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Nurses could be GPs - claim

Friday September 5th, 2008

Nurses should become the "front-line" providers of primary care, an academic claims today.

Patients could always see a nurse first and be referred to a GP, acting as a primary care consultant, for more complex conditions, according to an article in the British Medical Journal.

Professor Bonnie Sibald, a health services research specialist at Manchester University, claims GPs are frequently "duplicating" nurse services and their skills should be used for more complex health problems.

Leicester GP Dr Rhona Knight challenges the proposal in the same journal, in articles published on-line.

She says if nurses are to take over GP roles they should undertake a graduate medical course.

Dr Knight argues: "A lack of nationally agreed standards means that nurses have varied roles with inconsistent training, knowledge, experience and titles.

"Nurses would need increased training and a similar curriculum to GPs to be able to take the lead in dealing with all illnesses."

According to Dr Knight, GP training takes ten years whilst advanced nurse training may involved just 500 hours.

Matron takes charge of cleaners

Thursday September 4th, 2008

A matron is to take charge of a hospital's cleaning services in a new bid to eradicate infection.

Kathryn Patrick has been given the job of boosting cleaning services at the North Bristol NHS Trust.

Her job will be full-time but she will work some nursing shifts to keep up her professional expertise, the Nursing Standard reported.

She will be responsible for a domestic service team of 400 cleaners and will be supported by two managers.

But the Infection Prevention Society has queried the approach.

Chair Judy Potter said there were undoubtedly benefits to the role.

She added: "I would rather see matrons with cleaning responsibility as part of their role, not their sole position."

Ms Patrick said she was "proud" of her new role.

She said: “Every one who works in the Trust has an important job to do and the cleaning team have a fundamental part to play in helping to ensure that patients can expect clean surroundings when they access any of our services in hospital and the community, and in this respect the domestic team can play their part in helping to combat health care associated infections.

“Being a clinician myself, I understand where other clinicians are coming from and what their needs and expectations are from the domestic team and I will be working hard to strengthen this relationship.

“I will also be making it a priority to talk to patients and find out what they think about the cleanliness at the Trust and what they think we should be doing to make things better."

She added: This is an exciting new role and I am very proud to be one of the first clinical matrons to lead a domestic services team in the UK."

Caffeine problem in schools

Wednesday September 3rd, 2008

School nurses may need to recognise the symptoms of caffeine addiction, an expert has warned.

Chest pain, headaches, restlessness and sleeplessness may all be symptoms of this addiction, according to Bob Tait, of Drug Education UK.

The problem lies in the increasing popularity of energy drinks, according to Mr Tait.

Mr Tait issued his warning at a conference of independent school nurses organised by the Royal College of Nursing.

He said: "Children will drink them on the walk to school, at break and lunch time.

"If you have got a child who is worked up on an energy drink, they are going to be agitated during lesson time."If pupils are feeling unwell they are likely to go and see the school nurse."

He added: "If they come to you with these complaints, be aware that there may be a caffeine problem at the bottom of it."

A spokesman for the popular drink Red Bull told the Nursing Standard that it was not recommended for caffeine-sensitive people, including children.

Books on Child and Adolescent Health

Warning on joint replacements

Tuesday September 2nd, 2008

Slightly more than one per cent of British hip and knee replacements do not last three years, researchers reported last night.

Researchers from the Royal College of Surgeons said the findings compare "favourably" with the rest of the world.

But it also "reinforced" concerns about new surgical techniques.

Some 160,000 hip and knee replacements were performed in England and Wales in 2006.

Reporting in the journal PLoS Medicine, the researchers say they studied the records of 167,000 procedures for a four year period - linking National Joint Registry records to hospital records.

They found that one in 75 patients needed their replacements redone within three years.

But they found higher rates of failure when they studied two newish procedures of hip resurfacing and unicondylar prostheses. Both involve repair rather than full replacement and patients recover more quickly.

Researcher Jan van der Meulen and colleagues suggest: "Consideration should be given to using hip resurfacing only in male patients and unicondylar knee replacement only in elderly patients."

PLoS Med 5(8): e179. doi:10.1371/journal.pmed.0050179

New allergy centre planned

Monday September 1st, 2008

The government has taken steps to improve Britain's much criticised services for allergy sufferers.

New services are to be pioneered in the north-west region of England.

The region will get a "pilot" allergy centre to bring together the expertise of all clinicians interested in allergy, including GPs.

Some £60,000 has been granted for the project, which was recommended by a House of Lords select committee report 12 months ago.

The department of health said it had taken other steps to boost allergy care by commissioning a "care pathway" for children and developing national occupational standards.

It said some £4.7 million was being pumped into research.

A spokesman for Allergy UK welcomed the announcement.

He said "Particularly as there will be recognition of the important role of primary care in the provision of this service. We are sure that many valuable lessons will be learnt which eventually will lead to much improved services for allergy sufferers nationally."

Health Minister, Ann Keen said: "Allergies affect the lives of millions of people in this country, and we are ensuring this important issue gets the recognition it deserves."

Books on Asthma and Allergy Care

Britain fails health equity test

Friday August 29th, 2008

Britain was yesterday named as one of the most inequitable countries in the world for health.

Differences in Scotland were named by the World Health Organisation as being a glaring example of how life chances vary by geography.

And the WHO said "good policies" can improve the health of all people, regardless of wealth.

The comments, from the Commission on the Social Determinants of Health, were seen as a rebuff to governments that have made health "equality" an objective but failed to achieve it.

WHO said a child born in one suburb of Glasgow could expect to live a life as much as 28 years shorter than someone living in a wealthy neighbourhood just eight miles away.

In contrast the gap in life expectancy between wealthy Japan and poor Lesotho is 42 years.

And in Australia the difference for indigenous males and other men is 17 years.

The report states: "The toxic combination of bad policies, economics, and politics is, in large measure, responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible."

The report says that throughout most of the world health is linked to wealth - but some countries have broken this pattern and achieved good health despite low incomes.

These include Cuba, China, Costa Rica, Sri Lanka and the Indian state of Kerala.

Commission chair Sir Michael Marmot said: "We rely too much on medical interventions as a way of increasing life expectancy.

"A more effective way of increasing life expectancy and improving health would be for every government policy and programme to be assessed for its impact on health and health equity; to make health and health equity a marker for government performance."

Fellow commissioner Professor Fran Baum, of Flinders University, South Australia, said: ""It is wonderful to have global endorsement of the Australian Closing the Gap campaign from the commission established by the WHO.

"The commission sets Closing the Gap as a goal for the whole world and produces the evidence on how health inequities are a reflection of the way we organise society and distribute power and resources."

Patients to get sight-saving drug

Thursday August 28th, 2008

Patients are to get a sight-saving eye drug that can cost up to £10,000 a year in a novel deal with the pharmaceutical industry, it was announced yesterday.

Under the deal, announced by the National Institute for Health and Clinical Excellence, the NHS will pay for the first 14 treatments for Lucentis - but manufacturers' Novartis will pay for further treatments if they are needed.

