Thursday, 8 March 2012

Smoking and Health - 50 years on from landmark report

Smoking and Health - 50 years on from landmark report:
The RCP 1962 report
Fifty years ago the landmark report Smoking and Health was published by the Royal College of Physicians, which both drew the link between smoking, cancer and other diseases, and had a big impact on the public consciousness.

There is some very interesting footage from the time on the BBC's web site showing public reaction to the report. The article also traces the history of smoking and tobacco control policies since 1962, as well as the change from smoking being linked with affluence to it being linked to social disadvantage.

The RCP have now published 50 Years Since Smoking and Health which reviews the progress made since the original report as well as looking at the current situation in the UK and reviewing policy priorities.

Smoking is still an important public health concern though, and 100,000 people in Britain still die from tobacco related diseases every year.

With one month to go until larger shops will be required to hide tobacco displays from public view (and all shops by 2015), a debate about removing all branding from cigarette packs and National No Smoking Day on the 14th of March, 50 years on, smoking is still a vital health issue.

Hospital car parking fine 'error'

Hospital car parking fine 'error': Motorists parking at a Northamptonshire hospital are wrongly chased over fines by a private debt collection agency. BBC Northamptonshire

The problem with SUIs

The problem with SUIs: Until we trial independent investigations for the most serious of incidents (ie quality not quantity of investigations is critical), SUI reports will disappear into a filing cabinet and will still fail to capture the real lessons, says Martin Bromiley. Health Foundation

High costs drugs

High costs drugs:
There are a number of high cost drugs that are excluded from the Payment by Results (PbR) tariff. They are typically specialist, and their use is concentrated in a relatively small number of centres rather than evenly across all trusts that carry out activity in the relevant HRGs. These drugs would therefore not be fairly reimbursed if they were funded through the tariff. For all excluded activity, commissioners and providers should agree local prices.
The following guidelines, linked to current or expected future use, are intended as an appropriate indication of the drugs that may be considered by the high cost drug steering group for inclusion on the high cost drug exclusion list:
  • the drug and its expected associated costs of care are disproportionately high cost compared to the other expected costs of care within the HRG, which would affect fair reimbursement
  • there is, or is expected to be, more than £1.5 million spend or 600 cases in England per annum.
Other points to note are that:
  • high cost drugs are defined by the cost of the average expected use or unit of the drug. Low cost drugs, irrespective of prescribing volumes, will not be considered for inclusion on the HCD list
  • a high cost drug is a high cost drug irrespective of reason for prescription, though DH may choose to exclude certain drugs from PbR for specific indications
  • when a decision is made to exclude a high cost drug from PbR, it is added to the list using its British Approved Name (where available).
  • if a drug does not appear on the high cost drug exclusion list, then it is within the scope of PbR, unless it is part of an excluded service
  • the Oncology Regimens (OPCS 4 Chemotherapy Regimens) list of drugs is maintained by the Oncology Regimens Steering Group.
The link below will take you to the new high cost drugs request portal:
The final date for proposals to be considered for exclusion (and inclusion) to PbR is 31 March for the following years tariff.
This request portal should not be used for high cost devices or chemotherapy. These have separate portals available from:

'No evidence' for NHS risks fear

'No evidence' for NHS risks fear: There is "no real evidence" that releasing private documents would stop civil servants giving candid advice to ministers, a tribunal has heard. BBC News

NHS fights 'hitting patient care'

NHS fights 'hitting patient care': The controversy over NHS reform and pension changes is diverting hospital doctors away from improving patient care, a union leader says. BBC News

Telehealth could save NHS £1.2bn, but fears remain

Telehealth could save NHS £1.2bn, but fears remain: Minister points to major savings potential from telehealth, but fears voiced about isolation and local understanding Public Service

NHS bill on course to become law

NHS bill on course to become law: The House of Lords back amendments to the government's health bill, which now looks on course to become law within weeks. BBC News

NHS Confederation warns over risk to mental health improvement plans

NHS Confederation warns over risk to mental health improvement plans: The head of the NHS Confederation has warned that plans to improve the nation's mental health are at risk as the basic building blocks are not yet in place to make them a success.

