Cancer waiting time targets slip

30 May 2014 Last updated at 18:03

A key government target for treating people diagnosed with suspected cancer has been breached for the first time since it was introduced in 2009.

NHS England guidelines say that 85% of patients should wait a maximum of 62 days to begin their first treatment following referral from their GP.

But figures show this slipped to 84.4% from January to March this year.

Charities Cancer Research UK and Macmillan Cancer Support both said it was a worrying sign.

Continue reading the main story

"Start Quote

The UK already has some of the worst cancer survival rates in Europe. "

End Quote Mike Hobday Macmillan Cancer Support

The target for treating people diagnosed with cancer within 62 days fell from 85.8% during the previous quarter to 84.4% in the first three months of 2014.

Mike Hobday, director of policy and research at Macmillan Cancer Support, said the number of trusts missing this target had doubled over the last year.

"This is a clear warning sign that the NHS is under huge strain.

"The UK already has some of the worst cancer survival rates in Europe.

"More patients are now facing delays, which means more patients are facing anxiety for longer and more lives are being put at risk.

"We're very worried that the coordination of cancer care is getting worse and that cancer is being overlooked in the new NHS."

He said cancer patients were set to increase from two million to three million by 2020.

Sarah Woolnough, executive director of policy and information at Cancer Research UK, said some patients were being failed.

"The breach of the '62 day target' is very concerning, particularly as four in 10 of those who aren't treated within two months are having to wait three months or more.

"These targets exist to encourage swift diagnosis of cancer and access to treatment, which is vital to improve survival rates.

Continue reading the main story

"Start Quote

There is variation in meeting the challenging standards, and national performance against one of the targets has dipped"

End Quote Sean Duffy NHS England

"Patients want confidence that suspected cancer is taken seriously and prioritised by the NHS. We hope urgent action will be taken to ensure this breach is a one off."

Performance dip

Sean Duffy, national clinical director for cancer for NHS England, said work must be done to make sure standards are met.

"It is vital cancer patients are diagnosed and treated quickly so they have the best possible chance of recovery," he said.

"Latest figures show nationally the NHS has met and exceeded seven out of eight cancer waiting time standards. But there is variation in meeting the challenging standards, and national performance against one of the targets has dipped."

He said clinical commissioning groups (CCGs) were working with local providers in areas where the standard is not being met to ensure patients are treated quickly.

Other figures released by NHS England on cancer waiting times showed the number of people seen by a specialist within two weeks of an urgent GP referral for suspected cancer also dropped from 95.6% to 95%.

For people urgently referred for breast symptoms, where cancer is not suspected, 93.9% are being seen within two weeks, compared to 95.5% previously. The target is 93%.

In total, 60,425 patients with breast symptoms where cancer was not initially suspected were seen in the first three months of this year after being urgently referred.

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New NHS boss backs smaller hospitals

30 May 2014 Last updated at 22:52

Smaller community hospitals should play a bigger role especially in the care of older patients, the new head of the NHS in England has said.

In an interview in the Daily Telegraph, Simon Stevens signalled a marked change in policy by calling for a shift away from big centralised hospitals.

The health service chief executive said there needed to be new models of care built around smaller local hospitals.

The NHS said he was not suggesting the return of 50s-style cottage hospitals.

In recent years the health service has emphasised the benefits of centralised services.

This has paid dividends in areas such as stroke care and major trauma where significant benefits have been gained by concentrating specialist care.

But this has raised questions about the future of the many smaller district general hospitals across the NHS.

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In the interview in Friday's paper, Mr Stevens said they should play an important part in providing care, especially for the growing number of older patents who could be treated closer to home.

He said: "A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS.

"Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised."

Hospital closures

Simon Stevens' support for smaller hospitals comes as, in some parts of England, such hospitals close.

On Tuesday the closure of Ashby District Hospital in Leicestershire was announced.

A commissioning group said the 16-bed hospital needed £900,000 of repairs and was underused, and said it wanted to provide "more services closer to people's homes".

Earlier this month a health trust said Poltair Hospital in Cornwall would close, saying the "cost of backlog maintenance work to meet current standards is too expensive".

But West Cornwall Health Watch said the decision was based on "dangerously unproven assumptions" and West Cornwall MP Andrew George called it a "backward step".

Lowestoft Hospital in Suffolk closed its 25-bed inpatient facility at the end of March and the main hospital building is due to close later this year.

The hospital's north wing is to be redeveloped to offer services including phlebotomy and outpatient clinics.

But Lowestoft Coalition Against the Cuts said many elderly people would suffer owing to the closure of such "excellent local hospitals".

Mr Stevens said elderly patients were increasingly ending up in hospital unnecessarily because they had not been given care which could have kept them at home.

Mr Stevens also told the Telegraph:

• The NHS needed to abandon a fixation with "mass centralisation" and instead invest in community services to care for the elderly
• Waiting targets introduced by Labour became "an impediment to care" in too many cases
• The European Working Time Directive damaged health care in the NHS, making it harder to keep small hospitals open
• Businesses should financially reward employees for losing weight and adopting healthy lifestyles

An NHS England source said Mr Stevens was saying that smaller hospitals had a part to play in shifting services into the community, not that there would be no closures of local hospitals in the future.

Helen Tucker, vice president of the Community Hospitals Association, told BBC Radio 4's Today programme Mr Stevens' comments were "great news", sending a "good, strong message that small is beautiful".

A "balance is needed" with centralised specialist hospitals, she said, but smaller institutions were "the hospitals that local communities really value," she said.

Mr Stevens, a former adviser on health to Tony Blair, will outline his vision for the NHS in a major speech at the NHS Confederation conference in Liverpool on Wednesday.

Analysis

By Dominic Hughes, BBC health correspondent

In recent years the health service in England has emphasised the benefits of centralised services.

So those suffering from a stroke or a heart attack might be taken to a specialist centre rather than the local hospital.

But with only limited resources, the future of smaller district general and community hospitals has been less clear.

Now Simon Stevens, the new chief executive of the NHS in England, says they should play an important part in providing care - especially for older patents who could be treated closer to home.

That might mean they take over GP services or community care.

But what he is not calling for is a return to 1950s-style cottage hospitals nor is he saying that no hospitals will close.

It is more subtle - that the debate in the NHS has focused too much on centralisation and there is still a place for smaller local hospitals.

Chris Ham, the chief executive of the King's Fund think tank, told the BBC the plans could lead to "much more joined up, coordinated care that many older people need".

He added: "We know much of the demand for hospital care these days is for routine acute care for growing numbers of older people.

Continue reading the main story

We know much of the demand for hospital care these days is for routine acute care for growing numbers of older people"

End Quote Chris Ham King's Fund

"What they want is a really good, local, accessible hospital, there for them when they need it.

"This message is quite right, it will be welcomed by many people."

'Recalibrating'

Ruthe Isden, from charity Age UK, said Mr Stevens' comments were "very welcome to us" and she looked forward to hearing more details in his speech next week.

Speaking to BBC News, she said his views signalled a change in tone in the way the NHS is moving.

"In recent years, there has been a lot of thinking about specialist care but we also need to think about wrap-around, community care.

"This is a recalibrating of the way we think about these issues."

She added: "We need to invest in services which look at the holistic needs of the elderly. Things like social care, making sure they don't get lonely and that they are given opportunities to exercise.

"It's a case of not just seeing medical care as the answer to everything."

Katherine Murphy, the chief executive of the Patients Association, said: "For older patients in particular, the prospect of having to travel great distances to get to hospital can be daunting and inconvenient.

"Elderly people need to be treated close to home, with an emphasis on compassion, privacy, dignity and respect.

"In addition, there is a need to have a workforce in place that is trained to look after older people."

Mr Stevens took up the post of chief executive of the NHS in England after 11 years working for private health care firms in Europe, the US and South America.

