NG Healthcare Europe

Cancer drug giant Roche could cut jobs

Mon, 06 Sep 2010 11:59:00 +0100

Swiss pharma giant Roche plans to review its business and will likely cut costs in response to rising pressures on healthcare reforms and recent setbacks on key drugs, the company announced on Friday.

In a statement, Roche hinted at the failures of certain drugs by confirming they will "allocate resources to treatments and diagnostic tools providing the highest medical value." As a result, the new implementation will "not simply a cost-reduction effort but is above all about pro-actively setting the right priorities to ensure a successful future.

"In view of mounting pressures to curb healthcare costs -- especially in the United States and Europe -- together with recent developments in late-stage projects in the Roche pipeline, this initiative aims to adapt cost structures and accelerate productivity improvements group-wide."

Roche is the largest player on cancer drugs, but investors are currently waiting for the FDA's approval on its newest blockbuster, the breast cancer drug Avastin.

Chief executive Severin Schwan confirmed the initiative has been launched "from a position of strength". He added that "by contrast with many of our competitors, we are only marginally affected by patent expiries. Furthermore, despite the recent setbacks, we have one of the strongest R&D product pipelines in the industry".
Roche wasn't forthcoming in divulging numbers or cost savings, and confirmed that more comprehensive details would be announced later this year, and likely implemented in 2011 and 2012.

"Cost savings could easily reach two billion Swiss francs ($1.9 billion) as of 2012 to 2013, which would boost our earnings per share forecast by some 10 percent," said Helvea analysts Odile Rundquist and Karl-Heinz Koch.

"They will mainly be looking at the primary sales force and R&D for cuts, which will be mostly in the United States and Europe," said Sarasin analysts David Kaegi.

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Microsoft launches Healthvault

Wed, 23 Jun 2010 09:28:00 +0100

Three years after Microsoft launched its HealthVault cloud-based health-organiser platform in the US, it has announced the platform has launched in the UK.

HealthVault is designed to allow organisations to develop applications that led individuals monitor various aspects of their physiological performance, based on user-supplied data such as body mass index, blood pressure and heart rate.

"HealthVault is aimed at the 13 percent of the UK population who are actively engaged in monitoring their wellness," Dave Coplin, Microsoft's national technology officer said.

HealthVault allows individuals to store their own and their family's health information in a secure cloud-based storage system. Users control who can look at the data by specifying which applications and organisations have access rights, and can also audit who has accessed the data.

Developing HealthVault

In the UK, Microsoft has worked with Nuffield Health on applications for HealthVault, and hopes to talk to organisations such as the British Heart Foundation and the British Diabetic Association to develop monitoring apps.

John Coulthard, Senior Director of Healthcare and Life Sciences at Microsoft UK, said, "Not only does HealthVault put users in charge of their own health data, but it also offers huge opportunities for organisations in the healthcare ecosystem to build applications and services that help people engage in their health and wellness."

Microsoft has provided a software development kit (SDK) for developers based on Microsoft's .Net platform. For open source and developers on different proprietary platforms, Coplin said that HealthVault had a set of application programming interfaces (APIs) available on CodePlex, Microsoft's open-source repository, which would allow coders to develop languages including PHP and Python.

Microsoft has no plans to allow information exchange between HealthVault and NHS systems such as Summary Care Records. In addition, Microsoft said it would not at present integrate HealthVault with the NHS health organisation suite, HealthSpace.

Applications which interact with the HealthVault database must comply with Microsoft security and privacy policy, said Coplin. The cloud platform will be hosted in the UK at the same data centre as used by government organisation the Child Exploitation and Online Protection Centre (CEOP). Under European data protection law, citizen information must not be sent outside of Europe without consent. The UK data centre is administered by UK technology company Attenda.

Law enforcement and the intelligence services will only have access to the information should they present a warrant, said Coplin.

Jodie Humphries

Jodie Humphries graduated from Bath Spa University with a BA Hons in Creative Writing in 2008. She has worked for GDS Publishing for the digital group since July 2009. She has previous experience with writing for the web, running her own website since April 2007.

Has the answer to killing MRSA been found?

Tue, 22 Jun 2010 16:05:00 +0100

As the fear of the spread of MRSA continues, the news that a UK company has developed a 'green' sterilising solution which is powerful enough to kill life-threatening germs, such as MRSA, C.Diff and Salmonella, but is completely harmless to humans and the environment, could be a lifeline.

MRSA is a bacterium responsible for several difficult-to-treat infections in humans. Infections occur mostly in hospitals and healthcare facilities, with a higher incident rate in nursing homes or long-term care facilities.

HypoTech Ltd, based on the Isle of Wight, has for a number of years been developing the eco-cleansing solution, which replicates the human defence mechanism. The company has focused on making the natural biocide stable enough to be used in commercial and healthcare applications. The company says it has now come up with a product that is not only environmentally friendly, but has the necessary shelf life to be used in workplace and healthcare environments.

"The biocide has the potential to revolutionise how people work, the quality of our food and drink, how our hospitals operate and how we go about our daily lives," said Dan Spacie, chief executive officer of HypoTech.

"It is a major asset to both the public and private sector with the need today for both environmental and financial cost savings," he went on to say.

How does it work?

The solution mirrors the human chemotaxis process and produces the same active biocidal hypochlorous acid (HOCI), making it powerful enough to combat germs, such as MRSA, C.Diff and Salmonella, but without the toxins, irritants and chemicals associated with powerful sterilising solutions currently on the market. Its environmentally friendly properties also mean there are no hazardous waste disposal issues associated with the solution and its developer says it also saves on water and energy because there are no requirements to rinse it and it can be used in a cold environment.

