Many A&Es 'not sharing crime data'

31 January 2013 Last updated at 06:20 ET By Branwen Jeffreys Health correspondent, BBC News

A coalition pledge to make hospitals share violent crime data with police is being carried out in only a third of areas in England, an audit shows.

The government has written to hospitals and chief constables for an explanation after the Department of Health audit.

Accident and emergency departments are meant to share information about where knife or gun attacks are happening with the police and local council.

This was part of the government's programme for government in 2010.

'Disappointed'

In 2010 the coalition promised in its programme for government to make hospitals share non-confidential information with the police so crime hotspots could be identified.

Continue reading the main story

I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities - just get on with it"

End Quote Prof Jonathan Shepherd Cardiff University

In the government's mid term report, which measured progress against their programme for government they said "we have established a national scheme requiring hospitals to share information on gun and knife crime".

But an audit carried out for the Department of Health has revealed that is happening effectively in only a third of community safety partnership areas, and not at all in one-fifth.

The charity Victim Support said it was very disappointing that the plan was not being implemented.

Susannah Hancock, its assistant chief executive, said: "The NHS is the second most likely public service after the police to come into contact with victims of violent crime, many of whom will not have reported such incidents to the police at all. "

It is thought that police are aware of fewer than a third of assaults that lead to the victim being treated in hospital.

Pioneering research carried out in Cardiff tested the idea of regularly sharing collated information about the type and location of attacks, with all confidential patient information removed.

As a result, the city saw a 35% fall in the numbers of assault victims turning up at A&E for treatment between 2000 and 2005.

Professor Jonathan Shepherd, from Cardiff University, said the research showed sharing information costs little, and saves money in the longer term for the NHS and the criminal justice system. He said the findings of the audit were surprising, giving the strong evidence, and the commitment from government.

"I feel disappointed that it hasn't been taken up faster than this, and I would want to say to hospitals and local authorities this is straightforward, ethical information-sharing that makes for safer communities - just get on with it."

'Win-win'

Arrowe Park hospital, in the Wirral, has seen some impressive results from setting up systems to share information every month with the police and local council. Anyone arriving at A&E with an injury caused by a violent assault is taken through a standard set of questions about the location and circumstances of the attack.

The information has all patient data removed from it before it is shared. Between 2004 and 2010, the number of alcohol-related assault victims arriving for treatment fell by 30%.

Chris Oliver, from the Wirral University Hospital Trust, said the results had convinced busy staff in A&E to get involved: "It's owned by everyone within the department. The reception staff are very proactive when going through the questions. It's very rewarding for our staff to see the reduction in people coming into the department. It's a win-win."

The Department of Health said Health Minister Anna Soubry had written this week to all hospital chief executives and chief constables in England to remind them of the government's commitment on sharing information.

The letter says there are no legal reasons for not sharing anonymous information, and asks for any "good reasons why it cannot be done" in areas which have failed to put systems in place.

Despite this slow progress in implementing the approach in England, the idea has attracted international interest and there are pilot schemes under way in other countries.

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A&E waits and delays 'worsening'

30 January 2013 Last updated at 12:06 ET By Nick Triggle Health correspondent, BBC News

Patients going to A&E in England are facing longer waits and delays as growing pressure on hospitals put services under strain, figures suggest.

The data - highlighted by Labour - shows the problems have got worse over the past few months in particular.

The NHS is still meeting its target that 95% of people are seen in four hours, but the data suggests this winter has been more difficult.

There is also evidence of ambulances being left queuing outside hospitals.

Labour said the worsening situation was a result of government cuts, but ministers said the NHS was coping well.

An extra 47,000 patients have waited more than four hours in A&E this winter - a 20% rise on the same period 12 months previously.

Particular problems are being experienced by the major A&E units with the overall target only being hit because of the better performance of minor injury units and small A&Es.

'Unprepared for winter'

The data - compiled from official Department of Health figures and research by the Labour party - also showed a rise in ambulances having to wait more than 30 minutes to hand over patients once they arrive at hospital.

Continue reading the main story

Hospitals don't have enough staff and there are growing concerns for patient safety"

End Quote Andy Burnham Shadow health secretary

From 30 November to 20 January there were nearly 43,000 cases, up by 35% on the same period the year before.

There was even a case of an ambulance waiting more than five hours.

Elsewhere in hospitals, wards reported problems discharging patients. This is often related to a lack of community support from district nursing and social care being available for the most vulnerable patients.

Shadow Labour health secretary Andy Burnham said: "It is becoming clearer by the day that ministers left the NHS unprepared for winter. A number of A&Es are simply not coping.

"Hospitals don't have enough staff and there are growing concerns for patient safety."

The findings echo the concerns expressed by the College of Emergency Medicine in recent months.

College vice-president Taj Hassan said the rising pressures were "unsustainable".

"Safety of care delivery remains the top priority to maintain but unfortunately the rising numbers of patients, especially out of hours, continues to be a major challenge," he added.

Health Minister Norman Lamb said there would always be difficult weeks, especially during winter, but he added the NHS was still in line to meet the target this year.

He said this was being done despite an extra one million people visiting A&E units annually than two years ago.

"It really makes the case we have to do much more to keep people out of hospital."

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Hospital cuts over neighbour debt

31 January 2013 Last updated at 08:35 ET

The A&E department at Lewisham hospital in south-east London is to be downgraded and made smaller as part of cost-cutting measures.

Health Secretary Jeremy Hunt said the maternity unit at Lewisham would be replaced with a midwife-led facility.

The cuts aim to help tackle debts of £150m at the neighbouring South London Healthcare NHS Trust (SLHT).

At least 15,000 people took part in a protest march against the plans on Saturday.

Mr Hunt told MPs: "I respect and recognise the sense of unfairness people feel because their hospital has been caught up in the financial problems of its neighbour.

"However solving the financial crisis next door is also in the interest of the people of Lewisham because they too depend on the services which are currently part of South London Healthcare Trust."

Mr Hunt accepted six of the seven proposals put forward by special administrator Matthew Kershaw.

He said £36m would be allocated to expanding capacity at the hospitals which would take on high-risk births from Lewisham.

'Dangerous precedents'

He said the SLHT, which is in administration, was the "most financially challenged in the country", as it spends £60m a year, or 16% of its annual income, to service two PFI contracts signed in 1998.

Mr Hunt confirmed that the SLHT will be dissolved by October 2013 and its hospitals re-configured.

Up to three quarters of those currently attending Lewisham A&E could attend the new service at the hospital, he said.

Patients with more serious conditions could be taken to other hospitals.

He said overall the proposals could save up to 100 lives per year through higher clinical standards.

He said it was on the advice of NHS Medical Director Professor Bruce Keogh that the decision was taken to retain Lewisham Hospital's A&E in the best interests of patients.

Andy Burnham, shadow health secretary, said the move would "set dangerous precedents".

Joan Ruddock, Labour MP for Lewisham Deptford, said: "Today's proposals are a sham and a shambles and unacceptable to those who represent people in Lewisham."

Mr Hunt responded: "A sham and a shambles is what I inherited, not what I'm bequeathing."

The changes are part of a radical overhaul proposed in response to SLHT losing around £1.3m a week.

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Stiff upper lip 'harms cancer fight'

29 January 2013 Last updated at 21:52 ET By Michelle Roberts Health editor, BBC News online

The UK's "stiff upper lip" culture may explain why it lags behind other countries when it comes to beating cancer, say experts.

Researchers, who surveyed nearly 20,000 adults in six high-income countries, said they found embarrassment often stopped Britons visiting the doctor.

Respondents in the UK were as aware of cancer symptoms as those in Australia, Canada, Denmark, Norway and Sweden, but more reluctant to seek help, they said.

A third feared wasting a doctor's time.

One in six of the men and women aged 50-and-over surveyed in the UK was embarrassed about sharing their symptoms with a doctor, the researchers from King's College London and University College London, with help from Cancer Research UK and Ipsos Mori, found.

They said, in the British Journal of Cancer, that this may partly explain why the UK has a far lower cancer survival rate than other developed nations, despite good access to skilled medical staff and cutting-edge treatments.

Continue reading the main story

We don't know why British people feel like that. It may be that we are more stoic and have a war-time mentality"

End Quote Dr Lindsay Forbes Lead researcher

The researchers surveyed people in England, Wales and Northern Ireland, but not Scotland.

'UK phenomenon'

Data shows that for cancer survival, the UK ranks behind many countries, including the five other nations looked at in the study.

According to estimates, the lives of more than 5,000 cancer patients could be saved each year in England alone if the country matched the best European survival rates.

Former Health Secretary Andrew Lansley pledged to achieve this target by the next general election in 2015, with the government's cancer strategy.

Lead researcher Dr Lindsay Forbes said: "This is a real UK phenomenon. UK people really stood out in our study.

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Dr Lindsay Forbes: ''We need to try to understand why people worry about wasting their doctor's time''

"As a nation we are much more likely to say we are embarrassed about going to the doctor or we are worried that we will take up a doctor's time.

"We don't know why British people feel like that. It may be that we are more stoic and have a war-time mentality.

