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Tuesday, 18 July 2006 09:48
BNN: British Nursing News Online · www.bnn-online.co.uk
USE OF ALZHEIMER'S DRUG MAY BE LIMITED
The use of the drug donepezil for Alzheimer's disease is to be limited by the NHS, although it has been shown to slow down shrinking of the brain.

In a study, the drug donepezil did more than relieve symptoms in patients with mild mental impairment - it also had an effect on the size of the brain. But under draft proposals from the National Institute for Health and Clinical Excellence (NICE), it could be limited to those with moderate Alzheimer's and not available to those with milder symptoms.

In Scotland, the Scottish Intercollegiate Guidelines Network recommends using the drugs at all stages of illness. But there are fears that once the NICE guidelines are finalised, they will also be adopted in Scotland and patients will no longer have access to them.

The latest study used MRI scans to measure brain shrinkage in 131 patients with mild cognitive impairment - some were given donepezil and others a dummy drug.

The study found that patients who were carriers of certain genes linked to cholesterol metabolism, the use of the drug resulted in slower shrinking of the hippocampus, the part of the brain that is the key to memory.

Dr Clifford Jack, of the Mayo Clinic in the United States, said: "Our study results seem to imply that donepezil does more than provide symptom relief - it has an effect on a measure of brain health”.

Kate Fearnley, the policy director of Alzheimer Scotland, said: "This research is further evidence of why NICE's recommendation to delay treatment until people have moderate Alzheimer's is fundamentally flawed.

"Although it's a small study, it is in tune with other research which shows the brain changes of Alzheimer's disease may start years before diagnosis”.
   


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Tuesday, 18 July 2006 08:30
BNN: British Nursing News Online · www.bnn-online.co.uk
MORE SUPPORT NEEDED FOR BREASTFEEDING MOTHERS
Campaigners calling for more support for breastfeeding mothers are to lobby Westminster.
The campaigners are to demonstrate outside the Department of Health in Whitehall, followed by the presentation of a petition to Downing Street.

The campaigners are fighting for a national breastfeeding strategy overseen by a national infant feeding coordinator.

They also want a new law to protect a woman's right to breastfeed in public in England, as this law already exists in Scotland.

The campaign is backed by organisations such as the National Childbirth Trust (NCT), the Royal College of Midwives, and the Community Practitioners and Health Visitors Association.

Supporters say there is clear evidence that a comprehensive national breastfeeding strategy would help to raise rates of breastfeeding.

Rosie Dodds, of the NCT, said: "We need more support for breastfeeding mothers in order for them to feel comfortable and able to breastfeed for as long as they want and where they want”.

A Department of Health spokesperson said the Government was committed to promoting breastfeeding as the best form of nutrition for infants.

The aim was to increase breastfeeding rates by two percentage points every year, with a specific focus on women from disadvantaged groups.

"We are collecting data through the National Infant Feeding Survey 2005 on women's experiences of breastfeeding in public.

"We will keep the need for legislation under review in light of this evidence and the Scottish experience”.


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Monday, 17 July 2006 08:38
BNN: British Nursing News Online · www.bnn-online.co.uk
TWO NHS DOCTORS TO SET UP PRIVATE IVF CLINIC
Richard Fleming and Paul Mitchell two doctors are quitting their NHS jobs to set up Scotland's first standalone private fertility clinic.

Women, including those up to 45 years old and the overweight, will pay £3000 for one cycle of treatment at the Glasgow Centre for Reproductive Medicine.

But the Scotland Patients Association said the news was "totally unacceptable”.


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Sunday, 16 July 2006 09:23
BNN: British Nursing News Online · www.bnn-online.co.uk
SCOTLAND'S FIRST SPECIALIST NURSE TO COPE WITH INCREASED NUMBERS OF SKIN CANCER
Scottish health bosses have appointed Scotland's first specialist nurse to cope with increased numbers of skin cancer cases.

Skin care specialist Sheena Dryden will stress the importance of wearing sunscreen during school visits.

New initiatives will highlight the importance of avoiding the sun and using a high-factor sunscreen to protect against harmful UVA and UVB rays.

Sheena Dryden said: "There is a huge drive to try and start from nursery age to try to get the message across.

"The difficulty is people feel better when they are in the sun and when they have a tan, but they need to protect themselves from burning”.


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Sunday, 16 July 2006 09:16
BNN: British Nursing News Online · www.bnn-online.co.uk
NEW AUTISM TEST
Researchers at the University of Aberdeen are developing a revolutionary testing device to cut the time taken to diagnose autism in children.

The scientists believe their computer-based system will save parents months, even years, of waiting on the NHS for help.

The time taken for a diagnosis in Scotland varies from between six months and three years, according to support groups. However, Dr Mark Mon-Williams and colleague Dr Justin Williams believe their device could diagnose, or rule out, autism in an hour.

The scientists have been given a £178,000 grant by Scottish Enterprise to prove their test works. It could then be marketed commercially.