HypoTech said it was working with a number of partners to bring its solution to market following positive initial testing and said it expected strong worldwide sales.

"We are engaged in hospital, food and drink production, catering, general health and defence markets," said Spacie.

The solution is available in liquid, spray and wipe form and HypoTech has developed a number of variants to suit different markets, including medical sanitisation, hospitality, beverage manufacturing and food production and preparation.

Jodie Humphries

Germany seeks healthcare reform

Mon, 21 Jun 2010 16:14:00 +0100

German Chancellor Angela Merkel's coalition partners indicated have indicated over the weekend that they are nearing a decision on a healthcare reform. The reports come after months of bitter discord.

Members of Merkel's Christian Democrats (CDU) and the junior Free Democrat (FDP) coalition partner said they were making progress on plans to reduce a projected €11 billion deficit in state-backed healthcare funds by 2011.

The proposed healthcare reform is one of many issues which has prompted much squabbling within the centre-right government coalition.

One issue has been a proposal by Health Minister Philip Roesler of the FDP to charge individuals a monthly healthcare premium of €30 euros, irrespective of income.

The proposal has been vehemently opposed by Merkel's Bavarian coalition partners, the Christian Social Union (CSU).

"We are optimistic that we will meet the savings target of €4 billion," Roesler said after the first day of a healthcare summit.

Raising salaries - healthcare reform

During the discussions on the healthcare reform, it was questioned whether to raise the levy on German salaries which pays for the health system.

But experts on the economics of healthcare say the Merkel government is shirking the bigger question that also slipped by US President Barack Obama: how to lower the bill for treatment. As a rich country, Germany can easily fight off something like one dangerous virus.

When H1N1 swine-flu arrived last year, the German states swiftly launched a free-vaccination programme that cost €283 million euros. The programme proved a fiasco, with only seven percent of Germans lining up for their jabs. Millions of doses remain unused. That reinforced a perception that waste is rife in healthcare. About 90 percent of Germans buy health insurance from state-supervised funds. Roesler officials say the funds face a deficit of €11 billion next year as costs race ahead of their income.

Reports of waste have increased pressure on Roesler, who came to office last year with promises of reform, to reduce spending before he tries to increase the premiums Germans pay into the regulated system.

Little has come of Roesler's call in March this year to end the power of pharmaceuticals companies to set their own prices for patented drugs.

He proposes that all wage-earners pay a minimum base rate, plus a surcharge based on incomes. Analysts say this would mean a hike in contributions for many of the customers compared to the levies they pay at the moment.

In the next four decades, the number of working-age Germans paying into insurance schemes will sink from 50 million to 36 million. Combine that with the blessing of longer lives. Caring for the elderly, many of whom develop multiple chronic health problems, is the most expensive part of healthcare.

Jodie Humphries

27 e-health projects launched

Thu, 17 Jun 2010 10:22:00 +0100

27 e-health projects are to be launched this year by the European Union following a call under the EU Framework Programme 7 (FP7).

FP7 funds will be used to support research into monitoring systems for patients with chronic diseases. In particular, such tools should provide improved quality of life for chronically ill patients, enabling them to stay at home rather than have to be admitted to hospitals.

The Seventh Research Framework Programme, which is set to run until 2013 with a budget of €50 billion, has launched projects in three key areas; ICT for personal health systems, ICT for patient safety, and international cooperation on virtual physiological human research.

The EU's Research and Development Framework Programmes aim to bring together teams from different organisations and EU countries, to combine knowledge and experience to improve the standard of living for people in Europe.

Personal Health Systems

The projects around Personal Health Systems look at key technologies, such as biosensors and secure communications, which can be built into 'smart clothes' and implants which help patients and their doctors monitor and manage their health status.

Newly launched projects include the ICT4Depression consortium. Major depression is currently the fourth ranking disorder worldwide in terms of disease burden, and is expected to be the disorder with the highest disease burden in high-income countries by 2030. Estimated costs of depression are annually 177 and 147 million euro per 1 million inhabitants for major and minor depression respectively. Current treatment methods for depressive disorders can reduce the burden of this disease with about one third.

ICT4Depression consortium is developing ICT-based system for primary care to improve access to treatment by providing devices for monitoring activities and automatic assessment of the patient using mobile phone and web based communication.

Patient Safety projects address developments around software tools to help health professionals have the greatest possible information available to them whenever they make decisions which may have an impact on patient safety.

In addition, the Virtual Physiological Human is a network of researchers in the fields of bio-informatics, genomics, and neuro-informatics to help create a new generation of e-health systems to assist them in disease prevention, diagnoses and treatment.

Other new projects in the 27 e-health projects include AP@home, Bravehealth, iCARDEA and interstress.

Jodie Humphries

Focus on homeopathy with Homeopathy Awareness Week

Tue, 15 Jun 2010 15:53:00 +0100

This week is all about Homeopathy Awareness Week in England, celebrating the 10th anniversary of awareness in the country; it was originally founded by the Society of Homeopaths in 2000. For summer 2010, the theme is 'Women's Health'.

The week, sponsored by Nelsons, will run from 14 June to 21 June, with events including a makeover of Nelsons Homeopathic Pharmacy in London's Mayfair to recreate a Victorian pharmacy, the company says. This year Nelsons is celebrating its 150th birthday.

Homeopathy Awareness Week's theme for 2010 is 'women's health' and this theme offers a range of opportunities to educate women of all ages about homeopathy, covering a wide variety of ailments. Homeopathy has a large range of remedies which can help support women's health through the ages, from grandmothers to mothers and daughters.