NICE has been criticised for delaying approval of Lucentis (ranibizumab), which is a powerful new treatment for wet age-related macular degeneration.

About 26,000 people a year are diagnosed with the condition annually.

Yesterday NICE said it accepted the effectiveness of the drug, which it estimated, could give patients up to £8,000 a year in benefits.

NICE chief executive Andrew Dillon said: "Our guidance means that patients who are suitable for this treatment will have the same access to it, irrespective of where they live.”

Mr Gavin Walters, a retinal specialist at Harrogate and York District Hospitals, said: “We are delighted that final NICE guidance is here. Wet AMD can have a devastating effect on a person’s quality of life, taking away patients’ independence and their confidence.

"This guidance will undoubtedly help patients across England and Wales gain better access to treatment."

Warning over baby breathing monitors

Wednesday August 27th, 2008

Parents are being warned to check their "Baby Sleepsafe" monitors for damage.

These devices are connected to a sensor pad placed under the mattress, which monitors the baby's breathing movements. An alarm should sound if the baby stops breathing for 20 seconds or more.

The monitors may become inactive once they have been dropped, say the Medicines and Healthcare products Regulatory Agency (MHRA). In their advice released yesterday (August 26) the MHRA state that the device, manufactured by Axminster Electronics Ltd, may subsequently fail to monitor a baby's breathing.

The problem arose when a batch of Baby SleepSafe monitors was supplied with faulty battery terminals. Devices with serial numbers between 001360 and 001660 should be returned to the manufacturer for an upgrade, say the MHRA.

Devices with these serial numbers were supplied three to four years ago. Other batches of the monitors are not affected.

Clive Bray of the Agency said: "The MHRA's advice to parents is to firstly check the serial number, printed on the back of the monitor, above the battery compartment. If the number is between 001360 and 001660 then the monitor should be sent back to the manufacturer."

The battery terminals will be checked and replaced, as necessary, at the manufacturer's expense.

Mr Bray added: "Also check the battery terminals to make sure they are applying firm pressure to the batteries and are fitted with coil springs."

Safety-related incidents can be reported directly to the MHRA, by phone or on their website. There have not been any incidents linked to the monitors so far.

Teenage health timebomb - claim

Tuesday August 26th, 2008

It's not just knives - thousands more teenagers are suffering growing levels of health problems, it was claimed today.

Britain is now suffering a "teenage timebomb", according to figures collected by the Conservatives.

This shows that the annual number of teenagers admitted to hospital has risen by nearly a quarter - 23 per cent - since 2000.

The figures include adolescents admitted for drug and alcohol abuse and for smoking related illnesses.

They also include rising numbers of abortions and cases of sexually transmitted infections.

Some 12,700 teenagers are admitted to hospital for alcohol abuse but the Tories said 16,200 were admitted for smoking-related illnesses.

And in the north-east of England there had been a 118 per cent increase in teenage smoking.

Tory health spokesman Andrew Lansley said: "It's a sad indictment of our broken society that so many are turning to things like drug and alcohol abuse at such a young age."

Health secretary Alan Johnson announced a new drive to improve teen health in July. Chief medical officer Sir Liam Donaldson has called for drivers under 21 to be banned from consuming any alcohol.

Boost for palliative care research

Monday August 25th, 2008

Britain is to get the world's first purpose-built institute to research care of the terminally ill, it has been announced.

A one million pounds goverment grant will help to get the Cicely Saunders Institute for Palliative Care up and running at Kings College Hospital, London.

Professor Irene Higginson heads the department of palliative care at King's and is also scientific director of Cicely Saunders.

She said: "As the population lives longer, reductions in acute disease will mean many more people will need palliative care and support to live as well as possible, even as they approach the end of their lives.

"We look forward to continuing our work with the Department of Health in achieving this aim through our research, education and support programme at the Institute."

The institute is set to be ready by November next year.

It will get involved in research on support and treatments for conditions such as multiple sclerosis, end-stage kidney disease, heart failure and cancer.

Doubts over progress in diabetes care

Friday August 22nd, 2008

Major improvements have been made in NHS diabetes care over the past five years, according to a new analysis commissioned by the British government.

A report published on Wednesday (August 20) states that prevention efforts are improving and diagnoses are being made earlier.

People at risk of diabetes are being given better treatment and advice to avoid the condition, it states. The report also says that the approximately 600,000 people diagnosed with diabetes in the last five years are receiving the treatment they need to manage their condition.

These moves are in line with the government's commitment to "providing a preventative health service", explains health minister Ann Keen.

She said: "Today's report shows that the NHS is getting better and better at identifying people with diabetes and at supporting them to manage their condition. The Next Stage Review made prevention a priority for the NHS and this is especially relevant to diabetes, as a disease whose global increase in prevalence is partly a consequence of rising obesity.

"Our vascular risk assessment programme, Putting Prevention First is expected to prevent thousands of people developing diabetes each year."

However, some have accused the government of "painting a rosy picture" in this report. Chief executive of Diabetes UK, Douglas Smallwood, points out that diabetes leads to 100 amputations a week, and one in ten deaths in England are due to the condition.

"In areas of high deprivation this figure nearly doubles," he said. "Last year's accident and emergency admissions of children with diabetes complications rose to 3,000, an increase of eight per cent on the previous year.

"In view of such outcomes, this report paints too rosy a picture of the current standard of diabetes care."

Books on Diabetes

Nurses' pay rises may be reassessed

Wednesday August 20th, 2008

Negotiations on nurses' pay rises are set to be reopened following recent rises in inflation.

Pressure on NHS Employers and the government to reopen talks has been maintained since the NHS pay awards for 2009 and 2010 were announced in June. Under these awards, pay rises were set as 2.4 per cent for 2009 and 2.25 per cent for 2010.

A statement from the Royal College of Nursing says: "Our push to re-open talks has come in the light of pressure for nurses and healthcare assistants to cope with the increasing cost of living and the rises in inflation announced recently."

The RCN explains that the Retail Price Index, considered to be the most accurate measure of inflation, has risen to five per cent. NHS trade unions, including the RCN, issued a formal statement in June saying that should inflation continue to climb, it would trigger the re-opener clause negotiated as part of the three-year NHS pay deal.

Under the clause, the Pay Review Body will receive evidence from the unions this Autumn in support of higher pay rises. It will include an economic overview as well as evidence from each union, such as case studies of their members and specific recruitment and retention issues.

The Pay Review Body will consider the evidence between October and December. If they are persuaded, the Secretary of State will be asked for permission for nurses' pay rises to be reassessed.

"The facts will speak for themselves that there is a clear case for review," say the RCN. They add that the 2008 award of 2.75 per cent cannot be increased because it is already being paid.

Fantasy war over brain drug

Tuesday August 19th, 2008

Fantasy writer Terry Pratchett has clashed with NHS regulators over the availability of drugs for Alzheimer's disease.

Mr Pratchett, author of the Discworld series, has early-onset Alzheimer's disease and is buying the drug Aricept privately.

