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Thursday, 27 July 2006 09:29
BNN: British Nursing News Online ·
Bone cancer victims in England will not be given Velcade a life-prolonging drug - although it is available to patients in Wales, Scotland and Northern Ireland.

The drug which can put the cancer into remission and dramatically improve life expectancy is also available in every other developed country in the world.

But yesterday the National Institute for Health and Clinical Excellence (Nice) refused to approve Velcade for use in England on the NHS, saying it is not 'cost-effective'.

Eric Low, of the International Myeloma Foundation, said: “This is a shocking and devastating decision.

“It is unjust, unfair and ill-informed. We have missed a golden opportunity here.

“It is hard not to feel that we are being discriminated against as a less well-known, rarer cancer, because of the recent positive rulings on a number of big cancer drugs, such as Herceptin, which will undoubtedly put enormous pressure on NHS budgets.

“This will leave myeloma in the desert of cancer care treatment”.

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Thursday, 27 July 2006 08:46
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An outbreak of polio in Namibia, Africa, has prompted a fresh warning that the disease may be poised for a comeback.

The warning comes as the number of confirmed cases of polio in Namibia has hit 19, with a further 150 cases suspected, although until this recent outbreak the country had been free of the disease since 1995. Unusually, the outbreak has affected mainly adults, who get much sicker with polio than children do.

These adults probably missed childhood vaccination and had not developed a natural immunity by encountering wild forms of the virus. Levels of wild virus have plummeted since vaccination began in the country, leaving Namibians defenceless when the virus turned up from elsewhere - in this case from Angola, which in turn got it from Uttar Pradesh, India, where the disease remains endemic.

Bruce Aylward, head of the World Health Organization's polio eradication drive, said: "This just shows that we have to eradicate polio everywhere because, while endemic areas persist, the virus will find susceptible people”.

He added: "There are bigger immunisation gaps than at any time in the last 25 years.

"If the virus exists, it will blow up in an area”.

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Thursday, 27 July 2006 08:33
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Researchers at Aberdeen University, Scotland, have found how the body harnesses the power of electricity to heal cuts and grazes - an effect they manipulated to speed up wound healing dramatically.

And they have also identified a range of chemicals that can stimulate the flow of current at wound sites, in a major discovery that could eventually pave the way for improved treatment for wounds, as well as for non-healing ulcers and major burn injuries.

Professor Colin McCaig, the head of the School of Medical Sciences, said yesterday: "This is a potentially very exciting development. We are at the point of reinventing the clinical practice of electrical stimulation.

"As well as speeding up the healing of wounds, our research could have implications for non-healing ulcers, people with major burn injuries and diabetics, who often have very poor wound healing."

He explained that the role of the body's natural electricity in helping to heal wounds had been identified more than 200 years ago, but had become a forgotten area of medical science.

Prof McCaig said: "We have rediscovered something that has been known about for quite a long time - that within our bodies there are electrical signals. We know about signals that drive our heartbeats, for example. And these are what you would call intra-cellular electrical events.

"But what we are dealing with are electrical signals in the spaces between the cells. If you take a needle and stick it through your skin you would record a voltage difference. If you then create a hole in your skin, all that voltage shoves current out of the hole and short-circuits it.

"Current flows out the edge of the wound the instant you make the wound and is continually flowing out until it heals.

"What we have now discovered is what controls these electrical signals and ways of increasing them. And that's what gives you faster healing."

The team, headed by Professor Min Zhao, have identified the proteins and genes in human cells that play a key role in steering the cells to heal wounds in response to naturally occurring electrical signals at wound sites.

Prof Zhao said: "When a wound occurs it is remarkable how the cells in our body know where to go to heal it. Our studies show that electricity in the body is far more important than was previously thought and that it has significant potential in wound healing and possibly also regeneration.

"Our findings offer a novel perspective in understanding how cells move to heal and what genes and molecules the cells use to detect the electric fields”.

The team's findings have been based on the study of skin wounds and cornea wounds in the laboratory. And Prof Zhao explained: "We hope our next step is a clinical trial to see if we can translate our findings into patient care.

