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Frontline NHS staff given honours

Written By Unknown on Rabu, 31 Desember 2014 | 21.24

30 December 2014 Last updated at 23:14

A host of frontline NHS staff are among those recognised in the New Year Honour's list.

Among them are London-based GP Dr Sam Everington who has been given a knighthood after more than 20 years service in east London.

Meanwhile, Eileen Sills, the chief nurse at Guy's and St Thomas' NHS Foundation Trust, has been made a dame.

Nearly one in 14 of the honours awarded went to people working in the field, including eight nurses made MBEs.

Other notable recipients include knighthoods for Royal College of Surgeons of England president Prof Norman Williams, Andrew Morris, chief executive of Frimley Park Hospital NHS Foundation Trust, and Nilesh Samani, professor of cardiology at the University of Leicester.

'Amazing honour'

Dr Everington is widely recognised as one of the most radical GPs in the country who has led the way in pushing the boundaries of what GP practices can offer.

He is one of the lead doctors behind the Bromley-by-Bow practice, which houses 100 different projects from benefits and employment advice to arts and gardening therapy.

It has links with another 1,000 community organisations in a model of care that has been championed as the way forward for the NHS.

Dr Everington, who is a trained barrister, has also served as one of the lead doctors at the British Medical Association and in 1999 received an OBE for services to primary care.

He described his knighthood as a "wonderful surprise", adding: "I feel incredibly lucky to have the opportunity of working with fantastic partners, colleagues and patients."

Meanwhile, Ms Sills said: "This is the most amazing honour, I can't quite believe it.

"I have had an amazing 10 years at Guy's and St Thomas' and I would like to thank all the staff who work here because this recognition would not have happened without them."

Ms Sills qualified as a nurse in 1983 working in hospitals in Stockport and across London before joining Guy's and St Thomas'.

She was awarded a CBE in 2003 and has helped champion dementia training and safe staffing levels during her time as the lead nurse at one of the country's biggest NHS trusts.


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Knighthood for 'father of Viagra'

30 December 2014 Last updated at 22:31 By Jonathan Webb Science reporter, BBC News

Two chemists, one who kicked off the development of Viagra and another who is a YouTube celebrity, have received knighthoods in the New Year Honours.

Dr Simon Campbell started and oversaw research on Viagra while working for the drug company Pfizer.

Prof Martyn Poliakoff is a pioneer in green and sustainable chemistry, known for his "Periodic Table of Videos".

Peter Kendall, former president of the National Farmers' Union (NFU), becomes a Knight Bachelor.

'Father of Viagra'

Dr Campbell was associated with three new drugs during his 26-year stint at Pfizer, all aimed at treating high blood pressure.

The last one turned out to have a valuable side effect because it improved blood flow to the penis - and it famously hit the market in 1998 as Viagra.

But Dr Campbell was quick to point out that he was not the inventor of Viagra. He co-wrote the initial research proposal, with no mention of erectile dysfunction, before others took over the chemistry.

"I'm not on the Viagra patent," Dr Campbell told the BBC. "If you want, I would say I was the father of Viagra because I laid the seed and started the project.

"And I was there in New York, on my birthday in March 1998, when it was launched."

Dr Campbell was also the first chair of the Medicines for Malaria Venture, a landmark public-private partnership, which he said was a career highlight.

He said he had been especially proud to be elected as a fellow of the Royal Society in 1999 - an honour that is much rarer for scientists in industry rather than academia.

Dr Campbell reiterated concerns he has expressed previously about the increasing number of mergers and the size of pharmaceutical companies today.

"I don't believe you can manage innovation on that scale," he said, referring to research departments of thousands, rather than tens or hundreds of people.

"I like to work in groups of 100. I'm a great fan of the Roman centurion who had 100 men.

"When I had 100 chemists, I knew what they were all doing. When I had 200 chemists, it started to get a bit flaky."

Crazy idea

Prof Poliakoff said he was "excited and slightly overwhelmed" by the news of his knighthood.

Continue reading the main story

"Start Quote

By the time we finished, we had a lot of fans who said, 'Whatever you do, don't stop making videos!'"

End Quote Prof Martyn Poliakoff University of Nottingham

The chemistry professor at the University of Nottingham, who is also foreign secretary and vice-president of the Royal Society, is recognised by many as the face of his online video series - a 2008 project of which he remains "very proud".

"We made 120 videos in five weeks," he told BBC News, crediting video journalist Brady Haran with the "crazy" idea of making a short film for every chemical element.

"By the time we finished, we had a lot of fans who said, 'Whatever you do, don't stop making videos'!"

So the team continued - adding more videos and presenters to a YouTube channel that has now notched up more than 80 million views.

Part of the charm, Prof Poliakoff concedes, is that he looks the part of an archetypal mad scientist.

"Even I have to admit that I look like... what people imagine scientists to look like," he said - adding that his unmistakeable hair and glasses have seen him approached by fans in the Paris metro and Beijing Airport.

The professor also takes pride in the progress his field has made, particularly in the UK.

"Green and sustainable chemistry has now become one of the principle research themes at my university," he observed.

"I'm really quite excited that what I started as a lone activity has now become a major activity."

Martyn Poliakoff

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A pioneer in green chemistry, Prof Poliakoff is also known for his signature hair and chemistry-themed ties

'Massive honour'

One of leading figures in UK farming has also been recognised in the New Year Honours.

Continue reading the main story

"Start Quote

I was very keen that farming was seen as an innovative industry and one that was attractive to young people"

End Quote Peter Kendall Former NFU president

Peter Kendall, former president of the National Farmers' Union, has been awarded a knighthood.

Mr Kendall, who headed the NFU for eight years between 2006 and 2014, said it was "a massive honour" to become a Knight Bachelor in recognition for services to the agricultural industry in England and Wales.

"Hopefully, it reflects the growing awareness of the importance of the farming industry," he told BBC News.

Mr Kendall, who is now chairman of the Agriculture and Horticulture Development Board (AHDB), said that he used his time at the NFU to try and change the image of the UK farming industry.

"I was very keen that farming was seen as an innovative industry and one that was attractive to young people.

"It is very pleasing that people now see that they can follow careers in farming and it is more relevant to the next generation."

As was the case in the 2014 Birthday Honours, leaders in science and technology make up about 3% of the New Year Honours list, which includes 1,164 names.

Dr Vicky Robinson, Chief Executive of the NC3Rs (National Centre for the Replacement, Refinement and Reduction of Animals in Research) is appointed CBE for "services to science and animal welfare".

Neuroscientist Russell Foster, a professor at the University of Oxford who participated in the BBC's Day of the Body Clock, also becomes a CBE.

Climate physicist Prof Tim Palmer and wind-up radio inventor Trevor Baylis are also recognised with CBE awards.

Another Oxford professor and a former president of the Academy Medical Sciences, Sir John Bell, becomes a Knight Grand Cross - the highest class of knighthood - for his "services to medicine, medical research and the UK life science industry".

Follow Jonathan on Twitter


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Ebola screening tests under scrutiny

31 December 2014 Last updated at 09:10

Procedures for screening health workers returning to the UK after treating Ebola patients will be reviewed after an infected nurse flew from London to Glasgow despite raising concerns.

Pauline Cafferkey told officials at Heathrow she felt unwell but was allowed to continue her journey. She was diagnosed in hospital the next day.

Another passenger on her flight said screening had been "chaotic".

The chief medical officer said the case raised questions over precautions.

However, Dame Sally Davies said correct protocols had been followed.

"The risk of raised temperature when she came back appears to have been very low," she said.

"That's why we look at what we do all the time to see should we have been more precautionary, is it in the public's interest? Is it in the patient's interest?"

But she added: "I doubt it would have made much difference."

Chief Medical Officer Dame Sally Davies

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Chief Medical Officer Dame Sally Davies says Ms Cafferkey's temperature was "within the range for flying and that she was well"

Dame Sally said Ms Cafferkey had been in the early phase of the disease when she made the journey to the UK from Sierra Leone, via Casablanca, and her fellow passengers were at "very low risk" of being infected.

