Mid Staffs 'faces being dissolved'

28 February 2013 Last updated at 07:54 ET By James Gallagher and Nick Triggle BBC News

The scandal-hit Mid Staffordshire NHS Trust faces being dissolved after regulators announced the administration process was to begin.

The trust has been at the centre of one of the worst scandals in NHS history after neglect and abuse led to hundreds of needless deaths from 2005 to 2008.

Mid Staffordshire has also faced serious financial problems - it got a £20m bailout by government last year.

The regulator Monitor has now decided it should be put into administration.

This means an independent administrator will take over the running of the trust before coming up with proposals for the long-term.

A range of options are available, including closing down the trust altogether. If this happens essential services would be taken on by another organisation.

The administrator could also recommend the trust not be scrapped although it would not exist in its current form.

Monitor has decided "in principle" the process should start, although other bodies need to be consulted before the process officially starts.

That is only expected to take a couple of weeks.

Not sustainable

It is the second time an NHS trust has faced such a process - earlier this year the decision to break up South London Healthcare was agreed.

Mid Staffordshire looks after Stafford and Cannock Chase hospitals.

It was at the Stafford site that "appalling" care led to the deaths of more than 400 patients.

Continue reading the main story

The decision to progress with administration does not mean services are dangerous.

Regulators have already closed down wards and operating theatres at the trust's hospitals that are not able to provide safe care.

But it does mean the trust in its current form has no future.

In many ways this was inevitable. The trust is one of the smallest in the country.

The size of its maternity and emergency services are already below what is considered appropriate in an era when care is increasingly being specialised.

Many trusts on this scale have question marks over their future.

But couple that with its legacy of being at the centre of a harrowing care scandal which meant patients were refusing to be treated there and health staff opting not to work there and you have a downward spiral that it could be argued was irreversible.

There has been five major investigations into what went wrong, including the public inquiry published earlier this month which criticised the whole NHS for the handling of the problems.

It has also been clear for some time that the trust was struggling financially.

A report by Monitor earlier said in order to break even there would need to be savings of 7% of its yearly budget.

It has now concluded that the trust is neither clinically nor financially sustainable in its current form.

David Bennett, the chief executive of Monitor, said: "We are now consulting on whether to appoint administrators with the expertise to reorganise services in a way which is clinically robust and sustainable.

"Their priority will be to make sure that patients can continue to access the services that they need and they will work with the local community to do this."

Once the administrator is appointed they will have 150 days to come up with proposals for the future of the trust.

The Department of Health in England said the serious financial challenges the trust was facing was "putting at risk its work on improving services".

"It is important that valued local services will last and are able to continue providing high quality treatment and advice for patients," the spokesman added.

Professor John Caldwell, the trust's chairman, said "We have accepted for some time that the trust, working alone cannot produce a long lasting solution to the issues we face.

"We will continue to work with our regulators and commissioners to deliver the services they require to our local community."

Julie Bailey, founder of the campaign group Cure the NHS, which brought the failings at the hospital to national attention, said: "We are obviously distressed. But this was inevitable really."

21.24 | 0 komentar | Read More

Thriving cancer's 'chaos' explained

27 February 2013 Last updated at 20:50 ET By James Gallagher Health and science reporter, BBC News

The way cancers make a chaotic mess of their genetic code in order to thrive has been explained by UK researchers.

Cancer cells can differ hugely within a tumour - it helps them develop ways to resist drugs and spread round the body.

A study in the journal Nature showed cells that used up their raw materials became "stressed" and made mistakes copying their genetic code.

Scientists said supplying the cancer with more fuel to grow may actually make it less dangerous.

Most normal cells in the human body contain 46 chromosomes, or bundles of genetic code. However, some cancerous cells can have more than 100 chromosomes.

And the pattern is inconsistent - pick a bunch of neighbouring cells and they could each have different chromosome counts.

This diversity helps tumours adapt to become untreatable and colonise new parts of the body. Devising ways of preventing a cancer from becoming diverse is a growing field of research.

Chaos from order

Scientists at the Cancer Research UK London Research Institute and the University College London Cancer Institute have been trying to crack how cancers become so diverse in the first place.

It had been thought that when a cancer cell split to create two new cells, the chromosomes were not split evenly between the two.

However, lead researcher Prof Charles Swanton's tests on bowel cancer showed "very little evidence" that was the case.

Instead the study showed the problem came from making copies of the cancer's genetic code.

Cancers are driven to make copies of themselves, however, if cancerous cells run out of the building blocks of their DNA they develop "DNA replication stress".

The study showed the stress led to errors and tumour diversity.

Prof Swanton told the BBC: "It is like constructing a building without enough bricks or cement for the foundations.

"However, if you can provide the building blocks of DNA you can reduce the replication stress to limit the diversity in tumours, which could be therapeutic."

He admitted that it "just seems wrong" that providing the fuel for a cancer to grow could be therapeutic.

However, he said this proved that replication stress was the problem and that new tools could be developed to tackle it.

Future studies will investigate whether the same stress causes diversity in other types of tumour.

The research team identified three genes often lost in diverse bowel cancer cells, which were critical for the cancer suffering from DNA replication stress. All were located on one region of chromosome 18.

Prof Nic Jones, Cancer Research UK's chief scientist, said: "This region of chromosome 18 is lost in many cancers, suggesting this process is not just seen in bowel cancers.

"Scientists can now start looking for ways to prevent this happening in the first place or turning this instability against cancers."

21.24 | 0 komentar | Read More

Fukushima 'increased cancer risk'

28 February 2013 Last updated at 06:20 ET

People living near the damaged Fukushima nuclear plant in Japan have an increased risk of developing some cancers, the World Health Organization says.

The increased risk is limited to communities and some emergency workers exposed to radiation after the 2011 earthquake and tsunami, analysis shows.

For those living in the rest of Japan there is no health risk, it said.

Experts stressed the increased lifetime risk of cancer remained small.

The report is part of an ongoing assessment by international experts on the fallout from severe damage to the Fukushima Daiichi plant.

In March 2011, a powerful tsunami generated by a magnitude-9.0 earthquake out at sea slammed into the nuclear power plant in north-eastern Japan, damaging four of six reactors at the site.

Around 16,000 people were killed by the impact of the earthquake.

Continue reading the main story

The radiation doses received by the surrounding population are small, even for the most exposed communities"

End Quote Prof Richard Wakeford Dalton Nuclear Institute

A substantial amount of radiation was released into the environment and a 20km (12 miles) evacuation zone was set up.

The latest analysis has found that those living in the most contaminated areas around Fukushima are expected to have a small but higher than expected risk of cancer.

The biggest lifetime risks were seen in those exposed as infants, compared with children or adults.

For girls exposed to radiation from the accident as infants, the report found a 4% increase above the lifetime expected risk of solid tumours and a 6% increase above that expected for breast cancer.

Boys exposed as infants are expected to have a 7% increased risk of leukaemia above that expected in the normal population.

The biggest risk was seen in thyroid cancer, which for infant girls could be up to 70% higher than expected over their lifetime.

Demographic factors

But the WHO was keen to stress that these risks were relative and remained small.

For example, the lifetime risk of developing thyroid cancer over a lifetime for women is 0.75% and the additional risk for those exposed as infants in the most affected area is 0.50%.

The report also found that a third of emergency workers working in the plant after the disaster are at an increased risk of cancer.

Radiation doses from the damaged nuclear power plant are not expected to cause an increase in the incidence of miscarriages, stillbirths or congenital disorders.

Dr Maria Neira, WHO director for public health and environment, said: "The primary concern identified in this report is related to specific cancer risks linked to particular locations and demographic factors."

She added that the report underlined the need for long-term health monitoring of those who were at high risk, along with medical follow-up and support.

"This will remain an important element in the public health response to the disaster for decades."

Prof Richard Wakeford, visiting professor at Dalton Nuclear Institute at the University of Manchester and contributor to the WHO report, said: "The release of radioactive materials into the environment during the Fukushima nuclear accident was substantial but based on measurement data, the radiation doses received by the surrounding population are small, even for the most exposed communities.

"These doses produce an extra risk of cancer over a lifetime of about 1% at most, in addition to background lifetime cancer risks from all other causes of, on average, 40% for men and 29% for women."

He added: "Radiation exposure from the Fukushima accident has had only a small impact on the overall health of the nearby population, and much less outside the most affected areas."

21.24 | 0 komentar | Read More

Action on 'untreatable' gonorrhoea

26 February 2013 Last updated at 21:04 ET By Michelle Roberts Health editor, BBC News online

Health experts in England and Wales are on high alert for "untreatable" gonorrhoea that, in some countries, has developed resistance to antibiotics.

Although most UK cases are readily treatable, infection rates are rising.

And the Health Protection Agency (HPA) is launching an action plan to reduce transmission and monitor for and rapidly detect drug resistance.