But speaking to Panorama last night, he raged at the difficulties he had even to obtain the drug privately. It costs £2.50 a day.

The National Institute for Healthcare and Clinical Excellence has, from 2006, declined to back the prescription of Aricept for early onset disease.

Mr Pratchett said the NHS provided free treatment for obesity and impotence but not for early stage Alzheimer's and this showed "priorities are not right".

He said: "It's probably easier to get drugs off Fat Charlie round the back of the bus station than it is to get medicines - but there we are."

He went on: "In theory I should be that much worse, but my wife has said that I'm better now than I was in the autumn.

"Alzheimer's scares people and at four o'clock in the morning it scares me, and Aricept is well worth having for the relief that it brings."

He added: "It is a really nasty disease and I cannot imagine cancer patients being denied a drug like this in similar circumstances."

But NICE chief executive Andrew Dillon told the programme the evidence was "absolutely clear".

He said: "It isn't the right decision for the health service to make treatment available until patients as they inevitably will, move into the moderate stage of the disease."

NICE hits at critics

Monday August 18th, 2008

Leaders of Britain's drugs watchdog hit out at critics yesterday - blaming drug companies and local health trusts for lack of access to cancer drugs.

The chairman and chief executive of the National Institute for Health and Clinical Excellence gave separate interviews - hitting out at separate targets.

NICE has come under fire for putting an increasing emphasis on cost-effectiveness in its reports on newdrugs. Recently it ruled that a range of drugs for kidney cancer should not be funded by the NHS.

The chairman, Professor Sir Michael Rawlings, yesterday blamed the drug companies for this decision - saying they could afford to sell the drugs for a tenth of their cost.

Speaking to The Observer, he said: "Part of the problem is that the pharmaceutical industry is looking at a very bad period in the future because a lot of their big earners are going off patent, and many companies are looking at a 30 or 40 per cent reduction in the next five years unless they come up with new drugs.

"And so part of the cost is cushioning against that. The other thing, of course, is that the share price is very important to a pharmaceutical company."

He accused the companies of being unwilling to trim their high profit levels.

He said: "Pharmaceutical companies have enjoyed double-digit growth year on year and they are out to sustain that, not least because their senior management's earnings are related to the share price.

"It's not in their interests to take less profit, personally as well as from the point of view of the business. All these perverse incentives drive the price up."

Meanwhile the NICE chief executive Andrew Dillon blamed local primary care trusts for funding drugs that NICE had ruled as ineffective or not cost-effective.

Mr Dillon's comments are to be aired by the Panorama programme tonight.

He will say: "An almost limitless amount of money could be spent in this case on the health system.

"When you limit it then you set up the need to make choices and sometimes those choices are very difficult and very painful

"It is crushingly disappointing for anybody for whatever reason who has pinned their hopes on a new treatment, and so we don't take these decisions lightly and it's why we take great care and sometimes why we take longer than people would like to make those decisions.

"It shouldn't make any difference where you live. There ought to be a common basis for making decisions about exceptional circumstances and I think anybody who uses the NHS for their care is entitled to expect that."

Basic healthcare must improve, study shows

Friday August 15th, 2008

Basic care provided by both the NHS and private providers in England is not up to scratch, researchers claim today.

A team led by Dr Nicholas Steel at the University of East Anglia, UK, assessed the quality of healthcare received by patients aged 50 or above. They carried out interviews and gave questionnaires to 8,688 men and women, of whom 4,417 had one or more serious health conditions.

Overall, only 62 per cent of the recommended care was actually received. "Receipt of indicated care [i.e. care that met quality indicators] varied substantially by condition," they add.

Heart disease patients received the best level of care, followed by patients with hearing problems and pain conditions. A low standard of care was received by patients who experienced falls and those with osteoarthritis.

"Substantially more indicated care was received for general medical than for geriatric conditions," the researchers write on the website of the British Medical Journal, "and for conditions included in the general practice pay for performance contract."

They conclude that shortfalls in care were most noticeable in areas linked to disability, but few areas were exempt.

"Efforts to improve care have substantial scope to achieve better health outcomes and particularly need to include chronic conditions that affect quality of life of older people," they recommend.

In an editorial, Professor Bruce Guthrie of Dundee University, UK, supports this recommendation. However, he adds that the challenge is "to make the shift from identifying the problem using a national composite, to local measurement of the problem, and finally to local intervention to improve care".

Steel, N. et al. Self reported receipt of care consistent with 32 quality indicators: national population survey of adults aged 50 or more in England. The British Medical Journal, 2008;337:a957

Guthrie, B. Measuring the quality of healthcare systems using composites. The British Medical Journal, 2008;337:219;578

Gradual change for nurse training

Thursday August 14th, 2008

Nurse training is set to be "modernised" - but the change will be gradual, it was announced yesterday.

Nurses and others set their face against radical change of nurse education during a three months consultation organised by the Nursing and Midwifery Council.

The NMC said it will now go on to develop a new framework for nursing training - changing the way "tomorrow's nurses practice".

It plans to unveil its principles for the new framework at its council meeting on September 4.

More than 3,000 people took part in the consultation, which asked questions such as whether nurses should be trained as generalists or specialists.

Kathy George, of the NMC, said: "We have been speaking with nurses at education road shows around the UK, and they all agree this is a huge undertaking and one that should not be rushed.

"The new framework will effectively change the way tomorrow’s nurses practise, so the NMC is determined to get this right the first time around."

The English chief nursing officer, Dame Christine Beasley, said: "Much of the way in which we practice as nurses, and the values and principles that guide us, is learnt in the earliest days of our career. A high-quality learning experience is therefore essential from the outset. It is the foundation on which we build our professional lives.

"Today, a career in nursing offers unparalleled opportunities, as well as great challenges, in a rapidly changing and complex health care environment."

She added: "We must ensure tomorrow’s nurses receive the best possible education so they can meet the needs of patients, clients and the public and continue to uphold the highest possible standard of care."

Nurse health checks to cut sickness absence

Wednesday August 13th, 2008

A new initiative is under way to cut sickness absence among nurses and other NHS staff.

Workers in the health service currently take one in every 22 days off work as sick leave. This is twice the rate found in the private sector, Nursing Standard reports. Absence is thought to cost the NHS 1bn UK pounds a year.

Now ten pilot schemes have been set up around England, focusing on reducing sickness absence through voluntary health and lifestyle check-ups. The 3,000 NHS staff involved will be offered online health assessments covering diet, stress, sleep, exercise and alcohol consumption.

They receive a computer-generated report highlighting problems and giving specific advice. Department of health officials were criticised when the scheme was announced in June, but they are convinced that financial outlay will pay off.

Human resources manager Sue Whitehead, from Leeds Teaching Hospitals NHS Trust, believes the schemes will lead to improvements in the working environment. "It may be that staff say they do not have access to nutritious food while at work, so we could try to improve that," she said.

Louise Robson, human resources adviser at Sheffield Health and Social Care NHS Foundation Trust, added: "Nurses work in health care, but it is often the case that their own health gets puts aside to look after everyone else's."

