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Medics warn of dangers of freebirths

A concerning trend of women giving birth without qualified medics risks "reversing [care] to the middle ages," experts have said.

Figures show a rise in the number of women using doulas - a person who provides support to a pregnant woman before, during and after childbirth, and usually involves a home birth.

In some cases, doulas were persuading women to ignore medical advice, medically experts have said.

A senior consultant said mums-to-be were risking their child's life with medically unsupervised births, and their own health. She knew of a patient left with a colostomy bag after a doula advised them not to be stitched up following a fourth degree tear.

She is now calling on the government to introduce regulation for doulas.

Director of Doula UK Trudi Dawson told the BBC that they do not perform medical tasks and are only there for "advocacy and support".

She insisted members are not allowed to steer women towards making particular birth choices, adding: "We would signpost them to the evidence.

Mrs Dawson does not agree with calls from obstetricians for doulas to be regulated.

She added: "Obviously we can’t be the doula police but we are trying to make sure that there is kind of a gold standard by having a register of doulas who have done specific training, who've had a mentored period, and who stand by the philosophy and a code of conduct."

But a senior obstetrician and gynaecologist, who didn't want to be named, said she was "terrified" about women giving birth in medically unsupervised environments.

She said: "I just feel like freebirthing and allowing women to take that sort of risk with themselves, their bodies and their baby, is risking their baby dying and them potentially dying in that very unsupervised environment."

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Source: BBC News, 20 November 2024

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Women plan UK legal action over talc cancer claims

Hundreds of women in the UK are planning to take on one of the world's biggest pharmaceutical companies over alleged links between talc and cancer.

Diagnosed with ovarian cancer in 2021, Cassandra Wardle is one of the women launching a group action against the biggest seller of talcum powder, Johnson & Johnson (J&J).

Cassandra, who stumbled on a Facebook article linking cancer and talc following her diagnosis, said it was used on her as a baby and she continued to use it "for 20 years or more".

If it proceeds, the legal action would be the first of its kind brought against the pharmaceutical multinational in the UK.

With 1,900 potential claimants, including cancer patients, survivors and families, lawyers say it is set to be the largest pharmaceutical product group action in English and Welsh legal history.

The BBC has spoken to a number of women with gynaecological cancers - many are part of the group action - who believe their repeated use of talcum powder played a part in their diagnosis.

Their lawyers allege that for decades, talcum powder was contaminated with cancer-causing asbestos - something they claim J&J was aware of but sought to suppress.

J&J denies suppressing any information and denies any links between its baby powder, asbestos and cancer.

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Source: BBC News, 20 November 2024

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Mental health nurses on 999 calls reduce ED admissions

A new pilot project that sees mental health nurses speaking on 999 calls has seen a 40% reduction in the number of people in mental health crisis being admitted to emergency departments (EDs).

The project in the South Eastern Health Trust area, funded by the Public Health Agency (PHA), sees 12 mental health practitioners from the trust work with the Northern Ireland Ambulance Service (NIAS) in its control room in Belfast at the weekends.

It is aimed at people who call 999 in mental health distress.

In the scheme, a medical health practitioner will give a mental health assessment to de-escalate people from attending EDs, and prevent ambulances from going to people that are in mental health crisis.

The trust's project lead, Stephanie Patten, said the pilot has been proving successful so far.

"From April to September, there were 190 [mental health] calls," she told BBC News NI.

"40% of those calls were de-escalated which meant they did not require an emergency ambulance."

Ms Patten said this means people "have the right care and the right response at the right time" when they are in crisis, and don't have to wait on an ambulance or in a busy ED.

"An emergency department is not an appropriate place for someone who is depressed, anxious or distressed to be sitting waiting," she added.

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Source: BBC News, 20 November 2024

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Service rated ‘outstanding’ despite whistleblower concerns

A trust’s neonatal services have been rated “outstanding” just a year after concerns were raised about investigations into baby deaths.

The services at Bradford Teaching Hospitals Foundation Trust were rated “outstanding” overall and “outstanding” for caring and well led in a report published by the Care Quality Commission.

In its first standalone review of neonatal services at Bradford Royal Infirmary, the watchdog also gave the trust a “good” rating for safety, effectiveness and responsiveness.