The Scottish government said it was working to improve "intermediate care" as a "bridge between hospital and home".

Northern Ireland health minister Edwin Poots commissioned a review which said services should be provided "in the community, closer to people's homes where possible".

He said "significant progress" was now being made.

A spokesman for the Welsh government said it was "good to see England following Wales' lead on this issue".

Changes to the NHS in Wales were introduced in 2009 to "provide more care closer to people's homes".

"We have long recognised the important role of a community care-led NHS, which is integrated with social care, in delivering care to patients closer to their homes," the spokesman added.

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Babies can learn to love vegetables

31 May 2014 Last updated at 00:00

Children can learn to eat new vegetables if they are introduced regularly before the age of two, suggests a University of Leeds study.

Even fussy eaters can be encouraged to eat more greens if they are offered them five to 10 times, it found.

The research team gave artichoke puree to 332 children aged between four and 38 months from the UK, France and Denmark.

One in five cleared their plates while 40% learned to like artichoke.

Continue reading the main story

"Start Quote

After 24 months children become reluctant to try new things and start to reject foods"

End Quote Prof Marion Hetherington University of Leeds

The study also dispelled the popular myth that vegetable tastes need to be masked in order for children to eat them.

During the study, each child was given between five and 10 servings of at least 100g of artichoke puree.

The puree was either served straight, or sweetened with added sugar, or vegetable oil was mixed into the puree to add energy.

The researchers found there was little difference in the amount eaten over time between those who were fed the basic puree and those who had the sweetened one, suggesting that making vegetables sweeter does not encourage children to eat more.

Overall, they did find that younger children ate more artichoke than older children in the study.

Prof Marion Hetherington, study author from the Institute of Psychological Sciences at Leeds, said this was because children become picky and wary at a certain age.

"If they are under two they will eat new vegetables because they tend to be willing and open to new experiences.

"After 24 months, children become reluctant to try new things and start to reject foods - even those they previously liked."

Most children in the study were found to be "learners" (40%), who ate more artichoke over time.

Continue reading the main story

"Start Quote

If you want to encourage your children to eat vegetables, make sure you start early and often"

End Quote Prof Hetherington

Twenty-one per cent consumed more than three-quarters of their serving each time and were labelled "plate-clearers".

"Non-eaters" made up 16% of the children because they ate less than 10g even when it was offered for a fifth time, while the rest did not conform to any one group.

Prof Hetherington said her research, which is published in the journal PLOS ONE and funded by the EU, offered some valuable guidance to parents who want to encourage healthy diets in their children.

"If you want to encourage your children to eat vegetables, make sure you start early and often.

"Even if your child is fussy or does not like veggies, our study shows that five to 10 exposures will do the trick."

Globe artichoke was chosen as the vegetable in the study because parents said it was one of the vegetables they were least likely to cook.

NHS guidelines are to start weaning children on to solid foods at six months.

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Drugs to treat alcohol top £3m

29 May 2014 Last updated at 12:01

There were a million hospital admissions related to alcohol last year in England and £3.13m was spent on prescription drugs to treat alcohol dependency.

The Health and Social Care Information Centre's latest report shows that 65% of adults admitted were men, but more under-16 girls than boys were admitted.

Frequent drinking among men and women continues to fall.

Deaths from alcohol in England also decreased by 4% to 6,490.

The HSCIC figures, contained in Statistics on Alcohol - England, 2014 uses a number of sources of information to calculate alcohol-related hospital admissions.

The centre also gauges drinking behaviour among adults and schoolchildren in England.

Its report shows that of the 1,008,850 hospital admissions in England related to alcohol last year, where a disease, injury or condition is the main or secondary reason for admission, the majority were male patients.

But among under-16s, females were in the majority, with 2,480 admitted in 2012-13, compared with 1,890 males.

The North East of England recorded the highest rate of alcohol-related admissions (2,500 per 100,000 population) and the South East recorded the lowest (1,500 per 100,000 population).

The cost of prescribing drugs to treat alcohol dependency rose by around £200,000 to £3.13m in 2012. This is the first time the tally has reached £3m.

More than 183,000 items were prescribed in 2013.

Drinking down

However, although this cost is increasing, the HSCIC Health Survey for England suggests that the percentage of people in Great Britain who drink regularly is decreasing.

Between 2005 and 2012 the percentage who drank alcohol in the week before being interviewed fell from 72% to 64% for men, and from 57% to 52% for women.

The survey also shows that the percentage of men who drank alcohol on at least five days in the week declined from 22% to 14%.

The percentage of women who drank frequently fell from 13% to 9%.

Kingsley Manning, chair of the HSCIC, said: "Today's report highlights one of the areas of impact that alcohol dependence has on our NHS. The fact there has been a rise of nearly 70% in the prescribing of alcohol dependence drugs over the last decade is striking.

"These data provide an insight into the effect of alcohol on services, and will offer a better understanding to the public, health professionals and policymakers into this ongoing public health issue."

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Call to 'resist e-cigarette controls'

29 May 2014 Last updated at 09:34 By Jane Dreaper Health correspondent, BBC News

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Some doctors argue it is too early to know whether benefits outweigh potential risks, as Jane Dreaper reports

A letter signed by more than 50 researchers and public health specialists is urging the World Health Organization (WHO) to "resist the urge to control and suppress e-cigarettes".

The letter says the devices - which deliver nicotine in a vapour - could be a "significant health innovation".

But the UK's Faculty of Public Health says it is too early to know whether benefits outweigh potential risks.

The WHO said it was still deciding what recommendations to make to governments.

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The open letter has been organised in the run-up to significant international negotiations on tobacco policy this year.

Supporters of e-cigarettes, who argue the products are a low-risk substitute for smoking, fear they might become subject to reduction targets and advertising bans.

1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on

2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge

3. Liquid nicotine becomes vapour and is inhaled. The 'smoke' produced is largely water vapour. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow.

There has been a big growth in the market for e-cigarettes, but the Department of Health says they are not risk-free.

Critics say not enough is known about their long-term health effects. A recent report commissioned by Public Health England said e-cigarettes required "appropriate regulation, careful monitoring and risk management" if their benefits were to be maximised.

The letter has been signed by 53 researchers - including specialists in public health policy and experts such as Prof Robert West, who published research last week suggesting that e-cigarettes are more likely to help people give up smoking than some conventional methods.

Continue reading the main story

"Start Quote

We are deeply concerned that classifying these products as tobacco will do more harm than good"

End Quote Open letter to the WHO

Some of the signatories work on research into tobacco science and smoking cessation. Three were involved in advising the National Institute for Health and Care Excellence (NICE) on its guidelines about reducing the harm from tobacco.

'Perverse effect'

The letter says: "These products could be among the most significant health innovations of the 21st Century - perhaps saving hundreds of millions of lives.

"If regulators treat low-risk nicotine products as traditional tobacco products... they are improperly defining them as part of the problem.

"Regulators should avoid support for measures that could have the perverse effect of prolonging cigarette consumption.

"We are deeply concerned that the classification of these products as tobacco will do more harm than good.

"The potential for tobacco harm reduction products to reduce the burden of smoking-related disease is very large."

The organisers of the letter quote a leaked WHO document that refers to e-cigarettes as a "threat... which could result in a new wave of the tobacco epidemic".

The WHO treaty on tobacco control currently covers 178 countries and 90% of the world's population.

E-cigarettes are battery-powered devices that mimic the experience of smoking. Users inhale a vapour from a heated liquid that contains a concentration of nicotine.

Prof West, of University College London told the BBC e-cigarettes should be "regulated appropriate to what they are" and that they are "orders of magnitude safer" than tobacco cigarettes.

He called for "bespoke regulation", including banning sales for under-18s and having marketing directed at those who already smoke.