Gonorrhoea is the second most common bacterial sexually transmitted infection (STI) in England.

Continue reading the main story

• Infection can be passed on by unprotected vaginal, oral or anal sex
• It can also be passed from a pregnant woman to her baby
• Of those infected, about one in 10 men and nearly half of women do not have symptoms
• Gonorrhoea can be easily diagnosed with a swab test

In 2011, newly diagnosed cases jumped 25% to nearly 21,000.

At the same time, the risk of gonorrhoea developing resistance to the antibiotics doctors normally prescribe - ceftriaxone and azithromycin - fell slightly for the first time in five years.

However, cases of treatment failure have now been reported globally and, with no new drugs in the pipeline, England's chief medical officer has advised the government to add the threat of the infection's resistance to front-line antibiotics to the civil emergencies risk register.

Dame Sally Davies said: "We have seen a worrying rise in cases of drug-resistant gonorrhoea over the last decade.

"Antimicrobial resistance to common drugs will increasingly threaten our ability to tackle infections, and the Health Protection Agency's work is vital to addressing this threat."

Dr Gwenda Hughes, head of STI surveillance at the HPA, said: "We are seriously concerned about continuing high levels of gonorrhoea transmission and repeat infection, suggesting we need to do more to reduce unsafe sexual behaviour."

She said a priority was to encourage safer sexual behaviour and condom use, particularly among high-risk groups such as men who have sex with men, who account for more than a third of new gonorrhoea cases.

The first case of antibiotic-resistant gonorrhoea was found in Japan in 2011. Sweden has also encountered a case.

21.24 | 0 komentar | Read More

Poison probe nurse is suspended

27 February 2013 Last updated at 09:02 ET

A nurse cleared of poisoning patients at a hospital has been suspended for three months after admitting taking drugs from the site.

The decision came after a three-day disciplinary hearing for Rebecca Leighton, 29, who worked at Stepping Hill Hospital in Stockport.

She has been suspended from nursing by the Nursing and Midwifery Council.

Ms Leighton spent six weeks in jail but was freed as there was not enough evidence against her.

She was questioned in 2011 by police investigating the poisoning of 22 patients, eight of whom died.

The charges were later dropped but she admitted stealing drugs and medicines from the hospital.

'Trustworthy and reliable'

She is currently working at a care home in Stockport.

Sue Jackson, who runs the care home, told the hearing she has known Ms Leighton since she was a teenager and took her on after she was sacked from Stepping Hill.

She said Ms Leighton had been trustworthy, reliable, creative and caring in the six months she has worked at the home.

Ms Jackson added Ms Leighton had thought seriously about her actions and deeply regretted them.

The hearing was told that during police interviews, Ms Leighton claimed staff regularly took drugs such as the painkiller ibuprofen for their own use.

Patient deaths

Twenty-two people suffered hypoglycaemic episodes after saline drips were allegedly sabotaged with insulin between June and July 2011 at Stepping Hill.

Eight of these victims - who were treated on acute care wards for seriously ill patients - have now died.

A second nurse who worked on the same wards, Victorino Chua, was later held on suspicion of three counts of murder and 18 counts of causing grievous bodily harm.

He was further arrested on suspicion of tampering with medical records and has been released on police bail.

Mr Chua was held over the deaths of Tracey Arden, 44, Arnold Lancaster, 71, and Derek Weaver, 83.

Alleged poisoning victims William Dickson, 82, Linda McDonagh, 60, John Beeley, 73, Beryl Hope, 70, and Mary Cartwright, 89, are believed to have eventually died from natural causes.

21.24 | 0 komentar | Read More

Excess drinking 'is under reported'

26 February 2013 Last updated at 22:53 ET

The amount of alcohol consumed in England could be much higher than previously thought, a study suggests.

University College London researchers compared alcohol sales figures with surveys of what people said they drank.

They found there was a significant shortfall with almost half of the alcohol sold unaccounted for in the consumption figures given by drinkers.

This suggests as many as three-quarters of people may be drinking above the recommended daily alcohol limit.

The researchers reached their estimates by factoring in the "missing" alcohol - and found excess drinking was far more than suggested by official figures, they told European Journal of Public Health.

Experts said much alcohol use went unreported, partly because drinkers did not admit or keep track of how much they consumed.

'Health implications'

The study found that 19% more men than previously thought were regularly exceeding their recommend daily limit - and 26% more women.

Total consumption across the week was also higher than officially thought - with 15% more men, and 11% more women drinking above the weekly guidelines.

The current recommendation set by the UK Chief Medical Officers is not to regularly exceed four units per day for men and three units a day for women; the Royal College of Physicians recommends weekly alcohol limits of 21 units for men and 14 units for women - although these are currently under review.

A unit of alcohol is roughly equivalent to half a pint of ordinary strength beer, or nearly one small glass of wine.

Sadie Boniface, lead author of the study at University College, said: "Currently we don't know who consumes almost half of all alcohol in England. This study was conducted to show what alcohol consumption would look like when all of what is sold is accounted for, if everyone under-reported equally.

"The results are putative, but they show that this gap between what is seen in the surveys and sales potentially has enormous implications for public health in England."

The team used alcohol sales data from Revenue and Customs and compared it with two self-reporting alcohol consumption surveys conducted in 2008 - the General Lifestyle Survey (GLF) which analysed average weekly alcohol consumption in 12,490 adults, and the Health Survey for England (HSE) which looked at consumption on the heaviest drinking day in the previous week among 9,608 adults.

Counting units

The researchers say they will now look at the characteristics of those that are under-reporting the number of drinks they have had, and why.

They suggest it may be down to drinking patterns and habits - those that are mixing drinks, and drinking at different venues, may be more likely to under-report.

The charity Alcohol Concern suggests irregular and chaotic drinking behaviour may play a part: "When we're totting up our drinks total we don't always count some occasions as proper drinking.

"We may underestimate drink sizes and their alcoholic content, and not count holidays and special occasions like weddings, birthdays and Christmas when we often drink a great deal more than usual."

The researchers suggest that government drinking guidelines need to reflect actual consumption instead of reported drinking - especially when ascertaining what levels are associated with harm.

The Department of Health says this will be taken into consideration in their alcohol consumption review.

It said: "We already know people underestimate what they drink and many drink too much. That's why we work to help people make healthier decisions, including the recent Change For Life campaign to help them track consumption and understand the impact on their health.

"We're also tackling excessive drinking through our proposed minimum unit price at 45p per unit, tougher licensing laws, more GP risk assessments, better access to specialist nurses and more specialised treatment."

Diane Abbott MP, Labour's shadow public health minister, said: "This has got to be a wake-up call for the government and the country, because after more than two years of bitter internal rows, the government has got cold feet about its only proposed alcohol harm policy.

"More needs to be done to tackle problem drinking, which costs the country £21bn."

21.24 | 0 komentar | Read More

Dementia in care homes 'more common'

25 February 2013 Last updated at 19:28 ET By Nick Triggle Health correspondent, BBC News

More than 320,000 of the 400,000 people living in care homes in England, Wales and Northern Ireland now have dementia or severe memory problems, the Alzheimer's Society charity estimates.

It said the figure was almost 30% higher than previous estimates because of the rise in the ageing population and improvements in data collection.

Of 2,000 adults surveyed, 70% said they would be scared about going to a home.

Another two-thirds felt the sector was not doing enough to tackle abuse.

And just 41% of 1,100 family members and carers surveyed thought their loved ones' quality of life was good.

Alzheimer's Society chief executive Jeremy Hughes said: "Society has such low expectation of care homes that people are settling for average.

"Throughout our lives we demand the best for ourselves and our children. Why do we expect less for our parents?

Continue reading the main story

• Dementia is an umbrella term describing a serious deterioration in mental functions, such as memory, language, orientation and judgement.
• There are many types, but Alzheimer's disease, which accounts for two-thirds of cases, is the most well-known.

"We need government and care homes to work together to lift up expectations so people know they have the right to demand the best."

David Rogers, of the Local Government Association, which represents councils, said: "This report shows the lack of confidence in a care system which is buckling under the weight of rapidly growing demand and years of underfunding.

"Local authorities want to offer a service which goes beyond a basic level of care but this is becoming increasingly difficult as our population ages, costs climb and the already significant funding shortfall becomes even more severe."

Please turn on JavaScript. Media requires JavaScript to play.

Around one in three people over the age of 65 will develop dementia in their lifetime.

It is estimated that there are around 800,000 people in the UK who have dementia, but many have not yet been diagnosed.

The number of people with dementia is increasing because people are living longer.

By 2021 the number of people in the UK with dementia will have risen to almost 950,000, experts believe.

The government is looking to improve dementia care by building greater awareness and understanding of the condition, as well as pumping more money into research to find new treatments and hopefully a cure.

