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News Article
Public told not to delay cancer check-ups
Patient Safety Learning posted a news article in News
The public are being urged not to put off seeking help for worrying cancer symptoms because of NHS pressures. NHS England chiefs said record numbers were being seen for check-ups before Omicron hit - and despite the current situation cancer was being prioritised. There have been nearly 50,000 fewer cancer diagnoses across the UK since the start of the pandemic, Macmillan Cancer Support say. This risks an increase in late-stage diagnoses, reducing survival chances. Past surveys have suggested people are reluctant to come forward during surges in Covid cases because they did not want to be a burden to the health service. NHS England said record numbers had had urgent cancer check-ups in November when 246,000 saw a consultant after a referral by a GP - although just over three quarters of these were seen in the target time of two weeks. NHS England cancer director Dame Cally Palmer added it was vital people did not delay now even though hospitals were under huge strain. "NHS staff are working hard to ensure that those who are coming forward for checks can be seen quickly so that cancer can be caught at an earlier stage." She said common symptoms to look out for included diarrhoea that lasts for three weeks or more, new lumps or bumps and unexplained weight loss or fatigue. Read full story Source: BBC News, 2o January 2022 -
Content Article
Cervical cancer symptoms (Jo's Cervical Cancer Trust)
Patient Safety Learning posted an article in Women's health
Cervical cancer symptoms include vaginal bleeding that is unusual for you, changes to vaginal discharge, discomfort during sex and pain in your lower back or pelvis. If you have symptoms, you should contact your GP. -
Content ArticleThis article by the Royal College of Obstetricians & Gynaecologists and The My Body Back Project provides tips for healthcare professionals to make cervical cancer screening attendees feel as comfortable as possible during their appointments. Cervical screening can be very daunting for some women, and for those who have experienced sexual violence it can be triggering and cause emotional distress. The article provides the following tips, with more detailed guidance: Communication – language and listening - build trust by listening and acknowledging rather than downplaying any concerns. A sense of calm – how can you can make the environment feel calm and safe? Share control – Consider how you can demonstrate shared control within the consultation and examination. Position – a good position can make all the difference to their comfort and your ability to visualise the cervix. It’s about time…. Offer a double appointment so there is time to check in, build trust and for the woman or person with a cervix to feel ready to be examined.
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News Article
Cervical cancer: New screenings will save lives, says top doctor
Patient Safety Learning posted a news article in News
Changes in cervical cancer screenings will help save lives, not put them at risk, according to a top gynaecologist. Prof Alison Fiander said people should not be worried screenings have dropped from every three to every five years in Wales as tests are "more effective". Public Health Wales (PHW) said the new rules were for people aged 25 to 49. More than 1.2 million people backed calls for a rethink in a UK petition and politicians in Wales will debate it after 30,000 signed a Senedd petition. Women and people with a cervix - as it could also affect trans men too - who had not tested positive for human papillomavirus (HPV) will now wait two more years between tests. Health chiefs in Wales said they changed the interval between screenings to the same time as those in Scotland because tests are now more accurate. Cervical screening gaps in England and Northern Ireland remain at three years. But Wales' public health body did publicly apologise for causing "concern", and admitted health chiefs "hadn't done enough to explain the changes". Prof Fiander, a clinical lead at the Royal College of Obstetricians and Gynaecologists, said PHW had "missed an opportunity" to help educate people but reassured the public the change was safe and not a cost-cutting exercise. Read full story Source: BBC News, 18 January 2022 -
EventuntilWomen’s health is one of the most political issues of our time. Much like the rest of society, health systems have been created by men for men – and women have been left to fit around the edges. Despite incredible medical advances across the world for women, they remain infantilised and controlled by patriarchal health systems. PPP’s international report, chaired by Dame Clare Gerada and Dame Lesley Regan, will change this narrative. Join us to round off International Women’s Week on the 11th March 2022 to delve deeper into the report’s findings – as we challenge the status quo and put women back in control of their own bodies. This event has been kindly sponsored by Eli Lilly and Company and MSD. Topics covered during this event: Contraception Abortion Assisted Conception Cervical Cancer Prevention & Treatment Breast Cancer Prevention & Treatment The Inevitability of Womanhood: Menstruation & Menopause Taking a Gendered Lens to Data, Research and Policy Violence Against Women & Girls Agenda 2-2.45pm: Report launch A Women’s Health Agenda: Redressing the Balance is an expose of how we have got it so badly wrong when it comes to women’s health and what can be done to fix it. Globally, we are about to enter the fifth wave of feminism, and yet five movements of activism have not resulted in fundamental societal changes for women’s health. In this first session, report chairs Dame Clare Gerada and Dame Lesley Regan will present the report and dive deeper into its recommendations. 