UK News for May

Thousands quit after smoking ban

Monday June 30th, 2008

England's ban on public smoking persuaded as many as 400,000 people to quit, researchers claim today.

The proportion of smokers in England fell by 5.5 per cent in the nine months after the ban was introduced one year ago, a conference will be told.

In the previous nine months it fell by just 1.6 per cent - suggesting that even anticipation of the ban did not reduce smoking rates.

More than 32,000 people took part in the survey, reported to a conference in Birmingham, UK.

Researcher Professor Robert West, of Cancer Research UK, said: "These figures show the largest fall in the number of smokers on record. The effect has been as large in all social groups, poor as well as rich smokers.

"I never expected such a dramatic impact and of course there are no guarantees that smoking rates will not climb back up again."

Similar findings are reported in the journal Lancet Oncology today - and are due to be presented to the International Lung Cancer conference in Liverpool, UK, next week.

Researchers led by Dr John Pierce, of the University of California, San Diego, USA, write: "Not only do these policies achieve their aim of protecting the health of non-smokers by decreasing exposure to second-hand smoke, they also have many effects on smoking behaviour, which compound the expected health benefits."

Lancet Oncology July 2008

Heart attack treatment spreads

Thursday June 26th, 2008

Growing numbers of heart attack patients are undergoing an effective medical intervention to save them, according to a report published yesterday.

Heart attack patients in urban centres enjoy a specially good chance of getting primary angioplasty, according to the MINAP project.

Experts say the procedure to reopen blocked arteries is preferable to administering thrombolytic drugs to break up blood clots.

The study says that in London, Birmingham and other parts of the urban West Midlands thrombolytic treatment is infrequent in hospital.

MINAP shows that 54 hospitals in England and two in Wales can now perform primary angioplasty compared with 35 a year ago.

Some 4,472 patients underwent the procedure over the last year compared with 3,148 the previous year in England.

The report says thrombolytic treatment still plays a key role in treatment of heart attacks before hospital - especially where long journeys are involved.

Dr John Birkhead, MINAP clinical director, said: "This year has been noteworthy for the increase in numbers of patients receiving pre-hospital treatment (up 8 per cent) and primary angioplasty (up 42 per cent)."

The national heart director, Professor Roger Boyle, said: "We continue to see improvements in treatment at all levels of the health service, from more pre-hospital treatment given by paramedics, to increased numbers of hospitals able to provide lifesaving primary angioplasty.

"In the light of such good progress, it is immensely rewarding to see the mortality rate for heart attack patients continue to fall.

"We are continuing with our efforts to reduce the number of heart attacks and to save more lives. The proposed vascular checks programme to be rolled out nationally from next year represents a further advance in our national strategy."

NHS should think survival - Cameron

Wednesday June 25th, 2008

A new Tory government would switch NHS priorities towards improving survival rates, Tory leader David Cameron pledged yesterday.

Mr Cameron pledged to sweep away a range of NHS management targets - replacing them with health outcomes.

The Tories unveiled their new targets yesterday as Mr Cameron delivered a speech to the Royal College of Surgeons.

The targets would Britain to surpass average European performance on cancer, stroke, heart disease and lung disease.

There would also be annual improvements required in the condition of patients with long-term illnesses, in the number of adverse events and in patient satisfaction.

Mr Cameron said: "We still have some of the worst health outcomes in the whole of Europe. Right now, England's near the bottom of the table when it comes to five-year cancer survival rates.

"And it's awful that you're more likely to die from a stroke in England than you are in any other country in western Europe.

"So we've got a situation where we pump the same money into our health system as other countries, but on the thing that actually matters - a patient's health and the results of their actual treatment - we're doing worse."

Health minister Ben Bradshaw told the BBC: "The Tories plans would take us back to the bad old days of people waiting two years or more for an operation and languishing on trolleys in A&E.

"If you talk to both staff and people who use the NHS, having some core basic standards of service have been vital in driving up performance and outcomes."

Row as abortions increase

Monday June 23rd, 2008

Anti-abortion campaigners may be increasing the number of procedures undertaken - by highlighting their existence, it was claimed yesterday.

