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Cut music to 'an hour a day' - WHO

Written By Unknown on Sabtu, 28 Februari 2015 | 21.24

27 February 2015 Last updated at 14:27 James GallagherBy James Gallagher Health editor, BBC News website

People should listen to music for no more than one hour a day to protect their hearing, the World Health Organization suggests.

It says 1.1 billion teenagers and young adults are at risk of permanently damaging their hearing by listening to "too much, too loudly".

It said audio players, concerts and bars were posing a "serious threat".

WHO figures show 43 million people aged 12-35 have hearing loss and the prevalence is increasing.

In that age group, the WHO said, half of people in rich and middle-income countries were exposed to unsafe sound levels from personal audio devices.

Meanwhile 40% were exposed to damaging levels of sound from clubs and bars.

The proportion of US teenagers with hearing loss went from 3.5% in 1994 to 5.3% in 2006.

WHO v The Who

Dr Etienne Krug, the WHO's director for injury prevention, told the BBC: "What we're trying to do is raise awareness of an issue that is not talked about enough, but has the potential to do a lot of damage that can be easily prevented."

The full report argued: "While it is important to keep the volume down, limiting the use of personal audio devices to less than one hour a day would do much to reduce noise exposure."

Dr Krug said that a good ambition aim: "That's a rough recommendation, it is not by the minute, to give an idea to those spending 10 hours a day listening to an mp3-player.

"But even an hour can be too much if the volume is too loud."

Safe listening levels

The louder the noise (measured in decibels), the faster it damages the ear.

The WHO's safe listening times are:

  • 85 dB - the level of noise inside a car - eight hours
  • 90 dB - lawn mower - two hours 30 minutes
  • 95 dB - an average motorcycle - 47 minutes
  • 100 dB - car horn or underground train - 15 minutes
  • 105 dB - mp3 player at maximum volume - four minutes
  • 115 dB - loud rock concert - 28 seconds
  • 120 dB - vuvuzela or sirens - nine seconds

The World Health Organization recommends keeping the volume to 60% of the maximum as a good rule of thumb.

For people trying to drown out the noise of flying or train journeys, it says noise-cancelling headphones allow music to be heard clearly at a lower volume.

And the WHO adds that ear plugs should be worn at noisy venues and advises taking "listening breaks" and standing far away from speakers at gigs.

But what is the point of a concert if you are going to avoid the music?

"We do realise this is a bit of a struggle, like alcohol consumption, so many risk factors linked to pleasure are not easy to change, but we have to make people aware," Dr Krug said.

But as well as calling for personal responsibility, the WHO says governments and manufacturers have a responsibility.

It says clubs should provide chill-out rooms and give out free ear plugs, headphone manufacturers should set limits on the volume, and governments need to adopt stricter laws.

Paul Breckell, the chief executive of the charity Action on Hearing Loss, said: 'When listening to loud music, for every three decibel increase in level, to stay safe you should halve your listening time.

"For example, at 88 dB, safe allowable exposure is cut to four hours, at 91 dB, two hours and so on.

"I urge music lovers to consider the long term risks of listening to loud music from their personal music players over the 85dB safe level, as over exposure can trigger tinnitus, and remember that a good pair of noise cancelling headphones can make all the difference."


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Row over Savile hospital access claim

27 February 2015 Last updated at 01:14 By Noel Titheradge BBC News

The chief executive responsible for Stoke Mandeville hospital told a local MP in 2012 that Jimmy Savile was "not given free access" to clinical areas, the BBC has learnt.

Savile abused more than 60 people on the hospital site including wards where young children were treated.

Reading East MP Rob Wilson said Anne Eden's comments to him were "bordering on misleading".

Buckinghamshire Healthcare NHS Trust declined to comment.

Continue reading the main story

It is extremely disappointing that the answers I got at the time were inadequate and unfortunately wrong"

End Quote Rob Wilson MP

The MP's complaint follows the publication on Thursday of the report of an independent investigation into Savile's behaviour at the hospital.

It found that he had "virtually unrestricted access" to clinical areas and patients during the 1970s and 80s.

'Not full truth'

It also revealed that Savile was given a bedroom that allowed him to live "alongside young female students for four decades".

Following the emergence in September 2012 of the allegations about Jimmy Savile's abuse at Stoke Mandeville, Reading East MP Rob Wilson wrote to the Chief Executive of Buckinghamshire Healthcare NHS Trust to express his constituents' concerns about the claims.

Anne Eden sought to reassure him about Savile's freedoms at the hospital in an email sent on 12 October 2012, and obtained by the BBC through a Freedom of Information request.

"There has been a lot of conjecture in the media regarding Jimmy's access at Stoke Mandeville", she wrote. "I would like to clarify that he was not given free access around our clinical areas.

"To the best of my knowledge, whenever he attended the hospital, he would give advance notice and usually be in attendance with his fundraising team. He and his team were given access to a room, but this was not within the main hospital nor in any clinical area."

Mr Wilson said: "It is extremely disappointing that the answers I got at the time were inadequate and unfortunately wrong.

"I felt at the time I was corresponding with Ms Eden, that I was not getting to the full truth. There were clearly media reports suggesting that he had more access than she was telling me.

"I was very surprised to receive the first letter suggesting that he had no unsupervised access and suggesting there wasn't any great need to look further."

'Open secret'

He said he understood that the email was written at a difficult time for the hospital but "it was a very important issue where the truth - more than anything else - had to come out".

Meanwhile, a fomer cabinet minister who agreed a deal with Savile under which the late DJ would fundraise for the hospital on condition it was kept open, has told the BBC he accepts a share of responsibility for enabling Savile to abuse patients.

On BBC Newsnight, Lord Jenkin - who was social services secretary between 1979 and 1981 - said: "I deeply regret what we now know Jimmy Savile got up to in this hospital."

He told the programme he was not aware at the time that Savile was a sexual predator who had been given the freedom of the hospital.

"I have been appalled to read just how far he had gained access," he said.

When asked if he should have known about the level of freedom Savile had at Stoke Mandeville, he replied: "Maybe I should have, but I didn't."

Thursday's report said that Savile had abused 63 people connected to the hospital and that one formal complaint about him - made by the father of an 11-year-old girl - was ignored.

It said his reputation as a "sex pest" was an "open secret" among some staff but that allegations about his behaviour probably did not reach managers.

According to the report, Savile's victims, aged between eight and 40, were abused over a 24-year period between 1968 and 1992.

Sexual abuse by Savile ranged from inappropriate touching to rape - including the rape of children under the age of 12.


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Distinct ME stages found, says study

28 February 2015 Last updated at 02:31

Distinct changes in the immune systems of patients with ME or chronic fatigue syndrome have been found, say scientists.

Increased levels of immune molecules called cytokines were found in people during the early stages of the disease, a Columbia University study reported.

It said the findings could help improve diagnosis and treatments.

UK experts said further refined research was now needed to confirm the results.

Continue reading the main story

It appears that ME patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion"

End Quote Dr Mady Hornig University of Columbia

People with ME (myalgic encephalopathy) or CFS (chronic fatigue syndrome) suffer from exhaustion that affects everyday life and does not go away with sleep or rest.

They can also have muscle pain and difficulty concentrating.

ME can also cause long-term illness and disability, although many people improve over time.

It is estimated that around 250,000 people in the UK have the disease.

Disease pattern

The US research team, who published their findings in the journal Science Advances, tested blood samples from nearly 300 ME patients and around 350 healthy people.

They found specific patterns of immune molecules in patients who had the disease for up to three years.

These patients had higher levels of of cytokines, particularly one called interferon gamma, which has been linked to the fatigue that follows many viral infections.

Healthy patients and those who had the disease for longer than three years did not show the same pattern.

Lead author Dr Mady Hornig said this was down to the way viral infections could disrupt the immune system.

"It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop."

This shows there are distinct stages to the disease, she said. When the cytokine response starts to settle down, the disease also appears to quieten down.

Drug treatments

Peter White, professor of psychological medicine at Queen Mary University of London, said it was premature to draw any conclusions from the study.

"Only one out of the 51 immune proteins studied was elevated in all cases compared with controls, something that could happen by chance alone.

