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Found 1,220 results
  1. News Article
    The percentage of Americans reporting they or a family member postponed medical treatment in 2022 due to cost rose 12 points in one year, to 38%, the highest in Gallup’s 22-year trend. The latest double-digit increase in delaying medical treatment came on the heels of two consecutive 26% readings during the COVID-19 pandemic that were the lowest since 2004. The previous high point in the trend was 33% in 2014 and 2019. An average 29% of U.S. adults reported putting off medical treatment because of cost between 2001 and 2021. Americans were more than twice as likely to report the delayed treatment in their family was for a serious rather than a nonserious condition in 2022. In all, 27% said the treatment was for a “very” or “somewhat” serious condition or illness, while 11% said it was “not very” or “not at all” serious. Lower-income adults, younger adults and women in the U.S. have consistently been more likely than their counterparts to say they or a family member have delayed care for a serious medical condition. In 2022, Americans with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to say someone in their family delayed medical care for a serious condition (34% vs. 18%, respectively). Those with an income between $40,000 and less than $100,000 were similar to those in the lowest income group when it comes to postponing care, with 29% doing so. Read full story Source: Gallup News, 17 January 2023
  2. News Article
    Ministers must use legislation to address an “unacceptable and inexcusable” failure to address racial disparity in the use of the Mental Health Act (MHA), MPs and peers have said. The joint committee on the draft mental health bill says the bill does not go far enough to tackle failures that were identified in a landmark independent review five years ago, but which still persist and may even be getting worse. The committee says the landmark 2018 review of the MHA by Prof Simon Wessely – which the bill is a response to – was intended to address racial and ethnic inequalities, but that those problems have not improved since then “and, on some key metrics, are getting rapidly worse”. Lady Buscombe, the committee chair, said: “We believe stronger measures are needed to bring about change, in particular to tackle racial disparity in the use of the MHA. The failure to date is unacceptable and inexcusable. “The government should strengthen its proposal on advanced choice and give patients a statutory right to request an advance choice document setting out their preferences for future care and treatment, thereby strengthening both patient choice and their voice.” A Department of Health and Social Care spokesperson said: “We are taking action to address the unequal treatment of people from Black and other ethnic minority backgrounds with mental illness – including by tightening the criteria under which people can be detained and subject to community treatment orders. “The government will now review the committee’s recommendations and respond in due course.” Read full story Source: The Guardian, 19 January 2023
  3. News Article
    Death rates from cancer in the US have fallen by 32% over the three decades from 1991 to 2019, according to the American Cancer Society. The decline is thanks to prevention, screening, early diagnosis and treatment of common cancers, including lung and breast cancer. The drop has meant 3.5m fewer deaths. However, cancers are still the second leading cause of death in the US, after heart disease. In 1991, the cancer death rate was 215 per 100,000 people and in 2019 it dropped to 146 per 100,000 people. Lung cancer, of which there are 230,000more cases each year, kills the most patients, 350 per day. But people are being diagnosed sooner, and technological advancements have increased the survival rate by three years. The report also examined racial and economic disparities in cancer outcomes. The Covid-19 pandemic added to already existing difficulties for marginalised groups to get cancer screenings and treatment. For nearly every type of cancer, white people have a higher survival rate than black people. Black women with breast cancer face a 41% higher death rate than white women. Read full story Source: BBC News, 12 January 2023
  4. News Article
    Prostate cancer patients across the UK face a “postcode lottery” of care, a charity has warned, with men in Scotland almost three times more likely to be diagnosed at a late stage compared with men in London. Prostate Cancer UK said the proportion diagnosed when the disease may be too advanced to treat varied hugely depending on where patients lived. Health leaders called the findings “shocking”. In Scotland, more than a third (35%) of men are only diagnosed when the disease is classed as stage 4, meaning the cancer has spread to another part of the body – known as metastatic cancer. In London, the figure is 12.5%. Chiara De Biase, director of support and influencing at Prostate Cancer UK, said, "We can’t say for sure what’s behind this gap in diagnosis, but it’s clear that men are more likely to be diagnosed at an earlier stage in areas with higher rates of PSA blood testing. That means the key way to tackle this is by raising awareness – especially in places like Scotland which are worst-affected." Read full story Source: The Guardian, 12 January 2023
  5. News Article
