Nurses recorded wrong waiting times

Staffordshire nurses wrongly recorded waiting times

Tracey-Ann White and Sharon Turner has been found to have inaccurately recorded waiting times

Two nurses from Mid Staffordshire NHS Trust had been found to have inaccurately recorded patient waiting times in accident and emergency.

The failings by Sharon Turner and Tracey-Ann White, on various dates between 2000 and 2010, were to get round breaches of the four-hour target.

It is the primary full hearing into nurses from Stafford by a panel from the Nursing and Midwifery Council.

The regulator’s hearing was adjourned until Tuesday.

‘Get real’

The hearing was told Turner had ordered one staff nurse to inform another to “lie about it” in connection with the objective breaches.

She was also found to have racially abused junior doctors of Asian origin, touching on “the suicide bombers” and “him over there, Osama’s mate”.

In relation to patients, she had said “they need to get real”.

The trust confirmed White was still employed by the trust, but Turner was not working there.

Melanoma ‘hits body’s immune system’

Skin cancer ‘able to fight off body’s immune system’

A deadly type of skin cancer is in a position to fend off the body’s immune system, UK researchers have found.

Analysis of tumour and blood samples shows that melanoma knocks out the body’s best immune defence.

A potential test could workout which patients are inclined to reply to treatment, the Journal of Clinical Investigation reports.

Cancer Research UK said the body’s response was a “complex puzzle”.

Previous work from the team at King’s College London showed that while patients with melanoma produced antibodies that could attack tumour cells, the immune system often seemed powerless to stop the cancer progressing.

But in the latest research they discovered that the subtype of antibody attracted by the melanoma cells was the most ineffective at mounting the right sort of response.

In samples from 80 melanoma patients they say that the conditions created by the tumour attract IgG4 antibodies, which mount the weakest response and in turn interfere with any “strong” IgG1 antibodies that might be present.

By mimicking the conditions created by melanomas, they showed that in the presence of tumour cells, the immune system sent out IgG4 antibodies, but when faced with healthy cells it functioned as expected with IgG1 circulating.

They also confirmed that IgG4 was ineffective in launching an immune attack against cancer cells.

Potential test

In additional tests in 33 patients, they found that those with higher levels of the weak antibody IgG4 had a less favourable prognosis compared with those with levels nearer to normal.

Study author Dr Sophie Karagiannis said: “This work bears important implications for future therapies since not only are IgG4 antibodies ineffective in activating immune cells to kill tumours but they also work by blocking antibodies from killing tumour cells.”

She said not only was IgG4 stopping the patient’s more powerful antibodies from eradicating cancer, but it could also explain why some treatments based on boosting the immune response may be less effective in some patients.

Co-author Prof Frank Nestle said more work was needed on developing IgG4 as a potential test to improve patient care by helping to identify patients most likely to respond to treatments.

“This study can also inform the rational design of novel strategies to counteract IgG4 actions,” he added.

Dr Kat Arney, science communications manager at Cancer Research UK, said: “There’s a lot we don’t yet understand about how our immune system recognises and responds to cancer, so we’re pleased to have supported this new research that’s helping to solve such a posh puzzle.

“This work is still at an early stage, but it’s a step towards developing more effective treatments for skin cancer and potentially other types of cancer inside the future.”

Research looks at MS damage repair

MS damage repair treatment checked out by Edinburgh researchers

Myelin acts as a protective layer, insulating the nerves

New treatments which can help slow the progression of multiple sclerosis may be a step closer as a result of research by Edinburgh University.

In MS patients the protecting layer around nerve cells inside the brain, referred to as myelin, is damaged down.

Scientists have discovered that immune cells, often known as macrophages, help trigger the regeneration of myelin.

The researchers hope their work could eventually end in the improvement of latest drugs.

The sheath around nerves cells, product of myelin, is destroyed in MS, leaving the nerves struggling to pass on messages.

This ends up in issues of mobility, balance and vision. There is not any cure but current treatments specialize in limiting the wear to myelin.

‘Stripped away’

Now the team at Edinburgh University has found that the immune cells, referred to as macrophages, can release a compound called activin-A, which activates production of more myelin.

Dr Veronique Miron, from the Medical Research Council Centre for Regenerative Medicine on the university, said: “In multiple sclerosis patients, the protecting layer surrounding nerve fibres is stripped away and the nerves are exposed and damaged.

“Approved therapies for multiple sclerosis work by reducing the initial myelin injury – they don’t promote myelin regeneration.

“This study could help find new drug targets to complement myelin regeneration and help to revive lost function in patients with multiple sclerosis.”

The study, which checked out myelin regeneration in human tissue samples and in mice, was funded by the MS Society, the Wellcome Trust and the Multiple Sclerosis Society of Canada.

The findings are published in Nature Neuroscience.

Scientists now plan to begin further research to examine how activin-A works and whether its effects might be enhanced.

Dr Susan Kohlhaas, head of biomedical research on the MS Society, said: “We urgently need therapies that may help slow the progression of MS and so we’re delighted researchers have identified a brand new, potential approach to repair damage to myelin.

“We glance forward to seeing this research develop further.”

