Doctors Conducting Needless Treatments According to Academy of Medical Royal Colleges

Doctors are guilty of offering excessive numbers of prescriptions and engaging in testing procedures that are simply not required, according to senior medics.

The Academy of Medical Royal Colleges (AMRC) has intervened after research discovered that doctors commonly ordered X-ray, scans and drugs, in cases where they believed such action to be pointless.

Yet over 60% of medics suggest that their decisions had been motivated by a fear of legal action.

But the AMRC has constructed a list of 40 treatments and procedures that it believe to be of little or no benefit to patients.

The organisation suggests that doctors should empower patients and explain the side-effects and consequences of medication before prescribing.

And the number of scans that doctors are conducting should be reduced, with regular scans for terminally ill patients particularly misguided, according to the AMRC.

However, Adrienne Betteley, from Macmillan Cancer Support, was cautious about the potential prospect of cancer treament receding.

“Every single person living with cancer, regardless of what stage they are at, should have access to the treatment and the support they need. Chemotherapy is a crucial part of cancer treatment, having had an enormous impact on rising survival rates over the years. However, it can result in severe side effects therefore, it’s important that health care professionals consider the full impact when delivering something so powerful.”

But with the NHS having accrued a deficit of £2.45 billion during the most recent financial year, it is clear that hard decisions will have to be made.

Nonetheless, the AMRC emphasises that patients needs must come before money concerns.

Nonetheless, Prof Dame Sue Bailey, AMRC chairman, said doctors and patients should question whether interventions were “really necessary” before tests and treatments are carried out.

“We all have a duty to look after resources in healthcare, especially when the NHS is under so much pressure, but that’s not the main motivation for this initiative. What’s much more important is that both doctors and patients really question whether the particular treatment is really necessary. Medicine or surgical interventions don’t need to be the only solution offered by a doctor and more certainly doesn’t always mean better.”

Bailey also argued that dispensing treatment gratuitously can have a negative impact on patients who really require them.

“For some of these treatments it would simply be better for the patients if they weren’t being used. In others, the fact you are giving them to patients who do not need them is meaning that the patients who do need them need to wait longer.”

 
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UK Getting Good Deal on Cancer Drugs According to Lancet

A new study in the Lancet suggests that Britain is getting a good deal with regard to cancer drugs.

Research conducted by the authoritative journal indicates that the UK is paying significantly less for cancer drugs than many other wealthy nations.

While the UK, Greece, Spain and Portugal pay the least, on average, for the drugs that they utilise, Germany, Sweden and Switzerland pay the most.

The authors of the report stated that the process of purchasing cancer drugs en masse should be more transparent, owing to the fact that numerous nations apparently risk overpaying for critical drugs.

Considering the importance of the cancer treatments, this is clearly an urgent issue.

Nonetheless, it is at least good news for the British health industry that the UK is currently getting a good deal on medicines.

According to the report, drugs had accounted for nearly a third of the EU’s 51 billion euro (£37bn) cancer healthcare spending in 2009.

In order to get an accurate representation of the Western market, researchers assessed the pricing of 31 cancer drugs across 18 high-income countries in the Western world.

These included in the UK, Australia, New Zealand, France, Greece, Switzerland, Sweden and Portugal.

While cancer remains one of the biggest killers in the United Kingdom, the incidence of the disease also indicates its importance.

338,623 people in the UK were diagnosed with cancer in 2012.

Cancers of the breast, lung, prostate and bowel account for over half (53%) of all new cancer cases in the UK in 2012.

The Lancet found that prices of drugs in Switzerland, Germany and Sweden were frequently the highest – and for some drugs, such as interferon alfa 2b to treat leukaemia and skin cancer, the prices were twice as high.

It appears that at least patients and consumers in the UK are getting a reasonable deal on this key aspect of medicine.

Sabine Vogler, report author and researcher at the Austrian Public Health Institute, indicated that the system of discounts which operates at present led to the risk of some countries ovepaying for medicine.

“The discounts should be open to everyone, but industry doesn’t want to do it. However, it would allow some countries to see that they are overpaying.”

David Watson, director of pricing and reimbursement at the Association of the British Pharmaceutical Industry, largely supported this view, but also indicated that the situation for the UK was favourable present.

Watson suggested that cancer medicines are currently “affordable in the UK”, and that the UK was “getting a fair deal with regards to medicines pricing,” while the NHS was “getting good value for money”.

