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Speedier tests for cancer planned
GPs in England are to get speedier access to diagnostic tests to help spot less clear-cut cancer cases, Prime Minister Gordon Brown will pledge. Patients will get key tests within two weeks of seeing their GP, he will tell the Labour Party conference on Tuesday. It will mean faster reassurance for patients and could save thousands of lives by picking up cancers earlier, he is expected to say. Late diagnosis has been blamed for poorer cancer survival in the UK.
The Eurocare project reported that long-term survival rate data placed the UK below the European average. There is already a target in place for patients suspected by their GP to have cancer to be seen by a specialist within a fortnight. And the Cancer Reform Strategy published in 2007 highlighted better detection of cancer in primary care as a priority.
Greater access to tests will enable GPs to rule out cancer or get an early diagnosis, Gordon Brown will say. Eventually, he wants patients to have access to tests where necessary within one week of seeing their GP.
Details of funding for the additional diagnostic equipment and staff are not yet clear. It will initially be targeted at lung, colorectal and ovarian cancers, which account for more than a third of cancer deaths and where late diagnosis is a particular problem. But there are proposals to extend the initiative to all cancers within five years.
Survival rates
Professor Steve Field, chairman of the Royal College of GPs, said it had been pushing for direct access to tests, such as ultrasound or CT, for patients about whom there is a suspicion of something amiss but who do not meet the criteria for urgent two-week referral. "The two-week referral time for those patients where there is a high suspicion of cancer has made a major difference to patients and their GPs. But GPs would welcome the opportunity to refer patients directly for diagnostics such as MRI and CT scans, ultrasound and flexible sigmoidoscopy without having to refer to a specialist first." He added that it would provide particular benefit in ovarian cancer, which often presented with very vague symptoms and was hard to spot.
Shadow health secretary Andrew Lansley said just purchasing new equipment was not the way to tackle poor survival rates. He said: "We already have a shortage of radiographers which means that existing equipment is not used to full capacity. "We also need to improve the identification of symptoms in the community - through national screening programmes and better awareness of and response to symptoms, for example."
Harpal Kumar, Cancer Research UK's chief executive, said: "Increased investment to give GPs much faster access to diagnostic tests would be a vital step towards fixing this country's cancer problem and raising our survival rates towards being the best in Europe. "If we can detect cancer early it usually makes successful treatment more likely. And if the problem turns out not to be cancer, early tests help to put patients' minds at rest."
But he added that a range of approaches was needed to overcome late diagnosis. "We would like to see more government investment in public awareness campaigns and thought given to extending cancer screening programmes."
Peter Reynolds, chief executive of Ovarian Cancer Action, said most women with ovarian cancer were currently diagnosed with later stage disease. "GP awareness of the possible signs and symptoms of ovarian cancer is currently very low and this is another key issue that Ovarian Cancer Action is seeking to address, working in partnership with the Royal College of GPs." Target Ovarian Cancer, which conducted a mapping exercise of the disease this summer, also welcomed the promise of early tests. "Almost 7,000 women a year are diagnosed with ovarian cancer and the five year survival rate is very low at 30%", said Frances Reid, the charity's director of public affairs. "Rapid access to diagnostic tests, together with much needed increases in GP levels of awareness of symptoms will help to reduce delays in diagnosis and improve the outlook for women with the disease," she continued.
Meanwhile, health minister Andy Burnham has announced the start of a one-year pilot programme using the appeal of football to raise awareness of lung, bowel and prostate cancers in men aged 55 and over.
Copyright BBC Health News – Friday 25th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8275455.stm
Sensitivity to aspartame probed
Scientists are to assess whether the artificial sweetener aspartame causes health problems in people unusually sensitive to it. Expert advice is that aspartame - found in more than 4,000 products - is safe to consume. However, a number of people have reported sensitivity to the product including headaches, dizziness, vomiting, diarrhoea and fatigue. The University of Hull study is funded by the Food Standards Agency (FSA). Aspartame, 150 times sweeter than sugar, is found in products such as diet soft drinks, cereal bars, yogurts and chewing gum.