"We know that older people in particular can get a symptom and then wait for weeks or months before going to see their doctor."

Sara Hiom, of Cancer Research UK, said the charity "and others are working hard to understand and address these potential barriers to early presentation and encourage people to tell their doctor if they have noticed something different about their body".

"More work also needs to be done to tackle the poor awareness that cancer risk increases with age," she added.

The researchers note that Denmark also ranks relatively low for cancer survival. They suspect this could be due to delays in patients accessing timely hospital care - something which may also apply to the UK to some extent.

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Double arm transplant for soldier

29 January 2013 Last updated at 16:24 ET

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'One of my goals is to hand-cycle a marathon'

The first US soldier to survive losing four limbs in Iraq has said he is looking forward to swimming and driving after having a double arm transplant.

Brendan Marrocco, 26, was injured by a roadside bomb in 2009.

He also received bone marrow from the deceased donor of his arms, a therapy intended to help his body accept the new limbs with minimal medication.

His surgeon says it will take more than a year to know how fully Mr Marrocco will be able to use the new arms.

"The maximum speed is an inch a month for nerve regeneration," Dr W P Andrew Lee, who led the 13-hour surgery last month at Johns Hopkins Hospital in Baltimore, Maryland, told a news conference on Tuesday.

Four other soldiers have lost all four limbs and survived since Mr Marrocco.

'Sky's the limit'

He said he did not know much about the donor but was "humbled by their gift".

His surgery was only the seventh double-hand or double-arm transplant ever done in the US.

On Tuesday Mr Marrocco said he was looking forward to returning to driving and swimming after the transplant.

"I just want to get the most out of these arms, and just as goals come up, knock them down and take it absolutely as far as I can," Mr Marrocco said on Tuesday.

While he has used prosthetic legs, the former soldier said he hated not having hands.

"You talk with your hands. You do everything with your hands, basically, and when you don't have that, you're kind of lost for a while," he said.

Arm and hands prosthetics are generally not as advanced as those for feet and legs.

While he continues physical therapy at Johns Hopkins and later at Walter Reed National Military Medical Center, doctors are giving Mr Marrocco a good prognosis on the ultimate ability to use his new hands.

"He's a young man with a tremendous amount of hope, and he's stubborn - stubborn in a good way," said Dr Jaimie Shores, the hospital's clinical director of hand transplantation.

"I think the sky's the limit."

Mr Marrocco had been living in a specially outfitted home in Staten Island, but it was heavily damaged as the cyclone Sandy hit the New York City borough last year.

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A&E cap to address 'poor care'

29 January 2013 Last updated at 20:27 ET

The number of patients admitted to an east London hospital A&E unit is to be capped at busy times to improve care.

The Care Quality Commission (CQC) said the A&E department at Queen's Hospital, Romford, was providing patients with "unacceptably poor care".

It comes after inspectors found some A&E patients had to wait up to 11 hours before being transferred to a ward.

Barking, Havering and Redbridge University Hospitals NHS Trust said it was working to improve emergency care.

Check on improvements

Apologising to anyone who may have experienced poor care, trust chief executive Averil Dongworth said: "Improving performance in our emergency departments is the biggest challenge that we face, and is the area that is receiving the most attention from all parts of the organisation."

Inspectors made unannounced visits to the hospital in November and December having identified major concerns about the care and welfare of patients in March 2012.

Continue reading the main story

The area in which they were waiting was not set up to deliver good quality care to the standard CQC expects"

End Quote Matthew Trainer CQC

Their report said: "We carried out this inspection to ensure they had made improvements, in relation to concerns identified about meeting waiting times and delays experienced by patients in receiving care and the quality of the care they received."

It said they found people using the "Majors" area who required admission were waiting far too long to be transferred to other parts of the hospital - 5% waited more than 11 hours.

The report said the trust should be aiming to transfer 95% of patients who are being admitted to wards within four hours of arrival.

During the inspections people were being nursed on trolleys when they needed to be moved into beds, increasing the risk of pressure sores, dehydration and falls.

The "Majors" area did not have any washing facilities or storage for personal possessions, and did not offer people the privacy and dignity they are entitled to, the report said.

Protection measure

Elsewhere in the department, personal information, including diagnosis, was displayed where anyone, including other members of the public, could see it.

There were not enough consultant or junior doctors in A&E.

Matthew Trainer, deputy director of CQC in London, said: "No-one should wait 11 hours' plus to be transferred to a bed, but some of the people we saw during our unannounced inspection had done just that.

"The area in which they were waiting was not set up to deliver good quality care to the standard CQC expects."

He said it now planned to place a legal restriction on the number of people who can be admitted to the "Majors" part of A&E if people already there have been waiting for too long.

"This is designed to protect people from the risk of harm, and to give the trust breathing space to make the changes it needs to make," he said.

Another unannounced inspection found required standards in maternity services at the hospital were now being met.

Ms Dongworth said while the CQC report noted Queen's A&E department was designed to deal with 90,000 attendances a year, they were now seeing about 132,000 people.

"It also confirms that Queen's receives more blue light ambulances than any other hospital in London, " she added.

She said: "Dealing with this volume of patients is hugely challenging and requires a joined-up approach to ensure that the trust is supported by services in the community."

The CQC is due to meet the Trust Development Authority and local commissioners next week to discuss next steps.

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Call for soft-drink sugar tax

28 January 2013 Last updated at 19:46 ET By Michelle Roberts Health editor, BBC News online

Leading medical bodies are calling for a 20p-per-litre levy on soft drinks to be included in this year's Budget.

More than 60 organisations, including the Royal College of Paediatrics and Child Health, are backing the recommendation by food and farming charity Sustain.

They say it would raise £1bn a year in duty to fund free fruit and meals in schools to improve children's health.

The soft drinks industry says raising taxation is unnecessary.

The British Soft Drink Association (BSDA) says companies are already playing their part in the fight against obesity.

The BSDA's director general Gavin Partington said 61% of soft drinks "now contain no added sugar and we have seen soft drinks companies lead the way in committing to further, voluntary action as part of the government's Responsibility Deal calorie-reduction pledge."

He said 10p from every 60p can of drink already goes to the government in tax.

"Putting up taxes even further will put pressure on people's purses at a time when they can ill afford it," he said.

Continue reading the main story

• Sugary foods and drinks can only make us gain weight if overall we eat more calories than we use for energy
• Sugary drinks are potentially hazardous because they do not fill us up, meaning we can easily consume too much
• A 330-millilitres (half-pint) sugary drink typically provides 35g (0.17oz), or nine lumps of sugar
• The British Dietetic Association says some research suggests sugary drinks may be contributing to obesity in children
• In the UK, one in four adults is classified as obese and one in three children is already obese or overweight before they finish primary school
• If you want to cut down, try switching to drinking pure juice diluted with fizzy water, diet fizzy drinks, milk, no-added-sugar squash or water

But Sustain says the tax is a simple measure that would help save lives by reducing sugar in our diets and raising money to protect children's health.

It says the UK consumes more than 5,727 million litres of sugary soft drinks a year. Adding a 20p tax for every litre sold would raise more than £1.1bn.

Mike Rayner, of the department of public health at Oxford University and chairman of Sustain, said: "Just as we use fiscal measures to discourage drinking and smoking and help prevent people from dying early, there is now lots of evidence that the same approach would work for food.

"This modest proposal goes some way towards making the price of food reflect its true costs to society. Our obesity epidemic causes debilitating illness, life threatening diseases and misery for millions of people. It is high time government did something effective about this problem."

A Department of Health spokeswoman said: "Our primary responsibility is to help the nation to be healthier.

"We keep all international evidence under review. But we believe the voluntary action we have put in place is delivering results."

Shadow Health Secretary Andy Burnham disagrees and says it is clear that a voluntary approach is not working.

He said: "Labour is consulting on whether new limits on sugar, salt and fat content in food aimed at children would be a better way forward. This would help parents protect their children from foods which contain excessive levels of sugar, salt and fat in a way that a tax wouldn't."

Over the past 10 years, the consumption of soft drinks containing added sugar has fallen by 9% while the incidence of obesity has increased by 15%.

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'Ban non-medics from giving Botox'

28 January 2013 Last updated at 19:46 ET By Michelle Roberts Health editor, BBC News online

Only trained doctors, nurses and dentists should provide non-surgical cosmetic treatments such as Botox, say surgeons.

Currently people such as beauticians with no medical training can administer anti-wrinkle Botox injections, even though it is a potent neurotoxin.

The Royal College of Surgeons (RCS) wants to put an end to "Botox parties" and rogue traders.

The government has been assessing whether tougher laws are needed.

Lawless

NHS medical director, Sir Bruce Keogh, has been conducting a review into the cosmetic industry and will report back to government in March.

Continue reading the main story

"Start Quote

We have serious concerns that not all those who offer cosmetic procedures are adequately qualified, or that patients are getting accurate information prior to treatment"

End Quote Prof Norman Williams RCS president

The RCS in England wants a clampdown, and has set out a list of standards for the industry.

