Scot to have double hand transplant

25 June 2014 Last updated at 00:45 By Eleanor Bradford BBC Scotland Health Correspondent

A Scottish woman is to become the first person in the UK to have a double hand transplant, BBC Scotland can reveal.

Corinne Hutton had her hands and feet amputated last summer after a pneumonia infection led to blood poisoning.

She will become the second person in the UK to have a hand transplant, and the first to have both hands replaced.

Prof Simon Kay, who will lead the surgical team at Leeds General Infirmary, said: "I think the result will be exceptional."

He added: "I think she'll get very good function very quickly, and partly this is a tribute to the team in Glasgow who removed Corinne's hands in a way that would facilitate transplantation later."

Corinne, from Renfrewshire, lost her hands and feet last summer following a Streptococcus A infection, which caused pneumonia and sepsis.

Her chances of survival were put at just 5%. Her life was saved by a specialist team who travelled to Scotland from Leicester with an ECMO machine to oxygenate her blood.

"One of the consultants told me afterwards that, as they flew up, they weren't expecting to take me," said Corinne.

"When they arrived my condition was worse, but it was the weekend and he wasn't answerable to anyone else, and as I was going to die anyway he had nothing to lose. So they decided to take me."

'No worse off'

However the infection, along with the drugs Corinne needed, starved her hands and feet of blood, effectively causing gangrene. Her feet were amputated above the ankle, but doctors were able to save her wrists.

"I thought with a transplant they'd cut away my wrists and if it failed I'd be much worse off," she said.

"But they said the donor's hands would attach to my wrists and therefore if it fails I'm no worse off."

Skin from the donor's forearms will also be retained and used to cover up extensive scarring on Corinne's arms, in an operation which will involve four surgical teams.

"This operation from a technical point of view is much more complex," said Prof Kay, who carried out the UK's first hand transplant on Mark Cahill.

"In Mark's case we had to replace three nerves, whereas in Corinne's case it'll be more like 10, plus all the tendons need to be repaired individually. So from a technical point of view it's much more complex, but the concept is the same."

Corinne has undergone psychological testing as well as tissue testing ahead of her operation. Although the transplant team will try to find a good match, her new hands will always look different.

Stranger's hands

Doctors want to make sure she is psychologically strong enough to cope with seeing a stranger's hands at the end of her arms.

"I've been told that it's psychologically tough," said Corinne. "I like to think that I'd be grateful to whoever had given me those hands. I spoke to Mark and he agreed that was his angle on it."

She is expected to have some sensation from her new hands straight away, but it will take 14-16 months for the transplants to settle down. She will also have to take immuno-suppressants for the rest of her life, which carry some health risks.

Surgery is expected to take place this autumn and is being funded by the Scottish government.

Corinne also hopes her story will help to raise funds for the Finding Your Feet charity which was originally set up to raise funds for her recovery but which now helps other people who have limbs amputated.

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Patients 'facing longer GP waits'

25 June 2014 Last updated at 08:27 By Nick Triggle Health correspondent

Longer waits to see a GP in the UK are "becoming the norm", the British Medical Association is warning.

BMA GP leader Dr Chaand Nagpaul said "chronic underfunding" meant patients were often having to wait one or two weeks for an appointment.

Some patients struggled to get an appointment, he said. Data from the GP patient survey in England shows one in 10 could not last time they tried.

The government said measures addressing the issue were already in place.

Dr Nagpaul will highlight the issue of funding coupled with rising demand in a speech at the BMA's annual conference on Wednesday.

Continue reading the main story

"Start Quote

We hear daily from patients that they can't get appointments"

End Quote Katherine Murphy Patients Association

He will point out that annual consultations have risen by 40 million in England alone since 2008, hitting 340 million a year at the last count.

But he will tell delegates in Harrogate that the increase has come at a time when the amount spent on general practice as a share of the NHS budget has been falling.

Complex conditions

Figures from the Royal College of GPs show that in 2005-6 it stood at 10.7% of NHS spending, but by 2011-12 it had dropped to 8.4%.

Ahead of the speech Dr Nagpaul told the BBC: "Demand is outstripping supply. The patients we are seeing have more complex conditions and yet we still only have 10 minutes for each consultation - that is woefully inadequate.

"General practice is chronically under-funded and that is beginning to have an impact on the patient experience."