Continue reading the main story

"Start Quote

We need to weigh up the benefits of fewer people smoking against the risk of electronic cigarettes leading to more people starting to smoke"

End Quote Prof John Ashton Faculty of Public Health

A WHO spokesman said: "WHO is currently working on recommendations for governments on the regulation and marketing of e-cigarettes and similar devices.

"This is part of a paper that will be submitted to the parties of the WHO Framework Convention on Tobacco Control later this year.

"We are also working with national regulatory bodies to look at regulatory options, as well as toxicology experts, to understand more about the possible impact of e-cigarettes and similar devices on health."

The British Medical Association (BMA) has called for stronger regulation of the devices in the UK.

Dr Vivienne Nathanson, the BMA's director of professional activities, told BBC Breakfast there was evidence that children who had never smoked were starting to use e-cigarettes, having been influenced by marketing campaigns.

"Rather like cigarettes in the 50s and 60s, we really need to look at that and, I believe, ban it (advertising), to stop them advertising in a way that attracts children," she added.

Prof John Ashton, president of the Faculty of Public Health, said he was also concerned about children using e-cigarettes.

'No uniformity'

"We need to weigh up the benefits of fewer people smoking against the risk of electronic cigarettes leading to more people starting to smoke, particularly children," he said.

Prof Martin McKee, of the London School of Hygiene and Tropical Medicine, said: "The health community is completely divided on the subject of whether electronic cigarettes are safer than real cigarettes.

"While the signatories to this letter are clearly supportive, the World Health Organization, correctly, bases its decisions on the best available evidence."

He said it would be "premature" to advocate the use of e-cigarettes until their safety had been established.

The Welsh government wants to restrict the use of e-cigarettes in enclosed public places, because of concerns that they normalise smoking.

Richard Evans, vice-chairman of the Welsh Pharmacy Board, which is part of the Royal Pharmaceutical Society in Wales, believes they should be regulated in the same way as traditional cigarettes.

He said: "At the moment the products that are on the market - we don't know what standard they are. They can vary from product to product - there is no uniformity at all.

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Possible cynicism link to dementia

29 May 2014 Last updated at 13:33 By Pippa Stephens Health reporter, BBC News

People who have a cynical distrust of others, and think their motives are selfish, could have a higher risk of developing dementia, a study has said.

Researchers compared levels of cynical distrust in 622 people with the incidence of dementia.

They said people with high levels of distrust were twice as likely to develop dementia.

Experts said any findings that helped understand the disease were important, but called for larger studies.

Continue reading the main story

"Start Quote

People's view on life and personality may have an impact on their health"

End Quote Dr Anna-Maija Tolppanen University of Eastern Finland

Personality and disease

Dementia is a syndrome categorised by a decline in memory, thinking speed, mental agility, language, understanding and judgement.

One in three people aged over 65 in Britain will develop dementia, according to the Alzheimer's Society in the UK.

In 1998, volunteers, with an average age of 71, were asked to rate their agreement with statements such as "I think people would lie to get ahead", or "it is safer to trust nobody", said the researchers.

Scientists at the University of Eastern Finland said 46 people had developed dementia in the following decade.

Fourteen of the 164 people who showed high levels of cynical distrust in 1998 had developed dementia in this time, compared with nine out of the 212 people with low levels.

Dr Anna-Maija Tolppanen at the University of Eastern Finland led the study.

She said: "These results add to the evidence that people's view on life and personality may have an impact on their health."

Continue reading the main story

"Start Quote

The biggest risk factor for dementia is age, by far"

End Quote Dr Simon Ridley Alzheimer's Research UK

Explaining the results, Dr Tolppanen said: "People with different personality traits may be more or less likely to engage in activities that are beneficial for cognition, such as healthy diet, cognitive or social activities, or exercise.

"Or personality may act via morphological changes or structural differences in brains. Also, inflammation has been suggested as one link between cynicism and worse health outcomes."

She said the study was controlled for socioeconomic factors, age, sex, health status, and lifestyle, such as smoking and alcohol use.

Role of depression

But Dr Tolppanen said she had not accounted for people becoming depressed after the first stage of the assessment, or that the volunteers' depression might not have showed up adequately in questionnaires.

She added it was "really important" to replicate the findings on a much larger scale, to prove the link.

Dr Simon Ridley, head of research at Alzheimer's Research UK, said: "With the rising numbers of people affected with dementia, any addition our understanding of what might affect disease development is important."

He said that as only a small number of people in the study developed dementia, he would want to see a larger study conducted to be "more confident" in the proposed link.

Dr Ridley said the volunteers with a high level of cynical distrust could have been already beginning to develop dementia, and that depression, which may be both a risk factor and a symptom for dementia, could account for the cynicism.

"The biggest risk factor for dementia is age, by far," he said.

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Hospital admissions cut plan 'risky'

23 May 2014 Last updated at 01:02

A £3.8bn scheme to cut hospital admissions in England and treat more people at home is risky, and "overly optimistic", health researchers warn.

Writing for the BBC News website's Scrubbing Up column, Nigel Edwards from the Nuffield Trust says the Better Care Fund, due to start in 2015, could even lead to more hospital admissions.

He says cutting the length of hospital stays would be more effective.

The government says pilots in 14 areas are already working well.

Continue reading the main story

"Start Quote

More can be done quickly by reducing patients' length of stay "

End Quote Nigel Edwards Nuffield Trust

Mr Edwards says there is a proportion - perhaps around 15% of hospital admissions - who could be cared for in the community if GP and nursing services were improved.

Then, he says, there are a number of patients who may be admitted to hospital for a day or two and, while they could be cared for at home, the diagnostic and expert resources needed may well be the same.

He says the real issue is about those patients who remain in hospital for longer.

Care elsewhere

Writing in Scrubbing Up Mr Edwards says: "Most beds are occupied by relatively small numbers of patients who stay a long time.

"In fact, in medical wards 10% of the patients that stay in hospital for more than a week use over 71% of the beds.

Continue reading the main story

"Start Quote

It's a new joined-up approach which will transform patient care"

End Quote Norman Lamb Health minister

"More can be done quickly by reducing patients' length of stay.

"A large proportion of patients could be more effectively cared for elsewhere. This will require better social care, community services and new types of care."

The Foundation Trust Network, which represents NHS trusts which look after their own finances, said the fund was a "step in the right direction" but warned it carries "significant risk that needs to be managed".

Greatest need

Sir Merrick Cockell, chairman of the Local Government Association, said local areas piloting the fund were already going "above and beyond" what had been expected.

He added: "Most areas are now confident they will be able to provide services seven days a week, identify a lead professional for those in greatest need and use patients' NHS numbers to share information."

Sir Merrick said: "Increasing demand means that councils need an extra £400m each year just to maintain services at current levels.

Continue reading the main story

"Start Quote

The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year"

End Quote Sir Merrick Cockell, Local Government Association

"However, the BCF was never intended to solve the issues related to distressed health economies.

"The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year.

"It is the opportunity to transform and improve the lives of those using health and care services over the medium and long term at a lower cost."

Health Minister Norman Lamb said: "The Better Care Fund isn't just about cutting hospital admissions - it's about reducing the time people spend in hospital, having services closer to home and preventing people from getting ill in the first place.

"It's a new joined-up approach which will transform patient care."

He added: "No-one said it's going to be easy, which is why we are working closely with local areas to get their plans for integration right.

"But when we do, patients will get better care in the community and the NHS will be able to focus its attention on those who need it most. "

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Abortion clinic guidance published

23 May 2014 Last updated at 14:16

New guidance issued for abortion clinics in England makes clear that terminating a pregnancy on the grounds of gender alone is illegal.

It also states "pre-signing" abortion certificates without considering a woman's individual case is illegal.

The Department of Health guidance is being published after concerns over both issues were raised.

It will now assess abortion providers to ensure they are abiding by the updated rules.

The 113 independent clinics providing abortions for the NHS must do so in order to be re-approved to provide the service by the Health Secretary.