It comes a little over a year after Max McClean, Bradford’s former chair, resigned and called for trust CEO Mel Pickup to quit amid a breakdown in relations between the pair.

Max McClean subsequently raised a number of concerns, one of which was about delays in completing investigations into three neonatal incidents in April 2021.

This included the deaths of two newborn babies and another baby who was born with a permanent disability. Mr McClean claimed the investigations took 14 months to complete, much longer than the national guideline of 60 days. 

An external report compiled for the trust’s board, previously obtained by HSJ, said it was given “no evidence” the board were “fully appraised” about the delays to the investigations, and that Ms Pickup “should have made more demands for completion of the reviews”.

However, based on on-site assessments conducted on 15 and 16 May this year, the CQC report said the service was performing “exceptionally well”.

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Source: 20 November 2024

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Government launches independent review of Physician and Anaesthesia Associate professions

An independent review of Physician Associates (PAs) and Anaesthesia Associates (AAs) has been launched by the Health and Social Care Secretary Wes Streeting today to consider how these roles are deployed across the health system, in order to ensure that patients get the highest standards of care. Professor Gillian Leng CBE will independently lead the review.

The review will look into the safety of these roles, how they support wider health teams, and their place in providing patients with good quality and efficient care. It will also look at how effectively these roles are deployed in the NHS, while offering recommendations on how new roles should work in the future. It will consider the scope of PA and AA roles, which currently include gathering medical histories, performing initial examinations, organising tests to support doctors and reviewing patients before surgery.

To increase transparency in these roles, the review will also look into measures to ensure patients know when they are interacting with PAs or AAs, so they are clear on the type of clinician they are seeing and for what reason. 

The review and next steps will be published in the Spring.

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Source: Department of Health and Social Care, 20 November 2024

Related reading: Physician associates: What are the patient safety issues? An interview with Asif Qasim

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Progress made, but serious NHS drug shortages continue

The NHS continues to suffer a shortage of medicines, with alerts in place for conditions including alcoholism, ADHD, type 2 diabetes, and menopause, as UK manufacturers of generic drugs report shortages lasting over 6 months for over half of their medicines. 

Pabrinex vitamin B IM injections, which are used for alcoholism, debility, haemodialysis, and Wernickes encephalopathy, have not been available since August, and there are no plans for their return. 

Supply of ADHD medication currently varies, but issues remain for prolonged-release tablets of methylphenidate, the Department of Health and Social Care told Medscape News UK.

There is a limited supply of liraglutide and the wider GLP-1 receptor agonist medications used for type 2 diabetes and weight management.

Other medication safety alerts have been issued for the hormone replacement therapy (HRT) ethinylestradiol, potassium chloride syrup (KAY-CEE) for hypokalaemia, and phenytoin capsules for epilepsy seizures related to neurosurgery or head injury, status epilepticus, and ventricular arrhythmias. 

To address ADHD medication shortages, clinical guidelines have been issued to support switching to available medicines. Existing supplies have been conserved by not starting new patients on medicines that have limited supplies, but using alternatives, said James Davies, England director of the Royal Pharmaceutical Society (RPS), speaking to Medscape News UK. 

He added that certain strengths of paracetamol suppositories are in short supply and are expected to be restocked next February. “In the meantime, alternative treatments with the tablet, capsule, liquid, or IV formulations are considered where clinically appropriate, or using half of the suppositories that continue to be in stock and available,” he said. 

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Source: Medscape News, 15 November 2024

Further reading on the hub

Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 

  • Was there an impact on your health (physical and mental)? 
  • Were you told the reason for it not being available? 
  • Was the issue resolved? If so, how long did it take?If you are still impacted by medication supply issues, have you been told when you will be able to access them again?

To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our community forum. 

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USA: Leapfrog Group finds significant improvements in patient safety

The nonprofit Leapfrog Group’s fall 2024 Hospital Safety Grade report shows that US hospitals are making progress in patient safety across several performance measures, including notable improvements in healthcare-associated infections, hand hygiene and medication safety.

The report evaluates nearly 3,000 hospitals on their ability to prevent medical errors, accidents and infections. The Hospital Safety Grade uses up to 30 performance measures to assign an “A, “B,” “C,” “D” or “F” to individual hospitals and uses a public, peer-reviewed methodology, calculated by patient safety experts under the guidance of a national expert panel.