"I hope the authors will go on to re-examine their data after stratifying their samples by other factors that determine the different sub-groups that most scientists now accept make up this illness.

"Finally, as the authors themselves suggest, we need to see these results replicated independently."

Dr Charles Shepherd, medical adviser to the ME Association, said the research was interesting and useful, and added more support to what is already known about the abnormal immune response in people with chronic fatigue syndrome.

"If distinctive patterns of cytokine abnormality can be linked to both stage and severity of disease, this is a finding which could be used to aid diagnosis and open the door to the use of anti-inflammatory drug treatments that would dampen down the abnormal immune system response."

But he indicated that this was still some way off.

He added: "Although some doctors do still mistakenly believe that ME/CFS is a psychological illness, there is now very robust evidence being produced to show that we are dealing with a physical disease process that includes significant abnormalities involving the brain, muscle and the immune system."


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Age-related leukaemia cases may soar

Written By Unknown on Jumat, 27 Februari 2015 | 21.24

27 February 2015 Last updated at 03:17 James GallagherBy James Gallagher Health editor, BBC News website

It is "almost inevitable" that your blood will take the first steps towards leukaemia as you age, researchers show.

The cancer is often associated with children, but some types become more common with age.

The study, published in the journal Cell Reports, showed 70% of healthy people in their 90s had genetic errors that could lead to leukaemia.

The researchers warn that the number of cases could soar as life expectancy increases.

The team at the Wellcome Trust Sanger Institute, outside Cambridge, analysed the blood of 4,219 people.

They focused on accurately testing for errors in the DNA that are linked to the blood cancers. If one blood cell in a hundred carried such a mutation they would pick it up.

The results were a surprise.

They suggest 20% of people in their 50s have potentially cancerous mutations rising to 70% in people in their 90s.

One of the researchers, Dr George Vassiliou, told the BBC News website: "We had suspected people had these mutations, but didn't expect they would be an almost inevitable consequence of ageing.

"What it is saying is that a lot more people than expected are starting on the path to leukaemia, but thankfully only a few make it to the end."

Dramatic impact

While progression to leukaemia is currently rare, the scientists believe it could become more common as life expectancy increases.

Dr Vassiliou added: "There is one warning for the future, if there was a significant extension of life expectancy then there could be a significant increase in leukaemia.

"We don't know what percentage of people would go on to develop leukaemia, it might be one in 1,000 or even one in 100 or more and that would have a dramatic impact."

One in three girls and one in four boys born today are expected to live to 100.

Stem cells in the bone marrow manufacture blood.

It takes multiple mutations to transform one from a normal cell into a cancerous one.

With enough mutations it can dominate the production of blood either producing defective blood cells, or one just one type to the exclusion of others.

The researchers believe that searching the blood for such mutations may identify people at high risk of developing leukaemia who may, in the future, be targeted with preventative therapies.

Dr Kat Arney, from Cancer Research UK, said: "We know that the risk of developing most types of cancer increases with age.

"This is a fascinating and important study highlighting how the genetic makeup of blood cells changes as we get older, and may contribute to the development of leukaemia.

"It will be interesting to see if this kind of technique can be applied to other types of cancer too."


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Row over Savile hospital access claim

27 February 2015 Last updated at 01:14 By Noel Titheradge BBC News

The chief executive responsible for Stoke Mandeville hospital told a local MP in 2012 that Jimmy Savile was "not given free access" to clinical areas, the BBC has learnt.

Savile abused more than 60 people on the hospital site including wards where young children were treated.

Reading East MP Rob Wilson said Anne Eden's comments to him were "bordering on misleading".

Buckinghamshire Healthcare NHS Trust declined to comment.

Continue reading the main story

It is extremely disappointing that the answers I got at the time were inadequate and unfortunately wrong"

End Quote Rob Wilson MP

The MP's complaint follows the publication on Thursday of the report of an independent investigation into Savile's behaviour at the hospital.

It found that he had "virtually unrestricted access" to clinical areas and patients during the 1970s and 80s.

'Not full truth'

It also revealed that Savile was given a bedroom that allowed him to live "alongside young female students for four decades".

Following the emergence in September 2012 of the allegations about Jimmy Savile's abuse at Stoke Mandeville, Reading East MP Rob Wilson wrote to the Chief Executive of Buckinghamshire Healthcare NHS Trust to express his constituents' concerns about the claims.

Anne Eden sought to reassure him about Savile's freedoms at the hospital in an email sent on 12 October 2012, and obtained by the BBC through a Freedom of Information request.

"There has been a lot of conjecture in the media regarding Jimmy's access at Stoke Mandeville", she wrote. "I would like to clarify that he was not given free access around our clinical areas.

"To the best of my knowledge, whenever he attended the hospital, he would give advance notice and usually be in attendance with his fundraising team. He and his team were given access to a room, but this was not within the main hospital nor in any clinical area."

Mr Wilson said: "It is extremely disappointing that the answers I got at the time were inadequate and unfortunately wrong.

"I felt at the time I was corresponding with Ms Eden, that I was not getting to the full truth. There were clearly media reports suggesting that he had more access than she was telling me.

"I was very surprised to receive the first letter suggesting that he had no unsupervised access and suggesting there wasn't any great need to look further."

'Open secret'

He said he understood that the email was written at a difficult time for the hospital but "it was a very important issue where the truth - more than anything else - had to come out".

Meanwhile, a fomer cabinet minister who agreed a deal with Savile under which the late DJ would fundraise for the hospital on condition it was kept open, has told the BBC he accepts a share of responsibility for enabling Savile to abuse patients.

On BBC Newsnight, Lord Jenkin - who was social services secretary between 1979 and 1981 - said: "I deeply regret what we now know Jimmy Savile got up to in this hospital."

He told the programme he was not aware at the time that Savile was a sexual predator who had been given the freedom of the hospital.

"I have been appalled to read just how far he had gained access," he said.

When asked if he should have known about the level of freedom Savile had at Stoke Mandeville, he replied: "Maybe I should have, but I didn't."

Thursday's report said that Savile had abused 63 people connected to the hospital and that one formal complaint about him - made by the father of an 11-year-old girl - was ignored.

It said his reputation as a "sex pest" was an "open secret" among some staff but that allegations about his behaviour probably did not reach managers.

According to the report, Savile's victims, aged between eight and 40, were abused over a 24-year period between 1968 and 1992.

Sexual abuse by Savile ranged from inappropriate touching to rape - including the rape of children under the age of 12.


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Start date for 'Devo Manc' NHS plan

27 February 2015 Last updated at 12:53

Greater Manchester will begin taking control of its health budget from April after a devolution agreement was signed by the Chancellor George Osborne.

The region's 10 councils and health groups will take over £6bn allocated for health and social care, with full powers being devolved a year later.

Mr Osborne signed the memorandum of understanding, dubbed Devo Manc, for "better, more joined-up health care".

Labour MP Barbara Keeley said: "We're being handed over a funding crisis."

From 1 April, the region will start making its own decisions which will "provide the foundations" for a Greater Manchester health and social care strategy.

Manchester City Council said this, along with business and investment proposals, would also give a "transitional plan" for full devolution by April 2016.

'No NHS reorganisation'

Mr Osborne said: "We have a landmark agreement to bring the local NHS and social care much more closely together.

"I am excited about all this because not only does it mean the people of Greater Manchester having more control over the decisions that affect their lives, I believe it will also lead to better, much more joined-up health care.

"It's also a historic day for Greater Manchester. They are leading the country in this important change."

The agreement "does not require any reorganisation of the NHS or its principles", the city council said.

Under the plan
  • Greater Manchester takes responsibility for adult, primary and social care
  • The region will also control mental health and community services and public health
  • It will focus on preventative work in the community such as treating heart conditions by community specialists in a bid to ease pressure on hospitals
  • The 10 councils, 12 clinical commissioning groups, 15 NHS providers and NHS England will control the budget and deliver services
  • The group will also build strategies around governance, regulation, finances and health education to run the devolved health service

Ms Keeley, MP for Worsley and Eccles South, said: "The problem with Osborne's offer is that it is on existing budgets.

"A&E has just been through its biggest crisis for many many years, so let's be realistic about it.

