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Found 457 results
  1. News Article
    It is one of many mysteries about Long Covid: Who is more prone to developing it? Are some people more likely than others to experience physical, neurological or cognitive symptoms that can emerge, or linger for, months after their coronavirus infections have cleared? Now, a team of researchers who followed more than 200 patients for two to three months after their Covid diagnoses report that they have identified biological factors that might help predict if a person will develop long Covid. The study, published by the journal Cell, found four factors that could be identified early in a person’s coronavirus infection that appeared to correlate with increased risk of having lasting symptoms weeks later: The level of coronavirus RNA in the blood early in the infection, an indicator of viral load. The presence of certain autoantibodies — antibodies that mistakenly attack tissues in the body as they do in conditions like lupus and rheumatoid arthritis. The reactivation of Epstein-Barr virus, a virus that infects most people, often when they are young, and then usually becomes dormant. Having Type 2 diabetes, although the researchers and other experts said that in studies involving larger numbers of patients, it might turn out that diabetes is only one of several medical conditions that increase the risk of Long Covid. The researchers said they had found that there was an association between these factors and Long Covid whether the initial infection was serious or mild. They said that the findings might suggest ways to prevent or treat some cases of Long Covid, including the possibility of giving people antiviral medications soon after an infection has been diagnosed. “I think this research stresses the importance of doing measurements early in the disease course to figure out how to treat patients, even if we don’t really know how we’re going to use all that information yet,” said Jim Heath, the principal investigator of the study. However, the study authors and other experts cautioned that the findings were exploratory and would need to be verified by considerably more research. Read full story (paywalled) Source: The New York Times, 25 January 2022
  2. Content Article
    COVID-19 has meant people have died the ultimate medicalised deaths, often alone in hospitals with little communication with their families. But in other settings, including in some lower income countries, many people remain undertreated, dying of preventable conditions and without access to basic pain relief. The unbalanced and contradictory picture of death and dying is the basis for the Lancet Commission on the Value of Death. Drawing on multidisciplinary perspectives from around the globe, the Commissioners argue that death and life are bound together: without death there would be no life. The Commission proposes a new vision for death and dying, with greater community involvement alongside health and social care services, and increased bereavement support.
  3. News Article
    Death has become “over medicalised” and the public should be encouraged to discuss dying and grief, experts have said. There's a call for shift in attitude towards palliative care, with more emphasis on compassion and less on giving medication that may prolong pain. According to a new Lancet commission, an overemphasis on aggressive treatments to prolong life, global inequities in palliative care access, and high end-of-life medical costs have led to millions of people suffering unnecessarily at the end of their life. The authors also note that the pandemic has made death and dying more prominent in daily life, while health systems have been “overwhelmed” when trying to care for those dying. People often died alone, with families unable to say goodbye to loved ones or grieve together, the commission said – the effects of which will “resonate for years to come”. The researchers argue that many people, mainly in low- and middle-income countries, have no access to end-of-life care, and particularly to opioids, while those in high-income countries may be overtreated. Attitudes towards death and dying should be “rebalanced”, the authors conclude, away from a medicalised approach towards a “compassionate community model”, where families work with health and social care services to care for those dying. Read full story (paywalled) Source: The Telegraph, 31 January 2022
  4. Content Article
    The pandemic has shone a stark spotlight on so many inequities and inconsistencies in access to health and social care. Unfortunately, many of these inequities were already there and so, in some respects, its nothing new. In this blog, I want to draw attention to how visiting restrictions can result in worse outcomes for patients and their families. I will focus mainly on the needs of older adults in hospital or care, and those with dementia, because that has been my own experience. But these restrictive practices have affected so many groups: among them, those with mental health conditions and those with learning and behavioural difficulties. 
  5. News Article
    Experts have estimated that almost 300,000 people in Britain could have a potentially deadly heart valve disease called aortic stenosis - including almost 100,000 who are unaware they have it. The condition carries a high death rate if left untreated and occurs when the main valve which takes blood from the heart stiffens and narrows. Many people do not know they have the disease and only discover they do when it is too late for treatment. An international team of scientists, including experts from the Universities of Glasgow and Southampton, set out to research the extent of the disease in the UK. Their study, published in the journal Open Heart, estimated that in the UK in 2019 there were 291,448 men and women aged 55 and over with severe aortic stenosis. Of these, an estimated 68 per cent would have symptoms. This means an estimated 92,389 people have the disease and do not know it. The authors went on to estimate that more than 172,000 (59%) who have the disease will “die within five years without proactive management”. They concluded that aortic stenosis is a “common condition” in the UK but warned that “without appropriate detection and intervention, survival prospects are likely to be poor”. Read full story Source: The Independent, 25 January 2022
  6. Content Article
    This article, published in BMC Health Services Research, discusses the effectiveness of using checklists as training and operational tools to assist in improving the skills of general ward staff on the rescue of patients with abnormal physiology.