Establishing homeopathy

Homeopathy itself is a 200-year-old system of treatment, developed almost single-handedly by a German physician, Samuel Hahnemann, which uses highly diluted substances - sometimes so none of the original product is left - that are given orally in the belief that it will stimulate the body's self-healing mechanism.

The homeopathy industry is worth around GBP£40 million in the UK, and around €400million in both France and Germany. While this may seem small compared to the mammoth size of the pharmaceutical industry, real drugs have to be proven to be effective before being licensed in the UK - something the homeopathy industry does not have to prove, and something they would be entirely unable to prove.

Despite the size of the European market for homeopathy, the British Medical Association recently called homeopathy "witchcraft", and a parliamentary committee recommended stopping all NHS funding for it.

Homeopathy trials

The debate is set to continue over whether remedies make patients healthy. Today we have about 150 clinical trials of homeopathy. Typically they test the effectiveness of homeopathy by treating one group of patients with homeopathy, while a comparable, second group receives placebos, i.e. sugar pills that only look like the real thing.

These trials have generated vastly different results: some suggest homeopathy works, others fail to do so. The results of these various trials mean that both sides of the debate have arguments to pick when it comes to fighting their corner. This is likely to cause even more debate though.

Many researchers across the world have reviewed the evidence and concluded that homeopathic remedies are pure placebos. Five years ago, The Lancet even announced "The Death of Homeopathy".

As a result, one of the five NHS-funded homeopathic hospitals had to close. After assessing the science, its NHS trust found that the evidence did not justify any further funding.

But homeopathy did not die. In fact, it continues to thrive and now boasts many supporters, who say, "We are not stupid, we have experienced benefits and therefore know it works."

Homeopaths ignite the debate further by claiming that the clinical trials are artificial, inadequate research tools. They show us "real-life" studies where patients are monitored over time but are not compared to a placebo group. These observations invariably demonstrate impressive success rates after homeopathic treatments. So, we seem to be confronted with a perplexing contradiction: homeopathic remedies are placebos with no specific effects, but in "real life" they seem to work.

The solution to the conundrum is quite simple, however: the remedy does nothing and the homeopath does everything.

If you see a homeopath, you are typically asked many very detailed questions. The whole encounter lasts for about an hour, and at the end you receive a prescription. The remedy is a placebo but, never mind, the consultation and the expectations it raises have important effects.

Jodie Humphries

Rise in hospital deaths at weekend

Mon, 14 Jun 2010 13:19:00 +0100

No one wants to hear that they're more likely to die if they visit a hospital at the weekend. It's shocking for patients, but also for the doctors on duty who will face more pressure. But according to new research, there is a rise in hospital deaths over the weekend.

The new study is the largest ever to look at the differences between weekend and weekday mortality, focusing on the deaths of patients admitted as emergencies to 163 acute hospital trusts in England during 2005/06.

The figures showed that hospital patients in England are much more likely to die if they are admitted to a hospital over the weekend, rather than on a week day.

It's believed that a reliance on junior doctors as well as a lack of specialist services over the weekend period, are two reasons that are being cited to explain why the death rate at hospitals across England increased by seven percent at weekends over the 2005-06 period, research from the Dr. Foster Unit and the Department of Acute Medicine at Imperial College London found, reports Nursing Times.

3,369 more hospital deaths

The study found that the seven percent rise equates to 3,369 more deaths than would have been expected during weekday hours.

Dr. Paul Aylin, senior author of the Dr. Foster Unit at Imperial College London said: "Staffing levels are often lower at weekends, with fewer senior medical staff around, and some specialist services are less available. We believe this may be contributing to the increase in mortality rates on Saturdays and Sundays but we would like to see more research.

"Hospitals have been reassessing the working hours and rotas of their doctors and, considering the impact that staff availability may be having on mortality rates, this is a timely reminder to hospitals that they must take care not to jeopardise the quality and standard of patient care available at weekends when devising new staffing rotas."

The findings add further weight to a separate report published recently which found that the NHS was "too reliant" on junior doctors who are often left to work unsupervised on wards overnight and at weekends.

Some older consultants are reluctant to work later hours and prefer to stick to a standard week, which affects trainees, according to the review's author, Professor Sir John Temple.

In a critical study of the way consultants organise their workloads, Sir John said the service would need to be redesigned so consultants work more flexibly and are more "directly responsible" for patient care around the clock.

Sir John said that the need for junior doctors to 'fill gaps' in rotas meant that they did not have enough time with senior staff for training, resulting in inexperienced staff working without sufficient training during unsocial hours.

Jodie Humphries

Do you take a break at work?

Thu, 10 Jun 2010 13:29:00 +0100

Do you take a break at work, or do you find yourself working straight through your designated breaks? New research has found that one in four people in the UK often work all day without taking a break.

The research of 3,000 people by the Chartered Society of Physiotherapists found that more than half of those surveyed went to work when they were feeling unwell or stressed.

The reason given for the cause of stress, and why breaks were skipped, was staff shortages. While work can contribute to people's mental and physical well-being, overworking can lead to health problems, the CSP warned.

While a quarter of those polled took no lunch break at all, a third worked through most of theirs. Half of those who did so said it was because they had too much work to do, and a third because there were not enough staff to do the work required.

Causing physical pain

Working in the same position for long periods at a time meant many complained of physical pain, the report found.

The CSP warned that poor working practices increased the risk of chronic musculoskeletal disorders, like back pain - one of the most common reasons for long-term sickness leave in the UK.