She told BBC Breakfast: "The public health risk is negligible - Ebola's very difficult to catch."

Ms Cafferkey was diagnosed on Monday after returning from Sierra Leone, where she had travelled as part of a 30-strong group of healthcare workers from Save the Children.

She was allowed to leave Heathrow after her temperature was taken seven times.

Temperature screening
  • A normal body temperature is considered 37C
  • A raised temperature is one sign of Ebola and forms a core part of entry screening
  • The UK uses a relatively tough 37.5C as the cut off for further testing
  • Belgium and Australia use a higher threshold of 38C
  • India uses 38.3C
  • Spain and the US use 38.6C

Source: The Lancet

After an initial test, she told officials she believed a fever might be developing while she was waiting for a connecting flight to Glasgow.

Her temperature was taken a further six times over 30 minutes, but each test found her temperature to be normal.

She reported symptoms the following morning after arriving in Glasgow.

A Department of Health spokesman said: "Naturally, we will be reviewing what happened and the screening protocols, and if anything needs to be changed it will be."

Enhanced screening - which involves passengers having their temperature taken and completing a questionnaire about their health - was rolled out at some UK airports, including Heathrow, in October.

Dr Martin Deahl

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Dr Martin Deahl: "The whole process was a bit chaotic"

Save the Children said they had "robust and strict protocols in place to protect our staff."

A statement added: "Save the Children also asks staff to be careful outside of the treatment centre, where exposure to risks can be less obvious."

The charity's humanitarian director Michael von Bertele told BBC Radio 4's Today programme: "It's really important for us to try and understand whether it was a failure of training, of protection, of procedure, or indeed whether she contracted it in some incidental contact within the community.

"Because our workers don't just work inside the red zone, which is a very high-risk area, they do also have contact - although we are very, very careful in briefing people to avoid personal contact - outside of the treatment centre."

He also said that while protection is "of a very high standard", "nothing is risk-free" when it comes to dealing with Ebola.

But Dr Martin Deahl, a consultant psychiatrist who travelled back on the same flight as Ms Cafferkey, said there had been issues at Heathrow.

He said there were too few staff on duty and the rooms where returning volunteers were held were too small.

Ms Cafferkey is currently being cared for at the Royal Free Hospital, in Hampstead, north London.

She was said to be doing "as well as can be expected under the circumstances" by Scotland's First Minister Nicola Sturgeon.

Ms Cafferkey had no detectable fever or symptoms. Anyone displaying symptoms at screening, either in Sierra Leone or in the UK, would not have been allowed to travel.

One third of the 132 other passengers on the flight from Casablanca to Heathrow had been contacted by Public Health England, while advice had been given to more than half the 72 passengers from Heathrow to Glasgow, officials said.

Another healthcare worker who was recently in West Africa and fell ill in the Scottish Highlands has tested negative for the disease.

A third patient from Cornwall, who had recently returned from an affected country, has also tested negative.

Ms Cafferkey could be offered plasma from patients who have survived the virus as part of her treatment.

Dame Sally confirmed that plasma had been donated by British nurse William Pooley, who recovered from Ebola in September after also being treated at the Royal Free Hospital.

Having fought off the infection, his blood should help others do the same.

Other available treatments include antiviral drugs, but there are no stocks left of ZMapp - the drug used to treat Mr Pooley.

Ebola is transmitted by direct contact with the bodily fluids of an infected person, such as blood, vomit or faeces.

The virus has killed more than 7,800 people, mostly in West Africa, since it broke out a year ago.

The World Health Organization says the number of people infected by the disease in Sierra Leone, Liberia and Guinea has now passed 20,000.

What are the symptoms?

The early symptoms are a sudden fever, muscle pain, fatigue, headache and sore throat.

This is followed by vomiting, diarrhoea, a rash and bleeding - both internal and external - which can be seen in the gums, eyes, nose and in the stools.

Patients tend to die from dehydration and multiple organ failure.

Are you affected by the issues raised in this story? You can share your experiences by emailing haveyoursay@bbc.co.uk. If you are happy to speak to a BBC journalist, please include a telephone number.

Have your say


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First Ebola case linked to bat play

Written By Unknown on Selasa, 30 Desember 2014 | 21.24

30 December 2014 Last updated at 14:02 By Michelle Roberts Health editor, BBC News online

The Ebola victim who is believed to have triggered the current outbreak - a two-year-old boy called Emile Ouamouno from Guinea - may have been infected by playing in a hollow tree housing a colony of bats, say scientists.

They made the connection on an expedition to the boy's village, Meliandou.

They took samples and chatted to locals to find out more about Ebola's source.

The team's findings are published in EMBO Molecular Medicine.

Ebola trail

Meliandou is a small village of 31 houses.

It sits deep within the Guinean forest region, surrounded by towering reeds and oil palm cultivations - these are believed to have attracted the fruit bats carrying the virus passed on to Emile.

During their four-week field trip in April 2014, Dr Fabian Leendertz and colleagues found a large tree stump situated about 50m from Emile's home.

Villagers reported that children used to play frequently in the hollow tree.

Emile - who died of Ebola in December 2013 - used to play there, according to his friends.

The villagers said that the tree burned on March 24, 2014 and that once the tree caught fire, there issued a "rain of bats".

A large number of these insectivorous free-tailed bats - Mops condylurus in Latin - were collected by the villagers for food, but disposed of the next day after a government-led ban on bushmeat consumption was announced.

While bushmeat is thought to be a possible source of Ebola, the scientists believe it didn't trigger the outbreak.

Instead, it was Emile's exposure to the bats and their droppings as he played with his friends in the hollowed tree.

Pest control

The scientists took and tested ash samples from the tree and found DNA traces that were a match for the animals.

While they were unable to test any of the bushmeat that the villagers had disposed of, they captured and tested any living bats they could find in and around Meliandou.

No Ebola could be detected in any of these hundred or so animals, however.

But previous tests show this species of bat can carry Ebola.

Dr Leendertz, from the Robert Koch Institute in Germany, and his colleagues say this must be a pretty rare occurrence though.

Dr Leendertz said: "That is also obvious when you think about how many tonnes of bat meat is consumed every year.

"If more bats carried the virus, we would see outbreaks all the time."

He says it is vital to find out more about the bats.

"They have moved into human settlements. They do not just live in the trees but also under the roofs of houses in the villages.

"The Ebola virus must jump through colonies from bat to bat, so we need to know more."

But culling the animals is not the answer.

"We need to find ways to live together with the wildlife. These bats catch insects and pests, such as mosquitoes. They can eat about a quarter of their body weight in insects a day.

"Killing them would not be a solution. You would have more malaria."


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Prescription fraud plan criticised

30 December 2014 Last updated at 08:44 By Michelle Roberts Health editor, BBC News online

Pharmacists have heavily criticised plans to strengthen checks at the counter for entitlement to free prescriptions in England.

The Royal Pharmaceutical Society says asking pharmacists to police prescriptions could harm patient trust.

By 2018, a new database will be up-and-running for pharmacists to check before handing over a free prescription.

Ministers say these extra checks could save the NHS £150m a year, which will be ploughed back into the NHS.

Continue reading the main story

Claiming a free prescription when you are not entitled takes money away from other frontline patient services, and reduces the amount of money available to spend on patient care"

End Quote Health Minister Dan Poulter
Fraud checks

Currently, pharmacists largely rely on people's honesty when dispensing medicines for free.

Patients should present an exemption certificate and/or sign the back of the prescription form to say that they are exempt of any charge.

The NHS Business Services Authority runs checks, but only after a free prescription has been issued.

The Department of Health says this is not timely enough, meaning the system can be abused.

An estimated 30m prescription items totalling around £237m are incorrectly claimed each year.