There have long been concerns that the sweetener is linked to a raft of health problems, including a greater risk of cancer, fertility issues, nausea, double vision and an effect on appetite. However, after reviewing the available scientific literature, both the FSA and the European Food Safety Authority decided there was no firm evidence of any impact on health, and ruled that aspartame was safe to consume. Professor Stephen Atkin, who will lead the new research, said: "This study is not to determine whether aspartame can be consumed safely; this has already been established, but rather to see whether certain people are sensitive to it." The Hull team hope their work will lead to a larger international study to pin down the issue once and for all.
Body chemistry
Professor Atkin also hopes to secure funding to analyse the chemical breakdown of aspartame in the body. The sweetener can be broken down to produce methanol and formaldehyde, both of which have been previously linked to cancer. However, it is not clear whether this process takes place in the body, or, if it does, whether the metabolites are absorbed into the blood in sufficient quantity to produce any biological effect.
Andrew Wadge, Chief Scientist at the Food Standards Agency said: "The study will address consumer concerns, including anecdotal reports that have linked a range of conditions to aspartame. The Agency's view remains that aspartame can be consumed safely and we are not recommending any changes to its current use. However, we know that some people consider that they react badly to consuming this sweetener so we think it is important to increase our knowledge about what is happening."
One hundred people will take part in the Hull study, half of who have complained of side effects from aspartame. The study is expected to take 18 months. At present the Acceptable Daily Intake (ADI) for aspartame is set by the European Commission's Scientific Committee on Food (SCF) at 40 milligrams per kilogram of body weight. An adult would have to drink about 14 cans a day of diet soft drink, or consume about 80 sachets of sweetener to reach this amount.
Copyright BBC Health News – Friday 25th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8266707.stm
Prostate screening under scrutiny
Routine screening for prostate cancer has come under further scrutiny after two studies concluded it may do more harm than good. European researchers found the current prostate specific antigen (PSA) test cannot reliably rule out a future diagnosis of prostate cancer. Another article, also in the British Medical Journal, found the long-term benefits of screening were unclear. Although there is no formal screening in the UK, PSA testing is on the rise. It is not offered as standard but men can ask their GP for the test.
In March, ministers asked the UK National Screening Committee to review the existing advice on screening after a large European study reported it could cut deaths by 20%. A final decision will not be made until next summer. In the latest Swedish study, the researchers looked at the results of PSA tests in 540 men done several years before they were diagnosed with prostate cancer and compared them with results from 1,000 healthy men. They could not reliably find a cut-off point at which a PSA test predicted future prostate cancer. Only very low PSA concentrations - less than 1ng/ml - virtually ruled out a later diagnosis, they found.
NHS recommendations advise referral at 3ng/ml in men aged 50-59 and up to 5ng/ml in older men. Better ways of detecting prostate cancer are needed before screening can be recommended, they concluded.
Over-diagnosis
In the second paper - an analysis of the current evidence on screening - US researchers said there was still too little known about screening. They said over-diagnosis due to screening could be as high as 50% and said it was not clear how much overtreatment was happening because of PSA testing. Unnecessary treatment carries a risk of side-effects such as impotence and incontinence. Men need to be advised that the test cannot tell whether they have a life-threatening cancer and could take them through a "thicket of tests and treatments that they might have better avoided", the report added.
Prostate cancer is now the second most common cause of cancer deaths in men in the UK. In July, GPs were issued with updated advice on using PSA tests. Dr James Kingsland, a GP in Wallasey, Merseyside, and member of the government's scientific advisory group on prostate cancer risk management, said the latest research reinforces the current decision not to offer screening more widely in the UK. "It is using a test for something which it was never designed for, which is always dangerous. These are helpful studies but some people will be disappointed." He said better tests were being developed and in the meantime GPs should explain the risks and limitations of the PSA test to healthy men who ask for it.