Officials say they do not expect to find any major problems.

Good practice

Concerns over sex selection were raised after secret filming by the Daily Telegraph appeared to show two doctors agreeing terminations of female foetuses could go ahead.

However no charges were brought - and the Crown Prosecution Service said it was satisfied there was no intention to proceed with a termination.

A subsequent investigation into the work of abortion clinics found 14 were pre-signing certificates.

The law says two doctors have to certify an abortion under the terms of the 1967 Abortion Act.

But pre-signing suggests the second doctor has not considered that woman's individual case.

Under the updated guidance, doctors are reminded that pre-signing forms is not allowed and both doctors have a legal duty to certify abortions "in good faith".

The updated guidance restates the rules governing abortions. It says:

• abortion on the grounds of gender alone is not lawful
• two doctor need to certify that an abortion is permitted under the criteria in the 1967 Abortion Act and be prepared to justify their decision
• it is good practice for at least one of the doctors to have seen the pregnant woman
• pre-signing of certificates is "not compliant" with the Act

Updated annual birth ratio statistics for England and Wales for 2008-2012 have also been published by the department.

This data is broken down by the mother's country of birth and shows no evidence of sex selection occurring in the UK.

Ann Furedi, chief executive of the British Pregnancy Advisory Service which is a major provider of abortions for the NHS, said it abided by the guidance.

But she added: "There is no clinical need for two doctors to certify a woman's reasons for abortion, in addition to obtaining her consent - it simply causes delays."

Ann Scanlan, of the pro-life charity Life, said the organisation welcomed the re-emphasis on sex selection and pre-signing being against the law.

But Ms Scanlan said she was "disappointed but not surprised" that the guidance potentially allowed for neither of the two doctors certifying an abortion to actually see the woman concerned.

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Duchenne drug 'nears approval' in EU

24 May 2014 Last updated at 01:55

A drug to treat a particular form of Duchenne muscular dystrophy has been given the green light by the European Medicines Agency and could be available in the UK in six months.

Translarna is only relevant to patients with a 'nonsense mutation', who make up 10-15% of those affected by Duchenne.

The EMA decided not to pass the drug in January, but they have since re-examined the evidence.

A campaign group said the drug must reach the right children without delay.

Continue reading the main story

This decision by the EMA is fantastic news"

End Quote Robert Meadowcroft Muscular Dystrophy Campaign

There are currently no approved therapies available for this life-threatening condition.

The patients who will benefit the most are those aged five years and over who are still able to walk, the EMA said.

Duchenne muscular dystrophy is a genetic disease that gradually causes weakness and loss of muscle function.

Patients with the condition lack normal dystrophin, a protein found in muscles, which helps to protect muscles from injury.

In patients with the disease, the muscles become damaged and eventually stop working.

There are 2,400 children in the UK living with muscular dystrophy, but only those whose condition is caused by a particular 'nonsense mutation' - namely 200 children - are suitable to use Translarna.

Urgency in UK

The drug, ataluren, will be known by the brand name of Translarna in the EU. It was developed by PTC Therapeutics.

The next step will see the European Commission rubberstamp the EMA's scientific 'green light' within the next three months and authorise the drug to be marketed in the European Union.

At that point, individual member states, including the UK, must decide how it will be funded.

The Muscular Dystrophy Campaign is calling for urgent meetings with National Institute of Health of Clinical Excellence (NICE) and NHS England to discuss how Translarna can be cleared for approval and use in the UK.

It said families in the UK could have access to the drug by spring 2015.

Robert Meadowcroft, chief executive of the campaign, said: "This decision by the EMA is fantastic news.

"Most of those diagnosed with Duchenne muscular dystrophy, usually before the age of five, will use a powered wheelchair before they are 12, will not have the muscle strength to pick up a glass of water by the age of 20 and will not live to see their 30th birthday.

"This step forward for Translarna offers much needed hope."

He added that extending the numbers of patients taking Translarna would help to accelerate the development of the drug.

Clinical trials are still ongoing on the drug and the results will have to be sent to the EMA.

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Abortion clinic guidance published

23 May 2014 Last updated at 14:16

New guidance issued for abortion clinics in England makes clear that terminating a pregnancy on the grounds of gender alone is illegal.

It also states "pre-signing" abortion certificates without considering a woman's individual case is illegal.

The Department of Health guidance is being published after concerns over both issues were raised.

It will now assess abortion providers to ensure they are abiding by the updated rules.

The 113 independent clinics providing abortions for the NHS must do so in order to be re-approved to provide the service by the Health Secretary.

Officials say they do not expect to find any major problems.

Good practice

Concerns over sex selection were raised after secret filming by the Daily Telegraph appeared to show two doctors agreeing terminations of female foetuses could go ahead.

However no charges were brought - and the Crown Prosecution Service said it was satisfied there was no intention to proceed with a termination.

A subsequent investigation into the work of abortion clinics found 14 were pre-signing certificates.

The law says two doctors have to certify an abortion under the terms of the 1967 Abortion Act.

But pre-signing suggests the second doctor has not considered that woman's individual case.

Under the updated guidance, doctors are reminded that pre-signing forms is not allowed and both doctors have a legal duty to certify abortions "in good faith".

The updated guidance restates the rules governing abortions. It says:

• abortion on the grounds of gender alone is not lawful
• two doctor need to certify that an abortion is permitted under the criteria in the 1967 Abortion Act and be prepared to justify their decision
• it is good practice for at least one of the doctors to have seen the pregnant woman
• pre-signing of certificates is "not compliant" with the Act

Updated annual birth ratio statistics for England and Wales for 2008-2012 have also been published by the department.

This data is broken down by the mother's country of birth and shows no evidence of sex selection occurring in the UK.

Ann Furedi, chief executive of the British Pregnancy Advisory Service which is a major provider of abortions for the NHS, said it abided by the guidance.

But she added: "There is no clinical need for two doctors to certify a woman's reasons for abortion, in addition to obtaining her consent - it simply causes delays."

Ann Scanlan, of the pro-life charity Life, said the organisation welcomed the re-emphasis on sex selection and pre-signing being against the law.

But Ms Scanlan said she was "disappointed but not surprised" that the guidance potentially allowed for neither of the two doctors certifying an abortion to actually see the woman concerned.

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Hospital admissions cut plan 'risky'

23 May 2014 Last updated at 01:02

A £3.8bn scheme to cut hospital admissions in England and treat more people at home is risky, and "overly optimistic", health researchers warn.

Writing for the BBC News website's Scrubbing Up column, Nigel Edwards from the Nuffield Trust says the Better Care Fund, due to start in 2015, could even lead to more hospital admissions.

He says cutting the length of hospital stays would be more effective.

The government says pilots in 14 areas are already working well.

Continue reading the main story

"Start Quote

More can be done quickly by reducing patients' length of stay "

End Quote Nigel Edwards Nuffield Trust

Mr Edwards says there is a proportion - perhaps around 15% of hospital admissions - who could be cared for in the community if GP and nursing services were improved.

Then, he says, there are a number of patients who may be admitted to hospital for a day or two and, while they could be cared for at home, the diagnostic and expert resources needed may well be the same.

He says the real issue is about those patients who remain in hospital for longer.

Care elsewhere

Writing in Scrubbing Up Mr Edwards says: "Most beds are occupied by relatively small numbers of patients who stay a long time.

"In fact, in medical wards 10% of the patients that stay in hospital for more than a week use over 71% of the beds.

Continue reading the main story

"Start Quote

It's a new joined-up approach which will transform patient care"

End Quote Norman Lamb Health minister

"More can be done quickly by reducing patients' length of stay.

"A large proportion of patients could be more effectively cared for elsewhere. This will require better social care, community services and new types of care."

The Foundation Trust Network, which represents NHS trusts which look after their own finances, said the fund was a "step in the right direction" but warned it carries "significant risk that needs to be managed".