RCS president Prof Norman Williams said: "While the colleges and professional organisations involved in cosmetic practice are neither regulators nor legislators, the profession has a responsibility to provide standards to which we would expect our members to work.

"We have serious concerns that not all those who offer cosmetic procedures are adequately qualified, or that patients are getting accurate information prior to treatment. We hope these standards will feed into the ongoing review of the industry led by the NHS medical director, Sir Bruce Keogh, and improve quality of care for patients going forward."

The RCS makes several recommendations, including a proviso that anyone planning to have a cosmetic procedure should have a thorough psychological assessment beforehand.

Continue reading the main story

Anti-wrinkle injections

• There are various procedures designed to make the skin look younger without having to go under the knife
• Botox is an injection of a toxin which, at small doses, relaxes facial muscles to make wrinkles and lines less obvious
• Dermal fillers are injected to plump up the skin and flatten wrinkles
• If you're considering a procedure, find out what it involves, what the risks are and how much it costs
• Ask about the qualifications and experience of the person who will be giving it to you

Only those who have medically recognised qualifications and training and should carry out cosmetic procedures, such as breast surgery, liposuction and Botox treatment, and in a registered clinic with resuscitation equipment on hand in the event of an emergency, it recommends.

Practitioners have a duty to manage a patient's expectations of how they will feel after treatment, the RCS says.

They should not imply that patients will feel "better" or "look nicer", for example, and should instead use unambiguous language like "bigger" or "smaller" to describe what that patient is trying to change, it says.

The British Association of Aesthetic Plastic Surgeons (BAAPS), which represents about a third of plastic surgeons in Britain, would also welcome stricter controls.

BAAPS says all of its accredited surgeons are fully trained, vetted and qualified to carry out cosmetic procedures. But it cannot vouch for the rest working in the private sector.

Because of the lack of regulation, it is difficult to gauge the scale of the issue. Most cosmetic procedures are carried out privately, rather than on the NHS.

Estimates suggest that in 2011, there were 669,711 surgical and non-surgical cosmetic procedures carried out in the UK. BAAPS own figures show 43,172 surgical procedures were carried out by BAAPS members in 2011.

According to the Independent Healthcare Advisory Service (IHAS), about 200,000 anti-wrinkle injections, which includes Botox and dermal fillers, are carried out in the UK each year.

The IHAS runs a voluntary register of injectable-cosmetic providers aimed to help consumers find a skilled and trusted clinician.

A recent poll by ComRes of 1,762 people found many considered the cost of surgery more important than the qualifications of the people doing it or how they would be looked after.

Two-thirds of those questioned considered cost as a factor when deciding whether or not to have cosmetic surgery. Half said they would take the qualifications of their doctor into consideration and less than half would consider the quality of their aftercare when reaching a decision.

A Department of Health representative said: "The report from the Royal College of Surgery is timely as NHS medical director, Sir Bruce Keogh, is currently carrying out a review into regulation of cosmetic interventions, including cosmetic surgery.

"The review will be published in March. Its recommendations will be evidence-based, with the safety of the patient at the forefront."

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North measles outbreak 'serious'

29 January 2013 Last updated at 07:10 ET

More than 100 people have, or are suspected to have, measles, in one of the worst outbreaks in the North East in recent years.

The Health Protection Agency (HPA) said the disease was mainly spreading among unvaccinated schoolchildren and it was "seriously" concerned.

Since September there have been 49 suspected and 56 confirmed cases, compared to just 18 confirmed in 2011.

Almost a quarter of those affected have been hospitalised, the HPA said.

'More cases likely'

Parents are being urged to make sure their children have the required two doses of the MMR vaccine - the first at 12 months and the second dose at around three years and four months.

HPA North East spokeswoman, Julia Waller, said: "This measles outbreak is very serious and we are likely to see many more cases before it's over.

"The sad thing is that most, if not all of these cases could have been avoided if people had been up-to-date with MMR vaccination.

"There are still too many children and young adults who were not vaccinated.

"People with measles could also be a risk to those who are not able to protect themselves such as babies who are too young to be vaccinated."

Earlier in January the HPA issued similar guidance in the North West after there were 35 confirmed cases since September.

The most common symptoms are fever, cough, sore eyes and a rash that develops three or four days after the onset of illness, starting with the face and head and spreading down the body.

There is no treatment for measles and in very rare cases it can be fatal.

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Protest against hospital closure

26 January 2013 Last updated at 11:04 ET

At least 15,000 people have marched in protest against proposals to close services at a hospital in south London.

Organisers campaigning to save Lewisham Hospital say the plans are "crazy and ill thought out".

Under proposals, its A&E will close and the maternity unit be downgraded after neighbouring South London Healthcare NHS Trust ran up debts of £150m.

The government said "doing nothing is not an option" and is to make a decision on 1 February.

Campaigners are angry Lewisham Hospital, which is not part of the South London Healthcare NHS Trust, is being targeted in a re-organisation of services across the area following the trusts's financial problems.

Under the plans, the trust's Queen Elizabeth Hospital site in Woolwich would come together with Lewisham Healthcare NHS Trust to create a new organisation.

Lewisham's A&E unit would then be downgraded to an urgent care centre, meaning emergency cases would be seen at nearby hospitals. The maternity unit at Lewisham could also be slimmed down, meaning complex cases would be dealt with elsewhere.

South London Healthcare NHS Trust, which runs three hospitals, was placed in administration last year when it started losing about £1.3m a week.

The problems it faces are not unique. Last year it was reported 20 trusts had declared themselves financially unsustainable in their current form.

Matthew Kershaw, a special administrator, said in a report to the government that the trust should be broken up, with other organisations taking over the management and delivery of services.

If implemented fully, Mr Kershaw said his recommendations would result in a radical overhaul of services in south London, and help deliver "safe, high-quality, affordable and sustainable services."

Mr Kershaw also recommended the Department of Health (DoH) write off any debts to ensure new organisations were not "saddled with the issues of the past".

"I have said consistently that the status quo is not an option, and I believe these final, refined recommendations are the right ones, although I appreciate that some people will find them difficult to accept," his report said.

Continue reading the main story

If Jeremy Hunt can close a good local hospital here, he can do it anywhere in the country - nowhere is safe"

End Quote Dr Louise Irvine Save Lewisham Hospital

'Huge clinical risks'

In November thousands of people marched in protest at the plans and BBC London reporter Matt Morris said at least 15,000 attended Saturday's event. The Save Lewisham Hospital group said 25,000 took part.

Dr Louise Irvine, a local GP and chairman of the Save Lewisham Hospital campaign, said: "This decision is crazy and ill thought out.

"It is a big mistake and carries huge clinical risks of things going wrong for patients but also political risk.

"If Jeremy Hunt can close a good local hospital here, he can do it anywhere in the country - nowhere is safe."

A DoH spokesman said: "Where trusts face long-standing problems we have been clear that doing nothing is not an option."

The march went past Lewisham Hospital and ended with a festival in nearby Mountsfield Park.

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Decrease in 'man boob' operations

27 January 2013 Last updated at 20:05 ET By James Gallagher Health and science reporter, BBC News

The number of operations to deal with 'man boobs' has fallen by a fifth in the past year in the UK, data on cosmetic surgery suggests.

Meanwhile women had more procedures to inject fat than to remove it for the first time.

Eye lid surgery as well as face and neck-lift operations both soared in popularity in both sexes in 2012.

The British Association of Aesthetic Plastic Surgeons (BAAPS) said overall the number of procedures was stable.

There were 43,172 surgical procedures carried out by the BAAPS 230 surgeons last year.

There were 642 operations on moobs - man boobs - down 18% from 2011. Surgeons speculated that more people were heading back to the gym instead.

Breast augmentation was again the most common procedure in the UK with 9,843 going under the knife. That was a fall of 1.6% on the previous year, which was put down to the health scare around PIP breast implants.

There were concerns about the implants rupturing and leaking non-medical grade silicone into the body.

Fat movements

Fat transfers which take fat from one part of the body to inject into another, often the face, increased by 13%.

It was one of a suite of anti-ageing procedures which increased in popularity among men and women in the past year. Facelifts went up by 14%, brow lifts by 17% and eyelid surgery by 13%.

However, liposuction and tummy tucks both fell by more than 10% in men and women.

The president of BAAPS and consultant plastic surgeon, Rajiv Grover, said: "The growth rates for surgical facelifting and other anti-ageing procedures showed a double digit rise, despite a double dip recession.

"Whilst there is an undeniable rise in demand for non-surgical treatments of the face, for example Botox and fillers, once there is actual loose skin in the neck or jowling, only surgery is likely to make a significant improvement and the public seem to be increasingly aware of this.

"The considerable drop in body-shaping procedures such as liposuction and tummy tucks may well be due to people choosing to head back to the gym, perhaps inspired by an unforgettable summer of Olympic golds!"

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Stem cell 'first aid' for rat stroke

27 January 2013 Last updated at 20:06 ET

Stem cells given in the vital period immediately after a stroke may aid recovery, suggest researchers.

