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Clive Flashman

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  1. Clive Flashman
    As junior doctors begin a four-day strike today with a two-day strike by consultants a fortnight later, Sir Julian Hartley, chief executive of NHS Providers, said:

    "Trust leaders are very worried about six more days of severe disruption across the NHS this month.

    "We could be close to a tipping point. Trusts and staff are pulling out all the stops to reduce waiting times for patients but with no end to strikes in sight the sheer volume of planned treatment being put back due to industrial action will make it almost impossible for trusts to cut waiting lists as much as the government wants.

    "Waiting lists are now at a record high of 7.57 million, the pressure on urgent and emergency care services is relentless and an already stretched NHS is gearing up for another high-demand winter as pressure on tight budgets mounts.

    "A string of strikes – which have led to more than 835,000 routine treatments and appointments being put back since December – is estimated to have cost the NHS around £1bn already including lost income and hiring expensive staff cover.

    "The number of rescheduled appointments could be close to 1 million after this month's strikes and consultants have called another two-day strike in September. There will be a long-lasting effect on patients who have had treatment delayed and on already low staff morale.

    "Concerns are mounting too over how patient safety will be maintained during August's strikes as many NHS services will be even more stretched as many staff are on much-needed summer holidays and cover is harder to secure.

    "It's vital that the government and unions find a breakthrough urgently. Trust leaders understand the strength of feeling among striking staff and why they're taking action. Everyone in the NHS wants to concentrate on treating more patients more quickly rather than spend days making plans to cope with strikes.

    "People can still rely on the NHS during strikes, calling 999 in an emergency. For less urgent cases people should use 111 online for help and advice."
  2. Clive Flashman
    One of the world’s foremost virus experts has said survivors will be living with the effects of Covid-19 for “years to come” after he was struck down by a severe infection, and called for added support for those who have recovered from the disease. 
    Professor Peter Piot, who as director of the London School of Hygiene and Tropical Medicine has been at the forefront of the academic response to the pandemic, has spent his entire career studying viruses such as Ebola and HIV. 
    Prof Piot spent a week at the Royal Free Hospital in London in early April after contracting the disease. “I spent a week in isolation on a ward with three other men. I couldn’t leave the room. When I came out the thing I remember most is seeing the sky. London was deserted - it was in acute lockdown,” he said.
    The fever and splitting headache he had felt before being admitted were gone and apart from chronic exhaustion he was feeling better, he said. Getting out of bed was a struggle and he had to take rests when going up the many flights of stairs of his tall Georgian townhouse. But a week later he took a turn for the worse - he became breathless and his heart rate shot up to over 100. 
    Read the full article here
  3. Clive Flashman
    Patients are starting to suffer because health and care workers are unable to purchase fuel.
    The fuel crisis is starting to have an effect on the care of vulnerable patients, community and mental health service providers have warned. Many petrol stations are running short of fuel as a result of panic buying, after the oil firm BP warned that it would have to close some of its petrol stations because of the lack of lorry drivers. Currently there is a shortage of about 100,000 HGV drivers.
    Crystal Oldman, chief executive for the Queen’s Nursing Institute, which represents community nurses, told the journal HSJ that the fuel shortage was already affecting them: “This potentially means nurses cannot get to the patients they need to if they are unable to access fuel. At the very least, it will mean more time searching for petrol stations that have a supply, taking valuable time from their working day and more unpaid overtime will be undertaken as nurses will always prioritise their patient care.”
    Patient transport has also been affected. A source at a patient transport provider in the West Midlands told HSJ that it had been “a bit of a nightmare”. The provider had had to turn down a request for a patient going to London because of the fuel shortage and because of climate protesters disrupting motorway transport: “Ultimately those patients are either at home and distressed carrying a big risk in the community or [accident and emergency] departments which [are not] the right settings.”
    Read the full article here
    Source: Future Care Capital
  4. Clive Flashman
    After generations of inaction and very few novel ideas, researchers and activists are hopeful a new path is being charted in understanding and treating the crippling chronic condition
    “There’s an excitement at the moment,” says Andrew Horne. After decades of inaction, something is happening in endometriosis.