"Preventable deaths and harm in hospitals have been a major policy concern for decades. So, it is good news that Leapfrog’s latest Safety Grades reveal that hospitals across the country are making notable gains in patient safety, saving countless lives," said Leah Binder, President and CEO of The Leapfrog Group, in a statement. “Next, we need hospitals to accelerate this progress—because no one should have to die from a preventable error in a hospital.”

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Source: Healthcare Innovation, 15 November 2024

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PA employers must provide references to support registration

Employers of physician associates (PAs) will be required to provide a reference and an insurance and indemnity declaration as part of a PA’s application for registration with the GMC.

The regulation of PAs by the GMC is set to begin on 13 December, with registration open from 16 December. However, registration will not be legally required for another two years to allow for a transition period.

In a letter to employers last week, the GMC said PAs will need to provide a range of evidence to demonstrate knowledge, skills and behaviour to provide safe patient care. It said this would include an employer reference and an insurance and indemnity declaration.

The GMC clarified that this reference will need to be completed and signed by a supervising clinician who has oversight of the PA’s practice, which is likely to be the supervising GP.

‘We’d be grateful if you could support this process by making sure PAs, AAs [Anaesthesia Associates] and their supervisors are aware of and prepared for this requirement and requests that they may receive,’ said the letter.

PAs who have practised within the last five years will need an employer reference covering the most recent three months of employment. Supervisors will be provided with a specific form to complete, sign and date.

It added that most PAs will have indemnity cover under their employer’s scheme, but they will need to sign a declaration saying they have this in place when they apply for registration.

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Source: Management in Practice, 4 November 2024

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‘Real nastiness’: therapist training courses in UK can be ‘toxic’ and need regulating, say students

When Sally Mumford enrolled in a training course to become a psychotherapist in 2020, she was excited to start a new career.

She hoped to help people understand how their feelings and behaviour were shaped by their pasts. But she quickly realised that the course might not be what she had expected. “I arrived like a lamb to the slaughter,” she said. “There was a real nastiness that percolated down from the top.”

Mumford said her tutors at the training centre in London let bullying between students go unchecked. “It was all part of making you into a therapist. The whole ethos was to break you down and build you back up how they wanted you to be.”

Mumford is one of more than a dozen people who have studied for psychotherapy qualifications at UK institutions who told the Observer that some courses cross the line from challenging to toxic, with tutors bullying students. Some said their tutors made humiliating remarks to them in public, and left them feeling too scared to speak up or leave the course.

But the industry is largely unregulated; “psychotherapist” is not a protected profession, so anyone can set up a practice with that title.

Psychotherapist training is also unregulated, and there is a wide range of qualifications across the UK. 

Amanda Williamson, a psychotherapist who has been campaigning for regulation in the industry for more than a decade, is concerned about “toxic” training courses. “I’ve heard negative feedback about all manner of courses at prominent universities, including appalling tales of bullying and badly-run ‘group process’,” Williamson said.

Since psychotherapy training requires students to be vulnerable, she argues, regulations must be more rigorous than in other industries. Therapists and training institutions should be bound by a consistent code of ethics, and regulated by the same body, she said. “Regulation, or at least an inquiry to shine a light on these toxic hotspots that are allowed to fester … is very much overdue.”

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Source: The Guardian, 17 November 2024

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Fresh inquiry ordered into death after reports are rejected

NHS England has ordered a new independent investigation into the death of an autistic man nearly 10 years ago, after a previous report was effectively quashed.

Anthony Dawson died aged 64 from a burst gastric ulcer in an NHS-run care home in May 2015. An inquest found there were gross failings in his care, and his death was contributed to by neglect.

NHS England commissioned an independent investigation in 2017 from Sancus Solutions at a cost of £25,000. But its report — which went through seven drafts — was heavily criticised by Anthony’s sister, Julia, who said the drafts had significant factual errors and ignored aspects of his care.

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Source: HSJ, 19 November, 2024

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CNN: More than 1 in 3 surgical patients has complications, study finds, and many are the result of medical errors

Despite decades of calls for more attention to patient safety in hospitals, people undergoing surgery still have high rates of complications and medical errors, a new study finds.

More than a third of patients admitted to the hospital for surgery have adverse events related to their care, and at least 1 in 5 of these complications is the result of medical errors, the researchers found.

