Most cancer cases ‘referred quickly’

Most suspected cancers ‘referred after first GP visit’

Cancer Research UK said there has been more work to be done on early diagnosis

More than 80% of patients with suspected cancer in England are referred by their GP after only one or two consultations, a study suggests.

Data from greater than 13,000 cancer patients shows greater than half were cited a expert after the 1st trip to the doctor.

Harder-to-spot cancers, such as lung cancer, took longer to identify.

Cancer Research UK welcomed the figures, but said there was more work to be done on early diagnosis.

Much work has been done on improving early diagnosis in the past decade, including awareness campaigns, National Institute for Health and Clinical Excellence (NICE) guidelines on the symptoms for suspected cancer, and targets to fast-track referrals.

Late diagnosis and treatment of cancers has been highlighted as one reason behind poor cancer survival rates in the UK compared with other countries.

The study showed that work was still needed on some cancers that are harder to identify. About a third of lung and stomach cancer patients needed three or more consultations before they were referred to a specialist.

Study author Dr Georgios Lyratzopoulos, from the Cambridge Centre for Health Services Research, said the results suggested progress was being made.

“We now understand the typical symptoms of some cancers, like breast and melanoma, very well and that helps doctors to spot them quickly.

“Other cancers have less typical symptoms, making them more difficult to recognise straight away.

“Not suspecting cancer early enough can be stressful for patients and their relatives so understanding the symptoms of these cancers better is where we need to be making greater research efforts to help spot the disease earlier.”

Prompt referral

Prof Greg Rubin, the clinical lead for cancer at the Royal College of GPs and co-author of the study, said the results showed most patients were referred quickly but there has been a significant minority who had a few trips to the GP before suspicion was raised.

“NICE referral guidelines have helped people with classic symptoms to be seen more quickly but, for patients with less typical symptoms, the decision to refer isn’t always as simple,” he said.

Prof Rubin said the results, within the British Journal of Practice, showed GPs now needed to think about smarter ways of picking up hard-to-spot cancers sooner.

Easier access to diagnostic tests was one way, but the Department of Health was also trialling decision-making tools to help GPs spot cancer when patients presented with multiple symptoms, he said.

“Not all cancers should be treated the same, we need to get more selective about where we direct our efforts”, he added.

Sara Hiom, early diagnosis director at Cancer Research UK, said the findings were encouraging but there was still room for improvement.

“Progress is clearly being made but one in five people have to make more than two visits to their GP, although it’s not surprising that this is usually for those cancers which can be harder to identify,” she said.

She added that it was important patients acted on any persistent health changes that concerned them and had the boldness to return to their GP if problems failed to solve.

Bone marrow ‘frees men of HIV drugs’

Bone marrow ‘frees men of HIV drugs’

Two patients were taken off their HIV drugs after bone-marrow transplants appeared to clear the virus from their bodies, doctors report.

One of the patients has spent nearly four months without taking medication with out sign of the virus returning.

The team at Brigham and Women’s Hospital, inside the US, caution that this is far too soon to speak about a cure because the virus could return at any point.

The findings were presented on the International Aids Society Conference.

It is hard to do away with an HIV infection since it hides inside human DNA, forming untouchable “reservoirs” in body.

Anti-retroviral drugs keep the virus in check inside the bloodstream – but if the medicine stop, the virus comes back.

HIV gone?

The two men, who’ve not been identified, had lived with HIV for roughly 30 years.

They both developed a cancer, lymphoma, which required a bone-marrow transplant.

Bone marrow is where new blood cells are made and it’s considered a main reservoir for HIV.

After the transplant, there has been no detectable HIV within the blood for 2 years in a single patient and 4 within the other.

The pair came off their anti-retroviral drugs earlier this year.

One has gone 15 weeks, and the opposite seven, since stopping treatment, and no signs of the virus were detected to this point.

Dr Timothy Henrich told the BBC the consequences were exciting. But he added: “We’ve not demonstrated cure, we’ll need longer follow-up.

“What we will be able to say is that if the virus does stay away for a year or perhaps two years once we stopped the treatment, that the possibilities of the virus rebounding are going to be extremely low.

“It’s much too early at this point to exploit the C-word [cure].”

It is understood that the transplanted bone marrow was initially shielded from infection by the process anti-retrovirals. Meanwhile the transplant also attacked the rest bone marrow, which was harbouring the virus.

However Dr Henrich cautioned that the virus might be still be hiding inside brain tissue or the gastrointestinal track.

“If [the] virus does return, it will suggest that these other sites are an essential reservoir of infectious virus and new approaches to measuring the reservoir at relevant sites might be had to guide the improvement of HIV curative strategies,” he said.

Berlin patient

Timothy Brown, which is called the “Berlin patient” is assumed to be the primary person cured of Aids. He had a bone marrow transplant from a unprecedented donor who was proof against HIV.

The two US cases both received bone marrow from normal donors.

There was also a report of an HIV cure in a child born in Mississippi, US. She was treated with anti-retroviral drugs at birth so that’s thought the virus was cleared from the body before reservoirs were established.