    Now, says the professor of gynaecology and reproductive sciences at the University of Edinburgh, “I do think things are changing. There are more people working on it, so it’s bringing in people from different disciplines with new ideas.”
    In the space of a few months, from gatherings in Edinburgh and Washington DC, labs in Sydney and Japan, there is a sense that new ideas are bubbling to the surface, including a fundamental rethinking of endometriosis not as a disease of the pelvis, but rather, says Horne, “a whole-body disease”. It’s hard to pinpoint the exact moment when despair turned to hope in the research and patient community. There was no single breakthrough. No one person responsible.
    In March, the largest ever study on the genetics of endometriosis was published in Nature Genetics, which found genetic links to 11 other pain conditions as well as other inflammatory conditions. The study, involving DNA from more than 760,000 women, found ovarian endometriosis is genetically distinct from other types and indicated there may be a genetic predisposition to excessive inflammation in people with the condition. One of the researchers, Dr Nilufer Rahmioglu from the University of Oxford, described the data as a “treasure trove of new information”.
    Weeks later on the other side of the world, researchers from Sydney’s Royal Hospital for Women attracted international attention after they grew tissue from different types of endometriosis and compared how each responded differently to treatments. Jason Abbott, professor of obstetrics and gynaecology at the hospital, likened the development to those made in the treatment of breast cancer three decades ago.
    Two weeks on from the Australian discovery, Japanese researchers found a common form of bacteria may be contributing to the growth of endometriosis via inflammation.
    The frisson was, by then, hard to miss.
    Read the full article here: https://www.theguardian.com/society/2023/aug/10/its-really-only-the-beginning-are-we-on-the-cusp-of-a-breakthrough-in-endometriosis 
  5. Clive Flashman
    Like most women affected by incontinence, 43-year-old Luce Brett has her horror stories. As a 30-year-old first time mum she recalls wetting herself and bursting into tears in the “Mothercare aisle of shame”, where maternity pads and adult nappies sit alongside the baby nappies, wipes and potties.
    But, she adds, these isolated anecdotes don’t really do justice to what living with incontinence is really like. “It’s every day, it’s all day. People talk about leaking when you sneeze or when you laugh, but for me it was also when I stood up, or walked upstairs. It was always having two different outfits every time I left the house to go to the shops. Incontinence robbed me of my thirties; it made me suicidally depressed,” Luce explains.
    “Everyone kept telling me it was normal to be leaky after a vaginal birth. It took quite a long time for me to find the courage or the words to stop them and say: ‘Everybody in my NCT (National Childbirth Trust) class can walk around with a sling on, and I can’t do that without wetting myself constantly’,” she adds.
    Read full article here.
  6. Clive Flashman
    The exodus of healthcare workers from Nigeria, Ghana and Zimbabwe continues, despite the WHO red list and a range of laws to keep them at home.
    It took nearly three hours of queueing in Ikorodu general hospital in Lagos state, Nigeria, before Hadijat Hassan, a retired civil servant, could see a nurse. The 66-year-old has attended the clinic for health checks since being diagnosed with diabetes nearly 10 years ago. But since May, she says, the delays, often while suffering from excruciating pain in her legs, are worse than ever.
    “You can get there [the hospital] and meet about 50 people waiting to be attended to,” Hassan says. “They said all of their nurses and doctors have been leaving for abroad. Just a few are left.”
    In Nigeria, there is one doctor for every 5,000 patients, whereas the average in developed countries is one doctor for about every 254 people.
    A hospital official said the Ikorodu management get resignation notices from nurses and doctors almost every month.
    “Many leave for the US, Canada, UK and, most recently, Australia,” says the official, who asked to remain anonymous.
    The National Association of Nigeria Nurses and Midwives has reported there is now a ratio of one nurse to 1,160 patients. Its president, Michael Nnachi, said that more than 75,000 nurses had left Nigeria since 2017.
    “If you look at the conditions of service of health workers generally, you’ll see the difficult challenges complicated by the current economic realities,” he said, adding that rising inflation has compounded the problems.
