Cosmetic surgery cooling off period suggested

Doctors who carry out cosmetic procedures should give patients time to think before agreeing to go ahead.

Cosmetic surgery cooling off period suggestedThe General Medical Council (GMC) has produced the guidance to make surgical and non-surgical procedures, such as facelifts, breast implants, dermal fillers and Botox, safer.

It will now consult doctors and the public about the guidance, however plastic surgeons said they were already using a two week cooling off period.

In 2013, a report by NHS England’s medical director highlighted the risks associated with the cosmetic sector.

This followed safety concerns after nearly 50,000 women in the UK had PIP breast implants fitted.

The French implants were made from an unauthorised silicone filler and were found to have double the rupture rate of other implants.

In January, the Royal College of Surgeons published a consultation on proposals to improve standards in cosmetic surgery.

The GMC sets the standards that are expected of all UK doctors who carry out cosmetic procedures. It also tries to help patients understand what to expect from their doctor.

Some of the main points in the new guidance say that doctors should:

  • Be open and honest with patients and not trivialise the risks involved
  • Give patients enough time and information before they decide whether to have a cosmetic procedure, allowing them time to “cool off”
  • Ask patients to tell them how they have been affected by a cosmetic procedure, both physically and psychologically
  • Not target people under 18 through their marketing and seek additional advice from professionals who treat young people
  • Seek their patient’s consent themselves rather than delegate it
  • Not make unjustifiable claims about the results they can achieve and not give away procedures as prizes

Prof Terence Stephenson, the chairman of the General Medical Council, said some patients in this area were vulnerable and needed protecting.

“We are clear that doctors must not pressure patients to make rushed decisions they may end up regretting and they must give them enough information so they can make an informed choice.”

Rajiv Grover, consultant plastic surgeon and former President of the British Association of Aesthetic Plastic Surgeons (Baaps), welcomed the GMC’s guidance because he said some patients were psychologically unsuitable for cosmetic surgery.

“Cosmetic surgery has for too long been seen as a commodity but unfortunately once an operation is done – it can’t be taken back to the shop.”

He said Baaps had insisted on a two week cooling off period for many years and also encouraged a second consultation with a surgeon before a decision was made.

The association is looking into developing a screening tool to help identify patients who should not have surgery.

The final GMC guidance is expected to be published in early 2016.

Health Direct thinks the GMC initiative is a common sense approach to a growing issue as more people opt for cosmetic surgery.

Skin cancer linked to package holiday boom

A boom in cheap package holidays in the 1960s is partly behind the “worrying rise” in skin cancers in pensioners, Cancer Research UK suggests.

Skin cancer linked to package holiday boomThe charity says that although all ages are at risk, many older people would not have been aware of how to protect themselves four decades ago.

Figures show that 5,700 over 65s are diagnosed with the condition each year, compared to just 600 in the mid-1970s.

The condition can often be prevented by covering up and avoiding sunburn.

Around 13,300 people are diagnosed with malignant melanoma – the most serious form of skin cancer – each year in the UK. And 2,100 lives are lost to the disease annually.

Numbers are increasing across all age groups but the steepest rise is seen in over-65s.

The charity said all ages are benefitting from public health messages explaining the dangers of holiday sun.

Professor Richard Marais of Cancer Research UK (CRUK), said: “It is worrying to see melanoma rates increasing at such a fast pace, and across all age groups.”

“It is important people keep an eye on their skin and seek medical opinion if they see any changes to their moles or even to normal areas of skin.”

Research suggests that getting sunburnt just once every two years can increase the odds of developing malignant melanoma.

Dr Julie Sharp, head of health information at CRUK, said: “You can burn at home just as easily as you can on holiday, so remember to spend time in the shade, wear a T-shirt and a hat to protect your skin and regularly apply sunscreen that is at least factor 15 and has four stars.”

Johnathon Major, from the British Association of Dermatologists, said: “The increasing incidence of skin cancer within the UK is alarming.

“As people are living longer, more people are reaching an age where they are at a higher risk. Interest in package holidays and in fashion tanning are among the reasons that more people are developing skin cancer.”

“But it’s crucial to remember that you don’t have to go on holiday or use a sun bed to heighten your risk. Skin cancers can develop as a result of both short term and long term overexposure to the sun’s rays within the UK.”

