The healthmatters blog; commentary, observation and review
The Great British Sunday roast could become a thing of the past as new research reveals Brits are ditching the family favorite in favor of quicker and healthier alternatives. A survey by 1,034 UK adults by appliances etailer, AppliancesDirect, found that just 11% now enjoy the British tradition every week.
- Just 1 in 10 now sit down for a Sunday roast every week
- Brits are put off by the 800 calories per serving
For a health conscious 1 in 5 the 800 calories in a typical roast dinner was enough to put them off, opting to make healthier Sunday meal choices.
Sixty one percent cite not having enough people at home to cook a dinner as one of the reasons for not eating a Sunday roast weekly, while more than half said that it takes too long to make. A typical roast dinner with all the trimmings takes over two hours to cook, even more if you consider the washing up.
The cost of meat was a reason for 39% and 1 in 5 said they were too busy with social commitments to attend the weekly ritual.
Mark Kelly, marketing manager at AppliancesDirect comments: “Given the busy lives we now all lead and the number of children living away from home or at university it’s not surprising that less families are taking part in this much-loved tradition. However, appliances like pressure cookers and halogen ovens can help speed up the process. Sitting round the table with family or friends no matter what you’re eating is really important, as it gives people the chance to catch up after a busy week and spend quality time together.
“The data shows the way in which Brits are enjoying the tradition is changing with the times, but I believe that the Sunday roast will remain a favourite meal among Brits for many years to come. It’s just becoming an occasional treat rather than a weekly staple.”
The Sunday roast capital is Birmingham, who’s residents enjoy a roast dinner four times a month, compared to the people of Glasgow where the average consumption is just twice a month.
New analysis from Alzheimer’s Research UK has revealed that the number of dementia researchers working on the condition has almost doubled over six years. The charity’s report, published today (14 March) at their annual research conference in Aberdeen, highlights major improvements in the UK dementia research landscape as funding for research into the condition has increased. But while the gap between dementia and other disease areas has narrowed over time, with progress being made in scientists’ understanding of the condition, the analysis shows dementia research has still not caught up when compared to the huge impact of the condition. Figures from the report show that for every one dementia scientist, there are now four cancer researchers – compared to six in 2008/9.
- Alzheimer’s Research UK report reveals boost in people power following greater research investment.
- Despite this, dementia research capacity still lags behind other serious conditions.
The report, Keeping pace: progress in dementia research capacity, also comes as the charity launches its new Dementia Statistics Hub – an online ‘one-stop shop’ for the latest facts and statistics on dementia and research into the condition.
In 2012, Alzheimer’s Research UK published its influential Defeating Dementia report, which found that despite massive costs to the UK economy, there were relatively few scientists working to tackle dementia compared to other conditions such as cancer. Since then, there has been a drive to step up the fight against dementia on both a national and global scale, with an increase in research funding from Government and charities such as Alzheimer’s Research UK. Five years on, the charity set out to investigate the impact of this funding by repeating the original analysis.
Its new report, which compares the research landscape in 2015/16 to the 2008/9 picture, shows that:
- The number of UK dementia researchers has almost doubled, from 1,614 to 3,169.
- UK dementia research productivity has nearly doubled, from 3,209 scientific publications a year to 6,141.
- For every dementia researcher, four work on cancer – compared to six cancer researchers in 2008/9.
- In 2014/15, 61% of UK dementia publications were internationally collaborative, compared to just 51% in 2008/9.
While the number of dementia researchers has increased, the total number of scientists working in other disease areas has also risen. As a result, the gap in research capacity between dementia and cancer, while narrower, still exists six years after the original study. The analysis shows that there is still only one dementia researcher for every £2m of costs to the UK economy attributed to the condition, compared to 10 for cancer.
Hilary Evans, Chief Executive of Alzheimer’s Research UK, said: “Five years ago we challenged the UK Government to commit to long-term support for dementia research, and today we see the impact that greater investment can have. It’s heartening to see funding increases have resulted in more scientists focusing on this devastating condition, and more discoveries being made in the search for new treatments. Today we understand more than ever before about the diseases that cause dementia, now the challenge is to translate that knowledge into breakthroughs that will transform people’s lives. Dementia research has also benefited hugely from increasing international collaboration, and it will be crucial to ensure this trend continues as we negotiate our exit from the European Union.