He added waits of "one or two weeks were becoming the norm" for patients, although he said those needing urgent appointments would always be seen quickly.

His warning was backed up by the Patients Association.

Its chief executive, Katherine Murphy, said: "We hear daily from patients that they can't get appointments. It's even worse for those who want a named doctor for continuity of care. They are having to wait two or three weeks. It is becoming a real issue.

"We need more investment in general practice, but I think we also need greater flexibility from doctors - it can no longer be a nine to five service."

The Department of Health said this was already happening via its £50m Challenge Fund.

Continue reading the main story 'Not affordable'

More than 1,100 practices - one in eight of those in England - have signed up to the initiative to extend opening hours and make greater use of technologies such as Skype and e-mail.

A spokesman added the measures should make access "more convenient" for patients.

"People need to see a GP at a time to suit them," he said.

But Dr Beth McCarron-Nash, a GP based in Truro, said: "There is a drive towards convenience general practice, and actually we do need an open and honest debate with the public about what general practice is actually funded for.

Continue reading the main story

"Start Quote

Young doctors are leaving the UK, they're deciding not to be GPs"

End Quote Dr Beth McCarron-Nash

"We're struggling to cope with providing the need, let alone the convenience of what I call the Martini practice - seven days a week, any time, any place, anywhere. That, unfortunately, is not affordable."

Dr McCarron-Nash also said many practices were failing to recruit doctors.

"Why would you want to be a partner when actually [there is] liability in owning a practice, employing the staff, all the extra work that actually comes with being an employer, along with the workload demands?

"Young doctors are leaving the UK, they're deciding not to be GPs."

Labour shadow health secretary Andy Burnham said: "It is getting harder and harder to get a GP appointment under David Cameron's government.

"The lack of access to GPs is forcing many people to use much more expensive A&E departments.

"The next Labour government will invest £100m to help patients to get a GP appointment - either within 48 hours or a same-day consultation with a doctor or nurse for those who need it."

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Campaigners lose 'right to die' case

25 June 2014 Last updated at 10:02

Please turn on JavaScript. Media requires JavaScript to play.

Paul Lamb: "I haven't committed a crime, I don't deserve to be punished like this"

Campaigners have lost their appeal at the UK Supreme Court over the right to die - but the judges said Parliament should now act.

Justices ruled against Paul Lamb and Jane Nicklinson by seven to two.

A third man, Martin, lost his attempt to have the current prosecution guidance on assisted suicide clarified.

But five justices concluded they had the power to declare the current law breaches the right to a private life.

Had the court made such a declaration, it would have forced the government to introduce legislation to amend the law on assisted suicide.

Continue reading the main story

I am disappointed that we lost. But it is a very positive step. Parliament will have to discuss this"

End Quote Jane Nicklinson Campaigner

A majority of the justices said that the question they were being asked involved moral judgements rather than points of law - and the matter had to be addressed by a democratically-elected Parliament.

The cases involve the family of the late Tony Nicklinson, of Wiltshire, who had locked-in syndrome, and Paul Lamb, of Leeds, who was paralysed in a road crash.

They wanted the law changed to allow doctors to assist patients to die.

Nine justices had to decide whether a prohibition on assisted suicide was compatible with the right to respect for private and family life under the European Convention on Human Rights.

Five concluded the court had the "constitutional authority" to make a declaration, and two of the five said they would have done so.

'Positive step'

Mr Lamb and Mrs Nicklinson, the wife of Tony Nicklinson, said the conclusions were a "positive" step in the fight for change.

Continue reading the main story

The Supreme Court is our highest legal authority - and that also makes it a political creature. So its right-to-die judgement boils down to a single phrase directed at Parliament: Sort it out, or we will.

It argues that MPs have ducked the issue for too long - and it is time they, as our democratically-elected representatives, find the political backbone to amend the law on assisted suicide.

Lord Neuberger, the court's president, clearly finds current guidelines, whereby prosecutors consider criminal charges after a death, to be deeply unsatisfactory.

He proposes a transparent legal channel which would allow independent assessment of a patient's application to die.

Lady Hale, an international authority on law and the family, is bolder, saying the ban breaches human rights.

So make no mistake: if Parliament doesn't act, it may only be a matter of time before judges run of patience.

"I am very proud of myself," said Mr Lamb, 58. "I know it is going to change."

