help them improve – otherwise they have no right to be doing it at all.” He intends to take steps to ensure that senior doctors personally take responsibility for the accuracy of data relating to their specialist area that is published by their trust – whether in surgery, cancer care, diabetes or arthritis.

David Mitchell of the Vascular Society, which has been collecting mortality data on a voluntary basis from surgeons for several years but does not publish it, said they had embarked on a quality improvement programme, aimed at bringing the average death rate down to 3.5%.