Cameron promises seven day health services

All hospitals in England will provide “a truly seven day NHS” health service under a future Conservative government.

Cameron promises seven day health servicesMr David Cameron said that more hospitals must provide top-level treatment at the weekend, starting with emergency care.

In a wide ranging speech, he said his party’s message to various sections of the population was: “We’re with you.” This spring forum is about fighting back against Labour on the NHS.

The Conservatives are committing to providing full weekend hospital care in England – in line with the NHS’s own five year plan.

This is an attempt to try to neutralise the NHS and enable the Conservatives to return to what they want to be talking about – the economy.

Speaking at the forum in Manchester, Mr Cameron warned that figures showed patients were “more likely to die” if they were admitted at weekends.

According to the Conservatives, official studies suggest mortality rates for those admitted on Saturdays and Sundays are 11% and 16% higher respectively than for those admitted on Wednesdays.

“For years it’s been too hard to access the NHS out of hours. But illness doesn’t respect working hours. Heart attacks, major accidents, babies – these things don’t just come from nine to five,” Mr Cameron said.

At weekends, he said, “some of the resources are not up and running. The key decision makers aren’t always there.

“With a future Conservative government, we would have a truly seven-day NHS. Already millions more people can see a GP seven days a week but by 2020 I want this for everyone, with hospitals properly staffed especially for urgent and emergency care, so that everyone will have access to the NHS services they need seven days a week by 2020 – the first country in the world to make this happen.”

The Liberal Democrats said NHS England already had plans to open hospitals and GP surgeries seven days a week, while UKIP said the Tories had “degenerated the NHS beyond all recognition” during the last five years in government.

The Conservatives have pledged to guarantee a real-term increase in funding for the NHS during the next Parliament, extending the ring-fence in place for the past five years. Labour has said it will spend £2.5bn more than its opponents.

Health Secretary Jeremy Hunt said government reforms of the NHS were saving £1.5bn a year but that the NHS “will need more money”.

He added that the NHS’s own sums suggested the predicted £30bn annual shortfall could be “reduced with efficiency changes, and we’re backing that plan”.

New clinical standards set out in 2013 require hospitals to provide seven-day access to diagnostic tests, such as X-rays, ultrasound, MRI scans and pathology, as well as providing access to multi-disciplinary teams, which include expert nurses and physiotherapists.

In its blueprint for services over the next five years, published last October, NHS England said hospital patients should have access to seven day services by 2020. “

War on drugs is unwinnable

Four decades after President Nixon declared a “war on drugs”, US states have legalised the sale of marijuana and most Americans support legalisation.

War on drugs is unwinnableAcross the world, drug laws are being relaxed, from Uruguay to Portugal, Jamaica and the Czech Republic.

After many years prosecuting drugs offences as an Assistant US Attorney, growing frustration with the approach inspire

The US prison system is a disaster. There’s virtually no rehabilitation. Locking up low level individuals who have drug problems or who have limited other options is not effective, because they go to jail, they come out, they get involved with drugs again, and they go right back to it.

The war itself is at a draw- which will be maintained indefinitely unless there’s a dramatic change in our approach to drugs and drug trafficking.

Former Colombian President Cesar Gaviria worked on the Global Commission on Drug Policy report in 2011 which called on states to decriminalise drugs.

“Our recommendation is regulation for everything. That’s what Portugal did.

“If you look at the last 50 years, what has been done? In the US, 600,000 people in jail, £27 billion of spending a year. The highest rates of consumption of the whole world. You have to say that it doesn’t work. It’s a failed policy, and public opinion knows that.

“Ten years ago it was unthinkable that the US would move massively to the legalisation of cannabis. That taboo has been broken. In the US, a majority of people are talking about approving legalisation of marijuana.”

He cites the example of Uruguay, the first country to legalise the marijuana trade.

“All Latin America’s looking at Uruguay. It’s a country that also looks how to deal with the production, with the supply of the marijuana that is in the state hands. I don’t expect any major set back of the policy that the Uruguayans have put in place.”

“From the beginning in 1961, the objective of the UN Conventions has been to live in a world free of drugs, but it’s a utopia. It’s something unreachable. It’s not to recognise human nature.”

