What the papers say – weekly digest (15/12/23)

Your weekly digest of the top healthcare stories, covering news published from 11/12/2023 – 15/12/2023.

Daily Express

The Government suffered a Commons defeat last night (Monday) as MPs won a vote to ensure victims of the infected blood scandal are compensated. Tory MPs had vowed to rebel and back the Labour amendment to extend interim payouts to more victims of the scandal. MPs voted 246 to 242 to back an amendment from Labour’s Dame Diana Johnson requiring the Government to set up a body to administer the compensation scheme within three months of the Victims and Prisoners Bill passing. Up to 30,000 people received contaminated blood products in the 1970s and 80s, and more than 3,000 have died after contracting HIV or hepatitis C. An independent inquiry into the scandal was due to report this autumn but that was delayed until March 2024 due to the ‘’sheer volume and scale of material’’. Under an initial compensation scheme, only victims or bereaved partners can receive an interim payment of around £100,000.

Thousands of care homes, hospitals and hospices will have to allow residents to receive visitors after a change in the law, announced today (Tuesday). In a major victory for the campaigning Daily Express, transparency will finally be brought to the sector that has often ridden roughshod over the interests of  families for years. For the  first time, around-the-clock access to residents will be made as important as food, drink and properly qualified staff. Throughout the pandemic, desperate families branded the Care Quality Commission regulator ‘’toothless’’ after they were refused access as loved ones died inside, scared and alone. The CQC already has a set of ‘’fundamental standards’’ below which an individual’s care must never fall, including dignity and respect as well as safeguarding from abuse. Now the law will make visiting part of good care for some 15,000 regulated facilities. The CQC will have a clear mandate to check providers are meeting access obligations so those in care have vital connections with family and friends. Today’s announcement is recognition for those cruelly banned from bedside visits during Covid while pubs, restaurants and sports matches attracted hundreds of thousands. Current Department of Health and Social Care guidance urging access can be ignored and facilities can dictate their own terms. The new law, introduced speedily as secondary legislation, means the CQC will be fully answerable to families who cannot access a facility because of flu or norovirus outbreaks. Health facilities will now be graded  on access with those failing to comply, or in breach, named and shamed and barred from having top rankings. In addition to care homes and hospitals, it will allow patients to be accompanied to appointments at inpatient and outpatient settings, emergency departments and diagnostic services. It means no mother will be forced to give birth alone, will end the scandal of only one parent accompanying a sick child at paediatric A&E departments, while a family member or friend can go with cancer patients to chemotherapy sessions.

Health experts are calling for a national drive to raise awareness of inflammatory bowel disease and improve care across the country. Too many patients face a postcode lottery when it comes to getting diagnosis and treatment, doctors have claimed. A group of 30 clinicians, charity representatives, pharmaceutical leaders and patients have written to the Health Secretary urging action.  Their letter, seen by the Daily Express, calls for a national campaign to raise awareness of inflammatory bowel disease and reduce geographical variations in care. It says: ‘’IBD continues to be overlooked, with care and health disparities allowed to persist. People living with IBD across the UK continue to receive differing standards of care, from diagnosis to treatment, based on where they live. For example, overall waiting times for new patient appointments at gastroenterology clinics have been found to vary between one and 27 weeks.’’ IBD involves a group of  conditions that cause debilitating symptoms such as severe abdominal pain and diarrhoea. Crohn’s disease and ulcerative colitis are the main types, although patients can also be diagnosed with unspecified IBD. Around half a million people are thought to have IBD in the UK.

An arthritis drug can slow progression of type 1 diabetes by reducing damage to insulin-producing cells, a study found. Baricitinib is thought to help stop the immune system attacking cells in the pancreas that produce the hormone. The study – published in the New England Journal of Medicine – had 60 children and young adults taking a daily pill within 100 days of a new type 1 diabetes diagnosis. After 48 weeks their cells secreted more insulin and blood sugar was better controlled than patients who received a placebo dose. Professor Thomas Kay, of St Vincent’s Institute of Medical Research in Melbourne, Australia, said: ‘’If started early enough, and while the participants remained on the medication, their production of insulin was maintained.’’ Researcher Professor Helen Thomas hopes the drug will soon be available for patients.