Vivienne Ferris of the Royal College of Nursing commented: "It is positive that these help to look at the causes of problems." But she warned that shift-working makes it harder for nurses to take care of their health.

Scheme providers Vielife say a similar project at the financial company Prudential led to a 66 per cent in absence.

Baby boom pressures midwives

Tuesday August 12th, 2008

A baby boom is putting midwives under pressure, according to a survey published yesterday.

Midwives say their jobs are now more challenging than five years ago - with many saying their workloads have increase, according to the survey of some 2,500 midwives.

The quality of care, staffing levels and low pay were the top three concerns highlighted in the survey, according to the Royal College of Midwives.

Some 38 per cent said the pressures of the growing numbers of babies has cut the quality of care.

The RCM said official figures show a 2.5 per cent increase in midwife numbers set against a 3.5 per cent increase in the birth rate. The survey showed some 91 per cent of midwives reporting an increase in births.

The best news from the survey was that 96 per cent of midwives had enjoyed a year free of physical abuse - but 55 per cent reported some verbal abuse.

The general secretary of the Royal College of Midwives, Dame Karlene Davis, warned there was a risk of midwives leaving the profession.

She said: "Midwives' pay is not keeping pace with prices, staff numbers are not keeping pace with the birthrate, and investment is not keeping pace with the demands on the service.

"We are going to see a haemorrhage in the profession if the conditions midwives work in are not addressed. Give midwives the tools and resources to do their job and they will deliver a service of which this country can be proud."

New leader for NMC

Friday August 8th, 2008

A maternity services campaigner has been elected to lead the troubled Nursing and Midwifery Council.

Jill Crawford, from Newport Pagnell, Buckinghamshire, beat nurse representative Abbey Akinoshun in a contested vote for the presidency of the organisation's council.

The NMC was recently the subject of a devastating report from its own regulator, the Council for Healthcare Regulatory Excellence, and this led to the resignation of senior members.

Ms Crawford is a member of the National Childbirth Trust.

She said: "As President I feel my objective is clear - to ensure that this Council oversees the efficient and effective implementation of our action plan following the CHRE report and ensure that we are delivering our statutory functions in a way that will regain the trust and confidence of our stakeholders and the public whom we serve.

"We have a lot of work to do in a short amount of time."

She added: "Council has acknowledged the need for us to learn from recent events and work with our key stakeholders to prioritise the actions, make rapid progress and deliver a robust, efficient and effective organisation to the new Council that is coming into office on 1 January 2009."

Cash boost helps nurses improve compassionate care

Thursday August 7th, 2008

A large donation has enabled Scottish nurses to "put the human touch back into nursing".

Former nurse Ann Gloag, who made her fortune co-founding the Stagecoach bus company, donated 1m UK pounds last year towards a joint project between Napier University and NHS Lothian.

The three-year Leadership in Compassionate Care project aims to ensure that compassionate nursing practice is "integral to care" at NHS Lothian and in Napier University's undergraduate nursing curriculum. It plans to establish NHS Lothian centres of excellence in Ccompassionate care, called Beacon Wards. The project's founders also hope its lessons will be passed on to other organisations.

Ms Gloag founded the project after becoming concerned over trends in nursing and public and media criticism of the profession.

In an interview with Nursing Standard, she said: "I think nursing went through some difficult periods when changes in the NHS and the demands put on nurses distracted their focus away from being compassionate."

After visiting one of the participating wards recently, Ms Gloag commended staff on their success.

"Two patients who have had frequent hospital stays over a long period of time told me that the nurses and students now listen to them much more carefully and take their feelings much more into account when caring for them," she said.

"Too much time was being spent looking at computer screens rather than being on the wards. I do not think nurses ever lost the capacity for compassion - they lost their focus and the public became aware of that."

Vermin infect hospitals

Wednesday August 6th, 2008

British hospitals are suffering from an infestation of vermin, it was claimed today.

Freedom of Information requests have revealed that hospitals have called in pest controllers hundreds of times over the last year.

The worst affected hospital group was in Nottingham with more than 1,000 incidents over two years.

The Conservatives, who obtained the figures, said they illustrated the problems faced by hospitals in maintaining hygiene.

The figures showed that 70 per cent of NHS trusts called in pest controllers at least 50 times during the period.

There were wasps in a neonatal unit and in operating theatres and flying ants in another hospitals.

Pest controllers were also called in to deal with fleas and cockroaches.

Shadow health secretary Andrew Lansley said: "Labour have said over and over that they will improve cleanliness in our hospitals, but these figures clearly show that they are failing."

But a spokesman for the Health Protection Agency said: "In countries with good standards of healthcare the possibility for insects or pests to transmit infections in hospitals would be very remote.

"In the UK, wounds are treated appropriately and dressings applied to ensure good hygiene and prevent infection."

Health minister Ivan Lewis told the BBC: "The Hygiene Code requires NHS bodies to have a pest control policy that anticipates and manages this issue.

"Trusts should take rapid action and follow through with surveillance in place to avoid pest incidents and minimise hazards."

Parents to be told kids are "very overweight"

Tuesday August 5th, 2008

A national programme to let parents know their children are fat was launched yesterday - but "non-stigmatising" language will be used.

Most children are weighed and measured at the beginning and end of their time in primary school by school nurses.

Yesterday the government urged local primary care trusts to let parents know the results of the weighing and measuring.

It wants parents to be told if their children are obese - but by means of non-stigmatising language.

Some 40 per cent of the English primary care trusts have so far agreed to the project and others are considering it.

More than one in five children aged four or five are overweight or obese and by the age of 11 this has risen to nearly a third, government figures show.

Health minister Ivan Lewis said: "Research shows that most parents of overweight or obese children think that their child is a healthy weight.

"It's clear from research we've done that parents want to know their child's results and whether there is a concern about their health. But they want clear information which is helpful and non-stigmatising.

"Today we've published guidance which will help PCTs deliver this programme and help to make sure parents get the information they need about their child's results in ways that they have said will be most helpful."

The BBC quoted Tam Fry of the National Obesity Forum as calling on the government to use the word "obese".

He said: "I find this whole approach from the Department of Health a bit prissy and namby pamby. The Americans have gone back to using the term because it's the kind of shock word that makes parents sit up and take notice."

Suicide reductions - but not in prison

Monday August 4th, 2008

The government has claimed some success in cutting the suicide rate, especially among young men.

The latest figures are published amid growing concern about "imitation" deaths in Wales - and a new report states slow progress in changing media reporting of the problem.

Barriers at well known "jump points" and the development of emergency "talk down" techniques have all helped.

Between 2005 and 2006 there was a 7.5 per cent reduction in the number of self-inflicted deaths among young men in their 20s and early 30s, according to the 2007 annual report of the National Suicide Prevention Strategy.

The report shows an overall reduction in England of about two percent in suicides - from 8.5 per 100,000 to 8.3 per 100,000. The figures are averaged over a three year period.

But there was a big increase in prison suicides. These have increased to 82 in the last year compared with 71 a year earlier.