  7. Content Article
    Amid climbing covid case numbers and with scarce resources, Tara Vijayan describes what it has been like in the US to triage treatments that aim to prevent patients being hospitalised with COVID-19
  8. News Article
    A cervical cancer patient has been treated with the aid of artificial intelligence (AI) for the first time in the UK. Emma McCormick, 44, was treated at the St Luke's Cancer Centre in Guildford, Surrey. The Royal Surrey NHS Foundation Trust treated Ms McCormick, who is from West Sussex, using adaptive radiotherapy. The AI technology uses daily CT scans to target the specific areas that need radiotherapy. This helps to avoid damage to healthy tissue and limit side-effects, the hospital said. Patients are given treatments lasting between 20 and 25 minutes, although Ms McCormick's was slightly longer as she was the first patient, a hospital spokesman said. Ms McCormick received five AI-guided treatments per week for five weeks before having a further two weeks of brachytherapy. She said: "If it works for me, and they get information from me, it can help somebody else. It definitely worked and did what it was meant to do and so hopefully that helps others." Dr Alex Stewart, who treated Ms McCormick, said one of the benefits of the treatment was that it allowed for more precision, meaning there were fewer side-effects for the patients. Read full story Source: BBC News, 21 January 2022
  9. News Article
    A troubled integrated care system has been told it must provide more help to a severely under-pressure acute trust where patients were treated on the floor and in a storeroom. The Care Quality Commission said Devon ICS must give more “input” to University Hospitals Plymouth Trust, where inspectors warned staff could “not ensure the safety of all patients” arriving at the emergency department. During a visit to the trust’s Derriford Hospital in September, inspectors saw staff treating six patients who “lay on the floor” of the ambulatory assessment unit, while another patient who had been in the department overnight was being “treated/assessed in the ‘storeroom’” – according to the CQC’s report. Inspectors reported: “The department was overcrowded, there was no seating available… Social distancing was not possible.” While the CQC praised senior leaders in the ED and executive chiefs for being “open to challenge” and “understanding the problems” faced by the urgent and emergency care service, inspectors said there was only so much the trust could do alone. Catherine Campbell, head of hospital inspection at CQC, said: “The impact of a high number of patients attending to receive care, combined with reduced staffing levels in the ED, created issues that the trust couldn’t solve alone and further support was needed from the local health and social care system." Read full story (paywalled) Source: HSJ, 19 January 2022
  10. Content Article
    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.
  11. News Article
    A major IT incident at an acute trust is disrupting treatment for eye patients after a significant data loss, it has emerged. Sandwell and West Birmingham Hospitals Trust chief executive Richard Beeken revealed to his trust’s board that a data loss incident in December had “impacted on staff and patient care” after disrupting 20 systems across the organisation. Recovery of the full data set for patients receiving treatment at the Birmingham and Midland Eye Centre is still under way, and some have had operations postponed. Despite the incident, ophthalmologists are continuing to see the majority of patients, Mr Beeken said, telling HSJ: “[Numbers affected] are being kept to a minimum through the extraordinary efforts of the clinical team who are putting in extra hours to reassess each patient’s needs.” Scanning continues in the majority of cases and the trust is pressing on with recovery work for all historic images and patient contact details, though leaders believe the chances of 100% data recovery are “still slim”. No patient data was extracted during the incident and the information commissioner was made aware. Read full story (paywalled) Source: HSJ, 10 January 2022
  12. News Article
    Chest pains for a 63-year-old man might typically mean a hospital trip to check it out. But after Clive Pietzka's 999 call, an advanced paramedic practitioner carried out tests and discharged him. The Welsh Ambulance Service Trust (WAST) job is one of those in a growing team who work to keep people out of hospital. Solutions like this are being sought following ambulance queues for hospital and worst ever performance figures. Mr Pietzka, from Barry, who has a heart problem, said initially he did not want to call an ambulance because of high demand. "They're very busy with Covid and everything else. But the GP practice said to call 999," he said. However, on this occasion a rapid response vehicle - a car with a single paramedic - came within 15-20 minutes and tests were performed, without a hospital trip. Advanced paramedic practitioner John McAllister who attended said he sees people more medical low acuity cases rather than emergency and trauma conditions. "I use assessment techniques and diagnostic tools to assess patients, formulate a diagnosis then put a plan in place," he said. "It's about trying to treat them at the right time and the right place, without having to take them to A&E." Adding to the pressure of the pandemic and winter demand, a shortage of social care workers to support patients' safe discharge means a large number of patients find themselves in hospital longer than medically necessary. The knock-on impact means it is becoming harder for new patients to be treated and admitted. Penny Durrant, the service manager for the clinical support desk at WAST regional headquarters in Cwmbran, said current challenges had led to growth in her team. She said it was a "recognition of needing to do something different". Read full story Source: BBC News, 21 December 2021
  13. Content Article
    University Hospitals Leicester NHS Trust has published a guide to help parents and carers know what to do when young children fall ill. It gives advice on when and where to seek treatment for children suffering from common illnesses or injuries. The guidance, written by doctors, focuses on coughs, minor head injuries, vomiting and fever. The trust said it hoped to help families avoid long waits in A&E departments. Advice in the guide aims to help people decide whether to seek help from their GP, call 111, visit A&E or treat children at home.