Long-term absence is a particular problem. Although it only accounted for five percent of absences in the latest CBI/Pfizer Absence and Workplace Health Survey, the longer periods meant that it accounted for 20 percent of lost days in the private sector and 36 percent in the public sector. Back pain and mental health issues are key causes of long-term absence, according to the survey.

Berkeley Phillips, UK medical director, Pfizer, said: "We have long known that mental health, back pain and other musculoskeletal disorders are the leading causes of long-term absence, and this year's CBI report reinforces this. While employers view loss of productivity as the main impact of absence, as this report highlights, the economic consequences stretch much further and, as such, we as a society, need to do more to advance health and wellness at every stage of life."

Stress was also an issue the CSP found, with more than 40 percent feeling stressed at least once a week. For many of these people, staff shortages and a heavy workload were at the root of their anxiety.

Last year, the health watchdog NICE urged employers to do more to tackle stress and anxiety in the workplace.

Cost of sick days

Sickness absence and "sickness presence", when staff come to work feeling unwell, is estimated to cost employers and society about GBP£35 billion each year in reduced productivity, sick pay and benefits.

Employees in the UK took 180 million sick days last year, averaging 6.4 days each.

At least some of this could be recouped through healthier working practices and helping employees access treatment for musculoskeletal disorders, the CSP said.

"Work is good for us and can contribute to our physical and mental well-being - but not when overworking means people don't have the time or energy to look after their own health or when staff are at work but not fit for work," said Ann Green, chairman of the CSP.

Ben Willmott, of the Chartered Institute of Personnel and Development, said: "These findings should ring alarm bells for employers.

"A certain level of pressure at work is of course desirable. However when the pressure people face exceeds their ability to cope - in other words stress - it is likely to lead to time off work and is linked to conditions such as depression, anxiety and heart disease."

If you take a break at work, you are taking yourself away from a short space of time, and giving yourself time to unwind and move yourself away from the daily grind and move your mind to something that relaxes you.

Jodie Humphries

Electronic medical records - will the go-ahead continue?

Tue, 08 Jun 2010 15:14:00 +0100

Storing medical records online, a good idea or a bad idea? Well it would appear that the government have decided that the centralised electronic medical records are a good idea, despite the fact that the coalition hinted that they could be scrapped.

Summary Care Records (SCRs) - electronic records of a person's allergies and drug prescriptions, were developed as part of the previous Labour government's GBP£12.7 billion plan to revamp NHS IT.

Work began in November last year in England to create individual patients' records. The aim of SCRs is to make it easier for doctors to treat patients who they are not familiar with, for example, when a patient is treated in the A&E department of a hospital outside of the county where they live.

Uploading of electronic medical records will continue

Speaking in the House of Commons late last week, health minister Simon Burns said: "Uploading of information to the summary care record will continue to take place."

The creation of SCRs was temporarily halted earlier this year due to concerns over whether patients understood that they would automatically have an SCR created unless they chose to opt out.

According to Burns, SCRs will now only continue to be created in areas of England where it is felt patients understand the records are being created and that they have the ability to opt out of having an SCR created for them.

Then only last month, the NHS was accused of scaring patients into agreeing to have their personal details on the electronic records database. It was reported that the agency charged with rolling out the new system was warning of "adverse consequences" if people choose to opt out of the computerised network.

A document posted on the website of NHS Connecting for Health listed several dangers to patients if they continue to have their medical information stored on paper files.

Contrasting report on electronic medical records

The move comes in contrast to a report produced by Norman Lamb, the then Liberal Democrat health spokesman, in February this year which said: "The National Care Records Service should be abandoned.

"The strategy for the future should be based on local connectivity between primary and secondary health care and social care," silicon.com reported.

Last year, the Conservatives also proposed dismantling central IT infrastructure in favour of introducing common data formats for storing medical records in hospitals and GP surgeries across England.

Jodie Humphries

Should the NHS pay people to lose weight?

Mon, 07 Jun 2010 11:51:00 +0100

Last week we reported on EHM that America companies were taking action against obesity by offering their employees incentives, including money, to lose weight. Now NGH EU reports that it's being claimed that the NHS should offer money for people to lose weight.

Two thirds of British adults are either obese or overweight and it has been forecast that this could increase to nine in ten by 2050 if no action is taken.

It has been said that paying people up to GBP£3,000 to lose weight is much more successful than traditional diets, and should be rolled out across the NHS.

The founder of the scheme 'Pounds for Pounds' said that people who are paid according to how much weight they lose, and if they keep it off are more successful than those on traditional diets.

Winton Rossiter, founder of Weight Wins, said dieters who completed the programme lost on average two stone, or around 12 percent of their body weight, which was twice as much as those not being paid.

Should the NHS be spending money is this way?

Some will question if the NHS should be spending money in this way, especially as operations are being banned and staff are facing redundancy in order to save the health service GBP£20 billion over the next five years, the British paper The Telegraph reports.

The scheme included 402 people who were sponsored by the NHS Eastern and Coastal Kent. A spokesman said the results were "mixed" and three quarters of people dropped out before the end of the scheme despite the financial incentive on offer.

The programme works by adding up how much weight each participant has lost and how long it remains off for before applying a sliding scale of payments. Those who lose the most and keep it off earn the most money.

Winton Rossiter, founder of Weight Wins, which ran the trial, said: "We are absolutely thrilled with these results, which suggest that long-term financial incentives could be the best single weapon in the war on obesity. I urge the NHS and employers to adopt such schemes widely for the benefit of their patients and employees. I am so confident this works that, for our part, I am willing to guarantee results."