"There are big gaps in social care, our hospitals are in deficit [and] that's no way to do a proper job of integrating care, which is Labour's policy - to integrate health and social care at the local level."

The agreement is part of the government's northern powerhouse plan to close the economic gap between north and south by investing in regions.

The plan would see local leaders, and ultimately Greater Manchester's new directly elected mayor, control how budgets are allocated.

'Landmark agreement'

Deputy leader of Greater Manchester Combined Authority Sir Richard Leese said: "The first big change is to make sure that a lot of people aren't entering into needing healthcare that don't need to do so."

Sir Richard, who is also the leader of Labour-run Manchester City Council, said "people are spending too long in hospital" so "there will proper care packages available" when they return home.

The plan aims to ease the pressure on hospitals in the long-term.

Ann Barnes, chief executive of Stockport NHS Foundation Trust, said: "It is not about increasing power, but about increasing the health and prosperity of local people.

"We will have greater opportunities to respond swiftly and effectively to the needs of residents and really transform services for them. They will have a powerful voice in a powerful partnership."

NHS England chief executive Simon Stevens described the memorandum of understanding as a "landmark agreement".

"[It] charts a path to the greatest integration and devolution of care funding since the creation of the NHS in 1948," he said.

"Greater Manchester now has a unique opportunity for innovation and improvement in health and wellbeing. The eyes of the country will now be on what this new partnership can deliver, and today the work begins."


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WHO 'taken aback' by measles outbreaks

Written By Unknown on Rabu, 25 Februari 2015 | 21.24

25 February 2015 Last updated at 11:56

Measles vaccinations must be immediately stepped up across Europe and central Asia after a series of outbreaks, the World Health Organization says.

Officials say they have been "taken aback" by more than 22,000 cases in 2014 and the first months of this year.

The WHO demands that counties control the outbreaks with "no exception".

It say the surges threaten the goal of eliminating measles in the region by the end of 2015.

Continue reading the main story

It is unacceptable that measles continues to cost lives, money and time"

End Quote Dr Zsuzsanna Jakab WHO

Dr Zsuzsanna Jakab, WHO regional director for Europe, said: "When we consider that over the past two decades we have seen a reduction of 96% in the number of measles cases in the European region, and that we are just a step away from eliminating the disease, we are taken aback by these numbers.

"We must collectively respond, without further delay, to close immunization gaps.

"It is unacceptable that, after the last 50 years' efforts to make safe and effective vaccines available, measles continues to cost lives, money and time."

Country Number of cases

Source WHO, figures for Jan 2014 - Feb 2015

Kyrgyzstan

7,477

Bosnia and Herzegovina

5,340

Russian Federation

3,247

Georgia

3,291

Italy

1,674

Germany

583

Kazakhstan

537

Refusal to vaccinate

According to the organisation, a growing number of parents are refusing to vaccinate their children or are facing barriers in getting the immunisations they need.

Dr Nedret Emiroglu, from the WHO, says: "The priority is now to control current outbreaks through immunisation activities targeting people at risk,

"At the same time, all countries, with no exception, need to keep a very high coverage of regular measles vaccination, so that similar outbreaks won't happen again in our region, and measles can be eliminated once and for all."

The news comes after an 18-month-old boy died of measles in Berlin, sparking a nationwide debate about whether immunisations should be made compulsory.

In California, the department of public health has reported an outbreak of measles with more than 100 registered cases so far. Most of those showing symptoms of the disease were not vaccinated.


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'Give HIV drugs to healthy gay men'

24 February 2015 Last updated at 21:12 James GallagherBy James Gallagher Health editor, BBC News website

Healthy gay men should be offered daily HIV drugs to prevent infections, say campaigners.

A UK study, on 545 high-risk men, found one case of HIV could be stopped for every 13 men treated for a year.

The research team says it would be similar to the pill for women and would not encourage risky sex.

The findings have been described as a "game changer" and the NHS is considering how to adopt them.

Antiretroviral drugs have transformed HIV treatment and patients have a near-normal life expectancy.

Now there is a growing body of research showing the drugs can have a dramatic role in preventing new infections.

Massive fall

Gay men face a high risk of contracting HIV. In London, one in eight gay men has HIV while the figure is one in 26 in the rest of the UK.

In the first year of the study, 19 people developed HIV out of the 269 men who were not given the medicine.

There were just two cases in the 276 patients given preventative drugs - a fall of 86%.

The trial was altered as the early results were so promising, and all participants are now getting the drugs.

Risky sex?

Concerns had been raised that men given the drug would adopt riskier behaviours including stopping using condoms.

But the scientists found no difference in levels of other sexually transmitted infections, such as chlamydia.

"We certainly think the NHS should be considering making this available," said one of the researchers Dr Anthony Nardone from Public Health England.

He added: "I don't envisage all men taking PrEP [pre-exposure prophylaxis] for all their lives, but in effect what we're doing is giving men an option to get through periods of very high risk in their lives."

Fellow scientist Dr Mitzy Gafos, from University College London, said many gay men would not need the drugs as they were not having unprotected sex.

Estimates suggest that between 5,000 and 15,000 men in the UK would be suitable.

Dr Gafos added: "There's very clearly a group of individuals who would benefit from the availability of this product.

"PrEP is having an important impact on removing the inevitability of HIV for many individuals and enhancing the sexual experience, reducing their fears and the concerns that they go through in relationships."

The study has been presented at the Conference on Retroviruses and Opportunistic Infections in Seattle, but the full data has not yet been published in a medical journal.

HIV fear

Charlie Witzel, a 27-year-old Canadian living in London, took part in the trial.

He said higher rates of HIV in the capital meant he felt he was at high risk "just by being in London".

He told the BBC: "Like a lot of gay men my age, sex has always been associated with HIV for me, that has presented various barriers with intimacy."

Mr Witzel said the knowledge that the person most likely to infect you was a regular partner was a "massive challenge" in relationships.

He thinks the drugs should be available "like the contraceptive pill" as people were "quite good at evaluating their own risk and knowing when something is not relevant" such as after entering a monogamous relationship.

The cost of the medicines would come to £360 per month per person. However, the National Aids Trust said they would pay for themselves because of the costs of treating HIV.

Chief executive Deborah Gold said: "If we can stop people getting HIV by giving them PrEP, we have an ethical duty to do so.

"Furthermore, over the course of their lifetime the treatment of those 19 men will cost the NHS nearly £7m, so the financial argument is clear, as is the ethical one.

"PrEP needs to be available on the NHS as soon as possible for all those who need it."

'Game-changer'

The Terrence Higgins Trust charity said condom use had already prevented tens of thousands of HIV infections since the 1980s, but argued PrEP would be a valuable extra weapon in the armoury.

Its medical director Dr Michael Brady said: "PrEP is, quite simply, a game-changer.

"It is not a vaccine and it won't be for everyone, but once approved, we expect it to significantly increase the momentum in our fight against the virus."

The NHS is already considering how PrEP could be introduced.

Prof Simon Barton, from NHS England, said: "The findings of this study are very important and significantly add new data to existing international evidence.

"Several questions still need to be resolved about how the greatest benefit can be delivered to those at risk of infection and how the key elements in the study, such as follow-up testing and adherence support, can be commissioned to benefit individual and public health in real life settings."


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Manchester first NHS devolved region

25 February 2015 Last updated at 14:10

Greater Manchester is to become the first English region to get full control of its health spending, as part of an extension of devolved powers.

Chancellor George Osborne said the £6bn health and social care budget would be taken over by the region's councils and health groups.

Mr Osborne said it was a "really exciting development".

A Labour spokesman said NHS workers would "want to be persuaded of the case for a new layer of management".

The plan will come into force from April 2016.

Mr Osborne added: "This is what the NHS wants to see as part of its own future.

"And it's also about giving people in Manchester greater control over their own affairs in that city, which is central to our vision of the 'northern powerhouse'- so it's a very exciting development."

The plan would see local leaders, and ultimately Greater Manchester's new directly elected mayor, control how budgets are allocated.

The government hopes by integrating health and social care services, the change will ease pressure on hospitals and help to improve home care services for patients who need it.

A shadow Greater Manchester Health and Wellbeing board will be appointed, which will work closely with existing clinical commissioning groups of GPs.