Rats injected with stem cells 30 minutes after a stroke had almost normal brain function restored within a fortnight.

The Bolivian research team say the method has potential in human trials.

Current best practice is to treat many patients with "clot-busting" drugs in the "golden hour" after a stroke has taken place.

The research, published in the journal Stem Cell Research and Therapy, adds to others which have found that stem cells could aid stroke patients by boosting the body's ability to repair tissue damage.

Stem cells are the body's "master cells", with the potential to become many different cell types, and theoretically replace cells lost through disease or injury.

Recent tests in humans have show some promise, with stroke symptoms improving after an infusion of stem cells.

Continue reading the main story

Stem cells are an incredibly interesting area of stroke research."

End Quote Dr Clare Walton Stroke Association

The Bolivian team, from La Paz University Hospital, extracted a certain type of stem cells from fat and bone marrow, then injected them into the blood vessels of rats shortly after they had suffered an artificially-induced stroke.

Even though the introduced cells did not appear to travel to the affected region of the brain, the rats still did better than other rats who did not receive the cells.

Within 24 hours, they were already showing a speedier recovery, and two weeks later, they registered almost normal scores on behavioural tests.

Easy to use

The researchers said the early introduction of the cells might even interrupt the typical "chain reaction" of tissue damage which follows a stroke, in which the initial injury harms additional cells in surrounding areas.

Dr Exuperio Diez-Tejedor, who led the research, said: "Improved recovery was seen regardless of origin of the stem cells, which may increase the usefulness of this treatment in human trials.

"Adipose (fat) -derived cells in particular are abundant and easy to collect without invasive surgery."

The ease of collection, and the ability to use "allogenic" cells from other rats rather than having to harvest the animal's own cells and culture them, meant a treatment was available not weeks after a stroke, when the damage was done, but in this case minutes.

They wrote: "From the viewpoint of clinical translation allogenic stem cells are attractive because they can be easily obtained from young healthy donors, amplified, and stored for immediate use when needed after a stroke."

They suggested that it might be possible to overcome the risk of immune rejection of the donor cells in humans.

However, a spokesman for the Stroke Association said that human trials of this particular technique would not be possible in the near future.

Dr Clare Walton said: "Stem cells are an incredibly interesting area of stroke research and the results of this study provide further insight into their potential use for stroke recovery.

"However, we are a long way off these types of treatments being used in humans and a lot more research is needed."

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Chemical defects ‘last generations’

25 January 2013 Last updated at 20:24 ET

Scientists believe they have shown exposure to certain chemicals in the womb can cause changes that are passed through generations.

There is no firm evidence of this in humans, but Washington State University research showed a clear effect in rats.

They isolated defects linked to kidney and ovary disease and even obesity.

The work implicates a class of chemicals found in certain plastics, as well as one found in jet fuel.

The idea of "epigenetics" - that parents do not just pass their genes to their children, but subtle differences in the way those genes operate - is one of the fastest growing areas of scientific study.

Continue reading the main story

Your great-grandmother's exposures during pregnancy may cause disease in you"

End Quote Dr Michael Skinner Washington State University

The work of Dr Michael Skinner centres around the effects that certain chemicals can have on these processes, if the female is exposed at key points during pregnancy.

So far they have documented measureable effects from a host of environmental pollutants including pesticides, fungicides, dioxins and hydrocarbons.

However, they stress that the results are not directly transferable to humans yet, as the levels of chemicals used on the rats were many times more concentrated than anything a person would experience in normal life.

There is no data on even how an animal would respond at different doses, and no clues as to how the chemicals are causing these changes.

Environmental impacts

The studies, published in the journals PLoS One and Reproductive Toxicology, looked at the impact of phthalates, chemicals found in some forms of plastics, and a substance called JP8, found in jet fuel.

Rats exposed to phthalates had offspring with higher rates of kidney and prostate disease, and their great-grandchildren had more disease of the testicles, ovaries and obesity.

Female rats exposed to the hydrocarbon JP8 at the point in pregnancy when their male foetuses were developing gonads had babies with more prostate and kidney abnormalities, and their great-grandchildren had reproductive anomalies, polycystic ovary disease and obesity.

Dr Skinner said: "Your great-grandmother's exposures during pregnancy may cause disease in you, while you had no exposure.

"This is a non-genetic form of inheritance not involving DNA sequence, but environmental impacts on DNA chemical modifications.

"This is the first study to show the epigenetic transgenerational inheritance of disease such as obesity."

Andreas Kortenkamp, professor of human toxicology at Brunel University, said the results were "potentially very interesting", but much more work would need to be carried out before any impact on humans could be considered.

He said: "This is an exploratory study, but the authors themselves are clear that the data do not allow the possible risk to people to be assessed."

"There is a currently a lack of information about the dose-response relationship, and at this stage we are very unsure about the mechanisms that are involved."

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Dummy taped to baby in hospital

25 January 2013 Last updated at 09:55 ET

A member of staff has been suspended after a dummy was found taped to a baby's face at Stafford Hospital.

Staffordshire Police said it happened earlier this month and the baby was four months old at the time.

Colin Ovington from Mid Staffordshire NHS Foundation Trust said: "Fortunately, the baby was unharmed. We have a zero tolerance approach to poor patient care."

The trust is at the centre of a public inquiry into serious failings of care.

Apology to family

In a statement, Staffordshire Police said officers were investigating a complaint about a member of staff at the hospital and liaising with the baby's family and the NHS trust.

It said: "Officers from our Protecting Vulnerable People Department are at the very early stages of investigating a complaint concerning the treatment of a baby boy by a member of staff at Stafford Hospital earlier this month."

Mr Ovington, director of nursing and midwifery, said: "We cannot emphasise strongly enough that this incident is exceptional and apologise again to the family.

"We want other hospitals to learn from this so that we can be sure that it does not happen to any other baby."

A report following a £13m public inquiry into "appalling standards" of care at the hospital is to be published next month.

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Protest against hospital closure

26 January 2013 Last updated at 11:04 ET

At least 15,000 people have marched in protest against proposals to close services at a hospital in south London.

Organisers campaigning to save Lewisham Hospital say the plans are "crazy and ill thought out".

Under proposals, its A&E will close and the maternity unit be downgraded after neighbouring South London Healthcare NHS Trust ran up debts of £150m.

The government said "doing nothing is not an option" and is to make a decision on 1 February.

Campaigners are angry Lewisham Hospital, which is not part of the South London Healthcare NHS Trust, is being targeted in a re-organisation of services across the area following the trusts's financial problems.

Under the plans, the trust's Queen Elizabeth Hospital site in Woolwich would come together with Lewisham Healthcare NHS Trust to create a new organisation.

Lewisham's A&E unit would then be downgraded to an urgent care centre, meaning emergency cases would be seen at nearby hospitals. The maternity unit at Lewisham could also be slimmed down, meaning complex cases would be dealt with elsewhere.

South London Healthcare NHS Trust, which runs three hospitals, was placed in administration last year when it started losing about £1.3m a week.

The problems it faces are not unique. Last year it was reported 20 trusts had declared themselves financially unsustainable in their current form.

Matthew Kershaw, a special administrator, said in a report to the government that the trust should be broken up, with other organisations taking over the management and delivery of services.

If implemented fully, Mr Kershaw said his recommendations would result in a radical overhaul of services in south London, and help deliver "safe, high-quality, affordable and sustainable services."

Mr Kershaw also recommended the Department of Health (DoH) write off any debts to ensure new organisations were not "saddled with the issues of the past".

"I have said consistently that the status quo is not an option, and I believe these final, refined recommendations are the right ones, although I appreciate that some people will find them difficult to accept," his report said.

Continue reading the main story

If Jeremy Hunt can close a good local hospital here, he can do it anywhere in the country - nowhere is safe"

End Quote Dr Louise Irvine Save Lewisham Hospital

'Huge clinical risks'

In November thousands of people marched in protest at the plans and BBC London reporter Matt Morris said at least 15,000 attended Saturday's event. The Save Lewisham Hospital group said 25,000 took part.

Dr Louise Irvine, a local GP and chairman of the Save Lewisham Hospital campaign, said: "This decision is crazy and ill thought out.

"It is a big mistake and carries huge clinical risks of things going wrong for patients but also political risk.

"If Jeremy Hunt can close a good local hospital here, he can do it anywhere in the country - nowhere is safe."

A DoH spokesman said: "Where trusts face long-standing problems we have been clear that doing nothing is not an option."

The march went past Lewisham Hospital and ended with a festival in nearby Mountsfield Park.

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Swine flu infected 'fifth of people'

25 January 2013 Last updated at 08:44 ET By James Gallagher Health and Science reporter, BBC News

At least 20% of people, including half of schoolchildren, were infected with swine flu during the first year of the pandemic in 2009, according to data from 19 countries.

It is thought the virus killed 200,000 people around the world.

A World Health Organization-led study looked for evidence of the body's immune system fighting the virus.

It showed large numbers of people had been infected, although not all would have developed full-blown flu.

The H1N1 virus first appeared in Mexico in 2009 and rapidly spread around the world.

