Archive for the ‘Health’ Category:
By Adam Brimelow
Health correspondent, BBC News
Health service managers are facing a tough road ahead.
They have been told to plan for a shortfall of £20 billion over the next four years.
Yet a leading health research group has now said pressures on the NHS budget in England may not be as bad as has been assumed.
The King’s Fund has calculated that the projected gap in funding can be cut by a third.
Freezing pay, scaling back building projects and accepting current waiting times, could save £6.5 billion, it estimates.
But the fund also argues that improved efficiency should deliver better quality care.
And, it says, the approach taken by University College Hospital in developing better cancer care is a "solid example" of this.
"I think the focus for the NHS is and should be on why do we want to improve productivity – to do what"
Professor John Appleby, King’s Fund’s chief economist
The trust already pays for some of its patients having radiotherapy to stay in a nearby hotel, rather than remain in hospital.
Advances in treatment mean this is becoming an option for many more people. The trust’s chief executive, Sir Robert Naylor, says the idea has proved extremely popular.
"We started doing this four or five years ago in a four-star hotel across the road from the hospital, and to our surprise we found out that that was much more cost-effective.
"The hospital cost something like £300 a night to keep a patient in hospital, but it’s about a third of that price to put them up in a four-star hotel."
The trust is building a new cancer centre – paid for by selling off other properties – that will enable it to look after many more patients in this way.
Sir Robert says its highly specialised services will lead to even better survival rates.
The King’s Fund says approaches like this – keeping patients out of hospital – are vital for the NHS.
Home support
Professor Chris Ham, soon to be the fund’s chief executive, says the NHS should concentrate on improving links with social services to support vulnerable people in their own homes.
This joint approach is already working well in Torbay Care Trust in Devon.
Here district nurses, occupational therapists, physiotherapists and social workers are based in the same office, sharing visits, records and budgets to keep vulnerable patients independent and comfortable.
The lead district nurse in the trust’s Paignton team, Lorraine Webber, says bringing health and social care together makes it easier to provide better support.
"Whether that’s preventing a patient going in or facilitating quicker discharge for patients needing to come out, we can work together with colleagues rather than in a fragmented way.
"We can work together to support that patient in whatever it is they need and we can do it much quicker because we’re all here and we’re all working towards the same goal."
The health service is looking at these ideas with renewed urgency as the pressure grows to plug the funding gap.
In making its recommendations, the King’s Fund has gone back to a review for the treasury carried out by Sir Derek Wanless in 2002 – the report that was responsible for much of the increase in NHS funding in recent years.
This assumed that pay would rise to well above the rate of inflation. But in the pre-budget report last year the chancellor announced a squeeze on public sector pay.
Pay freeze
The King’s Fund’s chief economist, Professor John Appleby, says freezing pay could save the health service £3.5 billion.
"In a way the NHS will be in a situation where there’ll be real pay rises this year in 2010.
"But from April 2011 it is likely that there’ll be virtually nil pay rises so there will be essentially a pay freeze."
He also suggests that scaling back spending on buildings could claw back about £1.5 billion, while a similar amount could be saved by accepting that current waiting times are good enough.
"These are not uncontentious or easy decisions of course. But they are decisions that could be taken. And it does reduce in a sense the rather daunting productivity challenge that the NHS is facing."
And he warns against pursuing cuts simply in order to save money.
"I think the focus for the NHS is and should be on why do we want to improve productivity – to do what
"And I think the examples in terms of UCH and Torbay – those are solid examples of improving quality and releasing resources – saving some money – but not saving money as an end in itself, but to do something else with."
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
Infections spread by acupuncture needles are under-diagnosed worldwide, according to doctors in Hong Kong.
Writing in the British Medical Journal, they call for tighter infection controls and regulation.
Acupuncture is currently unregulated in the UK, but the government is consulting on the issue.
The British Acupuncture Council says their members follow a strict code of conduct which includes infection control measures.
Needle risk
Professor Patrick Woo and colleagues, from the University of Hong Kong, argue in an editorial that acupuncture may pose risks to patients because needles are inserted deep beneath the skin, and can introduce infection.
Drawing on worldwide studies, he says there have been cases where bacterial infections have been transmitted to patients who went on to develop serious problems.