The report adds: "While much progress has been made in the reporting of suicide by the media, many journalists and editors remain unaware of either general or in-house reporting guidelines on suicide."

Care services minister Ivan Lewis said: "The overall rate of suicide among the general population continues to fall and is now at a record low.

"The continued drop in suicides among young men and mental health in-patients is also encouraging, but we must do more to tackle the rise in prison suicides and promote sensitive media reporting of suicides."

He added: "We've already published 'Sensitive Coverage Saves Lives' to help improve media portrayal of suicide and suicidal behaviour. Now we will work to raise awareness of this guidance and ensure that in future, journalists cover suicides in a more sensitive and thoughtful way."

Stabbings cost to NHS

Friday August 1st, 2008

Violent attacks with deadly weapons are now costing the NHS at least three million pounds a year, researchers warned today.

Knives are the most commonly used weapons to inflict violent injury - but gunshots cost far more to treat, according to the Manchester University study.

Stabbings account for three quarters of the penetrative injuries treated by trauma teams whilst vehicle accidents are responsible for just two per cent of this kind of injury, according to the study.

Researchers studied records of trauma treatment over five years between 2000 and 2005 in 121 hospitals - half the total that receive trauma patients.

Some 1,365 patients were involved in the study. 91 per cent were men.

Writing on-line in the journal Injury, the researchers say that stabbings cost an average of £7,196 per victim whilst shootings cost an average of £10,307.

Some 47 per cent of patients needed critical care and seven per cent of stabbing victims died, the research found.

Dr Fiona Lecky, research director of the Trauma Audit Research Network, based in Manchester, said: "Considering the additional medical costs of rehabilitation and broader costs to society resulting from lost productivity, permanent disability, premature death and the pain and suffering of the victims and their families, there is a compelling argument for money to be better spent on prevention strategies that reduce violent incidents."

Injury on-line August 2008

Leadership clue to beating infection

Thursday July 31st, 2008

Strong leadership and better use of staff may be just as important as hand-washing in the drive to reduce hospital infections, according to a report published yesterday.

The report, by the King's Fund, praises the modern matrons programme for its impact on the problem - but says the matrons need support and "clear authority".

The report was commissioned by the Royal College of Nursing, which said the report highlighted the need for full staffing levels and manageable workloads for nurses.

RCN chief executive Dr Peter Carter said: "Much has been written about what patients, visitors and healthcare professionals can be doing as individuals to reduce infection rates in hospitals, hand-hygiene being a prime example.

"However, there has been very little research on what impact the actions of organisations and management can have on infection control.

"There is rarely no single cause for outbreak of infection or a simple cure. But we hope that by increasing awareness of the risk factors leading to outbreaks of infection that we can better tackle the causes so that patients and their families are assured a safe and worry-free hospital stay.

"This report suggests that infection rates appear to be lower where there is strong leadership, where wards are fully staffed and where workloads are manageable."

He added: "We know there is no silver bullet solution to ridding our hospitals of infection and the public, organisations and the government all have a role to play. Investment in infection prevention and control is critical, with the emphasis on prevention rather than reacting when things go wrong.

"We call on the government to provide the promised investment for more infection prevention nurses and that healthcare providers ensure there are stronger reporting mechanisms to enable nurses to raise their concerns about poor hygiene practices."

England losing nursing students to Wales

Wednesday July 30th, 2008

England's nursing students are increasingly studying in Wales, to benefit from the bursaries they receive there.

Nursing Standard reports that all pre-registration nursing students in Wales get an annual, non-means tested bursary of 6,372 UK pounds. In England bursaries are means tested, and students can only get non-means tested bursaries if they are studying for a diploma.

Nursing Standard says that the number of English students applying for nursing degrees in Wales has more than tripled since 2003.

This includes many of England's brightest students, warns Dame Betty Kershaw, education adviser at the Royal College of Nursing. "Students in England who want to gain a degree are being discriminated against," she believes, because they cannot get a bursary.

Nursing student Theresa Baldwin commutes from Liverpool to Glyndwr University in Wales. She told Nursing Standard: "It made more sense to travel to Wales to do the degree than to get into debt studying in England. It is stupid that 40 minutes across the border you can study for a degree with a bursary."

The magazine also reports that nearly half of students on the children's nursing degree course at Cardiff University are from England.

A spokesperson from the department of health commented: "No decision has yet been taken in England on whether to move to an all-degree nursing profession. In the meantime, as set out in the recently published Darzi report 'A High Quality Workforce', we are looking into the current anomaly of degree and diploma bursary funding."

Software booster for parents and MMR

Tuesday July 29th, 2008

Interactive software is to be tested in Yorkshire in a bid to boost parent confidence in the MMR vaccine, it has been announced.

The county recently suffered Britain's first measles deaths in two years after a teenager succumbed to the illness.

Some 971 cases of measles were reported in Britain last year.

Local researchers say that more effort needs to be made to give parents "credible and appropriate" information to encourage them to allow their children to have the MMR vaccine.

The National Institute for Health Research has awarded some £242,000 to Leeds University for the project, to be undertaken with the University of Sydney, Australia, where the software has been pioneered.

Researcher Dr Cath Jackson said: "We will be testing the Australian software alongside more traditional materials to find out the best way of giving parents the right support and information they need to make a decision about MMR.

"Parents criticise the literature and information currently available. They don't feel confident about saying yes to the vaccine when they don’t know enough."

She added: "Our previous research shows that many parents were unconvinced that the MMR vaccine is safe and 62 per cent did not consider that their MMR decision was informed.

"However, there was little opportunity to talk about reaching a decision because GPs and nurses simply don’t have the time. We found that some parents feel pressured into making an instant decision about MMR with health professionals assuming they will vaccinate their children."

Dr Martin Schweiger, a consultant in communicable disease control at the West Yorkshire Health Protection Unit, backed the project.

He said: "Mumps, measles and rubella are all serious diseases and become more so the older you get. If an unvaccinated pregnant woman gets rubella, then a damaged child may be the future price the family will pay for getting this wrong now.

"Health professionals need to have credible and appropriate information to give to those parents about to make a decision about immunising their children."

Activist wins senior nursing post

Monday July 28th, 2008

A gay rights activist has retained his senior post in the world's largest trade union for nurses.

Jason Warriner has been chair of the Royal College of Nursing's annual conference and will continue to hold the post for another two years.

Mr Warriner is a matron for sexual health and HIV at Guy's and St Thomas' NHS Foundation Trust in London.

He is a founder member of RCN OUT!, the union's lesbian, gay, bisexual and transgender group.

He said: "The last two years have been particularly pleasing as we've seen the College continue to modernise and it's lesbian, gay, bisexual and transgender (LGBT) members now play a higher profile role in events such as Gay Pride and the first LGBT Annual Health Summit.

"I am hopeful that my election and re-election serves as an example to other LGBT workers and encourages them to play a more prominent role in their workplace; and to stand for positions of influence."

He added: "I am also pleased that in the last two years there has been a greater recognition of the contribution LGBT nurses make to the health of the nation and I'm hopeful that this will continue."