Figures published last week showed increasing rates of abortions.

The biggest increase was a four per cent rise in Scotland - compared with a 2.2 per cent rise in England and Wales.

The figures showed an especially large jump in abortions involving under-aged mothers.

Some 165 girls under the age of 14 had abortions in 2007 compared with 135 in 2006.

And amongst under-16 year-olds there was a ten per cent increase, representing about 400 extra procedures.

Some 13,704 abortions were performed in Scotland - a much lower rate than the total of nearly 198,499 in England and Wales.

Yesterday Ann Furedi, chief executive of the British Pregnancy Advisory Service - which provides abortion services, said of Scotland: "The intention may have been to dissuade women from abortions, but in fact, because these type of attacks attracted so much publicity, it fixes the idea in women's minds that abortion is an option, and oddly enough, that may well reduce the stigma about it."

She told the Sunday Telegraph: "Even if the message is railing about sin, and an amoral society, the other point getting through is that lots of women are doing this, and that it is more acceptable."

The new figures come ahead of continued parliamentary debates on the Human Fertilisation and Embryology Bill.

Having seen off attempts to restrict abortion, the government is under pressure to put forward amendments to make it easier to obtain.

Health visitors and chaplains hold out as pay deal signed

Friday June 20th, 2008

Twelve health unions reached a deal on NHS pay yesterday - but one is holding out for possible action.

Under the deal negotiations can be reopened next year if inflation exceeds expectations.

Two unions which bitterly opposed the three year NHS deal, the Royal College of Midwives and the GMB, agreed to sign the deal on these terms.

But Unite, which represents health visitors, chaplains and a range of other staff, said it was pressing ahead with a strike ballot.

The union said its members have now voted for a ballot on industrial action.

Karen Reay, of Unite, said: "The message to government from our members in the health sector and across public services is clear. This government must listen and act on our members concerns.

"This unprecedented call for a ballot for industrial action must be heard."

Josie Irwin, lead negotiator for the Royal College of Nursing, said: "Our consultation responses told us that members recognise this is the best deal that could be negotiated but they are very concerned about the economic situation.

"That is why we have said we will not hesitate to trigger the re-opener clause if inflation continues to rise."

Quality of compassion to be measured

Thursday June 19th, 2008

Nurses are to be rated according to their compassion levels, it was announced yesterday.

Good hand-washing will also be measured as part of a series of indicators to assess the quality of nursing care, health secretary Alan Johnson said.

The move was welcomed by nursing leaders, who said it would give the profession recognition.

Mr Johnson did not say how compassion would be measured but most likely it would be based on patient surveys.

Safety measures would record the number of falls in wards and infection rates.

And measures of "effectiveness" would record management of pain, hand-washing and patient nutrition.

Mr Johnson told the NHS Confederation: "Our nurses do a brilliant job, often delivering very intimate care. They know instinctively that a patient's understanding of quality in the NHS is about much more than excellent clinical care.

"The personal touch is so important too. Patients want to be kept well-informed by staff and treated with compassion and sensitivity."

Dr Peter Carter, chief executive of the Royal College of Nursing, warned that nurses would need to understand the measures were intended to improve performance, not to "punish" poor nursing.

He said: "We are delighted that the government has recognised the need to measure quality in nursing care. These new standards are groundbreaking in that they will directly recognise nurses for the kind of care that patients really value."

NMC leaders quit

Wednesday June 18th, 2008

Britain's senior nursing regulators quit their posts yesterday after a damning report into the organisation they ran.

Members of the Nursing and Midwifery Council were accused of "inappropriate" conduct in the report issued on Monday.

And the organisation was accused of relying too heavily on lawyers - making life miserable for complainants and accused nurses alike.

Yesterday the NMC president Nancy Kirkland announced she was stepping down in the wake of the report.

And the chief executive Sarah Thewlis said she would be resigning also.

The report was published by the Council for Healthcare Regulatory Excellence following allegations of racism and bullying made in Parliament. No evidence of racism was found.

Ms Kirkland said she would stay on the NMC as a Scottish representative but would leave the president's post.