Prescriptions in England

You can get free NHS prescriptions if you are:

  • over 60, under 16 or aged 16-18 and are in full-time education
  • pregnant or have had a baby in the last 12 months and have a valid maternity exemption certificate
  • have a specified medical condition and have a valid medical exemption certificate
  • have a continuing physical disability that prevents you from going out without help from another person and have a valid exemption certificate
  • hold a valid war pension exemption certificate and the prescription is for your accepted disability
  • an NHS inpatient

You may also be entitled to free prescriptions if you or your partner receive certain allowances, such as income support.

Health Minister Dan Poulter said it was time to get tough on those who avoid paying their fair share towards the NHS.

"Claiming a free prescription when you are not entitled takes money away from other frontline patient services, and reduces the amount of money available to spend on patient care."

Chief Pharmaceutical Officer Dr Keith Ridge said the new measures aimed to strike the right balance between collecting charges and providing care.

But the body that represents pharmacists in Great Britain, the Royal Pharmaceutical Society, says the new system could get in the way of treating patients.

RPS Board Chair David Branford said: "This move to make pharmacists police the Government's unfair charging system is totally unacceptable to us.

"Our job is to put the needs of vulnerable people first and make sure they get the care they need."

Around 90% of prescriptions in England are currently dispensed free of charge.

Wales, Scotland and Northern Ireland have scrapped all prescription charges.


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Ebola patient arrives in London

30 December 2014 Last updated at 14:00

A health worker who was diagnosed with Ebola after returning to Scotland from Sierra Leone has arrived at a specialist treatment centre in London.

Pauline Cafferkey, who flew to Glasgow via Casablanca and London Heathrow, was taken to the Royal Free Hospital.

She is understood to have been flown to RAF Northolt in a military plane after leaving Glasgow in a convoy.

Passengers on flights she took to the UK are being traced, but officials say the risk to the public is very low.

Ms Cafferkey was part of a group of up to 50 NHS healthcare workers who returned to the UK at the weekend after volunteering in Sierra Leone.

Scotland's First Minister Nicola Sturgeon said she was "doing as well as can be expected in the circumstances".

Ms Sturgeon took part in two emergency meetings on Monday - one of the Scottish Government's resilience committee, and one of the UK-wide Cobra committee, chaired by David Cameron.

She told journalists that as a precaution, Health Protection Scotland has traced and contacted, or left messages with, 63 of the 70 other passengers who were on the same flight from London to Glasgow as the patient.

Efforts to contact the remaining seven passengers will continue, according to the first minister.

Health Protection Scotland has also contacted and given advice to the one person who Ms Cafferkey came into contact with after arriving in Scotland.

There is no plan to test any of the other 70 passengers who were on the flight unless they develop symptoms.

The eight people who were in the "close contact group" seated near to the patient on the plane have all been contacted or had messages left for them.

Ms Cafferkey, an associate public health nurse at Blantyre Health Centre, South Lanarkshire, left Gartnavel Hospital in Glasgow just after 03:00 GMT on Tuesday.

Two ambulances, escorted by six police cars, ferried her to Glasgow Airport, from where she was flown by a Royal Air Force Hercules aircraft to RAF Northolt in north-west London.

An air force ambulance then took Ms Cafferkey to the Royal Free Hospital in Hampstead, north London.

Ambulance carrying Ebola patient

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The BBC's Andy Moore: "She is here being treated in an isolation unit"

Ms Cafferkey, who had been working with Save the Children in Sierra Leone, arrived in Glasgow on a British Airways flight on Sunday but was placed in an isolation unit at Gartnavel Hospital on Monday morning after becoming feverish.

UK Health Secretary Jeremy Hunt said NHS safety measures in place were working well.

Mr Hunt, who chaired an emergency Cobra meeting on Monday evening, said the government was doing "absolutely everything it needs to" to keep the public safe.

"We are also reviewing our procedures and protocols for all the other NHS workers who are working at the moment in Sierra Leone," he added.

Under UK and Scottish protocol, she was moved to the high-level isolation unit at the Royal Free Hospital.

UK nurse William Pooley - who contracted Ebola in Sierra Leone earlier this year - was successfully treated at the same facility.

The bed in the isolation unit

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Dr Stephen Mepham explains how the isolation unit works

Ms Sturgeon, who chaired a meeting of the Scottish Government Resilience Committee on Monday, said the risk to the public was "extremely low to the point of negligible".

The first minister added that Ms Cafferkey was thought to have had direct contact with only one other person between arriving in Glasgow and attending hospital on Monday.

A second health worker who returned from West Africa recently is being tested in Aberdeen for Ebola, it has emerged.

But Ms Sturgeon said there was only a "low probability" the woman also had the disease as she had not been in direct contact with anyone infected with Ebola.

Analysis: BBC health editor Hugh Pym

This latest incident will raise questions about the screening process in place for passengers leaving West Africa and arriving at Heathrow.

Public health officials say the woman was taken aside on arrival in the UK and her temperature was taken - the procedure followed for all incoming health staff who say they have been in contact with Ebola patients.

Her temperature was found to be normal and she was not feeling unwell, so she continued her journey to Glasgow.

Someone with Ebola only becomes infectious once they develop symptoms. In this case, that only became apparent after she arrived in Scotland.

The task of contacting the passengers and crew on the flights she took is now under way. That will be complicated, but officials are insisting the risk to those people is extremely low.

Efforts are being made to trace the 71 other passengers who travelled on the same flight from London to Glasgow as Ms Cafferkey.

A British Airways spokesman said: "The safety and security of our customers and crew is always our top priority and the risk to people on board that individual flight is extremely low."

A telephone helpline has been set up for anyone who was on the BA 1478 flight which left Heathrow Airport on Sunday evening. The number is 08000 858531.

Tom Solomon, director of Liverpool's Institute of Infection and Global Health, said of the reaction to Ms Cafferkey's diagnosis: "We've had training exercises up and down the country and that's why you've seen that the response has been very calm and very controlled.

"It's very important that despite this case we have healthcare workers continue to go out to west Africa to help bring this disease under control."

Paul Cosford, medical director for Public Health England described Ms Cafferkey as a "very brave person", telling BBC Breakfast she had "put herself in the front line of care for people with Ebola".

He also said that about 150 people in the UK had been tested for Ebola recently - with all except Mr Pooley and Ms Cafferkey returning a negative result.

Professor Dame Sally Davies, Chief Medical Officer for England, said: "We have robust, well-developed and well-tested NHS systems for managing unusual infectious diseases when they arise, supported by a wide range of experts.

"The UK system was prepared, and reacted as planned, when this case of Ebola was identified."

Ebola is transmitted by direct contact with the bodily fluids - such as blood, vomit or faeces - of an infected person.

The virus has killed more than 7,800 people, mostly in West Africa, since it broke out a year ago.

The World Health Organization says the number of people infected by the disease in Sierra Leone, Liberia and Guinea has now passed 20,000.

What are the symptoms?

The early symptoms are a sudden fever, muscle pain, fatigue, headache and sore throat.

This is followed by vomiting, diarrhoea, a rash and bleeding - both internal and external - which can be seen in the gums, eyes, nose and in the stools.

Patients tend to die from dehydration and multiple organ failure.


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Life choices 'behind many cancers'

Written By Unknown on Minggu, 28 Desember 2014 | 21.24

26 December 2014 Last updated at 02:40

More than four in 10 cancers - 600,000 in the UK alone - could be prevented if people led healthier lives, say experts.

Latest figures from Cancer Research UK show smoking is the biggest avoidable risk factor, followed by unhealthy diets.

The charity is urging people to consider their health when making New Year resolutions.

Limiting alcohol intake and doing regular exercise is also good advice.

According to the figures spanning five years from 2007 to 2011, more than 300,000 cases of cancer recorded were linked to smoking.

Key risk factors

A further 145,000 were linked to unhealthy diets containing too much processed food.