    Black patients wait up to six months longer for an organ transplant than the general population, new NHS data shows. The best match comes from someone of the same ethnicity - but only 2% of donors in 2021/22 were black, while black people are 4% of the population. Black families are also less likely to agree to organ donation than white families, the figures show. The NHS says there's an "urgent need" for more people from ethnic minorities to donate. Winnie Andango from NHS Blood and Transplant said, "Black people wait longer because there's less people coming forward to give their organs from their ethnic group. During covid, so many patients were suspended but those have been added back onto the list, and that means if we had less organs for this ethnic minority group, we have even less right now." Health Minister Neil O'Brien said: "We need more people, especially those from black and Asian heritage, to register their organ donation decision and share it with their family so loved ones can follow their wishes." Read full story Source: BBC News, 12 January 2023
  6. News Article
    The poor state of children’s teeth is a damning indictment of widening inequalities in child health in England, the president of the Royal College of Paediatrics and Child Health has said. In an interview with The BMJ Camilla Kingdon said that paediatricians were seeing the effects of longstanding health inequalities widening as the cost of living crisis affects the types of ill health that children are presenting with. She further told The BMJ, “There are lots of examples. One that we often forget about is oral health and the state of children’s teeth, which is actually a national disgrace. The commonest reason for a child having a general anaesthetic in this country is dental clearance. That’s a terrible admission of failure.” In her interview with The BMJ, Kingdon identified asthma and nutrition as other major areas of child health where the UK was failing. She said that these trends were partly being driven by social factors and expressed concern at the lack of focus in policy on fixing them. She warned, “Our worry, with the health disparities white paper being kicked into the long grass, is that without that intention, without a clear signal from the government that this is a priority, all these ideas [for tackling child health inequalities] just won’t be prioritised and we will miss an opportunity to really intervene.” Read full story Source: BMJ, 4 January 2023
  7. News Article
    Mental health trusts will be expected to appoint a board member responsible for improving racial equality and to develop individual plans to eliminate systemic racism, according to new draft NHS England guidance seen by HSJ. The draft guidance says all providers will be required to draw up their own Patient and Carer Race Equality Framework by March 2024. These blueprints will outline how trusts plan to improve access, experience and outcomes for racialised communities, covering all services from talking therapies through to secure inpatient services. PCREFs were a key recommendation in the 2018 Mental Health Act review which identified disproportionate applications of the act in racialised groups and are part of NHSE’s wider mental health equalities strategy. Black people are 10 times more likely to receive a community treatment order after being an inpatient and their rate of detention under the act is four times as high as the rate for white people. The guidance follows HSJ last month revealing the “staggering” rise in restraints of black people in NHS care. Read full story (paywalled) Source: HSJ, 5 January 2023
  8. News Article
    NHS England has shelved priorities on Long Covid and diversity and inclusion – as well as a wide range of other areas – in its latest slimmed down operational planning guidance, HSJ analysis shows. NHSE published its planning guidance for 2023-24, which sets the national “must do” asks of trust and integrated care systems, shortly before Christmas. HSJ has analysed objectives, targets and asks from the 2022-23 planning guidance which do not appear in the 2023-24 document. The measures on which trusts and systems will no longer be held accountable for include improving the service’s black, Asian and minority ethnic disparity ratio by “delivering the six high-impact actions to overhaul recruitment and promotion practices”. Another omission from the 2023-24 guidance compared to 2022-23 is a target to increase the number of patients referred to post-Covid services, who are then seen within six weeks of their referral. Several requirements on staff have been removed, including to ”continue to support the health and wellbeing of our staff, including through effective health and wellbeing conversations” and ”continued funding of mental health hubs to enable staff access to enhanced occupational health and wellbeing and psychological support”. Read full story (paywalled) Source: HSJ, 4 January 2022
  9. News Article
    The Conservatives have been accused of “failing women” as analysis reveals gynaecology waiting times have trebled in the past decade, with more than 540,000 waiting for NHS care. NHS England data shows that in October 2012, the average waiting time to see a gynaecologist was 4.8 weeks. By October 2022, the most recent month for which figures are available, that figure had increased by 225% to 15.6 weeks. Many of the conditions experienced by women waiting to see a gynaecologist are progressive. Left untreated, they can need more complex or invasive surgery. Thousands are living in extreme pain as a result of the long waits, doctors, health experts and charities told the Guardian. The figures reveal that 38,231 women have been waiting more than a year. Ten years ago there were 15 women in England waiting longer than 12 months – and no one waiting two years. Today, 69 women have been waiting more than 24 months. Dr Ranee Thakar, the president of the Royal College of Obstetricians and Gynaecologists, said: “This new analysis adds to our own research that gynaecology waiting lists were outstripping other specialities long before the pandemic, and they continue to grow rapidly. “Shockingly, the fact we can now track this pattern back 10 years, shows how long overdue action is to address the unequal growth in waiting lists.” Thakar added: “Women’s health has been consistently deprioritised. Gynaecology waiting times are currently the longest we’ve seen since waiting list targets were introduced, leaving thousands of women with symptoms including extreme pain, heavy menstrual bleeding and incontinence.” Read full story Source: The Guardian, 19 December 2022
