Action on ‘untreatable’ gonorrhoea

Action on ‘untreatable’ gonorrhoea

Infection is as a result of the bacterium Neisseria gonorrhoea

Health experts in England and Wales are on high alert for “untreatable” gonorrhoea that, in some countries, has developed resistance to antibiotics.

Although most UK cases are readily treatable, infection rates are rising.

And the Health Protection Agency (HPA) is launching an action plan to lessen transmission and monitor for and rapidly detect drug resistance.

Gonorrhoea is the second one most typical bacterial sexually transmitted infection (STI) in England.

In 2011, newly diagnosed cases jumped 25% to almost 21,000.

At a similar time, the danger of gonorrhoea developing resistance to the antibiotics doctors normally prescribe – ceftriaxone and azithromycin – fell slightly for the primary time in five years.

However, cases of treatment failure have now been reported globally and, without a new drugs within the pipeline, England’s chief medical officer has advised the govt. to feature the specter of the infection’s resistance to front-line antibiotics to the civil emergencies risk register.

Dame Sally Davies said: “We’ve seen a worrying rise in cases of drug-resistant gonorrhoea during the last decade.

“Antimicrobial resistance to common drugs will increasingly threaten our ability to tackle infections, and the Health Protection Agency’s work is important to addressing this threat.”

Dr Gwenda Hughes, head of STI surveillance on the HPA, said: “We’re seriously concerned with continuing high levels of gonorrhoea transmission and repeat infection, suggesting we have to do more to minimize unsafe sexual behaviour.”

She said a concern was to encourage safer sexual behaviour and condom use, particularly among high-risk groups together with men who’ve sex with men, who account for greater than a 3rd of recent gonorrhoea cases.

The first case of antibiotic-resistant gonorrhoea was present in Japan in 2011. Sweden has also encountered a case.

Hospital inspections ‘to be tougher’

Hospital inspections to be more robust, chief inspector says

Fourteen hospital trusts has been investigated in light in their high mortality rates

The way hospital inspections in England was finished was flawed and they’re to become broader and more robust, the brand new chief inspector says.

Prof Sir Mike Richards said the system utilized by the Care Quality Commission (CQC) have been too narrow in focus.

He desires to recruit a “small army” of doctors, nurses, patients and carers to hold out inspections and ratings.

It comes as 11 trusts was put into special measures after previously unidentified failings were uncovered.

The move was announced on Tuesday after the general publication of an independent review led by NHS medical director Sir Bruce Keogh.

An investigation into 14 hospital trusts was launched earlier this year following the general public inquiry into the Stafford Hospital scandal, which said the public have been betrayed by a system which put “corporate self-interest” in advance of patients.

The trusts were identified as that they had the very best death rates in 2010-11 and 2011-12.

The probe involved in whether the figures indicated sustained failings within the quality of care and treatment on the trusts.

Only two of the 11 trusts that ended up in special measures were facing sanctions from the CQC.

‘Fair and transparent’

Setting out his plans to reform the best way hospitals are inspected, Sir Mike, who formally took up his post this week, said: “We’re changing it because we recognise it was flawed.”

He added the former system, which involved finishing up themed inspections on issues corresponding to nutrition and infection control, could be replaced by one who checked out the hospital in its entirety.

He said the changes were in keeping with the methods adopted by the Keogh review, which he was invited to participate in.

Sir Mike said the dimensions of the CQC inspection teams will be increased to greater than 20 – they have got traditionally involved about five people – to mirror the greater scope of the reviews.

They might be made of patients, doctors, nurses and other professionals to verify they’d greater breadth of data.

“i would like to begin building a small army of inspectors,” Sir Mike said.

“These inspectors have to come from different walks of life, a few of them could be practising clinicians who will come and do two or three inspections a year, some others might be retired clinicians, but importantly we’re also seeking patients and carers and we will be able to provide training.”

Under the recent regime, hospitals may also get school-style ratings of “outstanding”, “good”, “requires improvement” or “inadequate” – something that has already been announced by ministers.

