Monday 10 December 2012

cancer networks


Clinical networks which oversee the care of cancer, heart and stroke patients in the NHS have had their budgets and staff cut, figures show.
Some of the groups say they are postponing projects due to uncertainty from the changes made in England.
The data comes as a result of Freedom Of Information (FOI) questions put to the networks by Labour.
Ministers are confident the networks - set up to improve care and prevention of disease - will continue to do so.
But the shadow care minister, Liz Kendall, claimed the figures showed the networks were "in chaos" and facing "huge uncertainty about their future".
There are currently 28 cancer networks and 28 stroke and heart networks - both areas will be condensed into 12 groups across England after April, with diabetes joining heart and stroke care.
'Scaled back'
More than 75% of the clinical networks responded to the FOI request.
The cancer teams said funding had been cut by around 25%, and 73 staff had been lost since 2009.
The teams looking after heart and stroke care said their funding had been cut by 12% and 38 posts had gone in the past three years.

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The fact that the Board is putting £42m into the networks is a sign of how important we think they are.”
Prof Sir Mike RichardsNHS Commissioning Board
Ms Kendall said: "Ministers have repeatedly promised to protect the funding for clinical networks. The government should be working to support these local specialists."
The networks have been credited with improving and streamlining care for patients at a local level, and making their treatment more straightforward if they have to attend several hospitals.
Examples of achievements include reorganising stroke services so fewer patients die, and speeding up X-ray results for faster cancer diagnosis.
In the FOI responses, the networks say programmes they use to support doctors and nurses are already being scaled back - examples given include a chemotherapy nurse post not being replaced and community training programmes in rehabilitation after stroke no longer running.
'Unsettling times'
An oncologist from Yorkshire, where the new network will cover the whole of the Yorkshire and Humber region, said: "I never dreamt that a leviathan such as what is being proposed would be the plan.
"The new network will be too big to be able to reflect local capabilities and needs, yet too small to have the authority of national guidelines."
The NHS Commissioning Board plans to give funding worth £42m to four clinical network areas from April.
They will be cancer, cardiovascular disease, maternity and children's services, and mental health -including dementia. Posts for new clinical directors for different disease areas are due to be advertised next week.
The national director for cancer, Prof Sir Mike Richards, who will be the board's director for reducing premature mortality, acknowledged that cancer networks would have a "smaller proportion" of the networks' budget in the future - and he admitted the coming weeks would be "unsettling and difficult" for staff who might receive notices of their jobs being at risk.
He said: "Everybody recognises that the networks have played a huge part in delivering change. They have been a very important channel between the patients and doctors, and the Department of Health.
"I am confident that in the future the networks will continue to play their important role.
"The fact that the Board is putting £42m into the networks, as against the current £33m, is a good sign of how important we think they are.
"Although cancer networks will have a smaller proportion of the budget in the future, there are still backroom efficiencies that can be made, to make things work more effectively. Increasing the footprint of each network will make them more cost-efficient.
"I do recognise this is a time of maximum uncertainty, particularly with staff being put on notice. The next few weeks will be difficult."
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Saturday 8 December 2012

Lung disease patient


Over 1,000 doctors involved in the care of people with lung disease have expressed "grave concern" about the future of NHS care for their patients.
They have signed a letter to the head of the new NHS Commissioning Board in England, Sir David Nicholson.
It says staff are "disappointed and angry" that efforts to improve care for people with lung disease and asthma might "be left behind in the new NHS".
The Department of Health said it wanted "maximally effective" local services.
As part of the government's changes to the NHS in England, networks of doctors and nurses who organise care for the big killer diseases at a regional level are being restructured.
This is causing particular concern among professionals who look after patients with lung disease, because the 10 regional boards who had driven clinical improvements will no longer have support or funding after next April.

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We've very disappointed and angry that this apparatus is being dismantled. ”
Prof Mike MorganBritish Thoracic Society
The medical experts say treatment has been transformed in recent years, leading to better organisation of services such as oxygen delivery for patients who need it at home.
The letter says: "The respiratory improvement programme started by the Department of Health just two years ago is starting to make real progress in improving respiratory care, whilst also saving the NHS money.
"Yet the support and funding for all this work is being withdrawn from April 2013, just at the point when patients are about to really benefit.
"We are concerned that patients living with respiratory disease will be left behind in the new NHS."
Heartbreaking
The letter was put together during a conference organised by the British Thoracic Society in London this week.
One of the signatories, Prof Mike Morgan, who works in Leicester, said: "We've very disappointed that this apparatus is being dismantled.
"The government has identified respiratory disease as a priority, but appears to be removing the infrastructure that supports it.
"We've worked hard alongside patients to improve standards of care, and it's heartbreaking to see this work destroyed unnecessarily.
"This lack of supervision of the improvement of care won't work in future if it's left to its own devices."
The British Lung Foundation (BLF) says one in five people in the UK suffer from lung disease.
This includes three million people with Chronic Obstructive Pulmonary Disease (COPD) and four and a half million who have asthma.
'Unintelligible'
The BLF's chief executive, Dr Penny Woods, said: "At the moment, respiratory care in this country lags behind the rest of the developed world.
"Our patients are writing to MPs to express their concerns. We're worried that if these networks aren't continued, the variation in standards of care will get worse."
Neil Churchill, chief executive of Asthma UK, said: "The loss of networks and a coherent improvement programme will make it harder to reduce deaths and improve efficiency for respiratory diseases.
"Given their cost in lives and in pounds, this is simply unintelligible to doctors, nurses and patients. We have just three months to put this right."
A spokesman for the Commissioning Board said: "We fully recognise that respiratory disease is a high priority both for reducing premature mortality and improving long term quality of life.
"We look forward to working with the clinical community and leading respiratory charities on making local services maximally effective."
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French sperm count 'falls by a third