Obesity contributed to 88,000 cases and alcohol to 62,200.

Sun damage to the skin and physical inactivity were also contributing factors.

Prof Max Parkin, a Cancer Research UK statistician based at Queen Mary University of London, said: "There's now little doubt that certain lifestyle choices can have a big impact on cancer risk, with research around the world all pointing to the same key risk factors.

"Of course everyone enjoys some extra treats during the Christmas holidays so we don't want to ban mince pies and wine but it's a good time to think about taking up some healthy habits for 2015.

"Leading a healthy lifestyle can't guarantee someone won't get cancer but we can stack the odds in our favour by taking positive steps now that will help decrease our cancer risk in future."

Public Health England says a healthy lifestyle can play a vital role in reducing cancer risk. It says campaigns such as Smokefree, Dry January and Change4Life Sugar Swaps all aim to raise public awareness.


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Whooping cough 'evolving fast'

27 December 2014 Last updated at 01:21 By Emma Wilkinson Health reporter, BBC News

Whooping cough may be evolving to outsmart the currently used vaccine, say researchers.

Analysis of strains from 2012 shows the parts of the pertussis bacterium that the vaccine primes the immune system to recognise are changing.

It may have "serious consequences" in future outbreaks, UK researchers state in the Journal of Infectious Diseases.

But experts stressed the vaccine remains highly effective in protecting the most vulnerable young babies.

There has been a global resurgence of whooping cough in recent years.

In 2012, there were almost 10,000 confirmed cases in England and Wales - a dramatic increase from the last "peak" of 900 cases in 2008.

The outbreak led to 14 deaths in babies under three months of age - the group who are most vulnerable to infection.

Rising figures prompted health officials to recommend vaccination of pregnant women so immunity could be passed to their newborns - a strategy that a recent study showed was working well.

Evolving strains

But there has been much debate among experts about whether the introduction of a new vaccine in 2004 has been a factor in rising rates of whooping cough.

One issue is that immunity from the newer acellular vaccine - which contains specific proteins from the surface of the bacteria - does not seem to last as long as the previous whole cell version, leaving teenagers and adults lacking protection.

In the latest study, researchers analysed the genes coding for the proteins on the surface of the pertussis bacterium responsible for the UK outbreak.

They found proteins being targeted by the vaccine were mutating at a faster rate than other surface proteins not included in the vaccine.

Potentially it means the bacteria is changing quickly to get around immune system's defences put in place with immunisation.

What is whooping cough?

It is also known as pertussis and is caused by a species of bacteria, Bordetella pertussis

It mostly affects infants, who are at highest risk of complications and even death

The earliest signs are similar to a common cold, then develop into a cough and can even result in pneumonia

Babies may turn blue while coughing due to a lack of oxygen

The cough tends to come in short bursts followed by desperate gasps for air (the whooping noise)

Adults can be infected - but the infection often goes unrecognised

But the researchers are still trying to work out what the changes mean in reality - for example do the mutations boost the ability of the bacteria to cause infection.

"We wanted to look at strains from the UK to see if there was anything sudden that had occurred that had led to these really large outbreaks," said study leader Dr Andrew Preston from the University of Bath.

Vaccine effectiveness

The "million dollar question" he said was what, if anything, could be done to improve the vaccine - which is still the best defence we have - and prevent future outbreaks.

Options to consider include adding more or different proteins to the vaccine, adding novel adjuvants - chemicals which boost the immune response, or even revisiting the old-style whole cell vaccine, he said.

"Pertussis has a cyclical nature and other big question is are we going to see another increase in late 2015," he added

Prof Adam Finn, a paediatric immunology expert at the University of Bristol said the importance - or not - of the subtle changes found in the study was as yet unclear.

"But the control of pertussis is a significant worry," he added.

Only 60% of pregnant women have had the pertussis vaccine and we should be doing more to raise awareness of its benefits, he said.

"There is very good new evidence that vaccinating pregnant women protects their babies. And the group we really want to protect is newborn babies," he said.


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Police should target drunks - A&E boss

28 December 2014 Last updated at 13:12

Police should crack down on binge drinking to stop hospital staff being distracted by disorderly drunks, a leading doctor has said.

Dr Clifford Mann, president of the College of Emergency Medicine, said the "softer approach" used for anti-social drunkenness did not seem to be working.

Police could instead increase arrests, convictions and fines, he suggested.

Police Federation chair Steve White said the police force did not have the resources for such an approach.

'Wasting resources'

Crime prevention minister Lynne Featherstone said the government was "determined to tackle alcohol-fuelled harm", which she said cost society around £21bn a year.

The coalition had improved the powers available to the police and licensing authorities to tackle alcohol-related crime, and had banned the "worst cases of very cheap and harmful alcohol sales", the Liberal Democrat MP said.

A drunk man being treated

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BBC News spends a night on Norwich's SOS bus as peak Christmas Party season gets under way

Speaking to the BBC, Dr Mann said: "All I am saying at the moment is the softer approach - where we don't any longer arrest many people for being drunk and disorderly - certainly doesn't seem to be working."

He said the number of people arriving at A&E units while drunk was increasing year on year, while the number of licensed premises in the UK was also increasing and alcohol was getting cheaper.

"I think these people, by the nature of the disorder, they are distracting medical and nursing staff from looking after other patients and therefore are wasting public resources," he said.

"I think they therefore fall into the category of being drunk and disorderly in their behaviour and the police can act to take them away."

Matter for education?

But Mr White told the BBC that cuts to the police force had left 16,000 fewer officers in the country so a "zero tolerance" policy was impossible.

He said police were also frustrated with having to deal with drunk people, and cells were already full with people in similar conditions every Friday and Saturday night.

He added that courts, social services, ambulances and the government all had a role to play in reducing the number of people getting drunk and disorderly - and not solely the police.


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Life choices 'behind many cancers'

Written By Unknown on Sabtu, 27 Desember 2014 | 21.24

26 December 2014 Last updated at 02:40

More than four in 10 cancers - 600,000 in the UK alone - could be prevented if people led healthier lives, say experts.

Latest figures from Cancer Research UK show smoking is the biggest avoidable risk factor, followed by unhealthy diets.

The charity is urging people to consider their health when making New Year resolutions.

Limiting alcohol intake and doing regular exercise is also good advice.

According to the figures spanning five years from 2007 to 2011, more than 300,000 cases of cancer recorded were linked to smoking.

Key risk factors

A further 145,000 were linked to unhealthy diets containing too much processed food.

Obesity contributed to 88,000 cases and alcohol to 62,200.

Sun damage to the skin and physical inactivity were also contributing factors.

Prof Max Parkin, a Cancer Research UK statistician based at Queen Mary University of London, said: "There's now little doubt that certain lifestyle choices can have a big impact on cancer risk, with research around the world all pointing to the same key risk factors.

"Of course everyone enjoys some extra treats during the Christmas holidays so we don't want to ban mince pies and wine but it's a good time to think about taking up some healthy habits for 2015.

"Leading a healthy lifestyle can't guarantee someone won't get cancer but we can stack the odds in our favour by taking positive steps now that will help decrease our cancer risk in future."

Public Health England says a healthy lifestyle can play a vital role in reducing cancer risk. It says campaigns such as Smokefree, Dry January and Change4Life Sugar Swaps all aim to raise public awareness.


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Doctors warn of Loom bands danger

25 December 2014 Last updated at 02:22 By Emma Wilkinson Health reporter, BBC News

Doctors are warning parents of the need to be vigilant after a spate of children with loom bands stuck up their noses.

Although medics can usually get them out, there is a real risk children could choke on them, the Journal of Laryngology and Otology reports.

The tiny colourful rubber bands, which can be woven to make bracelets, are one of this year's most popular toys.

Emergency doctors reported four cases at one hospital in a week.