Mrs Nicklinson, from Wiltshire, whose husband Tony died aged 58 last year, added: "I am disappointed that we lost. But it is a very positive step. Parliament will have to discuss this. I think Tony would be very pleased at how far we have come."

Commenting on the ruling, Andrea Williams of Christian Concern, said: "This is good news for the many vulnerable people who would have been at risk if the attempt to weaken the law on euthanasia and assisted suicide had been allowed by the Supreme Court."

Andrew Copson, chief executive of the British Humanist Association, which supported the campaigners, said: "It is clear that the Supreme Court went as far as it was able in urging Parliament to take action on the vital issue of assisted dying."

A third man, known only as Martin, was seeking clarification of the Director of Public Prosecutions's (DPP's) guidance on the position of health professionals who assist a suicide.

Martin wants it to be lawful for a doctor or nurse to help him travel abroad to die with the help of a suicide organisation in Switzerland. His wife and other family want no involvement in his suicide.

The Supreme Court unanimously allowed the DPP's appeal against a previous Court of Appeal ruling in Martin's favour for clarification of the guidance.

Using an adapted computer operated by sight, Martin said in a statement: "I would implore the DPP to amend her written guidance as a matter of absolute priority.

"People in my situation, who have the right to choose how to end their lives, should be able to get the assistance they need from people outside their family."

Long battle

Mr Lamb has been almost completely paralysed from the neck down since a car accident more than 20 years ago and says he is in constant pain.

He has called for the law to be changed so any doctor who helped him die would have a defence against the charge of murder.

Tony Nicklinson was paralysed from the neck down after suffering a stroke while on a business trip to Athens in 2005.

After losing his High Court battle last year, he refused food and died naturally, aged 58, a week later at his home in Wiltshire. His widow, Jane, is continuing his legal battle.

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Lord Carlile said the UK offered "the best palliative care in the world", and there was no case for a law allowing assisted suicide

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Mental health services 'a car crash'

24 June 2014 Last updated at 13:05 By Michael Buchanan Social affairs correspondent, BBC News

Mental health services in England are "a car crash" and the health secretary is not taking the problems seriously, according to the outgoing president of the Royal College of Psychiatrists.

Prof Sue Bailey told BBC News mental health services were "in crisis".

She said Health Secretary Jeremy Hunt had a basic understanding of mental health, but had not made it a priority.

Mr Hunt rejected this, saying he had made it a priority and that he visited the front line of the NHS most weeks.

The government say they are improving mental health services and point to more £450m being spent on psychological therapies and to pilot projects they're funding to provide street triage, ensuring a psychiatric nurse accompanies officers to incidents where police believe people need mental health support.

Continue reading the main story

He has a basic understanding of it but whether he takes it seriously, the proof of which would be making it a priority, then sadly not"

End Quote Prof Sue Bailey Outgoing president of the Royal College of Psychiatrists

Strain

Mental health services are struggling to cope with rising demand at a time of shrinking resources.

Clinicians say the health effects of the recession and major welfare reforms are leading to more people accessing services.

However, patients are having to cope with a reduction in beds, forcing them to travel huge distances to access care.

Investigations by BBC News and online journal Community Care have also highlighted funding cuts to mental health trusts and children's mental health services.

'Real pressures'

"It's a car crash," said Prof Bailey.

"The system is in crisis and we need people to listen.

"The sums of money that could make a difference are not huge but they could make a large difference."

Prof Bailey, who steps down as president of the Royal College of Psychiatrists later this week following three years in the role, strongly attacked the health secretary for failing to engage.

Asked whether Mr Hunt takes mental health seriously, she replied, "He has a basic understanding of it but whether he takes it seriously, the proof of which would be making it a priority, then sadly not."

Mr Hunt, who became health secretary in September 2012, has regularly visited acute hospitals since being appointed.

He told BBC Radio 4's Today programme that he agreed with Prof Bailey that there were "some real pressures" in mental health delivery.

But he said: "We are the government that has put in law that we have to treat mental health and physical health on the same basis."

Mr Hunt added that he was "proud" to be the "first health secretary who goes out into the front line of the NHS most weeks, who doesn't just visit trusts but actually takes part".

But in the 21 months he has been in charge, he has visited mental health trusts on a handful of occasions, according to figures obtained by BBC News following a Freedom of Information Act request.