    The World Health Organization predicts a worldwide shortage of 10 million health and care workers by 2030 – mostly in low-income countries, where people are leaving for opportunities abroad.
    This is despite the WHO’s introduction of a safeguard list to stop rich countries poaching from poorer countries with staff shortages.
    The “red list”, launched in 2020 with plans to update it every three years, includes Nigeria, Ghana, Zimbabwe and 34 other African countries. Yet the UK’s nursing regulator, the Nursing and Midwifery Council, says more than 7,000 Nigerian nurses relocated to the UK between 2021 and 2022.
    Data from the Ghana Registered Nurses and Midwives Association shows that nearly 4,000 nurses left the country in 2022. In Zimbabwe, more than 4,000 health workers, including 2,600 nurses, left in 2021 and 2022, the government said.
    The WHO has no powers to prohibit recruitment of doctors from countries on the list, but recommends “government-to-government health worker migration agreements be informed by health labour market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries”.
    Read the full article here
  7. Clive Flashman
    Initial survey findings show the long road to recovery for people who have faced COVID at home without going into hospital
    New survey findings from over 1,000 people show that those recovering from mild-moderate COVID are struggling for weeks with symptoms, raising concerns that there is not adequate support for people who have not been in hospital with the illness.
    The ongoing survey is being run by Asthma UK and the British Lung Foundation, through their post-COVID HUB, which they set up, alongside a helpline and WhatsApp service, to support anyone left with breathing difficulties after COVID.
    Read full article here
  8. Clive Flashman
    The country’s largest clinical study is being launched in Greater Manchester to investigate the best gap between first and second Covid-19 vaccine doses for pregnant women.
    Led by St George’s, University of London, the Preg-CoV study will provide vital clinical trial data on the immune response to vaccination at different dose intervals – either four to six weeks or eight to 12 weeks. This data will help determine the best dosage interval and reveal more about how the vaccine works to protect pregnant mothers and their babies against Covid-19.
    Pregnant women are more likely to develop severe Covid-19 or die from the disease but are excluded from clinical trials with new vaccines. This means there are currently very limited clinical trial data on the immune response and side effects caused by the vaccines for these women.
    Read the full story here
    Source: National Health Executive
  9. Clive Flashman
    New analysis from Diabetes UK predicts that, without significant government action, up to 5.5m people in the UK could be living with diabetes by 2030. 
    The prediction is based on analysis of statistics from Public Health England and The Association of Public Health Observatories. It means that as many as 1-in-10 UK adults could be living with diabetes within a decade.  
    Additional analysis carried out shows that up to 17 million people - 1-in-3 UK adults - could be at an increased risk of developing type 2 diabetes by 2030, unless there's commitment from the governments of the UK to urgently invest in diabetes care and prevention. 
    It is known that there's been progress in diabetes care, such as the hundreds of thousands of people who have been supported by the NHS Diabetes Prevention Programme. But we need more action to stop our prediction from coming true. 
    That's why Diabetes UK are calling on the UK Government to: 
    Make more funding available to enable more people to avoid a diagnosis of type 2 diabetes through increasing access to proven preventative measures, such as the NHS Diabetes Prevention Programme  Support far more people diagnosed with type 2 diabetes to go into remission where possible  Improve access to weight management services   Ensure that everyone has the access to the care and diabetes checks they need – including tackling the backlog – as we move out of the pandemic.  The effects of the pandemic are still being felt in diabetes care. Millions of people with type 1 and type 2 diabetes haven't had vital health checks when they needed them, and thousands of diagnoses of type 2 diabetes have been delayed or missed. 
    Read full article here
    Original source: Diabetes UK
  10. Clive Flashman
    Antibiotic resistance is an increasing challenge for modern medicine as more naturally occurring antimicrobials are needed to tackle infections capable of resisting treatments currently in use.
    New research from the University of Warwick has investigated natural remedies to fill the gap in the antibiotic market, taking their cue from a 1,000-year-old text known as Bald's Leechbook. Read the full article here.
  11. Clive Flashman
    The Government has decided to cut the fee GPs are paid per Covid vaccination by a quarter, prompting BMA to issue a patient safety warning.