Losing the body weight

In the trial, 45 percent of participants lost five percent or more of body weight, deemed to be medically significant, and one patient lost eight stone.

The company is opening its trial to members of the public and increasing the maximum reward to GBP£3,000 for a weight loss of more than 10 stone (150lbs), which must be achieved and maintained over two years.

Data published on the 745 dieters found people lost more than a stone on average (7.2 percent of their body weight). This was more than double that of traditional dieters in a control group (5.5lb), the Press Association report.

The results include 402 people sponsored by NHS Eastern and Coastal Kent Primary Care Trust as part of a pilot, 36 percent of whom were men.

Only one in 10 of the dieters joined a weight loss group to reach their goal and just 24 percent belonged to a gym, 66 percent succeeded on their own by eating more sensibly and taking moderate exercise.

Participants pay a one-off registration sum of GBP£45 plus GBP£10 a month.

The Department of Health obesity strategy launched under the Labour Government suggested financial incentives could be used to encourage weight loss after similar programmes have shown some success in America.

A Department of Health spokesman said: "The Government wants people to eat well and be active as this will help them live longer. The NHS must focus on prevention to tackle public health challenges - including obesity.

"Any incentives to help people change their behaviour must be based on sound evidence."

Final rewards range from GBP£80 to GBP£3,000, depending upon the length of the plan and how much weight needs to be lost. People can either pay a monthly fee or they can be sponsored by their employer, insurer or local NHS trust.

Jodie Humphries

Knowing infection rates

Thu, 03 Jun 2010 16:01:00 +0100

Infection rates in hospitals have always been an area of concern. In fact, according to Richard Verdiramo of HandGiene Corp, who recently wrote an article for Next Generation Healthcare Europe, in the European Union, approximately four million illnesses and 37,000 deaths per year are attributable to healthcare acquired infections (HCAI).

Hospital acquired infections result in 16 million extra days of hospital stay at a cost of €5.5 billion per year. HCAI seems to increase the risk of death three times, compared to the mortality rate of uninfected patients with the same pathology. Hand washing and hand sanitising seriously reduce the risk of HCAI as well as reduce the cost. One study showed that a 10 percent reduction in HCAI cases in hospitals would save five times the cost of prevention efforts.

Since 2008, when NHS trusts across England and Wales began promoting hand hygiene to reduce HCAI, there has been a significant decrease in episodes of HCAI: 57 percent less of reported multi-drug resistant Staphylococcus aureus (MRSA) episodes, 61 percent less of Clostridium Difficile (C. difficile), and 40 percent less of all other reported episodes.

Nonetheless, infection incidence and the resultant suffering, disability and death are still too high. Even one careless person can wreak havoc.

Infection rates in hospitals

As healthcare acquired infections are a subject that should be of concern, the UK government has taken some form of action. People will be able to check the weekly MRSA and Clostridium difficile (C diff) rates at their local hospital.

From early next month, infection figures for all hospitals in England will be published every seven days on the data.gov.uk website.

But is this really the answer? Sure it will keep the population informed about their local hospital, but will it cause scaremongering? Isn't there the risk it will scare people away from visiting hospitals?

Health Secretary Andrew Lansley said to the Press Association, "This is an important step towards our broader plans to provide more relevant information to patients.

"It will enable people to make meaningful choices because they will be able to make comparisons between different hospitals and healthcare organisations.

"We want to make the large amounts of data that are already collected and used internally in the NHS work for patients, not just managers."

Jodie Humphries

Is manual observation the answer?

Wed, 02 Jun 2010 11:11:00 +0100

In this day and age, everything is about technology, from using our phones to keep our lives in check, through to electronic healthcare records instead of our usual paper records, through to ehealth. But is all this technology really the answer for healthcare? Has technology in healthcare gone over the top and is manual observation really the answer?

Nurses across the UK are returning to manual observations, following evidence that reducing reliance on technology can dramatically improve care, Nursing Times has reported. It's reported that trusts are abandoning or planning to reduce their use of automated machines that take blood pressure readings, amid fears that they make it more difficult to monitor vital signs.

Installing an old-fashioned sphygmomanometer beside every hospital bed may seem at odds with 21st century quality healthcare. However, recalling this "key cornerstone in nursing provision from the past" has already contributed to a 30 percent reduction in unexpected cardiac arrest outside critical care that Salford Royal NHS Foundation Trust has achieved since signing up with Patient Safety First in 2008.

"At first the idea that taking blood pressure manually could be the more accurate option seemed crazy," recalls Peter Murphy, Assistant Director of Nursing for Quality Improvement. "In fact it makes good sense. When you take blood pressure manually, you also check the pulse and touch the patient's skin and look at their face, [which are] all very important clinical observations. Having a nurse on hand to explain what's happening, especially if there is a problem, is a better experience for the patient."

At Medway Foundation Trust, critical care consultant nurse Catherine Plowright is planning to replace automated machines in a surgical ward with traditional sphygmomanometers for a trial period this summer.

"Standing with the patient and talking to them may well be the thing that makes the difference in picking up vital signs," she said.

She said the move had attracted "mixed responses" from clinical staff, but monthly observation audits will reveal whether it has helped staff detect signs that patients' conditions are deteriorating at an earlier stage.

George Elliot Hospital Trust system

George Elliot Hospital Trust is introducing a system in the next three months where all blood pressure readings taken with automated machines will then be checked against manual readings.

Director of nursing, quality and workforce Dawn Wardell said: "We're using much more machinery now. There's a whole piece of work that needs to be done to show us whether we should keep [technology] across the board."

She hopes to gather evidence as to whether the two techniques produce different results.