Greatest need

Sir Merrick Cockell, chairman of the Local Government Association, said local areas piloting the fund were already going "above and beyond" what had been expected.

He added: "Most areas are now confident they will be able to provide services seven days a week, identify a lead professional for those in greatest need and use patients' NHS numbers to share information."

Sir Merrick said: "Increasing demand means that councils need an extra £400m each year just to maintain services at current levels.

Continue reading the main story

"Start Quote

The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year"

End Quote Sir Merrick Cockell, Local Government Association

"However, the BCF was never intended to solve the issues related to distressed health economies.

"The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year.

"It is the opportunity to transform and improve the lives of those using health and care services over the medium and long term at a lower cost."

Health Minister Norman Lamb said: "The Better Care Fund isn't just about cutting hospital admissions - it's about reducing the time people spend in hospital, having services closer to home and preventing people from getting ill in the first place.

"It's a new joined-up approach which will transform patient care."

He added: "No-one said it's going to be easy, which is why we are working closely with local areas to get their plans for integration right.

"But when we do, patients will get better care in the community and the NHS will be able to focus its attention on those who need it most. "

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Duchenne drug 'nears approval' in EU

24 May 2014 Last updated at 01:55

A drug to treat a particular form of Duchenne muscular dystrophy has been given the green light by the European Medicines Agency and could be available in the UK in six months.

Translarna is only relevant to patients with a 'nonsense mutation', who make up 10-15% of those affected by Duchenne.

The EMA decided not to pass the drug in January, but they have since re-examined the evidence.

A campaign group said the drug must reach the right children without delay.

Continue reading the main story

This decision by the EMA is fantastic news"

End Quote Robert Meadowcroft Muscular Dystrophy Campaign

There are currently no approved therapies available for this life-threatening condition.

The patients who will benefit the most are those aged five years and over who are still able to walk, the EMA said.

Duchenne muscular dystrophy is a genetic disease that gradually causes weakness and loss of muscle function.

Patients with the condition lack normal dystrophin, a protein found in muscles, which helps to protect muscles from injury.

In patients with the disease, the muscles become damaged and eventually stop working.

There are 2,400 children in the UK living with muscular dystrophy, but only those whose condition is caused by a particular 'nonsense mutation' - namely 200 children - are suitable to use Translarna.

Urgency in UK

The drug, ataluren, will be known by the brand name of Translarna in the EU. It was developed by PTC Therapeutics.

The next step will see the European Commission rubberstamp the EMA's scientific 'green light' within the next three months and authorise the drug to be marketed in the European Union.

At that point, individual member states, including the UK, must decide how it will be funded.

The Muscular Dystrophy Campaign is calling for urgent meetings with National Institute of Health of Clinical Excellence (NICE) and NHS England to discuss how Translarna can be cleared for approval and use in the UK.

It said families in the UK could have access to the drug by spring 2015.

Robert Meadowcroft, chief executive of the campaign, said: "This decision by the EMA is fantastic news.

"Most of those diagnosed with Duchenne muscular dystrophy, usually before the age of five, will use a powered wheelchair before they are 12, will not have the muscle strength to pick up a glass of water by the age of 20 and will not live to see their 30th birthday.

"This step forward for Translarna offers much needed hope."

He added that extending the numbers of patients taking Translarna would help to accelerate the development of the drug.

Clinical trials are still ongoing on the drug and the results will have to be sent to the EMA.

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Hospital admissions cut plan 'risky'

23 May 2014 Last updated at 01:02

A £3.8bn scheme to cut hospital admissions in England and treat more people at home is risky, and "overly optimistic", health researchers warn.

Writing for the BBC News website's Scrubbing Up column, Nigel Edwards from the Nuffield Trust says the Better Care Fund, due to start in 2015, could even lead to more hospital admissions.

He says cutting the length of hospital stays would be more effective.

The government says pilots in 14 areas are already working well.

Continue reading the main story

"Start Quote

More can be done quickly by reducing patients' length of stay "

End Quote Nigel Edwards Nuffield Trust

Mr Edwards says there is a proportion - perhaps around 15% of hospital admissions - who could be cared for in the community if GP and nursing services were improved.

Then, he says, there are a number of patients who may be admitted to hospital for a day or two and, while they could be cared for at home, the diagnostic and expert resources needed may well be the same.

He says the real issue is about those patients who remain in hospital for longer.

Care elsewhere

Writing in Scrubbing Up Mr Edwards says: "Most beds are occupied by relatively small numbers of patients who stay a long time.

"In fact, in medical wards 10% of the patients that stay in hospital for more than a week use over 71% of the beds.

Continue reading the main story

"Start Quote

It's a new joined-up approach which will transform patient care"

End Quote Norman Lamb Health minister

"More can be done quickly by reducing patients' length of stay.

"A large proportion of patients could be more effectively cared for elsewhere. This will require better social care, community services and new types of care."

The Foundation Trust Network, which represents NHS trusts which look after their own finances, said the fund was a "step in the right direction" but warned it carries "significant risk that needs to be managed".

Greatest need

Sir Merrick Cockell, chairman of the Local Government Association, said local areas piloting the fund were already going "above and beyond" what had been expected.

He added: "Most areas are now confident they will be able to provide services seven days a week, identify a lead professional for those in greatest need and use patients' NHS numbers to share information."

Sir Merrick said: "Increasing demand means that councils need an extra £400m each year just to maintain services at current levels.

Continue reading the main story

"Start Quote

The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year"

End Quote Sir Merrick Cockell, Local Government Association

"However, the BCF was never intended to solve the issues related to distressed health economies.

"The Better Care Fund is not a quick-fix that will solve the problems of the health and social care system overnight and it is short-sighted to expect the BCF to payback results in its first year.

"It is the opportunity to transform and improve the lives of those using health and care services over the medium and long term at a lower cost."

Health Minister Norman Lamb said: "The Better Care Fund isn't just about cutting hospital admissions - it's about reducing the time people spend in hospital, having services closer to home and preventing people from getting ill in the first place.

"It's a new joined-up approach which will transform patient care."

He added: "No-one said it's going to be easy, which is why we are working closely with local areas to get their plans for integration right.

"But when we do, patients will get better care in the community and the NHS will be able to focus its attention on those who need it most. "

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Kidney dialysis machine for babies

23 May 2014 Last updated at 00:02

Italian scientists have designed a dialysis machine specifically to treat babies with kidney failure, which they say could improve treatment.

Dialysis machines for adults can cause complications when used in very young children, the Lancet study says.

The miniaturised machine has been tested on a newborn with multiple organ failure, whose kidney function was restored after 30 days.

UK experts warn dialysis is still very challenging, even with new equipment.

Continue reading the main story

"Start Quote

We do already treat about a dozen newborns successfully every year in the UK. Even though treatments have improved dramatically in the past two decades, it's still a very challenging procedure..."

End Quote Dr Jan Dudley Bristol Royal Infirmary

Prof Claudio Ronco, from the International Renal Research Institute at San Bortolo Hospital in Vicenza, designed and developed the new machine to treat babies and small infants weighing between 2kg and 10kg (4lb and 1st 8lb).

In his study, published in the Lancet, he said adult kidney dialysis machines were inaccurate and potentially unsafe when used in those babies.

Smaller scale

Prof Ronco said: "A major problem is the potential for errors in ultra-filtration volumes.

"Adult dialysis equipment has a tendency to either withdraw too much fluid from a child, leading to dehydration and loss of blood pressure, or too little fluid, leading to high blood pressure and oedema."

The new machine - named Carpe Diem (cardio-renal pediatric dialysis emergency machine) - replaces the lost function of the kidney by removing excess fluid and urine from the body through blood vessels.

It allows the use of a much smaller-sized catheter than normal which could prevent damage to blood vessels in babies, the study says.