His predecessor, Andrew Lansley, also visited mental health trusts a handful of times during his two years in the role.

Prof Bailey said: "When he [Mr Hunt] came to dinner with us, he was given a great number of offers to go and see mental health services, child services, services for the elderly, innovative projects and it would be good, especially as we go up to April 2015, to see each and every politician from the parties go out and visit mental health services."

Fixed fees

Prof Bailey, a consultant child and adolescent forensic psychiatrist in Manchester, will be replaced by Sir Simon Wessely as president of the Royal College.

She says the government's reforms of the NHS have worked against mental health services given the way that psychiatric services are funded.

Mental health services mainly have block contracts and are paid a fixed fee for a service rather than payment by results. So as demand increases, they do not get more money as patient numbers rise.

Prof Bailey has welcomed the legal commitment the government introduced to have parity of esteem between physical and mental health - ie the legal requirement that mental and physical health are treated equally - but asked: "Have we got parity in practice? I suspect not."

She will now move on to new roles, chairing various children's charities and working with Health Education England.

She said she would continue to promote mental health services, but in a broader context.

"One way to make societies healthier, including mentally healthier, is to invest in the health and education of women because women play this vital role in the rearing of the next generation," she said.

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Phones carry bacterial 'fingerprint'

24 June 2014 Last updated at 12:11 By Helen Briggs Health editor, BBC News website

Smartphones reflect the personal microbial world of their owners, say US scientists.

More than 80% of the common bacteria that make up our personal bacterial "fingerprints" end up on their screens, a study suggests.

Personal possessions, such as phones, might be useful for tracking the spread of bacteria, they report in PeerJ.

They reflect our microbiome - the trillions of different micro-organisms that live in and on our bodies.

Mobile phone users have been found to touch their devices on average 150 times a day.

Continue reading the main story

We share more than an emotional connection with our phones - they carry our personal microbiome"

End Quote Dr James Meadow University of Oregon

Scientists have found an overlap between the collection of micro-organisms naturally present on our bodies and those on the screens of smartphones.

They say this could one day be used to track people's exposure to bacteria.

In the study, biologists from the University of Oregon sequenced the DNA of microbes found on the index fingers and thumbs of 17 people.

They also took swabs of the subjects' smartphones.

A total of 7,000 different types of bacteria were found in 51 samples.

Proof-of-concept

On average, 22% of bacterial families overlapped on fingers and phones.

Some 82% of the most common bacteria present on participants' fingers were also found on their phones.

They included three families that are commonly found on the skin or in the mouth - Streptococcus, Staphylococcus and Corynebacterium.

Men and women both shared bacteria with their phones, but the connection was stronger in women.

Lead researcher Dr James Meadow said while the sample size was small, the findings were "revealing".

"This project was a proof-of-concept to see if our favourite and most closely held possessions microbially resemble us," he said.

"We are ultimately interested in the possibility of using personal effects as a non-invasive way to monitor our health and our contact with the surrounding environment."

The researchers say there is no evidence that mobile phones present any more infection risk than any other possession.

But they say our phones might one day be used to study whether people have been exposed to certain bacteria, particularly healthcare workers.

Emotional connection

The study confirms that "we share more than an emotional connection with our phones - they carry our personal microbiome", Dr Meadow added.

There is increasing scientific interest in the human microbiome - the population of trillions of micro-organisms that live in our gut, mouth, skin and elsewhere on our bodies.

Bacteria can be harmful but they can also have beneficial effects, particularly in the gut, by digesting food and making essential nutrients and vitamins.

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Fears hospital mistakes covered up

24 June 2014 Last updated at 13:15 By Nick Triggle Health correspondent, BBC News

A fifth of hospital trusts in England may be covering up mistakes, a government review suggests.

The analysis of reporting incidents shows 29 out of 141 trusts were not registering the expected number of safety incidents.

The review said this may be a sign of a "poor" safety culture.

Health Secretary Jeremy Hunt said it was important hospitals were "open and honest", and that patients had a right to know about problems with reporting.

Continue reading the main story

Healthcare carries inherent risk and while healthcare professionals work hard every day to reduce this risk every day, harm still happens"

End Quote Sir David Dalton Chief executive, Salford Royal Hospital

The data has been released as part of the Department of Health and NHS England's drive to improve safety in the NHS.