Dr Williams said: "At the moment, the tests are crude and can involve anything from bouncing a ball or weaving a shoelace through a hole to test co-ordination. An assessment of motor skills by an occupational therapist can take about three hours. Our machine could probably do it in about an hour”.

The machine involves taking computer-based measurements, which track children's movement and reactions to certain stimuli. About 60 patients have been involved in a trial.

Dr Williams said: "Different movement paths, especially jerky or erratic patterns, can indicate brain disorders such as ADHD and autism”.

Dr Mon-Williams added: "There is a lot of criticism of testing at the moment. A lot of the tests are repetitive, involve a lot of people, and they are expensive and time-consuming.

"We believe this is a relatively low-cost solution for the health service, as it will free up clinician and occupational therapist time”.

John McDonald, chair of the Scottish Society for Autism said: "There is a long way to go, but anything that can make a positive contribution to reducing the time taken for a diagnosis, and the distress caused to parents, should be supported”.


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Sunday, 16 July 2006 09:01
BNN: British Nursing News Online · www.bnn-online.co.uk
SCOTLAND'S PRIVATE HOSPITALS IN BREACH OF GUIDELINES
Inspections by the Care Commission, the standards watchdog, have found that more than half of Scotland's private hospitals are breaching national guidelines.

They found that four of the country's seven independent hospitals were judged to be falling short in areas such as staff checks, fire safety and medicine control during inspections during the past year.

The standards watchdog, revealed problems at Glasgow Nuffield Hospital, Fernbrae Hospital Dundee, Abbey Kings Park, Stirling, and the Murrayfield Bupa in Edinburgh, all private hospitals offering a range of services for patients paying for treatment.
Inspectors found that although patients were happy with the service they received, there were flaws in each of the hospitals and ordered them to make improvements.

A spokesman for the Care Commission said: "Where practice or procedures are found not to be in line with the National Care Standards we will make recommendations, requirements and, where necessary, take enforcement action to regulate for improvement in these services”.

Both the Nuffield and Fernbrae hospitals last night refused to comment on the reports.

Spokeswomen for the Murrayfield Bupa said it was “delighted” to have been given a “clean bill of health” and said staff were now fully aware of fire procedures.

A spokeswoman for the Abbey Kings Park said: "We were not too unhappy with the report, but we strive to improve on any constructive criticism given”.


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Sunday, 16 July 2006 08:52
BNN: British Nursing News Online · www.bnn-online.co.uk
TOP CONSULTANTS’ PAY OVER £200,000
New figures obtained by the newspaper the Sunday Herald shows that Scotland’s top doctors are earning salaries of almost a quarter of a million pounds a year.

The figures, obtained under freedom of information, show that in Lanarkshire, the five highest-earning consultants were paid between £200,000 and £225,000. In Glasgow, the biggest salary was £217,996, and in the Borders it was £200,000.

Shona Robison, SNP health spokeswoman, said: “For the money being paid to consultants, it is absolutely necessary for the public to know what improvements have been made to patient care. This [contract] was sold on the basis of great improvements to productivity and seeing more patients, and there is no evidence of that whatsoever”.

Margaret Davidson, chief executive of the Scotland Patients’ Association, raised concerns that cash was being diverted from other areas to fund the “extremely high” salaries. “Can they [health boards] afford these salaries?” she said. “If they can’t, it will be coming from patient services and patients will be affected”.

However, Tory health spokeswoman Nanette Milne acknowledged the contract was costing more than expected, but added: “I think for many years medical and consultant staffs were, relatively speaking, underpaid when you compare them to the equivalent in industry”.

Doctors’ leaders pointed out that the average consultant started on £70,000, and did not earn such large sums. Dr Peter Bennie, deputy chairman of the British Medical Association’s Scottish consultants committee, said that the higher salaries were due to bonuses, rather than the new contract. He added: “Salaries in the region of £200,000 are limited to a very small number of doctors at the top end of the salary scale who, in addition, have received the highest level of award for outstanding work.”

He also said that the new contract would take time to bed in and early criticisms were “not particularly helpful”.

“The increased expenditure on consultants’ salaries is recognition of our working hours and commitment to NHS Scotland. But even now, most consultants are still doing unpaid work”.

An Executive spokesman would not comment on specific salaries, but said the contract was being used to help improve services, such as waiting times. He added: “The contract is a once-in-a- generation fundamental shift in the way the work of the consultant is governed”.
   


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Sunday, 16 July 2006 08:35
BNN: British Nursing News Online · www.bnn-online.co.uk
DOCTORS’ SURGERIES FACE FINES OVER WAITING ROOM MUSIC
The Performing Rights Society (PRS) has told all GPs in Scotland to stop playing music in their waiting rooms or face fines for breach of copyright.

GPs use music from radios and CD players to soothe patients’ nerves and to protect their confidentiality by drowning out conversations with their doctor or other practice staff.

However, according to the PRS hundreds are breaking the law by playing music in their waiting rooms without a licence It is estimated that up to £52,000 could be raised for composers, performers and music publishers by forcing surgeries to purchase a licence worth £75 a year. The only alternative is to stop playing music altogether or subject patients to piped Muzak, which is not subject to the same royalty arrangements.