Social inequality in exercise is rising

Friday July 25th, 2008

The types of people most likely to participate in sports and exercise have changed over the last decade, new research suggests.

Dr Emanuel Stamatakis of University College London, UK, and colleagues analysed exercise figures in England from 1997 to 2006.

They found an increase in exercise among middle-aged and older adults, and a drop among young men. They also found increasingly strong differences in participation between less and more advantaged people.

For the study, 27,217 men and 33,721 women over the age of 16 completed surveys on their exercise habits.

Analysis showed that regular participation in sport and exercise increased slightly over the time period - from 40.8 to 41.2 per cent in men and 31.2 to 33.9 per cent for women.

"Gym and fitness club-based activities" rose from 17.0 to 19.2 per cent for men and 15.9 to 18.7 per cent for women. Running almost doubled among women, going from 2.4 to 4.0 per cent.

But mainly, the increases were found in adults over 45 years, say the researchers in the British Journal of Sports Medicine. Young men (16 to 29 years) became less likely to take part in cycling, dancing, running, and racquet sports.

Increases in exercise were "more pronounced among those from non-manual social classes, higher income households and white ethnic backgrounds", they team report, adding: "There are no signs that the gap in participation between lower and higher socioeconomic strata and between white and ethnic minority groups is narrowing."

They conclude: "Sport-promoting and health policy efforts should focus on these groups and try to expand participation."

Stamatakis, E. and Chaudhury, M. Temporal trends in adults' sports participation patterns in England between 1997 and 2006: the Health Survey for England. The British Journal of Sports Medicine, published online July 25, 2008.

Campaign against obesity - Johnson

Thursday July 24th, 2008

A national campaign to reduce waistlines is needed - but it should not involve "vilification", the health secretary said yesterday.

Families, industry and the public sector should work together to reduce levels of obesity, health secretary Alan Johnson said.

Mr Johnson said he had now written to nearly a quarter of a million local activists to encourage them to take part in the campaign.

Speaking to the Fabian Society last night, he said: "This national movement for change will enable every citizen in the country at every stage of their lives to get the encouragement and support they need to be healthy - from what they see on the television, to what they buy in the local supermarket, to the resources at their disposal in the local community, to how they travel to and from work or school, to the information and advice they get from health professionals.

"We are calling on everyone - from the smallest community keep fit class to the biggest retailers in the land - to join in this campaign to change the way we live our lives."

He said obesity is the most significant health issue facing the nation - with two thirds of adults and one third of children being overweight or obese.

He said: "Research shows us that vilifying the extremely fat doesn't make people change their behaviour. Commentators who point and shout at pictures of the morbidly obese simply fuel the problem.

"Those whose seriously unhealthy lifestyles are not advertised by their waist lines will simply say: 'Well that's not me. I don't need to change what I do.' But if you present the message more intelligently - if you explain to parents that many children, regardless of their size, have dangerous levels of fat in their arteries or around their organs, and this may reduce their life expectancy by up to 11 years - then people respond."

His campaign won backing from the Royal College of Nursing.

Chief executive Dr Peter Carter said it would require investment in school nurses and specialists.

He said: "600,000 nurses from across public and private healthcare, from community midwives to intensive care, have a part to play in educating the public about the dangers of obesity and ways in which they can adopt healthier lifestyles."

Books on Healthy Eating Ideas

Cervical cancer vaccine plan extended

Tuesday July 22nd, 2008

The new cervical cancer vaccine is to be offered to young women of 17 and 18, it was announced yesterday.

The extension will mean an additional 300,000 people receiving the human papillomavirus vaccine in the coming year.

Ministers said the move justified their decision to go for a low-cost vaccine, Cervarix.

Critics have accused the government of missing a chance to protect women against a wider range of viruses, responsible for genital warts.

The government says the vaccine will protect against viruses responsible for 70 per cent of cases of cervical cancer.

Health Minister Dawn Primarolo said: "Our policy to vaccinate girls against cervical cancer is one of the biggest public health campaigns in recent history. It will mean that up to 400 girls' lives will be saved each year.

"By choosing the right vaccine we have been able to make savings which means we can extend the programme to 17 and 18 year olds. This could save an additional 400 lives."

Drive to boost teen health care

Monday July 21st, 2008

Health professionals are being urged to improve their skills at dealing with young people, using new training materials.

The learning programme, launched last week, have been developed by the Royal College of Paediatrics and Child Health and by the Royal College of Nursing.

The colleges warned that the health of young people has failed to improve over the last 40 years in pace with progress amongst other age groups.

Smoking, alcohol, drugs, obesity, dangerous sex and poor mental health all place many adolescents in danger, they warn.

There are also rising rates of chronic illnesses such as asthma and diabetes.

The Adolescent Health Project offers face-to-face and e-learning on all aspects of adolescent health.

RCPH president Dr Patricia Hamilton said: "For too long, health services for adolescents have fallen between those provided for children and those for adults.

"Special skills and competencies are needed by all staff when dealing with young people. Health professionals need not just clinical skills and medical knowledge, but also particular skills in language, listening and communication."

And Fiona Smith, of the RCN, said: "Nurses are well placed to provide sensitive and confidential health advice to young people to help them make changes in their lives so they can lead a more healthier and active right life through to adulthood."

Further backing came from Professor Steve Field, chairman of the Royal College of GPs.

He said: "Improving health services for young people must be a priority for all health care professionals. Lifestyle choices made in adolescence can have a major impact on health later in life."

Launching the project, health secretary Alan Johnson said: "It is a very exciting step forward and clear recognition of the increased profile of adolescent health we will see reflected in our forthcoming Children and Young People's Health Strategy."

Books on Child and Adolescent Health

How A&E could tackle knife crime

Friday July 18th, 2008

Emergency department specialists could help tackle knife crime by helping identify violence "hotspots", an expert suggested today.

The proposal came as new government figures claimed violent crime is falling - whilst popular alarm at reports of teen deaths increases.

An 18-year-old became the 21st teenager to die in London this year last night.

Some 22,000 offences involving knives in England and Wales were recorded over the last year - the first time they have been recorded separately.

While police figures showed an eight per cent reduction in violent crime, they showed a two per cent increase in gun crime.

Professor Jonathan Shepherd's proposal, published on-line in the British Medical Journal, seeks to deal with suggestions that hospitals treat more victims of knife crimes than are reported to police.

He suggests that emergency departments could collect information anonymously from victims.

This would be shared with local crime reduction partnerships, helping them to identify troublespots and flashpoints.

Professor Shepherd, of the violence research group of Cardiff University, Wales, says: "It is not safe to assume that the most serious violence, including knife and gun violence, will have been reported."

He adds: "Key to this will be emergency medicine consultants being directly involved in partnership prevention work, including attending meetings with the police and local authority representatives."

Plan for terminal care at home

Thursday July 17th, 2008

Some £286 million is to be pumped into care for dying people - with a view to enabling more to die at home, it was announced yesterday.