  10. News Article
    Autistic people in England who do not also have a learning disability are approximately 51% more likely to die in a single year compared to the general population, according to a leaked document which estimates the mortality rate for the first time. According to an internal NHS England document, seen by HSJ, the standardised mortality rate between April 2020 and March 2021 was 16.6 deaths per 10,000 for people with autism and no learning disability compared to 11 deaths per 10,000 for the general population. NHSE also determined life expectancy for this group to be 75 years – 5.4 years less than the general population. Dominic Slowie, former national clinical director for learning disability, told HSJ that because of the different ways autism presents itself, it can be difficult to pinpoint causes of premature mortality. “In some cases, people with autism who are severely disabled and can’t communicate their needs in a conventional way are going to have premature mortality for the same reasons that people with a learning disability do, because people do not really understand the level of their need or do not investigate their need in a reasonably adjusted way,” he said. “While, if someone is presenting atypically in their communication, we mustn’t make presumptions – we must make reasonable adjustments to ensure they are investigated and diagnosed in the same way.” Read full story (paywalled) Source: HSJ, 13 December 2022
  11. News Article
    What started as a shoulder ache led to a whirlwind diagnosis of stage four cancer and a rare genetic mutation for Spike Elliott. But his journey also highlighted a worrying ethnicity data gap in our health system. It comes as research by one charity shows just how few patient records include ethnicity information in Wales. The Welsh government said it was working to improve the diversity of data collection and health research. One oncologist said it meant assumptions were made about how patients will respond, despite there being "clear differences" in how certain cancers affect different racial groups. "I was given a life expectancy of 6 to 12 months. That was statistically supported. "But I was alarmed when I was made aware that the statistics don't include the BAME (Black, Asian and Minority Ethnic) community. "Because what was my outcome then?" Read full story Source: BBC News, 21 June 2023
  12. News Article
    Thousands of disabled adults and children, including those with the highest and most complex needs, are having to wait more than four months for an NHS wheelchair, official health figures show. In one part of the country more than two-thirds of patients referred to the wheelchair service face waits of more than 18 weeks, or roughly four months, to get the help they need. Besides preventing them from getting around independently, and the mental health problems that can come from the resulting social isolation, a leading disability charity says disabled people can also be left with physical pain if forced to use poorly fitting or unsuitable chairs while they wait for upgrades and adaptations. Data published by NHS England shows 16.5% of patients – one in six – were waiting longer than the NHS target time of 18 weeks for a wheelchair, equipment for a wheelchair, or wheelchair modifications between October and December last year. This represents more than 6,000 adults and almost 1,600 children, of which thousands were registered as having high or specialist needs. The figures include new patients as well as re-referred patients whose needs may have changed or whose current equipment needs adjusting or modified. Read full story Source: National World, 21 March 2023
  13. News Article
    Two-thirds of GP practices from a sample of 100 in London declined to register a patient without an address, contrary to national rules which are meant to ensure homeless and excluded people can get healthcare, HSJ has found. NHS England guidance states anyone can register with a GP without proof of address, and that people without a permanent address “can still register using a temporary address or the address of the GP surgery”. Practices normally need to record an address, but the exception rule is meant to ensure people who are homeless, or living in unstable or short-term accommodation, are still able to access primary care or referrals for secondary services. Despite this, when HSJ called 100 randomly selected practices in London (about 9 per cent of the total), 64 refused to register the caller. Read full story (paywalled) Source: HSJ, 19 June 2023
  14. News Article
    Trusts and systems must draw up plans to improve the diversity of their executive and senior leadership teams over the next 12 months, and evidence progress against them by summer 2025, NHS England has announced. A new equality, diversity and inclusion (EDI) improvement plan also says every board and executive team member will have EDI objectives they will be assessed against during annual appraisals by spring 2024. The targets form part of six “high impact actions,” each with set targets that aim to address the “widely known intersectional impacts of discrimination and bias” within the NHS. Read full story (paywalled) Source: HSJ, 8 June 2023
  15. News Article