In October 2012, Health Secretary Jeremy Hunt announced dedicated funding of up to £50m to NHS trusts and local authorities to help tailor hospitals and care homes to the needs of people with dementia.

There are around 20,000 care homes in the UK.

21.24 | 0 komentar | Read More

Bad sleep 'dramatically' alters body

25 February 2013 Last updated at 19:28 ET By James Gallagher Health and science reporter, BBC News

A run of poor sleep can have a potentially profound effect on the internal workings of the human body, say UK researchers.

The activity of hundreds of genes was altered when people's sleep was cut to less than six hours a day for a week.

Writing in the journal PNAS, the researchers said the results helped explain how poor sleep damaged health.

Heart disease, diabetes, obesity and poor brain function have all been linked to substandard sleep.

What missing hours in bed actually does to alter health, however, is unknown.

So researchers at the University of Surrey analysed the blood of 26 people after they had had plenty of sleep, up to 10 hours each night for a week, and compared the results with samples after a week of fewer than six hours a night.

More than 700 genes were altered by the shift. Each contains the instructions for building a protein, so those that became more active produced more proteins - changing the chemistry of the body.

Meanwhile the natural body clock was disturbed - some genes naturally wax and wane in activity through the day, but this effect was dulled by sleep deprivation.

Prof Colin Smith, from the University of Surrey, told the BBC: "There was quite a dramatic change in activity in many different kinds of genes."

Areas such as the immune system and how the body responds to damage and stress were affected.

Prof Smith added: "Clearly sleep is critical to rebuilding the body and maintaining a functional state, all kinds of damage appear to occur - hinting at what may lead to ill health.

"If we can't actually replenish and replace new cells, then that's going to lead to degenerative diseases."

He said many people may be even more sleep deprived in their daily lives than those in the study - suggesting these changes may be common.

Dr Akhilesh Reddy, a specialist in the body clock at the University of Cambridge, said the study was "interesting".

He said the key findings were the effects on inflammation and the immune system as it was possible to see a link between those effects and health problems such as diabetes.

The findings also tie into research attempting to do away with sleep, such as by finding a drug that could eliminate the effects of sleep deprivation.

Dr Reddy said: "We don't know what the switch is that causes all these changes, but theoretically if you could switch it on or off, you might be able to get away without sleep.

"But my feeling is that sleep is fundamentally important to regenerating all cells."

21.24 | 0 komentar | Read More

Babies 'hear syllables' in womb

25 February 2013 Last updated at 19:29 ET By Michelle Roberts Health editor, BBC News online

Scientists say babies decipher speech as early as three months before birth.

The evidence comes from detailed brain scans of 12 infants born prematurely.

At just 28 weeks' gestation, the babies appeared to discriminate between different syllables like "ga" and "ba" as well as male and female voices.

Writing in Proceedings of the National Academy of Sciences (PNAS), the French team said it was unlikely the babies' experience outside the womb would have affected their findings.

The research lends support to the idea that babies develop language skills while still in the womb in response to their parents' voices.

Continue reading the main story

Babies hear can hear their mother's voice in the womb and pick up on the pitch and rhythm"

End Quote Prof Sophie Scott Speech perception expert at UCL

Experts already know that babies are able to hear noises in the womb - the ear and the auditory part of the brain that allow this are formed by around 23 weeks' gestation.

But it is still debated whether humans are born with an innate ability to process speech or whether this is something acquired through learning after birth.

The authors of the study in PNAS say environmental factors are undoubtedly important, but based on their findings they believe linguistic processes are innate.

Dr Fabrice Wallois and colleagues say: "Our results demonstrate that the human brain, at the very onset of the establishment of a cortical circuit for auditory perception, already discriminates subtle differences in speech syllables."

But they add that this "does not challenge the fact that experience is also crucial for their fine tuning and for learning the specific properties of the native language".

Their brain scan study was carried out in the first few days following birth, so it is possible that the noises and sounds the newborns encountered in their new environment outside of the womb may have triggered rapid development. However, the researchers doubt this.

Prof Sophie Scott, an expert in speech perception at University College London, said the findings supported and added to current knowledge.

"We know that babies hear can hear their mother's voice in the womb and pick up on the pitch and rhythm.

"And they use this information - newborn babies are soothed by their mother's voice from the minute they are born."

21.24 | 0 komentar | Read More

Brain's 'stroke shielding' cracked

24 February 2013 Last updated at 14:33 ET By James Gallagher Health and science reporter, BBC News

A part of the brain's ability to shield itself from the destructive damage caused by a stroke has been explained by researchers.

It has been known for more than 85 years that some brain cells could withstand being starved of oxygen.

Scientists, writing in the journal Nature Medicine, have shown how these cells switch into survival mode.

They hope to one-day find a drug which uses the same trick to protect the whole brain.

Treating a stroke is a race against time. Clots that block the blood supply prevent the flow of oxygen and sugar to brain cells, which then rapidly die.

But in 1926, it was noticed that some cells in the hippocampus, the part of the brain involved in memory, did not follow this rule.

Continue reading the main story

"We have shown for the first time that the brain has mechanisms that it can use to protect itself and keep brain cells alive"

End Quote Prof Alastair Buchan Oxford University

"They're staying alive when the prediction would say that they should die," said Prof Alastair Buchan from Oxford University who has investigated how they survive.

I'm a survivor

Experiments on rats showed that these surviving-cells started producing a protein called hamartin - which forces cells to conserve energy. They stop producing new proteins and break down existing ones to access the raw materials.

When the researchers prevented the cells from producing hamartin, they died just like other cells.

Prof Buchan said: "We have shown for the first time that the brain has mechanisms that it can use to protect itself and keep brain cells alive."

Their aim is to develop a drug that can produce the same effect, which could be given when an ambulance arrived. This would buy the brain time until clot-busting drugs could be given in hospital.

The researchers do not know why these cells have this defence, but other nearby cells in the hippocampus do not. There are differences in function. The cells that die are known as CA1 cells which are very plastic and are involved in laying down memories whereas the surviving, or CA3, cells are less adaptable.

Speaking to BBC News online, Prof Buchan said the focus of this research was on "ways to keep brain cells alive" which could have impacts beyond stroke - such as in Alzheimer's disease and spinal cord injuries.

Commenting on the study, Dr Clare Walton from the Stroke Association said: "Previous research has shown that some brain cells are naturally more resilient than others, and this study has identified a particular protein in the cells that is responsible.

"In the future, researchers could try to turn on this protein in other, less resilient brain cells to reduce the brain damage caused by stroke.

"The findings of this research are exciting, but we are still a long way off from developing a new stroke treatment."

21.24 | 0 komentar | Read More

UKBA 'risks pregnant women's health'

24 February 2013 Last updated at 20:15 ET

The UK Border Agency (UKBA) is endangering the health of some pregnant women seeking asylum and their babies by relocating them, a report has said.

The report by Maternity Action and the Refugee Council found examples of women moved against medical advice and too close to their due date.

Twenty women and 17 midwives involved in their care were interviewed.

A UKBA spokesman said the conclusions were drawn from a small sample, and ignored recent policy changes.

The study also found examples of:

• Women being moved to new accommodation multiple times
• Women being separated from the father of their baby
• Women giving birth without a birth partner following a move

The report also points out that asylum-seeking women often have high-risk pregnancies, due to serious physical health conditions that can be related to having fled torture, sexual violence or female genital mutilation in their own countries.

Many suffer from serious mental health conditions, including severe depression, flashbacks and suicidal thoughts, the report added.

But UKBA relocations were separating women from specialist treatment and monitoring, it said, contrary to National Institute of Health and Clinical Excellence guidance.

"It is high time the UKBA recognised asylum-seeking women as being a particularly vulnerable group with complex needs, and urgently ensure their policies reflect this," said Maternity Action director Rosalind Bragg.

"Our society is failing these women and their babies," said Cathy Warwick, general secretary of the Royal College of Midwives.

Ms Warwick added: "If these women or their babies are not to suffer serious consequences we must offer them the chance of continuity of care throughout pregnancy and childbirth from a team who understand their needs."

'Resources wasted'

There were also examples of NHS resources being wasted when scans and tests were repeated following a relocation, the report said.

Continue reading the main story

Wherever possible, women in the latter stages of pregnancy will not be moved"

End Quote Spokesman UK Border Agency

Shan Nicholas, interim chief executive at the Refugee Council, said: "We work with pregnant women every day who have been ripped away from their families and healthcare, causing undue distress and health problems at what should be an exciting and positive time of their lives.

"The UKBA must stop sending pregnant women to live in new cities unless all risks have been considered and adequate healthcare arrangements have been made."

The Refugee Council and Maternity Action are calling on the government to urgently review its policies to ensure the asylum system no longer puts women and their babies at risk.

A UKBA spokesman said: "We consider every case individually and, wherever possible, women in the latter stages of pregnancy will not be moved to a different area.