Injecting fat into the scalp could help to prevent balding and make hair thicker, a study has found. Using fatty tissue from the person’s thigh was found to help the hair  regenerate. The technique seems to work particularly well for scarring alopecia, which usually causes irreversible loss. But it also ‘holds promise’ for male pattern baldness. The review led by the Iran University of Medical Sciences, published in the Journal of Cosmetic Dermatology, looked at a study including four men and five women with baldness. They had fat removed from their thighs, with 20ml of fatty tissue then injected into their scalp three times at three-month intervals. These patients saw a significant increase in their hair thickness, six months after the treatment. The scientists concluded the treatment can significantly control damaging inflammation within the scalp, increasing hair density and diameter.

Being outgoing, conscientious and having a positive outlook make you less likely to suffer with dementia, a report claims. Experts found certain traits appear to be linked to a lower risk of the condition. Researchers analysed data from eight studies involving 44,000-plus people aged 49 to 81. They were followed for up to 21 years during which time 1,703 developed dementia. The ‘big five’ personality traits were measured – conscientiousness, being extrovert, openness to experience, neuroticism and agreeableness. They also focused on wellbeing and outlook.  Analysis revealed that people who were more conscientious, who were extroverts or had a positive outlook, were less likely to develop dementia. Lead author Emorie Beck, from the University of California, said: ‘’This was the most surprising finding to us.’’ The report said one answer may be that conscientious people are more likely to eat well and take care of themselves, which results in better health. The study was published in Alzheimers & Dementia: The Journal of the Alzheimer’s Association.

Daily Telegraph

A brain implant that allows people with head injuries to function again proved so successful in a trial that participants refused to turn off the device. The deep brain stimulation implant, developed by researchers at Stanford University in the US, aims to boost activity between the regions responsible for consciousness, learning, memory, thinking and problem solving. During early trials, five participants with brain injuries reported they were able to concentrate, read, remember, drive properly and get through the day without napping. The therapy proved so effective that researchers had trouble completing the final phase of the study, which was to switch off the device for three random participants – after two of the patients declined. Researchers selected patients for the trial who had recovered from comas with brain systems believed to be still well preserved but not functioning as well as previously. ‘’In these patients, those pathways are largely intact but everything has been down-regulated’’, said Dr Jaimie Henderson, professor of neurosurgery at Stanford. ‘’It’s as if the lights had been dimmed and there just wasn’t enough electricity to turn them back up.’’ The researchers hoped that precise electrical stimulation of specific areas could turn the ‘’lights’’ back up, and created a virtual model of each participant’s brain so they could trial stimulation at different locations ahead of surgery. Guided by these models, Dr Henderson implanted the devices in the five participants aged between 22 and 60 who had sustained injuries between three and 18 years earlier. After allowing the device to bed in for a fortnight, the participants spent 90 days with it turned on for 12 hours a day. At the end of the treatment period, the participants had improved their mental processing speeds by an average of 32 per cent, researchers said. When one participant was randomly chosen to have their device turned off for three weeks, their mental processing speed dropped by 34 per cent. The research was published in the journal Nature Medicine.