  14. News Article
    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
  15. News Article
    Deaf people are twice as likely to suffer mental health problems than those with hearing, a report has found. The All Wales Deaf Mental Health and Wellbeing Group said help in Wales was behind the rest of the UK and it wants to see significant improvements. It also described the inequalities faced by deaf people trying to access mental health support as "really frustrating". The Welsh government said it would consider the findings of the report. Ffion Griffiths, 23, from Neath, has been deaf since birth, and accessing child and adolescent mental health services in Wales has been a problem over the years. She had to travel to England to get the support she needed. "It's really frustrating because deaf people in England have more opportunities," she said. It means they can be treated and get better quicker but for us, how can we do that?" "How can we expect to recover if we don't have access to the services or any pathways for us to follow to get the treatment that we need in Wales?" Read full story Source: BBC News, 8 December 2021
  16. News Article
    A patient who suffered internal bleeding from surgery following an incorrect diagnosis, said he has "nightmares" about how he was treated. The public services ombudsman for Wales said it was "completely avoidable" and recommended health officials make a redress payment of £10,000. The man was initially referred to Cardiff's University Hospital of Wales with appendicitis. But, after a number of tests and scans, it was wrongly determined he had Crohn's disease, and colon surgery was recommended which led to a series of complications. The man, known as Mr D in the ombudsman's report, suffered internal bleeding from the initial surgery and required a stoma, despite being told the chances of that were "very, very slim". He also developed a hernia which required further surgery, and a mesh to be inserted. "I try and do things that wouldn't have been a problem for me years ago, and find I struggle," he said. "Sometimes I wake up still in pain from some of the scars. I sometimes have nightmares." The man, who has Asperger's syndrome, also said it was not taken into proper consideration during consultation. "I don't think there's a lot of things where people do take into account neurodiversity," he said. Ombudsman Nick Bennett called the case "regrettable" after investigating the man's complaint. "Physicians responsible for Mr D's care should have employed a watch and wait approach in which his condition would probably have settled without surgical treatment," he said. "Instead, Mr D, a vulnerable individual, faced completely avoidable trauma of unnecessary surgery and post-treatment complications - a trauma which saw him seek mental health support." Cardiff and Vale University Health Board said it accepted the findings. Read full story Source: BBC News, 7 December 2021
  17. Content Article
    This study in Pain Research and Management reviewed available literature about gender bias in the treatment of pain and gendered norms towards patients with chronic pain. The authors found that gendered norms about men and women with pain are present in research from different scientific fields. They highlight that awareness of the issue can help counteract gender bias in healthcare and support healthcare professionals to provide more equitable care.
  18. News Article
    A major GP group in Plymouth covering tens of thousands of patients could have its licence removed after failing to make ‘substantial improvements’ ordered by the Care Quality Commission (CQC). In August, the CQC rated the Mayflower Medical Group “inadequate” and last month the regulator said it had served a “letter of intent” on the group after another inspection. Such a letter is the last step the CQC takes before a provider’s licence is suspended. Licence suspension would affect around 40,000 people (a sixth of Plymouth’s population), who live in one of the highest areas of deprivation in the country – according to Public Health England (now the UK Health Security Agency). Among the CQC’s concerns were safety fears about the way medicines were prescribed, poor management of high-risk patients, coding issues, limited monitoring of the outcomes of care and treatment, and patients experiencing difficulties accessing care and treatment. Read full story (paywalled) Source: HSJ, 2 December 2021
  19. Content Article
    Waiting 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.
