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It’s time to transform the NHS – the pressures of Covid have left no doubt | Chris Hopson



Record numbers of Omicron-driven infections are turning into rapidly rising numbers of Covid patients in hospital. Staff absences, which have now reached 80,000 a day, are severely hampering the response. All on top of very high demand for non-Covid care during the most pressured four weeks in the NHS calendar.

There is good news. The vaccines are working. The surge of seriously ill older people the NHS saw last January, and feared so much this time, has not yet materialised. London, the original UK epicentre of Omicron, looks like it is now stabilising.

But after a decade of the deepest financial squeeze in NHS history, the health and care frontline is going to be stretched perilously thin in places over the next three weeks, as evidenced by the 25 trusts who have needed to declare a critical incident in the last week.

Trust leaders tell us that, due to the dedication, professionalism and flexibility of NHS staff and managers, the line should just about hold.

As we have demonstrated over the last 18 months, thanks to our national structure, the NHS can deliver in ways many other national health systems can’t.

We can booster-vaccinate a higher proportion of our vulnerable population more quickly and administer a higher number of new, life-saving, antiviral drugs than any other nation in Europe.

As we saw on 18 January 2021, when the NHS coped with 40,000 Covid patients in hospital on the same day, trusts can rally around to help neighbours when they hit serious trouble.

We can create “insurance policy” super-surge capacity across the country at incredible pace, with the first eight hubs now in place.

We can create virtual wards, using new technology to monitor less seriously ill patients remotely, only bringing them into hospital when needed.

These are the advantages of a single, taxpayer-funded, national system. A system with a proper national and regional infrastructure to support local trusts to work together to meet collective patient need, free from the requirement to maximise individual organisational profit.

But we must be open and honest about the impact this degree of pressure is having on patients and staff. And we need to recognise the pressure extends well beyond hospitals. Ambulances, mental health and community services, GPs and social care face unprecedented challenges too.

Social care provision is one of the areas of the NHS facing unprecedented challenges
Social care provision is one of the areas of the NHS facing unprecedented challenges. Photograph: Andrew Matthews/PA

Despite that extraordinary effort from the NHS frontline, thousands of patients are having to wait longer than the NHS would want for urgent care. For 999 calls to be answered. For ambulances to hand over patients to hospitals. For patients to be seen promptly in accident and emergency departments and discharged back home or to the care sector.

And, despite trusts working incredibly hard to avoid this, they are now having to delay planned care again, adding further to the growing care backlog. There is a clear, regrettable, impact on quality of care and, in the most pressured parts of the system, a worrying increase in patient safety risk.

The impact on frontline staff is also significant given that we are asking them, once again, to make an extraordinary effort. While some may live with the pressure, after two years of being on a “war footing”, others are now burning out.

Trust leaders are doing all they can to support their staff as effectively as possible, while managing the personal impact on their own lives. But there are some serious frustrations that still need to be addressed nationally, such as consistent and timely access to lateral flow and PCR tests when needed.

Covid-19 is, hopefully, a once-in-a-generation challenge. But when any system comes under pressure, its weakest links are revealed.

It is now very clear that the NHS and our social care system do not have sufficient capacity. That asking staff to work harder and harder to address that gap is simply not sustainable. That we need a long-term, fully funded, workforce plan to attract and retain the extra 1 million health and care staff the Health Foundation estimates will be needed by 2031.

And that we need a national transformation programme that embeds modern technology, 21st century medicine, integrated care closer to home and much greater emphasis on prevention at the heart of our health and care system.

These are the longer-term issues we will need to address once this immediate challenge has been met.

Chris Hopson is chief executive of NHS Providers

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Solar storms may cause up to 5500 heart-related deaths in a given year



In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart


17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus



Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer



Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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