Monday, 16 December 2013

'Seven-day week' for senior doctors

Anastrozole may cut breast cancer risk

Anastrozole may cut breast cancer risk The Daily Telegraph reports on a "remarkable breast cancer drug that could save the lives of thousands of women".
This solid and believable headline, along with similar ones from The Times and The Guardian, was based on large-scale, high-quality research looking at whether the drug anastrozole could reduce the risk of cancer in postmenopausal women who were at high risk of breast cancer.

Ten questions for your council

Ten questions for your council These ten questions aim to help local authorities promote the wellbeing of their population and improve the recovery of people with mental health problems by providing information about the size, impact and cost of the unmet need to both treat mental health problems, to prevent them from arising and to promote wellbeing. Centre for Mental Health

One in five patients with learning disabilities live in hospitals 100km or more from their families

One in five patients with learning disabilities live in hospitals 100km or more from their families

Hundreds of people with learning disabilities are still living in hospitals more than 100km from their homes, despite a Government pledge to ensure vulnerable people are cared for in their communities. The Independent

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First missed targets of the winter heighten fears that casualty wards will struggle with seasonal workload

First missed targets of the winter heighten fears that casualty wards will struggle with seasonal workload

Casualty wards in England have missed their waiting times targets for the first time this winter, heightening fears that accident and emergency units may struggle to cope with the seasonal spike in hospital admissions. The Independent

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Friday, 13 December 2013

Are we being fair to the NHS?

Are we being fair to the NHS? After more bad headlines, are we being fair to the NHS? BBC News

Detailed data on “never events” will help NHS care become even safer, says NHS England.

Detailed data on “never events” will help NHS care become even safer, says NHS England. NHS England  publishes more detailed data than ever before about “never events” – the serious errors in care that put patients at risk of harm and that should not happen if full preventative procedures are in place.

Mental health and community services

Mental health and community services This Briefing explores the opportunities and good practice currently developing in ‘combined’ or ‘integrated’ trusts, as well as the challenges. NHS Confederation

No health without mental health: mental health dashboard

No health without mental health: mental health dashboard The first annual mental health dashboard aims to show progress against the objectives set out in the ‘No health without mental health’ strategy. The dashboard includes information on: mental health services; the physical wellbeing of people with mental health problems; and experiences of stigma and discrimination. Department of Health

A fresh start for the regulation and inspection of GP practices and GP out-of-hours services

A fresh start for the regulation and inspection of GP practices and GP out-of-hours services his report sets out a new approach to inspecting and regulating all GPs and out-of-hours services, due to start in April 2014. Care Quality Commission 

National Health SHAMBLES: Three damning reports describe mothers abandoned during labour, serious hospital blunders every day and how...

National Health SHAMBLES: Three damning reports describe mothers abandoned during labour, serious hospital blunders every day and how... Public confidence in the Health Service is already at a record low following a run of inquiries exposing a culture of appalling patient care and bureaucratic cover-ups. The Daily Mail

The real NHS 'crisis' this winter is the constant threat of unrealistic cuts | Colin Leys

The real NHS 'crisis' this winter is the constant threat of unrealistic cuts | Colin Leys Hospitals are overwhelmed this winter, that is true, but they are being run down to make room for private healthcare.

FGM: Britain's first ever criminal charges could be brought as cases reopened

FGM: Britain's first ever criminal charges could be brought as cases reopened Exclusive: Home Office minister Norman Baker welcomes the development which could see charges brought for the first time against doctors and other individuals suspected of involvement in female genital mutilation. The Daily Telegraph

Women left fearful and alone in labour, says Care Quality Commission report

Women left fearful and alone in labour, says Care Quality Commission report Best and worst performing NHS Trusts identified by the the chief inspector of hospitals, as some mothers forced to endure "shocking and frightening" births. The Daily Telegraph

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Thursday, 12 December 2013

Teen death hospital quiet on action

Teen death hospital quiet on action A hospital criticised over the death of 17-year-old who bled to death refuses to explain disciplinary action it says has taken against staff. BBC News

VIDEO: Council to 'slash budget by £128m'

VIDEO: Council to 'slash budget by £128m' Northamptonshire County Council has revealed proposals to save £128m over next five years. BBC Northamptonshire

Investigating patient deaths: a waste of time and money?