"We want to find out if the drugs we have tried in our lab tests could actually be used to develop eye-drops to help eye wounds, or dressings for the treatment of other wounds”.

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Thursday, 27 July 2006 08:04
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In next month’s issues of Radiology magazine a report claims Americans are growing so large that patients are increasingly too big to fit into X-ray scanners. Their fat is also too dense for X-rays or sound waves to penetrate.

Hospital equipment manufacturers have to build new magnetic resonance imaging (MRI) scanners with extra-large boreholes to accommodate obese patients.

Dr Raul Uppot, one of the reports authors said: "In an obese person, because the ultrasound beam does not get to the organs or get to them adequately enough, we cannot get a picture”.

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Wednesday, 26 July 2006 10:18
BNN: British Nursing News Online ·
People must take more responsibility for their health to relieve pressure on the NHS; Tony Blair is expected to say.

In a major speech on Wednesday 26th July, the Prime Minister will reflect on how the role of the state in promoting social progress has evolved.

In particular, he will look at new ways of improving public health by promoting healthy living.

This is the PM's second lecture under the banner "Our Nation's Future" - special events intended to address the major long-term challenges for Britain.

The aim of these speeches is to launch a "real debate about the big challenges".

The speech follows the Government's Small Change, Big Difference campaign, set up to encourage people to improve their health.

"It has got to be about prevention as much as about cure," Mr Blair said on Tuesday at a Labour party event.

"The question is what the Government can do for the future to encourage more healthy lifestyles and living”.

He said the debate was "important because going forward we can't afford the healthcare costs if we don't take some of the responsibility as individuals for our healthcare”.

He added: "We are in a situation where no matter how much money we spend on health, if we are carrying more cases of diabetes than we need, losing vast sums on treating alcohol abuse and smoking; if we are in a position where we are still carrying these costs, in time we have got a crunch in policy down the line”.

The chairman of the health select committee, Kevin Barron, told the BBC that it is the Government's job to try to persuade people to live healthily.

"What all governments have to do is think about what's good for the public, getting the right messages out and just getting on with it," he said.

"Put right, argued properly, [with] sensible policies, we shouldn't be scared of somebody shouting to us 'nanny state'."

But Professor Danny Dorling from the University of Sheffield, an expert on health inequalities, does not think Tony Blair's ideas will be well received by the public.

"I think it will be perceived as insulting by those who it's aimed at.

"What you need to begin looking after yourself better is to have self respect, and self respect comes from being treated well by society.

"If you have a society that tells increasing numbers of people that they have less and less worth, while others are allowed to become richer and richer and richer, it's very hard to get people's self worth up”.

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Wednesday, 26 July 2006 10:06
BNN: British Nursing News Online ·
A plan to put NHS trusts on a firmer financial footing has been published by the Audit Commission.

Health Secretary Patricia Hewitt commissioned the report to find a strategy for dealing with the huge deficits incurred by some trusts.

The recommendations aim to support the Government’s major health reforms and put trusts and primary care trusts (PCTs) and the NHS overall in a position to operate on a sound and sustainable financial footing in the future. Key recommendations include:

• the principles of Resource Accounting and Budgeting (RAB*) should no longer be applied to NHS trusts, and that NHS trusts should move onto a regime which offers sharper, more appropriate incentives for good financial performance
• changes to PCT planning and financing arrangements which would put them in a stronger position to manage their financial risks;
• specific improvements to the Department of Health’s (DH) and strategic health authorities’ (SHAs) oversight and management of the service, covering the costing of policy initiatives, the way the Payment by Results tariff is developed and given greater certainty over the medium term, and the accuracy and availability of data;
• key elements of a more effective and swifter mechanism for identifying and dealing with financial distress at NHS bodies. In addition, financial support for organisations should be provided in the form of working capital and that the DH should establish a banking arrangement to do this; and
• the specific steps to be taken to improve the skills of finance staff and the capacity of boards.