Studies delving into adverse events and medical errors in hospital settings are few and far between, and each has slightly different methods, so their results aren’t always an apples-to-apples comparison. But the latest study, which was published Thursday in the BMJ, fits into a pattern of evidence going back decades, suggesting that hospitals haven’t made much progress on patient safety.

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Source: CNN, 15 November 2024

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Pharmacies vote to cut opening hours in funding protest

Pharmacy owners in England, Wales and Northern Ireland have voted in favour of cutting opening hours and stopping home deliveries for the first time, in a protest over government funding.

The National Pharmacy Association (NPA), which ran the ballot, is calling for an annual £1.7bn funding increase to plug the “financial hole”.

The NPA represents 6,500 of the UK's community pharmacies - that's around half of them. It says 99% of those that responded to the vote said they were willing to limit their services unless funding was improved.

Pharmacies could decide:

  • not to open beyond 40 hours a week, into evenings and at weekends.
  • to stop providing free home deliveries of medicines which are not funded.
  • not to offer emergency contraception, substance misuse and smoking support services.
  • to refuse to co-operate with certain data requests.
  • to stop supplying free monitored dose systems (medicine packs), other than those covered by the Equality Act.

NPA chairman Nick Kaye said the ballot result "overwhelmingly shows the sheer anger and frustration of pharmacy owners at a decade of cuts that is forcing dedicated health professionals to shut their doors for good".

He said he cared deeply about his patients - like other pharmacy teams - but he has never experienced a situation as desperate as this.

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Source: BBC News, 14 November 2024

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Dad dies days after getting delayed scan results

A Shropshire family has called for faster NHS test results, after a father waited three months for the outcome of a cancer scan which finally arrived five days before he died.

Pete Vagg was receiving chemotherapy at the Royal Shrewsbury Hospital, unaware his treatment wasn't working and that palliative care might have been an option.

His son Neil said his father "should have had a more dignified end of life, visiting his grandchildren abroad".

The Shrewsbury and Telford Hospital NHS Trust (SaTH) said: “Waiting times remain longer than we would want for our patients in some specialties".

Mr Vagg, 79, from Shrewsbury, had been living with cancer for a number of years, but it had spread to his bowel and liver.

He started chemotherapy and in July 2024 had a monitoring scan to check if the treatment was working.

His son said: "It was odd that every time his dad met the medical team there was still no scan result”. This meant no decisions could be made about his father's care, because nobody knew what was going on inside him, he added.

Julian Povey, who chairs the Shropshire, Telford & Wrekin GP Board, said it was a common situation with around a third of GP work now related to hospital outpatient appointments.

Dr Povey said people could wait eight weeks for an scan, and then another 12 weeks for the report.

Private companies are often tasked with interpreting scan results to take the pressure off hospitals, but Dr Povey said the trust "needs to look for alternatives to reduce waiting times".

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Source: BBC News, 18 November 2024

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Declining standards of care for stroke patients must be reversed, says charity

Ministers are being urged to improve declining care for stroke patients to lower the risk of death and disability as new figures show rising cases, especially among people in their 50s.

Thousands of stroke patients are missing out on appropriate treatment and rehabilitation, the standards of which have worsened over the past decade, the Stroke Association has said as it publishes the latest figures from the Sentinel Stroke National Audit Programme (SSNAP), the nation’s biggest stroke data audit covering England, Wales and Northern Ireland.

Separate NHS England analysis paints a picture of a healthcare system under increasing strain, as the number of people being admitted to hospital after a stroke has risen by 28% in the last 20 years. This included a 55% rise in admissions among people aged 50-59, bringing the number to 12,533 in 2023-24 – the highest increase among any age group. The rise is understood to be fuelled by obesity, poor diet and sedentary lifestyles.

The Stroke Association said that innovative treatments, such as thrombectomy, and basic care, such as hospital rehabilitation, are still being delivered inconsistently across different regions.

Juliet Bouverie, the chief executive of the Stroke Association, said: “The NHS stroke pathway has long been at crisis point. The recoveries of too many stroke survivors are being put at risk due to a lack of staff, spiralling waiting times and a lack of basic stroke care provision which compromises – rather than optimises – patient recovery.