In August 2013, a baby born prematurely weighing 2.9kg was the first person to be treated using the device. She had multiple organ failure after a complicated delivery.

After more than 20 days of treatment with the new machine, doctors were able to discontinue kidney dialysis on the patient.

Organ function was restored and the infant was discharged from hospital after 50 days, although she still had significant kidney dysfunction, the study notes.

Prof Ronco said: "We hope that our success will encourage the development of other medical technologies (eg catheters, fluids, and monitors) specifically designed for infants and small children."

'Challenging procedure'

Dr Jan Dudley, consultant paediatric nephrologist at Bristol Royal Infirmary, said she welcomed any equipment more suited to treating newborns, but she said it was "not impossible" to dialyse small babies with the current machines,

Continue reading the main story

"Start Quote

It will be interesting to see if, in the long term, this results in improved outcomes for babies with renal failure."

End Quote Elaine Davies Kidney Research UK

"We do already treat about a dozen newborns successfully every year in the UK," she said.

"Even though treatments have improved dramatically in the past two decades, it's still a very challenging procedure - there is only a 75% survival rate for these babies in their first 10 years of life."

Dr Meeta Mallik, a children's kidney specialist at Nottingham Children's Hospital, said there was a role for the Italian machine and it would give clinicians "more options for treating this challenging group of patients".

Writing in another article in The Lancet, Benjamin Laskin, from the Children's Hospital of Philadelphia, and Bethany Foster, from Montreal Children's Hospital in Canada, said the machine needed to be tested out on more young patients.

Elaine Davies, head of research at Kidney Research UK, said: "Although there are ways to dialyse very small babies with kidney failure, this is an interesting development and a step in the right direction in paediatric renal care.

"It will be interesting to see if, in the long term, this results in improved outcomes for babies with renal failure."

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Abortion clinic

23 May 2014 Last updated at 14:16

New guidance issued for abortion clinics in England makes clear that terminating a pregnancy on the grounds of gender alone is illegal.

It also states "pre-signing" abortion certificates without considering a woman's individual case is illegal.

The Department of Health guidance is being published after concerns over both issues were raised.

It will now assess abortion providers to ensure they are abiding by the updated rules.

The 113 independent clinics providing abortions for the NHS must do so in order to be re-approved to provide the service by the Health Secretary.

Officials say they do not expect to find any major problems.

Good practice

Concerns over sex selection were raised after secret filming by the Daily Telegraph appeared to show two doctors agreeing terminations of female foetuses could go ahead.

However no charges were brought - and the Crown Prosecution Service said it was satisfied there was no intention to proceed with a termination.

A subsequent investigation into the work of abortion clinics found 14 were pre-signing certificates.

The law says two doctors have to certify an abortion under the terms of the 1967 Abortion Act.

But pre-signing suggests the second doctor has not considered that woman's individual case.

Under the updated guidance, doctors are reminded that pre-signing forms is not allowed and both doctors have a legal duty to certify abortions "in good faith".

The updated guidance restates the rules governing abortions. It says:

• abortion on the grounds of gender alone is not lawful
• two doctor need to certify that an abortion is permitted under the criteria in the 1967 Abortion Act and be prepared to justify their decision
• it is good practice for at least one of the doctors to have seen the pregnant woman
• pre-signing of certificates is "not compliant" with the Act

Updated annual birth ratio statistics for England and Wales for 2008-2012 have also been published by the department.

This data is broken down by the mother's country of birth and shows no evidence of sex selection occurring in the UK.

Ann Furedi, chief executive of the British Pregnancy Advisory Service which is a major provider of abortions for the NHS, said it abided by the guidance.

But she added: "There is no clinical need for two doctors to certify a woman's reasons for abortion, in addition to obtaining her consent - it simply causes delays."

Ann Scanlan, of the pro-life charity Life, said the organisation welcomed the re-emphasis on sex selection and pre-signing being against the law.

But Ms Scanlan said she was "disappointed but not surprised" that the guidance potentially allowed for neither of the two doctors certifying an abortion to actually see the woman concerned.

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Chronic pain 'may be inherited'

21 May 2014 Last updated at 03:21

Four common chronic pain conditions share a genetic element, suggesting they could - at least in part - be inherited diseases, say UK researchers.

The four include irritable bowel syndrome, musculoskeletal pain, pelvic pain and dry eye disease.

The study of more than 8,000 sets of twins found the ailments were common in identical pairs sharing the same DNA.

The King's College London team say the discovery could ultimately help with managing these debilitating diseases.

Continue reading the main story

With further research, these findings could then lead to therapies which may change the lives of those suffering with chronic pain"

End Quote Dr Frances Williams Study author

While environmental factors probably still play a role in the four conditions, genes could account for as much as two-thirds of someone's chances of developing the disease, they believe.

They told the journal Pain that more research is needed to pinpoint the precise genes involved.

'Life-changing'

Chronic pain - pain which persists or recurs for months on end - is common and has many different causes, which can make it difficult to diagnose and treat.

While the pain can be related to other medical conditions, it is thought to be caused by problems with the nervous system, sending pain signals to the brain despite no obvious tissue damage.

Experts are keen to understand more about chronic pain to improve the quality of life of the millions of people who have to endure it.

Some have suspected that some people may have a genetic predisposition to chronic pain since many sufferers share similar symptoms and often have more than one of the different types of chronic pain conditions.

The team at King's College London decided to study identical and non-identical twins because these two groups provide an ideal comparison for investigating inherited genes - identical twins share the same DNA while non-identical twins do not.

Lead investigator Dr Frances Williams said: "This study is one of the first to examine the role of genetic and environmental factors in explaining the links between different chronic pain syndromes. The findings have clearly suggested that chronic pain may be heritable within families. With further research, these findings could then lead to therapies which may change the lives of those suffering with chronic pain."

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Brain research 'needs new strategy'

21 May 2014 Last updated at 00:01 By Helen Briggs BBC News

A shift in medical research priorities is needed to meet the challenge of fighting dementia, say animal welfare campaigners.

Animal research into new therapies has failed to deliver after years of experiments, they say.

Instead, labs should focus on human-based models such as brain scanning or studies of cells grown from patients.

Alzheimer's Research UK said no single approach could provide answers to such a complex disease.

Dr Gillian Langley, a scientist and consultant for the animal welfare charity, Humane Society International, is among a growing body of scientists who believe current research relies too much on animal models.

"Medical research is at a tipping point," she told BBC News.

Continue reading the main story

The exciting thing about this technology is that you can take cells from patients with a disease and then try to create a model of this disease in a dish"

End Quote Dr Eric Hill Aston University

"There is a growing realisation that animal studies are not producing the breakthroughs we're hoping for."

Writing in the journal Drug Discovery Today, she said it was time to consider a new paradigm in medical research for Alzheimer's disease.

Research was "lagging behind" areas such as toxicology, which is using research based on molecular disease pathways within cells and new tools such as genomics, she said.

"We need this overarching view - a new framework so we can use these 21st Century tools."

Model of complexity

Other scientists say human-based methods of research - once regarded as experimental - are already yielding results.

Professor Paul Lawrence Furlong of Aston University carries out brain imaging to try to develop methods for early diagnosis of dementia in patients.

"We're supportive of initiatives to move forward the human model for good scientific reasons," he said.

"In Alzheimer's, at the cellular level, many animal models are valuable. When we move up the model of complexity, there's a point at which the animal model becomes less valid."

Brain cells in a dish

He said researchers such as Dr Eric Hill at Aston University are working on stem cells (the master cells of the human body) to model Alzheimer's disease, which may eventually provide more robust ways of testing treatments.

"These cells were once skin cells that have been reprogrammed to become stem cells again," said Dr Hill.

"They were then differentiated to become neurons and astrocytes.