The board is expected to run from April, before control of the budget is handed over a year later.

Manchester City Council confirmed 10 local authorities, 12 clinical commissioning groups, 14 NHS partners, NHS England and the government are in discussions on a "groundbreaking agreement for health and social care".

Reacting to the proposals, Andy Burnham, Labour's shadow health secretary, said: "This has to be a solution that works everywhere or that could be offered to everywhere.

"If you're going to stick to the idea of a national health service you can't have a Swiss cheese NHS where some bits of the system are operating to different rules or have different powers and freedoms.

"I am a bit worried what I'm hearing because it does point to further break-up of the idea of the National Health Service."

National Analysis

Nick Triggle, BBC health correspondent

Ever since the NHS was created in 1948, it has remained separate from the council-run care system that oversees help in the home with tasks such as washing and dressing and care home places.

But as the decades have gone by and health care has shifted from curing illnesses to helping people manage long-term conditions such as dementia and heart disease, there has been an increasing sense that the two systems need to become more joined up.

All three main political parties have their own ideas of how this should be done - and NHS England chief executive Simon Stevens signalled his support for greater integration with the publication of his Five-Year Forward View last autumn.

But Greater Manchester has taken the bull by the horns and proposed a pooling of budgets.

At this stage (and it must be said the details are still emerging) it seems to mirror what is being rolled out in Scotland and what has happened in Northern Ireland since the 1970s. So will this catch on across the rest of England?

It could be argued it already has. From April there will be small pooled budgets in all 151 local authority areas - including the 10 boroughs in Greater Manchester - as part of the government's Better Care Fund initiative. They will be worth £5.3bn in total.

That represents less than 5% of the combined spending on health and care nationally, but is clearly a step towards full integration.

Richard Humphries, assistant director of the King's Fund think tank, said a full transfer of responsibility would be a reform "on a breathtaking scale" but could pose serious risks.

Speaking on BBC Radio 4's Today programme, he said: "Depending on the detail - and the detail is really crucial and we don't have that yet - you could either see this as a triumph for local democracy or creating real risks of yet another reorganisation of the NHS when it's barely recovered from the last one."

Councillor Mike Connolly, Labour leader of Bury Council, said: "Those decisions need to be made in Greater Manchester and not Westminster, and I welcome any form of devolution to the city region.

"We are all agreed, certainly in the Labour Party, that health and social care must be integrated because it's about providing that primary care - and it can only be good for healthcare across Greater Manchester."

In November, Mr Osborne announced plans for an elected mayor for Greater Manchester to preside over regional issues.

The move, agreed with leaders of the region's councils, will give local politicians greater control over billions of pounds of public money.

Regional Analysis

Kevin Fitzpatrick, BBC Radio Manchester

If the initial devolution deal for Greater Manchester was ground breaking, then this development changes the shape of local government in a way that would have been unthinkable just a few months ago.

By taking control of the entire NHS budget, the area's 10 councils, and ultimately the elected mayor, will be able to join up health and social care in a way that's never been possible before.

In addition to control of the £2bn of budgets agreed last year for skills and training, transport and planning, the £6bn that comes with this deal means local politicians will decide how more than a quarter of government money is spent in their area.

Local politicians describe the move as an incredible opportunity, but it also comes with risks with just over a year to plan before the money and a huge amount of new responsibility is handed over.

Greater Manchester must ready itself to break more new ground as devolution picks up pace.


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NHS 'must step in' over Avastin row

Written By Unknown on Selasa, 24 Februari 2015 | 21.24

24 February 2015 Last updated at 14:07 By Michelle Roberts Health editor, BBC News online

Doctors are calling on health ministers and NHS England to intervene to make a drug called Avastin routinely available to people with a debilitating eye condition known as wet AMD.

Wet age-related macular degeneration can cause blindness, without treatment.

Another drug exists but is far more expensive than Avastin.

Current regulations make it hard for physicians to prescribe Avastin instead, say the clinical leaders from 120 clinical commissioning groups.

Doctors can prescribe it "off-label", but they are only supposed to do that if there is no suitable licensed drug.

Continue reading the main story

This is a long standing issue within the NHS"

End Quote Dr Amanda Doyle NHS Clinical Commissioners

Another drug, called Lucentis, is licensed for wet AMD, but typically costs about £700 for an injection.

Avastin costs about £60, so switching to this drug could save the NHS in England £102m a year, according to the clinical leaders.

Both Lucentis and Avastin are owned by Roche - although Lucentis is marketed by Novartis in the UK.

Sight saver

The campaigning doctors, who represent about 60% of England's clinical commissioning groups (CCGs), are now asking the health secretary and the boss of the NHS to step in.

Dr Amanda Doyle, co-chair of NHS Clinical Commissioners, said: "This is a long standing issue within the NHS, and the numbers of CCGs who have united behind this shows the strength of feeling there is to ensure that we have all the available options to be able to deliver the best possible care for our patients.

"As clinicians, we are seeing an increase in the incidence of this chronic eye condition due to an ageing population, and as commissioners we have a responsibility to ensure that every pound spent is done so to the best effect, and that is even more important with the current financial pressures the NHS is facing."

The National Institute for Health and Clinical Excellence (NICE) watchdog, which looks at the cost effectiveness of drugs used by the NHS, can only appraise a treatment if it has been licensed.

Likewise, the UK's Medicines and Healthcare Products Regulatory Agency can only consider licensing a drug if an application has been put in.

Roche advises against using Avastin off-label.

In a statement it said: "Avastin was developed and approved only for the treatment of patients with cancer.

"Avastin is not licensed for wet age-related macular degeneration because it is not developed and manufactured to meet intraocular standards.

"We have an obligation to inform healthcare professionals and patients about the known risks associated with use of our medicines."

Clinical trials suggest both drugs can treat wet AMD.

Wet AMD
  • Wet AMD can develop very quickly, making serious changes to patients' vision in a short period of time
  • It affects a tiny part of retina at the back of the eye, called the macula, leading to problems with central vision
  • It tends to affect older people, but experts still don't fully understand why or what causes it
  • First problems people notice are with their ability to see detail - straight lines start to look wavy, for example

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Peanut allergy 'cut by early exposure'

23 February 2015 Last updated at 22:46 James GallagherBy James Gallagher Health editor, BBC News website

Eating peanut products as a baby dramatically cuts the risk of allergy, a study suggests.

Trials on 628 babies prone to developing peanut allergy found the risk was cut by over 80%.

The King's College London researchers said it was the "first time" that allergy development had been reduced.

Specialists said the findings could apply to other allergies and may change diets around, but warned parents not to experiment at home.

Daily nut

The research team in London had previously found that Jewish children in Israel who started eating peanuts earlier in life had allergy levels 10 times lower than Jewish children in the UK.

The trial, reported in the New England Journal of Medicine, focused on babies as young as four months who had already developed eczema - an early warning sign of allergies.

Skin-prick tests were used to identify those who had not yet developed peanut allergy or had only a very mild response.

Children under five should not eat whole peanuts, because of the risk of choking, so half were given a peanut-based snack. The other half continued avoiding peanuts.

Feeding

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Sofia Magnuson was introduced to peanuts early on in her life as part of the trial

The trial indicated that for every 100 children, 14 would normally go on to develop an allergy by the age of five.

But this fell by 86% to just two out of every 100 children with the therapy.

Even the children who were already becoming sensitive to peanuts benefited. Their allergy rates fell from 35% to 11%.

Lead researcher Prof Gideon Lack told the BBC: "[It was] exciting to us to realise for the first time that in allergy, we can actually truly prevent the development of disease.

"It represents a real shift in culture."

He said that high-risk children "need to be evaluated, have skin-prick testing and dietary advice, [before], in most cases, early introduction of peanut".

Prof Lack added: "We realise this goes very much contrary to previous advice, but it is very much essential that we direct our attention to this group of infants and stem this growing epidemic of peanut allergy."

Until 2008, at-risk families were told to actively avoid peanut products and other sources of allergic reactions.

Analysis

By James Gallagher, health editor, BBC News website

Allergy levels are soaring.

In the US, the prevalence has more than quadrupled since 2008, and it's a pattern replicated across much of the Western world as well as parts of Asia and Africa.