“Governmental change is long overdue, and the 10-year health plan is an ideal opportunity to ensure everyone who has a stroke can survive and live well.”

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Source: The Guardian, 18 November 2024

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Gynaecology waiting lists double, leaving women in pain

Waiting lists for gynaecology appointments across the UK have more than doubled since February 2020, BBC research reveals.

Records show around three-quarters of a million (755,046) women's health appointments are waiting to happen - up from 360,400 just before the pandemic.

This would suggest around 630,000 people - at the very least - are on the list to be seen for problems that range from fibroids and endometriosis to incontinence and menopause care.

Health ministers across the UK say they are working on plans to improve the situation, but health leaders say that women are being let down.

"Women are being let down" and change is "urgently needed," says Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG).

The college's new report, external looks at the impact on people waiting for care.

"Gynaecology is the only elective speciality that solely treats women and has one of the worst waiting lists across the UK.

"This reflects the persistent lack of priority given to women and women’s health, " Dr Thakar says.

"Women are suffering. We know it is affecting their mental health. They are not able to go to work, they are not able to socialise."

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Source: BBC News, 18 November 2024

Further reading on the hub:

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Poor leadership diversity behind higher mortality of black and Asian children

The lack of diversity in NHS leadership is a contributor to ongoing higher maternal and infant mortality among some minority ethnic groups, experts have warned.

Habib Naqvi, chief executive of the NHS Race and Health Observatory, called for local organisations to be held to account for a lack of diversity in leadership.

At present, he said, it was contributing to racial and cultural bias, and in turn to NHS “policies and practices impacting patient experiences and outcomes, including those for ethnic minority mothers and babies”.

Mr Naqvi said: “Evidence clearly shows that a fully engaged and representative workforce at all levels leads to better care, safety, and optimal outcomes for all patients.

“NHS organisations should focus on evidence-based interventions that support the progression of ethnic minority staff across the workforce pipeline.”

He said interventions should target communities at high risk of premature births, including anti-racism approaches to quality improvement in maternity and neonatal services.

To implement such approaches, he said: “There needs to be leadership that represents the NHS workforce as a whole and the communities it serves.” He added: “At the moment, the NHS leadership does not have the diversity of thoughts needed to implement these policies.”

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Source: HSJ, 18 November 2024

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Hospital porters to strike over ‘diabolical’ treatment by trust

Hospital porters at an acute trust are set to strike over what a union has called “diabolical” treatment.

Around 60 porters at University Hospital Southampton belonging to the Unite union will stage a series of 24-hour walkouts starting on 28 November and then every Monday and Friday throughout December and January.

Unite has said its members have been subjected to “endemic bullying” and “diabolical” working conditions, such as having to inform managers before and after using the toilet, being denied breaks to drink water, and having seating removed.

The union has also alleged that its members have been disciplined for raising concerns about patient safety, understaffing, and the quality of equipment.

Unite regional officer Kate Attwooll said: “The strike action will inevitably cause serious disruption across the hospital, but this is entirely the fault of management; they are well aware of the problems but have failed to take action to prioritise staff and patient safety and dignity.

“Strike action could still be avoided but that would require management introducing the changes needed to end the endemic bullying of porters at UHS.”

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Source: HSJ, 15 November 2024

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Unnecessary training wastes 100,000 days a year, says NHSE

Unnecessary “mandatory training” is wasting more than 100,000 days of NHS staff time every year, NHS England estimates.

This is largely because some refresher training is taking place more frequently than national rules require, according to a survey and analysis by the national body. 

Some staff groups are completing training which is either “not relevant or has limited benefit”, it said in a letter yesterday.

Doctors and others have long complained about the burden of mandatory training on their time, particularly resident doctors, alongside job pressures, pay and working conditions.

NHS England now wants to “optimise, rationalise and redesign statutory and mandatory training” to help reduce burden and improve staff experience, it said.

The letter to HR, nursing and medical directors said: “We forecast these actions will reduce the time burden on staff by up to 100,000 days each year with no material risk, with particular benefit to resident doctors (postgraduate doctors in training).

“Across the NHS in England, approximately 250,000 people go through new starter processes each year, and approximately 50 per cent of these are or were employed by another organisation.

“With statutory and mandatory training taking an average of one day to complete, the estimated saving of 100,000 days is considered conservative.”