“We still need parity for dementia research: having started from a low base, we are still playing catch-up with other disease areas and we must increase the pace. Already 850,000 people are living with dementia in the UK, and that number will rise to over 1million by 2025 unless new treatments and preventions can be found. At Alzheimer’s Research UK we have stepped up our own research and have bold plans to go even further, but we still need the continued focus of Government and other funders if we are to tackle what is fast becoming the greatest medical challenge of our generation.”
To see figures from the report as well as up-to-date facts and statistics visit Alzheimer’s Research UK’s Dementia Statistics Hub at www.dementiastatistics.org
Dr Linda Patterson OBE FRCP
I’m Linda Patterson and I write about current issues in healthcare. To find out more of my background click here.
I want to give a realistic commentary, based on my experience as a physician and leader in the UK NHS, having a wider system perspective .
I want to avoid the “catastrophic ” and knee jerk oppositional thinking which often characterises current debate. My opinions are informed by my absolute commitment to universal healthcare ,which is the mark of a civilised society, and I believe the NHS “financed out of general taxation and free at the point of use “is the most equitable system for delivery of that , and also a great achievement.
Children’s palliative care charity Together for Short Lives is disappointed at the lack of support in the Spring Budget for the UK’s 49,000 children with life-limiting or life-threatening conditions.
We believe that the Chancellor had a golden opportunity to transform the lives of these seriously ill children by addressing the postcode lottery in funding for children’s palliative care.
It’s very disappointing and worrying that the Chancellor has excluded seriously ill children’s social care from the £2 billion additional funding which he has announced for local authorities in England. This blow compounds recent funding cuts. Councils’ contribution to the cost of providing children’s palliative care in the voluntary sector fell significantly by 61% between 2014/15 and 2015/16. It is simply unsustainable for local authorities to contribute just 1% to the costs incurred by children’s palliative care charities.
The Chancellor could also have followed the example set by Scottish Government ministers, who have increased funding for children’s hospices so there is parity with funding for adult hospices. It is an outrage that on average, adult hospices in England receive 33% of their funding from statutory sources and children hospices receive an average of 22%.
Unless these funding gaps are addressed, then we, as a country, are making a judgement that we place greater value on the life of an adult than that of a child. This is not fair.
The government also had the opportunity to right a wrong by lifting the baby benefit bar which currently means that children under three are unable to access the mobility component of the Disability Living Allowance (DLA). This benefit would allow families to buy or have access to a specially adapted vehicle which would allow families to travel safely with their children and the bulky life support equipment they need. The change required to support these families would amount to £5-6m a year. It would transform the lives of over 2,000 children and their families.
Barbara Gelb OBE, Chief Executive of Together for Short Lives, said: “Budget 2017 confirms our worst fears: sadly it seems only the loudest voices are being heard and the weakest, the most vulnerable children in our society, and their families, are being pushed to the periphery. Unless the government actively steps in to fix this broken system, which is supposed to give these families the support they need, then they will never be part of the ambition for a stronger, fairer, better Britain which works for everyone.”
You can read what we called on the Chancellor to do at Budget 2017 in Together for Short Lives representation to the Treasury. Together for Short Lives will continue to press ministers to bring about the reforms so desperately needed by the 49,000 children in the UK who need palliative care. We welcome the government’s intention to publish a green paper on social care funding; we will use this opportunity to make a strong case for social care funding for children and young people to be put on a more secure and sustainable long term footing.
Applying for that fulfilling job as a midwife or teacher? Then be warned, you could potentially lose out on your dream role especially if you live in London, according to uCheck, who carry out Disclosure and Barring Service (DBS) checks. The infographic by uCheck shown below reveals just how long a DBS check – a criminal police check that is mandatory for people wishing to work with children or vulnerable adults – takes to be processed across the UK.