Anti-bodies

Continue reading the main story

• Virus particles - known as virions - are tiny particles responsible for viral infection
• Typically 100 times smaller than human cells
• Viruses present wherever there are cells to infect and are most common biological entities on earth
• Influenza kills a very small proportion of those it infects but viruses such as HIV, polio and smallpox (now eradicated) can be more deadly

An international group of researchers looked at more than 90,000 blood samples before and during the pandemic in countries including India, Australia and the UK.

They looked for antibodies which are produced when the body is infected with H1N1.

By comparing the figures before and during the pandemic, the researchers can determine how many people were infected as the virus spread around the world.

Approximately 24% of people had been infected overall, but half of school-age children showed signs of infection.

One of the researchers, Dr Maria Van Kerkhove from Imperial College London, said fewer than two in every 10,000 people infected died during the pandemic.

"However, those that did die are much younger than in seasonal flu so the years of life lost will be much more," she told the BBC.

"The figures drive home how incredibly infectious the virus is," she said.

Many older people, who typically die during outbreaks of flu, were protected as they had been exposed to the virus decades before.

Prof John Oxford, a virology expert at Queen Mary, University of London, said the figures "make sense".

"It was the busiest virus on the block and it displaced other influenza viruses - it was the only virus in town."

He said a similar pattern would be expected in other countries which were not analysed in the study.

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Dummy taped to baby in hospital

25 January 2013 Last updated at 09:55 ET

A member of staff has been suspended after a dummy was found taped to a baby's face at Stafford Hospital.

Staffordshire Police said it happened earlier this month and the baby was four months old at the time.

Colin Ovington from Mid Staffordshire NHS Foundation Trust said: "Fortunately, the baby was unharmed. We have a zero tolerance approach to poor patient care."

The trust is at the centre of a public inquiry into serious failings of care.

Apology to family

In a statement, Staffordshire Police said officers were investigating a complaint about a member of staff at the hospital and liaising with the baby's family and the NHS trust.

It said: "Officers from our Protecting Vulnerable People Department are at the very early stages of investigating a complaint concerning the treatment of a baby boy by a member of staff at Stafford Hospital earlier this month."

Mr Ovington, director of nursing and midwifery, said: "We cannot emphasise strongly enough that this incident is exceptional and apologise again to the family.

"We want other hospitals to learn from this so that we can be sure that it does not happen to any other baby."

A report following a £13m public inquiry into "appalling standards" of care at the hospital is to be published next month.

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Chemical defects ‘last generations’

25 January 2013 Last updated at 20:24 ET

Scientists believe they have shown exposure to certain chemicals in the womb can cause changes that are passed through generations.

There is no firm evidence of this in humans, but Washington State University research showed a clear effect in rats.

They isolated defects linked to kidney and ovary disease and even obesity.

The work implicates a class of chemicals found in certain plastics, as well as one found in jet fuel.

The idea of "epigenetics" - that parents do not just pass their genes to their children, but subtle differences in the way those genes operate - is one of the fastest growing areas of scientific study.

Continue reading the main story

Your great-grandmother's exposures during pregnancy may cause disease in you"

End Quote Dr Michael Skinner Washington State University

The work of Dr Michael Skinner centres around the effects that certain chemicals can have on these processes, if the female is exposed at key points during pregnancy.

So far they have documented measureable effects from a host of environmental pollutants including pesticides, fungicides, dioxins and hydrocarbons.

However, they stress that the results are not directly transferable to humans yet, as the levels of chemicals used on the rats were many times more concentrated than anything a person would experience in normal life.

There is no data on even how an animal would respond at different doses, and no clues as to how the chemicals are causing these changes.

Environmental impacts

The studies, published in the journals PLoS One and Reproductive Toxicology, looked at the impact of phthalates, chemicals found in some forms of plastics, and a substance called JP8, found in jet fuel.

Rats exposed to phthalates had offspring with higher rates of kidney and prostate disease, and their great-grandchildren had more disease of the testicles, ovaries and obesity.

Female rats exposed to the hydrocarbon JP8 at the point in pregnancy when their male foetuses were developing gonads had babies with more prostate and kidney abnormalities, and their great-grandchildren had reproductive anomalies, polycystic ovary disease and obesity.

Dr Skinner said: "Your great-grandmother's exposures during pregnancy may cause disease in you, while you had no exposure.

"This is a non-genetic form of inheritance not involving DNA sequence, but environmental impacts on DNA chemical modifications.

"This is the first study to show the epigenetic transgenerational inheritance of disease such as obesity."

Andreas Kortenkamp, professor of human toxicology at Brunel University, said the results were "potentially very interesting", but much more work would need to be carried out before any impact on humans could be considered.

He said: "This is an exploratory study, but the authors themselves are clear that the data do not allow the possible risk to people to be assessed."

"There is a currently a lack of information about the dose-response relationship, and at this stage we are very unsure about the mechanisms that are involved."

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NHS drug decisions 'are flawed'

24 January 2013 Last updated at 18:59 ET By Jane Dreaper Health correspondent, BBC News

The formula used by the NHS to recommend which drugs should be funded is "flawed" and should be scrapped, researchers say.

The European Commission-funded study tested the assumptions of the system used by NICE (the National Institute for Health and Clinical Excellence).

Researchers concluded the watchdog's system failed

to reflect variations in views on illness and disability.

NICE called the study "limited" and said the measure it used was the best.

NICE uses a method called quality-adjusted life years (QALY) for assessing the value of new drug treatments in England and Wales. A similar system is used by the Scottish Medicines Consortium (SMC).

The formula looks at the cost of using a drug for a year and weighs it against how much someone's life can be extended and improved. Generally if a treatment costs more than £20,000-30,000 per QALY, it would not be recommended as cost-effective by NICE.

Continue reading the main story

"This isn't a scientific way to classify and prioritise the drugs - mathematically, it's totally flawed."

End Quote Ariel Beresniak Research leader

The European Consortium in Healthcare Outcomes (ECHOUTCOME) researchers will present their findings at a conference in Brussels on Friday.

Their work has already prompted a backlash by UK-based experts, who defended the current system for making decisions.

The researchers analysed a detailed questionnaire with more than 1,300 respondents - including 301 in the UK.

Their findings criticised the QALY system for grading different states of health. The researchers said people varied in their views about the impact of different levels of illness or disability, and in their approach to risk.

They also found that people's willingness to sacrifice remaining years of life in order to have better health varied enormously over different periods of time.

The researchers said 71% of the respondents would prefer to live 15 years in a wheelchair than die after 10 or five years in a wheelchair - but the remaining 29% said they would prefer to die earlier rather than spend 15 years in a wheelchair.

The project leader, Ariel Beresniak, a French doctor and economist who used to work in the drug industry, said: "Important decisions are being made on the basis of QALY, but it produces the wrong results.

"This isn't a scientific way to classify and prioritise the drugs - mathematically, it's flawed.

"We think it is time to open this debate, particularly as some of the newer European countries are trying to organise their health assessment systems and might be considering QALY.

"NICE has made negative recommendations about many major innovative drugs, based only on arbitrary incremental cost per QALY.

"Agencies such as NICE should abandon QALY in favour of other approaches."

Cost-benefit approach

A similar method is used by Canada and Australia for assessing new treatments.

The researchers suggest instead using a cost-benefit approach - such as how many cases of remission a drug can provide, or how many relapses it might prevent.

A NICE representative said: "We need to use a measure that can be applied fairly across all diseases and conditions. The QALY is the best measure anyone has yet devised to enable us to do this.

"It's developing and improving all the time and the criticisms in this rather limited study haven't shaken our confidence in its value to NICE in helping make decisions on the best way to use new and sometimes very expensive drugs and other health technologies."

John Cairns, professor of health economics at the London School of Hygiene and Tropical Medicine and a member of the NICE's appraisal committee for 10 years, said: "QALYs are certainly not perfect and we should be looking for better ways of informing decision making.

"But getting rid of an imperfect system without replacing it with a better one is not the way forward."

Dr Andrew Walker, an economist at the University of Glasgow, with 10 years' experience of reviewing new medicines at the SMC, said: "I am amazed it has taken these authors three years and one million euros to establish what we already know, that QALYs are not perfect.

"Anyone who makes decisions using QALYs and who cannot think of at least three issues with them is not thinking hard enough.

"As an alternative they propose cost per remission in arthritis, but I ask them to tell me how they define remission, how long remission lasts and how much we are willing to pay for one remission.

"If we want to spend more on cancer medicines, it has to come from somewhere. The researchers speak as though there were no budget limits."

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Kidney failure risk for diabetics

24 January 2013 Last updated at 20:50 ET

Keeping your kidneys healthy could be one of the best ways to extend your life if you have Type 2 diabetes, researchers have suggested.

The University of Washington study found that having kidney disease meant a much higher risk of early death.

UK experts say that the NHS is still not putting enough effort into detecting and controlling kidney problems caused by diabetes.

Figures from 2012 suggest only seven in 10 patients get vital annual checks.