Think child, think parent, think family: final evaluation report

Think child, think parent, think family: final evaluation report:
In July 2009, SCIE published a guide entitled Think child, think parent, think family: a guide to parental mental health and child welfare to help services improve their response to parents with mental health problems and their families. This is the final evaluation report of the project, documenting the progress made by the sites involved, and making recommendations for future activity.

An economic case for patient and public involvement in commissioning

An economic case for patient and public involvement in commissioning:
This work, commissioned by the Department of Health, looks at the economic case for public and patient engagement as well as developing a decision support tool. Fourteen detailed case studies were carried out to identify how meaningful and effective involvement in commissioning can drive economic, quality and user experience benefits for the NHS and partner organisations – as well as the populations they serve.

Premature births down after smoke ban

Premature births down after smoke ban: The premature birth rate in Scotland has fallen by 10% since the country introduced a ban on smoking in public places in 2006.
Researchers believe this is another benefit of the smoke-free approach, alongside reductions in heart disease and childhood asthma.
Writing in the journal Plos Medicine, researchers examined data for 700,000 women over a 14-year period and looked at smoking and birth rates for p... Healthcare Today

'NHS should rent telehealth equipment like iPhones': health minister

'NHS should rent telehealth equipment like iPhones': health minister:
Care services minister Paul Burstow wants the NHS to pay for telehealth and telecare through monthly contracts
Paul Burstow, the care services minister, has indicated that he would like to see telehealth and telecare services provided to the NHS without the need for up-front capital payments.
Speaking at the King's Fund international congress on telehealth and telecare, Burstow said a community nurse supervisor should be able to pay for a blood pressure monitor through a monthly contract, in a similar way to that in which people pay for iPhones or Blackberrys.
Such a strategy is already used in Gloucestershire, where the NHS is working with provider Tunstall. The company covers the up-front costs, such as clinical engagement, pathway redesign and training, and supplies NHS Gloucestershire on a per patient per month basis.
"NHS Gloucester avoids the need for large scale up-front costs, and it enables the supplier to build relationships with patients and customers that it otherwise would not have," the minister said.
Burstow also predicted that in time the cost of the telehealth and telecare technologies will start to fall.
"Costs in the UK are significantly higher than they are in the US, and it is no wonder because in the current situation we have only 6,000 users, compared to 10 times that number in the veterans' association in the US," said Burstow. "That is why we are looking at promoting our campaign, 3millionlives, why we want to grow this rapidly."
One of the principal challenges to the large scale take up of telehealth and telecare is broadband capacity, said Burstow, particularly because many of those who stand to benefit from the technologies live in rural areas where broadband provision is worst, although the government has earmarked £530m of funding to improve the situation.
There are also issues, according to Burstow, with NHS and social care staff not having sufficient skills and understanding about telehealth and telecare.
To resolve this issue, the government has asked the NHS Institute to develop a support programme for staff and patients so they can make the most of these technologies at a local level. Guardian Professional.