"Last year we introduced a revised pregnancy dispersal policy which includes a commitment to not move any pregnant woman during the four weeks before or after her due date."

He said that asylum-seekers were only moved when it was "safe and practical to do so", adding: "Those with severe or complex healthcare needs have their clinicians notified throughout the process."

21.24 | 0 komentar | Read More

Slow-grow babies 'catch-up' by teens

25 February 2013 Last updated at 00:04 ET

Babies who are slow to gain weight in the first months of their lives generally catch up to their peers by age 13, a large UK study shows.

Researchers, writing in the journal Pediatrics, said the results would reassure parents whose babies fail to put on weight quickly.

And they warn against boosting the calorie intake of slow-growing babies as this may increase obesity.

Experts said that monitoring of weight gain in infants remained vital.

The researchers looked at data from 11,499 children who took part in a large study in Bristol in the 1990s.

It showed that 507 who were slow to gain weight in the first eight weeks of life recovered fairly quickly and had almost caught up by the age of two years.

Another group of 480 children who were slow to gain between eight weeks and nine months continued to put on weight slowly until they were seven years, but then had a spurt and caught up by the age of 13.

Normal range

Continue reading the main story

In the past a lot of parents have been caused a lot of unnecessary anxiety by health professionals and this is a positive and reassuring message"

End Quote Prof Alan Emond University of Bristol

The different patterns of recovery between the two groups were likely due to different reasons for slow weight gain, the researchers said.

All the children were still lighter and shorter than their peers by the time they were teenagers, but within the normal range.

The findings highlight the importance of monitoring a baby's weight and height gain during the first few weeks and months, but not creating anxiety with parents of slow-growing babies, said study leader Prof Alan Emond from the University of Bristol.

"In the past, a lot of parents have been caused a lot of unnecessary anxiety by health professionals and this is a positive and reassuring message."

He said in many cases slow growth where children who are otherwise well do not follow the standard 'curve' is just because they are following their genetic potential.

"The second point for health professionals is that for a child that is well with no symptoms they can be relaxed and not worry about pushing calories because you can push them the other way."

Feeding habits in the second six months of life determine a child's future weight gain, so consuming too many calories in infancy can lead to obesity later on, he explained.

Dr Simon Newell, vice-president of the Royal College of Paediatrics and Child Health, said he broadly agreed with the conclusions of the researchers but stressed that poor weight gain was something which needed to be monitored closely.

"The weight when you're first born is the impact of pregnancy, the weight at eight weeks is related to how well you are feeding, then for the next year there will be an adjustment to your natural centile."

He said health professionals needed to look at the whole picture.

"I would encourage parents to use growth charts but if measurements show your baby is smaller than average it may be completely normal."

21.24 | 0 komentar | Read More

Hospital food schemes 'wasted money'

21 February 2013 Last updated at 20:39 ET

Please turn on JavaScript. Media requires JavaScript to play.

Watch this patient give his verdict on one Nottingham hospital's new approach to mass catering

The government has wasted more than £54m on "failed" schemes to improve hospital food, according to the food and farming pressure group Sustain.

Its report says compulsory nutritional standards are needed to ensure patient meals improve.

It warned there had been little change in the past two decades despite numerous initiatives, many fronted by celebrity chefs.

A health minister said patients were being asked to influence menus.

Broadcaster Loyd Grossman and celebrity chef Albert Roux are among those backing the call for legally binding hospital food standards.

Both have fronted high-profile campaigns to improve hospital food.

The report from the Campaign for Better Hospital Food - which is run by Sustain and backed by 89 organisations - found that since 1992 there had been 21 initiatives to improve patient meals.

Continue reading the main story

It's time for the government to take effective action by introducing mandatory standards for patient meals"

End Quote Alex Jackson Campaign for Better Hospital Food

But the schemes failed because they relied on hospitals to voluntarily adopt their recommendations, the report concluded.

At a cost of more than £54m, the money wasted was equivalent to 34 new hospital kitchens, it said.

The group claimed the government had ignored at least 14 warnings from government advisers, MPs, commercial caterers, and health, environmental and animal welfare organisations that voluntary initiatives to improve hospital food were failing.

'Meetings, speeches, gimmicks'

It wants to see food-based standards in line with those introduced in schools in England in 2006 in all UK hospitals in the next 18 months.

Alex Jackson, co-ordinator of the Campaign for Better Hospital Food, said: "This report must serve as a lesson to Jeremy Hunt that simply publishing recommendations for the improvement of hospital food isn't good enough, as every one of his predecessors in the last 20 years has found out.

"It's time for the government to take effective action by introducing mandatory standards for patient meals."

Loyd Grossman, who led the Better Hospital Food initiative between 2001 and 2006, said although his team had a number of successes, their efforts were hampered by a lack of political will.

"There has not yet been a noticeable change in the way hospital food is produced, prepared, cooked and served."

Albert Roux, who was asked in 1995 by the Department of Health to give his opinion about how to improve hospital food, added that "meetings, speeches and gimmicks" do not work.

"What we need now is change to the whole hospital food system, starting with the introduction of food standards for every patient meal."

Health Minister Dan Poulter admitted that schemes based on celebrity chefs had not worked in the past.

"Patients are the ones who consume hospital food and are best-placed to decide what is good and what is not.

"That is why an army of thousands of patient assessors will join a tough new inspection programme starting in April 2013 to drive up standards."

He added that there were many fantastic examples of very good food across the NHS and centrally imposed standards were not the answer.

Katherine Murphy, chief executive of The Patients Association, said patients regularly contacted their helpline about poor standards of food in hospital.

"High quality, nutritious food is an essential part of a patient's overall hospital experience. It plays a fundamental role in their recovery and helps them to return home sooner," she said.

21.24 | 0 komentar | Read More

Slow care leads to foot amputations

22 February 2013 Last updated at 19:49 ET

Thousands of diabetes patients end up having a foot amputation because of slow treatment, a charity warns.

Diabetes UK says that up to 80% of foot amputations could be avoided if better care was in place.

Patients are suffering because many areas do not have services in place to quickly deal with foot ulcers and infections.

By 2015, the number of diabetes-related amputations is expected to rise to 7,000 a year.

When diabetes, both Types 1 and Type 2, is present for many years, especially if it is poorly controlled, it can cause complications such as reducing blood flow to vessels in the feet and nerve damage which reduces sensation.

This increases the risk of ulcers and infections that may lead to amputation.

A report produced in collaboration with the Society for Chiropodists and Podiatrists and NHS Diabetes points out that people with diabetes are more than 20 times more likely to have an amputation than the rest of the population.

It recommends that all hospitals have a multi-disciplinary footcare team as recommended in national guidelines.

Figures suggest that 40% of hospitals currently do not have such teams in place.

Every hospital also needs to be able to guarantee that people with urgent foot problems can be assessed by the right professionals within 24 hours, the report urges.

This is because ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it.

Prevention

Continue reading the main story

This is not something that requires more money. In fact, putting these kind of systems in place can actually save money because the amputations that they prevent are so expensive"

End Quote Barbara Young Chief executive of Diabetes UK

In addition people with diabetes who are at high risk for foot problems need to know what to look out for and what to do when a problem develops.

Barbara Young, chief executive of Diabetes UK, said it is unacceptable that every week people with diabetes who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough.

"It is not as if this is a problem we don't know how to solve.

"If every hospital had a multi-disciplinary footcare team and ensured access to that team within 24 hours, then that would make a huge difference to the amputation rates."

She added that some prevention work was so poor that people were not even asked to take their shoes off when attending their annual foot check.

"This is not something that requires more money," she continued.

"In fact, putting these kind of systems in place can actually save money because the amputations that they prevent are so expensive.

Matthew Fitzpatrick, spokesman for the College of Podiatry, said they strongly welcomed the recommendations.

"The most important aspect is that patients appreciate how to check themselves and are seeking appropriate advice when they need it.

"If they're worried then their local podiatrist should be the first port of call."

21.24 | 0 komentar | Read More

Foreign doctors 'must speak English'

23 February 2013 Last updated at 20:59 ET By James Gallagher Health and science reporter, BBC News

Foreign doctors wanting to treat NHS patients in England will have to prove they have the necessary English skills, the government has confirmed.

Concerns were raised after a German doctor, Dr Daniel Ubani, gave a patient a fatal overdose on his first and only shift in the UK.

He had earlier been rejected for work because of poor English skills.

From April there will be a legal duty to ensure a doctor's English is up to scratch before they are employed.

Foreign doctors will have to prove they can speak a "necessary level of English" before they are allowed to treat patients in hospitals or in GP surgeries, the Department of Health said.

Dr Ubani had been refused work by Leeds Primary Care Trust, but was later employed in Cambridgeshire.

From April, there will be a national list of GPs to prevent doctors being rejected in one part of the country and then cropping up somewhere else. GPs will have to prove their language skills before being put on the list.