Approximately 5% of people in the UK have been diagnosed with diabetes, and careful management of their condition through a combination of medication and lifestyle changes can mean it has relatively little impact on their lives.

However, if the disease has been present for some time prior to diagnosis, or is poorly managed afterwards, the risk of life-changing complications rises.

These include eye and lower limb problems, and kidney problems.

Continue reading the main story

There really is no excuse for this - there is clear guidance saying that kidney function should be tested."

End Quote Cathy Moulton Diabetes UK

The research, in the Journal of the American Society of Nephrology, looked at mortality rates over a 10-year period in more than 15,000 adults, with and without diabetes.

Kidney disease was present in 9.4% of the people without diabetes, and 42.3% of those with diabetes.

They found that 7.7% of those without diabetes or kidney disease died over the course of the decade-long study.

This rose to 11.5% for people with diabetes but no kidney disease, but soared to 31.1% for people with diabetes and kidney disease.

'No excuse'

Lead researcher Dr Maryam Afkarian said: "People with type-two diabetes have many other risk factors for cardiovascular disease and mortality, so we expected that kidney disease would predict a part, but not a majority, of higher mortality."

Singling this group of patients out for intensive treatment, or working harder to prevent kidney disease from taking hold, could be a powerful way of reducing deaths among people with diabetes, she added.

Cathy Moulton, a clinical adviser at Diabetes UK, said that if detected early, diabetic kidney disease could be controlled using blood pressure medication.

However, the charity's 2012 report found that as many as three in 10 patients were missing out the simple blood or urine tests that would reveal their kidney problems.

She said: "There really is no excuse for this - there is clear guidance saying that kidney function should be tested.

"Very often the doctor will be taking blood for other purposes, such as checking cholesterol levels, so it is the easiest thing in the world to do."

Kidney failure would cost the NHS thousands more in expensive dialysis treatments, she added.

Diabetes UK has compiled a list of 15 "healthcare essentials" that it says every patient with the disease should read and ensure they are receiving from the NHS.

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Swine flu infected 'fifth of people'

25 January 2013 Last updated at 08:44 ET By James Gallagher Health and Science reporter, BBC News

At least one in five people, including half of schoolchildren, were infected with swine flu during the first year of the pandemic in 2009, according to data from 19 countries.

It is thought the virus killed 200,000 people around the world.

A World Health Organization-led study looked for evidence of the body's immune system fighting the virus.

It showed large numbers of people had been infected, although not all would have developed full-blown flu.

The H1N1 virus first appeared in Mexico in 2009 and rapidly spread around the world.

Anti-bodies

An international group of researchers looked at more than 90,000 blood samples before and during the pandemic in countries including India, Australia and the UK.

They looked for antibodies which are produced when the body is infected with H1N1.

By comparing the figures before and during the pandemic, the researchers can determine how many people were infected as the virus spread around the world.

Approximately 24% of people had been infected overall, but half of school-age children showed signs of infection.

One of the researchers, Dr Maria Van Kerkhove from Imperial College London, said fewer than two in every 10,000 people infected died during the pandemic.

"However, those that did die are much younger than in seasonal flu so the years of life lost will be much more," she told the BBC.

"The figures drive home how incredibly infectious the virus is," she said.

Many older people, who typically die during outbreaks of flu, were protected as they had been exposed to the virus decades before.

Prof John Oxford, a virology expert at Queen Mary, University of London, said the figures "make sense".

"It was the busiest virus on the block and it displaced other influenza viruses - it was the only virus in town."

He said a similar pattern would be expected in other countries which were not analysed in the study.

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Female smoking risk 'has soared'

23 January 2013 Last updated at 22:22 ET By James Gallagher Health and science reporter, BBC News

Women smoking nowadays are far more likely to die as a result of their habit than they were in the 1960s, according to a new study.

Changing habits such as starting earlier and smoking more cigarettes have been blamed on dramatically increased risks of lung cancer.

The trends, reported in the New England Journal of Medicine, show death rates in women have caught up with men.

The study looked at data from more than two million women in the US.

The first generation of women smokers started during the 1950s and 60s. In those early years, women who smoked were nearly three times more likely to die from lung cancer as people who had never smoked.

Looking at medical records from women between 2000-2010 showed they were 25 times more likely to die from lung cancer than their non-smoking friends.

It follows a similar pattern in men, who reached a similar level in the 1980s.

Lead researcher Dr Michael Thun said: "The steep increase in risk among female smokers has continued for decades after the serious health risks from smoking were well established, and despite the fact that women predominantly smoked cigarette brands marketed as lower in 'tar' and nicotine.

"So not only did the use of cigarette brands marketed as 'Light' and 'Mild' fail to prevent a large increase in risk in women, it also may have exacerbated the increase in deaths from chronic obstructive lung disease in male smokers, since the diluted smoke from these cigarettes is inhaled more deeply into the lungs of smokers to maintain the accustomed absorption of nicotine."

Research published last year suggested that lifelong female smokers died a decade earlier than those who never started.

However, those who gave up by the age of 30 almost completely avoided the risks of dying early from tobacco-related diseases with those stopping by 40 died a year younger.

Speaking after that study, Prof Sir Richard Peto, at Oxford University, said "If women smoke like men, they die like men."

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Antibiotic 'apocalypse' warning

24 January 2013 Last updated at 08:18 ET By James Gallagher Health and science reporter, BBC News

The rise in drug resistant infections is comparable to the threat of global warming, according to the chief medical officer for England.

Prof Dame Sally Davies said bacteria were becoming resistant to current drugs and there were few antibiotics to replace them.

She told a committee of MPs that going for a routine operation could become deadly due to the threat of infection.

Experts said it was a global problem and needed much more attention.

Antibiotics have been one of the greatest success stories in medicine. However, bacteria are a rapidly adapting foe which find new ways to evade drugs.

MRSA rapidly became one of the most feared words in hospitals wards and there are growing reports of resistance in strains of E. coli, tuberculosis and gonorrhoea.

Prof Davies said: "It is clear that we might not ever see global warming, the apocalyptic scenario is that when I need a new hip in 20 years I'll die from a routine infection because we've run out of antibiotics."

She said there was only one useful antibiotic left to treat gonorrhoea.

"It is very serious, and it's very serious because we are not using our antibiotics effectively in countries.

Continue reading the main story

We have to be aware that we aren't going to have new wonder drugs coming along because there just aren't any."

End Quote Prof Hugh Pennington University of Aberdeen

"There is a broken market model for making new antibiotics, so it's an empty pipeline, so as they become resistant, these bugs, which they would naturally but we're breeding them in because of the way antibiotics are used, there will not be new antibiotics to come."

Possible solutions will be included in her annual report to be published in March.

Empty arsenal

The World Health Organization has warned the world is heading for a "post-antibiotic era" unless action is taken.

It paints a future in which "many common infections will no longer have a cure and, once again, kill unabated".

Prof Hugh Pennington, a microbiologist from the University of Aberdeen, said drug resistance was "a very, very serious problem".

"We do need to pay much more attention to it. We need resources for surveillance, resources to cope with the problem and to get public information across.

But he said it was not a problem entirely of the UK's making.

"People are going abroad for operations, going abroad for, let's say, sex tourism and bringing home gonorrhoea which is a big problem in terms of antibiotic resistance - and then there's tuberculosis in many parts of the world.

Prof Pennington said the drugs companies had run out of options too as all the easy drugs had been made.

"We have to be aware that we aren't going to have new wonder drugs coming along because there just aren't any."

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Cancer fear raised over horsemeat

24 January 2013 Last updated at 08:29 ET

A drug that can potentially cause cancer in humans may have entered the food chain via horses slaughtered in UK abattoirs, Labour claims.

Shadow environment secretary Mary Creagh said "several" UK-slaughtered horses had tested positive for the carcinogen phenylbutazone.

Agriculture minister David Heath said all meat was checked to ensure it was fit for human consumption.

The news comes after horse and pig DNA was recently found in some burgers.

Some of these were sold in Tesco, Iceland, Lidl and Aldi and Dunnes. Tesco took out adverts in British newspapers apologising for the matter.

There is no suggestion that these burgers contained phenylbutazone.

'Right to know'

Phenylbutazone is an anti-inflammatory drug which is given to horses for the treatment of lameness, pain and fever.

It is banned from entering the human food chain within the EU and horses that have been administered the drug should have the information recorded on their passport.

Continue reading the main story

For horsemeat containing bute to get into the food chain, several safety processes have to fail.

First the horse's passport tracking its drug history has to be misleading - an illegal act in itself.

Then the horse has to get past the spot checks - relatively easy because not many are carried out.

Finally, the meat has to end up being processed and sold for human use - almost always on the Continent, very little being eaten here.

The numbers involved in this scenario cannot be large since only around 8,000 horses are slaughtered each year.

But checks since 2007 do show bute turning up in small but consistent quantities. And the stuff is best avoided.

A specialist Defra committee says it has "serious adverse effects". Real harm is very unlikely, but the episode once again raises awkward questions about the international meat trade.

But Labour claim the issuing of horse passports in the UK is fragmented, as there are 75 approved issuing organisations in the UK, with no national database to track the information.