Iraq doctor ‘suspended’ over torture

Iraqi doctor ‘suspended over torture links’

Dr Al-Byati was found to were “complicit in acts of torture”

An Iraqi doctor who was an “accessory to torture” under Saddam Hussein’s regime has been suspended for 12 months, a medical tribunal has ruled.

But it said Mohammed Al-Byati’s actions were “not so serious” that he should be struck off the UK’s medical register.

Dr Al-Byati, 47, who has worked at UK hospitals since January 2000, treated detainees in Iraq from 1992 to 1994.

The Medical Practitioners Tribunal Service found he had known some of his patients were injured through torture.

On Thursday, the fitness to practise panel ruled Dr Al-Byati was “complicit in acts of torture”, although it was not alleged he witnessed any acts of torture first hand.

The tribunal also said there was no criticism of his clinical performance in the UK.

‘Not so serious’

Following its findings that Dr Al-Byati’s fitness to practise medicine was impaired due to his actions in Iraq 20 years ago, the panel ruled on Friday that it would be “sufficient and proportionate” to suspend his medical registration for 12 months.

The panel’s chair, Professor Michael Whitehouse, said: “Having considered all the evidence placed before it, and the exceptional circumstances in which Dr Al-Byati found himself, the panel is of the view that his misconduct, although serious, was not so serious as to be fundamentally incompatible with his continuing to be a registered medical practitioner.

He said the panel wished to “demonstrate clearly to him, the profession and the public that – even though his involvement as an adjunct to torture was outside his control – such conduct is unacceptable”.

He added the length of time would allow the doctor “a sufficient period to reflect upon the seriousness with which the panel views his actions”.

The panel had already accepted the General Medical Council’s (GMC) case that it was neither Dr Al-Byati’s wish nor his intention for a number of those he had treated to be tortured further.

Professor Whitehouse acknowledged that Dr Al-Byati desired to continue to practise “as he loves his work and desires to aid people”, and that his actions have been a “consequence of his completing his compulsory military service” under Saddam Hussein’s dictatorship where dissent was not tolerated.

Appearing before the panel on Tuesday, Dr Al-Byati said he were a junior doctor in Iraq and were “terrified” of what would happen to him and his family if he failed to do as he was told.

He said he had not known the folk he was treating have been tortured, insisting he was “completely innocent of those charges”.

Doctors urged to chop medicines waste

Doctors urged to chop medicine prescription waste

Pharmacists say there are plenty of reasons patients stockpile drugs

Doctors were urged to alter how they prescribe medicines to forestall £300m of substances being thrown away every year.

Pharmacists say this will likely be easy to do – if doctors offered more tailored, personal advice to patients and stopped prescribing quite a lot of drugs to hide long periods of time.

But doctors say patient demands make it hard to make such changes,

Behind the counter of Ash Son’s pharmacy in south London lie several yellow bags which illustrate the issue.

They contain drugs which have been handed back over a one-month period and are worth thousands of pounds.

“Currently now we have about six bags and two drums,” Mr Son says. “All of it goes to the incinerator; we cannot re-use any of those drugs because we simply have no idea if they have been stored correctly.”

He explains that there are a lot reasons patients can be stockpiling drugs.

Some people change their medicine at the advice of doctors, while others simply prefer to stop taking the pills.

Official advice is to come back unwanted drugs back to the chemists, but Mr Son accepts that many individuals will hang directly to them or just throw them away.

“That stuff we haven’t any idea about, and carries risk because it’s disposed in landfill and might leach into our water supply.”

‘Patient expectations’

Mr Son is vice-chair of the English pharmacy board of the Royal Pharmaceutical Society and says patients must be more sensible of their attitude to what they wish.

Ash Son and the medication he cannot use

“Have an easier discussion together with your doctor about your medicines,” he says. “We will focus on when patients simply haven’t taken the medicine and they’ve continued to be prescribed, or they’re just not appropriate”.

He also believes doctors should stop prescribing quite a lot of drugs to hide long periods, instead sticking to a regime of standard repeat prescriptions.

Following a central authority report into what quantity of money the NHS wastes on medicines, published in December 2012, the NHS in England, Scotland and Wales was working to lift awareness of the problem with a firm called Medicines Waste UK.

The company’s managing director Jan James said: “This isn’t about apportioning blame to any specific group, it’s about working together in order that we collectively reduce waste.”

NHS England, that’s implementing the government’s action plan for medicines waste, has launched a project working across primary and secondary care inside the south of britain, that is estimated to have saved nearly £3m in its first year.

Pharmacists say there are numerous reasons patients stockpile drugs

NHS England’s deputy chief pharmaceutical officer, Clare Howard, said there have been “many complex factors” behind the difficulty.

“These include the ways that medicines are developed, doctors’ prescribing habits, the ways that “repeat” medicines are ordered, and naturally patients’ understanding of the significance of taking medicines as prescribed and ensuring they simply order what they wish,” she said.

A campaign was developed to remind patients of 3 key messages: only order the medicines you’d like; take your medicines with you into hospital and remove unwanted medicines safely.

The Royal College of GPs said: “Many patients expect a prescription on the end in their consultation, particularly antibiotics for common colds and infections on the way to recover naturally or respond better to other treatments, and this may make it difficult for GPs to prescribe appropriately.

“Prescribing was designated a clinical priority and we have now already produced a variety of resources, with the Health Protection Agency to support GPs on this area.”