Please turn on JavaScript. Media requires JavaScript to play.

Health Minister Dr Dan Poulter says English skills "must be up to scratch"

Health minister Dr Dan Poulter said the measures were about protecting patients, who "should be able to understand and be understood by their doctor if we are to give them the best care they deserve".

"These new checks will ensure that all doctors who want to work in the NHS can speak proficient English and to prevent those who can't from treating patients," he said.

New powers for the body which regulates doctors in the UK - the General Medical Council - are also being discussed. A change of law could give it powers to test the communication skills of doctors from within the EU as it already can for non-EU doctors.

Niall Dickson, chief executive of the GMC, said tighter rules would "strengthen patient safety".

He added: "Our position is clear - patients must be confident that the doctor who treats them has the right communications skills to do the job.

Please turn on JavaScript. Media requires JavaScript to play.

Niall Dickson from the General Medical Council says the new rules are "extremely welcome"

"If doctors cannot speak English to a safe standard then the GMC must be able to protect patients by preventing them from practising in the UK.

"At present we can do that for doctors who have qualified outside Europe but we cannot do it for doctors within the European Union.

"We have been working hard for some time to close this loophole in UK legislation which has caused so much concern to patients and their families and we are delighted that the government has decided to act."

Katherine Murphy, chief executive of the Patients Association, said: "New language checks for doctors are welcome, and long overdue.

"Lessons from the past have served to highlight the tragic consequences of poor language skills."

Dean Royles, director of the NHS Employers organisation, said foreign doctors had made an "invaluable contribution" but safety needed to be the "top priority".

21.24 | 0 komentar | Read More

Hospital food schemes 'wasted money'

21 February 2013 Last updated at 20:39 ET

Please turn on JavaScript. Media requires JavaScript to play.

Watch this patient give his verdict on one Nottingham hospital's new approach to mass catering

The government has wasted more than £54m on "failed" schemes to improve hospital food, according to the food and farming pressure group Sustain.

Its report says compulsory nutritional standards are needed to ensure patient meals improve.

It warned there had been little change in the past two decades despite numerous initiatives, many fronted by celebrity chefs.

A health minister said patients were being asked to influence menus.

Broadcaster Loyd Grossman and celebrity chef Albert Roux are among those backing the call for legally binding hospital food standards.

Both have fronted high-profile campaigns to improve hospital food.

The report from the Campaign for Better Hospital Food - which is run by Sustain and backed by 89 organisations - found that since 1992 there had been 21 initiatives to improve patient meals.

Continue reading the main story

It's time for the government to take effective action by introducing mandatory standards for patient meals"

End Quote Alex Jackson Campaign for Better Hospital Food

But the schemes failed because they relied on hospitals to voluntarily adopt their recommendations, the report concluded.

At a cost of more than £54m, the money wasted was equivalent to 34 new hospital kitchens, it said.

The group claimed the government had ignored at least 14 warnings from government advisers, MPs, commercial caterers, and health, environmental and animal welfare organisations that voluntary initiatives to improve hospital food were failing.

'Meetings, speeches, gimmicks'

It wants to see food-based standards in line with those introduced in schools in England in 2006 in all UK hospitals in the next 18 months.

Alex Jackson, co-ordinator of the Campaign for Better Hospital Food, said: "This report must serve as a lesson to Jeremy Hunt that simply publishing recommendations for the improvement of hospital food isn't good enough, as every one of his predecessors in the last 20 years has found out.

"It's time for the government to take effective action by introducing mandatory standards for patient meals."

Loyd Grossman, who led the Better Hospital Food initiative between 2001 and 2006, said although his team had a number of successes, their efforts were hampered by a lack of political will.

"There has not yet been a noticeable change in the way hospital food is produced, prepared, cooked and served."

Albert Roux, who was asked in 1995 by the Department of Health to give his opinion about how to improve hospital food, added that "meetings, speeches and gimmicks" do not work.

"What we need now is change to the whole hospital food system, starting with the introduction of food standards for every patient meal."

Health Minister Dan Poulter admitted that schemes based on celebrity chefs had not worked in the past.

"Patients are the ones who consume hospital food and are best-placed to decide what is good and what is not.

"That is why an army of thousands of patient assessors will join a tough new inspection programme starting in April 2013 to drive up standards."

He added that there were many fantastic examples of very good food across the NHS and centrally imposed standards were not the answer.

Katherine Murphy, chief executive of The Patients Association, said patients regularly contacted their helpline about poor standards of food in hospital.

"High quality, nutritious food is an essential part of a patient's overall hospital experience. It plays a fundamental role in their recovery and helps them to return home sooner," she said.

21.24 | 0 komentar | Read More

Hope over anti-resistance flu drug

21 February 2013 Last updated at 20:40 ET

A new type of flu drug that can stop resistant strains in their tracks shows promise, say US researchers.

It permanently blocks a key enzyme on the surface of the flu virus, stopping it from spreading to other cells.

In mice it was found to effective against strains which were resistant to the two flu antivirals currently on the market, the journal Science reported.

The World Health Organization estimates that influenza affects three to five million people every year.

Resistance to the existing flu drugs Relenza and Tamiflu is becoming an increasing problem, largely due to their overuse.

The more exposure the flu virus has to the drugs - and in some countries it is available as a preventive treatment before people even catch the infection - the more chance it has of working out how to evade their effects.

Yet in the event of a flu pandemic they are the only weapon available for treating patients in the months before a vaccine can be developed.

'Broken key'

A team of researchers from Canada, the UK and Australia developed a compound that binds to an enzyme on the surface of the flu virus called neuraminidase.

This enzyme is responsible for severing the connection between the flu virus and human cell so it can move on and infect other cells.

The new class of drugs - DFSAs - permanently bind to the enzyme, blocking its action and stopping it from spreading further, the journal Science reported.

Currently available antivirals also work by attaching to this enzyme.

But DFSAs do so in such a way that the flu virus cannot evolve to be resistant to the drug without rendering itself useless.

Tests in mice showed it works against both A and B influenza types and known resistant flu strains and researchers are now doing tests in other animals.

Study leader Prof Steve Withers from the University of British Columbia said: "Our drug agent uses the same approach as current flu treatments - by preventing neuraminidase from cutting its ties with the infected cell.

"But our agent latches onto this enzyme like a broken key, stuck in a lock, rendering it useless."

Co-author Dr Andrew Watts from the University of Bath said: "Our drug can work even better in drug resistant strains than in natural viruses emphasising that it is working through a totally different mechanism."

He added that realistically it would be six to seven years before the drug came to market.

Prof John Oxford, a virology expert at Queen Mary, University of London, said the work seemed to be a significant step forward.

"It is always nice to have an extra drug in the medicine cupboard and it would be reassuring if in the near future we had a second line drug."

21.24 | 0 komentar | Read More

Slow care leads to foot amputations

22 February 2013 Last updated at 19:49 ET

Thousands of diabetes patients end up having a foot amputation because of slow treatment, a charity warns.

Diabetes UK says that up to 80% of foot amputations could be avoided if better care was in place.

Patients are suffering because many areas do not have services in place to quickly deal with foot ulcers and infections.

By 2015, the number of diabetes-related amputations is expected to rise to 7,000 a year.

When diabetes, both Types 1 and Type 2, is present for many years, especially if it is poorly controlled, it can cause complications such as reducing blood flow to vessels in the feet and nerve damage which reduces sensation.

This increases the risk of ulcers and infections that may lead to amputation.

A report produced in collaboration with the Society for Chiropodists and Podiatrists and NHS Diabetes points out that people with diabetes are more than 20 times more likely to have an amputation than the rest of the population.

It recommends that all hospitals have a multi-disciplinary footcare team as recommended in national guidelines.

Figures suggest that 40% of hospitals currently do not have such teams in place.

Every hospital also needs to be able to guarantee that people with urgent foot problems can be assessed by the right professionals within 24 hours, the report urges.

This is because ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it.

Prevention

Continue reading the main story

This is not something that requires more money. In fact, putting these kind of systems in place can actually save money because the amputations that they prevent are so expensive"

End Quote Barbara Young Chief executive of Diabetes UK

In addition people with diabetes who are at high risk for foot problems need to know what to look out for and what to do when a problem develops.

Barbara Young, chief executive of Diabetes UK, said it is unacceptable that every week people with diabetes who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough.

"It is not as if this is a problem we don't know how to solve.

"If every hospital had a multi-disciplinary footcare team and ensured access to that team within 24 hours, then that would make a huge difference to the amputation rates."

She added that some prevention work was so poor that people were not even asked to take their shoes off when attending their annual foot check.

"This is not something that requires more money," she continued.

"In fact, putting these kind of systems in place can actually save money because the amputations that they prevent are so expensive.

Matthew Fitzpatrick, spokesman for the College of Podiatry, said they strongly welcomed the recommendations.