The majority of official complaints about cancer care are caused by delays in GP referrals, an analysis of reports by the Medical Defence Union (MDU) has found. About four in five of the expressions of dissatisfaction and claims for compensation made by cancer patients were against GPs, according to the MDU, which provides indemnity for clinicians. A study of 106 complaints involving prostate and testicular cancer patients in a two-year period and published in 2018 revealed that 92 per cent had taken action against their GP. The most common reason was a delay in referring men to a specialist doctor despite them having symptoms. This was attributed to misdiagnosis, a lack of a ‘’family doctor’’ to provide continuity of care, and missed follow-up appointments. For example, some men with high protein-specific antigen (PSA) test scores were not given follow-up examinations, while one man – who did ultimately have prostate cancer – was denied a PSA test despite having a family history of the disease. More than half of the complaints led to claims for clinical negligence. A separate study revealed a similar trend among women being treated for breast cancer, with 77 of 84 claims directed at GPs and all of them citing missed or delayed diagnoses. In 58 cases, the women were under 50 and so were not eligible for NHS screening. A report published last week by Cancer Research UK found that Britain is still lagging behind its European counterparts despite a ‘’war on cancer’’ announced 18 months ago.

A fifth of people are on NHS waiting lists in Britain’s worst hit areas, analysis has shown. With 7.8 million people waiting for care in England, it means on average there are about one in eight people – or 12.4 per cent – waiting for an appointment or procedure. This increases to one inf five in areas with the most demand. Southend, Mid Essex, and West Sussex have the greatest proportion of people waiting for treatment, according to analysis  by the Liberal Democrats, ranging from 21 per cent to 17.7 per cent. Castle Point and Rochford in Essex and Stockport and  Wigan Borough in Greater Manchester make up the areas where more than one in six people are waiting for an NHS appointment, the House of Commons Library analysis said. Health officials have criticised the metric because it uses constituency populations as a basis rather than a hospital’s catchment area. The waiting list has risen by 600,000, from 7.2 million, since Rishi Sunak pledged to cut waiting lists.

A senior coroner has issued a warning about the inability of foreign health staff to speak English after hearing about carers of an elderly woman who died did not know the difference between ‘’bleeding’’ and ‘’breathing’’. Barbara Rymell, 91, became trapped by a mechanical stair lift after a fall at her care home and staff could not free her. Her two carers – one Romanian and one Indian – were unable to explain to the emergency services what had occurred and did not know the difference between the OAP being ‘’alive or alert’’. Their lack of English ‘’severely hampered’’ the 999 call handler’s response and made a meaningful assessment ‘’virtually impossible’’, the coroner said. Following the call, Mrs Rymell’s case was classified as ‘’serious’’ rather than requiring ‘’immediate’’ response. By the time paramedics arrived she had passed away. Samantha Marsh, senior coroner for Somerset, has written a Prevention of Future Deaths report to the Home Office and Care Minister Helen Whately. In it she said the test for foreign  staff is ‘’wholly insufficient’’. The Taunton inquest heard dementia sufferer Mrs Rymell died on her first day at Ashley House residential home in Langport. Mrs Marsh said: ‘’It was obvious neither of the staff were sufficiently proficient in English to be able to explain clearly the nature of the medical emergency.’’ The inquest concluded Mrs Rymell had died of misadventure as a result of a fall.

A breakthrough treatment for prostate cancer is being rolled out nationwide to NHS clinics. High frequency sound waves are used to destroy less serious tumours with milder side-effects than traditional cures, which are used on more advanced cases. Patients can be treated in one day and return to normal activities within two weeks but enjoy similar success to more invasive procedures. High-Intensity Focused Ultrasound has only been available in London. But the first HIFU unit outside the capital is opening at Royal United Hospitals Bath with further centres planned in King’s Lynn, Liverpool and Fife. The RUH Bath deployment is co-funded by cancer charity Prost8 and UK Focused Ultrasound Foundation. Philip Keevil, chair of the venture philanthropy body UKFUSF, said it ‘’is transforming the treatment of a number of  medical disorders including many cancers and diseases of the brain.’’ Around 52,000 men are affected by the disease each year and about 12,000 of those could be treated with HIFU.