Investigating patient deaths: a waste of time and money? When you investigate and only identify a root cause, you’re missing the real potential learning. You must work with trained investigators who can look at all casual factors. And you must want to do it, says Martin Bromiley. The Health Foundation

Mental health trusts face funding cut

Mental health trusts face funding cut Mental health trusts in England have had their funding cut by more than 2% in real terms over the past two years, figures show. BBC News

VIDEO: Dementia treatment by 2025 pledge

VIDEO: Dementia treatment by 2025 pledge On Wednesday leaders from the G8 nations committed to finding a cure or treatment for dementia by 2025. BBC News

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Cancer hospital claims made in 2011

Cancer hospital claims made in 2011 A hospital chief executive was told of data manipulation claims in 2011, the BBC discovers.

Doctors given new coma guidelines

Doctors given new coma guidelines All patients in a coma or vegetative state should have access to specialist care, according to new guidelines. BBC News

First drop in obesity prevalence among final year primary school children in England

First drop in obesity prevalence among final year primary school children in England The proportion of Year 6 primary school children who are obese or overweight has fallen for the first time in six years, according to the Health and Social Care Information Centre

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State of maternity services report 2013

State of maternity services report 2013 The focus of this report is the collation and interpretation of some of the basic numbers that tell the story of the state of maternity services. It looks at the rising birth rate in England and also the complexity of the midwifery workload due to factors such as the continuing growth of births to older women. Royal College of Midwives

Thousands of patients' lives put at risk by ‘years of basic GP failures’

Thousands of patients' lives put at risk by ‘years of basic GP failures’

Patients may have been exposed to serious harm “for many years” because of basic errors by family doctors and GP surgery staff, including vaccines not being properly kept and treatment rooms so dirty they were found to contain maggots. The Independent

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The NHS needs to welcome complaints and staff who raise concerns

The NHS needs to welcome complaints and staff who raise concerns When warning signs are ignored, minor problems can turn into crises.

Wednesday, 11 December 2013

Millions of pounds still needed to meet targets for county NHS bosses

Millions of pounds still needed to meet targets for county NHS bosses County health chiefs have announced they are seeking nearly £15m of improvements to meet financial targets before the end of the financial year. Northamptonshire Telegraph

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Parkside House nurses guilty of misconduct

Parkside House nurses guilty of misconduct Five nurses who worked at a Northampton care home where pensioners lived on porridge and had pressure sores so deep their bones were exposed have been found guilty of misconduct. Northampton Chronicle and Echo

Hospital criticised over failures which allowed teenager to bleed to death

Hospital criticised over failures which allowed teenager to bleed to death Opportunities were missed to save Victoria Harrison, 17, as she bled for 15 hours following a routine operation at Kettering General Hospital. The Daily Telegraph

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State of the nation 2013

State of the nation 2013 This report highlights the continuing challenge that diabetes continues to present to the NHS and that quality of care is uneven throughout the country. Checking against NICE standards people who live in the best-performing CCG area are four times more likely to be given eight of the vital health checks recommended by NICE as compared to people living in the worst-performing area. It argues that diabetes care is adequately funded but that the focus of the spending should be on prevention rather than treatment. Diabetes UK

Jail sentence for PIP implant boss

Jail sentence for PIP implant boss The founder of French company PIP, which distributed defective breast implants, is sentenced to four years in prison for fraud. BBC News

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NICE issues warning over dangerous IV drip use

NICE issues warning over dangerous IV drip use New guidelines from the health watchdog the National Institute for Health and Care Excellence (NICE) on the use of intravenous (IV) drips have prompted a flurry of headlines, with The Guardian reporting that, "Thousands of patients [are] dying from incorrect use of IV drips", and The Daily Telegraph claiming that, "Tens of thousands harmed in hospital by IV drip blunders".

Essential reading for smart spending: Dr Foster hospital guide 2013

Essential reading for smart spending: Dr Foster hospital guide 2013 This report examines how financial austerity is affecting the way money is spent on hospital treatments; the impact of drug and alcohol problems on patients and hospitals; the quality of care at weekends; and the measurement of hospital mortality. The data has been presented in a series of posters which aim to celebrate good care and highlight areas of improvement.