  20. News Article
    Women requiring the surgical removal of mesh implants have said "very little" has happened since a landmark Scottish government announcement in the summer. The pledge means patients can now receive free treatment from specialists in America and England. But campaigners said initial assessments in Glasgow were taking up to two years. The Scottish government said it was working with NHS Specialist Services to improve waiting times. Implant use was stopped in Scotland after hundreds of women were left with painful, life-changing side effects. In July, the Scottish government announced surgery and travel costs to Spire Health Care in Bristol and the Mercy Hospital in Missouri in the United States would be covered. The cost of each procedure is estimated to be £16,000 to £23,000. Marian Kenny, who is waiting on surgery to remove a mesh implant. joined the protest outside the New Victoria Hospital and admitted she felt "deflated" by the lack of progress in recent months. She told BBC Scotland: "For so much of this fight, we have been fighting to get it stopped and this is the only time we have been fighting for ourselves. We don't want to be guinea pigs any more." Health Secretary Humza Yousaf acknowledged the pain, suffering and distress mesh survivors have been through. He said he hoped to finalise contracts with the clinics in Bristol and Missouri "as quickly as we possibly can". Mr Yousaf added: "I would hope to have an update relatively soon. "I know they have been waiting too long and I promise them I don't want them to be waiting any longer than they have to." Read full story Source: BBC News, 24 November 2021
  21. News Article
    There has been a 27% rise in people dying while in treatment for drug and alcohol addiction during the pandemic, an official report shows. Changes to support and reduced access to healthcare during lockdowns are likely to have been factors, it says. Between April 2020 and March 2021, 3,726 people died while in contact with drug and alcohol services - up from 2,929 the year before. The figures, published by the Office for Health Improvement and Disparities, for England, show a small 2% rise in the overall numbers of adults receiving help for drug and alcohol problems from 2020 to 2021. Out of more than a quarter of a million people affected, more than half were in treatment for problems with opiates - medicines to treat pain - and a quarter with alcohol problems. The proportion of deaths in treatment for alcohol addiction rose by 44% to 1,064 and for opiate addiction by 20% to 2,418. UKAT, a group providing residential detox treatment, said a "concerning" number of services closed their doors to addicts during the pandemic. "But drug and alcohol treatment is critical care intervention and cannot be simply put on pause," said Nuno Albuquerque, head of treatment for the group. "It cannot be a coincidence that more people have subsequently lost their lives when they were in fact trying to save it." Read full story Source: BBC News, 25 November 2021
  22. Content Article
    There are many respects in which the modern medical system is not fit for purpose and poses a threat to human health. In so many situations, our superficial assumptions about medicine are wrong. Having more tests to identify disease is often not better than leaving those “well enough” alone, labelling people with a specific disease may not be helpful, and more medicine may not be better than less medicine or no medicine at all. In our eagerness to intervene, we can end up doing harm. This fits with the estimation that around 30% of medical care is ineffective and another 10% is harmful. But why do doctors recommend tests, or diagnose and prescribe treatments that don’t help people? Ian A Harris, an orthopaedic surgeon, and Rachelle Buchbinder, a professor of clinical epidemiology, discuss in this BMJ opinion article.
  23. News Article
    The first pill designed to treat symptomatic Covid has been approved by the UK medicines regulator. The tablet - molnupiravir - will be given twice a day to vulnerable patients recently diagnosed with the disease. In clinical trials the pill, originally developed to treat flu, cut the risk of hospitalisation or death by about half. Health Secretary Sajid Javid said the treatment was a "gamechanger" for the most frail and immunosuppressed. In a statement he said: "Today is a historic day for our country, as the UK is now the first country in the world to approve an antiviral that can be taken at home for Covid." Read full story Source: BBC News, 4 November 2021
  24. Content Article
    This review in Medical Decision Making looks at how healthcare organisations might successfully use patient decision aids (PtDAs) to support person-centred care. It aimed to develop context-specific program theories that explain why and how PtDAs are successfully implemented in routine healthcare settings. Based on the results of their review, the authors recommend the following strategies for organisations wishing to embed PtDAs: Co-production of PtDA content and processes (or local adaptation) Training the entire team Preparing and prompting patients to engage, Ensuring senior-level buy-in Measuring to improve
  25. News Article
    A health watchdog has scrapped a previous recommendation of graded exercise therapy for ME. The National Institute of Health and Care Excellence (NICE) has published a long-awaited and contentious final update to guidance on treatment. Many patients with ME or chronic fatigue syndrome (CFS) say the therapy, which encourages patients to slowly increase their levels of activity, makes their condition worse. The advice was due out in August, but NICE pulled the publication at the last minute. At that time, NICE said the delay was necessary to allow more conversations with patient groups and professionals, so that its advice would be supported. There are strong and varied views on how the illness should be best managed. The updated guidance for England and Wales recommends people judge their own "energy limit" when undertaking activity of any kind, and a physical activity programme should only be considered in specific circumstances. It warns practitioners: "Do not advise people with ME/CFS to undertake exercise that is not part of a programme overseen by an ME/CFS specialist team, such as telling them to go to the gym or exercise more, because this may worsen their symptoms." It also clarifies advice on a talking therapy, known as CBT, stressing that it is only helpful in treating anxiety around the condition, not the illness itself. And it emphasises the need for early and accurate diagnosis. Read full story Source: BBC News, 29 October 2021
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