Sir Mike said those deemed inadequate can also face being put into special measures, which involves teams of external experts being brought in to make certain changes happen.

And he said the CQC will be paying close attention to death rates, in addition to other triggers which includes patient surveys, mistakes and infection rates to determine which trusts need to be prioritised for inspection.

The new process could be “robust, fair and transparent”, he added.

The first wave of 18 inspections is because of start within the next month, with the purpose of inspecting all 161 trusts by December 2015.

Funding of £25m for the hot initiative will come from more cash announced for the CQC by Health Secretary Jeremy Hunt in April.

Excess drinking ‘is underestimated’

Excess drinking of alcohol ‘is underestimated’

Ad hoc drinking may mean we don’t actually understand how much we’re consuming

The amount of alcohol consumed in England can be much higher than previously thought, a study suggests.

University College London researchers compared alcohol sales figures with surveys of what people said they drank.

They found there has been an important shortfall with almost 1/2 the alcohol sold unaccounted for within the consumption figures given by drinkers.

This suggests as many as three-quarters of folks can be drinking above the recommended daily alcohol limit.

The researchers reached their estimates by factoring within the “missing” alcohol – and located excess drinking was excess of suggested by official figures, they told European Journal of Public Health.

Experts said much alcohol use went unreported, partly because drinkers didn’t admit or keep track of ways much they consumed.

‘Health implications’

The study found that 19% more men than previously thought were regularly exceeding their recommend daily limit – and 26% more women.

Total consumption around the week was also higher than officially thought – with 15% more men, and 11% more women drinking above the weekly guidelines.

The current recommendation set by the united kingdom Chief Medical Officers seriously is not to regularly exceed four units per day for men and 3 units an afternoon for ladies; the Royal College of Physicians recommends weekly alcohol limits of 21 units for men and 14 units for ladies – although these are currently under review.

A unit of alcohol is roughly corresponding to half a pint of normal strength beer, or nearly one small glass of wine.

Sadie Boniface, lead author of the study at University College, said: “Currently we do not know who consumes almost half all alcohol in England. This study was conducted to indicate what alcohol consumption would appear to be when all of what’s sold is accounted for, if everyone under-reported equally.

“The implications are putative, but they show that this gap between what’s seen within the surveys and sales potentially has enormous implications for public health in England.”

The team used alcohol sales data from Revenue and Customs and compared it with two self-reporting alcohol consumption surveys conducted in 2008 – the overall Lifestyle Survey (GLF) which analysed average weekly alcohol consumption in 12,490 adults, and the Health Survey for England (HSE) which checked out consumption at the heaviest drinking day inside the previous week among 9,608 adults.

Counting units

The researchers say they’ll now look into the characteristics of these which are under-reporting the variety of drinks they have got had, and why.

They suggest it usually is right down to drinking patterns and habits – those who are mixing drinks, and drinking at different venues, can be prone to under-report.

The charity Alcohol Concern suggests irregular and chaotic drinking behaviour may play an element: “When we’re totting up our drinks total we do not always count some occasions as proper drinking.

“We may underestimate drink sizes and their alcoholic content, and never count holidays and special occasions like weddings, birthdays and yuletide after we often drink a lot greater than usual.”

The researchers suggest that government drinking guidelines are looking to reflect actual consumption as opposed to reported drinking – especially when ascertaining what levels are linked to harm.

The Department of Health says this would be considered of their alcohol consumption review.

It said: “We already know people underestimate what they drink and lots drink an excessive amount of. That’s why we work to assist people make healthier decisions, including the new Change For all times campaign to assist them track consumption and understand the impact on their health.

“We’re also tackling excessive drinking through our proposed minimum unit price at 45p per unit, tougher licensing laws, more GP risk assessments, better access to specialist nurses and more specialised treatment.”

Diane Abbott MP, Labour’s shadow public health minister, said: “This has got to be a wake-up demand the govt and the rustic, because after greater than two years of bitter internal rows, the govt. has got cold feet about its only proposed alcohol harm policy.