Continue reading the main story

It's not necessarily dangerous if they are stuck up the nose, but when objects are small enough they can go backwards and be inhaled or choked on"

End Quote Dr Donald MacGregor Paediatrician

The team at the Monklands hospital, in Scotland, urged parents to keep a careful eye on young children playing with loom bands.

They said an inhaled loom band or clip could prove fatal.

Noses or ears

Dr Iain Bohler, a surgical registrar and report author, who has since moved to New Zealand, said while it was common for children to turn up at hospital with small objects in their noses or ears, medics had only started to see this with loom bands fairly recently.

"Often foreign bodies are removed with little more than distress to the child, however, in the worst case scenario, they can lead to blocked airways, cardiorespiratory arrest and death."

Dr Bohler said that loom bands could be a lot of fun, unleashing children's creative minds.

"I would however stress with utmost sincerity, the need for parental vigilance in supervising young children playing with loom bands, or any other toy or item with small parts."

Global craze

Rainbow loom, the plastic device for weaving the small bands, was invented in 2011.

The craze for making them into jewellery and even items of clothing has taken off worldwide.

Celebrities including the Duchess of Cambridge and David Beckham have been spotted wearing loom band bracelets.

Two of the children reported by Dr Bohler had inserted one of the s-shaped hooks - used to complete loom band bracelets - into their nose. One child ended up swallowing it after initially choking.

The other two young children had managed to get loom bands stuck in their nasal passages.

Local anaesthetic and crocodile forceps were needed, with the children becoming very distressed at attempts to get the objects out.

Dr Bohler said: "Should any parents be remotely concerned their child has swallowed or inhaled any object, they must contact emergency services immediately."

Dr Donald MacGregor, spokesman for the Royal College of Paediatrics and Child Health, advised parents to be aware that "small objects will always get into places you don't want them to be with young children."

He called for families to ensure they knew what to do in the event of choking.


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Whooping cough 'evolving fast'

27 December 2014 Last updated at 01:21 By Emma Wilkinson Health reporter, BBC News

Whooping cough may be evolving to outsmart the currently used vaccine, say researchers.

Analysis of strains from 2012 shows the parts of the pertussis bacterium that the vaccine primes the immune system to recognise are changing.

It may have "serious consequences" in future outbreaks, UK researchers state in the Journal of Infectious Diseases.

But experts stressed the vaccine remains highly effective in protecting the most vulnerable young babies.

There has been a global resurgence of whooping cough in recent years.

In 2012, there were almost 10,000 confirmed cases in England and Wales - a dramatic increase from the last "peak" of 900 cases in 2008.

The outbreak led to 14 deaths in babies under three months of age - the group who are most vulnerable to infection.

Rising figures prompted health officials to recommend vaccination of pregnant women so immunity could be passed to their newborns - a strategy that a recent study showed was working well.

Evolving strains

But there has been much debate among experts about whether the introduction of a new vaccine in 2004 has been a factor in rising rates of whooping cough.

One issue is that immunity from the newer acellular vaccine - which contains specific proteins from the surface of the bacteria - does not seem to last as long as the previous whole cell version, leaving teenagers and adults lacking protection.

In the latest study, researchers analysed the genes coding for the proteins on the surface of the pertussis bacterium responsible for the UK outbreak.

They found proteins being targeted by the vaccine were mutating at a faster rate than other surface proteins not included in the vaccine.

Potentially it means the bacteria is changing quickly to get around immune system's defences put in place with immunisation.

What is whooping cough?

It is also known as pertussis and is caused by a species of bacteria, Bordetella pertussis

It mostly affects infants, who are at highest risk of complications and even death

The earliest signs are similar to a common cold, then develop into a cough and can even result in pneumonia

Babies may turn blue while coughing due to a lack of oxygen

The cough tends to come in short bursts followed by desperate gasps for air (the whooping noise)

Adults can be infected - but the infection often goes unrecognised

But the researchers are still trying to work out what the changes mean in reality - for example do the mutations boost the ability of the bacteria to cause infection.

"We wanted to look at strains from the UK to see if there was anything sudden that had occurred that had led to these really large outbreaks," said study leader Dr Andrew Preston from the University of Bath.

Vaccine effectiveness

The "million dollar question" he said was what, if anything, could be done to improve the vaccine - which is still the best defence we have - and prevent future outbreaks.

Options to consider include adding more or different proteins to the vaccine, adding novel adjuvants - chemicals which boost the immune response, or even revisiting the old-style whole cell vaccine, he said.

"Pertussis has a cyclical nature and other big question is are we going to see another increase in late 2015," he added

Prof Adam Finn, a paediatric immunology expert at the University of Bristol said the importance - or not - of the subtle changes found in the study was as yet unclear.

"But the control of pertussis is a significant worry," he added.

Only 60% of pregnant women have had the pertussis vaccine and we should be doing more to raise awareness of its benefits, he said.

"There is very good new evidence that vaccinating pregnant women protects their babies. And the group we really want to protect is newborn babies," he said.


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Planned NHS cash changes spark anger

Written By Unknown on Kamis, 25 Desember 2014 | 21.24

24 December 2014 Last updated at 12:13
Generic image of staff in a hospital

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"The plan is to pay a reduced fee to hospitals for each extra patient they take on", reports Hugh Pym

Hospital specialists have hit out at plans to reduce funding for specialised operations and treatments NHS trusts provide, including some cancer care.

Some 345 specialists have written to NHS England saying the changes could mean longer waiting lists and avoidable deaths, the Daily Telegraph reports.

Under the plans, centres treating more patients than expected would receive just half the extra treatment costs.

NHS England says these services have already seen a big increase in funding.

Lower income

The body channels taxpayers' money to the select NHS trusts that provide specialist services for conditions such as uncommon cancers, burns and medical genetics.

Its proposals - due to come into force in April - aim to curb a growth in spending in this area.

NHS England says providers had seen their incomes rise by more than £1bn over two years.

Curbing this growth in spending would free up resources to be used on other services including care for mental health patients, ambulance provision, casualty departments and GP care.

Analysis: Hugh Pym, BBC Health Editor

It's another illustration of a central question about the future direction of the NHS - what should priorities be at a time of rising demand for care and more sophisticated medical technology and treatment becoming available?

NHS England have taken a decision to shift some resources from specialised provision, including some complex cancer surgery, to areas which they feel are in need of more funding, such as mental health. In effect it has a cake, agreed with the Department of Health, and it has decided to slice it differently from next year. There is no plan to cut specialised services, rather to pay hospitals less for each new patient they take on.

Hospitals and their consultants are understandably upset that their income for new work will be lower than they expected. They warn that patients will suffer as waiting lists for treatment will get longer. Why, they argue, should people needing cancer treatment lose out at all?

No final decisions have been reached. The haggling will continue over the next few weeks. Whatever the outcome, the debate about a health service with finite resources but ever-increasing demands on it won't go away.

However, the letter quoted by the Daily Telegraph says the proposals will leave hospitals with a choice of treating patients and incurring a financial loss, or not treating them at all.

"The clinical consequences of these longer waiting times and a lower quality service to patients with conditions such as heart disease, liver disease, leukaemia, complex cancers etc will be severe," it reportedly says.

Continue reading the main story

Each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another"

End Quote Dr Mark Porter British Medical Association council chair

"There will inevitably be avoidable deaths as patients die on waiting lists or find that their disease has progressed during the wait for treatment, to the point that it is no longer curable."

A consultation period ends on Wednesday with a final decision expected early next year.

NHS England said in a statement: "We will listen carefully to all consultation responses on these proposals, while recognising that providers of specialised services have enjoyed income increases of over £1bn over the past two years."

Dr Mark Porter, of the British Medical Association which represents doctors, said: "This is a way of putting into action the latest round of NHS cuts, but the funding changes ignore the underlying problem that those hospitals facing unprecedented levels of demand are being forced to provide patient care at a loss, pushing more and more into deficit and collapse.

"The BMA believes that each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another."