A ten year strategy for "end of life" care services calls for 24 hour community nursing services to care for people who want to die at home.

There will also be specialist care palliative outreach services and research into the best care for the dying.

The proposals had been foreshadowed in the Darzi review of health services and this had called for greater opportunities for dying people to stay at home.

Actor Hugh Grant, speaking for the Marie Curie charity, said: "Since 2004 Marie Curie Cancer Care has campaigned hard for the public to have the choice to die at home.

"I am delighted to see that the Government is now honouring its 2005 Manifesto pledge to double investment in end of life care."

Health secretary Alan Johnson said: "People coming to the end of their lives and their loved ones deserve high quality, compassionate and dignified care, on their own terms. This strategy will help make that happen."

The plans were welcomed by the Royal College of Nursing but it warned it would need trained staff.

He said: "Delivering quality palliative care requires a well resourced workforce and it is vital that Strategic Health Authorities recognise the need to invest in the staff that provides these specialist services.

"There are numerous examples of the voluntary sector and independent hospices delivering high quality care across the UK and it's important that such work is recognised."

Children with eating disorders need expert nursing

Wednesday July 16th, 2008

Nurses have an increasingly important role helping children who suffer from eating disorders, says Nursing Standard today.

Eating disorders are becoming more common among younger children in the UK, including boys, says the article. Nurses working in specialist units can offer a lifeline as they have a particular set of skills and qualities that can help.

In 2007, 206 cases of eating disorders were reported in children under the age of 13. Patients were as young as eight years old, and half needed to be admitted to hospital.

ChildLine received 1,900-plus calls on the subject last year. Sue Minto from ChildLine said: "Eating disorders in children are among the most challenging problems that counsellors have to deal with. They are a minefield for everyone affected by them.

"One of the saddest revelations is the sense that, for some, the disorder is a coping mechanism that stops them from 'doing something worse' and, as an alternative to suicide, is a familiar friend that keeps them alive."

She added that family, friends and professionals need to work together to ensure there is always someone to turn to.

Dee Dawson of treatment unit Rhodes Farm in north London, UK, believes good nursing is vital. "Having sympathetic nurses and carers around them can help change these children's views on eating and exercising," she said.

Manager of the Mildred Creak Unit at Great Ormond Street Hospital in London, Philip Yearley, agrees. He said: "I believe passionately that nurses make a huge difference because we are with the child 24 hours a day - almost like being a parent. Other professionals do not see the children all the time."

Baby boom pressures midwifery care

Monday July 14th, 2008

New figures from the Office for National Statistics show a rise of three per cent in the number of births in England and Wales over a year.

There were 690,013 live births in 2007, compared with 669,601 in 2006, reported the ONS last week (on July 10).

Fertility rate figures, also released last week, show that each woman now has an average of 1.91 children - the highest since 1973. The number of births went up in every English region.

This shows that the emerging baby boom is continuing to put pressure on midwifery services, commented Dame Karlene Davis of the Royal College of Midwives. She said: "In 2007, in England, there were over 90,000 more live births than in 2001, a rise of over 16 per cent, but the number of midwives is not keeping pace with the increasing birth rate. Indeed we are seeing midwives posts being lost and services being cut.

"This is putting midwives under huge pressure, leaving many women and their babies facing poor a service and a poor birth experience, and difficulty getting much needed support at home after the birth, as highlighted by the recent Healthcare Commission report."

The report was commissioned after a series of investigations into deaths at maternity hospitals. A survey of 150 trusts found low staffing levels and poor facilities in some hospitals.

Dame Karlene added: "At the heart of this is the need to deliver a real quality service to women, their babies and their families. We need investment that actually reaches the front line, better staffing levels and better facilities. It has also got to start happening now."

Family nurses boost chances

Thursday July 10th, 2008

England's new family nurse programme is helping boost the chances of vulnerable children, a report said yesterday.

The Family Nurse Partnership scheme began in ten areas of England last year.

Nurses are assigned to build close relationships with families, helping them to adopt healthier lifestyles and provide good care for babies.

An independent evaluation shows that the programme has enrolled more parents under the age of 20 than over it - and that clients gave the programme high marks.

Nurses also gave the scheme a high rating.

One nurse said: "I applied for my post as a Family Nurse after reading about its success in the United States. At first I thought it sounded too good to be true. Here was a long standing, tried and tested programme that seemed to have a long lasting positive affect on peoples lives.

"It is very different from my previous role as a health visitor. We work closely with the parents from early pregnancy so that by the time they have their babies we have travelled a long way together.

"We place particular emphasis on working with fathers and I have found that they are pleased to be included, and want to learn as much as they can and be very hands on in their children’s upbringing."

Children's minister Beverly Hughes said: "I am pleased to see that the programme is giving these young mothers and fathers a fantastic opportunity to learn and develop crucial skills so that they can give their children the best start in life.

"The research shows that this alternative way of working by family nurses is making a real difference to the lives of young parents."

Healthier eating scheme for public sector canteens

Wednesday July 9th, 2008

New healthy eating measures are to be implemented for public sector workers, patients and prisoners.

Canteens catering for these groups have been targeted by a government healthy eating initiative encouraging them to meet new guidelines on fat, salt and sugar content, presentation and portion sizes.

The move was announced by Public Health Minister Dawn Primarolo yesterday (July 8) as part of the government's "Food Matters - Towards a strategy for the 21st Century" strategy.

Under the plans, the government will award a new Healthier Food Mark to canteens that meet food criteria such as "Providing nutritionally balanced, appetising and enjoyable menus built around choice and variety".

The scheme is already compulsory in schools, and will be taken up on a voluntary basis by the NHS, prisons and government offices.

Ms Primarolo said: "Our ultimate aim is for healthy food to be the norm across England - in hospitals, care homes, prisons and in all public workplaces across the country and to ensure that patients are well fed.

"The public sector has a duty to look after their staff and people in their direct care, such as patients and prisoners, so it's essential we serve up healthy and nutritious food."

Almost a third of all meals served by caterers in the UK are served in public sector institutions. Every day, about one million meals are served to NHS patients and staff alone.

If successful, the scheme will eventually be rolled out across the entire public sector. Schools that are already signed up to healthy eating will automatically qualify for the Healthier Food Mark unless Ofsted inspectors state that the school's food standards are not up to scratch, say the department of health.

NHS plans for infection damages active

Tuesday July 8th, 2008

The NHS has set aside more than £40 million to pay damages over hospital infections, it was revealed today.

The figure set aside by the NHS Litigation Authority was revealed through Freedom of Information requests.

Some 100 victims have already received more than £7 million, according to the Daily Telegraph.

Another 243 claims have been lodged.

The figures related to MRSA and C.difficile.

Meanwhile a European study warns that Britain's problems may pale in comparison with the risks faced by other countries.

The study of antibiotic resistance in cattle showed it is at low levels compared with Belgium, France, Latvia and Spain.

The study, reported in Acta Veterinaria Scandinavica, warns there is evidence of MRSA in cattle in Spain and France.