In March, Mr Hunt set the target of saving 6,000 lives over the next three years by reducing the number of serious mistakes.

He asked trusts to join the Sign up to Safety campaign and draw up plans to halve "avoidable harm" such as medication errors, blood clots and bedsores by 2016-17.

He said this could stop a third of preventable deaths in the coming years - equivalent to 6,000 lives saved.

Safe staffing

On Tuesday the government will launch the next stage of this campaign, a website which will allow patients to view the performance of individual hospitals on measures such as safe staffing levels and infection rates.

It will also reveal which trusts have been given a poor rating for open and honest reporting. This has been decided after reviewing the way trusts report safety incidents into the National Report and Learning System as well as looking at the results of the staff survey question relating to safety reporting.

Those with lower-than-expected incident reporting, which is widely acknowledged to be a sign of problems, will be followed up by NHS England officials.

Nick Triggle - Health Correspondent BBC News

The latest announcement on patient safety makes alarming reading. One in five sounds like problems are widespread.

But what the government has done is essentially risk-profile - that is to say work out which trusts fall outside the expected range.

They do this by working out what average performance is. In this case, it is to do with how many safety incidents are reported.

Some leeway is then given to allow those who are just above or below the average to be grouped together in the expected range. This leaves a number of good and bad outliers - which, by definition, will be around 20% to 25% of the total.

This is a tried-and-tested method that has been used by groups such as Dr Foster for years. Indeed, the Care Quality Commission did it when they gave each hospital a risk rating last year. That time one in four fell into the "bad" category.

This, of course, is not the same as saying the trusts are risky. The government argues publicising its risk analysis in this way is about being open and honest. That maybe true, but the danger is that the subtleties of the message can get lost.

Mr Hunt told BBC Radio 4's Today programme that this was not about "humiliating" anyone.

"The NHS is there for patients and if a hospital has a problem with its reporting culture, I think patients have a right to know that," he said.

The health secretary said if patients were aware of these problems, hospitals would be encouraged to take more speedy action.

The founder of the Clinical Human Factors Group, which campaigns for a safer NHS, warned that "simply naming and shaming" would not bring the best results.

Martin Bromiley, whose wife died in 2005 following a minor operation in hospital, said understanding why organisations were not reporting incidents was key.

"We need to try and understand the organisations that aren't reporting," he told the Today programme.

"We need to understand the cultures and what things they are doing that are not encouraging openness."

Mr Bromiley said the best organisations were the ones that encouraged learning.

He said there might have been an "unconscious incompetence" when it came to those failing to be open because they did not understand the process of developing a "safety culture".

The website is being hosted on the NHS Choices site and will be launched on Tuesday afternoon.

The Department of Health stressed that there could be justifiable reasons for low reporting, such as the trust being safe or innocently not using the recording system properly, but that it was only right the concerns be investigated further.

'Avoidable harm'

Mr Hunt said: "The NHS is leading the world in achieving new safety standards but the battle to reduce avoidable harm is constant.

"Unsafe care causes immeasurable harm to patients and their families, and also costs the NHS millions in litigation claims."

Sir David Dalton, the chief executive of Salford Royal Hospital and leader of the safety campaign, urged hospitals to be open.

"Healthcare carries inherent risk and while healthcare professionals work hard every day to reduce this risk every day, harm still happens.

"Some is unavoidable but most isn't. Sign up to Safety seeks to reduce this harm and is a unique opportunity for us all to work together to listen, learn and act to make a difference."

Are you, or is someone you know, affected by the issues in this story? You can email your experiences to Haveyoursay@bbc.co.uk using the subject Hospital safety.

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'Sugar tax' call for child obesity

22 June 2014 Last updated at 06:33

A "sugar tax" should be introduced by the UK government to help curb obesity in childhood, a campaign group says.

Action on Sugar has produced a seven-point plan to discourage children from consuming foods and soft drinks with high levels of added sugar.

The group wants measures brought in to cut added sugar in food by 40% by 2020, to cut fat in foods and to ban sports sponsorship by "junk food" companies.

The Department of Health has said it will consider the recommendations.

Action on Sugar is a group of specialists concerned with sugar and its effects on health. It says one in five 10 to 11-year-olds in the UK are now obese, while one in three are overweight.