    The NHS in England is "failing women", the government's women's health ambassador has said. Prof Dame Lesley Regan, appointed to support the Women's Health Strategy implementation, was speaking to BBC Radio 5 Live's Naga Munchetty. Last month, Munchetty, 48, revealed she had been diagnosed with the womb condition adenomyosis, after waiting years in severe pain. Dame Lesley said she wanted women to be able to self-refer to specialists. Women and girls should not have to seek "permission [to] go and have your crippling menstrual pain sorted out", she said. Read full story Source: BBC News, 6 June 2023
  16. News Article
    A new alert system will warn the public when high temperatures could damage their health this summer in England. Run by the UK Health Security Agency and the Met Office, it is aimed at reducing illness and deaths among the most vulnerable as climate change makes heatwaves more frequent. The Heat Health Alert system will operate year-round, but the core alerting season will run from 1 June to 30 September. The system will offer regional information and advice to the public and send guidance direct to NHS England, the government and healthcare professionals. Individuals can sign up to receive alerts directly and people can specify which region they would like to receive alerts for. Dr Agostinho Sousa, head of extreme events and health protection at the UK Health Security Agency, said, "It is important we are able to quantify the likely impacts of these heatwaves before they arrive to prevent illness and reduce the number of deaths." Read full story Source: BBC News, 1 June 2023
  17. News Article
    A controversial new Florida bill will allow physicians to opt out of performing certain services because of "sincerely held" religious, moral, or ethical beliefs. The bill, part of a "medical freedom" legislative package signed last week, permits healthcare providers to make conscience-based objections to providing medical care and protects them from getting sued or losing their licenses. Critics say the new law could exacerbate health disparities and lead to discrimination against certain groups of patients, including LGBTQ+ individuals and women seeking reproductive healthcare. Psychologists could refuse to treat someone for gender dysphoria, for example. Doctors could refuse to prescribe birth control, administer childhood vaccines, or accept patients with state insurance. Kenneth W. Goodman, professor and director of the University of Miami's Institute for Bioethics and Health Policy, told Medscape Medical News the legislation could upset a longstanding precedent. "To deny care based on unspecified and unarticulated 'moral, ethical, or religious reasons' opens the door to neglect, abandonment, and suspicion," Goodman said. "It undermines two millennia of a cornerstone of medical ethics: take care of your patients — no matter who they are." Read full story Source: Medscape, 18 May 2023
  18. News Article
    One of the first studies to examine the full lifespan of people living with Down syndrome (DS) has provided evidence in support of health guidelines specifically for people with the condition. Life expectancy for people with DS had increased dramatically over the last 80 years or so, yet people with the condition still died at an earlier age than people in the general population or those with other intellectual disabilities, said the authors of a new study, published in The Lancet. This meant that there was an "opportunity to improve health outcomes for this minority", they said. There continued to be disparities in surveillance, diagnosis, and treatment of common health conditions in people with intellectual disabilities, including those with DS, highlighted the authors, with ongoing premature mortality and excess morbidity identified in these groups. In April 2022, the Down Syndrome Act was introduced in England, which stipulated that the Government must provide information to the NHS and local councils on how to provide the most appropriate care and support for people with DS. Read full story Source: Medscape, 26 May 2023
  19. News Article
    Healthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed. An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity. The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”. Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country. “While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes." Read full story Source: The Independent, 21 May 2023
  20. News Article
    Male GPs are less likely to refer eligible patients for IVF, research by a fertility charity suggests, raising concerns about access to NHS-funded treatment. The Progress Educational Trust’s (PET) report highlights “utter confusion” and a lack of knowledge among GPs about eligibility criteria for NHS-funded treatment, which it says is exacerbating the so-called IVF postcode lottery. GPs typically make the initial referral to fertility clinics, meaning that they play a crucial role in access. “For NHS treatment, GPs are the main initial gatekeeper. If you’re not getting pregnant, that’s who you go to for advice and support,” said Sarah Norcross, the director of PET. “It struck me that, when people have a known cause of infertility, male GPs still weren’t passing them on.” The report is based on a survey of 200 GPs and commissioners across England, carried out by an independent research company, which investigated knowledge of national fertility guidelines and criteria they use for referral decisions. Read full story Source: The Guardian, 19 May 2023
  21. News Article