A Nursing Times survey last year found 85 percent of respondents used automated technology to monitor vital signs. But 42 percent felt reliance on this equipment could make nurses less likely to identify, or act on, signs of patient deterioration.

Patient observation and the deteriorating patient is one of the central elements of a National Patient Safety Agency drive to increase engagement with nurses.

NPSA head of patient safety (deterioration) Kate Beaumont said there needed to be a debate as to whether there should be a wholesale return to manual observations, particularly for blood pressure readings.

She said: "It seems to be more accurate when someone has an abnormal blood pressure, particularly when it's low. But more importantly, it encourages and promotes an improved patient assessment by nurses because it encourages nurses to touch, feel and press."

Jodie Humphries

Drug tests via exhaled breath

Fri, 21 May 2010 11:53:00 +0100

A new technique which enables drug tests via exhaled breath has found to be possible. A new study from the Swedish medical university Karolinska Institutet presents a new technique that makes drug testing possible through exhaled air for the first time.

The researchers found by examining people who had received emergency care for an amphetamine overdose, that in all cases there were traces of amphetamine andmetamphetamine in the exhaled breath.

Professor Olof Beck, who led the study, said, "Traditionally, drugs tests have been carried out using urine and blood samples."

"In recent years we've been trying to find simpler alternatives using saliva, which, unfortunately, has proved difficult. Our results open the way for a new kind of drugs test, which is simple and safe to conduct and that requires no integrity-violating monitoring or medical staff."

Drug abuse and drug tests

Around the world, drug abuse is a huge social problem and drugs tests are used widely and comprehensively by not only the healthcare and social services, but by the legal system, at workplaces and schools.

Reliable drugs tests are important for making correct diagnoses and for keeping tabs on drug users to ensure that they are following their prescribed treatment. Alcohol use can easily be checked in a breathalyser, and the technology is available for conducting measurements in a way that does not violate a person's integrity. Measurements of other substances in the exhaled breath are also available for diagnosing diseases such as cancer, asthma and diabetes.

The study, which was published in the latest issue of the Journal of Analytical Toxicology, saw scientists at Karolinska Institutet develop a new and unique method for collecting narcotic substances from the exhaled breath.

To develop the methods, they asked their subjects to breathe into a specially designed mask for ten minutes. From there, the exhaled air was collected and passed through a filter, which trapped the narcotic substances. These filters were then analysed using combined liquid chromatography and tandem mass-spectrometry, techniques that are highly sensitive and reliable.

Collecting samples

The researchers took samples from 12 patients who had been admitted into emergency care with toxic symptoms after having taken amphetamines. The samples were taken after the effects of the drug had worn off and with the permission of the regional ethical review board in Stockholm. The ingestion of the drug was confirmed in the patient group through urine and blood samples.

In all cases, the researchers were able to ascertain the presence of amphetamine and metamphetamine (a narcotics-classed central-stimulating substance similar to amphetamine) in the exhaled breath as well. The measured excretion rate was between 0.2 and 139 pg/min, which is very low compared to the blood and urine. No amphetamine ormetamphetamine were detected in samples from healthy controls.

"The results are convincing and very promising," said Professor Beck.

"The study is the first to report the possibility of measuring drugs in the exhaled breath, and represents a unique, unexpected finding. We now have to move on to other drugs that are of interest for this type of breath test, and to develop the sampling and analysis methods. An instrument like a breathalyser for drugs would be the optimal solution for the efficient control of drug use by motorists, for example."

Jodie Humphries

Eye operation options

Fri, 14 May 2010 11:07:00 +0100

According to a report published in the latest issue of The Cochrane Library, an eye operation which is normally reserved for patients with severe nearsightedness may be a safer alternative to standard laser eye surgery for patients with less severe forms of nearsightedness.

Researchers at Moorfields Eye Hospital NHS Foundation Trust in London reviewed three clinical trials that randomly assigned patients to different types of surgery used to correct nearsightedness (myopia).

Myopia is the leading cause of vision impairment around the globe, according to the World Health Organization. In the US, 32 million people aged 40 and older are myopic.

While in the UK, a quarter of Britons are short-sighted and the popularity of laser surgery to correct the condition has soared. A procedure involving insertion of an artificial lens may be set to challenge its dominance.

Common surgical procedures in eye operations

The more common surgical procedure, excimer laser refractive surgery, treats myopia by removing parts of the cornea. The second procedure, which is relatively new and not used as widely, implants a thin lens called aphakic intraocular lens (IOL ) permanently into the eye to eliminate the need for eyeglasses or contact lenses. Both procedures change the path of light entering the eye and bring images into sharper focus.

In laser surgery, a razor-thin layer is shaved from the outer surface of the eye, the cornea, to focus light from an image in the right place on the retina. The new surgery achieves the same effect by inserting an artificial intra-ocular lens, known as a "phakic", in front of the natural lens.

In the first systematic review comparing the two methods, published online by the Cochrane Library, researchers say the insertion of the lenses had advantages. Allon Barsam, of Moorfields Eye Hospital in London, said: "The worst outcome of either procedure is that after treatment, even with glasses, your vision is worse.

"We found that patients who had lenses inserted were less likely to have lost vision than patients who had laser treatment. One problem with lasers is that you can't go back and [restore a layer of the cornea] but you can remove the lens."

The lens method has a slightly higher risk of cataract and further tests are needed, Dr. Barsam said.

The researchers' conclusions were based on three clinical trials that included a total of 228 eyes in 132 men and women ranging in age from 21 to 60. The patients had moderate to severe myopia, WebMD state.