Professor Peter Reuter from the school of public policy at the University of Maryland has been a leading academic in the field of drugs policy for decades.

“The need for national leaders to stand up and talk about the scourge of drugs, and signal to the population that being tough on drugs was a priority was an important part of the war itself.

“There’s going to be less and less of that. I think there’s going to be a change both in tone and substance, so the ‘war on drugs’ will become a less and less plausible metaphor for describing policy. I think it’s going to be a public health rhetoric for the foreseeable future.

“I do believe that we have in a sense had an experiment with trying to be very aggressive about controlling drugs through use of prohibition. And we have a sense that that did not work well. And so we’re now trying to find better ways of managing the problem, and I think that’s welcome.

“If you look at the number of people who are in prison for drug offences, at least in the US, that’s an important indicator of the change in real policy, and those numbers are starting to go down. Not dramatically, but they are definitely going down, and many states are making changes that are likely to accelerate that decline.”

As drug laws soften he argues the question of regulation becomes key, as happened when gambling was legalised:

“Lottery play was always seen as a bad thing, you legalised it because you wanted to take money away from organised crime, but the result was that the state lotteries became the most aggressive promoters.

“You have slogans like ‘Why be a mug and work when you can play the lottery and win easily?’, just the kind of slogan you’d associate with the worst commercial promotion, but done by the state.

“Alcohol is still heavily promoted, and it’s promoted in states that have state liquor monopolies, and we’ve only recently really been able to restrict smoking promotions.

“You cannot with a straight face say that marijuana legalisation won’t lead to more marijuana dependence.

“Choose your problem. There is no solution. Use of psychoactive drugs is a social problem like a whole lot of other social problems. We manage it. And we may manage it better or worse, but the notion that we solve a problem is simplistic. We’re simply managing a problem.”

Fourty per cent of cancers are avoidable

Four in 10 cancer cases- 600,000 in the UK- could be prevented if people led healthier lives say experts.

Fourty per cent of cancers are avoidableThe latest research figures from Cancer Research UK show smoking is by far the biggest avoidable risk factor- followed by unhealthy diets.

The charity is urging people to consider their health when making their New Year resolutions.

Limiting alcohol intake and doing regular exercise is also good advice.

According to the figures spanning five years from 2007 to 2011, more than 300,000 cases of cancer recorded were linked to smoking.

A further 145,000 were linked to unhealthy diets containing too much processed food.

Obesity contributed to 88,000 cases and alcohol to 62,200.

Sun damage to the skin and physical inactivity were also contributing factors.

Prof Max Parkin, a Cancer Research UK statistician based at Queen Mary University of London, said: “There’s now little doubt that certain lifestyle choices can have a big impact on cancer risk, with research around the world all pointing to the same key risk factors.”

“Of course everyone enjoys some extra treats during the Christmas holidays so we don’t want to ban mince pies and wine but it’s a good time to think about taking up some healthy habits for 2015.”

“Leading a healthy lifestyle can’t guarantee someone won’t get cancer but we can stack the odds in our favour by taking positive steps now that will help decrease our cancer risk in future.”

Public Health England says a healthy lifestyle can play a vital role in reducing cancer risk. It says campaigns such as Smokefree, Dry January and Change4Life Sugar Swaps all aim to raise public awareness.

Millions of Ebola vaccine doses ready by end of 2015

Millions of doses of experimental Ebola vaccines will be produced by the end of 2015 the World Health Organization has announced.

Millions of Ebola vaccine doses ready by end of 2015The WHO said “several hundred thousand” would be produced in the first half of the year and vaccines could be offered to health workers on the frontline in West Africa as soon as December 2014.

However, the WHO cautioned that vaccines would not be a “magic bullet” for ending the outbreak as there is no proven cure or vaccine for Ebola.

In response to the largest epidemic of the disease in history, the WHO is accelerating the process of vaccine development- it normally takes years to produce and test a vaccine, but drug manufacturers are now working on a scale of weeks.

Two experimental vaccines, produced by GlaxoSmithKline (GSK) and the Public Health Agency of Canada, are already in safety trials.

The GSK vaccine is being tested in Mali, the UK and the US. Research on the Canadian vaccine is also under way in the US with further trials expected to start in Europe and Africa soon.

