Looking at LINks Blog

Should NHS Direct stay or nay? Tell us what you think!

Wednesday, 01 September 2010 - Paula

(courtesy of bbc.co.uk)

The government has confirmed it is planning to scrap the NHS Direct telephone service in England and replace it with an alternative service.

A new 1-1-1 helpline is already being piloted in north-east England.

It was previously reported that the new service may replace NHS Direct, but now the Department of Health has confirmed it will definitely do so.

The move comes as the government curtails public spending, even though it has promised to protect the NHS.

The change will not affect existing NHS helpline services in Scotland and Wales.

Health Secretary Andrew Lansley announced the plan to scrap NHS Direct in England during a hospital visit this week.

NHS Direct currently employs more than 3,000 staff, 40% of whom are trained nurses. It is understood the ratio on the 1-1-1 helpline is "slightly less" in the pilot, but no figures are yet available for what will happen when the scheme is rolled out nationally.

Critics claim the change would undermine the quality of the service by reducing the number of qualified nurses answering calls, but chief executive of NHS Direct Nick Chapman told the BBC the new helpline would be better and more cost effective than NHS Direct.

He said: "More value for money doesn't necessarily mean that something will be worse. It will be a more seamless service."

He said the 1-1-1 helpline's telephone number would also be easier for callers to remember than the current NHS Direct one.

In June GPs urged the government to get rid of NHS Direct, claiming it was not cost effective.

The plan has provoked an angry reaction from Labour, with shadow health secretary Andy Burnham using it as evidence of what he claims is the government's intention to "dismantle" the NHS.

He said: "The health secretary's statement will stun people across the NHS.

"It is yet more evidence that Andrew Lansley is on a vindictive mission to break up the NHS, ruthlessly dismantling services before alternatives are in place."

Mr Burnham told the BBC that the government had shown "arrogance" and acted in a "cavalier" way by choosing to scrap NHS Direct without consulting the public.

He said the service saved the NHS £200m a year and played a key role in taking pressure off the health service.

He said: "It's been a proven success for a decade and simply to scrap it is no way to run the NHS."

Lord Prescott: "You know you are talking to a nurse or a doctor; to have a call service will not be the same."

Roughly 14,000 people a day call NHS Direct for medical advice, with the service costing £123m a year to run.

Former Labour health secretary Frank Dobson, who helped establish NHS Direct in 1998, told the BBC the decision to replace the service was "crackers," and said the professionally staffed advice line would be replaced with a "call centre".

His views were echoed by former deputy prime minister, Lord Prescott, who urged the public to sign an online petition he initiated to save the helpline.

He said people would lose trust in using the new service if it was staffed by fewer qualified nurses.

He told the BBC: "It will be a lesser service determined by saving money.

"(The government) told us they would cut the deficit, not the NHS. This is another promise broken."

Dr Peter Carter, chief executive and general secretary of The Royal College of Nursing , said reducing the number of specialist nurses who worked on the new helpline was "short-sighted."

He said: "We urge the government to consult fully and look at all the evidence before enacting changes which could leave people without expert advice from trained nurses."

Gail Adams, head of nursing for the public service union Unison, told the BBC that NHS Direct staff would be "devastated" by news that the service was to be scrapped.

She said the service's success was based on "compassionate nurses providing sensitive care," and that less qualified staff could not offer the same level of expertise and reassurance to the public.

BBC political correspondent Arif Ansari said NHS Direct had a "mixed record," with critics complaining that its staff were too cautious in their advice to callers.

"There are people who have used NHS Direct and say they did not get a lot from it," he said.

Mr Ansari said GPs were unhappy that many callers were unnecessarily referred to their local hospital when they did not require treatment there.

Mr Chapman said staff involved with the 1-1-1 helpline "pathfinder" in north-east England were currently working with the local ambulance service to handle calls relating to health information or inquiries about medicines.

He said the service would also be tested in the East Midlands and in the East of England, where helpline staff would also assist with nurse assessment, health information and referrals.

"When detailed plans are made to roll out the service nationally, we hope NHS Direct staff will be able to contribute their experience to the new service," he said.

Top eight cancer signs pinpointed

Friday, 27 August 2010 - VRC

(courtesy of bbc.co.uk)

The eight unexplained symptoms most closely linked to cancer have been highlighted by researchers.

The Keele University team also points to the age at which patients should be most concerned by the symptoms, which include blood in urine and anaemia.

The other symptoms are: rectal blood, coughing up blood, breast lump or mass, difficulty swallowing, post-menopausal bleeding and abnormal prostate tests.

Cancer Research UK said unusual changes in a person's health should be checked.

The researchers were looking for symptoms which gave a one in 20 or higher chance of turning out to be cancer.

Although this still represents a relatively low chance of anyone with the symptom having the disease, any suspicion of cancer can mean that the patient is sent for tests more quickly, in order to catch the disease as early as possible.

The figure for each symptom was calculated by combining the results of 25 previous studies.

They found that, if the patient was below the age of 55, there were only two signs which reached the 'one-in-20' threshold.

These were a rectal prostate examination which gave abnormal results, and a breast lump.

After 55, but only in men, there was evidence that difficulty swallowing could be a sign of oesophageal cancer, while blood in the urine was highlighted as a particular concern for men and women aged over 60.

Dr Mark Shapley, who led the research, said: "GPs should audit their management and reflect upon these cases as part of their appraisal to improve quality of care.