She said: "Although I have only been President of the NMC for a short time (8 months), I share and take responsibility for the criticisms made by CHRE and I feel honour bound to do so.

"I therefore intend to resign as President of the NMC in order to maintain public confidence in the NMC and the important work the organisation continues to do to safeguard the health and well-being of patients and the public."

Ms Thewlis said: "Leading a demanding organisation such as the NMC brings great professional satisfaction, particularly an organisation responsible for protecting the public.

"However, with that professional satisfaction also comes personal accountability, leadership and a shared sense of responsibility for the NMC. That is why I have taken this decision."

Nurse watchdog condemned

Tuesday June 17th, 2008

Nursing regulators were reeling yesterday after a damning report condemned their behaviour.

The Nursing and Midwifery Council was accused of relying too much on lawyers - and its council members were accused of inappropriate conduct.

The report was published by the watchdogs' watchdog, the Council for Healthcare Regulatory Excellence, after MPs complained in parliament about the NMC, accusing it of bullying and racism.

The CHRE report also accused the NMC of giving poor service to members and failing to use computer systems properly - but it found no evidence of racism.

The report states: ".We have seen and heard evidence of behaviour that is undoubtedly experienced as bullying by many people involved."

It says there has been a "constant" recourse to lawyers for each and every complaint - and this has not been helpful.

An NMC spokesman admitted the report was "tough reading".

He said: "The report identifies the NMC's strengths in the provision of standards and guidance for nurses and midwives. But we are acutely aware that there is still a big job to do at the NMC."

But CHRE Chief Executive, Harry Cayton said: “We have serious concerns about the inadequate operation of the NMC’s fitness to practise processes, governance framework and lack of strategic leadership, the inconsistent availability and provision of information to Council to ensure effective planning and decision making and its ability as an organisation to retain the confidence of key stakeholders."

And a joint statement by by four nursing unions call for "urgent" implementation of the report's recommendations.

The statement says: "Whilst the report states that they are fulfilling their statutory function its clear that they are not doing this to the reasonable standard that the public and registrants should expect."

Trusts still struggle to beat bugs

Monday June 16th, 2008

Dozens of hospital managers have admitted failing to meet standards for preventing infection, it was announced today.

A Healthcare Commission report shows that 26 per cent of English NHS Trusts admit to failing to meet one of its standards - some 103 out of 391.

The standards require them to keep facilities clean, to have adequate infection control and to follow guidelines on decontaminating equipment.

The Commission reports today on Trust's annual self-assessment of their performance.

The trust declarations will be subject to checks by the Healthcare Commission before it publishes its final annual report.

Commission chief executive Anna Walker said: "However the picture on hospital acquired infection is mixed. There were improvements in two out of the three relevant standards.

"But overall we are still in a situation where too many trusts have self declared non compliant."

GPs get one million backers

Thursday June 12th, 2008

Primary care staff have collected well over one million signatures calling for traditional GP practices to be saved, it was announced today.

The BMA reported the success of its general practice petition to the ocnference of the local medical committees today.

The petition has been collected in surgeries throughout Britain objecting to primary care being handed over to "large commercial companies".

The BMA said the signatures were collected in the space of three weeks.

The announcement underscores a week in which alarmed government ministers launched an all-out onslaught on the BMA, accusing it of "scaremongering" over polyclinics.

But LMC chairman Dr Laurence Buckman will today attempt to hand the petition into 10 Downing Street.

He will warn of short-term contracts being handed out to polyclinics.

He will say: "If the government won't listen to you, their doctors, then surely it will listen to the 1.2 million men and women who call for a halt to the plans to promote the use of commercial companies in general practice.

"Voters don't want funding to move from GP practices to commercial companies who are accountable primarily to shareholders rather than patients. They want to be treated as patients, not customers."

Drink spiking with drugs very rare

Wednesday June 11th, 2008

Fear of drink spiking is out of proportion to the true risk, a nurse reports today.

Shelley Cummings, a senior sister at Royal Surrey County Hospital in Guildford, Surrey, UK, carried out an audit in her emergency department. She examined the data from patients' notes between 2005 and 2007.