“More must be done to tackle problem drinking, which costs the rustic £21bn.”

Largest NHS trust gets finance help

Barts Health NHS Trust calls in finance help squad

The Trust is paying £115m a year for the brand new Royal London hospital site

England’s largest hospital trust is to name in a expert squad to aid it tackle its “biggest ever financial challenge”.

Sources at Barts Health NHS Trust have told BBC London if the trust did nothing it can face being taken over by outside administrators.

The trust had planned to avoid wasting £77m this financial year but after three months it’s already £15m behind its target.

It is already talking about cutting about 1,000 posts.

One of its biggest problems is the massive bill this is purchasing the recent Royal London Hospital site in Whitechapel.

Opened in February by the Queen, it was a part of a £1bn private finance initiative and paying back that PFI is costing the Trust £115m a year.

‘Not in administration’

The Trust has a turnover of £1.25bn and a workforce of 15,000.

Sources told BBC London that specialist teams from the NHS Trust Development Authority would start work on the Trust on Thursday.

They will discuss with all clinical groups and think about how to economize.

Sources stressed that any changes to services would only go ahead if a robust clinical and safety case was made for them. They said care and quality weren’t negotiable.

They admitted though that it was possible that some services could be moved around to attempt to economize, but said the choice to name in outside help was necessary to help get the trust “back on course”.

In a press release, the trust said: “We want to be clear that Barts Health will never be in administration.

“Having not met our own financial targets for the primary quarter of the financial year, we’ve got, with immediate effect, placed ourselves in financial turnaround.

“Financial turnaround has not been imposed on us, and by taking this decision proactively and on the earliest possible opportunity, we believe we have now acted responsibly to secure our long-term financial viability, allowing us to continue to supply world-class healthcare to the folk of east London and beyond.”

A NHS Trust Development Authority spokesperson said: “They’ve alerted us that they have got fallen behind on their financial statement within the first quarter of this year and we are able to work with them at the plans to recover their financial position.”

The trust runs the Royal London Hospital, St Bartholomew’s, Whipps Cross, Mile End, London Chest Hospital and Newham University Hospital.

Robot designed to take care of elderly

Robot to handle elderly made at University of Salford

The robot is designed to take meals to residents

A robot designed to assist deal with elderly people have been invented on the University of Salford.

“Carebot” P37 S65 might possibly be programmed to remind them to take medication and exercise, answer questions or even tell them jokes.

Researcher Antonio Espingardeiro, who developed the robot, said it can help care home staff and improve residents’ quality of life.

It can recognise faces and recall the necessities of every patient, he said.

The robot may also be programmed with speech therapy and object recognition exercises to assist individuals with dementia.

It is in a position to acting as a video link to maintain in contact with doctors and family, playing games and giving updates at the news.

The robot, standing at concerning the height of an individual, could also carry meals to residents.

Mr Espingardeiro is seeking investment to perfect the robot before selling it.

He said: “Care of the elderly is a tough issue but as populations age we’re facing a tricky choice.

“I’ve already established that robots can give meaningful interaction to supplement human contact, and from my work with care homes I’ve seen first-hand how both staff and residents cash in on their presence.”

Genetic advance in Down’s syndrome

Genetic advance in Down’s syndrome

Down’s syndrome is brought on by another chromosome

US scientists say they’ve moved a step toward having the ability to treat disorders because of an additional chromosome.

They have “switched off” the chromosome that causes the indications of Down’s syndrome in human cells within the lab.

The research, published in Nature, could at some point bring about new medical treatments for the condition.

Future work could be of real benefit to individuals with Down’s syndrome, said the united kingdom Down’s Syndrome Association.

Humans are born with 23 pairs of chromosomes, including two sex chromosomes, creating a total of 46 in each cell.

People with Down’s syndrome have three – instead of two – copies of chromosome 21.

This causes symptoms inclusive of learning disabilities and early-onset Alzheimer’s disease, in addition to a better risk of blood disorders and heart defects.