2.50-3.45pm: Why violence against women and girls is a public health issue Violence against women and girls (VAWG) has been a topic of much discussion both within the UK and internationally over the past year – and rightly so. However, VAWG is rarely seen as a public health issue. In a recent study of over 20,000 women, Victim Focus found that 99.7 per cent of this sample had been repeatedly subjected to some form of male violence within the UK. Furthermore, the World Health Organisation ascertains that almost a third of women aged 15-49 report they have been subjected to physical or sexual abuse by an intimate partner. Violence against women is preventable, and the health sector has a crucial role to play in providing healthcare to women subjected to violence. In this session, experts from various disciplines will discuss the health and political issues around VAWG and what needs to be done to address this systemic societal problem. Speakers to be announced. 3:50-4:25pm: Keynote Speaker Our keynote speaker will assess the current challenges facing women’s health within both the international and UK context. Covid-19 is not a gender-neutral disease, and its burdens continue to fall most heavily on women. Similarly the climate crisis is most keenly felt by women across the world and poses huge health challenges. Our keynote speaker will discuss how 2022 can build on past activism to change the trajectory facing women’s health. Keynote to be announced. 4.25-4.30pm: Chair’s Close 4.30-6.00pm: Networking Drinks Register for this event
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Content ArticlePancreatic cancer is the fifth most common cause of cancer death in the UK, with an annual incidence of nearly 9,600. On average, 23 people die each day from the disease. The UK has one of the worst survival rates in Europe, with average life expectancy on diagnosis just 4 to 6 months and a relative survival to 1 year of approximately 20%. Only 3% of people survive for 5 years or longer. This figure has not improved much in over 40 years, and it is not yet clear how the more recent trend of increased surgery and adjuvant chemotherapy will affect survival. There are often delays in access to diagnosis and treatment and this NICE guideline will help to improve this.
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Content Article
The less survivable cancers: symptoms and key facts
Patient Safety Learning posted an article in Cancers
Today, 11 January 2022, the Less Survivable Cancers Taskforce (LSCT) launches its first ever Less Survivable Cancers Awareness Day, to raise the profile of these cancers and to highlight the critical importance of early diagnosis in improving survival. -
News Article
Urgent debate over cervical cancer screenings
Patient Safety Learning posted a news article in News
An urgent debate has been called in the Senedd over a move to extend routine cervical screenings in Wales from every three years to five years. Public Health Wales (PHW) said those aged 25-49 who had not tested positive for human papillomavirus (HPV) would now wait two more years between tests. PHW said it was because the screening tests are now more accurate. However, 30,000 people signed a petition against it, citing the risk it could cause an increase in deaths. Particularly concerned are those who have not received the HPV vaccine, a national immunisation programme for which began in 2008 for girls aged 12 to 13. The number of signatures on the official petition on the Welsh Parliament's website was more than enough to trigger the issue to be looked at. The change follows a recommendation from the UK National Screening Committee. Last week, Public Health Wales apologised for causing "concern" over how it explained changes to screenings following its announcement. Read full story Source: BBC News, 10 January 2022 -
News Article
Scotland: Cancers with low survival rate 'being detected too late'
Patient Safety Learning posted a news article in News
People with some of the deadliest forms of cancer are being diagnosed later than ever as a result of disruption to healthcare caused by the Covid pandemic, campaigners have warned. Stomach, lung, pancreatic, brain, stomach and oesophageal cancers have some of the poorest long-term survival rates and have always been disproportionately diagnosed late following an emergency hospital admission. However, campaigners are concerned that the poor prognoses for these patients have been exacerbated by factors such as a reluctance to attend A&E or bother GPs during the pandemic, and by bottlenecks in the numbers of patients waiting for tests such as CT scans or endoscopy. A drive to raise awareness of the symptoms for these cancers – which are not subject to any routine screening programmes – along with a push for more investment into research for treatments has been launched today to mark the first Less Survivable Cancers Awareness Day. Dawn Crosby, head of Scotland and Northern Ireland for Pancreatic Cancer UK and a member of the Less Survivable Cancers Taskforce, said: “We know that delays in diagnosis lead to much poorer outcomes for patients with these rapidly-advancing cancers. We also know the trauma associated with receiving a diagnosis in an emergency setting for both patients and families." “These cancers are currently difficult or impossible to treat at later stages and the time from diagnosis to death is often brutally short compared to more survivable cancers. “The situation is critical and has been exacerbated by the Covid-19 pandemic. The Taskforce is calling for a significant increase in research funding, as well as a commitment to increasing resources for early diagnosis for less survivable cancers so we can close the deadly cancer gap.” Read full story Source: The Herald, 11 January 2022 -