This study has generated huge excitement at what it could mean for preventing allergies developing.

However, there are still many unanswered questions.

How regularly do children have to take the peanut snacks? What stage should they start? What happens when the children stop taking the peanut snacks?

How are health care services going to adopt this?

And excitingly, will this work in other types of food allergy?

It is these unknowns that mean no doctors are saying parents should take matters into their own hands.

But as a New England Journal of Medicine editorial states the results are "so compelling and the problem of the increasing prevalence of peanut allergy so alarming, new guidelines should be forthcoming very soon".

The findings have attracted excited responses from other doctors, and there is speculation similar approaches might work with other allergies, such as egg protein.

Prof Simon Murch, from University Hospital Coventry, a spokesman for the Royal College of Paediatrics and Child Health, said the results were "brilliant".

He said: "It is potentially a very significant moment as it demonstrates that turning around our current approach may give better results.

"Obviously more studies will have to be performed on other potential allergens, but it is a very significant paper and is likely to change practice, at least for peanut, around the world."

When to eat them?
  • There is often confusion about when peanuts are safe as the guidelines used to advocate avoidance
  • Peanuts are now thought to be safe in pregnancy
  • If there is no family history of allergies or eczema then health officials say peanut butter and other ground or crushed nuts are okay after six months
  • If there is a heightened risk then parents should consult a doctor.
  • This research suggests careful introduction of peanut may help such children, but parents should not do this on their own
  • No child under five should eat a whole nut

He added that it was "unlikely" that previous policies were behind the rising tide of allergies as cleaner homes, modern food and gut bacteria were also likely to be playing a role.

However, he cautioned families not to rush out and buy a jar of peanut butter.

"This has to be looked at very closely by regulatory bodies, it is very possible this will lead to changes in recommendations," he said.

"But this is a single study, although very well conducted, so it is absolutely not at the stage you can recommend to families."

Dr Andrew Clark, a leading allergy specialist at Addenbrooke's Hospital in Cambridge, found last year that allergic children could be trained to tolerate peanut by slowly exposing them to higher and higher doses.

He said: "This could be a turning point in the way we try to prevent food allergy in the future, it really does prove a principle that it is possible to reduce the prevalence of peanut allergy early in childhood by feeding infants peanut in a careful and controlled way.

"But we should remember this study was carried out at an internationally renowned centre, and they selected children at quite low risk of a severe reaction.

"Don't try this at home."


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Deciding vote on three-person babies

24 February 2015 Last updated at 00:12 James GallagherBy James Gallagher Health editor, BBC News website

Peers will decide later whether to make the historic move to allow the creation of babies with DNA from two women and one man.

The modified form of IVF would be used to prevent mitochondrial diseases.

If the House of Lords votes in favour, then the UK would be the first country to introduce laws to allow the creation of babies from three people.

The chief medical officer has urged peers to vote in favour, but the plans remain contentious.

Earlier this month, 382 MPs voted in favour, and 128 against the technique that stops these genetic diseases being passed from mother to child.

Power packs

Mitochondria are the tiny compartments inside nearly every cell of the body that convert food into useable energy.

They are passed down only from the mother and have their own DNA, although it does not alter appearance or personality.

The technique, developed in Newcastle, uses a modified version of IVF to combine the healthy mitochondria of a donor woman with DNA of the two parents.

It results in babies with 0.1% of their DNA from the second woman and is a permanent change that would echo down through the generations.

While scientific reviews suggest it should be safe, nobody will know until it is finally attempted.

The House of Lords will debate the proposal and vote at around 14:30 GMT.

Speaking ahead of the vote, chief medical officer Prof Dame Sally Davies told the BBC: "These children die in the first few months or years of life, because their muscles collapse, their hearts fail, their brains don't develop and they die. This is tragic.

"I would ask the Lords to vote for this as the Commons have and the mothers really want."

The Catholic and Anglican Churches in England said the idea was not safe or ethical, not least because it involved the destruction of embryos.

Other groups, including Human Genetics Alert, say the move would open the door to further genetic modification of children in the future - so-called designer babies, genetically modified for beauty, intelligence or to be free of disease.

Estimates suggest 150 three-person babies could be born each year.

If the measure goes ahead, the first "three-person" baby could be born next year.


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Deaths in detention 'avoidable'

Written By Unknown on Senin, 23 Februari 2015 | 21.24

23 February 2015 Last updated at 02:45

The deaths of hundreds of people with mental health conditions who were held in detention could have been avoided, an inquiry in England and Wales found.

It focused on adults detained on psychiatric wards, in police cells and prisons between 2010-13.

The Equality and Human Rights Commission said a host of problems including basic errors and a failure to involve families were to blame.

Officials are calling for the NHS to work towards a "zero suicide" approach.

Continue reading the main story

We need urgent action and a fundamental culture shift to tackle the unacceptable and inadequate support "

End Quote Mark Hammond Equality and Human Rights Commission
'Known triggers'

The wide-ranging report looked at people detained for a variety of reasons - for example patients admitted to hospital when their own was safety was considered to be at stake.

It included those detained in police cells and looked at people in prisons with mental health conditions too.

Between 2010-13 the analysis shows 367 adults with mental health issues died of "non-natural" causes while detained on psychiatric wards and police cells.

Rebecca Wilson

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An inquest into Rebecca Wilson's death found that poor monitoring by her hospital gave her the opportunity to take her own life

Some 295 adults died in prison - many of whom had mental health conditions.

According to the report, non-natural deaths include suicides, deaths caused by another person, including homicide - and other deaths, for example by overdose.

Authors gathered detailed information from family members and worked with official bodies such as the Care Quality Commission (CQC), Her Majesty's Inspectorate of Constabulary and the Independent Police Complaints Commission.

Their main findings include:

  • A number of basic mistakes being repeated - for example staff not adequately monitoring patients and prisoners at serious risk of suicide
  • A failure to involve families or gather information that may have helped prevent deaths - such as previous treatment plans and discussions about known triggers of self-harm
  • Poor communication between staff - including crucial information being lost during the transfer of prisoners
  • Inappropriate use of restraint - such as the use of face-down restraint and the use of Tasers

Mark Hammond, chief executive officer of the commission, said: "This inquiry reveals serious cracks in our systems of care for those with serious mental health conditions.

"We need urgent action and a fundamental culture shift to tackle the unacceptable and inadequate support for vulnerable detainees."

The report makes a number of recommendations, including:

  • Trigger systems in prisons and hospitals to alert staff to issues that could prompt self-harm, for example the anniversaries of the deaths of close relatives
  • A mental health liaison officer for each police force to provide adequate training
  • Much more involvement for families.

The Department of Health says it is calling on every part of the NHS to commit to a new "zero suicide" ambition.

Modelled on a depression care programme in Detroit which had no suicides for more than two years, officials hope this can be replicated more widely in England.

Health experts are also working with NHS England and the CQC in an attempt to improve the investigation system for deaths of patients in hospitals.

Separate official reviews are also being conducted surrounding the care of prisoners at risk of self-harm and young people who have died in custody since 2007.


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Call for global single-use syringes

23 February 2015 Last updated at 09:04 James GallagherBy James Gallagher Health editor, BBC News website

Smart syringes that break after one use should be used for injections by 2020, the World Health Organization has announced.

Reusing syringes leads to more than two million people being infected with diseases including HIV and hepatitis each year.

The new needles are more expensive, but the WHO says the switch would be cheaper than treating the diseases.

More than 16 billion injections are administered annually.

Normal syringes can be used again and again.

But the smart ones prevent the plunger being pulled back after an injection or retract the needle so it cannot be used again.

Dr Selma Khamassi, the head of the WHO team for injection safety, told the BBC News website: "This will hopefully help eliminate the 1.7 million new hepatitis B cases, the 300,000 hepatitis C cases and the 35,000 HIV cases every year, and all those we don't have figures for, such as Ebola and Marburg."

Nightmare in Cambodia

By David Shukman, Science Editor, BBC News

The people of the farming community of Roka in Cambodia are living through exactly the nightmare scenario that the World Health Organization wants to stamp out with a new policy on syringes.

In wooden huts and farmhouses dotted among paddy fields, families are struggling to cope with the bombshell of a sudden and frightening mass infection of HIV.