A spokeswoman for the National Screening Committee said they had commissioned researchers at Sheffield University to produce various models of what a screening programme in the UK would actually look like, the results of which will inform the decision on whether to introduce screening.
Copyright BBC Health News – Thursday 24th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8273621.stm
HIV vaccine 'reduces infection'
An experimental HIV vaccine has for the first time cut the risk of infection, researchers say. The vaccine - a combination of two earlier experimental vaccines - was given to 16,000 people in Thailand, in the largest ever such vaccine trial. Researchers found that it reduced by nearly a third the risk of contracting HIV, the virus that leads to Aids. It has been hailed as a significant, scientific breakthrough, but a global vaccine is still some way off.
The study was carried out by the US army and the Thai government over seven years on volunteers - all HIV-negative men and women aged between 18 and 30 - in parts of Thailand. The vaccine was a combination of two older vaccines that on their own had not cut infection rates. Half of the volunteers were given the vaccine, while the other half were given a placebo - and all were given counselling on HIV/Aids prevention.
Participants were tested for HIV infection every six months for three years. The results found that the chances of catching HIV were 31.2% less for those who had taken the vaccine - with 74 people who did not get the vaccine infected and 51 of the vaccinated group infected. The vaccine is based on B and E strains of HIV that most commonly circulate in Thailand not the C strain which predominates in Africa.
'Encouraging'
"This result is tantalisingly encouraging. The numbers are small and the difference may have been due to chance, but this finding is the first positive news in the Aids vaccine field for a decade," said Dr Richard Horton, editor of the Lancet medical journal. "We should be cautious, but hopeful. The discovery needs urgent replication and investigation."
Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases said: "For the first time, an investigational HIV vaccine has demonstrated some ability to prevent HIV infection among vaccinated individuals. "Additional research is needed to better understand how this vaccine regimen reduced the risk of HIV infection, but this is certainly an encouraging advance for the HIV vaccine field."
The findings were hailed by the World Health Organization (WHO) and the Joint United Nations Programme on HIV/Aids (UN/Aids). They said while the results were “characterised as modestly protective... [they] have instilled new hope in the HIV vaccine research field". Some 33 million people around the world have HIV.
Copyright BBC Health News – Thursday 24th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8272113.stm
Brown to unveil 7 day cancer test pledge
Patients will undergo diagnostic tests for cancer within seven days of concerns being raised, prime minister Gordon Brown is to pledge.
The commitment will be honoured by Labour by the end of the next five year Parliament, if the party is elected at the next general election, the prime minister will say at the Labour Party’s annual conference in Brighton. The plan, which will see initial tests being carried out within seven days and a patient seeing a specialist within 14 days, will cost £1bn.
Funds for the programme will be made available as the government’s hospital rebuilding project comes to an end, allowing it to direct resources towards diagnosis capacity and improving primary or community care facilities. Labour claims the focus on early diagnosis could save up to 10,000 lives per year and achieve one of the best survival rates in the world.
A new five year plan on diagnostic capacity is expected to be announced in the autumn.
Copyright Health Service Journal, Monday 28th September 2009 15:45
Source: http://bit.ly/zhsw5
Health secretary vows to protect PCTs amid spending cuts
Health secretary Andy Burnham has said his focus is on protecting the frontline, but could not promise health services would be ring-fenced from anticipated spending cuts.
Mr Burnham said he was “not going to do Alistair Darling’s job,” when questioned over health service spending.He said the era of “catch up funding” to bring the NHS up to the European average was over, but his main focus was on “the frontline, to protect primary care trusts”.“I’m pretty clear in saying I will protect the frontline of the health service and I don’t want to see us slipping backwards having made so much progress,” he said.
In a BBC interview, Mr Burnham refused to be drawn on questions over whether the health service will be protected from any cuts. He said: “It’s not a promise I can make.”