    Factors like deprivation should be considered in prioritising waiting lists, NHS England’s inequalities director has said, but in a ‘very sophisticated, thoughtful way’ alongside clinical need and waiting times. NHSE said in summer 2020 the service would “restore services inclusively”, and some systems and trusts have developed tools they say could allow them to consider factors such as deprivation, race, employment, and lifestyle risk factors, such as smoking. But the issue has been controversial. Research for University Hospitals Coventry and Warwickshire Trust, which has developed a new prioritisation system, found many members of the public are opposed to taking these factors into account. NHSE standard contract guidance for 2023-24, seemingly cautioning against such moves, said: “[The Department of Health and Social Care] asked us to make clear that providers are ‘recommended to prioritise waiting lists according to clinical need and then in chronological order from the longest waiting patient.’” Read full story (paywalled) Source: HSJ, 18 May 2023
  22. News Article
    Healthcare providers caring for pregnant patients in the months after the US Supreme Court’s decision to strike down Roe v Wade have been unable to provide standard medical care in states where abortion is effectively outlawed, leading to delays and worsening and dangerous health outcomes for patients, according to an expansive new report. In the wake of the Supreme Court’s ruling last year, individual reports from patients and providers have shed some light on the wide range of harm facing pregnant women in states where access to abortion care is restricted or outright banned. But a first-of-its-kind report from the University of California San Francisco captures examples from across the country, documenting 50 cases in more than a dozen states that enacted abortion bans within the last 10 months, painting a “stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” according to the report’s author Dr Daniel Grossman. “Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” he said in a statement accompanying the report. “Pregnant people deserve better than regressive policies that put their health and lives at risk.” Read full story Source: The Independent, 16 May 2023
  23. News Article
    More than 26,000 adults with severe mental illness die prematurely each year from preventable physical illnesses, analysis by the Royal College of Psychiatrists suggests. New data from the Office for Health Improvement & Disparities shows 120,273 adults in England with severe mental illness, including psychosis, post-traumatic stress disorder and schizophrenia, died before the age of 75 between 2018 and 2020. Of these, the College estimates 80,182 deaths (two in three) were potentially preventable, which is an average of 26,727 people each year. Preventable deaths include deaths from diseases like cancer and heart disease which could have been prevented with earlier detection and treatment or lifestyle changes. While adults with severe mental illness are more likely to engage in unhealthy behaviours like smoking and drinking alcohol excessively, they are also less likely to access screening and treatment for a range of reasons including stigma associated with having a mental illness. While cancer is the leading cause of premature death among those with a severe mental illness, it also significantly increases the risk of dying before the age of 75 across a range of physical health conditions. Adults with severe mental illness are on average: 6.6 times more likely to die prematurely from respiratory disease 6.5 times more likely to die prematurely from liver disease 4.1 times more likely to die prematurely from cardiovascular disease 2.3 times more likely to die prematurely from cancer. Read full story Source: Royal College of Psychiatrists, 17 May 2023
  24. News Article
    Blind people are being put “at risk” when the NHS provides them with “inaccessible” information about their health, a charity has warned. People with sight loss have missed appointments, cancer screenings or been unable to use home test kits because of a lack of clear instructions in an accessible format, according to the sight loss charity RNIB. It warned that denying people access to their information can also “cause embarrassment and loss of dignity”. Linda Hansen, from Bradford, who is severely sight-impaired, said that she needed to get her daughter to read her the results of a medical exam which was sent to her in print format. Ms Hansen, 62, said: “I can get my bank statement or a gas bill in accessible formats, but yet I still receive health information that I can’t read. What could be more personal than your health status?” A new RNIB campaign – My Info My Way – has been launched calling for all blind and partially sighted people to be given accessible information. The charity said that a failure to provide information in an accessible format is putting blind and partially sighted people “at risk”. Read full story Source: The Independent, 16 May 2023
  25. News Article
    Hundreds of babies are dying unnecessarily because overstretched maternity services are delivering substandard care and struggling to overcome entrenched poverty and racial inequalities, a report has warned. The report by baby loss charities Sands and Tommy’s says the government’s aim to halve the number of stillbirths and neonatal deaths in England by 2025 is stalling, while there is no target in Scotland, Wales or Northern Ireland. Stillbirths are creeping up in England after falling in the past decade. Babies dying before and during delivery rose to just over four in every 1,000 births in 2021. Similarly, long-falling rates of neonatal deaths, where newborns die within the first four weeks of birth, are also rising. There were 1.4 deaths of newborn babies for every 1,000 births in 2021, compared with 1.3 in 2020. Robert Wilson, head of the charities’ joint policy unit, said the government and NHS need to make fundamental changes. “The UK is not making enough progress to reduce rates of pregnancy loss and baby death, and there are worrying signs that these rates are now heading in the wrong direction,” he said. Read full story Source: The Guardian, 14 May 2023
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