 
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90 Per Cent of Acute Hospitals Failing to Meet NHS Targets

According to analysis, 90 per cent of acute hospitals are failing to perform satisfactorily.

With the acute sector having been set stringent targets, over nine out of ten hospitals are failing to meet their requirements.

This is a significant decline from when the acute sector was last assessed earlier this year.

According to the latest data which has been provided by 225 acute hospital sites in England, 207 (92 per cent) failed to achieve their planned staffing levels for qualified nurses working during the day.

The data, which has been published on the NHS Choices website, also indicated that 182 hospitals in the NHS failed to have enough registered nurses working at night.

These disturbing figures can be placed in the context of increasing difficulties within the health service.

Numerous financial issues have come to light in recent months, not least the fact that the NHS is expected to accumulate a deficit of £2 billion in the existing fiscal year.

And reports from within the NHS have indicated that the health service is already running at winter occupancy levels ahead of the busiest period of the year.

Meanwhile, the debate and dispute related to the pay and working conditions of junior doctors rumbles on, with industrial action expected following a vote later this week.

The deterioration in performance may reflect trusts increasing their planned levels for registered nurses on wards following safe staffing guidance from the National Institute for Health and Care Excellence published last year.

It was already known ahead of the release of the statistics that there is a nationwide shortage of nurses, but the extent of this has been laid bare by the figures.

Research indicated that eleven hospitals within the NHS were able to fill less than 80 per cent of the required capacity with regard to nursing numbers.

And the majority were not able to fill 90 per cent of this quotient, 69 per cent of hospitals assessed having a fill rate of 80-90 per cent according to the NHS Choices figures.

Hospitals from various regional locations were found to be underperforming and struggling to reach nursing capacity, with the issue clearly an NHS-wide phenomenon.

The opinion of analysts and healthcare professionals is that the Francis report is central to the existing situation.

While the dearth in nursing provisions is worrying, it is equally clear that the NHS needs to invest significantly in nursing to meet increasing demand.

Better quality care, superior operational efficiency, and improved NHS performance with regard to treating conditions are all known to be hugely dependent on nursing staff.

This massive issue is yet another facing the NHS at a time of crisis in the health service.

 
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Australian Government Commissions Ketamine Depression Trial

A new study in Australia will test the legitimacy of ketamine as a drug to treat depression.

The substance is more readily associated with recreational drug use, and is also utilised as a horse tranquiliser.

Recent research has suggested that the drug could act as an effective anti-depressant.

In order to investigate the matter further, the University of New South Wales will be conducting a unique study into the matter.

The academic institution has received a $2 million grant from the Australian National Health and Medical Research council in order to explore and trial the use of the drug.

This research will get underway next April.

200 patients will participate in the initial clinical trials, with ketamine being compared against an active placebo.

Professor Colleen Loo of the Black Dog Institute is leading the University of New South Wales study, and reflected on the fact that the safety of the substance is a primary focus of this trial.

“We need to properly test if we can use ketamine as a treatment over a whole course of multiple doses,” Loo reflected.

At present, ketamine is only available in Australia as a prescription anaesthetic.

It has also been more commonly used by revellers due to its hallucinogenic properties.

Yet despite the fact that ketamine has never been associated with treatment for depression, it is now thought that it could serve a legitimate role in this field of medicine.

It has already been demonstrated in a related study that the drug can achieve good short-term results for treating depression.

And with this in mind, the research in Australia will focus on whether it can possibly be utilised as a long-term aid against the debilitating mental condition.

Professor Loo outlined the importance of understanding the longer term potential of ketamine as a depression treatment.

“You want to have a treatment that’s going to bring you out of depression and keep you well. What we need to do in taking the next step is look at whether giving people repeated doses can actually lead to a longer-lasting improvement, and this will be, as far as I know, the largest trial in the world of this type, looking at this,” Loo stated.

The grant serves as part of a $630 million investment package from the Australian federal government for more than 800 health and prevention disease projects across the country.

It is estimated that 45 per cent of Australians will experience a mental health condition at some point during their lives.

 
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Care Quality Commission Releases Statement on Wolverhampton Chemotherapy Scandal

The Care Quality Commission has released a statement regarding issues related to Royal Wolverhampton Hospital.

This institution has recently been the subject of media headlines, following a historical case that plagued the Midlands hospital.

Between 2005 and 2010, numerous patients were given inappropriate chemotherapy treatments, not recommended by the national guidelines of the time.

This was not investigated for several years, until the Care Quality Commission was first alerted to concerns related to the Wolverhampton hospital back in September 2013.