Roche has swooped for an obesity drug maker in a $2.7bn (£2.1bn) deal as it becomes the latest pharmaceutical giant to join the race to develop new weight-loss treatments. The Swiss company is to buy California-based Carmot Therapeutics, which is in late-stage trials for a weekly injection designed to help lose weight. It comes as a wave of global drug makers race to develop the next generation of treatments, following booming demand. Currently on the market are Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound. Teresa Graham, of Roche, told Reuters: ‘’There  is an opportunity for deeper weight loss to happen more quickly and tolerability is maybe one of the bigger issues.’’

The Guardian

NHS bosses have raised ‘’extreme concerns’’ over strikes by junior doctors, saying they ramp up pressure in the toughest months traditionally faced by the health service. The British Medical Association announced the walkouts in England this month and in January after talks with the Government to resolve the pay dispute broke down. The three-day strike from December 20 is in two weeks’ time, while the six-day January 3-9 action will be the longest in NHS history. Health commentators expressed dismay at the news, with many raising concerns for patient safety. NHS leaders will prioritise urgent and  emergency care to ‘’protect patient safety’’ during the walkouts. But Professor Sir Stephen Powis, national medical director for the NHS in England, said :’’It is extremely concerning the health service is set to face another escalation in industrial action, with the longest consecutive strike in NHS history during one of the most challenging periods.’’ The BMA said on Tuesday junior doctors have been offered a 3% rise on top of the average 8.8% increase they were given in the summer. But the union said the cash would be split unevenly across different doctor grades and would ‘’still amount to pay cuts for many’’.

More than 40 million women a year experience lasting health issues after childbirth, a global review has found, prompting calls for greater recognition of common postnatal problems. The analysis of maternal health shows a high burden of long-term conditions that last for months and even years. One in three new mothers worldwide are affected. The findings emerged from a series published in the Lancet Global Health and eClinicMedicine, backed by the UN’s Special Programme on Human Reproduction, the World Health Organization (WHO) and the US Agency for International Development. The analysis examined health problems arising or continuing six weeks after childbirth or later.  These problems included pain during sex, affecting 35% of postpartum women; low back pain (32%); anal incontinence (19%); urinary incontinence (8-31%); anxiety (9-24%); depression (11-17%); perineal pain (11%); fear of childbirth (6-15%) and secondary infertility (11%). Researchers called for greater recognition within the healthcare system of these common problems, many of which occur beyond the point where women typically have access to postnatal services.

Leading scientists are calling for a change in the law to help IVF patients donate unused embryos to biomedical research after a collapse in donations over the past 15 years. The increasing commercialisation of IVF, overstretched NHS clinics and cumbersome paperwork are blamed for a 25-fold decrease in donated embryos. Scientists described some patients going to ‘’extraordinary lengths’’ to ensure their embryos could be used for research rather than be discarded, with many private clinics failing to routinely offer donation as an option. Figures obtained by the Guardian show that the number of embryos donated to research, after IVF treatment, fell steadily from 17,925 in 2004 to just 675 in 2019, the most recent year for which data is available. In the same year, 76,427 embryos were transferred in IVF cycles and 172,915 were discarded, according to figures from the Human Fertilisation and Embryology Authority (HFEA). An HFEA survey in 2017 found that 58% of patients would prefer to donate embryos to research rather than allow them to perish, with just 6% saying they would prefer their embryos to be discarded. But only around one in five clinics routinely facilitate donation.

A review of 302 domestic homicides recorded in a four-year period found that the majority of those killed had made contact with the police, health services and other public agencies before their death. Nicole Jacobs, the government’s independent domestic abuse commissioner for England and Wales, said the findings highlighted a lack of ‘’political will’’ at national level to learn from what were often avoidable deaths. Every domestic homicide of people aged over 16 is subject to a formal review and recommendations are made, but Jacobs said there had been insufficient analysis of the outcomes by the Home Office and other government departments. Based on the reviews between 2015 and 2019, collated by Manchester Metropolitan University for the commissioner, she said it was clear that lives had been lost where action could have been taken. In the NHS there was no national formal model for a nurse or doctor to flag that a patient might have suffered from domestic violence. Among the 58 reviews where recommendations had been made for the health services, 78% of the victims and 69% of the perpetrators had been to health services such as GPs or hospitals prior to the homicide. In the worst-case scenario, Jacobs said, there might be no follow-up at all of individuals who arrived at a hospital with signs of being abused.  While the frontline services at a local level would collaborate and coordinate following a domestic homicide, the lessons were going unheeded at a national level, it has been claimed. Jacobs said: ‘’There needs to be some political will to make sure that some of the things that we know are working well are not so patchwork. Our systems were never built with an understanding of domestic abuse, full stop. So in a way, it’s the systemic changes that we need.’’