To the astonishment and shock of this rural backwater, babies, schoolchildren and even the 82-year-old abbot of the local Buddhist temple, who is celibate, have all tested HIV-positive.

And there is one common factor that links them, directly or indirectly: nearly all of them received injections from an unlicensed doctor suspected of reusing his syringes.

The virus would have been spread from one patient to another, resulting in an escalating tally of infections that now stands at 272, with further rises expected as more tests are carried out.

Four of the victims - three elderly women and a baby - have since died.

More from David's visit to Cambodia

This is also a problem in rich Western countries.

An outbreak of hepatitis C in the US state of Nevada was traced back to a doctor who used the same syringe to give anaesthetic to multiple patients.

'Cost-effective'

Standard syringes cost between two cents (1.3p) and four cents. The smart syringes cost between four and six cents.

The WHO describes it as a "small increase". However, the tiny difference in the price of one needle becomes huge when it is scaled up to 16 billion injections.

Dr Khamassi added: "Injection safety is, I think, the most cost-effective way to prevent all these diseases.

"If we compare the price of most expensive syringes to the cost of treatment for an HIV case, or a hep C case, there is no comparison."

The WHO is also calling for sheathed needles that prevent doctors accidentally pricking their fingers.

This has happened many times during the Ebola outbreak in West Africa.

But they would treble the cost of the syringes and the WHO says these would have to be introduced "progressively".

The WHO is calling on industry to expand production and find ways of reducing the cost of the safer needles.

Marc Koska, head of Safepoint - which campaigns to stop the reuse of syringes - told the BBC: "It's totally, totally possible.

"We've already done this with immunisation, which represents less than 10% of the injections given in the developing world, and that has been a fantastic success.

"Now we're targeting the 90% of what we call curative injections."

But the measure will not be the end of the typical syringe.

They will be needed for needle exchange programmes for drug users as well as in some treatments in which multiple medicines are mixed in the syringe before being injected.


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UK Ebola medics under investigation

23 February 2015 Last updated at 12:06

Five UK Ebola nurses and doctors are under investigation by regulators, Public Health England says.

They are looking into the screening of medics who flew back to England on 28 December after treating patients in Sierra Leone.

On this flight was Scottish nurse Pauline Cafferkey - who developed Ebola - and some of her colleagues.

Questions have arisen over the health assessments and protocols that were followed.

Media reports have suggested Ms Cafferkey may have had signs of Ebola before leaving Sierra Leone but regulators have not commented on this.

Public Health England said: "During our recent assessment of the screening of some returning healthcare workers at Heathrow on 28 December, information emerged which needed to be passed to the General Medical Council and the Nursing and Midwifery Council.

"We are aware that the regulators are now considering the matter and it would be inappropriate for PHE to comment further at this time.

"The risk to the general public from Ebola remains very low."

Symptom check

Ms Cafferkey - who had volunteered with Save the Children at a treatment centre in Kerry Town, in Sierra Leone - was diagnosed with Ebola in December, after returning to Glasgow via London.

After having her temperature checked several times at Heathrow, she was allowed to board a connecting flight to Glasgow.

She has now recovered from the virus following treatment at the Royal Free Hospital in London.

The Nursing and Midwifery Council, which looks into whether healthcare workers are fit to practise, said: "Following information we received from Public Health England, we can confirm that we are investigating allegations about the conduct of three nurses."

Two doctors are also being checked by the medical regulator the General Medical Council.

A spokesperson said the enquiries were "at an early stage".


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Fifteen-minute Ebola test approved

Written By Unknown on Minggu, 22 Februari 2015 | 21.24

20 February 2015 Last updated at 10:48 James GallagherBy James Gallagher Health editor, BBC News website

The first rapid blood test for Ebola has been approved for use by the World Health Organization.

It should allow patients to be identified, isolated and cared for as quickly as possible in an attempt to bring an end to the outbreak that has killed more than 9,300 people.

It is less accurate than conventional tests, but takes minutes rather than hours to get a result.

The test also works without electricity so it can be used in remote regions.

Current Ebola testing requires a laboratory to analyse the blood for fragments of the virus's genetic material.

It can take between 12 and 24 hours to get a definitive answer.

The ReEBOV Antigen Rapid Test, developed by US company Corgenix, searches the blood for a different part of the virus.

Trials in West Africa suggest it correctly identifies about 92% of people who have Ebola.

Remote locations

The World Health Organization said: "While less accurate, the antigen test is rapid, easy to perform and does not require electricity.

"It can therefore be used at lower health care facilities or in mobile units for patients in remote settings."

It added that, where possible, the results from the rapid test should be confirmed by the more precise conventional testing.

There were 128 new cases of Ebola in the three affected countries - Liberia, Sierra Leone and Guinea - last week.

More than 23,250 people have been infected in the outbreak and 9,380 have died.

Dr Ben Neuman, a lecturer in virology at the University of Reading, said: "The new test could help to quickly confirm outbreaks in remote areas without the need to send samples to a testing clinic and wait for results.

"The new test isn't about saving the lives of infected people, but it can help in the long run by making it easier and quicker to detect Ebola outbreaks."


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NHS foundation trusts deficit rises

21 February 2015 Last updated at 02:48

NHS foundation trusts are £321m in deficit, according to the health regulator Monitor.

More than half of all foundation trusts - which are given foundation status as a mark of excellence - are now in the red, Monitor's quarterly report warned.

The report, which looked at 147 trusts between October and December last year, said the use of expensive agency staff was having a drastic impact on budgets.

The Department of Health said it was increasing budgets by £2bn next year.

The report found that 78 trusts (53%) were in deficit, of which 60 are acute trusts which manage hospitals in England.

Many of the organisations were clearly struggling with their finances as a result of increased pressure on services, Monitor's quarterly report warned.

The need to make cost savings was also putting trusts under "exceptional pressure", it added.

Increasing demand

The £321m deficit had risen from £254m in the previous quarter, while it was £167m in the three months prior to that, the report found.

Trusts spent £419m more than planned on staff because of high use of contract and agency workers, while £810m worth of cost savings was £210m less than planned.

Foundation trusts saw 2.7 million people in their A&E units between October and December last year; 8% more than the same period the year before, research showed.

They also treated more than 2.3 million non-emergency patients in the quarter; an increase of 7% on the same period in 2013.

The 149 foundation trusts, which make up nearly two-thirds of all NHS trusts, failed to meet national waiting-time targets for A&E, routine and cancer care for three successive quarters, Monitor said.

Foundation trusts are awarded their title when they are considered well run enough to take on more independence from their local health authority.

It means they have a significant amount of managerial and financial freedom compared with other NHS trusts.

Monitor also said it had taken regulatory action against 28 foundation trusts - 19% of the sector - because of governance or financial concerns.

Its chief executive, Dr David Bennett, said the NHS needed to "move rapidly towards more joined-up, efficient models of care" if it was to deal with the growth in demand for services.

'Financial difficulties'

Responding to the report, health think tank The Health Foundation pointed out that the figures did not include the recent period of severe winter pressure.

Adam Roberts, its senior economics fellow, said it was "extremely unlikely" that NHS acute hospitals in England would break even at the end of the financial year.

A financial deficit was now "the norm for NHS providers", he said.

A Department of Health spokesman said it expected the NHS as a whole to end the year in financial balance.

"We know the NHS is busier than ever, which is why we're increasing the budget by an extra £2bn next year to back the NHS's long-term plan to move more care from hospital to home," he said.

"All NHS organisations know that financial discipline must be as important as safe care and good performance."


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Dementia research to receive £300m

21 February 2015 Last updated at 13:37

More than £300m is to be spent by the government on research into dementia, the prime minister has announced.

David Cameron said an international dementia institute would be established in England over the next five years in a bid to make the UK a world leader for research and medical trials.

Some 1.3 million NHS workers will also receive additional training in how to care for people with dementia.

The PM said dementia was "one of the greatest challenges of our lifetime".

There are approximately 850,000 people living with dementia in the UK, with the number expected to hit a million within the next 10 years.

'Bold ambition'

The government said a separate multimillion-pound fund would be launched within weeks to help establish an international investment scheme to discover new drugs and treatments that could slow the onset of dementia, or even deliver a cure, by 2025.