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Source: HSJ, 15 November 2024

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Doctors warn of ‘massive’ winter crisis in UK’s overstretched A&E departments

Emergency doctors have sounded the alarm over an approaching winter crisis that they say is already putting patients in overstretched A&E departments at risk.

Nearly all medics (94%) fear patients are coming to harm because of the conditions in A&E departments around the UK, according to a snapshot survey of 83 medics from emergency departments from the Royal College of Emergency Medicine (RCEM). Most (87%) are not confident their departments will cope well over the winter months, while 41% feel less prepared for this winter compared with last year.

More than four-fifths (83%) of the emergency doctors surveyed between 7 and 13 November said patients were being cared for in corridors, which can leave people stranded for hours on trolleys or chairs, while more than half (51%) had seen patients forced to wait outside emergency departments in ambulances.

The president of the RCEM, Dr Adrian Boyle, said: “This is a stark warning from those on the frontline. Clinicians are worried and patients are unsafe. Winter is coming and it looks like we are facing a massive crisis is every part of the UK. We cannot just ignore winter and our patients.”

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Source: The Guardian, 18 November 2024

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Without ‘immediate action’ nearly 260 million Americans will be overweight or obese by 2050

Without immediate action, researchers have warned that nearly 260 million Americans, an increase of more than 41 million adults, will be considered overweight or obese by 2050.

That includes 213 million adults over 25 – nearly three-quarters of the adult population – and more than 43 million children and adolescents between the ages of five and 24.

Around one in five children, at least one in three adolescents, and two in three adults are expected to have obesity, with the highest levels concentrated in southern states.

“Our analysis lays bare the decades-long failure to tackle the growing overweight and obesity epidemic in the USA. The catastrophic consequences of the surge in overweight and obesity among children are already evident in the rising prevalence of childhood hypertension and type 2 diabetes,” University of Washington Professor Emmanuela Gakidou said in a statement.

She noted that being obese or overweight can trigger serious health conditions like diabetes, heart attacks, stroke, cancer, mental health disorders, and premature death.

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Source: The Independent, 14 November 2024

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Premature birth rates in US remain at historic high, report finds

Premature birth rates in the US remain at a historic high, according to a new report.

On Thursday, March of Dimes, a maternal health non-profit organization, released its latest findings which say that the national premature birth rate of 2023 remains at 10.4%, largely due to chronic conditions, inadequate prenatal care and racial disparities. In contrast, the premature birth rate 10 years ago was at 9.6%.

Grading the US a D+ for its premature birth rates, the study found that more than 370,000 babies were born prematurely in 2023. Additionally, Black mothers face a premature birth rate of 14.7%, almost 1.5 times higher than the national average.

The study pointed to major risks for premature births including inadequate prenatal care and chronic health issues.

Last year, the rate of inadequate prenatal care was 15.7%, with even higher rates among Black and American Indian and Alaska Native communities. Inadequate prenatal care is linked to a 9% increase in the rate of premature births compared with those who receive adequate prenatal care, the study found.

“As a clinician, I know the profound impact that comprehensive prenatal care has on pregnancy outcomes for both mom and baby,” Amanda P Williams, March of Dimes’s interim chief medical officer said in a statement.

“Yet, too many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births. The health of mom and baby are intricately intertwined. If we can address chronic health conditions and help ensure all moms have access to quality prenatal care, we can help every family get the best possible start.”

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British Bangladeshi men have highest rates of lung cancer in England

British Bangladeshi men have the highest rates of lung cancer in England, according to a study that reveals clear patterns in how the disease affects different communities in the country.

Disparities that go beyond smoking have been revealed by the University of Oxford researchers’ analysis of 17.5 million people’s health records and 84,000 lung cancer cases.

The findings, from Oxford’s Nuffield Department of Primary Care Health Sciences, coincide with the rollout of the targeted lung health check programme across England, which aims to reach 40% of the eligible population by March 2025 and 100% by 2030.

The new research found “ethnic background and social circumstances” are crucial factors in cancer risk, how it develops, and the type.

Lung cancer occurred twice as frequently in the most deprived areas compared with the least – with 215 cases per 100,000 people among men in the poorest areas, compared with 94 cases in the most affluent, the study found.

For women, rates in the most deprived areas were at 147 per 100,000, compared with 62 in the least deprived.