"The most important aspect is that patients appreciate how to check themselves and are seeking appropriate advice when they need it.

"If they're worried then their local podiatrist should be the first port of call."

21.24 | 0 komentar | Read More

Hope over anti-resistance flu drug

21 February 2013 Last updated at 20:40 ET

A new type of flu drug that can stop resistant strains in their tracks shows promise, say US researchers.

It permanently blocks a key enzyme on the surface of the flu virus, stopping it from spreading to other cells.

In mice it was found to effective against strains which were resistant to the two flu antivirals currently on the market, the journal Science reported.

The World Health Organization estimates that influenza affects three to five million people every year.

Resistance to the existing flu drugs Relenza and Tamiflu is becoming an increasing problem, largely due to their overuse.

The more exposure the flu virus has to the drugs - and in some countries it is available as a preventive treatment before people even catch the infection - the more chance it has of working out how to evade their effects.

Yet in the event of a flu pandemic they are the only weapon available for treating patients in the months before a vaccine can be developed.

'Broken key'

A team of researchers from Canada, the UK and Australia developed a compound that binds to an enzyme on the surface of the flu virus called neuraminidase.

This enzyme is responsible for severing the connection between the flu virus and human cell so it can move on and infect other cells.

The new class of drugs - DFSAs - permanently bind to the enzyme, blocking its action and stopping it from spreading further, the journal Science reported.

Currently available antivirals also work by attaching to this enzyme.

But DFSAs do so in such a way that the flu virus cannot evolve to be resistant to the drug without rendering itself useless.

Tests in mice showed it works against both A and B influenza types and known resistant flu strains and researchers are now doing tests in other animals.

Study leader Prof Steve Withers from the University of British Columbia said: "Our drug agent uses the same approach as current flu treatments - by preventing neuraminidase from cutting its ties with the infected cell.

"But our agent latches onto this enzyme like a broken key, stuck in a lock, rendering it useless."

Co-author Dr Andrew Watts from the University of Bath said: "Our drug can work even better in drug resistant strains than in natural viruses emphasising that it is working through a totally different mechanism."

He added that realistically it would be six to seven years before the drug came to market.

Prof John Oxford, a virology expert at Queen Mary, University of London, said the work seemed to be a significant step forward.

"It is always nice to have an extra drug in the medicine cupboard and it would be reassuring if in the near future we had a second line drug."

21.24 | 0 komentar | Read More

Doctors raise concerns via helpline

21 February 2013 Last updated at 11:59 ET By Jane Dreaper Health correspondent, BBC News

A whistle-blowing helpline set up by the UK's regulator of doctors two months ago has led to 12 investigations into allegations of a "very serious" nature.

Figures seen by the BBC show the confidential phone line has had 187 calls since its launch.

One in seven was thought to be serious enough for the General Medical Council (GMC) to make further inquiries.

Most of the callers were doctors but some members of the public rang too.

The 12 "very serious" investigations involve complaints which suggest a doctor may not be fit to practise and there may be a risk to patient safety.

Continue reading the main story

"Start Quote

There are situations where doctors genuinely feel intimidated by the environment they're in and don't feel they can raise concerns"

End Quote Niall Dickson General Medical Council

The phone calls have also triggered four less serious inquiries - these are allegations which could justify action by the regulator if they were part of a wider pattern of concern about a doctor.

The GMC is considering information in seven other cases that have come to light through the confidential phone line. Four cases were looked into and then closed.

Relatively high numbers of calls were from the north-west of England, the West Midlands and London.

The GMC launched its helpline in December, to enable doctors to raise serious concerns about patient safety if they felt unable to do so locally.

Every doctor in the UK was sent new guidance in March last year, making it clear that they had a professional duty to act to protect patients' interests at all times.

The chief executive of the GMC, Niall Dickson, said: "We haven't engaged in a massive publicity campaign around this line, so the response shows there is a need for this service.

"Some of the doctors were phoning up with serious concerns, which has resulted in ongoing investigations. We're very pleased that concerns are reaching us - it's one way of pursuing areas where patients may be at risk.

"There are situations where doctors genuinely feel intimidated by the environment they're in and don't feel they can raise concerns. That's something which we, the health service and the profession more generally have got to tackle.

"We've got to move to a situation where it is absolutely routine for professionals to put patient safety first at every opportunity - even if this means raising concern about a more senior colleague."

Advice and support

Some of the 187 helpline calls were directed elsewhere - to the nurses' regulator, for example - or they involved more general inquiries, such as doctors wishing to pay their registration fees.

The question of why concerns about poor care in the NHS do not always get flagged up or dealt with have been an issue since the Francis report into the failings at Mid-Staffordshire trust was published a fortnight ago.

The GMC phone line has received 43 calls since then - this does not represent a surge.

The regulator is to hear four "fitness to practise" cases involving doctors from Mid-Staffordshire. The first of these is due to begin next month.

There are various avenues for reporting poor care.

Continue reading the main story

Who to call

• GMC's confidential helpline number is 0161 923 6399
• Whistle-blowing helpline number is 08000 724725
• RCN whistle-blowing helpline number is 0345 772 6300
• Patients Association helpline number is 0845 608 4455
• The CQC number for whistle-blowers or people reporting poor care is 03000 616161

A free whistle-blowing helpline covering concerns about the NHS and the social care sector was launched by the previous Health Secretary, Andrew Lansley, in January last year. The charity Mencap has a three-year contract worth £480,000 to run the line.

It has had 1,325 calls since then - and 105 requests for advice by email. It gives advice and support to individuals, employers and trade unions.

The Patients Association receives more than 8,000 calls on its helpline every year.

Patients and members of staff can also ring the main regulator of NHS and social care organisations in England, the Care Quality Commission (CQC).

The CQC says it received around 600 calls a month last year which it classified as "genuine concerns" from whistle-blowing staff.

The Royal College of Nursing (RCN) launched a phone line to support whistle-blowing nurses in 2009. It received around two calls a week in its first year.

21.24 | 0 komentar | Read More

Hospital food schemes 'wasted money'

21 February 2013 Last updated at 20:39 ET

Please turn on JavaScript. Media requires JavaScript to play.

Watch this patient give his verdict on one Nottingham hospital's new approach to mass catering

The government has wasted more than £54m on "failed" schemes to improve hospital food, according to the food and farming pressure group Sustain.

Its report says compulsory nutritional standards are needed to ensure patient meals improve.

It warned there had been little change in the past two decades despite numerous initiatives, many fronted by celebrity chefs.

A health minister said patients were being asked to influence menus.

Broadcaster Loyd Grossman and celebrity chef Albert Roux are among those backing the call for legally binding hospital food standards.

Both have fronted high-profile campaigns to improve hospital food.

The report from the Campaign for Better Hospital Food - which is run by Sustain and backed by 89 organisations - found that since 1992 there had been 21 initiatives to improve patient meals.

Continue reading the main story

It's time for the government to take effective action by introducing mandatory standards for patient meals"

End Quote Alex Jackson Campaign for Better Hospital Food

But the schemes failed because they relied on hospitals to voluntarily adopt their recommendations, the report concluded.

At a cost of more than £54m, the money wasted was equivalent to 34 new hospital kitchens, it said.

The group claimed the government had ignored at least 14 warnings from government advisers, MPs, commercial caterers, and health, environmental and animal welfare organisations that voluntary initiatives to improve hospital food were failing.

'Meetings, speeches, gimmicks'

It wants to see food-based standards in line with those introduced in schools in England in 2006 in all UK hospitals in the next 18 months.

Alex Jackson, co-ordinator of the Campaign for Better Hospital Food, said: "This report must serve as a lesson to Jeremy Hunt that simply publishing recommendations for the improvement of hospital food isn't good enough, as every one of his predecessors in the last 20 years has found out.

"It's time for the government to take effective action by introducing mandatory standards for patient meals."

Loyd Grossman, who led the Better Hospital Food initiative between 2001 and 2006, said although his team had a number of successes, their efforts were hampered by a lack of political will.

"There has not yet been a noticeable change in the way hospital food is produced, prepared, cooked and served."

Albert Roux, who was asked in 1995 by the Department of Health to give his opinion about how to improve hospital food, added that "meetings, speeches and gimmicks" do not work.

"What we need now is change to the whole hospital food system, starting with the introduction of food standards for every patient meal."

Health Minister Dan Poulter admitted that schemes based on celebrity chefs had not worked in the past.

"Patients are the ones who consume hospital food and are best-placed to decide what is good and what is not.

"That is why an army of thousands of patient assessors will join a tough new inspection programme starting in April 2013 to drive up standards."

He added that there were many fantastic examples of very good food across the NHS and centrally imposed standards were not the answer.

Katherine Murphy, chief executive of The Patients Association, said patients regularly contacted their helpline about poor standards of food in hospital.

"High quality, nutritious food is an essential part of a patient's overall hospital experience. It plays a fundamental role in their recovery and helps them to return home sooner," she said.