Sir Michael Lyons, Acting Chairman of the Audit Commission, said:"The NHS is a unique and complex organisation and its economy is equally complex. Our proposals are challenging and wide-ranging, and they may take time to implement. But, the financial management and accounting regime of the NHS needs to change to keep pace with the many significant new health reforms that are designed to further improve the NHS. Crucially, our recommendations support the NHS reforms, would enable trusts and PCTs to achieve better value for taxpayers' money and contribute to consistent, reliably funded services for patients".

The Commission believes its recommendations would ensure that the DH meets its commitments to HM Treasury and the taxpayer while enabling trusts to operate in a more businesslike way. Other outcomes would be to:

• bring greater clarity to the financing system both for individual organisations and for the NHS as a whole;
• improve further the professionalism of NHS finance staff; and
• increase the capacity and capability of individual bodies to manage their affairs and at the same time increase their accountability for doing so.

Shadow health minister Stephen O'Brien said: "This report is a damning indictment of financial mismanagement in the NHS that goes right to the top”.

A Department of Health spokeswoman said: "We will now take some time to reflect in more detail on the recommendations made, and will publish a response later in the year”.

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Wednesday, 26 July 2006 09:54
BNN: British Nursing News Online ·
New mothers are to be given personalised "baby plans" under NHS guidelines announced yesterday. The guidance, issued by the National Institute for Health and Clinical Excellence (Nice), and the first to set out national standards of postnatal care for new mothers, applies to women in England and Wales.

The NICE guidelines cover care for the first eight weeks of a baby's life.

They say health professionals should ensure they only give women the help and advice that is relevant to them - so if they have not had a Caesarean or a birth involving stitches, they do not need any information on those topics.

Professor Rona McCandlish, who chaired the guideline development group said: "In the past postnatal care has often been considered the 'Cinderella service' of maternity care.

"This guideline recognises that women, babies and families deserve highest quality care after birth.

"It establishes clear, much needed national standards for healthcare professionals to help them offer women the support they need in the hours, days and weeks following birth”.

Dr David Elliman, a consultant in community child health, said: "New babies require huge amounts of care and attention, and this can be daunting, particularly for first time parents.

"Helping mothers to know what signs and symptoms could indicate something serious so they know what to worry about and what is normal gives them reassurance and confidence.

"Giving babies the best start in life through good quality post natal care means they are less likely to have health problems during childhood and into adulthood”.

Dame Karlene Davis, General Secretary of the RCM, said: "Good maternity services are the vital building block for long-term health improvement”.

Rosie Dodds, of the National Childbirth Trust, said: "The development of personalised care plans will help to ensure healthcare professionals provide individually tailored care for each woman.

"And the emphasis on communication between mothers and healthcare professionals is certainly a step in the right direction to ensuring all women are aware of the support available”.

But she added: "These guidelines don't recommend a minimum number of postnatal care visits.

"We know access to supportive care throughout the first few weeks is essential to emotional and physical well-being of most new parents.

"It would help to work towards an understanding of the amount of care all women should be offered, with additional care available for those who need it”.

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Wednesday, 26 July 2006 09:17
BNN: British Nursing News Online ·
According to a committee set up in the aftermath of the drug trial at Northwick Park Hospital which left six men seriously ill, say that the rules governing initial drug safety trials on human guinea pigs should be changed

The Expert Scientific Group was asked by the health secretary, Patricia Hewitt, to review what lessons could be learned from the trial. Three recommendations put forward by the authors are that doctors should consider using ill patients as test subjects rather than healthy volunteers; subjects should be given the experimental drug sequentially, rather than all at once; and doctors should be more conservative about the dose given to the first human subjects.

The Expert Scientific Group, led by Professor Gordon Duff said its recommendations applied to trials involving drugs such as monoclonal antibodies - of which TBN 1412 is one.

Professor Duff said: "Clinical trials in general have an excellent safety record, but in the light of the TGN 1412 incident there is a need to look at the future safety of clinical trials involving novel and potentially higher risk drugs

"Our interim report provides proposals for the future authorisation of trials involving these types of products and to further improve safety.