Gene therapy, which uses genes to regard illnesses, was attempted for problems because of a single defective gene. But in the past, the assumption of having the ability to silence the consequences of a complete chromosome had appeared beyond the realms of possibility, even inside the lab.

Now scientists on the University of Massachusetts Medical School have shown that, in theory, this could be possible but would take decades of study.

A team led by Dr Jeanne Lawrence inserted a gene called XIST into the stem cells of someone with Down’s syndrome grown within the lab.

‘Exciting research’

The gene plays a task in normal cell development by switching off one of several two X chromosomes found in female embryos, ensuring daughters avoid a double dose of X chromosome genes.

The experiments showed that the gene was in a position to silence the additional copy of chromosome 21, helping correct unusual patterns of growth within the cells.

Dr Lawrence told BBC News: “The research implies that we’ve got a brand new way – in an instant – to review the cellular basis for Down’s syndrome, which can help identify drugs for Down’s syndrome.

“Collectively we’ve got made it conceivable – not necessarily possible or effective, that also must be proven – but conceivable that you would be able to use only a single gene to correct the over-expression of the complete chromosome. So it makes genetic therapy for Down’s syndrome more conceivable where it really wasn’t before.”

Commenting at the study, Carol Boys, chief executive of the Down’s Syndrome Association, said it was exciting new research from a really well-respected team.

“The findings may have serious implications for future work that can be of real benefit to those with Down’s syndrome,” she said.

“We’re an overly good distance from understanding how these findings might translate into clinical applications however it can be that they’re going to be of serious assistance within the look for conventional treatments for a number of the medical conditions that affect individuals with Down’s syndrome.”

Dr Lucy Raymond, from the dept of medical genetics on the University of Cambridge, said the gang had demonstrated a vital proof of concept.

“That is a thrilling breakthrough, but this process continues to be at an overly early [cellular] stage and we’re nowhere near seeing this procedure getting used within the treatment of Down’s syndrome in people.”

A&E patients are waiting longer

A&E patients waiting longer, say new Scottish government statistics

Health Secretary Alex Neil said it was a hectic winter for emergency departments

More everyone is watching for longer periods in hospital emergency departments, in accordance with new figures.

One in 10 admissions weren’t seen within a target of 4 hours between October and December.

Health Secretary Alex Neil said it was a hectic winter for A&E departments and he will be ploughing in £6m to take care of the 2013 winter period.

The Scottish government announced it was investing £50m over three years in an overhaul of emergency care.

The Scottish Conservative Party said the most recent figures showed that the country’s casualty wards had recorded their “worst performance for greater than six years”.

Health spokesman Jackson Carlaw said: “This problem was getting progressively worse and now we all know the genuine extent of the crisis.

“The Scottish government must explain why it was a whisker far from hitting these targets in past years, only to be now spectacularly missing them.”

In October, 94.4% of patients were treated within four hours of attending A&E, the figure for November stood at 93.5% and for December it fell further to 90.3.

Mr Neil said it was important that as many of us as possible were treated within four hours in their admission to accident and emergency and, while the overwhelming majority were, he added that “improvements can still be made”.

In other waiting time statistics, it was revealed that only seven people did not be treated within a brand new NHS waiting guarantee of 12 weeks.

The legal ruling came into effect initially of October.

Out of 58,070 patients, seven missed the 12-week guarantee, but they were treated within a couple of days of that period ending.

Mr Neil was pleased the majority were making the most of the recent legal guarantee.

However, he said he desired to see 100% of patients being given the perfect to be “treated quickly”.

“i’ve got already made clear that we’re taking significant action to enhance unscheduled care in Scotland to be sure persons are seen and treated in our hospitals and as quickly as possible,” added Mr Neil.

“Changing your complete system takes time, that’s why – as a part of that investment package of £50m – we shall be doubling our winter planning fund to £6m this year.”

Last week, the financial watchdog, Audit Scotland, said poor record keeping by health boards made it difficult to mention even if hospitals were really treating people quickly or manipulating their waiting figures.