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NHS is in crisis but the roots go much further back than Omicron | NHS



Back in October Sajid Javid insisted: “We don’t believe that the pressures currently faced by the NHS are unsustainable.” It was a statement that did not age well. It led to snorts of derision from senior doctors and hospital bosses, some of whom wondered what planet the health secretary was living on.

Days later Roland Sinker, the chief executive of Cambridge university hospitals NHS trust, gave a vivid insight into how easily NHS hospitals can get overwhelmed. He told a staff Zoom meeting that the loss of 150 out of 900 beds at the trust’s main hospital – Addenbrooke’s, one of the NHS’s finest – meant that “we could barely function before Covid”. With “150 beds out of 900” unavailable, “this is ceasing to function as a hospital”.

Days earlier a patient had died in the back of an ambulance outside the hospital. Its inability to cope with demand was so worrying, Sinker said, that it might have to send patients to London or Birmingham. “I’m much more anxious and scared now” than when he took over in 2015, he admitted, adding: “You’d have to be asleep to not realise the profound nature of the crisis we’re in.”

Fast forward two months and a growing number of NHS trusts in England, struggling in the face of an Omicron-driven surge in staff sickness, are now having to declare a “critical incident” – an admission that they cannot cope with the extreme pressure they are facing. “Unfortunately this does mean postponing some non-urgent operations and outpatient appointments to accommodate those patients with the most urgent clinical need,” Aaron Cummins, the chief executive of the university hospitals of Morecambe Bay trust in Cumbria, explained in a statement on Monday. It is easy to see such situations as proof that those places are overwhelmed.

On Tuesday it emerged that the NHS ambulance service covering the north-east of England has begun asking friends and relatives of people who have dialled 999 to bring them to hospital themselves, even if they are having a suspected stroke or heart attack, because it cannot guarantee that paramedics will reach them in anywhere near the expected response times.

Ministers prefer to trumpet the record funding the NHS is now receiving, and that the largest number of people ever now work in it in England, than hear such stories of the inability of the nation’s most important service to do its job.

At Tuesday’s Covid press conference Boris Johnson declined to define what an “overwhelmed” NHS looked like. He denied suggestions that it was already in that state, though did concede that “there will be a difficult period for our wonderful NHS in the next few weeks because of Omicron”. The reality is that today’s pileup of problems shows that much of the NHS is already overwhelmed.

As the NHS Providers boss, Chris Hopson, points out, while the service’s current difficulties are the result of “an exceptional Covid surge”, years of government decision-making have left it in this weakened state. “Recent winters and NHS performance pre-Covid show that, after [a] decade of longest/deepest financial squeeze in NHS history, NHS has serious capacity/demand mismatch and broken workforce model,” he said.

The NHS in England has had close to 100,000 vacancies for years now, including for about 40,000 nurses and 10,000 doctors. The price of persistent understaffing is paid daily by health personnel routinely working extra hours to ensure patients get good care; that goodwill helps keep the NHS from falling over. Patients experience it in the form of delays in getting help or having a diagnostic test. And it is also felt by a service which, in some parts, too often teeters perilously close to falling over, usually under the extra strain winter brings, but sometimes in summer too, and certainly as a result of Omicron.

Analysis by Stephen Rocks of the Health Foundation thinktank shows that the UK has only 3.93 hospital doctors per 100,000 people – the lowest in Europe. It also has just 2.42 beds per 100,000 people, the second lowest in Europe after Sweden, which has only 2.07. And it also ranks low down the international league table for its supply of nurses, CT scanners and MRI scanners.

The size of the NHS budget is important. But providing high-quality healthcare involves more than that. It also involves giving the service the staff it needs and taking firm action to reduce illness.

Today’s immediate, escalating NHS crisis has long roots, which are also political roots. Years of decisions by David Cameron, Theresa May and Boris Johnson, especially their inaction on staffing, left it enfeebled and woefully underprepared for this level of extreme pressure, which the critical incidents and unavailability of ambulances dramatically illustrate. The service’s many supporters can only hope that it does not break altogether in the coming days.

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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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