The group has produced an action plan for the government following a request for its views from Health Secretary Jeremy Hunt.

The seven proposed measures are:

• Reduce added sugars in food by 40% by 2020
• Ban all forms of targeted marketing of ultra-processed, unhealthy foods and drinks to children
• Disassociate physical activity with obesity by banning junk food sports sponsorships
• Reduce fat by 15% in ultra-processed foods by 2020
• Limit the availability of ultra-processed foods and sweetened soft drinks as well as reducing portion sizes
• Introduce a sugar tax to incentivise healthier food

The group's chairman, Prof Graham MacGregor, said current policies were not working and that obesity could be prevented if "the food environment is changed".

"The UK requires the implementation of this coherent strategy, starting by setting incremental sugar reduction targets for soft drinks this summer. No delays, no excuses," Prof MacGregor said.

Dr Aseem Malhotra, cardiologist and science director of Action on Sugar, said it was "really quite shameful that the food industry continues to spend billions in junk food advertising targeting children".

"It's time to bust the myth of physical activity and obesity and dissociate junk food and sport," he added.

A Department of Health spokesman said: "We know some people eat too many calories including sugar. Childhood obesity is at its lowest since 1998 but more should be done.

"Next week we will get expert scientific advice on sugar which will help shape future thinking. We will consider these recommendations as part of this."

Earlier this year Dame Sally Davies, the chief medical officer for England, said a sugar tax may have to be introduced to curb obesity rates.

She told a committee of MPs that she believed "research will find sugar is addictive", and that "we may need to introduce a sugar tax".

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Parties 'using NHS to win votes'

23 June 2014 Last updated at 00:03 By Nick Triggle Health correspondent, BBC News

Nearly three quarters of the public believe the political parties are designing health policy to win votes, and not what is best for the NHS, a poll has suggested.

The survey of almost 2,000 people in the UK found 73% were sceptical about the motivation of politicians.

One in four also said they were dissatisfied with the way the NHS was being run.

The survey was commissioned by the British Medical Association (BMA).

The poll carried out by Ipsos Mori also found two-thirds wanted the NHS to manage itself without the involvement of politicians.

Another 46% also said politicians should have low or no involvement in how the NHS is run.

That was one of the aims of the reforms introduced by Andrew Lansley when he was health secretary.

But commentators have noted that since Jeremy Hunt has replaced him there has been a push to retain a much more hands-on approach.

'Manipulated'

The poll was released at the start of the BMA's annual conference, which is being held in Harrogate.

BMA leader Dr Mark Porter said: "The government promised to remove micromanagement from the NHS and yet the opposite has happened.

"There are even claims that NHS England, set up to be independent of Whitehall, is being manipulated for political purposes."

He also mentioned a key policy put forward by Labour - the pledge to offer GP appointments within 48 hours - adding: "Patient care is taking a back seat to scoring points over the dispatch box."

Dr Porter said "doctors want to see politics taken out of the NHS once and for all", saying it was "clear that the public feel the same way".

He went on to accuse the government of wasting money on "untested policies" and promised doctors would continue to "fight" for what was right for the NHS in the lead up to the election.

Both the government and Labour party defended their approaches.

Health Minister Dr Dan Poulter said: "Our reforms cut unnecessary red tape and gave doctors and nurses, who know their patients best, the power and freedom to make decisions in the best interests of their local community."

Meanwhile, a spokesman for Labour said access to GPs was a real problem and its plans, which include additional funding, were a "serious" attempt to improve services.

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Soaps to screen organ donor adverts

23 June 2014 Last updated at 07:43

Viewers of Coronation Street and Pobol y Cwm will be the first to see public information films explaining the change in Wales' organ donor rules next year.

From December 2015, Wales will be the first UK nation to introduce a system where people will be presumed to have agreed for their organs to be donated.

The Welsh government hopes that a change in the law will increase transplant rates by 25%.

The adverts are to be broadcast during Monday evening's episodes of the soaps.

They aim to show why the Welsh government says the system needs to be changed to cut the number of deaths of people who are waiting for a transplant.

Continue reading the main story

I hope the adverts will also prompt those watching at home to talk with their loved ones about their organ donation wishes"

End Quote Mark Drakeford Health Minister

Ministers say 36 people in Wales died last year while they waited for a transplant organ.