Andrew Gwynne, Labour's Shadow Health Minister, said NHS England needed to listen carefully to the hundreds of hospital consultants who had raised serious concerns about funding plans for specialist services.

"These proposals could put lives at risk and harm patient care."

He said it was right to move appropriate services out of hospital, into the home and community setting.

"That is how we can reduce pressure on hospitals and allow them to deliver the specialist services that need to be done in the hospital."


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Doctors warn of Loom bands danger

25 December 2014 Last updated at 02:22 By Emma Wilkinson Health reporter, BBC News

Doctors are warning parents of the need to be vigilant after a spate of children with loom bands stuck up their noses.

Although medics can usually get them out, there is a real risk children could choke on them, the Journal of Laryngology and Otology reports.

The tiny colourful rubber bands, which can be woven to make bracelets, are one of this year's most popular toys.

Emergency doctors reported four cases at one hospital in a week.

Continue reading the main story

It's not necessarily dangerous if they are stuck up the nose, but when objects are small enough they can go backwards and be inhaled or choked on"

End Quote Dr Donald MacGregor Paediatrician

The team at the Monklands hospital, in Scotland, urged parents to keep a careful eye on young children playing with loom bands.

They said an inhaled loom band or clip could prove fatal.

Noses or ears

Dr Iain Bohler, a surgical registrar and report author, who has since moved to New Zealand, said while it was common for children to turn up at hospital with small objects in their noses or ears, medics had only started to see this with loom bands fairly recently.

"Often foreign bodies are removed with little more than distress to the child, however, in the worst case scenario, they can lead to blocked airways, cardiorespiratory arrest and death."

Dr Bohler said that loom bands could be a lot of fun, unleashing children's creative minds.

"I would however stress with utmost sincerity, the need for parental vigilance in supervising young children playing with loom bands, or any other toy or item with small parts."

Global craze

Rainbow loom, the plastic device for weaving the small bands, was invented in 2011.

The craze for making them into jewellery and even items of clothing has taken off worldwide.

Celebrities including the Duchess of Cambridge and David Beckham have been spotted wearing loom band bracelets.

Two of the children reported by Dr Bohler had inserted one of the s-shaped hooks - used to complete loom band bracelets - into their nose. One child ended up swallowing it after initially choking.

The other two young children had managed to get loom bands stuck in their nasal passages.

Local anaesthetic and crocodile forceps were needed, with the children becoming very distressed at attempts to get the objects out.

Dr Bohler said: "Should any parents be remotely concerned their child has swallowed or inhaled any object, they must contact emergency services immediately."

Dr Donald MacGregor, spokesman for the Royal College of Paediatrics and Child Health, advised parents to be aware that "small objects will always get into places you don't want them to be with young children."

He called for families to ensure they knew what to do in the event of choking.


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Sierra Leone declares Ebola lockdown

25 December 2014 Last updated at 09:02

Sierra Leone has declared lockdown of at least three days in the north of the country to try to contain the Ebola epidemic.

Shops, markets and non-Ebola related travel services will be shut down, officials said.

Sierra Leone has already banned many public Christmas celebrations.

More than 7,500 people have died from the outbreak in West Africa so far, the Word Health Organization (WHO) says, with Sierra Leone the worst hit.

Sierra Leone has the highest number of Ebola cases in West Africa, with more than 9,000 cases and more than 2,400 deaths since the start of the outbreak.

The other countries at the centre of the outbreak are Liberia and Guinea.

State of emergency

Alie Kamara, resident minister for the Northern Region, told AFP news agency that most public gatherings would be cancelled.

"Muslims and Christians are not allowed to hold services in mosques and churches throughout the lockdown except for Christians on Christmas Day", he said.

No unauthorised vehicles would be allowed to operate "except those officially assigned to Ebola-related assignments" he added.

The lockdown would operate for at least three days but this could be extended if deemed necessary, officials said.

Sierra Leone has been in a state of emergency since July.

The outbreak began a year ago in the West African country of Guinea, but only gained international attention in early 2014.


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Three e-cigarette TV adverts banned

Written By Unknown on Rabu, 24 Desember 2014 | 21.24

24 December 2014 Last updated at 06:44

Three television adverts for electronic cigarettes have been banned, just weeks after the rules were changed so people could be shown using them.

Two of the adverts featured a woman exhaling vapour which, according to the Advertising Standards Authority (ASA), appeared to glamourise the smoking of tobacco products.

Another was said to be encouraging non-smokers to take up e-cigarettes.

The ASA had received more than 200 complaints about the adverts.

Since November, manufacturers have been allowed to advertise the use of electronic cigarettes on TV, as long as they do not promote tobacco or target non-smokers or young people.

Critics of so-called e-cigarettes argue that the devices may encourage people to see smoking as acceptable.

Vapour focus

Two adverts for Must Have, which trades as VIP Electronic Cigarettes, showed a woman exhaling vapour - known as vaping - as a voiceover recommended "the great taste of VIP".

The ASA received 199 complaints, including some from organisations such as Ash (Action on Smoking and Health), the Association of Directors of Public Health UK (ADPH) and the British Medical Association (BMA).

Must Have argued that the adverts stated the product was an e-cigarette, which they said made it clear that no tobacco was being promoted.

But although the advert did not mention tobacco, the ASA ruled that close-ups of the woman exhaling drew particular attention to the vapour.

The ASA said: "We considered that the manner in which the vapour was exhaled and the heightened focus on this action created a strong association with traditional tobacco smoking.

"Because the ads presented it, as the central focus of the ads, in a sultry and glamorous way, we considered that they indirectly promoted the use of tobacco products."

'Irresponsible' advert

In a separate ruling, the ASA banned a Vape Nation advert for encouraging ex-smokers to use e-cigarettes.

The clip promoting KiK e-cigarettes featured a group of adults using and discussing the devices, with one man saying: "I used to smoke normal cigarettes, but after I quit, I tried these. I actually prefer them."

The ASA received seven complaints from viewers who argued the advert would encourage non-smokers, and particularly former smokers, to use them.

Vape Nation denied this, arguing the advert was aimed at current smokers.

But the ASA said: "We considered that the man's statement could encourage non-smokers to take up using e-cigarettes and we therefore concluded the ad was irresponsible."

It ruled all three adverts must not appear again in their current form.


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Ebola crisis 'likely to last a year'

24 December 2014 Last updated at 07:49

West Africa's Ebola crisis is likely to last until the end of 2015, says a leading researcher who helped to discover the virus.

Peter Piot, who has just returned from Sierra Leone, told the BBC that he was encouraged by progress there and by the promise of new anti-viral therapies.

But he also warned that vaccines would take time to develop.

The current Ebola outbreak, the deadliest to date, has so far killed more than 7,300 people.

Most of the victims have been in Sierra Leone, Liberia and Guinea.

Prof Piot was one of the scientists who discovered Ebola in 1976 and is now Director of the London School of Hygiene and Tropical Medicine.

He said that even though the outbreak has peaked in Liberia and was likely to peak in Sierra Leone in the next few weeks, the epidemic could have a "very long tail and a bumpy tail".

Professor Peter Piot, Director of the London School of Hygiene and Tropical Medicine.

Please turn on JavaScript. Media requires JavaScript to play.

"This epidemic all started with one case" - Professor Peter Piot

"The Ebola epidemic is still very much there. People are still dying, new cases are being detected," he told the BBC World Service's Newsday programme.

"We need to be ready for a long effort, a sustained effort [for] probably the rest of 2015."

But he added that he was impressed by the progress that he had seen in Sierra Leone.

"Treatment centres have now been established across the country with British help. You don't see any longer the scenes where people are dying in the streets," he said.

He also said he was also encouraged that thanks to simple treatments such as intravenous fluids and antibiotics, mortality rates had fallen to as low as one in three.

"Getting it below that will require specific therapies that are now going to be tested," he said, adding that he hoped that within three months it would be clear which anti-viral therapies were effective.