Bangladeshi men showed the highest lung cancer rates, followed by white, Chinese and Caribbean men.

Prof Julia Hippisley-Cox, a senior author of the study, said: “We need to ensure our cancer services are reaching all communities effectively and that everyone has the same opportunity for early diagnosis.

“Tackling these disparities isn’t just about lung cancer: when we address these fundamental inequalities in healthcare access and social deprivation, we can improve health outcomes across many conditions.”

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Source: The Guardian, 14 November 2024

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End GP partnership model to help A&E waits, says NHSE lead

The NHS needs to take more “radical” steps to improve emergency care waiting times, including making primary care a salaried service, a senior national clinical lead has said.

Chris Moulton, clinical lead for emergency medicine for NHS England’s Getting It Right First Time programme, said the health service “cannot continue” its current approach to addressing long accident and emergency waits and the harm they cause.

Speaking at NHS Providers’ annual conference this week, Dr Moulton said significant changes in primary and community care were needed while caring needs to become a more “respected profession”.

Dr Moulton said: “Tinkering with the system, improving it in small ways, is good, but it’s not going to solve the problem. To solve the problem of emergency care in the UK, we have got to do some very radical things.

“Primary care has got to change. I think that primary care needs to be salaried like the rest of the NHS.

“Community care needs to change. Community care is OK when it works, which is usually for a limited number of hours in the week. Community care perhaps doesn’t need to be 24/7, but it certainly needs to be more available and cover many more hours in the week.”

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Source: HSJ, 14 November 2024

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More than 800 million people around the world have diabetes, study finds

The number of people with diabetes has doubled over the past 30 years to more than 800 million worldwide, according to a groundbreaking international study.

Global analysis published in the Lancet found that rates of diabetes in adults doubled from about 7% to about 14% between 1990 to 2022, with the largest increase in low and middle-income countries.

The study is the first global analysis of diabetes rates and treatment in all countries. Scientists at NCD-RisC in collaboration with the World Health Organization used data from more than 140 million people aged 18 or older from more than 1,000 studies in different countries. They applied statistical tools to enable accurate comparisons of prevalence and treatment between countries and regions.

The study highlighted growing health inequalities. More than half of global diabetes cases were concentrated in four countries. Of those with diabetes in 2022, more than a quarter (212 million) lived in India, 148 million were in China, 42 million were in the US and 36 million in Pakistan. Indonesia and Brazil accounted for a further 25 million and 22 million cases, respectively.

Dr Ranjit Mohan Anjana, the joint first author and president of the Madras Diabetes Research Foundation in India, said: “Given the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world.

“Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise, through measures such as subsidies for healthy foods and free healthy school meals as well as promoting safe places for walking and exercising including free entrance to public parks and fitness centres.”

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Source: The Guardian, 13 November 2024

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Physician Associates: Minister hints at pause in expansion

Health Secretary Wes Streeting said there are “legitimate concerns” over the role of physician associates (PAs) amid worries they are being used to replace fully-qualified doctors.

He said he wanted to look into the issues around the roles before a planned expansion in the number of medical associates.

Mr Streeting acknowledged there were concerns around the tasks PAs were doing and transparency, with patients not necessarily realising they were not being treated by a doctor.

There has been an ongoing debate within the NHS about the use of such roles, with the Academy of Medical Royal Colleges calling for a review into PAs and anaesthesia associates (AAs) to “clarify claims around their safety and usefulness in patient-facing roles”.

Mr Streeting told BBC Breakfast: “I am taking these concerns seriously and I’ve spent a lot of time listening to clinicians, listening to physician associates as well, by the way.

“I think they do have a role to play and can add value, not least in freeing up doctors’ time to do the things that only doctors can do.

“But I think there are legitimate concerns about the extent of doctor substitution and replacing doctors with PAs, there are issues around transparency.

“As patients, we should know who we’re seeing, who’s in front of us and why, and we’ve got to take those issues seriously.”

Mr Streeting said he would be saying more about the associate roles “in the coming weeks”, hinting an expansion in the number of the roles could be paused while work is carried out to address concerns.

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Source: Medscape, 13 November 2024

Read our interview this week with Asif Qasim, Consultant Cardiologist and Founder of MedShr, about the role of physician associates in the NHS and the patient safety issues.

Read more

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