In this month's issue of the journal Emergency Nurse, she reports that a total of 75 patients had "drink spiking" as their reason for attendance. Eighty-two per cent were women, mostly between 18 and 22 years of age, and often presenting between midnight and 4am.

They reported feeling strange, forgetting periods of time, feeling unwell, drowsiness or weakness. Almost all (95 per cent) had consumed alcohol. Only a third were referred to the police or given urine sampling kits for analysis, and quarter left hospital before seeing a doctor.

When a doctor's letter was available, a third were classed as intoxicated, with no mention of drink spiking. When spiking was mentioned it was often qualified with statements such as "claimed" or "alleged".

Ms Cummings believes that when drinks are spiked it is more likely to be with extra alcohol rather than drugs such as flunitrazepam, better known as Rohypnol.

"Media reports have heightened public concern about the risks of taking drugs unknowingly, and have led to an increase in the number of people attending emergency departments while intoxicated, in the belief that their drinks had been spiked," she said.

In England, no urine samples sent for analysis between March 2006 and January 2008 gave positive results for either Rohypnol or GHB (gamma hydroxybutyrate) - the drugs most commonly associated with drink spiking.

Cummings, S. Altered perceptions. Emergency Nurse, Vol. 16, June 2008, pp. 10-13.

Teens face cancer delays

Monday June 9th, 2008

Many teenagers who develop cancer face significant delays in getting treatment, a conference in London is to be told today.

A study found that teenagers with bone tumours had waited an average of 15 weeks for diagnosis after their symptoms first appeared.

Although the delays were partly caused by their hesitating to go to a GP, the study also found delays in referral to specialists.

Many teenagers reported four GP visits before referral and some reported delays of up to four years before diagnosis.

Professor Tim Eden, of Manchester University, whose post is sponsored by the Teenage Cancer Trust, reported surveys of some 200 young people with cancer.

Nurse Sam Smith, of Christie Hospital, Manchester, will tell the conference, organised by the Trust, that 80 per cent of teenagers sought help quickly while seven per cent reported having delays for months.

She said that as many as 50 per cent of patients with bone or brain tumours or Hodgkin's lymphoma reported four or more visits to a GP before referral.

Professor Eden said: "A small number of patients may delay in seeking help and we can improve education about health and the meaning of symptoms for the public, but the biggest challenge seems to be to overcome delays by professionals.

"We need to assist professionals in: recognising signs and symptoms as being potentially serious; referring patients in a timely fashion to appropriate experts; but above all, considering the possibility of cancer in this age range.

"Cancer is, after all, the most common disease causing death in the 15-24 age range, accounting for 11 per cent of all deaths."

NHS matron numbers double

Friday June 6th, 2008

The number of modern matrons working in the NHS has doubled in the last year, it was announced yesterday.

There are now 5,538 modern matrons, health secretary Alan Johnson announced today (June 6).

Gordon Brown pledged to boost matron numbers in his keynote speech at the Labour party conference in September last year. The prime minister promised to add around 3,000 matrons to the previous 2,153.

Speaking at the time, Dr Carter of the Royal College of Nursing said: "The RCN has long called for more modern matrons with a central, supported role in the NHS that recognises their key contribution in tackling hospital acquired infections, driving up standards of patient care and providing leadership on the wards.

"This investment is badly needed and is a welcome signal that this government is making a genuine commitment to the future of the NHS and its workforce that will be of long-term benefit to staff and their patients."

The department of health states that matrons are "strong clinical leaders given the power to make things better for patients and families, with distinctive uniforms to ensure that they are highly visible".

Alan Johnson announced today that the new matrons have been told to order additional cleaning or change cleaning contracts if standards are not up to scratch.

"We set ourselves an ambitious milestone last year to double the number of matrons and I am very pleased that we have been able to meet this need with more than five thousand matrons now in post," he said.

Chief Nurse at Guy's and St Thomas' Hospital NHS Trust, Eileen Sills, commented: "We now have a very talented group of matrons and I have no doubt that they will make a real difference."

Call for overseas service

Thursday June 5th, 2008

British nurses and midwives are to find out about how they can reverse the "brain drain" of staff from poor countries.

The two professional colleges have teamed up with aid organisations to discuss how their members can help the developing world.