The sperm count of French men fell by a third between 1989 and 2005, a study suggests.
The semen of more than 26,600 French men was tested in the study, reported in the journal Human Reproduction.
The number of millions of spermatozoa per millilitre fell by 32.3%, a rate of about 1.9% a year. And the percentage of normally shaped sperm fell by 33.4%.
The average sperm count remained within the fertile range, but experts want to see more research into possible causes.
One of the paper's authors, Dr Joelle Le Moal, an environmental health epidemiologist, said: "To our knowledge, this is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period.
"This constitutes a serious public health warning."

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Something in our modern lifestyle, diet or environment like chemical exposure, is causing this.”
Prof Richard SharpeUniversity of Edinburgh
But Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: "The change in sperm concentration described, 73.6 to 49.9 million per millilitre [on average for a 35-year-old], is still well within the normal range and above the lower threshold of concern used by doctors which is suggestive of male infertility, 15 million per millilitre."
There has much been debate in the past 20 years over whether sperm quality has decreased, with research supporting both sides of the controversy. This latest research adds weight to the numerous European studies that suggest one in five young men has a sperm count low enough to impair fertility.
Prof Richard Sharpe, from the University of Edinburgh, said: "Something in our modern lifestyle, diet or environment like chemical exposure, is causing this.
"We still do not know which are the most important factors, but perhaps the most likely is a combination, a double whammy of changes, such as a high-fat diet combined with increased environmental chemical exposures."
The study analysed data from the French database Fivnat, which logs information from 126 assisted reproduction centres. Researchers examined semen samples provided by men aged between 18-70 whose partners were undergoing fertility treatment because of blocked or missing fallopian tubes.
'Jury out'
As the study took place over a period of years, it is important that methods remained the same for comparison- but critics have questioned this.
Dr Pacey said: "In the paper, the authors claim that the methods for measurement of sperm concentration and motility 'have not changed noticeably during the study period', yet to me this is an odd thing to say as in my experience they have changed remarkably everywhere else in the world.
"I would argue that the 'jury is still out' on this issue."
While the study took into account factors that can affect sperm quality, such as age, researchers were unable to control for socio-economic factors, smoking or weight, which have been shown to have a major impact.
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Friday 23 November 2012

SARS-like virus cases found

LONDON: A new virus from the same family as SARS which sparked a global alert in September has now killed two people in Saudi Arabia, and total cases there and in Qatar have reached six, the World Health Organisation said.

The U.N. health agency issued an international alert in late September saying a virus previously unknown in humans had infected a Qatari man who had recently been in Saudi Arabia, where another man with the same virus had died.

On Friday it said in an outbreak update that it had registered four more cases and one of the new patients had died.

"The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case)," the WHO said.

The new virus is known as a coronavirus and shares some of the symptoms of SARS, or Severe Acute Respiratory Syndrome, which emerged in China in 2002 and killed around a 10th of the 8,000 people it infected worldwide.

Among the symptoms in the confirmed cases are fever, coughing and breathing difficulties.

Of the six laboratory-confirmed cases reported to WHO, four cases, including the two deaths, are from Saudi Arabia and two cases are from Qatar.

Britain's Health Protection Agency, which helped to identify the new virus in September, said the newly reported case from Qatar was initially treated in October in Qatar but then transferred to Germany, and has now been discharged.

Coronaviruses are typically spread like other respiratory infections, such as flu, travelling in airborne droplets when an infected person coughs or sneezes.

The WHO said investigations were being conducted into the likely source of the infection, the method of exposure, and the possibility of human-to-human transmission of the virus.

"Close contacts of the recently confirmed cases are being identified and followed-up," it said.

It added that so far, only the two most recently confirmed cases in Saudi Arabia were epidemiologically linked - they were from the same family, living in the same household.

"Preliminary investigations indicate that these two cases presented with similar symptoms of illness. One died and the other recovered," the WHO's statement said.

Two other members of the same family also suffered similar symptoms of illness, and one died and the other is recovering. But the WHO said laboratory test results on the fatality were still pending, and the person who is recovering had tested negative for the new coronavirus.

The virus has no formal name, but scientists at the British and Dutch laboratories where it was identified refer to it as "London1_novel CoV 2012".

The WHO urged all its member states to continue surveillance for severe acute respiratory infections.

"Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases," it said. (Reuters)
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