"The exciting thing about this technology is that you can take cells from patients with a disease and then try to create a model of this disease in a dish. "

However, the charity, Alzheimer's Research UK, said no single approach could address such a complex disease, with animal models, brain studies and new approaches involving stem cells all playing a role.

"Alzheimer's is a complex disease and the brain is a complex organ," said head of research Simon Ridley.

"I think modelling that in a cell culture or in a dish, it's a huge challenge.

"So I think it's very important that we keep a broad perspective on the different types of research, really to try to answer specific questions."

Dr Laurie Butler, of the University of Reading, added: "With the number of those affected by dementia set to triple over the next 30 years it's vital we examine all research approaches if the UK is going to fulfil Jeremy Hunt's promise of transforming the country into a 'global leader' in fighting dementia. "

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NHS 'Masterchef' contest launched

21 May 2014 Last updated at 13:07 By Eleanor Bradford BBC Scotland Health Correspondent

The Scottish government has launched a competition aimed at improving standards of catering in the health service.

Chefs and catering teams will compete to provide meals for 100 people which are locally sourced and meet nutritional guidelines.

The winning menu will be rolled out across the whole of NHS Scotland.

However, critics of the Good Food Challenge 2014 say it is a poor use of NHS finances.

Hospitals in Scotland and Wales are required to meet national nutritional standards. However the last time the standard of catering was assessed in Scotland was in 2010, when a report found that one in five hospitals failed to meet the nutritional needs of patients.

Since then the Scottish government says more has been done to improve patients' nutrition.

All patients are screened for malnutrition on admission, and wards also operate "protected mealtimes" to make sure patients are not interrupted by medical procedures while eating their meals.

Last year Scotland's biggest health board, NHS Greater Glasgow and Clyde, admitted that it spent an average of just over £4 a day per patient. Its catering budget had been cut by almost £1m in the previous year.

Scotland has not seen the same level of dissatisfaction with hospital meals as England, where the Campaign for Better Hospital Food has been launched by the charity Sustain.

But BBC Scotland has been contacted by a mother who said the standard of food given to her son, who is receiving long-term treatment at the Sick Kids' Hospital in Edinburgh, was "terrible".

She claimed main meals were "highly processed" and "usually cold" while puddings were "cake and custard - school dinner style" and "never appetising".

The woman added: "I find it pretty shocking that children with serious illnesses who need good nutrition get fed this junk food.

"It's hard enough caring for an ill child without having to fret at every meal time about what they will eat and whether you should go out of the hospital to get them something else.

"I bet if a manager ate them for a week things would change."

Nick Taylor, who spent six weeks in Aberdeen Royal Infirmary after a motorbike accident in 2012, said the biggest issue he experienced was food being either "dried out or developing a skin across the top" by the time it was served to patients.

Continue reading the main story

We are taking a range of steps to help people make better food choices, taking account of food's healthiness, quality, seasonality and freshness"

End Quote Alex Neil Health secretary

Mr Taylor added: "I was lucky because due to my injuries I had to eat 4,000 plus calories per day so I was given an additional menu which included things like chips and baked potatoes.

"So I was able to make the menus work for me a lot easier than other people on the ward. Some of the food was actually OK."

Mr Taylor said the rest of the care he received on the word was "phenomenal".

Health Minister Alex Neil launched the chefs competition during a visit to the catering department of St John's hospital in Livingston, where more than 1,500 meals are prepared every day.

Mr Neil said: "Scotland is known as a land of food and drink with some of the best natural produce in the world. Despite this Scotland still has one of the poorest diet-related health records in the developed world.

"Whatever the reasons for our dietary habits, the Scottish government is determined that our culture must change if we are to prosper as a nation.

"That is why we are taking a range of steps to help people make better food choices, taking account of food's healthiness, quality, seasonality and freshness."

Mr Neil said "huge progress" had already been made in the Scottish NHS, with a nutritional database helping health boards to analyse recipes and ensure meals are nutritionally balanced and match patients' individual needs.

He added: "The NHS Good Food Challenge 2014 is an excellent opportunity for our committed catering teams to show what they can deliver and to come up with new recipes that are tasty, healthy and can be shared across the NHS."

Regional heats are expected to take place over the summer, with the final towards the end of the year.

What do you think of the food quality in hospitals? Have you taken a photo of a hospital meal? Please send us your comments and photos. You can email us at haveyoursay@bbc.co.uk using the subject line 'NHS Meals'.

Send your pictures and videos to yourpics@bbc.co.uk or text them to 61124 (UK) or +44 7624 800 100 (International). If you have a large file you can upload here.

Read the terms and conditions

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Mobile phone child health risk probe

20 May 2014 Last updated at 00:00 By Nick Triggle Health correspondent, BBC News

A major investigation into whether mobile phones and other wireless technologies affect children's mental development is getting under way.

The study - funded by the government and industry - will track 2,500 11- and 12-year-olds from September.

It will look at their cognitive ability - thinking skills, memory and attention - and then repeat the tests in 2017.

The researchers say "very little" is known about what impact these technologies have on children.

The World Health Organization has said research in this area is of the "highest priority".

More than 160 secondary schools in the outer London area will receive invitations to enrol pupils into the study.

Much of the research into mobile phone use has focused on adults and in particular, the risk of brain cancer. No evidence of harm has been established to date.

Nonetheless, NHS advice is that children under the age of 16 should use mobile phones only for essential purposes and, where possible, with hands-free kits.

Informed choices

The theory has been put forward that children's brains may be more susceptible because they are still developing.

This research - led by Imperial College London - will put that idea to the test by asking children and their parents about their use of mobile phones and wireless devices, such as tablets, as well as analysing data from operators.

The 11-12 age group is particularly important as many children get mobiles at that age to coincide with starting secondary school. Some 70% of that age group now own a mobile.

Lead investigator Dr Mireille Toledano said: "The advice to parents is based on the precautionary principle given in absence of available evidence and not because we have evidence of any harmful effects.

"As mobile phones are a new and widespread technology central to our lives, carrying out the study is important in order to provide the evidence base with which to inform policy and through which parents and their children can make informed life choices."

The researchers will now be writing to 160 secondary schools in the outer London area asking pupils to take part.

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Prostate cancer 'linked to sex bug'

20 May 2014 Last updated at 01:37 By Michelle Roberts Health editor, BBC News online

Prostate cancer may be a sexually transmitted disease caused by a common yet often silent infection passed on during intercourse, scientists say - but experts say proof is still lacking.

Although several cancers are caused by infections, Cancer Research UK says it is too early to add prostate cancer to this list.

The University of California scientists tested human prostate cells in the lab.

They found a sex infection called trichomoniasis aided cancer growth.

Continue reading the main story

There are still no known lifestyle factors that seem to affect the risk of developing the disease - and no convincing evidence for a link with infection"

End Quote Nicola Smith Cancer Research UK

More research is now needed to confirm the link, they say in the journal Proceedings of the National Academy of Sciences (PNAS).

Sex infection

Trichomoniasis is believed to infect some 275 million people worldwide and is the most common non-viral sexually transmitted infection.

Often, a person will have no symptoms and be unaware that they have it.

Men may feel itching or irritation inside the penis, burning after urination or ejaculation, or a white discharge from the penis.

Women may notice itching or soreness of the genitals, discomfort with urination, or a discharge with an unpleasant fishy smell.

This latest research is not the first to suggest a link between trichomoniasis and prostate cancer. A study in 2009 found a quarter of men with prostate cancer showed signs of trichomoniasis, and these men were more likely to have advanced tumours.

The PNAS study suggests how the sexually transmitted infection might make men more vulnerable to prostate cancer, although it is not definitive proof of such a link.

Prof Patricia Johnson and colleagues found the parasite that causes trichomoniasis - Trichomonas vaginalis - secretes a protein that causes inflammation and increased growth and invasion of benign and cancerous prostate cells.