It hopes the global fund will bring together investment from the private, public and philanthropic sectors under a single scheme to pay for research projects into the disease.

Faster assessments by GPs are also included in the prime minister's challenge on dementia 2020 plans.

The prime minister first launched the dementia challenge for England in March 2012, building on the previous government's national dementia strategy.

Mr Cameron visited High Wycombe to meet people with dementia and dementia friends – people who are able to spot signs of the illness and help sufferers.

He said: "What today's announcement is about is a very simple but bold ambition, and that is to make the United Kingdom the best place on the planet in terms of researching into dementia, in terms of diagnosing people with dementia and then in terms of treating, helping and caring for them."

Signs of dementia
  • Struggling to remember recent events
  • Problems following conversations
  • Forgetting the names of friends or objects
  • Repeating yourself
  • Problems with thinking or reasoning
  • Confusion in familiar places

The NHS workers receiving extra training on how to provide best standards of care for people with dementia will range from surgeons to hospital porters, the government said.

There are also plans to give three million more "dementia friends" training in how to support those with the condition.

Other pledges include having the majority of people in England living in "dementia-friendly communities" in five years' time by making shops, transport and other public places more accessible to people with the condition.

Labour's shadow health secretary Andy Burnham welcomed the announcement but said more needed to be done to support dementia sufferers now.

He said: "Hundreds of thousands of vulnerable older people have lost social care support since David Cameron entered Downing Street. Social care in England is close to collapse but this government is in denial about it."

Professor Simon Lovestone, from Oxford University, said recent trials for new drugs had failed.

"We now need to do better clinical trials, we need to do them earlier in the disease process, and for that we need tests for early diagnosis and we need better drugs," he said.

"And I think that the announcement that's been made today, together with the investment that's already been made in the UK, puts the UK at the leading front of a truly international effort that will actually deliver on this."

Professor Nigel Hooper, dementia researcher at the University of Manchester, told BBC Breakfast £300m was "a great investment" but said cancer research received five times as much funding globally as dementia.

Initial dementia assessments will take place in an average of six weeks and will be followed by support such as informing sufferers of local services that can help them, as well as advice for their carers.


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Fifteen-minute Ebola test approved

Written By Unknown on Sabtu, 21 Februari 2015 | 21.24

20 February 2015 Last updated at 10:48 James GallagherBy James Gallagher Health editor, BBC News website

The first rapid blood test for Ebola has been approved for use by the World Health Organization.

It should allow patients to be identified, isolated and cared for as quickly as possible in an attempt to bring an end to the outbreak that has killed more than 9,300 people.

It is less accurate than conventional tests, but takes minutes rather than hours to get a result.

The test also works without electricity so it can be used in remote regions.

Current Ebola testing requires a laboratory to analyse the blood for fragments of the virus's genetic material.

It can take between 12 and 24 hours to get a definitive answer.

The ReEBOV Antigen Rapid Test, developed by US company Corgenix, searches the blood for a different part of the virus.

Trials in West Africa suggest it correctly identifies about 92% of people who have Ebola.

Remote locations

The World Health Organization said: "While less accurate, the antigen test is rapid, easy to perform and does not require electricity.

"It can therefore be used at lower health care facilities or in mobile units for patients in remote settings."

It added that, where possible, the results from the rapid test should be confirmed by the more precise conventional testing.

There were 128 new cases of Ebola in the three affected countries - Liberia, Sierra Leone and Guinea - last week.

More than 23,250 people have been infected in the outbreak and 9,380 have died.

Dr Ben Neuman, a lecturer in virology at the University of Reading, said: "The new test could help to quickly confirm outbreaks in remote areas without the need to send samples to a testing clinic and wait for results.

"The new test isn't about saving the lives of infected people, but it can help in the long run by making it easier and quicker to detect Ebola outbreaks."


21.24 | 0 komentar | Read More

NHS foundation trusts deficit rises

21 February 2015 Last updated at 02:48

NHS foundation trusts are £321m in deficit, according to the health regulator Monitor.

More than half of all foundation trusts - which are given foundation status as a mark of excellence - are now in the red, Monitor's quarterly report warned.

The report, which looked at 147 trusts between October and December last year, said the use of expensive agency staff was having a drastic impact on budgets.

The Department of Health said it was increasing budgets by £2bn next year.

The report found that 78 trusts (53%) were in deficit, of which 60 are acute trusts which manage hospitals in England.

Many of the organisations were clearly struggling with their finances as a result of increased pressure on services, Monitor's quarterly report warned.

The need to make cost savings was also putting trusts under "exceptional pressure", it added.

Increasing demand

The £321m deficit had risen from £254m in the previous quarter, while it was £167m in the three months prior to that, the report found.

Trusts spent £419m more than planned on staff because of high use of contract and agency workers, while £810m worth of cost savings was £210m less than planned.

Foundation trusts saw 2.7 million people in their A&E units between October and December last year; 8% more than the same period the year before, research showed.

They also treated more than 2.3 million non-emergency patients in the quarter; an increase of 7% on the same period in 2013.

The 149 foundation trusts, which make up nearly two-thirds of all NHS trusts, failed to meet national waiting-time targets for A&E, routine and cancer care for three successive quarters, Monitor said.

Foundation trusts are awarded their title when they are considered well run enough to take on more independence from their local health authority.

It means they have a significant amount of managerial and financial freedom compared with other NHS trusts.

Monitor also said it had taken regulatory action against 28 foundation trusts - 19% of the sector - because of governance or financial concerns.

Its chief executive, Dr David Bennett, said the NHS needed to "move rapidly towards more joined-up, efficient models of care" if it was to deal with the growth in demand for services.

'Financial difficulties'

Responding to the report, health think tank The Health Foundation pointed out that the figures did not include the recent period of severe winter pressure.

Adam Roberts, its senior economics fellow, said it was "extremely unlikely" that NHS acute hospitals in England would break even at the end of the financial year.

A financial deficit was now "the norm for NHS providers", he said.

A Department of Health spokesman said it expected the NHS as a whole to end the year in financial balance.

"We know the NHS is busier than ever, which is why we're increasing the budget by an extra £2bn next year to back the NHS's long-term plan to move more care from hospital to home," he said.

"All NHS organisations know that financial discipline must be as important as safe care and good performance."


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Dementia research to receive £300m

21 February 2015 Last updated at 13:37

More than £300m is to be spent by the government on research into dementia, the prime minister has announced.

David Cameron said an international dementia institute would be established in England over the next five years in a bid to make the UK a world leader for research and medical trials.

Some 1.3 million NHS workers will also receive additional training in how to care for people with dementia.

The PM said dementia was "one of the greatest challenges of our lifetime".

There are approximately 850,000 people living with dementia in the UK, with the number expected to hit a million within the next 10 years.

'Bold ambition'

The government said a separate multimillion-pound fund would be launched within weeks to help establish an international investment scheme to discover new drugs and treatments that could slow the onset of dementia, or even deliver a cure, by 2025.

It hopes the global fund will bring together investment from the private, public and philanthropic sectors under a single scheme to pay for research projects into the disease.

Faster assessments by GPs are also included in the prime minister's challenge on dementia 2020 plans.

The prime minister first launched the dementia challenge for England in March 2012, building on the previous government's national dementia strategy.

Mr Cameron visited High Wycombe to meet people with dementia and dementia friends – people who are able to spot signs of the illness and help sufferers.

He said: "What today's announcement is about is a very simple but bold ambition, and that is to make the United Kingdom the best place on the planet in terms of researching into dementia, in terms of diagnosing people with dementia and then in terms of treating, helping and caring for them."

Signs of dementia
  • Struggling to remember recent events
  • Problems following conversations
  • Forgetting the names of friends or objects
  • Repeating yourself
  • Problems with thinking or reasoning
  • Confusion in familiar places

The NHS workers receiving extra training on how to provide best standards of care for people with dementia will range from surgeons to hospital porters, the government said.

There are also plans to give three million more "dementia friends" training in how to support those with the condition.

Other pledges include having the majority of people in England living in "dementia-friendly communities" in five years' time by making shops, transport and other public places more accessible to people with the condition.