Ms Creagh told Mr Heath in the Commons: "I am in receipt of evidence showing that several horses slaughtered in UK abattoirs last year tested positive for phenylbutazone, or bute, a drug which causes cancer in humans and is banned from the human food chain.

"It is possible that those animals entered the human food chain."

When she asked if Mr Heath was aware of the cases, the minister replied: "The Food Standards Agency carry out checks in slaughterhouses to ensure that equine animals presented for slaughter are fit for human consumption in the same way as they do for cattle, sheep and other animals.

"In addition, the FSA carry out subsequent testing for phenylbutazone and other veterinary medicines in meat from horses slaughtered in this country.

"Where positive results for phenylbutazone are found, the FSA investigates and takes follow-up action to trace the meat."

'Very serious'

Ms Creagh then asked if that meant Mr Heath was aware of the issue.

"I'm astonished that you have not raised this and I think the public have a right to know," she said.

She also said the news was a "very serious development" and demanded action to ensure that "illegal and carcinogenic horsemeat stops entering the human food chain".

And she called on the government to reverse a "reckless" decision to end the National Equine Database.

But Mr Heath replied: "There is no difficulty in tracing the use of a horse passport. To suggest the National Equine Database was required to do that is simply erroneous."

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Prostate cancer risk 'has trebled'

22 January 2013 Last updated at 23:06 ET

Prostate cancer risk has risen to such a degree that one in every seven boys will develop it, projections suggest.

Experts say the trebling of lifetime risk - up from one in 20 in 1990 - is partly because doctors are spotting more cases and partly because men are living longer meaning more develop it.

Cancer Research UK, which compiled the data and made estimates for boys born in 2015, says although the cancer rates are rising, deaths are going down.

They have dropped by 20% in 20 years.

In 1990, prostate cancer killed about 29 men in every 100,000.

Today it claims about 10,000 lives in the UK each year - just under 24 men in every 100,000.

The challenge

Better medicines and tests now mean prostate cancers can be diagnosed and treated earlier, which improves the survival odds.

Continue reading the main story

These stats reinforce our concerns that the number of men being diagnosed with the disease is rising at an alarming rate"

End Quote Dr Sarah Cant Prostate Cancer UK

But experts say there is much more to be done, starting with finding a more accurate way to detect the disease.

The current test, called PSA, is less than ideal and can cause men undue anxiety by showing up tumours in the prostate gland that might never go on to cause any health problem. And two out of three men with a raised PSA level do not have prostate cancer.

Prof Malcolm Mason, of Cancer Research UK, said: "We're detecting more cases of prostate cancer than ever before. And we're carrying out an intensive amount of research to find better methods than PSA to distinguish between the minority of cases that are life threatening and do need treatment - the vipers - from the majority of cases that don't - the grass snakes."

He said that targeting the tests at men who have a higher risk of developing prostate cancer might be a better approach than screening all men.

Scientists are working on new ways to detect prostate cancer, including blood tests, medical scans and urine tests.

Dr Sarah Cant, of Prostate Cancer UK, said: "Although it is heartening that prostate cancer death rates appear to have reduced over recent years, these stats reinforce our concerns that the number of men being diagnosed with the disease is rising at an alarming rate.

"With so many more men expected to be living with the disease in the future, it is more urgent than ever that prostate cancer is higher up the nation's health agenda so that men can get the world class treatment and care they deserve.

"Due to a significant legacy of underinvestment, men with prostate cancer are still faced with diagnostic tests and treatments which are decades behind where we need to be."

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Alcohol 'disrupts sleep cycles'

22 January 2013 Last updated at 21:35 ET By Michelle Roberts Health editor, BBC News online

A tipple before bedtime may get you off to sleep faster but it can disrupt your night's slumber, say researchers who have reviewed the evidence.

The London Sleep Centre team says studies show alcohol upsets our normal sleep cycles.

While it cuts the time it takes to first nod off and sends us into a deep sleep, it also robs us of one of our most satisfying types of sleep, where dreams occur.

Used too often, it can cause insomnia.

Many advocate a nightcap - nursing homes and hospital wards have even been known to serve alcohol - but Dr Irshaad Ebrahim and his team advise against it.

Fragmented sleep

Dr Ebrahim, medical director at the London Sleep Centre and co-author of the latest review, published in the journal Alcoholism: Clinical & Experimental Research, said: "We should be very cautious about drinking on a regular basis.

Continue reading the main story

Sleep may be deeper to start with, but then becomes disrupted"

End Quote Chris Idzikowski Director of the Edinburgh Sleep Centre

"One or two glasses might be nice in the short term, but if you continue to use a tipple before bedtime it can cause significant problems.

"If you do have a drink, it's best to leave an hour and a half to two hours before going to bed so the alcohol is already wearing off."

He said people could become dependent on alcohol for sleep.

And it could make sleep less restful and turn people into snorers.

"With increasing doses, alcohol suppresses our breathing. It can turn non-snorers into snorers and snorers into people with sleep apnoea - where the breathing's interrupted."

From the hundred or more studies that Dr Ebrahim's team looked at, they analysed 20 in detail and found alcohol appeared to change sleep in three ways.

Firstly, it accelerates sleep onset, meaning we drop off faster.

Next, it sends us into a very deep sleep.

These two changes - which are identical to those seen in people who take antidepressant medication - may be appealing and may explain why some people with insomnia use alcohol.

But the third change - fragmented sleep patterns the second half of the night - is less pleasant.

Alcohol reduces how much time we spend in rapid eye movement (REM) sleep - the stage of sleep where dreams generally occur.

As a consequence, the sleep may feel less restful, said Dr Ebrahim.

Chris Idzikowski, director of the Edinburgh Sleep Centre, said: "Alcohol on the whole is not useful for improving a whole night's sleep. Sleep may be deeper to start with, but then becomes disrupted. Additionally, that deeper sleep will probably promote snoring and poorer breathing. So, one shouldn't expect better sleep with alcohol."

The Sleep Council said: "Don't over-indulge. Too much food or alcohol, especially late at night, just before bedtime, can play havoc with sleep patterns.

"Alcohol may help you fall asleep initially, but will interrupt your sleep later on in the night. Plus you may wake dehydrated and needing the loo."

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Poor kids 'more likely to be obese'

23 January 2013 Last updated at 06:40 ET

Children from poor backgrounds are more likely to be overweight, a minister has claimed, blaming "an abundance of bad food" for the situation.

Anna Soubry said 50 years ago youngsters from deprived households were taunted for being "skinny runts", but this state of affairs had reversed.

"When I walk around, you can almost now tell somebody's background by their weight," she told the Daily Telegraph.

Campaigners said government policies were exacerbating child poverty.

Ministers have threatened food manufacturers with legislation unless they cut the amount of fat, sugar and salt in their products and urged firms to sign up to the voluntary "responsibility deal" to reduce calories.

The Conservative MP, a junior minister in the Department of Health who is in charge of public health, said a third of children leaving primary school were overweight or obese and the poorest were among those most at risk.

During her school days, Ms Soubry said poorer children were known as "skinny runts", because there were not getting the right food.

"You could tell the demography of children by how thin they were. You could see by looking at their eyes," she said.

'Breakfast buns'

But she said there was a now a link between childhood poverty and obesity: "Obviously, not everybody who is overweight comes from deprived backgrounds but that's where the propensity lies."

Continue reading the main story

If the government fails to act we will continue storing up huge problems for the country and the NHS in the long term"

End Quote Diane Abbott Shadow health minister

She added: "It is a heartbreaking fact that people who are some of the most deprived in our society are living on an inadequate diet. But this time it's an abundance of bad food."

Too many parents, she added, believed there was no alternative to junk food because it was cheap. She expressed concern at the number of children whose breakfast consisted of packet of crisps and a fizzy drink or fried meat in a bun.

She also said she lamented the growth of "TV meals" at the expense of families sitting around their dinner tables.

According to Department of Health figures, the poorest children are almost twice as likely to be obese than the richest.

'Not working'

The Child Poverty Action Group said there was clear connection between deprivation and obesity but ministers needed to revisit their own policies rather than blame parents.

"The real reason why our obesity problem is going to get bigger in the years ahead is because our child poverty problem is going to get much bigger as a result of the government's own policies," said the organisation's head of policy Imran Hussain.

"Poor children are much more likely to miss out on healthy food on cost grounds than children living in households with average incomes. And research shows that when the incomes of poor families rise, parents spend the gains on improving the diets of their children through buying fresh fruit."

Labour, which has launched a consultation on the case for statutory limits on the amount of sugar and salt in children's food, said the government was "doing nothing" to tackle the obesity crisis among children.

"It is clear that their voluntary approach is not working," said shadow health minister Diane Abbott. "If the government fails to act we will continue storing up huge problems for the country and the NHS in the long term."

Education Secretary Michael Gove has asked two restaurant owners to examine how nutrition in schools can be improved, but TV chef Jamie Oliver has criticised the government's approach, saying healthy food standards are being eroded.