They say more studies should now follow to further explore this finding - particularly since we still do not know what causes prostate cancer.

Nicola Smith, health information officer at Cancer Research UK, said: "This study suggests a possible way the parasite Trichomonas vaginalis could encourage prostate cancer cells to grow and develop more quickly.

"But the research was only done in the lab, and previous evidence in patients failed to show a clear link between prostate cancer and this common sexually transmitted infection.

"There's been a lot of research into prostate cancer risk and we're working hard to piece together the puzzle.

"But there are still no known lifestyle factors that seem to affect the risk of developing the disease - and no convincing evidence for a link with infection.

"The risk of prostate cancer is known to increase with age."

Prostate cancer is now the most common cancer in men in the UK - about one in nine men will get it at some point in their lives.

It is more common in men over 70, and there appears to be some genetic risk since the disease can run in families.

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E-cigarettes 'help smokers to quit'

20 May 2014 Last updated at 10:34 By Nick Triggle Health correspondent, BBC News

Smokers who use e-cigarettes to quit are more likely to succeed than those who use willpower alone or buy nicotine replacement therapies, such as patches or gum, a study suggests.

The survey of nearly 6,000 smokers found a fifth had quit with the aid of e-cigarettes.

That was 60% higher than those who did not use the devices, the study said.

The University College London team said they were "cautiously positive" about the role e-cigarettes could play.

E-cigarette use has shot up in recent years.

Action on Smoking and Health estimate there are more than 2m people using them - triple the number from two years ago.

Half of current or ex-smokers have not tried them compared to 8% in 2010.

Users experience the sensation of smoking by inhaling a vapour which contains a concentration of nicotine.

But they remain controversial. The Welsh government wants to restrict their use in public places, because of fears they normalise smoking.

'Widespread appeal'

However, lead researcher Prof Robert West, one of the UK's leading experts in this field, said: "E-cigarettes could substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking."

But he also pointed out that despite the findings - published in the journal Addiction - by far the most effective way of quitting was to use NHS stop smoking services which tripled the odds of a smoker quitting when compared to buying nicotine replacement treatments without specialist help.

And he added: "Some public health experts have expressed concern that widespread use of e-cigarettes could 're-normalise' smoking. However, we are tracking this very closely and see no evidence of it.

"Smoking rates in England are declining, quitting rates are increasing and regular e-cigarette use among never smokers is negligible."

E-cigarettes are currently not available on the NHS, but the drugs regulator the Medicine and Healthcare Products Regulatory Agency is looking to licence them as medicines from 2016.

Prof West said it was too early to say whether and which e-cigarette products could be made available, as there needed to be more research into the safety of long-term use.

However, he said from what is currently known the contents of the e-cigarette vapours will be much less risky than smoking.

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Brazil 2014 dengue risk predicted

17 May 2014 Last updated at 00:37

Scientists have developed an "early warning system" to alert authorities to the risk of dengue fever outbreaks in Brazil during the World Cup.

The analysis, published in The Lancet Infectious Diseases, estimates the chances of an outbreaks of the mosquito-borne infection disease.

They say the risk is high enough to warrant a high-alert warning in three venues - Natal, Fortaleza and Recife.

If they come top of their group, England will play in Recife on 29 June.

About a million fans are expected to travel to the 12 different cities hosting matches during the World Cup, which runs from 12 June to 13 July.

Brazil recorded more cases of dengue fever than anywhere else in the world between 2000 and 2013, with more than seven million cases reported.

Dengue is a viral infection that is transmitted between humans by mosquitoes.

It can cause life-threatening illness and there are currently no licensed vaccines or treatments.

Screens, air-conditioning and using insecticides can all reduce the risk of being bitten,

Dengue spread

The early-warning system covers 553 "microregions" across Brazil.

The team looked at rain and temperature data from 1981 to 2013 as well as population density data and altitude

The risk of dengue fever is low in Brasilia, Cuiaba, Curitiba, Porto Alegre, and Sao Paulo.

However, they predict that there is some chance of dengue risk exceeding medium levels in Rio de Janeiro, Belo Horizonte, Salvador and Manaus.

Continue reading the main story

Travellers, particularly those attending matches in high-risk cities might return home with dengue"

End Quote David Harley and Elvina Viennet, Australian National University in Canberra

The three cities with the greatest chance of high dengue risk are Natal, Fortaleza, and Recife.

Dr Rachel Lowe from the Catalan Institute of Climate Sciences in Barcelona, Spain, who led the research, said: "Recent concerns about dengue fever in Brazil during the World Cup have made dramatic headlines, but these estimates have been based solely on averages of past dengue cases.

"The possibility of a large dengue fever outbreak during the World Cup, capable of infecting visitors and spreading dengue back to their country of origin, depends on a combination of many factors, including large numbers of mosquitoes, a susceptible population, and a high rate of mosquito-human contact."

The researchers say being able to plan in advance can give local authorities the time to implement measures to reduce or contain epidemics in their areas and to deal with the mosquito populations there.

Writing in the same journal, David Harley and Elvina Viennet from the Australian National University in Canberra say: "Travellers, particularly those attending matches in high-risk cities, might return home with dengue.

"Those who return home unwell will seek treatment. Doctors must be aware of causes for febrile illness in World Cup spectators."

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Patients asked to shape nursing code

19 May 2014 Last updated at 02:19

Patients and the public are being urged to have their say over what standards nurses and midwives should abide by.

The Nursing and Midwifery Council (NMC) is drafting a new version of its code, which sets out standards of conduct, performance and ethics.

It will say patients should be treated with kindness, consideration and respect.

The NMC decided to revise the existing code partly because of events such as the scandal at Stafford Hospital.

There, patients were found to have died needlessly.

One of the criticisms made of the failings in care there was a lack of compassion from some nursing staff.

The Francis report made 290 recommendations to prevent "another Stafford" including a pilot for nurses to spend time working as support workers and healthcare assistants before taking their degrees.

The draft code covers areas such as care, communication, teamwork, professionalism and complaints handling.

The NMC regulates the UK's 670,000 nurses and midwives. Nurses have to be registered with the NMC to practise - and they have to abide by the code.

Patient needs

Jackie Smith, NMC chief executive, said: "The Nursing and Midwifery Council exists to protect the public, and the code is central in all that we do.

"It explains exactly what is expected of all nurses and midwives, no matter how and where they practise or what stage of their careers they are at.

"This is a chance to tell us what is important to you, and explain exactly what you expect from the people who care for you."

Jane Cummings, Chief Nursing Officer for England, said: "This is an important opportunity to help develop compassionate, high-quality nursing care for now and the future."

Dr Peter Carter, Chief Executive and General Secretary of the Royal College of Nursing said: "The NMC's Code of Conduct has been around for a long time and the standards and behaviours that it sets are taken extremely seriously by all nursing staff.

"Our members are skilled professionals dedicated to the care and support of their patients and committed to upholding the highest of standards.

"Modern nursing is a complex and demanding profession and so it is only right for the Code of Conduct to be revised in line with all the changes and developments that have taken place.

"Consulting a wide range of people from patients to the nurses themselves will help the NMC to develop a Code of Conduct in line with the reality of modern nursing and the RCN looks forward to participating in the process."

Katherine Murphy, chief executive of the Patients Association, said: "It is vital that healthcare is centred around the needs of the patient.

"The NMC Code lays out the standards of conduct to which all nurses and midwives must adhere when treating their patients. It is therefore essential that patients themselves are genuinely and meaningfully involved at all stages in the planning, development and implementation of the code.

"We strongly encourage patients and the public to get involved with this important consultation process and help shape the future of healthcare provision in the UK."

The consultation can be viewed on the NMC website.

Have you recently received care from nurses or a midwife? Are you a nurse or midwife? What would you like to see included in a revision to the code? You can email your comments to haveyoursay@bbc.co.uk, using the subject line 'Nursing code'.

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