They include joint destruction, multi-organ failure, flesh-eating disease and paralysis.
He says acupuncture has also been associated with hepatitis B.
"The risk of severe side effects associated with acupuncture in the UK is one in every 200,000 cases"
Dr Mike Cummings, British Association of Medical Acupuncturists
Professor Woo believes the link with acupuncture often goes unrecognised because of the long incubation period of some of the transmitted infections.
The authors call for clinicians to "have a high index of suspicion" for infections that might be transmitted by acupuncture and to "alert health authorities about clusters of cases".
They conclude that "to prevent infections transmitted by acupuncture, infection control measures should be implemented, such as use of disposable needles, skin disinfection procedures, and aseptic techniques".
"Stricter regulation and accreditation requirements are also needed," they say.
Strict code
British acupuncturists say practitioners who belong to a professional body in the UK have very high standards.
Janet Stringer, a practitioner and spokesperson for the British Acupuncture Council, said members undergo a three and a half year training and follow a strict code which includes the infection control measures suggested in the article.
She said: "Our code covers measures like single-use disposable needles.
"Clean needle technique is taken very seriously."
Dr Mike Cummings, medical director of the British Association of Medical Acupuncturists, said severe infections associated with acupuncture were "incredibly rare".
"Overall acupuncture is extremely safe," he said.
"We inform patients that the risk of severe side effects associated with acupuncture is one in every 200,000 cases."
Unregulated
But Edzard Ernst, Professor of Complementary medicine at the University of Exeter, said that although virtually all UK practitioners would use disposable needles, the infection risk depended on the competence of the therapist.
He said that although acupuncturists who were medically trained would know how to handle sterility, he would be more worried about some of those who do not have a medical background.
He pointed out that acupuncture is unregulated in the UK and anyone can set themselves up as an acupuncturist without training or accreditation.
The government has recently been consulting on whether, and if so how, to regulate herbal medicine and acupuncture practitioners.
A spokesman for the Department of Health said: "We received over 6,000 responses and we are currently in the final stages of the analysis. Our response will be published as soon as possible.
"We won’t pre-empt the outcome of the consultation, but safety will be our main concern in making decisions."
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
Maternity services for obese women are not good enough and may be putting mothers-to-be at risk, experts warn.
The Centre for Maternal and Child Enquiries said units were short of basic equipment like extra-wide operating tables and beds.
Its poll of UK services also showed obese pregnant women were not getting the right advice and assessments.
A Department of Health spokeswoman said the UK remained "one of the safest countries in the world to have a baby".
The Centre for Maternal and Child Enquiries, an independent research group which is partly funded by the NHS, said it had teamed up with doctors to issue new guidelines to the NHS on treating obese mothers-to-be
These cover issues such as what assessments, support and advice should be given to the women.
"Obesity has gone up so fast that services are struggling to keep up"
Dr Jo Modder, lead researcher
It has also asked services to ensure they have clear policies and the right resources in place.
Obese mothers-to-be are at higher risk of a wide variety of complications, including stillbirths, diabetes and pre-eclampsia.
They are also more likely to need caesareans and should therefore have assessments during pregnancy to see what special arrangements may have to be put in place.
But the survey, which gathered information from 320 maternity units as well as a range of other midwife and obstetric services that come into contact with pregnant women, showed only half of places always offered these assessments.
Only a third gave specific diet advice while 60% of maternity units did not have central records of what equipment they had available.
And nearly half did not have official policies and guidelines for treating obese patients, the group said.
Rising rates
The findings come amid rising rates of obesity in pregnancy. One in five mothers-to-be are obese – double the proportion from a decade ago.
Lead researcher Dr Jo Modder said the current standard of services could "potentially be putting women at risk".
She added: "Obesity has gone up so fast that services are struggling to keep up. I think services could be improved to provide more appropriate care."
Professor Sir Sabaratnam Arulkumaran, president of the Royal College of Obstetricians and Gynaecologists, which helped draw up the guidelines, agreed the NHS needed to do more.
But he added obese women also needed support to be encouraged to lead healthier lives before becoming pregnant.
"The long-term challenge is behavioural."