EU funding for research and innovation 2014-2020: seizing the opportunities for NHS organisations

EU funding for research and innovation 2014-2020: seizing the opportunities for NHS organisations Horizon 2020, the new European funding programme for research and innovation for the period from 2014 to 2020, aims to improve access to finance for research and innovation so that innovative ideas can ultimately be turned into products and services, creating growth and jobs in Europe. This briefing gives an overview of Horizon 2020 and of the opportunities it offers to the NHS. The NHS Confederation

Current healthcare systems 'won't cut it' says new NHS boss

Current healthcare systems 'won't cut it' says new NHS boss Current healthcare systems "will not cut it" and radical changes are needed to meet patients' needs, the new head of the NHS says. The Daily Telegraph

Deaths at scandal-hit NHS hospital were not properly investigated because senior midwives 'failed to identify' bad practice, claims damning...

Deaths at scandal-hit NHS hospital were not properly investigated because senior midwives 'failed to identify' bad practice, claims damning... The deaths of mothers and babies at a scandal-hit NHS hospital were not properly investigated because senior midwives “failed to identify” bad practice, according to a damning report. The Independent

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G8 Dementia Summit: PM pledges to double funding for research by 2025

G8 Dementia Summit: PM pledges to double funding for research by 2025

Scientists seeking new treatments for dementia will have their funding doubled by 2025, the Prime Minister has pledged, as world leaders meet in London for the first ever G8 Dementia Summit. The Independent

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Tuesday, 10 December 2013

NHS Nene Clinical Commissioning group is being placed in a period of financial recovery

NHS Nene Clinical Commissioning group is being placed in a period of financial recovery Nene CCG has significantly reduced the shortfall however it is anticipated if the same number of patients continue using the system until the end of the financial year, the CCG will have a year-end gap of £8.6m. Northampton Herald and Post

Hospital procedures changed after death of teen

Hospital procedures changed after death of teen Kettering General Hospital says it has changed procedures for caring for post-operative patients after the death of a teenager last year following an appendectomy operation. Northamptonshire Telegraph

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Dementia: Five priorities for research

Dementia: Five priorities for research Research into the biggest care problem of a generation BBC News

One fifth of drips 'are dangerous'

One fifth of drips 'are dangerous' A fifth of patients on an intravenous drip develop complications because they are given the wrong levels of fluid, according to a review of guidance in England and Wales. BBC News

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VIDEO: 'The paramedics put safety first'

VIDEO: 'The paramedics put safety first' Barbara Hakin, deputy chief executive of NHS England, has said it is "sometimes in the best interest of patients' safety that they remain in the ambulance after they have arrived at hospital". BBC News

NHS budget protected but tough times remain for health service

NHS budget protected but tough times remain for health service The health budget is to be protected from the level of cuts affecting other parts of the public sector until June 2016. NHS Confederation

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Test could give two-year warning for Alzheimer's

Test could give two-year warning for Alzheimer's "New test can give two years' warning of Alzheimer's," reports the Mail Online. The news comes from a small Canadian study that found that a specific change in brain activity seen on MRI testing, combined with certain memory difficulties, was 87.5% accurate at predicting the development of Alzheimer's disease.

'Safe' levels of air pollution could still be harmful

'Safe' levels of air pollution could still be harmful “EU air quality rules are still too lax to protect us from pollution,” The Independent reports. It says that air quality regulations may not be sufficient to protect people from harmful sooty particles in traffic and factory fumes.

GPs unfairly attacked for missing cancer cases

GPs unfairly attacked for missing cancer cases BMA questions claims that half of cancer cases are missed by GPs OnMedica

End postcode lottery of cancer care, say MPs

End postcode lottery of cancer care, say MPs Cancer care in the UK is a postcode lottery with regional divides leaving many people facing lengthy waits to be diagnosed and unable to access treatment, a new report has warned. The Daily Telegraph

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NHS job cuts harming patient care and safety, say staff

NHS job cuts harming patient care and safety, say staff

NHS job cuts have harmed hospital care and patient safety, according to more than half of UNISON union members working in the health service have reported. The Independent

Lack of effective policy on exercise 'is tantamount to mass child neglect'

Lack of effective policy on exercise 'is tantamount to mass child neglect' The failure of UK governments past and present to bring in effective policy to encourage British children into exercise is tantamount to mass “child neglect”, a group of experts has said. The Independent

Monday, 9 December 2013

Scrutiny of operations ‘could impact on patients’ claims hospital boss

Scrutiny of operations ‘could impact on patients’ claims hospital boss The clampdown on some NHS operations could have “a considerable impact on patient experience”, according to the boss of Northampton General Hospital. Northampton Chronicle and Echo

Ambulances 'face long delays at A&E'

Ambulances 'face long delays at A&E' Some patients are facing long waits in ambulances outside A&E departments, with one case involving a delay of more than six hours, figures show. BBC News

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NHS England rolls out new personal health budget sites

NHS England rolls out new personal health budget sites SEVEN new sites have been set up to look at rolling out personal health budgets to people who use mental health services.