    NHS England has published the new enhanced service specification for Covid vaccines to be delivered between 1 September and 31 March next year, setting out that GPs will be paid £7.54 for each vaccine administered – down from £10.06 – and continue to be paid £10 for each housebound patient.
    The fee had already been reduced from £12.58 last year, when the BMA advised GPs to review whether they were still able to fulfil the ES commitments.
    The new specification said that practices with ‘sufficient workforce capacity so as not to impact the delivery of essential services and appropriately trained and experienced staff’ must indicate their willingness to participate in the programme before 5pm on 29 August.
    The Item of Service fee for flu remains £10.06 of each vaccine delivered, according to the new specification published last week.
    But the BMA said that that NHS England’s decision to reduce the Covid fee ‘undervalues general practice and threatens the safety of vulnerable patients’.
    Read the full article here: https://www.pulsetoday.co.uk/news/clinical-areas/respiratory/25-cut-to-covid-vaccine-ios-threat-to-patient-safety-bma-warns/ 
  12. Clive Flashman
    The number of women in the UK who have not had vital NHS breast screening, which can stop people dying from breast cancer, has risen by an estimated 50% - to nearly 1.5 million women - since services resumed, the leading UK breast cancer charity warns during Breast Cancer Awareness Month.  
    Breast Cancer Now reveals an alarming increase of around half a million women who haven’t been screened since services restarted in summer 2020, estimating that around 1,480,000 fewer women in the UK had breast screening between March 2020 and May 2021, compared to pre-pandemic levels. This comes a year after the charity reported that almost one million women had missed breast screening due to COVID-19 seeing services paused.
    According to the charity, nearly 12,000 people in the UK could have been living with undiagnosed breast cancer at the end of May 2021, due to the impact of the pandemic on breast screening services and fewer women being referred to specialists with possible symptoms of the disease since March 2020 – a frightening prospect when early detection can stop people dying from the disease.
    Full article here
    Source: Breast Cancer Now
    Also covered in the Independent
  13. Clive Flashman
    This survey looks at the experiences of people who stayed at least one night in hospital as an inpatient.
    The results show that, generally, people’s experiences of inpatient care were positive and overall differences between COVID-19 and non-COVID-19 patients were small, suggesting that care provided was consistent. Most people said they were treated with respect and dignity, had confidence and trust in the doctors and nurses that treated them and observed high levels of cleanliness.
    Survey findings were less positive, however, for areas of care including people’s experiences of receiving emotional support, information sharing and hospital discharge.
    For the detailed findings, click here
    Original source: Care Quality Commission
  14. Clive Flashman
    All GP appointments should be done remotely by default unless a patient needs to be seen in person, Matt Hancock has said, prompting doctors to warn of the risk of abandoning face-to-face consultations.
    In a speech setting out lessons for the NHS and care sector from the coronavirus pandemic, the health secretary claimed that while some errors were made, “so many things went right” in the response to Covid-19, and new ways of working should continue. He said it was patronising to claim that older patients were not able to handle technology.
    The plan for web-based GP appointments is set to become formal policy, and follows guidance already sent to GPs on having more online consultations. But the Royal College of GPs (RCGP) hit back, saying it would oppose a predominantly online system on the grounds that both doctors and patients benefited from proper contact.
    Read full article here
  15. Clive Flashman
    Bristol Children’s hospital tried to ‘deceive’ Ben Condon’s parents about his death, NHS ombudsman says
    An eight-week-old baby died after “a catalogue of failings” in his treatment at a children’s hospital, which then tried to “deceive” his parents about his death, an official inquiry has found.
    Doctors failed to spot that Ben Condon was suffering from a deadly bacterial infection and did not give him antibiotics until an hour before he died, the NHS ombudsman said.
    “We found that Ben and his family suffered serious injustice in consequence of the failings we found in his care and treatment,” the parliamentary and health service ombudsman said in a report that contained damning criticisms of Bristol Children’s hospital. The errors were all “lost opportunities” to help Ben recover from his illness and so increased the risk of him dying.