The results are expected in December. After that, trials will move to countries affected by Ebola, probably starting with Liberia. That will allow researchers to assess how effective the vaccine is and what dose is needed to provide protection.

Healthcare workers, who place themselves at risk when treating patients, will take part in the first trials in West Africa.

The WHO says we should have the first hints of how effective these experimental vaccines are by April.

There are no plans for mass vaccination before June 2015 but the WHO has not ruled it out.

The WHO says vaccines are likely to be key to ending the outbreak, even if cases fall in the next few months.

Dr Marie Paule Kieny, a WHO assistant director-general, said: “While we hope that the massive response, which has been put in place will have an impact on the epidemic, it is still prudent to prepare to have as much vaccine available as possible if they are proven effective.

“If the massive effort in response is not sufficient, then vaccine would be a very important tool. And even if the epidemic would be already receding by the time we have vaccine available, the modelling seems to say vaccine may still have an impact on controlling the epidemic.”

The vaccine plan was the culmination of a day of talks at the WHO in Geneva.

As well as the two vaccines already in trials, there are a further five in the pipeline which could yet play a role in the outbreak.

The World Bank and the charity Medecins Sans Frontieres will help finance the vaccine.

There are also suggestions that an “indemnity fund” could be set up in case people have a serious adverse reaction to a vaccine being rushed through, but until a vaccine is found to prevent the virus from spreading, treating and isolating sufferers will remain the key strategy for containing the outbreak.

Patients’ internet diagnoses not useful warn doctors

Many patients are going to their GP and asking them what treatment they want based on research from the internet doctors warns.

Patients' internet diagnoses not useful warn doctorsA third of the UK physicians surveyed said patients would come with suggestions for what prescription they should receive and fewer than 5% of doctors felt it was helpful.

Major technology firms such as Apple and Samsung are investing heavily in tech that can monitor a user’s health.

The survey of 330 UK physicians – 300 of them GPs – was carried out by Cello Health Insight, a medical market research firm.

“Doctors have witnessed an explosion in the quantity and quality of information now available to them and their patients via digital media and technology,” said Dan Brilot, the company’s digital director. “Consumers are increasingly seeking out information (and technological tools such as fitness and health apps) to provide as much information as possible before – and after – consultation.”

However, doctors were finding technology useful for their own needs. Specifically, Cello’s survey said three quarters of those surveyed turned to the internet for research on conditions.

Many GPs would also use the internet to share new information with colleagues.

While self-diagnosis was proving troublesome, most of those surveyed did advocate the use of technology for general monitoring with more than half saying that apps designed to make sure treatment is taken or administered correctly are useful.

The NHS provides a service that suggests apps for patients that have been checked for accuracy. The apps could help diabetics keep a check on their blood sugar and patients monitor their own blood pressure.

Overweight seen as the norm warns chief medical officer

Being overweight is increasingly seen as the norm, England’s chief medical officer warns.
Overweight seen as the norm warns chief medical officerIn her annual report on the state of health, Dame Sally Davies said this was concerning, pointing out many people did not recognise they had a problem.

Parents of overweight children were also failing to spot the signs too, she said.

Dame Sally blamed the way weight was being portrayed by the media and clothes industry.

  •     Body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height.
  •     It is calculated by measuring weight (in kilograms) and dividing it by height (in metres) squared to give a BMI score
  •     A BMI of 25 to 29.9 is considered overweight and one of 30 or above is considered obese.

“I have long been concerned that being underweight is often portrayed as the ideal weight, particularly in the fashion industry.

“Yet I am increasingly concerned that society may be normalising being overweight.

“Larger mannequins are being introduced into clothes shops and “size inflation” means that clothes with the same size label have become larger in recent decades.

“And news stories about weight often feature pictures of severely obese people, which are unrepresentative of the majority of overweight people.”

Dame Sally also reiterated her belief that a sugar tax may be necessary to combat obesity.

At the start of March she told the Health Select Committee it may be needed, although she hoped not.

This caused some controversy as the government’s approach has been characterised by working with industry to get them to make food and drink products healthier.

In her report she says this should continue, but if it fails to deliver a tax should be “considered”.

She said children and adults of all ages are consuming too much sugar.

Nearly two thirds of adults and a third of children are overweight or obese – classed as a body mass index of above 25. This is about double the numbers in the early 1990s.