At this time, a comprehensive inspection of the trust was carried out, and it became clear that chemotherapy treatment had not been administered appropriately.

After a lengthy investigation, the Care Quality Commission referenced the chemotherapy treatment at Royal Wolverhampton Hospital in its most recent report.

This was published back in September 2015, at which time the Care Quality Commission rated the trust as requiring improvement.

Following on from this assessment, Professor Sir Mike Richards, Chief Inspector of Hospitals at the Care Quality Commission, has been commenting on the ongoing issue, and the existing situation at the Wolverhampton hospital.

Richards firstly noted the history of this particular complaint.

“We were informed that an internal investigation had been conducted in 2009. This showed that a number of patients had received treatment for their cancer which was not recommended in national guidelines. We were also informed that this non-standard practice had ceased by 2009.

“In 2014, the trust commissioned a further external investigation by two leading oncologists. This concluded that there had been unsatisfactory practice but that with one exception this had resulted in no long-term harm. This review also looked at a more recent group of patients and confirmed that the unsatisfactory practice had ceased.”

Richards followed up by updating healthcare professionals on the action that has taken place during 2015.

“We inspected the trust again in June 2015. Our inspection team included a senior cancer specialist to enable us to look specifically at the trust’s current chemotherapy service. The conclusion of this inspection matched that of the previous reviews. We found that changes had been made and that the trust was providing a safe chemotherapy service. We have had several conversations with a whistleblower about these issues.

“Our report was published in September 2015 with a reference to the whistleblower. It concludes that the trust has acted properly to concerns raised and taken steps to learn from the incident.”

Richards concludes by correcting errors in the published Care Quality Commission report.

“However, although our report went through a factual accuracy check, unfortunately there was a typographical error in it, which should have stated that the care the patients received was ‘not in line with practice at the time’. This has since been corrected.

“Making sure that patients get safe, high-quality and compassionate care continues to be our priority. If we receive information to suggest that patients are not being cared for appropriately then we will not hesitate to take action.”

As a result of the inappropriate conduct at the hospital, fifty-five cancer patients at New Cross Hospital were given extra chemotherapy treatment they did not need in a scandal revealed by an NHS whistleblower.

 
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German Scientists Use EVs to Repair Damage in Stroke-Impaired Mice

New research published in Stem Cells Translational Medicine could provide a real breakthrough in understanding and treating strokes.

A team of German researchers has discovered that extracellular vesicles (EVs) – tiny membrane-enclosed structures that travel between cells – can have similar efficacy in assisting the brain to recover from a stroke as adult stem cells.

The research was conducted at the University of Duisburg-Essen, where scientist administered EVs to a group of stroke-impaired mice, while another tranche of the mammals was treated with adult stem cells from bone marrow.

Following a four-week monitoring period, the researchers concluded that both groups demonstrated similar degrees of neurological repair.

Aside from the positive effect that EVs were observed to have on brain recovery, there was also evidence that they contributed to the modulation of post-stroke immune responses. Thus, there is hope that EVs can provide long-term neurological protection.

It is hoped that with further research that the study could lead to a new clinical treatment for ischemic strokes.

This would be extremely advantageous, as scientists involved in the study believe that EVs carry far fewer risks than adult stem cell transplants.

Team co-leaders Thorsten Doeppner, a neurologist, and Bernd Giebel, a transfusion medicine specialist spoke on the findings of their work, proclaiming it to be a significant breakthrough.

“We predict that with stringent proof-of-concept strategies, it might be possible to translate this therapy from rodents to humans, since EVs are better suited to clinical use than stem cell transplants,” said Doeppner and Giebel.

With the study promising huge potential to treat serious conditions in the future, further research is now being undertaken to investigate the role that EVs can play in treating cancer, infectious diseases, and neurological disorders.

Although this study was not the first to acknowledge the effectiveness of EVs in the post-treatment of strokes, the the Duisburg-Essen study is a pioneering effort in terms of its side-by-side analysis of EVs brain repairing qualities.

“The fact that intravenous EV delivery alone was enough to protect the post-stroke brain and help it recover highlights the clinical potential of EVs in future stroke treatment,” Doeppner and Giebel proclaimed.

The study was the result of a collaboration between ten researchers from Duisburg-Essen’s Department of Neurology and Institute for Transfusion Medicine.

Every year, around 110,000 people have a stroke in England and it is the third largest cause of death, after heart disease and cancer.

 
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