The issues are to be discussed at a conference later this month organised by the Royal colleges of midwives and nursing together with Voluntary Service Overseas and Medecins San Frontieres.

It comes after a report of the Global Health Workforce Alliance last month which warned that policies are "failing" to boost numbers of health workers in poor countries.

"The number of people being educated and trained is too small to make a difference."

The taskforce says Africa alone needs another 1.5 million health workers.

The conference, entitled "Work Overseas: Use your skills to change lives" is aimed at all nurses and midwives who are interested.

A spokeswoman said: "Delegates will learn about the realities of working internationally in aid or development as a nurse or midwife, and gain an understanding of the role of major charities in global health and humanitarian aid.

"They will also have an opportunity to network with providers of healthcare overseas and to discuss how working overseas fits with their future career."

Doubt over hospital wipes

Wednesday June 4th, 2008

Disinfectant wipes in British hospitals are failing to decontaminate surfaces properly, researchers reported yesterday.

Wipes that are purchased to kill bacteria only work once - and after that spread germs rather than kill them, Welsh researchers said.

The findings were reported in Boston, Massachusetts, USA, to the conference of the American Society for Microbiology.

Researcher Dr Gareth Williams, of Cardiff University, said the disinfectant wipes need to be tested to ensure they successfully remove bacteria.

The study of existing wipes found that some could "remove" large numbers of bacteria from surfaces. But they did not kill them - only transfer them elsewhere.

Dr Williams said: "Our work suggests that if these wipes encounter highly contaminated surfaces in practice, the survival of bacteria on the wipe material could lead to the cross-contamination of other surfaces if used more than once."

He calls for routine "surveillance" to ensure that cleaning programmes are working.

Johnson will bring back friends

Tuesday June 3rd, 2008

The NHS will give better support to its volunteers under plans announced yesterday.

The new plans aim to boost organisations such as the WRVS and Leagues of Friends, who have sometimes been marginalised by the commercialisation of the NHS.

Health secretary Alan Johnson spent time working as a volunteer in a hospital shop at St Bartholomew's Hospital, London, yesterday before announcing a six months consultation on how to improve support for volunteers.

The consultation says hospitals need to give better support to managers of voluntary organisations and to recognise that they face significant administration costs.

Ministers say there is evidence that volunteering is also good for volunteers and improves their physical and mental health.

Mr Johnson said: "Volunteers do an amazing job, they are vital to the lifeblood of the NHS and social care services. Volunteering does not just benefit patients, research has shown that it makes the volunteers happier too.

"There is a long established tradition of volunteering across the full range of health and social care settings, indeed the NHS grew from the pre-NHS voluntary hospitals."

Plans to deter teen smokers

Monday June 2nd, 2008

Increased pack sizes and vending machines that require proof of age might help prevent young people starting to smoke, according to new government proposals.

Released on World No Tobacco Day, the proposals suggest larger pack sizes might prevent teenagers being able to afford them.

The consultation suggests that vending schemes could be banned or restricted to adults.

It also suggests removing branding and logos from tobacco packaging, limiting displays in shops and banning the advertising of cigarette papers and other "paraphernalia".

More than 200,000 children and teenagers under the age of 16 take up smoking every year.

Public health minister Dawn Primarolo said: "If banning brightly coloured packets; removing cigarettes from display; and removing the cheap option of a pack of ten helps save lives, then that is what we should do - but we want to hear everyone's views first.

"Smoking related disease kills 87,000 people a year, the equivalent to the entire population of a major city such as Durham. Despite much progress over the past ten years with 1.9 million fewer smokers since 1998, smoking it is still the biggest killer in England."

The British Medical Association said the government had taken on board many of its recommendations.

But the World Health Organisation said governments needed to ban all tobacco advertising, promotion and sponsorship.

It warned that the industry was using the Internet to influence young people as well as traditional media.

Dr Douglas Bettcher, of WHO, said: "The tobacco industry employs predatory marketing strategies to get young people hooked to their addictive drug.

"But comprehensive advertising bans do work, reducing tobacco consumption by up to 16 per cent in countries that have already taken this legislative step."

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