And it warns of a "frightening number" of samples of E.coli resistance in France, Spain, Italy and Belgium.

Researcher Rene Hendriksen, from the Technical University of Denmark, said: "The differences in resistance may reflect the differences in antimicrobial use between countries and veterinarians."

Acta Veterinaria Scandinavica

Sir Trevor plugs healthy lifestyle

Monday July 7th, 2008

Broadcaster Sir Trevor Macdonald has signed up to raise awareness of the risk of cancer amongst Britain's ethnic minorities.

He will launch a cancer awareness week for black and minority ethnic communities tonight at a launch in the House of Commons.

According to Cancer Research UK, people of ethnic minority background are less likely than others to recognise the signs of cancer.

The organisation says other barriers exist which can cause delays in getting access to treatment and services.

Sir Trevor said: "According to Cancer Research UK half of all cancers could be prevented by changes to lifestyle and it is vital that we get that message across to Britain's many and varied BME communities.

"Raising awareness about the signs and symptoms of cancer means that the disease is more likely to be caught in the early stages and allow patients the best chance of recovery.

"Providing information about how to change your lifestyle to reduce your risk of getting cancer is as important as developing new treatments and drugs to combat the disease."

Vanessa Gordon-Dseagu, of Cancer Research UK, said: "We hope the community-based events taking place this week will bring greater awareness of cancer to people who need to access information and cancer services."

GP plan will use web active

Friday July 4th, 2008

On-line registrations and email consultations will be introduced as part of the drive to encourage patients to shop around for GPs, it was announced yesterday.

And in a further nod to new technology, patients will be encouraged to log on to "myhealthspace" to book appointments and update their care records.

The technologies are part of the government's new primary care strategy launched yesterday.

It includes a pledge to change GP funding to reward practices that take on new patients.

Performance and quality information about GP and community services will be published on the NHS Choices website, according to the strategy.

The strategy pledges to make it easier for GPs to refer patients to exercise classes or stress counselling.

It also promises to "transform" community health services to "unlock" the talents of 250,000 staff, including health visitors and community nurses.

One Devon GP, Professor Michael Dixon, chair of the NHS Alliance, described the strategy as a "big thumbs up" for general practice.

He said: "The principles and values upon which it is based, such as the registered list, quality and personal care and continuity, are those that matter most to good GPs."

But Dr Laurence Buckman, chairman of the BMA's GP committee, said the strategy contained many "positive" points but government had lost the profession's trust.

He said: "Some of the ideas are not new - patients have always been able to consult by phone and practices have always been funded on the basis of the number of patients who are registered with them.

"Many of the ideas, such as personal plans for all patients, faster and simpler access to a wider range of community based services and early intervention to improve the long-term outcomes for patients, are good and welcome."

More power for Welsh ward sisters

Thursday July 3rd, 2008

New government plans mean that ward sisters and charge nurses in Wales will get more decision-making power.

They will be "put firmly back in charge of patient care", according to Nursing Standard. Under the changes, nurses will be able to decide on ward rules, such as visiting times and the organisation of cleaning chores.

To support them into a more powerful role, sisters will receive special training on staff management and overseeing wards to improve patients' experiences.

There are also moves to standardise nurses' uniforms across Wales. The aim is to allow patients to recognise nurses more easily, and will include dedicated changing facilities and in-house laundry services.

The changes were outlined in the Welsh Assembly government's report Free to Lead, Free to Care, released last week. They are fully endorsed by Rosemary Kennedy, the Welsh chief nursing officer.

Ms Kennedy said: "Somewhere along the way we lost our way and let general management take over, rather than keep patients as our focus. Now there will be a clear mandate from chief executives, backed up by executive nurses, that ward sisters have full and absolute control over the care environment."

She explained that the new uniform facilities will help to improve infection control and prevent nurses having to travel to work in uniform.

These plans tie in with Lord Darzi's review of the NHS, which proposes a boost in the size of independent nurse-led provision of primary care. It also recommends an increased investment in nurse education and training.

"In the future, the NHS will have a culture where nurse leaders are supported and empowered to effect meaningful change," says Dr Peter Carter of the Royal College of Nursing.

Football hero sets goal for prostate cancer treatment

Wednesday July 2nd, 2008

The lack of treatment options offered to many men with advanced prostate cancer was publicised yesterday by England's most eminent footballer.

Sir Geoff, the 1966 World Cup hero, is fronting a campaign calling for better access to treatment to fight the disease, which has affected such footballing giants as Ray Clemence and Denis Law.

Sir Geoff scored a hat-trick in the 1966 World Cup Final, delivering England its only World Cup.

The "7 out of 10" campaign is sponsored by the drug company sanofi-aventis and has been backed by leading doctors, MPs and patient groups. The campaign aims to encourage all men with prostate cancer to be aware of their options, and to help break down barriers currently preventing them accessing treatment.

To launch the campaign, Sir Geoff and ten other high-profile men including Professor Jonathan Waxman, head of oncology at Hammersmith Hospital and Ian Banks, of the Men's Health Forum, gathered at the Albert Embankment, in front of St Thomas' hospital in London, UK.

They represented the many thousands of prostate cancer patients around Britain. Cancer Research UK estimates that about 35,000 men are diagnosed with prostate cancer every year - making it the most commonly diagnosed cancer in men in the UK.

Sir Geoff said: "I am at an age when prostate can affect your life. I think a lot of men don't own up to having it. Sometimes they don't go forward to have the tests and don't know what is available as treatment.

"There is not enough uniform treatment of the disease. Around 35,000 men get diagnosed, 10,000 die and of this figure only 30 per cent know about the treatments available. That means 70 per cent are not getting the treatments available for this particular disease."

Books on Men's Health and other Conditions

Soldiers unharmed by vaccines

Tuesday July 1st, 2008

Multiple vaccinations have not caused ill health to soldiers in Iraq, British experts report today.

Researchers from King's College London instead found that 'recall bias' - when people link a perception of ill health with their memory of multiple vaccinations - is to blame.

Research associate Dominic Murphy and colleagues randomly chose 4,882 soldiers with a median age of 32 years who had all been to Iraq since 2003.

All had been given vaccinations of tetanus, typhoid and yellow fever and an anthrax vaccine offered to those prepared to sign a consent form.

Researchers used detailed questionnaires to ask soldiers about the maximum number of vaccinations they had received in any one day.

They then randomly selected and assessed the health records of 10 per cent of the group to see if multiple vaccinations had led to adverse health effects reported at the time.

There were "significant associations" between people recalling two or more vaccinations in one day and complaints of fatigue, common mental disorders and a variety of physical symptoms, they report in the British Medical Journal.

But the medical records of 10 per cent of the group found there were no health differences between people who had one or multiple vaccinations.

Significantly, this 10 per cent had, like the entire group, also been more likely to report ill health if they recalled having had two or more vaccinations in one day.

Military personnel's memories of the number of vaccinations had in one day "cannot be considered reliable" unless they only had one vaccination, which they remembered correctly, said researchers.

BMJ 2008. doi:10.1136/bmj.a220

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