Jodie Humphries

Risks of working overtime

Wed, 12 May 2010 11:59:00 +0100

We all do it, spend that extra time in the office to get that piece of work finished or get a little extra research done. But have you considered what the impact of doing extra work can have on your health?

According to new research, working overtime can have an effect on your health. People who regularly put in overtime and work 10 or 11-hour days increase their risk of heart disease by nearly two-thirds.

The findings come from a study of 6000 British civil servants, which was published online in the European Heart Journal. Men and women aged between 39 and 61 took part in the study, and were followed for an average of 11 years.

The research found, after accounting for known heart risk factors such as smoking, those who worked three to four hours of overtime per day ran a 60 percent higher risk.

One or two hours' overtime made no difference to people's health, the researchers from University College London and the Finnish Institute of Occupational Health found.

Experts involved in the study said the findings highlighted the importance of a good work-life balance.

Finding time to relax

Overall, there were 369 cases where people suffered heart disease, which caused death, had a heart attack or developed angina.

The research found that the number of hours spent working overtime appeared to be strongly linked in many of the cases.

People who spend more time at work have less time to exercise, relax and unwind. They may also be more stressed, anxious, or have depression.

The researchers stated that a career-minded person will also tend to be a "Type A" personality who is highly driven, aggressive or irritable.

"Employees who work overtime may also be likely to work while ill - that is, be reluctant to be absent from work despite illness," they added.

Lead researcher Mianna Virtanen, an epidemiologist at the Finnish Institute of Occupational Health in Helsinki and University College London, said: "More research is needed before we can be confident that overtime work would cause coronary heart disease."

Cathy Ross, senior cardiac nurse at the British Heart Foundation, which part-funded the research, said: "This study raises further questions about how our working lives can influence our risk of heart disease.

"Until researchers understand how our working lives can affect the risk to our heart health, there are simple ways to look after your heart health at work, like taking a brisk walk at lunch, taking the stairs instead of the lift, or by swapping that biscuit for a piece of fruit."

Jodie Humphries

Dirty tactics and the electronic records database

Tue, 11 May 2010 11:46:00 +0100

The electronic records database has received much criticism, probably more criticism than compliments. Previous warnings have stated that the centralised database could be open to abuse. While in April, some parts of the country faced delays as the upload of personal details onto the electronic records database was delayed until the public were made more aware of what the upload involves.

Electronic records are central to the NHS computer upgrade in England. The records are set to contain basic details like name, allergies, medication and adverse reactions, with further details possibly being added over time, they are intended to replace the current system, under which health records are written on paper files in GPs' offices and cannot easily be accessed by hospital staff.

Yet, the NHS has been accused of scaring patients into agreeing to have their personal details on the electronic records database. It's been reported by the British paper The Telegraph that the agency charged with rolling out the new system is warning of "adverse consequences" if people choose to opt out of the computerised network.

NHS document on the electronic records database

A document posted on the website of NHS Connecting for Health lists several dangers to patients if they continue to have their medical information stored on paper files.

The document states that "The information in your SCR (summary care records) could save you and the NHS time, but could also one day be lifesaving. The NHS has significant problems with lost records and test results and treatment and prescribing errors."

Yes, the NHS is admitting it has problems, but this just sounds like scare-mongering designed to get you to give your consent.

It goes on to state that "Healthcare staff treating you may not be aware of your current medications in order to treat you safely and effectively.

"Healthcare staff treating you may not be made aware of current conditions and/or diagnoses leading to a delay or missed opportunity for correct treatment.

"Healthcare staff may not be aware of any allergies/adverse reactions to medications and may prescribe or administer a drug/treatment with adverse consequences."

While acknowledging confidentiality risks over the digital database, the document continues: "It is ... misleading to suggest that not having such a record is risk free."

Information about more than 1.25 million patients have already gone on to the electronic records database, which eventually could hold up to 50 million records.

Jodie Humphries

Healthcare IT providers

Mon, 10 May 2010 16:07:00 +0100

In recent years, healthcare IT has become more and more important. And as hospitals invest in healthcare IT, IT providers provide a more significant role than they ever have in healthcare.

As such, I'm sure many were eagily awaiting the results of Garnter's latest IT services worldwide market share report. The report found that Dell is the number one healthcare IT services provider in the world. The report also ranks Dell second for computer hardware support in the education market.

Gartner, one of the world's leading information technology research and advisory company's, based the report on 2009 revenue. The results reflect the combined revenue of both Dell and Perot Systems, which was acquired by Dell in 2009, creating a new business unit called Dell Services, reports eHealthnews.

Healthcare services market

Dell's leadership in the healthcare services market is one product of its acquisition of Peroy Systems, which combined the deep domain and industry expertise of both companies to provide healthcare organisations with an even greater range of offerings.

Dell is one of the few companies that can offer healthcare payers and providers truly end-to-end solutions including hardware, implementation, hosting, consulting, back office functions (such as enrollment and billing), and services around electronic medical records, health information exchanges and health insurance exchanges.

"As the worldwide market leader in healthcare services and one of the two largest providers of computer hardware support in education, our goal is to deliver solutions that enable our customers to focus on what they do best. Nowhere is this more critical than in thehealthcare and education markets. We believe Dell's rankings in the recently-released Gartner report would not be possible without the continued trust our customers have placed in us year after year. We look forward to furthering this trust while providing industry-leading solutions that keep ahead of the ever-changing developments inhealthcare and education," said Peter Altabef, the President of Dell Services.

As we look to the future and healthcare implements technology even further, the role of healthcare IT providers will grow and grow.