Study questions role of vitamin D in disease

Study questions role of vitamin D in disease "Doubt cast on vitamin D's role against disease," reports BBC News. The news come from a study summarising a large body of evidence from the best kind of trials – randomised controlled trials (RCTs).

Transforming healthcare: the role for the finance team

Transforming healthcare: the role for the finance team This briefing looks at how NHS finance practitioners can contribute to the transformation agenda. Healthcare Financial Management Association

Meeting needs and reducing distress: guidance on the prevention and management of clinically related challenging behaviour in NHS settings

Meeting needs and reducing distress: guidance on the prevention and management of clinically related challenging behaviour in NHS settings This guidance is for the use of clinical and non-clinical NHS staff and managers and may also be of interest to patients and service users, carers and families. It aims to help staff prevent and manage clinically related challenging behaviour by minimising a patient’s distress, meeting their needs and delivering high quality personalised care, in an environment that is safe for staff, patients and visitors. NHS Protect

Middle-aged drink and drug abusers put strain on NHS

Middle-aged drink and drug abusers put strain on NHS Doctors say burden unsustainable as people in 40s lead surge in admissions, adding they risk cancer as result of drinking habits.

Half of GPs don't refer cancer patients urgently, first league tables show

Half of GPs don't refer cancer patients urgently, first league tables show Family doctors accused of failing cancer sufferers after first ever GP league tables found more than half not referring such patients to specialists quickly enough. The Daily Telegraph

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NHS weekend failings: Report shows patients 24% more likely to die if operation is on a Friday

NHS weekend failings: Report shows patients 24% more likely to die if operation is on a Friday

NHS patients having an operation on a Friday are 24 per cent more likely to die than if they had one earlier in the week, in a damning indictment for the standard of care provided at weekends. The Independent

Britain's poor 'will die before they retire' if pension reforms aren't matched by health improvements

Britain's poor 'will die before they retire' if pension reforms aren't matched by health improvements

Thousands of Britain’s poorest people “will be dead before they can retire” if sweeping pension reforms are not matched by urgent action on health inequalities between rich and poor, experts have said. The Independent

Friday, 6 December 2013

East Midlands Ambulance Service prosecutes more attackers than any NHS trust

East Midlands Ambulance Service prosecutes more attackers than any NHS trust East Midlands Ambulance Service has topped the league table for taking legal action against people who have assaulted its paramedics. Northampton Chronicle and Echo

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Engaging with BME communities: insights for impact

Engaging with BME communities: insights for impact This report highlights ways in which providers and commissioners have developed innovative solutions and approaches to better cater for and engage with BME communities. NHS Confederation

Admissions avoidance and diabetes: guidance for clinical commissioning groups and clinical teams

Admissions avoidance and diabetes: guidance for clinical commissioning groups and clinical teams This report finds that there are tens of thousands of people with diabetes a year who are not receiving the support they need to manage their condition from primary care or do not have sufficient access to specialist diabetes teams once they get to hospital. It calls on the NHS to do more both to prevent diabetes-related hospital admissions and to make hospital stays shorter. Diabetes UK

Avoiding unhappy returns: radical reductions in readmissions, achieved with volunteers

Avoiding unhappy returns: radical reductions in readmissions, achieved with volunteers This research finds that almost 150,000 older people had no support on returning home from hospital and for those that did get some kind of help, approximately 20 per cent didn’t receive continuing support. This report contains a summary of the achievements of the Hospital 2 Home scheme in Leicestershire service in it's first year, finding that over 600 older people have been supported, with very low readmission rates to hospital among those who used the scheme. Royal Voluntary Service

NHS struggle to meet £20bn savings target hits elderly hardest

NHS struggle to meet £20bn savings target hits elderly hardest Knee and hip replacement operations and cataract removals fall to lowest level for five years as patients left longer in pain.
Patients are being denied knee replacements and cataract removals as the NHS struggles to meet its £20bn savings target, official data has revealed.