Copyright Nursing Times, Monday 28th September 2009 15:42
Source: http://bit.ly/SrRjo
Warning over NHS compensation ads
Hospitals in Wales are being told by the health minister to stop handing out leaflets which include advertisements offering help to claim compensation. Edwina Hart said it is "highly inappropriate" for the NHS to advertise services from personal injury lawyers. She had written to all NHS trusts about it but was "disappointed" adverts were still used at Cardiff's University Hospital of Wales. Cardiff and Vale NHS Trust said the leaflet was distributed by mistake. The health minister was contacted after a patient received an information leaflet at the hospital in Cardiff with advice on exercises for sprained ankles. But on the back was an advertisement with the headline "Been Injured? Not sure what to do next?"
Plaid Cymru AM Leanne Wood, who was contacted by the patient who lives in her South Wales Central constituency, said: "The advertisement then featured details of a company which provided help in claiming compensation for a variety of incidents including road traffic accidents, a slip or trip or accidents at work." She said she understood the advertisements were used to subsidise the cost of patient information leaflets. "But it seems rather odd to me that the Cardiff and Vale NHS Trust should allow advertising along these lines when it could potentially lead to claims against hospitals and encourages the compensation culture," she said. "I noticed in the trust's annual accounts for 2008-09, that the trust set aside £3.2m as potential liabilities for personal injury claims."
The AM wrote to Ms Hart, who said she had written once again written to Cardiff and Vale NHS Trust to express her "disappointment" that the adverts had continued to appear on leaflets, despite previously being asked to stop them.
'Old leaflet'
The health minister said she had written to all NHS organisations in March 2008 and at the start of this year instructing them to stop using the advertisements to subsidise the cost of patient information leaflets. "Cardiff and Vale NHS Trust responded to my officials with assurances that they do not use patient information materials containing advertisements by personal injury lawyers," said Ms Hart. "I am, therefore, extremely disappointed to hear that this activity is continuing. I have written to Jan Williams, Chief Executive of the trust, asking her to provide me with an explanation."
A Cardiff and Vale NHS Trust spokesperson said: "The trust fully supports the withdrawal of all patient information leaflets featuring adverts for personal injury lawyers. Regrettably, this was an occasion where an old leaflet was still in circulation and given to a patient. "Immediate checks are being carried out in all areas so that any leaflets featuring adverts for personal injury lawyers are removed and replaced as soon as possible."
Tuesday 15th September 2009
Mecca pilgrims must have flu jab
Swine flu fears
Pilgrims will also need to be vaccinated against H1N1 swine flu, if a vaccine becomes universally available before the Hajj in November. The new measures have been introduced because of the risks of viruses spreading in such a large concentration of people. The Hajj is the journey that every adult Muslim must undertake at least once in their lives if they can afford it and are physically able.
"It is inevitable that at an event where two million people are expected to meet, viruses will spread quickly - and this year there is greater concern about flu, particularly for vulnerable people", said Communities Minister Shahid Malik. He said any British Muslim planning to travel in November should check the Foreign Office travel advice, or call 0845 850 2829. Pilgrims are also advised to have comprehensive travel insurance, and to carry vaccination cards with them. The Foreign Office is sending its own delegation to the Hajj, which will include doctors and consular staff, to help British pilgrims.
Copyright BBC Health News – Tuesday 15th September 2009
Source: http://news.bbc.co.uk/1/hi/help/6915817.stm
Hospital's inquiry 'too narrow'
A solicitor representing campaigners has condemned a second inquiry into failings at Stafford Hospital as "a narrow, private process." Richard Stein, who is acting for the Cure the NHS (CtN) group, was speaking on the opening day of the inquiry. He said many relatives felt other reports had already established what happened to patients. In March, a Healthcare Commission report said "appalling" emergency care had led to patients "dying needlessly". It also condemned the local NHS trust for allowing unqualified staff to carry out checks on patients. CtN held a silent protest after a meeting on Tuesday.