Londoners looking to start their new role might need to hold fire as they wait on average 109 days to get clearance. Mayday Healthcare PLC – a nursing agency which provides medical and healthcare jobs in London – reported they have been affected negatively by the Metropolitan Police Force’s DBS turnaround times and disclosed they have four members who have been awaiting their certificates for six months, and one applicant who withdrew his application completely due to the long turnaround time.
Nurses or childcare workers looking for a role in Dorset or North Yorkshire also have the right to be concerned, with Dorset Police taking 58 days to complete DBS checks and North Yorkshire Police taking 28 days. But if you live in Norfolk, Guernsey or Northern Ireland, police typically take 3.1 days or less to perform their checks, leaving potential employees to get on with the job in hand.
A survey of more than 423,000 NHS staff has shown their workplace is improving, despite the huge financial pressures and public demand on healthcare.
Responding anonymously to the annual NHS Staff Survey, staff reported small but measurable improvements in 26 of the 32 key categories, including having confidence to raise concerns about clinical practice, feeling supported by managers and recommending their workplace for employment or receiving care.
Danny Mortimer, Chief Executive of NHS Employers, which supports employers to deliver quality care, said:
“Despite incredible pressures on our workforce, their commitment and resilience shines through. Against all the odds, staff are generally feeling better at work and more confident in the care they provide. This is a tribute to them and the teams and managers they work with.
“There are areas of real concern, however. Organisations across the NHS must do more to address bullying and the poorer experience of BME colleagues. Members of the public who abuse our staff must know they will be held accountable for their actions.
“The survey shows that efforts to improve the NHS workplace are being effective. The task going forward is to keep sharing good practice and to keep ensuring national and local leaders listen to staff and provide the support they need to make it through this difficult period.”
Some key findings of the survey, which took place from October to November 2016, include:
- The score (out of 5) given by staff for their confidence and security in reporting unsafe clinical practice improved from 3.63 (in 2015) to 3.67 (in 2016).
- The score (out of 5) given by staff for receiving support from immediate managers improved from 3.72 (in 2015) to 3.76 (in 2016).
- The score (out of 5) given by staff for recommending the organisation as a place to work or receive treatment improved from 3.72 (in 2015) to 3.75 (in 2016).
This 2016 NHS Staff Survey, which is published by is available from today (7 March 2017) here: http://www.
Within minutes of last Saturday’s demonstration moving off from its assembly point, Telegraph columnist Asa Bennett wrote: “Jeremy Corbyn has no clue how to help the NHS. That’s why the public wants him nowhere near it”. http://www.telegraph.co.uk/news/2017/03/04/jeremy-corbyn-has-no-clue-help-nhs-public-wants-nowhere-near/. There’s nothing like getting the first punch in.
The show of labour movement force organised by the People’s Assembly and Health Campaigns Together was huge, even if the organisers’ estimate of 250,000 was optimistic. It brought together large numbers of community activists and a wide range of trades unionists around a simple, shared political perspective on the NHS. The much-heralded but infrequently seen Corbynist enrolment finally reached the streets, joining the public sector unions (big battalions: Unite, Unison, GMB) and some professional organisations (the BMA, RCN and Royal College of Midwives).
The simple, shared perspective is well illustrated by the message on one demonstrator’s home-made placard. The catchy and memorable rule of thumb – “underfund, overstretch, demonise, privatise” – makes sense of current events, of personal experiences and of long-standing fears for the NHS. It is grounded in distrust of the Conservatives’ real attitudes towards the public sector and the welfare state as a whole, a deep feeling in the population. It draws on assumptions about conspiracies fomented by devious politicians, also a deep public belief. And it is tinged with despair – another home-made placard, shown in a video clip on the Independent’s website, said this bluntly: “The NHS is all we have left to be proud of”.
None of these feelings, beliefs and political judgements needs to be ‘true’ to work – they are all contestable – because they have unrivalled explanatory power. Slower growth in NHS budgets can be understood as under funding. Efforts to increase NHS productivity (common to all governments since 2002) feel like overstretch. Bullying criticism of professionals (a strong NHS habit trickling down from the very top) easily morphs into demonization. Add all these together and ‘setting the NHS up to fail’ looks like a covert neo-liberal political strategy.