Content Article
NHSE's Core20PLUS5 – An approach to reducing health inequalities
Sam posted an article in Health inequalities
Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities at both national and system level. The approach defines a target population cohort – the ‘Core20PLUS’ – and identifies ‘5’ focus clinical areas requiring accelerated improvement. Supporting information about Core20PLUS5 -
News Article
Prostate screening could be ready in five years
Patient Safety Learning posted a news article in News
Screening for prostate cancer could be possible in the next five years, according to one of the UK's leading experts. Prof Ros Eeles, from the Institute of Cancer Research, said advances in genetics and medical imaging were making it possible. About 50,000 people in the UK are diagnosed with the disease each year, and nearly 12,000 die. NHS England said prostate screening had been notoriously tricky. Despite it being one of the most common cancers, there is no equivalent of the regular mammograms that detect breast cancer. There is a blood test that looks for levels of a protein called prostate specific antigen (PSA). But it is controversial and the UK's National Screening Committee does not recommend it. PSA tests are used to guide doctors and help monitor tumours. But using them to screen healthy people means they miss some cancers and cannot distinguish between people with high PSA levels who need treatment and those who do not. Read full story Source: BBC News, 27 December 2021 -
Content ArticleThis report examines the impact of the Covid-19 pandemic on people living with long-term conditions and highlights that many have deteriorated faster than usual due to being unable to access rehabilitation services. It makes recommendations to the government aimed at restoring rehabilitation support services. The report was produced collaboratively by The Alzheimer's Society, The Stroke Association, Macmillan Cancer Support, The Centre for Mental Health, Age UK, The College of Podiatry, The Royal College of Speech and Language Therapists, The Royal College of Occupational Therapists, The Chartered Society of Physiotherapy and The British Dietetic Association.
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News Article
Swift action needed to prevent 'cancer catastrophe' as NHS fails to meet target
Patient Safety Learning posted a news article in News
Swift action is needed from the Scottish Government to prevent a “cancer catastrophe”, campaigners have claimed, as new figures showed the NHS has again failed to meet a key waiting times standard. Ministers have set the target of having 95% of patients begin treatment within 62 days of being referred for help because cancer is suspected. But the latest data showed another decline in performance against this in the period July to September, with only 83.1% beginning treatment in this timeframe – down from 84.1% in the previous quarter and below the 87.3% that was achieved in July to September last year. None of Scotland’s health boards met the goal of starting to treat patients within two months of referral – and nor was this target achieved for any cancer types. The latest figures from Public Health Scotland showed that in NHS Orkney, only two out of five (40%) of patients referred with an urgent suspicion of cancer began treatment within two months, the lowest rate in Scotland. And less than three quarters (71.8%) of those suspected of having bowel cancer began treatment within two days, compared to 76 per cent of those with cervical cancer, 91.5% of those with lung cancer and 92.7% of those with breast cancer. It comes as the number of people being referred to help increased by almost a third from the same time last year. Read full story Source: The Scotsman, 14 December 2021 -
Content ArticleSerena Roberts died as the result of an ovarian cancer which was not diagnosed until her death. She was initially seen for an ultrasound scan in April 2020 having reported symptoms of recurrent very heavy vaginal bleeding, and had been recommended to be referred to a gynaecologist for review but was not referred. In November 2020 her GP marked her referral letter as urgent, but this was entered as routine on the e-referral system and did not include important risk factor details regarding her BMI. Her condition worsened and on her second admission to hospital in March 2021 she died. The Coroner in her report highlights concerns about significant delays in patients being seen in secondary care for gynaecological referrals from GPs, the understanding and application of NICE guidance on heavy premenstrual bleeding in General Practice and the documentation and processes relating to referrals to secondary care from the GP.