21.24 | 0 komentar | Read More

Mosquitoes 'ignore insect repellent'

20 February 2013 Last updated at 20:56 ET By Rebecca Morelle Science reporter, BBC World Service

The widely used insect repellent Deet appears to be losing its effectiveness against mosquitoes, scientists say.

Researchers from the London School of Hygiene and Tropical Medicine say mosquitoes are first deterred by the substance, but then later ignore it.

They say more research is needed to find alternatives to Deet, which was first developed by the US military.

The research was carried out on Aedes aegypti, a species of mosquito that spreads dengue and yellow fever.

The findings are published in the journal Plos One.

Dr James Logan from the London School of Hygiene and Tropical Medicine, said: "The more we can understand about how repellents work and how mosquitoes detect them, the better we can work out ways to get around the problem when they do become resistant to repellents."

Human bait

Deet - or N,N-diethyl-meta-toluamide - is one of the most widely used active ingredients in insect repellents. It was developed by the US military, following its experience of jungle warfare during World War II.

Continue reading the main story

Mosquitoes are very good at evolving very very quickly"

End Quote Dr James Logan London School of Hygiene and Tropical Medicine

For many years, it was not clear exactly how the chemical worked, but recent research suggests that insects simply do not like the smell.

However, there are concerns that some mosquitoes are growing resistant to it.

To find out more, researchers from the London School of Hygiene and Tropical Medicine took some A. aegypti mosquitoes in the laboratory, and tempted them with a human arm covered in Deet.

As expected, the repellent put the insects off their potential meal.

However, a few hours later when the same mosquitoes were offered a chance to dine again, the researchers found that the Deet was less effective.

To investigate why this might be happening, the researchers attached electrodes to the insects' antenna.

Dr Logan explained: "We were able to record the response of the receptors on the antenna to Deet, and what we found was the mosquitoes were no longer as sensitive to the chemical, so they weren't picking it up as well.

"There is something about being exposed to the chemical that first time that changes their olfactory system - changes their sense of smell - and their ability to smell Deet, which makes it less effective."

Arms race

Earlier research by the same team found that genetic changes to the same species of mosquito can make them immune to Deet, although it was not clear if there were any mosquitoes like this in the wild.

Dr Logan said it was vital to understand both these permanent genetic and temporary olfactory changes that were taking place.

He said: "Mosquitoes are very good at evolving very very quickly."

He stressed that the findings should not stop people from using Deet in high risk areas, but that they would help scientists who are trying to find new versions that could be effective.

To follow up on the study, the researchers now plan to find out how long the effect lasts after the initial exposure to the chemical.

The team would also like to study the effect in other mosquitoes, including the species that transmit malaria.

21.24 | 0 komentar | Read More

Falling drug breakthroughs 'a myth'

21 February 2013 Last updated at 03:50 ET

Fears the number of new medicines available to patients in the UK is declining have been rejected.

Researchers found the number of drugs introduced during the last 30 years had in fact increased slightly, the BMJ Open journal reported.

This comes despite persistent suggestions they have dwindled, the Birmingham University team said.

Researchers came to the conclusion after analysing data in the British National Formulary guide on drugs.

They looked at how many new medicines were added between 1971 and 2011.

The average number of drugs introduced per year was just under 23, varying from nine in the lowest year to 34 in the highest.

The researchers said there were steep peaks and troughs over this period, including a dip between 1998 and 2006. Since then the numbers have risen again.

It has meant in recent years there have been 0.16 more drugs being produced every year than there were in the 1970s.

'Pessimism'

Previous research projects which have found declines in the number of new medicines focused on smaller periods of time, the study said.

But it still said the rising costs of drug development and the increase in time in takes from to bring a new drug to the market remains an ongoing problem for the pharmaceutical industry.

Report author Dr Derek Ward said: "We started this research because there was a great deal of pessimism within the industry and among pharmaceutical companies about the number of new drugs that were getting to the market.

"We found that looking at the data over the longer term there was a slight increase. This is obviously a good thing for patients, if more new medicines are becoming available."

Dr Phil L'Huillier, from Cancer Research Technology, part of Cancer Research UK, said: "This is encouraging news. Although the cost of developing drugs is accelerating, meaning that the number of drugs per pound invested in research and development is decreasing, there is a wealth of innovation in UK drug discovery.

"The landscape is shifting with pharmaceutical companies increasingly collaborating with academia for discovery and development of drugs. This more collaborative model is being applied to the high-risk innovative early stages of drug discovery, with companies taking on the highly expensive later stage development.

"Cancer Research Technology has recently launched a £50M fund to stimulate investment in drugs discovery in the UK to support innovative early-stage drugs discovery and development and bridge the gap between work carried out in the lab right up to early phase clinical trials to prove drugs can benefit for patients."

Association of the British Pharmaceutical Industry chief executive Stephen Whitehead said: "It is a common myth that our industry has struggled to develop new medicines, when in reality the research pipelines of companies are healthy."

21.24 | 0 komentar | Read More

NHS waiting list information 'poor'

21 February 2013 Last updated at 05:22 ET By Andrew Black Political reporter, BBC Scotland

Scotland's public sector watchdog said it was unable to say whether NHS waiting list manipulation had taken place, due to "poor" information.

In a small number of cases, it said patients were inappropriately marked as unavailable for treatment, but could not say whether these were deliberate.

Audit Scotland said the management and scrutiny of the system "had not been good enough".

Health Secretary Alex Neil insisted the problem was "historical".

Speaking on BBC Radio Scotland's Good Morning Scotland programme, the minister admitted that IT systems had not been robust enough but that was now changing.

He added that the ability to list patients as "socially unavailable", thereby removing them from the waiting time system, no longer existed.

Audit Scotland investigated after problems came to light in NHS Lothian and in Tayside.

They were criticised for removing patients from the 18-week waiting list when they refused to travel to England for treatment, marking them as "unavailable for social reasons".

Please turn on JavaScript. Media requires JavaScript to play.

It also emerged that some staff at NHS Tayside said they felt under pressure to say patients were "unavailable" for appointments in order to meet waiting-times targets.

The latest Audit Scotland report - which covered the period when Lothian waiting lists were being manipulated, between April and December 2011 - said there was "widespread use across Scotland" of the social unavailability patient code during that time.

It said use of the code rose from 11% of patients in 2008 to more than 30% in mid-2011, which came during a time when waiting time targets were being shortened.

Audit Scotland also said key areas of waiting time systems were inadequate.

It said limited information in the records of patients waiting for treatment meant it was not always possible to identify changes or check that status codes were applied appropriately.

'Better scrutiny'

The figure started dropping at the end of that year, but Audit Scotland said the reason for this was unclear due to the lack of available information.

"Audit Scotland found a small number of instances where unavailability codes were used inappropriately," the watchdog stated.

"Due to the poor information, it was not possible to determine whether these were due to human error, inconsistent interpretation of guidance, or deliberate manipulation."

Scotland's auditor general, Caroline Gardner, said: "The management and scrutiny of the waiting-list systems have not been good enough.

"During the period we reviewed, the Scottish government and boards were focussed on making sure waiting times targets were being met but not giving enough attention to how this was being done.

"Better scrutiny of the increasing use of social unavailability codes could have highlighted concerns earlier. It also could have identified where waiting times pressures were building in the system."

Continue reading the main story

NHS Greater Glasgow and Clyde: In the electronic system used in the south of Glasgow, the full patient record was not accessible once a patient was removed from the waiting list.

NHS Grampian: Records often had no information recorded about why social unavailability was applied.

NHS Forth Valley: Good practice in the way information was recorded in its electronic waiting list system, with detailed notes in patient records.

Covers period from April-December, 2011

Mr Neil said most of the recommendations in the Audit Scotland report were already being implemented.

He told the BBC: "Patients are happy with the waiting times, what we are unhappy with is - now an historical situation - is the lack of robustness in some of the IT systems to record the detail of information that we need."

Mr Neil said the social unavailability code was replaced in October by a new system giving patients more flexibility to agree when they want to be treated.

The explicit agreement of patients is also needed if they want their treatment to be delayed.

The minister has announced that a pilot phone line for patients seeking advice on waiting times will be opened later this year.

The health secretary said work was also under way to make sure patients knew their rights.

Labour health spokeswoman Jackie Baillie said: "This report makes clear that hidden waiting lists were widespread, not just in Lothian, and the SNP government was aware there was a problem and did nothing.

'Bizarre rise'

"It preferred to believe it's own spin and hype than concern itself with what was really going on in our hospitals."

Scottish Conservative deputy leader Jackson Carlaw added: "If you look at the trends presented here, it is difficult to reach any other conclusion than the deception used by NHS Lothian may well have been mirrored elsewhere.

"If that isn't the case, the Scottish government needs to explain why there was such a bizarre rise in patients who became unavailable over a fairly short period of time."