Professor Cathy Warwick, of the Royal College of Midwives, said: "NHS trusts should be looking at what works and learning from each other to ensure the highest standards of care are available."
The Department of Health spokeswoman said: "It’s vital that obese pregnant women are able to receive specialist advice, support and risk management throughout their pregnancy."
But she stressed that the UK was one of the safest nations in which a woman could give birth.
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
Written on March 18th, 2010 by Editorno shouts
HealthDay – (HealthDay News) — Just as when they were pregnant,
breast-feeding moms need to monitor the drugs they take, which could reach
their infants.
Written on March 18th, 2010 by Editorno shouts
HealthDay – THURSDAY, March 18 (HealthDay News) — Scientists have found evidence
that older men with higher levels of selenium are less likely to suffer
from dysglycemia, or improper blood-sugar metabolism.
Written on March 18th, 2010 by Editorno shouts
HealthDay – THURSDAY, March 18 (HealthDay News) — A stressful pregnancy may
increase the risk that a baby will develop asthma, a new study finds.
Written on March 18th, 2010 by Editorno shouts
HealthDay – THURSDAY, March 18 (HealthDay News) — U.S. health officials
issued new federal rules Thursday cracking down on the sale of cigarettes
and other tobacco products to children and teens.
Written on March 18th, 2010 by Editorno shouts
HealthDay – THURSDAY, March 18 (HealthDay News) — A review of research on
gene expression-based prognostic signatures in lung cancer contends that
the signatures aren’t ready for prime time.
Written on March 18th, 2010 by Editorno shouts
HealthDay – THURSDAY, March 18 (HealthDay News) — The obesity epidemic is
hitting children harder than ever, with 7.3 percent of boys and 5.5
percent of girls classified as extremely obese in a California study,
researchers from Kaiser Permanente report.
Emma Wilkinson
Health reporter, BBC News
One in five deaths in children in England and Wales is due to potentially preventable infections, a study suggests.
Half of the 1,300 infection-related deaths in a two-year period were in children with other health problems.
Health Protection Agency researchers said greater vigilance by doctors could significantly child mortality.
Childhood vaccines have a key role in cutting unnecessary deaths, they said.
The study, which analysed data from 2003 to 2005, is the first to look at the burden of deaths from specific infections in children.
"We have very good vaccination programmes in place – but we also need to make sure we are up to date with the latest vaccines out there"
Dr Shamez Ladhani
Looking at death certificates in children aged 28 days to 14 years old, they found 20% of a total 6,987 deaths were related to an infection.
Underlying health problems in children dying from infectious disease included prematurity, cerebral palsy and cancer.
In deaths where a specific type of infection was recorded, 59% were bacterial, 31% viral and 8% fungal.
One finding which particularly worried the researchers was a high rate of deaths from some intestinal infections in children with underlying medical problems, as these are infections which would not normally be a problem in healthy children but can often be resistant to treatment.
Prevention
As this is the first time such analysis has been done, the researchers had no data to compare the findings with.
But they said the results backed a recent report on the care of critically ill children in the UK which called for better recognition of serious illness in children and more aggressive treatment.
A study published last year warned that more needed to be done to prevent children with cancer dying from potentially preventable infections.
Writing in the Pediatric Infectious Disease Journal, they said that adding in more vaccines to the routine childhood programme would be one way to cut the number of deaths.
Influenza, hepatitis B, rotavirus, and chicken pox vaccines are among those that are currently available but not included in the schedule.
Dr Shamez Ladhani, study leader and consultant in paediatric infectious disease, said ensuring good uptake of currently used vaccinations would also have an impact on deaths.
"We have very good vaccination programmes in place – but we also need to make sure we are up to date with the latest vaccines out there."
He added that doctors needed to be more vigilant for infection in seriously ill children to ensure they get treatment quickly enough.
"We also need to look at surveillance and keep an eye out for antibiotic resistance."
Dr David Vickers, a registrar at the Royal College of Paediatrics and Child Health, said: "We support the need to research whether new vaccinations should be added to the routine childhood immunisation programme.
"Earlier recognition of ill children and more systematic management through the use of clinical protocols both offer the potential to reduce mortality from infection."
This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.
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