Dr Michael Brady, the medical director of the Terrence Higgins Trust, said: “It’s too early to understand whether HIV have been eradicated from these men’s bodies or whether it could actually return.

Doctors say it’s far too soon to discuss a cure for HIV, as James Gallagher reports

“However, the case means that what happened to Timothy Brown, the Berlin Patient was perhaps not a one-off.

“A bone marrow transplant is a fancy and dear procedure, which comes with significant risks.

“For many those with HIV, it might be more dangerous to undergo a transplant than to continue managing the virus with daily medication.

“So while here is in no way a workable cure, it does give researchers another signpost towards one.”

The head of the inspiration for AIDS Research, Kevin Frost, said: “These findings clearly provide important new information that would well alter the present excited by HIV and gene therapy.

“While stem-cell transplantation isn’t a viable option for folks with HIV on a broad scale due to its costs and complexity, these new cases may lead us to new approaches to treating, and ultimately even eradicating, HIV.”

Paracetamol pack limits ‘cut deaths’

Fall in paracetamol deaths ‘linked to pack limits’

Further reducing the limit on paracetamol tablets in each pack might be needed, the study says

Deaths from paracetamol overdoses fell by 43% in England and Wales within the 11 years after the law on pack sizes was changed, in line with a study.

But the variety of people taking paracetamol overdoses had not declined, says the Oxford University study published within the BMJ.

In 1998, the govt. restricted pack sizes within the UK to 32 tablets in pharmacies and 16 in other shops.

Researchers say the figures will not be bring about “complacency”.

Paracetamol overdoses are a typical approach to suicide and a frequent reason for liver damage.

Previous studies suggested the verdict to confine the scale of packs of paracetamol sold over-the-counter showed initial benefits in both these areas, but there has been no data at the long-term impact.

Using figures from the Office for National Statistics, the Oxford researchers checked out deaths involving paracetamol in people aged 10 years and over between 1993 and 2009.

They found there have been fewer deaths after the legislation was introduced in 1998 than would was predicted in accordance with trends dating back to 1993.

The study also found that patients registered for a liver transplant as a result of a paracetamol overdose had reduced by 61% following the legislation. This was akin to 482 fewer registrations over 11 years.

Prof Keith Hawton, lead researcher from the University of Oxford Centre for Suicide Research, said lives have been saved for the reason that change within the law.

“While a few of this effect might have been because of improved hospital management of paracetamol overdoses, we believe that this has largely been due to introduction of the legislation.

“We’re extremely pleased that this measure has had such benefits, but think that more must be done to scale back the toll of deaths from this cause.”

Despite the reduction in deaths from paracetamol, the study found there were no decline in overdose cases after 1998.

The study added that additional measures could be had to reduce the death toll, corresponding to lowering the limit on tablets in packs further, reducing the paracetamol content of the tablets and enforcing the legislation more effectively.

Health trust faces procurement probe

Northern Health Trust faces contract procurement probe

Mr Poots said anyone with details about the abuse of public money should come forward

Investigations are under approach to examine if almost £1m of probably irregular payments were made by the Northern Health Trust.

Health Minister Edwin Poots said it concerned procurement issues.

Following whistle-blowing allegations, a probe is examining how certain building contracts were obtained throughout the trust.

It is focusing specifically at the management of contracts within buildings and other managerial issues.

In an announcement to the assembly, Mr Poots said while a report has yet to be finalised, an external audit has identified around £860,000 worth of payments which may be potentially irregular.

“It’s far apparent that there are many procurement control weaknesses within the trust’s estates function and investigations are still ongoing,” he said.

“During this respect, external audit, as a part of their audit at the 2012/13 annual accounts, have identified £860,000 of payments in respect of measured day term contracts, that may be potentially irregular as a result of procurement issues.”

As a result, compliance checks are to be completed within the remaining health trusts.

To restore public confidence, the minister said anyone who has details about the abuse of public money should come forward.

‘Culture change needed in Welsh NHS’

Culture change needed in Welsh NHS says lawyer

The Welsh government say they’ve systems to make sure quality within the NHS

The lead lawyer for the general public inquiry into neglect of hundreds of patients at Stafford Hospital has said a culture change is required within the NHS in Wales.

Peter Watkin Jones warns key conclusions shouldn’t be ignored in Wales.

The head of a patient watchdog said hospital banding could possibly be introduced.

Health Minister Lesley Griffiths has already defended standards inside the Welsh NHS, saying robust systems are in place.

The public inquiry at Stafford Hospital found that failings went right to the pinnacle of the health service.

It highlighted “appalling and unnecessary suffering” there that resulted in hundreds of deaths between 2005 and 2008. Five other hospitals in England are to be investigated.

The inquiry chairman, Robert Francis QC, said that “complacency inside the system has meant that every one too often patient complaints had been ignored”.

‘Embraced’

On Wednesday, giving her initial response, Lesley Griffiths said: “i feel in Wales now we have robust systems in place to make certain quality and safety are on the heart of NHS care.

“a up to date survey showed 92% of individuals listed here are satisfied with that care, however, we aren’t complacent.”