NHS bill: last-ditch opposition as coalition bids to push it through

NHS bill: last-ditch opposition as coalition bids to push it through:
Shadow health minister pins hopes on risk assessment, desertion of last two royal colleges, and activists condemning the bill at Lib Dem conference
Shadow ministers are preparing a last-ditch attempt to delay the health bill next week, as most signs pointed to the bill reaching the statute book on 20 March, prompting a new two-year argument outside parliament on the bill's true impact on the NHS.
Ministers and officials acknowledge in private, with an almost gallows humour, the political damage caused by the bill. They think the sooner it is law and out of the limelight, the better. No more amendments or pauses will be contemplated. The hysterical predictions about its impact can then be exposed, ministers argue.
But Andy Burnham, the shadow health secretary, was refusing to give up the fight, even though the Lords had voted through some of the most controversial measures on Tuesday night with large majorities.
He admitted: "One of the frustrating things in the past fortnight is that the more friendless this bill becomes, the more determined the government seems to be to push it through.
"I hope the dynamic can still be changed, but it is getting desperately late." He is pinning his remaining hopes on three external forces.
First, a tribunal – probably this week – may rule the NHS risk assessment should be published , which is bound to lead to an appeal by the government. If so, Burnham hopes peers at the third reading next week will delay the bill for a further month until the risk assessment is published. Lord Owen, the former SDP leader who went down a storm at the NHS workers' rally tonight, is likely to try to move for such a delay next week. Labour peers, disappointed by the scale of their defeats this week, still say there is a realistic chance crossbench peers could be persuaded to delay the bill on this basis.
Second, it is likely that two further royal colleges will come out against the bill shortly, leaving an embarrassed coalition government in the awkward position of supporting a bill designed to empower professionals, but deserted by health professional bodies themselves. The Royal College of Surgeons will meet on Thursday after a demand for an extraordinary general meeting was accepted. Up until now, the RCS has refused to oppose the bill outright, preferring engagement on specific issues. The Royal College of Physicians is due to complete a survey of its 30,000 members next Thursday, and is likely to join opposition.
Burnham's third hope is that the Lib Dem activists at their Gateshead conference this weekend will stand up to pressure from their leaders and vote to drop the bill, a decision that would be a huge embarrassment for Nick Clegg.
On Friday, the party's federal conference committee will have to choose between two rival emergency amendments to put forward for debate – one opposing the bill outright and another saying the bill has been amended enough to make it worth supporting. The latter amendment, supported by Lady Williams, argues that significant changes have been made to the bill as a result of Lib Dem pressure in the Lords, including "ensuring that competition in the NHS is in the interests of patients, based on quality not price; securing the commissioning process against damaging conflicts of interest; ensuring that any profits from treating private patients in foundation trust hospitals are invested in the NHS; [and] underpinning the independence of public health".
The underlying argument is that the Lib Dems have made the NHS better protected from the private sector than it had been under Labour, an argument Burnham rejects as "the most distorting piece of spin I have ever heard. The whole point of this bill is that it takes the NHS in a new direction."
Williams has admitted frustration in the Lords that the detailed virtues and vices of the bill are now little debated as two big entrenched encampments face each other. She complained that the legitimate balanced role of competition in the NHS was being forgotten.
She told peers : "I am thoroughly fed up with reading pieces on social network sites such as Twitter, which have presented the debate in terms of how we must be in favour of marketisation. That is simply absurd and it makes me angry. It adds to what has become a silly debate, a fictional debate. I am fed up with reading about how I am actually a secret marketiser when I know when perfectly well I am not."
Indeed it must be frustrating for peers. Few will have followed the complex proceedings, and compromises, over the role of Monitor, national tariffs, and the expansion of competition.
Williams retains a special status in her party, and she must know she will have disappointed many by her judgment call – one she admits may prove to be wrong. The weekend conference will reveal whether she can take her unhappy party with her. The Guardian

Dementia is 'next global health time bomb'

Dementia is 'next global health time bomb': Dementia should be made a top health priority on a par with cancer and lung disease, a leading expert has said, after it has become the next global "time bomb". The Daily Telegraph

Three million could benefit from 'doctor by broadband' by 2017, claims minister

Three million could benefit from 'doctor by broadband' by 2017, claims minister: Some three million patients could be consulting their doctors and managing their health conditions online by 2017, saving the NHS £1.2 billion, Paul Burstow, the Care Services Minister, has claimed. The Daily Telegraph

Alzheimer’s treatment in late stages of disease does slow progression

Alzheimer’s treatment in late stages of disease does slow progression:
More than 100,000 people in the UK suffering the “savage” effects of advanced Alzheimer’s disease could benefit from drug treatment to slow its progression. The Independent