    Read the full article here
    Source: The Guardian
    Also covered in the Independent
  16. Clive Flashman
    The BMA has advised practices to immediately start offering consultations of 15 minutes or more; and apply to close their patient list, as part of the fightback against the Government’s new GP access plan.
    It set out a range of measures GPs should take to protect their staff and patients and ‘prioritise’ core work amid pressure to return to pre-pandemic ways of working.
    In an email bulletin sent to GPs on Friday, the BMA’s GP Committee said that practices ‘should not feel pressured to return to a traditional 10-minute treadmill of face-to-face consultations that are neither good for patients nor clinicians’.
    It said: ‘Instead, they should offer patients consultations that are 15 minutes or more [and] apply to close the practice list to focus on the needs of existing patients.’
    Read full article here
    Original source: Pulse
  17. Clive Flashman
    I fell sick on 25 March. Four months later, I’m still dealing with fever, cognitive dysfunction, memory issues and much more
    I just passed the four-month mark of being sick with Covid. I am young, and I had considered myself healthy.
    My first symptom was that I couldn’t read a text message. It wasn’t about anything complex – just trying to arrange a video call – but it was a few sentences longer than normal, and I couldn’t wrap my head around it. It was the end of the night so I thought I was tired, but an hour later I took my temperature and realized I had a fever. I had been isolating for 11 days at that point; the only place I had been was the grocery store.
    My Day 1 – a term people with Long Covid use to mark the first day of symptoms – was 25 March.
    Four months later, I’m still dealing with a near-daily fever, cognitive dysfunction and memory issues, GI issues, severe headaches, a heart rate of 150+ from minimal activity, severe muscle and joint pain, and a feeling like my body has forgotten how to breathe. Over the past 131 days, I’ve intermittently lost all feeling in my arms and hands, had essential tremors, extreme back, kidney and rib pain, phantom smells (like someone BBQing bad meat), tinnitus, difficulty reading text, difficulty understanding people in conversations, difficulty following movie and TV plots, sensitivity to noise and light, bruising, and petechiae – a rash that shows up with Covid. These on top of the CDC-listed symptoms of cough, chills and difficulty breathing.
    Read the full article here.
  18. Clive Flashman
    Teens who have been bullied by their peers, or who have considered or attempted suicide, may be more likely to have more frequent headaches than teens who have not experienced any of these problems, according to a study published in the August 2, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study does not prove that bullying or thoughts of suicide cause headaches; it only shows an association.
    “Headaches are a common problem for teenagers, but our study looked beyond the biological factors to also consider the psychological and social factors that are associated with headaches,” said study author Serena L. Orr, MD, MSc, of the University of Calgary in Canada. “Our findings suggest that bullying and attempting or considering suicide may be linked to frequent headaches in teenagers, independent of mood and anxiety disorders.”
    The study involved more than 2.2 million teens with an average age of 14 years. 
    Read the full article here: https://www.eurekalert.org/news-releases/997216
  19. Clive Flashman
    Five-year survival rates are expected to fall due to delays in getting urgent referrals or treatment at the height of the pandemic.
    Thousands of lives may be lost to cancer because 250,000 patients were not referred to hospital for urgent checks, says a report to be published this week. Family doctors made 339,242 urgent cancer referrals in England between April and June, down from 594,060 in the same period last year — a drop of 43%.
    The fall in the number of people seeing their GP with symptoms, and in referrals for scans, is resulting in cancers being spotted too late, according to the research by the Institute for Public Policy Research (IPPR) and Carnall Farrar, a healthcare management consultancy.
    Full article on The Times website here (paywalled).
  20. Clive Flashman
    The agency is now showing disease incidence among unvaccinated people, as well as those who received Johnson & Johnson, Pfizer, and Moderna vaccines.
    The U.S. Centers for Disease Control and Prevention has published information on its COVID Data Tracker about rates of cases and deaths among fully vaccinated and unvaccinated people.  In August, according to the data, unvaccinated people had a 6.1 times greater risk of testing positive for COVID-19, and an 11.3 times greater risk of dying from the disease.  