Developing a vaccine would be more complicated, he said, but must be done "so that when there is another epidemic or maybe when this epidemic drags on for a long time, that we have that vaccine available".


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Planned NHS cash changes spark anger

24 December 2014 Last updated at 12:13
Generic image of staff in a hospital

Please turn on JavaScript. Media requires JavaScript to play.

"The plan is to pay a reduced fee to hospitals for each extra patient they take on", reports Hugh Pym

Hospital specialists have hit out at plans to reduce funding for specialised operations and treatments NHS trusts provide, including some cancer care.

Some 345 specialists have written to NHS England saying the changes could mean longer waiting lists and avoidable deaths, the Daily Telegraph reports.

Under the plans, centres treating more patients than expected would receive just half the extra treatment costs.

NHS England says these services have already seen a big increase in funding.

Lower income

The body channels taxpayers' money to the select NHS trusts that provide specialist services for conditions such as uncommon cancers, burns and medical genetics.

Its proposals - due to come into force in April - aim to curb a growth in spending in this area.

NHS England says providers had seen their incomes rise by more than £1bn over two years.

Curbing this growth in spending would free up resources to be used on other services including care for mental health patients, ambulance provision, casualty departments and GP care.

Analysis: Hugh Pym, BBC Health Editor

It's another illustration of a central question about the future direction of the NHS - what should priorities be at a time of rising demand for care and more sophisticated medical technology and treatment becoming available?

NHS England have taken a decision to shift some resources from specialised provision, including some complex cancer surgery, to areas which they feel are in need of more funding, such as mental health. In effect it has a cake, agreed with the Department of Health, and it has decided to slice it differently from next year. There is no plan to cut specialised services, rather to pay hospitals less for each new patient they take on.

Hospitals and their consultants are understandably upset that their income for new work will be lower than they expected. They warn that patients will suffer as waiting lists for treatment will get longer. Why, they argue, should people needing cancer treatment lose out at all?

No final decisions have been reached. The haggling will continue over the next few weeks. Whatever the outcome, the debate about a health service with finite resources but ever-increasing demands on it won't go away.

However, the letter quoted by the Daily Telegraph says the proposals will leave hospitals with a choice of treating patients and incurring a financial loss, or not treating them at all.

"The clinical consequences of these longer waiting times and a lower quality service to patients with conditions such as heart disease, liver disease, leukaemia, complex cancers etc will be severe," it reportedly says.

Continue reading the main story

Each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another"

End Quote Dr Mark Porter British Medical Association council chair

"There will inevitably be avoidable deaths as patients die on waiting lists or find that their disease has progressed during the wait for treatment, to the point that it is no longer curable."

A consultation period ends on Wednesday with a final decision expected early next year.

NHS England said in a statement: "We will listen carefully to all consultation responses on these proposals, while recognising that providers of specialised services have enjoyed income increases of over £1bn over the past two years."

Dr Mark Porter, of the British Medical Association which represents doctors, said: "This is a way of putting into action the latest round of NHS cuts, but the funding changes ignore the underlying problem that those hospitals facing unprecedented levels of demand are being forced to provide patient care at a loss, pushing more and more into deficit and collapse.

"The BMA believes that each patient should get the treatment they need where and when they need it, instead of essentially robbing one part of the system to pay for another."

Andrew Gwynne, Labour's Shadow Health Minister, said NHS England needed to listen carefully to the hundreds of hospital consultants who had raised serious concerns about funding plans for specialist services.

"These proposals could put lives at risk and harm patient care."

He said it was right to move appropriate services out of hospital, into the home and community setting.

"That is how we can reduce pressure on hospitals and allow them to deliver the specialist services that need to be done in the hospital."


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E-books 'damage sleep and health'

Written By Unknown on Selasa, 23 Desember 2014 | 21.24

23 December 2014 Last updated at 00:45 By James Gallagher Health editor, BBC News website

If you curl up under the duvet with an e-book for a bedtime read then you are damaging your sleep and maybe your health, US doctors have warned.

A team from Harvard Medical School compared reading paper books and light-emitting e-readers before sleep.

They found it took longer to nod off with a back-lit e-reader, which led to poorer quality sleep and being more tired the next morning.

Original Kindle readers do not emit light so should be fine, say experts.

Experts said people should minimise light-exposure in the evening.

Whether you are perusing the Man Booker shortlist or leafing through Zoella, the impact of reading on your sleep is probably the last thing on your mind.

But there has been growing concern about the dangers of light before bedtime.

Body clock

Our bodies are kept in tune with the rhythm of day and night by an internal body clock, which uses light to tell the time.

But blue light, the wavelength common in smartphones, tablets and LED lighting, is able to disrupt the body clock.

Blue light in the evening can slow or prevent the production of the sleep hormone melatonin.

Twelve people were locked in a sleep laboratory for two weeks.

They spent five days reading from a paperback and five days from an iPad.

Regular blood samples showed the production of the sleep hormone melatonin was reduced by reading an e-book.

People also took longer to fall asleep, had less deep sleep and were more tired the next morning.

The researchers said other e-readers such as the Nook and Kindle Fire produced similar wavelengths of light and would have the same impact.

The findings were published in the journal Proceedings of the National Academy of Sciences.

'Concern'

Lead researcher Prof Charles Czeisler told the BBC News website: "The light emitted by most e-readers is shining directly into the eyes of the reader, whereas from a printed book or the original Kindle, the reader is only exposed to reflected light from the pages of the book."

He said disrupting sleep in turn affected health.

"Sleep deficiency has been shown to increase the risk of cardiovascular disease, metabolic diseases like obesity and diabetes, and cancer.

"Thus, the melatonin suppression that we saw in this study among participants when they were reading from the light-emitting e-reader concerns us."

Sleep hygiene

Dr Victoria Revell, who researches the impact of light on the body at the University of Surrey, told the BBC: "This is a very good study and I think it's really interesting.

"We should be advising people to minimise their [light-emitting e-reader] use in the evening, particularly teenagers who are a group that are using their phones and tablets late in to the evening."

Teenagers naturally have a late body clock, which makes them slow to rise in the morning and up late at night.

"People who already have a delayed body clock are delaying themselves much further and that is a very important message," Dr Revell added.

Prof Czeisler agreed, saying there was "special concern" for teenagers who were already sleep deficient by being forced to get up early for school.


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Tackle loneliness to 'shield' A&E

23 December 2014 Last updated at 00:46 By Adam Brimelow Health Correspondent, BBC News

NHS leaders are urging people to look in on elderly friends and neighbours over the Christmas period to ease pressures on hospital A&E departments.

They warn loneliness and isolation can increase the risk of emergency hospital admissions.

They say people are more likely to report health problems in good time if they have someone to talk to .

The Patients Association says the service could be heading for a "crunch weekend".

Hospitals and ambulance services are already coming under enormous pressure this winter.

Figures released on Friday showed in England there were more than 440,000 visits to A&E the previous week - a rise of 6% on the same period last year.

Emergency admissions reached record levels, rising to more than 111,000.

Continue reading the main story

We often see a sharp spike in emergency admissions at this time of year and we know that the majority of these are elderly people who have stored up a health problem at home and haven't sought treatment early hoping it will 'go away'"

End Quote Prof Keith Willett NHS England
'Spike' in admissions

NHS leaders say they want to keep people out of busy A&E departments "as far as possible".

They are worried that over the festive period the impact of loneliness and social isolation could cause a major "spike" in admissions.

Prof Keith Willett, NHS England's national clinical director for acute care, cited a recent study in south west England in which 45% of elderly patients admitted as an emergency said they were socially isolated.

"We are calling on the public to think about those people living nearby who might benefit from a visit.

"If they see other people they are more likely to mention a health problem and then are more likely to seek help early."

And - with GP surgeries closed for some of the festive period - Prof Willett reminded people to order medicines in good time so they do not run out.

Lifesaving services

It is a similar message across the UK for the festive period.