Jodie Humphries

|Going digital

Heart disease risk for successful women

Fri, 07 May 2010 11:47:00 +0100

The question 'does being a successful woman endanger you?' may seem like a strange question, but according to a new report young women with high pressure jobs are up to twice as likely to develop heart disease.

Women who said their work pressure was 'much too high' were found to be 50 percent more likely to develop heart disease than those who said that their job was manageable.

Other studies have found a connection between men in high pressure jobs and the risk of heart disease but little research has been done on women. Previously, it was thought that younger women were protected from heart disease by the female hormone oestrogen.

Latest research on Danish nurses

The research, published in the journal Occupational And Environmental Medicine, looked at the impact of work pressure on heart disease risk among 12,116 nurses all aged between 45 and 64 at the start of the study in 1993 who followed for a period of 15 years.

The latest research, carried out on Danish nurses, found that those who said their work pressure was a little too high were 25 percent more likely to develop heart disease over the next 15 years.

Those that reported the highest pressure were found to have a 50 percent increased risk but when the researchers took into account smoking and lifestyle factors this was reduced to 35 percent.

Although the researchers said smoking and poor lifestyle are also connected to high pressure jobs and should not be completely discounted, the article High-flying women 'more likely to develop heart disease' states.

When the researchers looked at the data for the first five years, it was found the effect was even greater with women who felt themselves to be highly pressurised at almost twice the heart disease risk as those not under pressure.

Admitted to hospital with heart disease

By 2008, 580 women had been admitted to hospital with heart disease, of which 138 had suffered a heart attack, 369 had angina and 73 had another type of heart disease.

The influence was strongest and only significant for women under 51 at the start of the study.

The researchers, from Glostrup University Hospital in Denmark, said older women may have less of a risk of heart disease for several reasons, which includes if they have already left work.

Lead author Dr. Yrsa Andersen Hundrup, Research Centre for Prevention and Health, concluded: "This study adds to the previous body of evidence suggesting harmful effects of excessive psychological demands at work on cardiac health, but is one among very few that demonstrates the effect among women."

June Davison, cardiac nurse at the British Heart Foundation, said: "Feeling under pressure at work means stressed employees may pick up some unhealthy bad habits and add to their risk of developing heart problems.

"Pressurised workers may reach for cigarettes, snack foods and alcohol to make themselves feel better.

"If you feel under pressure you should try and tackle it in a positive way and get active during work hours."

Jodie Humphries

Do you get enough 'green exercise'?

Wed, 05 May 2010 10:25:00 +0100

Do you get out of the office or out of the hospital long enough to do some exercise? Sure you may take a trip to the gym, but do you get the right amount of 'green exercise'? A new study has found that just five minutes of exercising in the countryside can boost your mental health.

Scientists have suggested that a short walk, cycle, run or even gardening in green spaces can boost your well-being.

The research, conducted by Dr. Jo Barton and Professor Jules Pretty at Essex University showed that exercising in wilderness areas or near water tended to have the biggest impact on mental state. Other rural areas and city parks were also beneficial.

Dr. Barton said to the British paper The Telegraph, "A walk a day should help to keep the doctor away - and help to save the country money. There is a large potential benefit to individuals, society and to the costs of the health service if all groups of people were to ‘self-medicate' more with green exercise."

Combating the lack of green spaces

In order to combat the lack of green spaces in some areas, the researchers are calling for the development of specially designed green areas that can be used for therapy purposes.

The research findings add to the growing evidence that green spaces can have a positive impact on people's health.

Experts claim the combination of exercise and the sense of escape that being surrounded by nature and "fresh air" can bring, provides a psychological boost.

The greatest health changes were seen in the young and the mentally-ill, although all age and social groups were seen to benefit.

Jodie Humphries

Robot arm used for heart surgery

Thu, 29 Apr 2010 11:06:00 +0100

For the first time ever, surgeons at a Leicester hospital have carried out pioneering heart surgery using a remote-controlled robot arm. The arm was used to correct a ‘short circuit' in a heart that was beating too fast on 70 year-old Kenneth Crocker.

The use of a robot arm allows surgeons, who usually have to wear lead aprons and risk radiation exposure from x-rays, to operate from another room.

Speaking about the robot arm, Dr. Andre Ng, who carried out the procedure at Glenfield Hospital, said the robot arm can be more accurate.

How does it work?

A 6mm wide catheter fitted with a pinhole camera and light was first inserted into Mr. Crocker's groin using keyhole surgery.

Dr. Ng and his team then used the robot arm - attached to the bed - and a TV monitor to control its journey through Mr. Crocker's body.

The catheter gyrates on the end of the robot's arm when it detects fibres on the heart's surface which cause the irregular rhythm.

The operation involves steering a thin tube through veins to the heart. Rogue tissue can then be burned away.

Radio frequencies are then blasted down the catheter to burn away the faulty fibres, correcting the flow of electrical currents and restoring a regular heartbeat.

Dr. Ng, consultant cardiologist, said to the BBC: "The new robotic procedure is an important step forward because, while some procedures are straightforward, others can take several hours.

"Because X-rays are used to allow the doctor to monitor what is going on inside the patient, it means that doctors standing close to the patient wear radiation shields such as lead aprons which are burdensome.

"Protracted procedures can lead to clinician fatigue and high cumulative radiation exposure.

"The benefit of the robotics system to the patient is that movement of the catheter could be done with great precision."

The GBP£350,000 Remote Catheter Manipulation System was made by US company Catheter Robotics Inc. It has been in development for four years but this is the first time it has been used on humans.

After the success of the first operation, the procedure could benefit more than 600 patients a year at the hospital.

Jodie Humphries