"There should be more open public debate on the level of risk that triggers a recommendation for referral by a GP."

Professor Amanda Howe, honorary secretary of the Royal College of General Practitioners, said: "It's useful to see these well-known 'red flag' symptoms and signs validated in primary care research, and reinforces the importance of encouraging patients to discuss worrying symptoms early with their GP."

However, a spokesman for Cancer Research UK said that these were by no means the only potential warning signs for cancer.

"The particular symptoms this study has highlighted are already thought of as important potential signs of cancer, but there are more than 200 different types of cancer, which cause many different symptoms.

"So if you notice an unusual or persistent change in your body it's important to get it checked out. When cancer is diagnosed at an early stage, treatment is often more likely to be successful."

Death of Marsden Chaplain, David Brown

Many of you who were treated at the Royal Marsden will remember the Chaplain, David Brown, with fondness.  As one of our LINk member remembers:
'...I tended to phone David whenever I had a problem connected with cancer;  his knowledge was profound, and he was able to give me much helpful information.  His advice was always sensible and practical, and helped when I was feeling lost and bewildered.'

David's funeral will be at Christchurch on Saturday, 4th September at 1 pm.  Christchurch is just off Royal Hospital Road, at the Cheyne Walk end.

A new NHS Trust for Kensington and Chelsea....

Friday, 20 August 2010 - Sarah

Central London Community Healthcare (CLCH) is the local community health services provider, formed from the alliance of the three boroughs of Hammersmith and Fulham, Kensington and Chelsea, and Westminster. CLCH provides over 60 community and in-patient services to a population of over 600,000 including:

• Adult community nursing services
• Child and family
• Rehabilitation and palliative care services
• Offender health services
• Continuing care services
• Specialist services
• Walk-in and minor injury services
• PMS and GwSI

Now that CLCH has formed, the next step is to become an independent NHS trust, recognised by the Department of Health, and from this progress to an NHS foundation trust. The K&C LINk is following CLCH’s progress and intends to maintain a close interest in the new organisation as CLCH develops services that respond to the specific needs of the local population and strives to raise the quality of patient care.

Osteoporosis needs managing – but NHS neglects to help

Tuesday, 10 August 2010 - VRC

Osteoporosis: Bone-Building Exercises are Best Defense

A rushed consultation in hospital delivered the news that now I had Osteoporosis;  a side effect of one of the drugs I was given to ‘help’ with cancer.

Gulping – I asked what could I do?

“Exercise”.  And that was that.

So off I went,  cycling even more than before, and going swimming whenever I could.

Then one day something said to me that I should get things properly checked out.  The hospital where I was being treated had given me such cursory advice that I should check things up.  Good thing I did, because I had been doing the wrong type of exercise.

Those with Osteoporisis need to do HIGH IMPACT EXERCISES, such as jogging, dancing, tennis, aerobics, walking, etc.

So if I hadn’t thought to ask, I would have been doing all that extra exercise for no extra benefit.  Makes you sick.

I sit on a LINk committee, and I am so mad at the lack of sensible advice I received (or didn’t receive) that when everyone comes back after summer hols I shall be hammering away demanding that in EVERY hospital in our area that treats cancer, the Physios give EVERYONE diagnosed with Osteoporisis an introductory course explaining what type of exercise we should undertake, and how it can best be incorporated into our lifestyle.

A recent article in www.HealthNewsDigest.com says, ” Current research on osteoporosis is focused on how exercise can help prevent and treat this condition.

Resistance is the key factor in both types of exercise that build bone: weight-bearing aerobic exercise and weight lifting. In weight-bearing exercise, your muscles resist the force of gravity to keep you in an upright position. In weight lifting, you apply resistance to the muscle to stimulate growth (hypertrophy) of the muscle fibers. In both cases, the pull of the muscle on the bone causes a parallel hypertrophy to the bone.

Exercise has a dramatic effect on the growing skeleton, which is why it is essential for children to be physically active. Once the skeleton stops growing, the effect of exercise on the bone is more modest. If you do not develop adequate bone-mineral density at an early age, your risk of osteoporosis increases in the postmenopausal years.

Protect your joints from injury, and use good judgment regarding high-impact exercise and high-intensity weight training.  Focus on strengthening the bony sites most vulnerable to fracture: the thighbone, the spine and the wrist.
Add balance training, such as stork stance and “tight rope” walk.

To improve your stability, incorporate exercises using the stability ball, BOSU and foam rollers.

From 50-plus and post-menopausal, the goal is to conserve bone and reduce the risk of falls and fractures.
Continue with strength training, balance and stability exercises.

If you are doing a walking program, be sure to vary your route to include hills and steps, adding intervals of increased speed or jogging, if appropriate.

Focus on stretching exercises to maintain your height and spinal alignment. Changes in posture become more pronounced at this age and can cause a shift in your center of gravity, increasing your risk of falling”.

And being an American website, they say “If you have been diagnosed with osteoporosis, check with your health care professional for exercise guidelines and restrictions”  !!!!

More information from National Osteoporosis Society:  www.nos.org.uk

For more information on getting involved with the design and delivery of cancer services, please contact the Cancer Sub-group via the K&C LINk office on ph: 020 8968 7049 or for those of you outide of Kensington & Chelsea please see the Macmillan User Involvement map