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News ArticleHealth experts have expressed fears over the impact tighter Covid restrictions in England could have on cancer patients as alarming new figures reveal that the number taking part in clinical trials plummeted by almost 60% during the pandemic. Almost 40,000 cancer patients in England were “robbed” of the chance to take part in life-saving trials during the first year of the coronavirus crisis, according to a report by the Institute of Cancer Research (ICR), which said COVID-19 had compounded longstanding issues of trial funding, regulation and access. Figures obtained from the National Institute for Health Research by the ICR show that the number of patients recruited on to clinical trials for cancer in England fell to 27,734 in 2020-21, down 59% from an average of 67,057 over the three years previously. The number of patients recruited for trials fell for almost every type of cancer analysed. Health experts said the relentless impact of Covid on the ability of doctors and scientists to run clinical trials was denying many thousands of cancer patients access to the latest treatment options and delaying the development of cutting-edge drugs. Read full story Source: The Guardian, 9 December 2021
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Content ArticleThis article in the Journal of Minimally Invasive Gynaecology provides an interpretation of the 2014 US Food and Drug Administration (FDA) statement on power morcellation, a gynaecological procedure in which a device is used to slice up fibroid tissue for extraction through small incisions. Although use of power morcellation makes surgery less invasive, it has been shown to spread cancer if it exists within the patient's tissues. This article looks at the legal impact of the FDA statement, which warns against using laparoscopic power morcellators in the majority of women undergoing hysterectomy or myomectomy for uterine fibroids.
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Content ArticleWaiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased. This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic. The report sets out: how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards; the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.
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News ArticleThe NHS may be missing more than 9 million referrals, while patients face a “postcode lottery” for cancer treatment and routine operations, a parliament watchdog has warned. Millions of patients have either avoided or been unable to obtain healthcare during the pandemic leaving the NHS with a potential unknown backlog of operations, which could push the national waiting list to 12 million by 2025. A report from the government’s National Audit Office today also warned patients across England are facing a postcode lottery in terms of waits with some hospital waiting lists far larger than others following the pandemic. Eve Byrne, head of campaigns and public affairs, at Macmillan Cancer Support, said: “This report confirms what we hear day in, day out from people living with cancer. Chronic staffing shortages are already having a devastating impact on cancer patients, and we have major concerns that is only set to worsen without urgent action. She said the government’s plan to tackle operations backlog must be backed up by steps to ensure enough nurses staff. “Without these critical pieces of the puzzle, we risk increasing numbers of people facing later diagnoses, poorer care and potentially worse chances of survival. This has to change,” she added. Read full story Source: The Independent, 1 December 2021
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News Article
Late diagnosis of breast cancer rises as NHS struggles in Covid crisis
Patient Safety Learning posted a news article in News
Soaring numbers of women are being diagnosed with advanced breast cancer, undermining their chances of survival, because of Covid’s disruption of NHS care, a charity has warned. The number of women being diagnosed with the disease at stage 4 is as much as 48% higher in some months than expected, with the pandemic to blame, says Macmillan Cancer Support. At the same time, fewer women are being confirmed as having breast cancer at stage 1, when their chances of responding well to treatment and living longer are much higher. Macmillan estimates that there is now a backlog of 47,300 people across the UK who have not yet been diagnosed with some form of cancer, as a direct result of Covid. They include people who could not access care in the usual way because many NHS services were scaled back, and also those who were too scared to seek help or did not want to add to the pressure the health service was already under. None have had a confirmed diagnosis of cancer, though some may be undergoing tests or screening. Steven McIntosh, Executive Director of Advocacy and Communications at Macmillan Cancer Support, says: “Nearly two years into the pandemic, there is still a mountain of almost 50,000 people who are missing a cancer diagnosis. Thousands more are already facing delays and disruption as they go through treatment. While hard-working healthcare professionals continue to do all they can to diagnose and treat patients on time, they are fighting an uphill battle. Cancer patients are stuck, waiting in a system that doesn’t have the capacity to treat them fast enough, let alone deal with the backlog of thousands who have yet to come forward.” “The Government has promised an NHS Elective Recovery Plan. This must show how it will tackle spiralling pressures on cancer services. It has never been more crucial to boost NHS capacity to treat and support everybody with cancer, so people receive the critical care they need now and in the years to come.” Read full story Source: The Guardian, 26 November 2021 -
Content ArticleThis e-book provides an extensive overview of the day-to-day challenges posed by antimicrobial resistance, tools for setting up stewardship programmes and guidance of how to make the most of existing programmes. Its resources apply the principles of antimicrobial stewardship to a wide range of professions, populations and clinical/care settings. It was published by the British Society for Antimicrobial Chemotherapy in collaboration with the European Society of Clinical Microbiology and Infectious Diseases.