    Interestingly, the agency also breaks out case and death rates by vaccine product. In mid-August, at the peak of the latest wave, unvaccinated people made up the greatest percentage of COVID-19 cases, at an incident rate of 736.72 cases per 100,000 people.  Johnson & Johnson had the second-highest incidence rate, at 171.92 cases per 100,000.  Pfizer had the third-highest, at 135.64.  And Moderna had the lowest rate, at 86.28 cases per 100,000 people.  
    The death rate mirrored the breakdown in terms of vaccine product and frequency, although the numbers were far lower across the board.  Again, at the peak in mid-August, the death rate among unvaccinated people was 13.23 in 100,000 people.   Rates for vaccinated people were dramatically reduced, at 3.14, 1.43 and 0.73 for Johnson & Johnson, Pfizer, and Moderna, respectively.  
    When it came to age groups, peak case rates were highest among unvaccinated 12-17 year olds, followed by unvaccinated 30- to 49-year-olds. And 30- to 49-year-olds also had the highest case incidence among vaccinated people when broken down by age group, followed by fully vaccinated 18- to 29-year-olds.   Those older than 80 had the highest death rates among both unvaccinated and vaccinated individuals.  
    The COVID Data Tracker site also includes integrated county views, forecasting and hospitalizations by vaccination status.  
    Read the full article here
    Original source: Healthcare IT News
  21. Clive Flashman
    The Centers for Disease Control and Prevention acknowledged last week that a significant number of COVID-19 patients do not recover quickly, and instead experience ongoing symptoms, such as fatigue and cough.
    As many as a third of patients who were never sick enough to be hospitalized are not back to their usual health up to three weeks after their diagnosis, the report found.
    Read the full article here
  22. Clive Flashman
    Over the past few months, we have been living in unprecedented and uncertain times as a result of the Covid-19 pandemic. Lockdown measures, school closures and social distancing have all had a substantial impact on the way we live our lives.
    But, what have been the experiences of children, young people and their families during this time? And how has children’s well-being been affected?
    Our well-being research
    Every year we (The Children's Society) measure the well-being of children in the UK through a regular survey, with the findings presented in our Good Childhood Report. This research has shown how, since 2009, children’s well-being in this country has been in decline.
    In our 2020 survey, we included a number of questions to gauge the impact of Covid-19 and the resulting social distancing/lockdown measures on children’s lives. The survey was completed between April and June, when the UK was in lockdown.
    Our latest briefing, Life on Hold, brings together the findings of these survey questions about Covid-19, together with children’s own accounts. 
    Read the full article and findings here.
  23. Clive Flashman
    Findings from the Care Quality Commission's (CQC’s) latest annual survey of people who stayed as an inpatient in hospital show that most people had confidence in the doctors and nurses treating them and felt that staff answered their questions clearly. However, just over a third (40%) of patients surveyed left hospital without written information telling them how to look after themselves after discharge (up from 38% in 2017), and of those who were given medication to take home, 44% were not told about the possible side effects to watch out for. 
  24. Clive Flashman
    Initial data from the COVID-19 Infection Survey. This survey is being delivered in partnership with IQVIA, Oxford University and UK Biocentre.
    Full article here
    Table of contents in the report:
     
    1.       Main points
    2.       Number of people in England who had COVID-19
    3.       Regional analysis
    4.       Incidence rate
    5.       Test sensitivity and specificity
    6.       COVID-19 Infection Survey data
    7.       Collaboration
    8.       Glossary
    9.       Measuring the data
    10.    Strengths and limitations
    11.     Related links
  25. Clive Flashman
    Three quarters of patients surveyed at Jinyintan Hospital in Wuhan, China had at least one ongoing symptom
    The majority of people admitted to hospital with coronavirus still had symptoms six months after getting ill, a new study has revealed.
    Over three quarters of Covid patients surveyed at Jinyintan Hospital in Wuhan, China had at least one ongoing symptom – with the most commonly reported being fatigue or muscle weakness. A total of 1,733 patients, with a median age of 57, were examined for the study between 7 January and 29 May last year. At a follow-up, 76% of patients reported at least one ongoing symptom.
    Read the full article here
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