A spokesman for the PRS defended the move, which is part of a UK-wide campaign to recoup royalties from businesses and other organisations. “The money received for these licences will be divided between composers and songwriters, the vast majority of whom are jobbing composers and songwriters, not the big names that most people think of,” the spokesman said.

“We only charge for music being played in waiting areas, we do not charge for music used for a therapy session or a treatment room.

“We want to make doctors aware that they may need a licence. We expect most of them to comply but ultimately an injunction could be issued to stop music being played and the doctor involved could be required to pick up the court costs”.

Dr Barbara West, a Glasgow GP and secretary of the Glasgow and Clyde local medical committee, is among those who have been targeted.

“This is not a joke, the PRS are very serious about it,” she said. “They have been targeting GP practices throughout Scotland and have sent us a letter warning that for using music, whether it’s on the television, radio, CD or when we put telephone calls on hold, we need a licence.

“A lot of practices have not been aware of this and they have been rushing around trying to get a licence before they are fined. We have had a lot of calls from doctors asking whether they really have to get a licence and we have told them that they must because this is not an idle threat”.

West added that most GPs were reluctant to stop playing music.

“We use music to create a relaxed atmosphere and as an aid to preserve confidentiality,” she explained. “If a patient is talking to a receptionist across a reception desk and there is a chilly silence in the waiting room, then other people can hear what is said. If there is music playing it distracts other people and muffles the sound, making it less likely they will hear what is being said”.


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Saturday, 15 July 2006 10:27
BNN: British Nursing News Online · www.bnn-online.co.uk
ALL DOCTORS WILL HAVE TO PROVE THEY ARE SAFE TO PRACTISE
Under a radical overhaul of regulation doctors will face "MoTs" every five years to make sure they are still fit to do their job, as part of proposals set out in the wake of the Shipman murders.

The UK's Chief Medical Officer, Sir Liam Donaldson, said a more robust testing process to determine if doctors should stay on the medical register would increase public confidence.

Yesterday, Sir Liam said his main concern was patient safety and he said there must be "a robust revalidation process".

"At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise, whereas an airline pilot would face over 100 checks over a similar timescale," he said.

Under the proposals, out for consultation until November, the revalidation process would have two components.

The first, covering all doctors, would mean general five-yearly checks on performance before they are relicensed.

In addition, specialists like GPs and consultants would have to be re-certified in their particular speciality, with tests set by the relevant Royal College.

As well as five-yearly revalidation, Sir Liam also said that employers' annual appraisals of doctors needed to be made more consistent across the UK so these could feed into the assessments. The new proposals will also regulate nurses and chiropractors.

Sir Graeme Catto, president of the GMC, welcomed Sir Liam's proposals on revalidation, but said other recommendations would need more careful consideration. "We will continue our drive to create a modern, independent system of medical regulation which delivers for patients and commands the support of doctors," he said.

The British Medical Association criticised plans to change the burden of guilt in fitness-to-practise cases. "Patient safety is paramount and no-one wants to put people at risk by bad practice," the BMA chairman, James Johnson, said. "But it seems wrong to be able to take away a doctor's livelihood because of something found on a balance of probability, rather than proving something beyond reasonable doubt. It opens the door to miscarriages of justice”.

But the proposals were welcomed by the lawyer representing the families of Shipman's victims. Ann Alexander said: "The families of Shipman's victims deserve such a thorough reform to a system that failed them. We must maintain this momentum for change to safeguard not only our lives, but also the reputation of the NHS both in this country and throughout the world."

A Scottish Executive spokesman said: "Public safety is paramount. That is why we welcome these reviews, which look to improve safeguards for patients. We look forward to using the consultation period to analyse in detail the implications of the report's recommendations”.

   


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Friday, 14 July 2006 09:01
BNN: British Nursing News Online · www.bnn-online.co.uk
ADOLESCENT DAUGHTERS COULD BE VACCINATED AGAINST CERVICAL CANCER
As the Department of Health (DoH) prepares the ground for a national immunisation programme parents are being discreetly canvassed on whether they would let their adolescent daughters be vaccinated against cervical cancer.

Two vaccines, most effective in girls between 10 and the early teens, are expected to be licensed for girls and young women in Britain within 12 months. Although immunising girls before they are sexually active may prove controversial, parents surveyed for the Government are said to be "very positive", with mothers more interested in details than fathers.

Most were aware of cervical cancer, but knowledge of its precursor, the human papilloma virus (HPV), was more limited. "Some parents raised concerns about introducing the vaccine in primary school and opinion tended towards offering it in early adolescence at secondary school," said minutes of the joint committee on vaccination and immunisation (JCVI).

The DoH hopes to publish more details soon in a scientific journal. The research indicates how seriously officials are considering a national programme to vaccinate hundreds of thousands of pre-teens.

A spokeswoman for the department said last night: "Any change or addition to the vaccination programme is made following careful consideration of all available data by the JCVI”.

Scotland and Wales could go their own way on a national immunisation programme, but usually follow England.


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