Labour's shadow health secretary Andy Burnham welcomed the announcement but said more needed to be done to support dementia sufferers now.

He said: "Hundreds of thousands of vulnerable older people have lost social care support since David Cameron entered Downing Street. Social care in England is close to collapse but this government is in denial about it."

Professor Simon Lovestone, from Oxford University, said recent trials for new drugs had failed.

"We now need to do better clinical trials, we need to do them earlier in the disease process, and for that we need tests for early diagnosis and we need better drugs," he said.

"And I think that the announcement that's been made today, together with the investment that's already been made in the UK, puts the UK at the leading front of a truly international effort that will actually deliver on this."

Professor Nigel Hooper, dementia researcher at the University of Manchester, told BBC Breakfast £300m was "a great investment" but said cancer research received five times as much funding globally as dementia.

Initial dementia assessments will take place in an average of six weeks and will be followed by support such as informing sufferers of local services that can help them, as well as advice for their carers.


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Drug-resistant malaria 'huge threat'

Written By Unknown on Jumat, 20 Februari 2015 | 21.24

20 February 2015 Last updated at 00:15 James GallagherBy James Gallagher Health editor, BBC News website

Resistance to the drug that has saved millions of lives from malaria has been detected over a wider area than previously thought, scientists warn.

The ability of the malaria parasite to shrug off the effects of artemisinin has been spreading since it emerged in South East Asia.

Tests, published in Lancet Infectious Diseases, now show this resistance on the verge of entering India.

Experts said the development was "alarming" and an "enormous threat".

Deaths from malaria have nearly halved since 2000, and the infection now kills about 584,000 people each year.

But resistance to artemisinin threatens to undo all that hard work, and it has been detected in:

  • Cambodia
  • Laos
  • Thailand
  • Vietnam
  • Myanmar, also known as Burma

Blood samples from 940 people with malaria from 55 sites across Myanmar showed this resistance was widespread across the country.

One site, in the Sagaing region, showed that resistant parasites were just 25km (15 miles) from the Indian border.

'Clear threat'

One of the researchers, Dr Charles Woodrow, from the Mahidol-Oxford Tropical Medicine Research Unit, in Thailand, told the BBC News website: "We can see artemisinin resistance is clearly present quite close to the Indian border, that's clearly a threat and in the future is likely to lead to extension of the problem to neighbouring areas."

Artemisinin is normally given as part of combination therapy.

Initially the other drug will pick up the slack to keep the combination effective, but Dr Woodrow says this resistance will "inevitably" lead to it failing.

"If this were to spread into India, malaria will continue to affect rural populations there, but there may not be an immediate effect on cure-rate," he said.

"But beyond the short term, there is very likely to be a problem, and there are very few [other] drugs on the table."

History lesson

This has all happened before.

Chloroquine probably saved hundreds of millions of lives, but resistance was discovered in 1957 around the border between Cambodia and Thailand.

Resistance spread around the world and reached Africa 17 years later.

There is no evidence of artemisinin resistance in Africa yet, although there is concern that history is about to repeat itself with deadly consequences.

Dr Woodrow told the BBC: "The evidence from the global spread of chloroquine resistance is this translates to a large increase in the number of cases and a higher number of deaths."

Why South East Asia?

South East Asia has been implicated in the rise of resistance to both chloroquine and artemisinin.

The main explanation is that lower levels of natural malaria immunity exist in the region than in Africa.

With no background resistance, the drugs have to do all the work in infected patients in South East Asia.

But there are far more cases of malaria in Africa, and repeat infection is common so people there develop some immunity.

It means the natural immune system and the drug share the load of fighting off malaria.

This makes South East Asia a riper region for the parasite to develop resistance.

Prof Philippe Guerin, the director of the Worldwide Antimalarial Resistance Network, said: "This study highlights that the pace at which artemisinin resistance is spreading or emerging is alarming.

"We need a more vigorous international effort to address this issue in border regions."

Prof Mike Turner, the head of infection and immunobiology at the Wellcome Trust medical charity, said: "The new research shows that history is repeating itself, with parasites resistant to artemisinin drugs, the mainstay of modern malaria treatment, now widespread in Myanmar.

"We are facing the imminent threat of resistance spreading into India, with thousands of lives at risk."


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Patients face fines on free scripts

20 February 2015 Last updated at 05:05 By Nicola Lawrence and James Gallagher BBC News

Patients with life-long conditions are being fined up to £100 for collecting their free prescriptions, the BBC has discovered.

They say they were not told of a rule change that meant their exemption certificates had to be updated.

Charities and pharmacists said patients were being labelled "fraudsters" and being "unfairly" punished.

The NHS said it was the "patient's own responsibility to check their entitlement".

Radio presenter Sybil Ruscoe told BBC Radio Oxford: "I have been fined for having free insulin.

"Hundreds of us have had fines in the post. Basically we're being criminalised for having a chronic illness.

"It's bad enough having type 1 diabetes - you have to prick yourself with needles seven or eight times a day - and now I'm being criminalised for doing something I wasn't told was wrong."

Not informed

She had type 1 diabetes diagnosed in 1999 and was told that she was entitled to free prescriptions for life.

The system changed in 2002 and a new medical exemption certificate that needed renewing every five years was introduced.

But those issued the old exemptions were not informed of the change.

They have started facing fines since the NHS Business Services Authority took over responsibility for checking people's eligibility last September.

The body started issuing fines of up to £100 plus the cost of the prescription.

Government ministers have openly championed getting tough on prescriptions.

'Unacceptable'

The charity Diabetes UK says "large numbers" of people are affected, although there is no clear overall total.

Its chief executive, Barbara Young, told the BBC: "This is a policy designed to tackle fraud, but because of the poor way it has been implemented it has resulted in the unfair fining of people with a lifelong health condition.

"It is unacceptable and needs to change."

She said that people should have been warned first, rather than just fined.

Neal Patel, of the Royal Pharmaceutical Society, shared that sentiment: "No-one should be labelled a fraudster just because they have forgotten to renew their medical exemption certificate.

"The effect of this fine is to punish people with long-term conditions for their illness.

"We'd like to see a far more constructive approach which supports and informs patients rather than make them bear the bureaucratic burden of an unfair system."

An NHS Business Services Authority spokeswoman said: "It remains the patient's own responsibility to check their entitlement before claiming free prescriptions.

"To be clear, it is written in regulation that it is the exemption certificate that entitles a patient to free prescriptions, not the medical condition alone."

Do you collect a free prescription for a life-long condition? Have you received a £100 fine as a result? You can share your experiences by emailing haveyoursay@bbc.co.uk

Please include a contact number if you wish to be contacted by a BBC journalist.

Have your say


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Fifteen-minute Ebola test approved

20 February 2015 Last updated at 10:48 James GallagherBy James Gallagher Health editor, BBC News website

The first rapid blood test for Ebola has been approved for use by the World Health Organization.

It should allow patients to be identified, isolated and cared for as quickly as possible in an attempt to bring an end to the outbreak that has killed more than 9,300 people.

It is less accurate than conventional tests, but takes minutes rather than hours to get a result.

The test also works without electricity so it can be used in remote regions.

Current Ebola testing requires a laboratory to analyse the blood for fragments of the virus's genetic material.

It can take between 12 and 24 hours to get a definitive answer.

The ReEBOV Antigen Rapid Test, developed by US company Corgenix, searches the blood for a different part of the virus.

Trials in West Africa suggest it correctly identifies about 92% of people who have Ebola.

Remote locations

The World Health Organization said: "While less accurate, the antigen test is rapid, easy to perform and does not require electricity.

"It can therefore be used at lower health care facilities or in mobile units for patients in remote settings."

It added that, where possible, the results from the rapid test should be confirmed by the more precise conventional testing.

There were 128 new cases of Ebola in the three affected countries - Liberia, Sierra Leone and Guinea - last week.

More than 23,250 people have been infected in the outbreak and 9,380 have died.

Dr Ben Neuman, a lecturer in virology at the University of Reading, said: "The new test could help to quickly confirm outbreaks in remote areas without the need to send samples to a testing clinic and wait for results.

"The new test isn't about saving the lives of infected people, but it can help in the long run by making it easier and quicker to detect Ebola outbreaks."


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