Cancer: two in three patients will survive by end of decade

Cancer: two in three patients will survive by end of decade The number of people dying from breast, prostate and bowel cancer will almost halve by 2020, new figures suggest. The Daily Telegraph

Social workers invaded my body and stole baby, says mother forced to have caesarean

Social workers invaded my body and stole baby, says mother forced to have caesarean Mother who had forced caesarean section before being told baby would be taken into care accuses social workers of stealing her baby. The Independent

Equivalent of 20 classrooms-full of children take up smoking every day in UK, according to research

Equivalent of 20 classrooms-full of children take up smoking every day in UK, according to research

The equivalent of 20 classrooms-full of children take up smoking every day in the UK, new research has estimated, as doctors urged local authorities to view cutting smoking rates as “a child protection issue”. The Independent

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Thursday, 5 December 2013

Nurses who left pensioners at Northampton care home malnourished with bones exposed found guilty of neglect

Nurses who left pensioners at Northampton care home malnourished with bones exposed found guilty of neglect Five nurses have been found guilty by a misconduct panel of neglect at a Northampton care home where pensioners lived on porridge and had pressure sores so deep their bones were exposed. Northampton Chronicle and Echo

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'Let me keep my dead husband's sperm'

'Let me keep my dead husband's sperm' A 28-year-old woman has begun a legal bid to prevent her dead husband's frozen sperm, stored in a CARE fertility clinic in Northampton, from being destroyed. BBC News

World dementia cases 'set to treble'

World dementia cases 'set to treble' The number of people living with dementia worldwide is set to treble by 2050, according to a new analysis. BBC News

Doctors in training speak out on undermining and patient safety

Doctors in training speak out on undermining and patient safety Nearly one in five doctors in training has witnessed someone being bullied in their current post, and more than one in four has experienced undermining behaviour themselves, according to a major survey from the General Medical Council.

HP plans open source offer for NHS

HP plans open source offer for NHS Hewlett Packard is planning to provide a full electronic patient record system on the open source framework being developed by NHS England. E-Health Insider

Study may bust myth of 'fat and fit' healthy obesity

Study may bust myth of 'fat and fit' healthy obesity

The Times has reported that the idea you can be ‘fat and fit’ is “a big fat myth”.
The term ‘fat and fit’ refers to the hypothesis that if you are obese, but all other metabolic factors such as blood pressure, are within recommended limits, then your obesity will not have a harmful effect on your health.
This new research brought together the results of 12 studies into the effects of different weight and metabolic health factors on risk of cardiovascular disease and mortality.

Improving care for lung cancer patients: a collaborative approach

Improving care for lung cancer patients: a collaborative approach The purpose of this booklet is to give lung cancer teams across the country an overview of the aims, activities and achievements of the Improving Lung Cancer Outcomes Project (ILCOP). It outlines the ILCOP approach to quality improvement and also contains four case studies. Royal College of Physicians

New five-year pricing deal on NHS branded medicines agreed

New five-year pricing deal on NHS branded medicines agreed Costs of these drugs to NHS will be flat-lined for two years from Jan 1st. OnMedica

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UK cancer survival rates ‘lag behind Europe’

UK cancer survival rates ‘lag behind Europe’

Britain’s survival rates for nine of the ten most common forms of cancer lag behind the European averages, a major study has shown. The Independent

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Fitness to work test DOES disadvantage mentally ill: Court of Appeal upholds ruling against Government

Fitness to work test DOES disadvantage mentally ill: Court of Appeal upholds ruling against Government The Court of Appeal has upheld a ruling that the Government's controversial fitness to work test does disadvantage people with mental health problems. The Independent

Wednesday, 4 December 2013

Corby best in country for dementia diagnosis

Corby best in country for dementia diagnosis People with dementia in Corby are more likely to receive a diagnosis of the condition than anywhere else in the country. Northamptonshire Telegraph

Fraudsters threaten donations for county’s air ambulance

Fraudsters threaten donations for county’s air ambulance The Air Ambulance Service (TAAS) is calling on its supporters to be wary of rogue collectors posing as the charity. Northamptonshire Telegraph