Oral hearings
Mr Stein said CtN now intended to seek a judicial review of the limited scope of the independent inquiry. "It's extremely disappointing for patients and for bereaved relatives that it's going to be a narrow, private process rather than the open, public and all-embracing one that the people of Stafford need and deserve," he said. Speaking after inquiry chairman, Robert Francis QC, had outlined the terms of reference, CtN founder Julie Bailey described its scope as a "whitewash" which would not establish what went wrong. After meeting with interested parties, Mr Francis promised it would allow patients and their families to give an account of their experiences.
Medical information
He confirmed oral hearings, including those involving staff and senior managers at the hospital, would be held in private. Asked why the inquiry would be held in private, Mr Francis pointed out much of the material he would have to consider would be sensitive and confidential medical information. Mr Francis said: "I drew to the secretary of state's attention [to the] view of mine and also the request by Cure the NHS that the terms of reference should be extended. He wrote to me recently... declining in that respect to extend the terms of reference."
Initial checks
The report in March said about 400 more people died at the hospital between 2005 and 2008 than would be expected. It also found receptionists carried out initial checks on patients. The Care Quality Commission, which replaced the Health Commission, said there had been progress, but some areas had to be addressed "urgently". The trust has said lessons had been learned and staffing levels had been increased.
Copyright BBC Health News – Tuesday 15th September 2009
Source: http://news.bbc.co.uk/1/hi/england/staffordshire/8256331.stm
Health Hotline Needs to Improve
A health service hotline needs to improve its integration with the NHS in Wales, an official report recommends. NHS Direct Wales is a 24-hour health advice service used via the telephone or the internet and designed to take pressure off frontline medical staff. But the Wales Audit Office has said it needs to be more efficient, improve call handling and have better promotion of its services. The assembly government said it would consider the report's findings.
NHS Direct Wales costs £9m and in 2008/09 the service received more than 340,000 calls and 450,000 visits to its website in 2008/2009. It is designed to take pressure off frontline NHS staff and many have used it during the swine-flu outbreak. And it has helped a third of callers look after themselves without recourse to GPs or accident and emergency departments. The Wales Audit Office report says costs are roughly comparable with England and it provides a valuable service. The audit office said the £9m-a-year was a valuable service but added that several improvements should be made.
'Realise potential'
But it also said NHS Direct Wales could improve promotion of its service to the public, especially to older people and those in rural areas. Call handling times could be improved and staff absence through sickness and turnover levels cut back. And it said the service could be more seamlessly integrated with the rest of the NHS. The report recommends:
- Information on cost and performance should be given at national and local level.
- Patients' behaviour and choices should be monitored.
- NHS Direct Wales should take action to support more appropriate forms of unscheduled care.
- The assembly government and local health boards should investigate ways NHS Direct Wales could help manage chronic conditions.
The Auditor General for Wales, Jeremy Colman, said: "While NHS Direct provides valuable services which most people seem to like, there is scope for it to be much more effectively integrated within the unscheduled care system, providing a more seamless service for the public. I hope the wider NHS will take on my recommendations in order to realise the potential of NHS Direct to help make the unscheduled care service easier for the public to use."
Chair of the assembly audit committee, Jonathan Morgan AM, said NHS Direct Wales should be recognised as central to the health service. But he said it was seen as something separate, rather than a core part of the unscheduled care system and its contribution was "poorly understood across the NHS". Welsh Liberal Democrat health spokesman Peter Black AM, said the report's findings worried him. "I have had concerns for some time at the way that NHS Direct Wales appears to operate independently of the rest of the health service and this report reinforces my views," he said.
An assembly government spokesperson said: "The Health Minister, Edwina Hart, has received a copy of the report and she will consider its findings and recommendations."
Carol Jones, the director of the Board of Community Health Councils in Wales who used to work at NHS Direct Wales, said more needs to be done to raise public awareness.
She said: "Clearly the majority of the public do not have an awareness about what the service offers. Marketing would help significantly. Very rarely do we hear from anyone within NHS Direct Wales about any issues to do with health, so that really is a bit of a guide as to how much awareness there is. I think a lot can be done to raise the profile."
Tuesday 15th September 2009
http://news.bbc.co.uk/1/hi/wales/wales_politics/8255203.stm