"Clearly the Northwick Park incident has informed the work of the group but this is not a further investigation into the incident.

"It is about the wider issue of such clinical trials and about ways to ensure that this type of trial is safe and effective for the future”.

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Wednesday, 26 July 2006 09:05
BNN: British Nursing News Online ·
Hospital are being forced into spending hundreds of thousands of pounds on reinforced beds and strengthening mortuary slabs due to an increasing number of obese patients.

The issue was highlighted yesterday when the Norfolk and Norwich University Hospital announced that it had to spend £40,000 on equipment - including beds, hoists, armchairs and commodes - to cater for obese patients.

In neighbouring Suffolk, the James Paget Hospital at Gorleston, near Lowestoft, has been forced to buy a specialist bed that will take a patient weighing up to 71 stone and two operating tables that can take people weighing up to 50 stone.

Andrew Stronach, spokesman for the Norfolk and Norwich, said: "The new beds we are ordering will be able to take patients in excess of 40 stone. At the moment, if the standard beds contain a patient weighing more than 35 stone, the electric motors used to adjust the beds burn out.

"In years gone by, we would see a few patients who were very large and we would hire in a special bed on an occasional basis which could cope with people weighing up to 37 stone.

"But now we are seeing people who weigh 40 stone or more much more frequently and we are having to gear up to deal with this. Hospitals up and down the country are doing the same."

As part of a £200,000 refurbishment of the mortuary, new fridges will be installed, designed to store obese bodies. "We will be increasing the space in our mortuary by 20 per cent by adding 10 new bariatric fridges," said Mr Stronach.

Bariatrics is the branch of medicine that deals with the diagnosis, treatment and prevention of obesity.

"Our current fridges can accommodate bariatric bodies but a normal 10-space fridge will be filled by only four bariatric cases. We will be converting a post-mortem table so that it can take bariatric bodies. We are also spending around £17,000 on two bariatric mortuary trolleys."

Prof Peter Kopelman, director of the Institute of Health at the University of East Anglia, commented: "When you get more and more obese patients, health trusts have to provide the relevant facilities, but it is a sad indictment of our society."

Mr Stronach agreed that obesity problems were "a considerable issue, not only in terms of people's health but in the cost to the health service". He added: "It is a symptom of a major public health problem. In the past five years, we have been seeing many more adults who are very overweight and it is putting a strain on their health and on the health service. Obesity really is a major, major problem”.

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Wednesday, 26 July 2006 08:55
BNN: British Nursing News Online ·
UNISON, the UK's largest health union, is to ballot staff at NHS Logistics for strike action over government plans to privatise part of the health service.

Staffs at the five depots are angry at the proposed transfer of the entire organisation to private haulage company DHL.

NHS Logistics is a not-for-profit organisation supplying hospitals, GP surgeries and patients with more than 43,000 items including essential surgical supplies and products ranging from aerosols and arrowroot to zinc and castor oil.

Karen Jennings, UNISON Head of Health said:

"NHS Logistics is an award-winning organisation - an NHS success story delivering a first class service. The Government's decision to privatise it is driven by pure dogma and an obsession with market testing.

"No wonder our members are bitter and angry about the way they are being treated. They are proud to work for the NHS and feel betrayed by a government that is handing them over to DHL, like one of the packages they deliver.

"DHL will be rubbing their hands together at the thought of getting hold of such a successful business operation, with a lucrative turnover of around £777m a year.

"Meanwhile, staffs who have worked hard to build up a first class service with a world class reputation now face job cuts”.

Paul Harper UNISON Branch Secretary at NHS Logistics' Maidstone Depot said:

"Strike action is a last resort but we have no choice. Members are extremely upset about the transfer and I am confident we will get a yes vote.

"We work hard to provide a first rate service to the NHS and take pride in being an essential part of the health team.

"We deliver direct to hospital wards and operating theatres so getting it wrong could be a matter of life and death. This is not a service the government should be gambling with by handing it over to a parcel delivery company”.


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