In Scotland, Shona Robison, cabinet secretary for health, wellbeing and sport, said people should think through their options.

"We are encouraging people to make themselves aware of the services available to them over the festive period and think about where best to turn if their condition is not life-threatening.

"NHS 24, the local pharmacy, the GP surgery or minor injuries unit may be the better place to go rather than a busy A&E unit, keeping emergency lifesaving services free for those who really need them."

The chairman of the Patients Association, Dr Mike Smith, said there was a risk people could "completely swamp" A&E departments because of a lack of faith in out of hours services.

"We need a new way of providing 24/7 community services, it's going to have to evolve, the current situation is very difficult for people to cope with."

Speaking for the British Medical Association, Dr Chaand Nagpaul, said services were in place to help people without them having to turn straightaway to their nearest hospital emergency department.

"There is a service available through the bank holiday period. People can get to see a GP if they need to through NHS 111.

"Knowing that, there is no need to feel they have to rush to A&E."


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Ebola vaccine 'promising in Africa'

23 December 2014 Last updated at 00:47 By Smitha Mundasad Health reporter, BBC News

The first-ever trial of an Ebola vaccine in Africa shows promising initial results, according to a report in the Lancet medical journal.

Scientists say it is a crucial step as other vaccines have shown lower levels of protection in African populations.

Tests involving Ugandan and American volunteers reveal the vaccine is so far safe and generates an immune response in both populations.

It provides reassurance for other trials currently underway, they say.

The Ebola virus has killed more than 6,900 people in the worst-affected countries of Sierra Leone, Liberia and Guinea.

No proven vaccine exists to prevent people from getting the disease, though several trials are underway.

The aim of a successful vaccine is to train the immune systems of healthy people to produce antibodies - proteins capable of fighting off any future infections.

Viral protection

Researchers from the National Institutes of Health tested this experimental vaccine on healthy adults in Uganda, having first trialled it in the United States.

Dr Julie Ledgerwood, the lead researcher, said: "This is the first study to show comparable safety and immune response of an experimental Ebola vaccine in an African population.

"This is particularly encouraging because those at greatest risk of Ebola live primarily in Africa and diminished vaccine protection in African populations has been seen for other diseases."

According to the study some 57% of people in Uganda who received the Ebola vaccine alone developed antibodies against Ebola in their blood.

Dr Sridhar of the University of Oxford, commenting on the research, said the data provided reassurance about separate Ebola virus vaccines trials currently underway in Mali, the US and the UK.

But further tests would be needed to see if the antibodies are strong enough and long-lasting enough to provide adequate protection against the disease.


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Ambulance wait times 'may increase'

Written By Unknown on Senin, 22 Desember 2014 | 21.24

21 December 2014 Last updated at 14:45
Ambulance

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Labour has said Health Secretary Jeremy Hunt has questions to answer over the plans

Target times for ambulances to reach some seriously ill patients could be lengthened, the BBC has learned.

A leaked NHS document includes plans to change the response time for some Red 2 patients - those with "serious but not the most life-threatening" conditions - from eight to 19 minutes in England.

It said the plans had been backed by Health Secretary Jeremy Hunt, subject to approval by ambulance trust bosses.

The government said no decisions had been made. Labour has demanded answers.

And the party has rejected suggestions from ambulance chiefs that it was told about the plan to change response times and raised no objections.

"We have never given any support for this plan. When raised in passing, [Shadow health secretary Andy] Burnham explicitly warned of the need for caution and consultation as he repeated today, " a Labour spokesperson told BBC political correspondent Carole Walker.

"The evidence needed to be produced first and it hasn't been. Instead, ministers are forcing it through from January, in the middle of a crisis, without proper planning," the spokesperson added.

Mr Burnham has written to Mr Hunt asking him to explain why the measures - proposed to be brought in within weeks - were not disclosed to Parliament days after he signed them off.

The leaked document, drawn up for the Association of Ambulance Chief Executives and dated 16 December, said NHS England had "explicitly stressed" the plans were confidential and "should not be disseminated beyond the group" involved in the discussions.

The document said there were existing plans for changes "after the general election" in May.

But it said Prof Keith Willett, head of acute care at NHS England, had made an "urgent request" for discussions due to "unprecedented demand" on health services - and the "target for implementing these changes was the first week of January 2015".

In an interview with the BBC, Prof Willett stressed nothing had been agreed but the proposals must be taken "very seriously".

He said the plans would be scrutinised, and only implemented if proved safe and following testing.

Analysis

By BBC home affairs correspondent Sally Chidzoy

A whistleblower leaked the memo to the BBC because of serious concerns over patient safety, fears the plans were rushed at the height of winter when the service is under unprecedented pressure and anger over the secrecy involved.

To many in the service, the general ideas are good - but there this concern it should have been a more thoughtful exercise where time was taken to consult widely and the public was involved in the process.

Paramedics say response times distort their ability to treat patients because they have to chase the clock.

They say some illnesses such as strokes, should be moved up a category.

The target for these changes was early January, according to the document, but it seems unlikely the proposals will now go ahead by then.

One ambulance service director, who asked not to be named, told the BBC: "This is being done for political expediency rather than patient safety and it's being done with the full blessing of Jeremy Hunt.

"This is being pushed through with limited consultation with the chief executives and the health service as a whole."

Professor Keith Willett

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Professor Keith Willett, head of acute care at NHS England: ''We may well be able to give individual patients a better response''

Martin Berry, executive officer of the College of Paramedics, said he was not opposed to change but it could not be done "behind closed doors".

"There's been no effort to engage with the paramedic profession. We're just very concerned about the way this has been kept in the dark."

The College, which represents paramedics across the UK, said it would be discussing the proposals with AACE and NHS England and seeking to be involved in negotiations.

President of the College of Emergency Medicine, Dr Clifford Mann, said the proposals appeared "sensible" but they needed to be trialled to provide evidence to prove it was not a "cosmetic exercise".

Call types:
  • Red 1: Respiratory or cardiac arrest - response in eight minutes
  • Red 2: All other life-threatening emergencies, such as stroke and fits - response in eight minutes
  • Other response times are agreed locally

Ambulance trusts dealt with almost 8.5 million emergency calls in 2013-14 in England, an average of 16.1 calls per minute.

The national target is for ambulance trusts to reach 75% of Red 1 patients within eight minutes, and 95% within 19 minutes. The time starts as soon as an emergency call is connected.

Red 2 targets are currently the same, except that the "clock start" can be up to 60 seconds after a call is connected.

The changes proposed to Red 2 are:

  • A "small number" moved to Red 1 - those where a short extra wait "could have a potentially serious detrimental impact"
  • Just under half to keep the 75% within eight minutes target, but trusts will have up to three minutes from receiving a call before the clock starts
  • About 40% to have a 19-minute response target, as well as three minutes before the clock must start

The Red 2 category includes strokes and fits, but the document does not say which conditions would be put in each of the new categories.

It said the proposed changes could bring "substantial improvements".

The document also said trusts would be able to cut the number of fast-response cars being used in favour of deploying more double-crewed ambulances.

But it acknowledged the plans have not had the "breadth of exposure that would normally be expected".

'Full apology'

Mr Burnham said: "Jeremy Hunt was dragged before Parliament last Thursday to answer questions on NHS winter planning but treated [it] with contempt. It is outrageous that he decided to keep MPs and the public in the dark about a decision he had already taken and one which will have far-reaching implications across the NHS...

"This leak leaves Jeremy Hunt with extremely serious questions to answer. He must do so today."

He said if the health secretary did not have an "acceptable reason for withholding information" he should make a full apology to MPs.

Mr Hunt has not commented but the Department of Health said the health secretary "would only agree to proposed changes that improve response times for urgent cases".

The leak comes after it emerged on Friday that pressures in England's A&E units had hit record levels, with the lowest percentage of patients seen within four hours since monitoring began in 2010.


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