Food poverty 'a health emergency'

Food poverty 'a health emergency' Food poverty in the UK has now become such a big problem that it should be seen as a "public health emergency", a group of health experts says. BBC News

Private sector access to NHS pension

Private sector access to NHS pension The government may extend the NHS pension scheme to private companies or charities who mainly look after health service patients. BBC News

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25,000 doctors have their licences renewed in first year of checks

25,000 doctors have their licences renewed in first year of checks In its first year of operation the new system of checks for doctors practising in the UK has seen nearly 25,000 doctors have their licence revalidated. The GMC

Prosecution for illegal records access

Prosecution for illegal records access A former GP surgery manager has been prosecuted and fined for illegally accessing the medical records of nearly 2000 patients, most of whom were women in their 20s and 30s. E-Health Insider

Sperm blocking study brings 'male pill' closer

Sperm blocking study brings 'male pill' closer "Researchers announce discovery of proteins that can be blocked to prevent the launch of sperm cells during ejaculation," The Guardian reports. The paper explains that if drugs can be found that turn off these proteins, a male contraceptive pill could become a reality.
However, the news is based on a study on mice in a laboratory.

What can useful bureaucracy in the NHS achieve?

What can useful bureaucracy in the NHS achieve? Clinical staff think two thirds of the data and information they collect is relevant to patient care.

April to June is busiest time of year for A&E - not winter, reveals report

April to June is busiest time of year for A&E - not winter, reveals report

April to June is consistently the busiest time of year for A&E wards – not winter, according to a new report into accident and emergency services in England. The Independent

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Tuesday, 3 December 2013

Community marks World AIDS Day 2013

Community marks World AIDS Day 2013 Members of the local community came together at the Guildhall to mark World AIDS Day 2013 and lit candles to remember those who have died and to promote safe sex and HIV testing. NHFT News

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HK confirms first H7N9 bird flu case

HK confirms first H7N9 bird flu case Hong Kong confirms its first case of the new strain of the H7N9 bird flu in a domestic worker from Indonesia, who officials say is in critical condition. BBC News

Inquiry into donor blood vCJD risk

Inquiry into donor blood vCJD risk An inquiry is being launched to check the safety of donor blood amid concerns about an infection risk from the human form of "mad cow disease". BBC News

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Lessons from Europe: the value of tariff redesign

Lessons from Europe: the value of tariff redesign Payment mechanisms can be a powerful lever for strengthening healthcare delivery – driving quality and efficiency gains. NHS Confederation

Disease-specific pathways and hospital-based care are a redundant strategy for the multi-morbidity future, says Sir John Oldham

Disease-specific pathways and hospital-based care are a redundant strategy for the multi-morbidity future, says Sir John Oldham Over the next 40 years, most healthcare systems worldwide will face a tsunami of need from people with long-term conditions such as diabetes, chronic airways disease and circulatory diseases. There will be a rise of 252 per cent by 2050, and this is built into existing demography and prevalence. The mathematics are inescapable. In England… Continue reading » NHS Voices

Heart's strain rate may be raised by energy drinks

Heart's strain rate may be raised by energy drinks Caffeine energy drinks “intensify heart contractions,” BBC News reports.
The news is based on a small study of 18 healthy adults who had heart scans taken before and one hour after drinking an energy drink containing caffeine and taurine (a chemical said to have stimulant properties).

Towards whole person care

Towards whole person care This paper reviews the case for change in the English health and care system and considers how to move towards a ‘whole person care’ approach. It sets out broad themes on creating a health and care system that is fit for the future. It makes a case for a number of person-centred guarantees at the heart of the vision for whole person care, focused on people with long-term conditions and older people. Institute for Public Policy Research

Review recommends one ombudsman for public sector services

Review recommends one ombudsman for public sector services The new ombudsman would combine the functions of the Local Government and Health Service Ombudsmen. OnMedica

Leap in care home deaths linked to blood infections

Leap in care home deaths linked to blood infections The number of care home residents dying with blood infections has soared by almost 50 per cent over the past decade, official figures show. The Daily Telegraph

'Unacceptable' that only half of NHS staff took routine flu vaccination

'Unacceptable' that only half of NHS staff took routine flu vaccination NHS staff who do not take a routine flu vaccine this winter are putting frail patients' lives at risk, a leading doctor has warned. The Independent

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