The Conservatives are quick to point out that all this mobilisation means nothing. The balloons and vuvuzelas and chants make a carnival, part of the drama of the NHS, an outpouring of emotion among underlings allowed their one-day ‘festival of fools’. Worse, the demonstration was just a big manifestation of Labour’s current dilemma. On the NHS it can only drum up its own tribe. It cannot convince a broader public which is sceptical about the constant demand for more spending on the NHS. Labour might save the NHS, goes this argument, but the NHS will not save Labour. Evidence? Look at the Copeland by-election campaign and outcome.
This may be right, but it may also be too soon to tell. The convergence of community activism around the NHS with an angry and injured trades union movement may be more potent than the Conservatives think. The NHS is everywhere, and crosses tribal boundaries. Constituencies that seem secure Conservative seats may experience challenges from a growing and increasingly confident coalition of campaigners about the direction in which the local NHS is going. Attempts to reconfigure (as Vanguards, STPs or whatever comes next) or outsource (to private providers or managers) their services may encounter more resistance than ever before.
That resistance will need to speak with a sceptical electorate, with other tribes. It will talk about the differences between cuts and cost-containment, about productivity and overstretch, about holding professionals to account not demonising them, and about the failures of supply-side privatisation, not its success. Then the rules of thumb will no longer be enough, and a new story will have to be told. If we can tell that different story the NHS may well be here to stay. Former Tory Prime Minister John Major, talking recently about Brexit not the health service, put it nicely: “We cannot move to a radical enterprise economy without moving away from a welfare state. Such a direction of policy, once understood by the public, would never command support”.
Ahead of Wednesday’s budget, the NHS Confederation, which among others includes NHS Clinical Commissioners and the Mental Health Network, has called on the government to admit that the health service cannot provide everything for everybody with current levels of funding.
The Confederation and its networked organisations have also called for immediate extra funding for social care and a commitment to deal with longer term funding issues for both health and social care:
“We understand that the government has spared the NHS from some of the more severe cuts affecting other parts of the public sector, but this same period has witnessed unprecedented rising demand and unprecedented low growth in health spending. The NHS has managed better over the last few years than many predicted – it has been more resilient and done well to deliver the current levels and quality of service. But there is a need for a frank admission about the limitations as to what patients can expect, and a willingness at national level to acknowledge that services must be able to prioritise what they can and cannot provide.”
“The crisis in social care also needs to be addressed – even at the best of times, this service has been ignored and underfunded, but we are now at a critical point where local councils despite their best efforts are incapable of keeping up with demand, leaving more than one million older people in real need without any support whatsoever and health services, including mental health, overwhelmed.
“We acknowledge that the government has massive and challenging responsibilities in managing the economy and the Brexit process, but unless action is taken – immediately in the case of social care – the plight of patients and those who use social care will deteriorate further.
“We recognise the government may need a limited period to work out its preferred long-term solution to the social care funding problem, but that cannot be an excuse either for not acting now or for pushing major decisions into the future.
“It is already clear that many MPs from all parties are concerned and that concern will surely grow – this may be a funding headache now, if it not addressed it will become a political headache before long.
“The NHS and local government must play their part – funding should be conditional on reform, joined up services on the ground, and an absolute commitment to patients and others who use services rather than sectional or organisational interests.”
The NHS European Office used Rare Disease Day (28 February) to warn that UK patients with rare diseases could soon be pushed to the back of a queue if the UK is ejected from important European networks that combat these illnesses. It called on the Government to defend the UK’s major role in these 24 ‘European Reference Networks’ (ERNs) during Brexit negotiations and to try to prevent its ejection.
ERNs are the most tangible and advanced form of European cross-border healthcare and six of them are UK-led from within some 40 NHS hospitals involved in these Networks. They allow leading specialist care providers across Europe to collaborate and rapidly share the most cutting-edge information on rare diseases, such as some neuromuscular and auto-immune conditions.
The NHS European Office – which is part of the NHS Confederation – is warning that leaving these ERNs would cause delays in access to innovative treatment for many UK patients with rare diseases, and reduce opportunities to take part in potentially life-saving clinical trials. There is also a real risk that talented UK clinicians and scientists would be tempted to migrate abroad.