Liberal Democrat MSP Jim Hume said: "This report takes the gloss off of the SNP government's record on waiting times targets.

"People across Scotland will find the report's findings disappointing and unsettling given that, prior to the waiting-times scandal coming to light, as many as 30% of inpatients in Scotland were marked as socially unavailable."

Iain Gray, convener of Holyrood's cross-party audit committee, said it would be looking into the issues raised in the report, adding: "Patient wait times are a major NHS performance target and extremely important to the patients themselves."

21.24 | 0 komentar | Read More

Sars-like virus death reported in UK

19 February 2013 Last updated at 05:47 ET By James Gallagher Health and science reporter, BBC News

A patient infected with a new respiratory illness similar to the deadly Sars virus has died in the UK.

He was being treated at the Queen Elizabeth Hospital in Birmingham and died on Sunday morning, the hospital has confirmed.

Of the 12 people known to have been infected with the virus around the world, six have died.

The threat to the general population is thought to be small, although the virus has shown signs of spreading in people.

Three members of the same family have been infected with the virus in the UK as well as another patient who was flown in from Qatar for treatment.

It is thought one family member picked up the virus while travelling to the Middle East and Pakistan and then the virus spread to his son and another family member.

The son, who died, had a weakened immune system, which would have left him more vulnerable to the infection.

Continue reading the main story

Saudi Arabia: Five cases, three deaths

Jordan: Two cases, two deaths

UK: Four cases, one death

Germany: One case, flown from Qatar

Total: 12 cases, six deaths

Source: Health Protection Agency/World Health Organization

The hospital said it extended its sympathies to the family and was working with the Health Protection Agency to test other people who may have come into contact with the virus.

The infection causes pneumonia and sometimes kidney failure.

The exact source of the new virus and how it spreads is still unknown. The leading theory is that it comes from animals and the new Sars-like virus does appear to be closely related to a virus in bats.

The threat posed by the virus is thought to be low as it struggles to spread in people.

Please turn on JavaScript. Media requires JavaScript to play.

Speaking on Thursday, Dr Paul Cosford, deputy chief executive at the HPA, said: "It appears very difficult to catch"

Prof John Watson, head of the respiratory diseases department at the Health Protection Agency, said: "The routes of transmission to humans of the novel coronavirus have not yet been fully determined, but the recent UK experience provides strong evidence of human-to-human transmission in at least some circumstances.

"The three recent cases in the UK represent an important opportunity to obtain more information about the characteristics of this infection in humans and risk factors for its acquisition, particularly in the light of the first ever recorded instance of apparently lower severity of illness in one of the cases.

"The risk of infection in contacts in most circumstances is still considered to be low and the risk associated with novel coronavirus to the general UK population remains very low."

Prof Ian Jones, from the University of Reading, said: "Given the previous health status of the patient it may be premature to assume the death was a result of the infection but even if it was, it is unlikely to signify a change in the virus.

"No general virus spread has been reported meaning the risk to the public remains very low."

21.24 | 0 komentar | Read More

'Bionic legs' for military amputees

19 February 2013 Last updated at 06:58 ET

Injured military personnel who have legs amputated are to be given the most up-to-date prosthetic limbs after the government set aside £6.5m for them.

The micro-processor limbs, known as "bionic legs", will be available to service personnel who have been wounded in Iraq or Afghanistan and will offer them greater stability and mobility.

The move is expected to benefit about 160 members of the armed forces.

The Help for Heroes charity said the money would help "transform lives".

Defence Secretary Philip Hammond said it was a top priority to give troops the best possible care and support.

Chancellor George Osborne, who is making the money available from the Treasury's special reserve, added: "Our troops are heroes who have and continue to give absolutely everything for their country and it is only right that we do everything possible to help them, especially when they suffer injury.

Walk backwards

"I am delighted, therefore, that we have been able to make funding available for this cutting-edge prosthetic technology, which will go a long way to improving the lives of people who have done so much for the UK."

Please turn on JavaScript. Media requires JavaScript to play.

Defence Minister Mark Francois says the money will provide "the best, most capable legs"

Experts say the "bionic legs" - the same as those used by Paralympics discus thrower and former soldier Derek Derenalagi - will significantly improve the quality of life and speed of rehabilitation for amputees.

The new technology provides better stability and greater mobility, as well as improvements in the ability to step over obstacles, negotiate stairs and walk backwards safely.

The limbs will be fitted where clinically appropriate at the Headley Court military rehabilitation centre in Surrey.

Please turn on JavaScript. Media requires JavaScript to play.

Captain Nick Beighton: "I'm a typical soldier, we want the newest, shiniest things."

Paralympic rower Captain Nick Beighton, who lost both legs in an explosion during a foot patrol in Afghanistan in 2009, welcomed the micro processor limbs as a "big step up in technology".

"To have the opportunity to try it and to use it and get the latest technology is fabulous for us because it just gives us that freedom to get out and do more things and have greater functionality and more independence," said the 31-year-old London 2012 competitor.

'Proven benefits'

Surgeon General Air Marshal Paul Evans said: "The next generation of micro processor knee is a fantastic prosthetic development and now seen to have proven benefits for certain amputees. It will improve the quality of life and rehabilitation for our patients, where it is clinically suitable.

"Not only does it provide better stability and improved mobility but will also help reduce back pain and aid rehabilitation generally."

Bryn Parry, chief executive of the Help for Heroes charity, said: "Our wounded servicemen, women and veterans deserve the best. This announcement will help transform lives.

"We must remember that there is no one-size-fits-all solution and that each individual must be given the best prosthetic for them."

21.24 | 0 komentar | Read More

IVF guidelines raise age limit to 42

19 February 2013 Last updated at 20:34 ET By James Gallagher Health and science reporter, BBC News

Couples struggling to have a baby should get fertility treatment more quickly and older women should gain access to IVF, new NHS guidelines say.

IVF should be offered after two years of failed attempts, not the current three, says the National Institute for Health and Clinical Excellence.

And the upper age limit should rise from 39 to 42 in England and Wales.

Some fertility experts fear the guidelines may not lead to changes because they are not binding.

In the past, NHS trusts have struggled to find the money to meet the IVF recommendations.

A report in 2011, showed one in four NHS trusts offered the full three cycles. Each round costs £3,000.

Around one in every seven heterosexual couples in the UK who are trying for a baby experience problems conceiving a child.

Please turn on JavaScript. Media requires JavaScript to play.

The Oxford Fertility Unit's Tim Child said will give hope to many couples.

In 2011, nearly 14,000 women became pregnant through IVF.

The new guidelines, which apply to England and Wales only, state that women aged between 40 and 42 should be offered one cycle of IVF as long as it is their first time and they have enough eggs.

The age limit for NHS-funded fertility treatment is 38 in Scotland and 39 in Northern Ireland, according to the Human Fertilisation and Embryology Authority.

Tim Child, who helped devise the guidelines and is the director of the Oxford Fertility Unit, said the decision was not taken lightly.

"When a woman reaches her mid-30s her fertility begins to decline, even more so from her late 30s.

"However, many women do conceive naturally in the 40 to 42 year age group. But for those who can't, and who have been diagnosed with the medical condition of infertility, then improvement in IVF success rates over the last decade mean that we are now able to offer cost-effective treatment with a single IVF cycle."

Medical advances mean this age group has similar success rates to that of younger women when the original guidelines were introduced in 2004.

The update still recommends women under 40 are offered three cycles of IVF.

Some fertility experts raised concerns that the expanded recommendations may not happen in reality.

Dr Sue Avery, a spokesperson for the British Fertility Society and from Birmingham Women's Fertility Centre, told the BBC: "It's good that there's the possibility there, but the funding does not match.

"I can't see any prospect of it happening immediately. Our biggest concern is hanging on to the funding we've got."

The guidelines also introduced rules designed to significantly reduce the number of twins and triplets being born.

'Increased risks'

Multiple births, a consequence of implanting more than one embryo to increase the odds of success, are one of the biggest risks associated with IVF for both mother and child.

Twins tend to be born smaller and earlier - triplets even more so.

Women under the age of 37 should have only one embryo transferred in their first cycle.

Please turn on JavaScript. Media requires JavaScript to play.

Caroline Wood: "We were fortunate, we could afford the treatment"

Subsequent cycles, and cycles in older women, can consider implanting two embryos.

Most couples should no longer be offered intrauterine insemination on the NHS, as its results are no better than sex.

However, when there is not an option - such as same sex couples and patients with certain disabilities - it would still be an option.

Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said fertility problems could have a devastating effect on couples.

He welcomed the guidelines, but warned there were risks attached.

"The recommendation that IVF treatment be made available up to the age of 42 provides more choice for women, but they should still be aware of the increased risks associated with pregnancy at advanced maternal age," he said.

21.24 | 0 komentar | Read More