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Cleaning jobs 'link' to adult asthma

21 January 2013 Last updated at 21:48 ET

People who work with cleaning products risk developing asthma, believe UK experts who have explored the link.

Their study of more than 7,000 people suggests exposure to bleach and other chemicals is a factor in one in six cases of adult-onset asthma among British people in their mid-50s .

The study, in Thorax, identified 18 high-risk jobs - four of which involved cleaning.

Top of the list were farmers, followed by aircraft mechanics and typesetters.

General cleaners, office cleaners, domestic helpers and care workers all featured on the list.

So too did hairdressers and laundry workers.

Experts say a person's working environment is to blame rather than their occupation per se.

Inhaled particles

Hundreds of occupational agents have been linked to asthma. This includes flour and grain as well as detergents.

Fine particles can be inhaled into the airways and cause irritation.

Lead researcher Dr Rebecca Ghosh said cleaning products were starting to be recognised as a potential cause of asthma.

She said there were specific Control of Substances Hazardous to Health (COSHH) guidelines relating to cleaning products.

Employers are expected to control exposures to hazardous substances and report any cases of occupational asthma.

"Occupational asthma is widely under-recognised by employers, employees and healthcare professionals. Raising awareness that this is an almost entirely preventable disease would be a major step in reducing its incidence," Dr Ghosh said.

Malayka Rahman, of Asthma UK, said: "We advise anyone who works in the industries highlighted in this study and who have experienced breathing problems to discuss this with their GP, and we urge healthcare professionals to make sure they consider possible occupational causes in adult-onset asthma and tailor their advice to people with asthma accordingly."

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Long-term aspirin 'blindness link'

21 January 2013 Last updated at 23:03 ET By James Gallagher Health and science reporter, BBC News

People who regularly take aspirin for many years, such as those with heart problems, are more likely to develop a form of blindness, researchers say.

A study on 2,389 people, in the journal JAMA Internal Medicine, showed aspirin takers had twice the risk of "wet" age-related macular degeneration.

The disease damages the 'sweet spot' in the retina, obscuring details in the centre of a patient's field of vision.

The researchers said there was not yet enough evidence to change aspirin use.

Taking low doses of aspirin every day does reduce the risk of a stroke or heart attack in patients with cardiovascular disease. There are even suggestions it could prevent cancer.

One in 10 people in the study, conducted at the University of Sydney, were taking aspirin at least once a week. On average the participants were in their mid-60s.

Eye tests were performed after five, 10 and 15 years.

Continue reading the main story

The evidence is now accumulating about the association of aspirin and wet AMD, however, it is not overwhelming at this point"

End Quote Macular Society

By the end of the study, the researchers showed that 9.3% of patients taking aspirin developed wet age-related macular degeneration (AMD) compared with 3.7% of patients who did not take aspirin.

Their report said: "The increased risk of [wet] AMD was detected only after 10 or 15 years, suggesting that cumulative dosing is important.

"Given the widespread use of aspirin, any increased risk of disabling conditions will be significant and affect many people."

Wet AMD is caused by blood vessels growing in the wrong place. They cause swelling and bleeding which damages the retina.

The process can happen very quickly with vision being damaged in days. Age, smoking and a family history are the main risk factors.

High-risk

There are already known risks of aspirin such as causing internal bleeding. The research team suggest the risk of damaging eyesight "may also need to be considered".

They acknowledge that for most patients there is "insufficient evidence" to change how aspirin is prescribed.

However, they suggested using the drug may need to be reappraised in high-risk patients such as those with wet AMD in one eye already.

Prof Jie Jin Wang, an expert in vision research at Sydney University in Australia, said this was something doctors might want to discuss with high-risk patients.

The Macular Society said: "The evidence is now accumulating about the association of aspirin and wet AMD, however, it is not overwhelming at this point.

"For patients at risk of cardio-vascular disease, the health risks of stopping or not prescribing aspirin are much higher than those of developing wet AMD.

"Patients who are taking aspirin because their doctor has prescribed it should not stop taking it without consulting their doctor first."

Matthew Athey, from the RNIB charity, said any concerns should be discussed with a family doctor.

"However, this is interesting research as age-related macular degeneration (AMD) is the leading cause of sight loss in the UK, and this study could contribute to our understanding about why some people may develop 'wet' type macular degeneration.

"Further research is needed to clarify and investigate some of the issues raised in the study, however this association may be valuable for doctors in the future when considering aspirin for their patients."

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Meningitis jab gets Europe licence

22 January 2013 Last updated at 04:58 ET By Michelle Roberts Health editor, BBC News online

A vaccine to protect children against one of the most common and deadly forms of meningitis has been licensed for use in Europe.

The Bexsero vaccine licensed by the European Commission is the first to cover meningococcal B meningitis - until now vaccines had protected against only some of the bacterial types involved.

About 1,870 people contract meningitis B each year and one in 10 die.

The UK has yet to recommend the jab.

The Joint Committee on Vaccination and Immunisation (JCVI) which provides vaccination advice to the government plan to meet in June when they will discuss the vaccine and whether to add it to the list of vaccines routinely offered to young children.

Meningitis UK said: "We urge the JCVI and UK government to introduce the new MenB vaccine to the childhood immunisation schedule as soon as possible. Every day of unnecessary delay in introducing this vaccine will cost lives. We must not allow children to die from this disease if it can be prevented."

Now it is licensed in the UK and other EC countries, it could potentially be bought and used by healthcare providers.

Continue reading the main story

• Inflammation of membranes covering brain and spinal cord
• It can be caused by viruses or bacteria
• Meningitis B is the most common cause of bacterial meningitis in the UK
• It can also cause septicaemia
• There are a number of vaccines that can prevent many cases of viral and bacterial meningitis, including MMR, Meningitis C, PCV and DTaP/IPV/Hib vaccination

About a quarter of all survivors of meningitis B are left with life altering after-effects, such as brain damage or limb loss.

Children under the age of five are the most at risk from the bacterial infection, which leads to inflammation of the brain and spinal cord.

Experts say the jab is likely to be effective against 73% of the different variations of meningitis B.

A vaccine against the less common meningitis C has been administered since 1999 and is now widely given to babies in the first year of their life.

It has led to a large fall in the number of cases in people under the age of 20.

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'Quadruple helix' DNA in humans

20 January 2013 Last updated at 14:19 ET By Jonathan Amos Science correspondent, BBC News

Cambridge University scientists say they have seen four-stranded DNA at work in human cells for the first time.

The famous "molecule of life", which carries our genetic code, is more familiar to us as a double helix.

But researchers tell the journal Nature Chemistry that the "quadruple helix" is also present in our cells, and in ways that might possibly relate to cancer.

They suggest that control of the structures could provide novel ways to fight the disease.

"The existence of these structures may be loaded when the cell has a certain genotype or a certain dysfunctional state," said Prof Shankar Balasubramanian from Cambridge's department of chemistry.

"We need to prove that; but if that is the case, targeting them with synthetic molecules could be an interesting way of selectively targeting those cells that have this dysfunction," he told BBC News.

Tag and track

It will be exactly 60 years ago in February that James Watson and Francis Crick famously burst into the pub next to their Cambridge laboratory to announce the discovery of the "secret of life".

What they had actually done was describe the way in which two long chemical chains wound up around each other to encode the information cells need to build and maintain our bodies.

Today, the pair's modern counterparts in the university city continue to work on DNA's complexities.

Balasubramanian's group has been pursuing a four-stranded version of the molecule that scientists have produced in the test tube now for a number of years.

It is called the G-quadruplex. The "G" refers to guanine, one of the four chemical groups, or "bases", that hold DNA together and which encode our genetic information (the others being adenine, cytosine, and thymine).

The G-quadruplex seems to form in DNA where guanine exists in substantial quantities.

And although ciliates, relatively simple microscopic organisms, have displayed evidence for the incidence of such DNA, the new research is said to be the first to firmly pinpoint the quadruple helix in human cells.

'Funny target'

The team, led by Giulia Biffi, a researcher in Balasubramaninan's lab, produced antibody proteins that were designed specifically to track down and bind to regions of human DNA that were rich in the quadruplex structure. The antibodies were tagged with a fluorescence marker so that the time and place of the structures' emergence in the cell cycle could be noted and imaged.

This revealed the four-stranded DNA arose most frequently during the so-called "s-phase" when a cell copies its DNA just prior to dividing.

Prof Balasubramaninan said that was of key interest in the study of cancers, which were usually driven by genes, or oncogenes, that had mutated to increase DNA replication.

If the G-quadruplex could be implicated in the development of some cancers, it might be possible, he said, to make synthetic molecules that contained the structure and blocked the runaway cell proliferation at the root of tumours.

"We've come a long way in 10 years, from simple ideas to really seeing some substance in the existence and tractability of targeting these funny structures," he told the BBC.

"I'm hoping now that the pharmaceutical companies will bring this on to their radar and we can perhaps take a more serious look at whether quadruplexes are indeed therapeutically viable targets."

Jonathan.Amos-INTERNET@bbc.co.uk and follow me on Twitter: @BBCAmos

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