Furthermore, flagship initiatives could be affected, including the 100,000 Genomes Project, launched by the Prime Minister in 2012, which aims to better understand how DNA can predict and prevent disease.
The TUC has published an analysis that provides a regional breakdown of where NHS and adult social care services are most reliant on workers from the EU. The TUC says that the government’s refusal to confirm that EU workers can stay is putting NHS patients at risk, along with older and disabled people who use social care.
The regions where services would suffer most if EU workers are no longer allowed to remain after Brexit are London (13% care workers and 9.8% NHS workers are EU migrants), the South East (10% care workers and 6.1% NHS workers), and the East of England (8% care workers and 6.0% NHS workers).
TUC General Secretary Frances O’Grady said: “The government is creating appalling uncertainty for thousands of NHS workers and care workers. It’s a terrible way to treat dedicated public servants. And if Brexit means they have to leave, our health and social care services will struggle to cope. The prime minister should guarantee EU citizens living and working in Britain the right to remain in the UK – and she should do it now, ahead of negotiations. It’s the right thing to do. And it will regain some of the goodwill Britain needs to negotiate the best possible Brexit deal.”
A new survey by the British Medical Association has found that two thirds of people across the UK (65 per cent) support a ‘soft’ opt-out organ donation system. The survey, which questioned 2011 members of the public, also found that while two out of three people (66%) want to donate their organs at death only a third (39%) are signed up to the organ donation register.
Currently England, Northern Ireland and Scotland have an opt-in organ donation system where a person has to register their consent to donate their organs in the event of their death. Under an opt-out system, which has already been introduced in Wales, there would be a presumption in favour of consent for organ donation unless a person had registered an objection in advance.
If an objection had not been registered, family members would still be given the opportunity to confirm whether the individual had any unregistered objection, as an extra safeguard, before any procedures went ahead. The BMA has long advocated a ‘soft’ opt-out system with safeguards for organ donation and continues to believe this is the best option for the UK to reduce the shortage of organs and save lives.
Stigma and mental ill-health
New figures, released in January, reveal the devastating impact of stigma faced by those of us with a mental health problem. Results from the biggest UK wide survey into the impact of mental health stigma showed that almost two fifths (38%) of respondents had been negatively treated as a result of their mental health problem – potentially affecting millions nationwide. The independent public poll was carried out across a sample of 2,000 adults living with a range of mental health problems. 16% didn’t know or preferred not to say whether or not they had been negatively treated while fewer than half (46%) said they had not.
Of those who had experienced stigma and discrimination:
- Almost 1 in 5 (19%) lost their job
- Over half (54%) lost contact with a loved one (friend, family member or partner)
- More than 1 in 10 (12%) couldn’t go through with an important life event (e.g. wedding, graduation)
- Over half (55%) stopped socialising or going out
The findings were released on Time to Talk Day, a nation-wide push to get people talking more openly about mental health, collectively, on a day when thousands of people, including celebrities; politicians; the Prime Minister; high street organisations and schools, will be doing the same. Time to Talk Day is organised by Time to Change, the campaign for England that aims to change how we all think and act about mental health problems, led by the charities Mind and Rethink Mental Illness. For more information about Time to Talk Day visit http://www.time-to-change.org.uk/timetotalkday
Not just an ordinary bear
For the first time, plant-based Cannabidiol (a legal extract of Cannabis, also known as CBD) is available in gummy bear form. London based Love Hemp sold through their initial stock of over 2,000 bears in under 48 hours of trading, seemingly to the surprise of their manufacturer. Designed as a food supplement, each fruit-flavoured bear contains 10mg Cannabidiol and is enriched with Vitamins B12 & D3. The CBD infused gummy bears do not contain yeast, wheat, gluten, dairy, eggs, or peanuts. The bears are sold in packs of 5, 10 or 25, priced at £5.99 for the smaller packs – except you cannot buy them at the moment; you have to join a waiting list.
Whilst this makes them arguably the most expensive gummy bears available in the UK, studies have linked Cannabidiol consumption with a range of benefits from reduced stress and anxiety, to heart health and muscle recovery. Combined with Vitamins often lacking from our diet, the bears are intended to support a healthy lifestyle, say the manufacturers.