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News ArticleLondon’s fragmented children’s cancer services will finally be reformed following a decade of delays and allegations of cover-up by senior officials. NHS England has said it will adopt recommendations that will see the capital’s services brought up to standards already common across the rest of the country, with children’s cancer centres needing to be based in hospitals with full paediatric intensive care units. The changes will be imposed “with no exceptions or special arrangements permitted,” it said in a letter yesterday. This means the Royal Marsden’s children’s service at its base in Sutton, south London, will have to move to a new hospital. Currently sick children who deteriorate at the Marsden’s site have to be rushed by ambulance to St George’s Hospital 40 minutes away. More than 330 children were transferred from the Marsden to other hospitals between 2000 and 2015 and in one year 22 children were transferred for intensive care a total of 31 times, with some experiencing at least three transfers individually. The changes will also affect cancer care at University College London Hospital which links with Great Ormond Street Children’s Hospital. The world-renowned Royal Marsden trust, whose chief executive Dame Cally Palmer is also NHS England’s national cancer director, was at the centre of a cover-up scandal before the COVID-19 pandemic. In 2019, the Health Service Journal revealed a major report, commissioned by NHS bosses in London following the deaths of several children, had been “buried” by NHS England. Read full story Source: The Independent, 12 November 2021
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News Article
Alarm over ‘serious’ delays in diagnosing childhood cancer in England
Patient Safety Learning posted a news article in News
Health experts have raised the alarm over “serious” delays in diagnosing children and young people with cancer, as a study reveals the number found to have the disease during the pandemic fell by almost a fifth. The University of Oxford found a “substantial reduction in childhood, teenage and young adult cancer detection” in England last year. The research, being presented on Friday at the National Cancer Research Institute (NCRI) festival, showed a 17% drop in cases diagnosed in the under-25s last year compared with previous years. The impact of Covid on adults with cancer is well known. However, previously little has been known about the toll on younger patients. As well as the fall in the overall numbers of children diagnosed with cancer, researchers found that even those whose cancer was spotted last year were more likely to have been diagnosed only after being admitted to intensive care. That suggests long delays in accessing care may have made them much sicker, experts say. Read full story Source: The Guardian, 12 November 2021 -
News Article
AI skin cancer diagnoses risk being less accurate for dark skin – study
Patient Safety Learning posted a news article in News
Artificial intelligence (AI) systems being developed to diagnose skin cancer run the risk of being less accurate for people with dark skin, research suggests. The potential of AI has led to developments in healthcare, with some studies suggesting image recognition technology based on machine learning algorithms can classify skin cancers as successfully as human experts. NHS trusts have begun exploring AI to help dermatologists triage patients with skin lesions. But researchers say more needs to be done to ensure the technology benefits all patients, after finding that few freely available image databases that could be used to develop or “train” AI systems for skin cancer diagnosis contain information on ethnicity or skin type. Those that do have very few images of people with dark skin. Dr David Wen, first author of the study from the University of Oxford, said: “You could have a situation where the regulatory authorities say that because this algorithm has only been trained on images in fair-skinned people, you’re only allowed to use it for fair-skinned individuals, and therefore that could lead to certain populations being excluded from algorithms that are approved for clinical use." “Alternatively, if the regulators are a bit more relaxed and say: ‘OK, you can use it [on all patients]’, the algorithms may not perform as accurately on populations who don’t have that many images involved in training.” That could bring other problems including risking avoidable surgery, missing treatable cancers and causing unnecessary anxiety, the team said. Read full story Source: The Guardian, 9 November 2021 -
Content Article
Artificial intelligence (AI) is increasingly being used in medicine to help with the diagnosis of diseases such as skin cancer. To be able to assist with this, AI needs to be ‘trained’ by looking at data and images from a large number of patients where the diagnosis has already been established, so an AI programme depends heavily upon the information it is trained on. This review, published in The Lancet Digital Health, looked at all freely accessible sets of data on skin lesions around the world. -
Content ArticleThis study in the International Journal of Radiation Oncology, Biology and Physics assesses the impact of the early Covid-19 pandemic on incident learning through evaluation of events reported to the Radiation Oncology Incident Learning System® (RO-ILS) in the USA. The authors conclude that reporting to RO-ILS declined during the early Covid-19 pandemic, especially in hotspot areas, suggesting that resources and time were diverted away from incident reporting to address other critical needs. However, three of the five top reporting practices that stopped reporting during early Covid have since reported events after the analysis timeframe, suggesting the decline may be temporary.