The adverts will run on radio, television and social media in the run up to national transplant week, from 7-13 July.

A mother, a young boy, a lady in her 50s and a young man feature as four fictional individuals with a digital clock counting down the time they have available.

A second advert, to be screened nearer national transplant week, is a straight forward call for viewers to talk to their loved ones about whether or not they want to be organ donor.

Wales adopts the presumed-consent system on 1 December 2015.

Health Minister Mark Drakeford said: "These prime-time television and radio adverts are a very important element of the campaign going forward.

"The use of the countdown clock is an effective means of highlighting the urgent need for more organ donors each and every single day as a means of saving lives.

'Landmark'

"I hope the adverts will also prompt those watching at home to talk with their loved ones about their organ donation wishes as we prepare for December 2015 and the introduction of this landmark law in Wales."

Currently, people across the UK join a voluntary scheme and carry a card if they wish to donate organs.

Evidence from other countries with an opt-out system indicates that the rise in organ donors is small with about 15 additional donors provided each year and approximately 45 extra organs.

There has been opposition to the scheme but ministers have insisted it will be implemented sensitively.

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Skin and liver cancer up in England

19 June 2014 Last updated at 17:56 By Pippa Stephens Health reporter, BBC News

The numbers of people diagnosed with skin cancer and liver cancer have risen sharply in England.

Between 2003 and 2012, skin cancer cases increased by 78% in men and 48% in women, according to Office for National Statistics (ONS) figures, which are not adjusted for population growth.

Cases of liver cancer had risen by 70% in men and 60% in women, the ONS said.

Alcohol, obesity and hepatitis B and C are the main causes of liver cancer.

Overexposure to the sun is thought to be behind the skin cancer rise.

In 2012, breast cancer was the most common cancer in women, affecting 31% of those with a cancer diagnosis.

In men, prostate was the most commonly diagnosed cancer - at 26%.

Lung and bowel cancers were the second and third most prevalent cancers in men and women respectively.

Continue reading the main story

"Start Quote

We all know people who we would never describe as alcoholics but are heavy drinkers - and they are at risk"

End Quote Andrew Langford British Liver Trust

'Treading a fine line'

Skin cancer is now the fifth most common cancer and accounts for 4% of new cases.

The number of newly diagnosed cases increased from 3,109 in men and 3,886 in women in 2003 to 5,535 in men and 5,746 in women in 2012.

Changes in clothing trends and an increase in sunbathing were behind the rise, said the ONS.

Liver cancer is now the 18th most common cancer in England and accounts for 1% of new cases.

The number of new cases increased from 1,440 in men and 889 in women in 2003 to 2,449 for men and 1,418 for women in 2012.

Andrew Langford, chief executive at the British Liver Trust, said the figures were "unfortunately, unsurprising".

He said: "It is a very fine line people are treading at the moment. The three main causes of liver cancer are alcohol, obesity and viral hepatitis.

"Part of the problem is people often associate liver cancer with alcoholics. But we all know people who we would never describe as alcoholics but are heavy drinkers - and they are at risk."

Continue reading the main story

"Start Quote

"It is vital to... stop the next generation taking up the deadly habit that kills half of all long term users"

End Quote Matt Wickenden Cancer Research UK

'Killer habit'

He said that people who drank should have two to three days off a week to let their liver rejuvenate.

Lung cancer rates rose by 18% in women between 2003 and 2012, but fell by 8% in men.

Changing smoking patterns were behind the split, said the ONS, as there was a fall in the number of men who smoked in the past 50 to 60 years, but a rise in the number of women taking it up during the same time.

Matt Wickenden, at Cancer Research UK, said more than 40% of cancers could be prevented through lifestyle changes and that smoking caused "nearly a fifth of all cancers".

He added: "It is vital to reduce smoking rates, and so we're urging the government to introduce plain, standardised tobacco packaging without delay to stop the next generation taking up the deadly habit that kills half of all long-term users."

The rate of breast cancer diagnoses has remained fairly constant over the past decade. Age was the main risk factor for breast cancer, with 80% of women diagnosed in 2012 aged over 50, said the ONS.

Alcohol, obesity, lack of physical exercise, hormonal and reproductive factors were behind 27% of breast cancer cases, the research said.

Age was also the biggest risk factor for prostate cancer, said the study, with 89% of new cases in 2012 in men aged over 60.

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