Neuroimaging studies have shown that CBD can affect the limbic and paralimbic regions of the brain including the amygdala, which plays a key role in the fear response. When exposed to stressful situations, subjects who had been given CBD showed less activity in these parts of the brain and felt less anxiety. CBD has also been linked with relieving the symptoms of irritable bowel disease (IBS) — a common and sometimes painful condition. Worldwide, the UK ranks second in the number of web searches for CBD products online.
Sticking to the rules, or not.
The Chief Executive of NHS England, Simon Stevens does not seem too bothered by his frosty relationship with the Prime Minister, who did not warm to his public criticism of her claims on NHS funding. You have to give the man credit for his determination. He has announced new restrictions on hospital bed closures and prophesied the end of the purchaser-provider split. Biding his time (or not risking his position), he has also declined to seek more money for the NHS from the Government, for the moment.
First, the clamp-down on bed closures. NHS England has said that any planned bed cuts must:
Demonstrate that sufficient alternative provision, such as increased GP or community services, is in place alongside or ahead of bed closures, and that the new workforce will be there to staff them, and/or;
Show that specific new treatments or therapies – the example given is new anti-coagulation drugs used to treat strokes – will reduce hospital admissions and/or;
Demonstrate that hospitals using beds less efficiently than the national average have a credible plan to improve performance without affecting patient care.
Perhaps predictably, BMA Council Chair Dr Mark Porter said in response: “While the principle of this move sounds sensible, it is astounding that NHS leaders are still talking about cutting the numbers of beds even though we know that patients are being already unfairly let down by a huge lack of beds in our hospitals”.
Second, speaking to the House of Commons public accounts committee hearing recently, Simon Stevens reported that between six and 10 of the 44 Sustainability and Transformation Plans were set to become “accountable care organisations or systems, which will for the first time since 1990 effectively end the purchaser provider split, bringing about integrated funding and delivery for a given geographical population. The response from private sector providers, as reported by the Health Service Journal, was that the implementation of STPs and the development of new care models should not lead to inflexible monopoly provision of health services and that patient choice, fair treatment of provider and a diversity of healthcare provision should be upheld.
Third, capital spending – mainly investment in buildings or equipment – will need to increase significantly in order to fulfil the ambitions set out in STPs. Capital reserves have been raided to keep hospital deficits down, but the NHSE Chief Executive is not pushing his luck, deferring a campaign to relax Treasury stringencies on capital funding until the Autmn financial statement.
Patient centred, us?
Earlier this year the Court of Appeal dismissed an application by NHS England to reverse a decision by a High Court judge last year who ruled a teenager with a severe form of narcolepsy should be prescribed with the drug sodium oxybate.
Since the 2016 ruling, NHS England has made the drug routinely available to children with narcolepsy. It pursued its appeal despite the fact that the teenager in the case was now receiving the drug and would continue to be treated with it regardless of the outcome of the appeal. NHS England was ordered to pay costs for the , anticipated as around £200,000. As the Health Service Journal pointed out, sodium oxybate costs £13,000 a year, meaning the legal fees paid by NHS England on the case could fund the teenager’s treatment for 15 years.
It is not just capital accounts that are being raided by Trusts desperate to reduce their deficits. The NHS Sustainability and Transformation Fund (not to be confused with an STP) has also been broken into. The Sustainability and Transformation Fund was introduced to reward trusts that agreed to meet their financial targets, yet some 40 trusts have received up to two-thirds of their STF allocation, even though they are forecast to significantly miss their targets.
However, it is not all doom and gloom. It was always obvious to anyone working in the NHS that Trusts would be unable to keep the deficit down to last summer’s target of £250m. NHS England and NHS Improvement stopped referring talking about this target some time ago, and the crucial number is now £800m, the reserve that CCGs hold in case of overspending by hospitals. Although the predicted deficit has risen to £873m, it may well be possible to reduce this to around £800m with some creative accounting and some land sales. Then, hey presto! The NHS deficit is written off by the reserves, and everybody will give a sigh of relief, especially in the Cabinet.