A blood test that can spot if a patient’s brain is ageing faster than the rest of their body could help predict dementia decades before it develops, research suggests. It means conditions such as Alzheimer’s could be caught and treated in the vital early stages. A US study found patients whose organs were ageing faster had a higher risk of developing diseases in that organ within 15 years. Accelerated ageing of the brain and blood vessels was found to be a better predictor of  Alzheimer’s progression than the best blood-based biomarker. Researchers checked levels of almost 5,000 proteins in the blood of 1,398 healthy patients aged 20 to 90 at an Alzheimer’s research centre. The Stanford University study focused on 11 key organs including the brain, heart, muscles and vascular system. Researchers flagged all the proteins whose genes were four times more highly activated in one organ compared with others. They found 858 organ-specific proteins and trained their algorithm to guess a person’s age based on them. The study – published in Nature – revealed almost 20% of patients showed ‘’strongly accelerated age’’ in one organ, while 1.7% showed ageing in multiple organs.

Babies really do see the world differently, researchers have found, after revealing infants less than six months old do not fall for a visual illusion that can trick older children and adults. Experts say that is because information processing in very young children’s brains is not fully developed, meaning they make different assumptions about what they see. Writing in the journal Proceedings of the Royal Society B, researchers reported how they showed a screen featuring red and green dots to infants aged five to eight months. Dots of one colour moved upwards in the centre but downwards on the right and left, while dots of the other colour did the reverse. Adults see a visual illusion: the red dots all appear to move in one direction, and the green dots in the other. To explore whether this occurs for infants, the team subsequently presented the children with a screen showing dots of one colour. These either all moved in the same direction, or moved in one direction in the centre and the opposite direction at the sides. Babies tend to look longer at unfamiliar things. The data revealed those younger than six months spent longer looking at the screen when the dots moved in the same direction, while older infants spent longer looking at the screen when the dots moved in both directions. This suggests the younger infants did not perceive the initial illusion of the same-colour dots moving in the same direction.

The Times

The elderly and disabled will ‘’pay a heavy price’’ for the government’s crackdown on foreign care workers, NHS leaders and charities have warned. Care workers will be barred from bringing dependants with them to the UK from the spring as part of a five-point plan announced by James Cleverley, the home secretary, to bring about the ‘’biggest-ever reduction in net migration.’’ NHS Providers, which represents NHS hospitals, mental health, community and ambulance services, said that the curb on care workers was ‘’deeply concerning’’ and would exacerbate major shortages in the UK’s health and social care services. There is a shortage of 120,000 staff in the NHS and over 150,000 in social care. Damian Green, the former Conservative cabinet minister, said that the measures may ‘’cause damage to the care sector’’. Caroline Abrahams, head of the charity Age UK, warned: ‘’We are worried that older and disabled people in need of care, and their families, will pay a heavy price for the government’s changes to the migration rules.’’