Ms Griffiths is anticipated to offer a more detailed response on Thursday.

Peter Watkin Jones said attitudes in any respect levels within the NHS must change around the board in order that patients’ interest are put first to verify the Stafford Hospital scandal isn’t repeated.

He said: “Every organisation at each level must workout the way it will be sure that cultural change could be embraced and enacted by them,”

Cathy O’Sullivan, chief officer of Aneurin Bevan Community Health Council, speaking on BBC Radio Wales, rejected an offer of introducing a first-rate inspector of hospitals, saying close monitoring of the NHS in Wales was already in place.

Banding hospitals

“What’s really required is is a degree of independence in reviewing the NHS and dealing with the organisations very closely in order for actually all of that’s information is gathered together.

“That’s already happening in Wales and that i do not know that a person inspector for the NHS in Wales would make much difference to that,” Ms O’Sullivan said.

However, she was also asked whether a rating system of banding hospitals in Wales, reminiscent of schools, would help.

Ms O’Sullivan said: “The additional info you may give patients the higher and that i do not have an issue with that.

“The entire purpose of keeping the patient within the middle, focussing at the patient is to be open and transparent and be candid about what’s actually happening in health care services.”

The Welsh MP given the role to study how English NHS hospitals do something about complaints says she hopes Wales will follow up a few of her proposals.

Cynon Valley MP Ann Clwyd was handed the role by David Cameron after she spoke out in regards to the poor care her late husband received on the University Hospital of Wales, Cardiff.

Since then she has received over 1,400 complaints about hospital standards, including a host from Wales.

Ann Clwyd criticised the care her late husband received from some nurses

Ms Clwyd will work alongside South Tees Hospitals NHS Trust chief executive Tricia Hart.

Their review will consider how issues raised by patients and their families are listened to and acted upon.

Although this may talk about English hospitals, Ms Clwyd said she hopes most of the proposals would be taken on by Wales.

Last year Ms Clwyd said her husband Owen Roberts died “like a battery hen” in hospital in Cardiff.

She has previously tackled the prime minister inside the Commons about how he would reply to complaints about nurses who did not show care and compassion to patients.

‘Major’ problems for NHS 111 service

‘Major’ problems for NHS 111 service

NHS 111 only started being rolled out in April

The way forward for the hot NHS non-emergency telephone service in 1 / 4 of britain have been thrown into doubt after one of the crucial major providers admitted it was facing major problems.

NHS Direct won 11 of the 46 contracts for the 111 service, that is within the means of being rolled out.

But the organisation has now pulled out of 2 areas and admitted the others can be “unsustainable”.

The 111 service have been plagued with difficulties in recent months.

Older motorcyclist injury warning

Older motorcyclists ‘more prone to be injured’

Refresher courses come in for those coming back to biking

Motorcyclists over the age of 60 are thrice likely to be hospitalised after a crash than younger bikers, a US study suggests.

The report within the journal Injury Prevention found that serious chest and rib cage fractures were quite common.

The authors suggest that reduced bone strength in older adults and their ability to purchase more powerful bikes may play an element.

Motorbike groups inside the UK say they have got seen similar trends.

Nich Brown, from the Motorcycle Action Group, said: “The collection of older motorcyclists in Britain has risen over the last decade – as has the number being injured. Although the numbers are much smaller than america – the percentage of damage in each age group is analogous.

“In addition an ageing population, the recognition of motorcycling among older riders – with the time and money to spend, means more are returning to biking or taking it up for the primary time – for one of the most part quite safety.”

The study analysed data between 2001 to 2008 from the united states National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) which collects information from 100 US hospitals that have an A&E.

During this era about 1.5 million adults over the age of 20 needed emergency treatment resulting from a bike crash.

Bikers over the age of 60 were thrice prone to be admitted to hospital in comparison to those of their 20s and 30s – and two-and-a-half times prone to sustain a significant injury.

The authors of the study said: “The greater severity of injuries among older adults can be because of the physiological changes that occur because the body ages, bone strength decreases, fat distribution may change and there’s a decrease within the elasticity of the chest wall.

“Other factors corresponding to a delayed reaction time, altered balance and irritating vision make older adults more liable to crashing.”

They indicate that underlying illnesses like cardiac disease, hypertension and diabetes will even increase the upward thrust of complications.

‘Keep skills up’

Data on motorbike size was not available to the researchers, but they suggested that older adults usually tend to buy bikes with larger engines – resulting in more severe injuries.

Upper body fractures were more common in older adults – while arm, shoulder and hand fractures were much more likely in folks that were younger.

This should be due to the their faster reaction times – sticking their arms out to offer protection to their fall, suggests Chris Hodder from the British Motorcyclists Federation.

He said: “There are fewer accidents here within the UK than the united states – we’ve had a superb rider training programme during the last 40-50 years – while inside the US training was a mixed picture by way of its size and differences across states. Also drink-driving is far a much bigger problem there.

“There are many post-test courses within the UK. In case you are coming back to motorcycling it’d be good to seem out for refresher training. Folks that ride regularly should keep their skills up. You probably have the cash, fine quality chest protectors also are a good suggestion.”