Nearly two million children are growing up in homes with smokers and experts want more to be done to help new parents and pregnant women quit. A report by Future Health Research has shown that in England there are 1.8 million households with children in which one adult smokes. Passive smoking harms children’s developing airways, lungs and immune system, which can lead to chest infections, and causes about 22,000 new cases of asthma each year in the UK. It said that a government plan to ban smoking for younger generations was not enough because children will still be exposed to second-hand smoke from adults. A suggestion is expanding a scheme that offers pregnant women up to £400 in gift cards to quit. Data shows that 8.8 per cent of women smoke during pregnancy in England. Smoking can harm unborn babies and increases the risk of complications. Research shows pregnant women are more likely to give up if their partners do. The report, Delivering Smokefree Families, called for expectant fathers to be targeted with messages about the importance of smoke-free families placed in cigarette packets. About 5.3 million people smoke in England and is highest among those aged 25 to 34, at 16 per cent. It said this was concerning because new parents are likely to be in this bracket.

The NHS has ‘’squandered billions’’ on agencies to plug chronic staff shortages, the Royal College of Nursing said today (Wednesday). Data obtained by the union under freedom of information laws reveals that hospitals in England have spent more than £3 billion on agency nurses and support staff in the past few years. The college collated information from 182 NHS trusts. It said every region had spent millions of pounds, enough to pay almost 31,000 full-time nurses or to have trained more than 86,000 new ones. In total, NHS trusts spent £3.2 billion between 2020 and 2022, with London spending the most at almost £630.5 million, followed by the southeast at £582 million. Hospitals use agency staff to fill gaps in rotas. In England, trust leaders are allowed to pay a maximum of 155 per cent of usual staff hourly rates for agency staff, a limit that can be exceeded only ‘’on exceptional patient safety grounds’’. NHS England data shows that at the end of September, one in ten registered nursing posts – 42,306 vacancies – stood empty.

A hack that released genetic profiles stolen from the DNA testing firm 23andMe was far greater than first thought and affected about 6.9 million people, it emerged last night (Monday). 23andMe, a home DNA testing company, said that almost half of its customer base of 14 million people had information stolen during a major hacking attack in October, far exceeding the 14,000 people that it previously said were affected by the hack. 23andMe told TechCrunch, a technology website, that hackers accessed the personal information of 5.5 million people who opted into 23andMe’s DNA Relatives feature, which allows customers to automatically share some data with others. Another 1.4 million people were affected as they had their family tree information shared. The data included the person’s name, year of birth, relationship status, the percentage of DNA shared with other relatives, ancestry reports, and their reported location. 23andMe is a leader in the $3 billion genetic testing market. For up to $200, customers can take a test which reveals their background and can also identify gene variants linked to diseases like Alzheimer’s and Parkinson’s.

Charities that treat thousands of people with problem gambling say they are at risk of collapse, because their funding will be diverted to the NHS under landmark gambling reforms. Last year 6,645 people were treated under the National Gambling Support Network (NGSN), an industry-funded coalition of organisations providing free support and therapy across the UK. The network employs hundreds of staff, with a focus on early intervention for problem gambling, such as by going to homeless shelters and identifying people in debt from betting. The NGSN is commissioned by GambleAware, an independent charity that is funded through voluntary donations from gambling companies. Long-awaited government plans for a statutory levy on the gambling industry mean this model will change. Gambling companies will have to pay about £100 million a year to the NHS to fund addiction research and treatment. Doctors and GambleAware have welcomed the levy, but they say that some of the funds should go to the existing charitable support network, alongside NHS addiction clinics.

The trend towards vegan diets is putting the health of pregnant women and babies at risk, a global study suggests. Researchers found 90 per cent of expectant mothers in high-income countries, including the UK, were lacking key vitamins for healthy pregnancies. They included vitamins B12, B6 and D, as well as folic acid and riboflavin. All are found ‘’in abundance’’ in meat and dairy products, the scientists said. Keith Godfrey, the lead author and professor of epidemiology from the University of Southampton, said: ‘’The push to – net-zero is likely to further deplete expectant mothers of vital nutrients.’’ The study is published in Plos Medicine and involved 1,729 women aged 18 to 38 when they conceived. When recruited, more than 90 per cent had ‘’low or marginal’’ levels of at least one of the vitamins.