Four In Five Hospitals ‘Not Safe Enough’ In England

Safety at four in five hospital trusts in England is not good enough, inspectors say.

Staffing and overcrowding are major concerns – and they warned that patients are at risk as hospitals faced unprecedented pressures.

The Care Quality Commission review also highlighted delays getting tests and treatments and poor care of life-threatening conditions such as sepsis.

Ministers said the findings should be used to root out poor practices.

But inspectors warned some of the problems were beyond the control of hospitals because of rising demands being placed on them.

10 charts that show why the NHS is in trouble
The review of all 136 hospital trusts in the country found 11% were rated as inadequate on safety and 70% required improvement.

Among the problems highlighted were:

  • Bed occupancy rates routinely above recommended levels
  • Poor care given to patients with life-threatening conditions such as sepsis and kidney injuries
  • Too many long waits for operations, such as knee and hip replacements
  • Too few nurses in medical and elderly care wards, midwives in maternity units and doctors in A&Es
  • Temporary escalation wards – set up during busy periods – predominantly staffed by agency workers who were not familiar with the hospital practices
  • Poor control of infections because of insufficient hand hygiene and patients with infections not being isolated properly
  • Problems with medicines management, including out-of-date drugs, and maintenance of equipment
  • Tests being delayed because of poor information-sharing and record-keeping

Hospital chief inspector Prof Sir Mike Richards said safety remained a “real concern” with many trusts failing to learn when things go wrong.

But he also said he had some sympathy for hospitals given the rising demands being placed on them.

“The scale of the challenge that hospitals are now facing is unprecedented – rising demand coupled with economic pressures are creating difficult-to-manage situations that are putting patient care at risk.

“What is clear is that while staff continue to work hard to deliver good care, the model of care that once worked well cannot continue to meet the needs of today’s population.”

He also highlighted strengths, saying staff were good at providing care with compassion and leadership remained strong in many places.

When these factors were taken into account, it meant a third of trusts could be rated as good or outstanding overall.

The CQC also inspected 18 specialist hospital trusts, including sites dedicated to cancer and heart treatment. They tended to fare better.

The report marks the culmination of three years of new tougher inspections brought in after the Mid Staffordshire hospital scandal.

10 charts that show why the NHS is in trouble

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Receptionists ‘Put People Off Seeing Doctor’

Receptionists quizzing patients about why they need to see their GP could be putting some sick people off visiting their surgery, a survey suggests.

Of almost 2,000 adults questioned for Cancer Research UK, four in 10 said they disliked having to discuss their ills with office staff in order to get an appointment.

Many were worried about making a fuss.

Experts say patients must be forceful and not take no for an answer if they have symptoms that need investigating.

The government says it is funding training to help receptionists learn how to be sensitive to patients’ needs.

Probing Questions

Receptionists are the first point of contact in primary care and it is their job to decide which patients should see the GP and how urgently.

They do a vital job, but feedback from patients reveals some can be off-putting.

In the survey, the top three barriers to seeing a GP were:

  • difficulty getting an appointment with a particular doctor (41.8%)
  • difficulty getting an appointment at a convenient time (41.5%)
  • dislike of having to speak to the GP receptionist about symptoms (39.5%)

Around a third of the patients interviewed were also concerned that they might be negatively viewed as the type of person who makes a fuss, the Journal of Public Health – which published the survey results – said.

Lead researcher Dr Jodie Moffat urged people with symptoms to “grab the bull by the horns” and seek help rather than suffer in silence.

“Don’t let yourself be put off. Make that appointment,” she said.

“Be forceful. I know that’s easier said than done. But it’s clear that a new sign or symptom, or something that has stayed or got worse over time, needs to be checked out by a GP.”

Worrying symptoms that need a medical opinion include bleeding, a persistent cough, a change in bowel habit and unexplained lumps or swellings.

‘Onus’ On Receptionists

Dr Moffat said: “If you find it hard, ask a friend or a relative to make an appointment for you. Or go online. Lots of GP surgeries now take online bookings.”

Prof Elizabeth Stokoe, from Loughborough University, recently carried out a study that listened in to the conversations of patients and GP receptionists.

She found patients often had to drive the conversation to get answers.

“The onus should be on the receptionist to provide all the information, but often it is the patient who has to push to get it.

“If they don’t push then they get no service at all or they desperately scrabble to get their voice heard.”

‘Smooth Running’

Dr Maureen Baker, chairwoman of the Royal College of GPs, said doctors understood that their patients would prefer to speak directly to them about their health, especially when it is something sensitive or embarrassing – but it is not always possible.

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The Health-Care Survivor’s Comment

If I am ever faced with what I consider to be unnecessary questions, in this context, I have a very simple, and effective reply:

It’s about my health… I think my doctor is best qualified to help me. Thank you very much.

Student Doctor Numbers To Rise By 25%

The number of medical school places will increase by 25% from 2018 under plans to make England “self-sufficient” in training doctors.

The government’s plan will see an expansion in training places from 6,000 to 7,500 a year.

Ministers believe increasing the number of home-grown doctors will be essential given the ageing population.

There is also concern it will become more difficult to recruit doctors trained abroad in the future.

About a quarter of the medical workforce is trained outside the UK, but the impact of Brexit and a global shortage of doctors could make it harder to recruit so many in the future.

Prime Minister Theresa May told the BBC: “We want to see the NHS able to recruit doctors from this country. We want to see more British doctors in the NHS.”

The increase also comes after the government has spent a year at loggerheads with junior doctors over the pressures being placed on them to fill rota gaps.

Doctor Workforce In Numbers
  • 150,000
Doctors Working In NHS
  • 25% are foreign
  • 9% due to retire in next five years
  • 2% more needed each year to keep up with demand
  • 7-10% of posts are vacant

Source: BBC, Civitas, NHS, DoH, GMC

Life On The Frontline

Dr Daniel Bunce, 27, is in his third year of being a junior doctor after completing his medical degree. He is now working in a hospital in the south west in intensive care.

He says he got into medicine because he wanted to “care for people and make a difference”.

“It’s been difficult. There is so much pressure, particularly during winter. We just don’t have the time to spend with patients that we need to provide the care we want to because we are rushing around just trying to keep up.

“I’m now working in intensive care so the staff to patient ratios is much better than it was when I was on medical wards. But the workload is making people I work with think about whether this is something they want to do for the rest of their career.

“The increase in medical school places is a good move, but we will have to see what impact it has in hospitals in the long-term.”

Medical degrees take five years to complete, so it will be 2024 before the impact of these extra places is felt.

But Mr Hunt told the Conservative Party conference in Birmingham on Tuesday: “We need to prepare the NHS for the future, which means doing something we have never done properly before – training enough doctors.

“Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to stay post-Brexit.

“But is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”

Mr Hunt said the steps would mean that by the end of the next Parliament the health service in England would be “self-sufficient” when it comes to training doctors.

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Could Turmeric Really Boost Your Health?

Bold health claims have been made for the power of turmeric. Is there anything in them, asks Michael Mosley.

Turmeric is a spice which in its raw form looks a bit like ginger root, but when it’s ground down you get a distinctive yellowy orange powder that’s very popular in South Asian cuisine. Until recently the place you would most likely encounter turmeric would be in chicken tikka masala, one of Britain’s most popular dishes.

These days, thanks to claims that it can improve everything from allergies to depression, it’s become incredibly trendy, not just cooked and sprinkled on food but added to drinks like tea. Turmeric latte anyone?

Now I’m usually very cynical about such claims, but in the case of turmeric I thought there could be something to it. There are at least 200 different compounds in turmeric, but there’s one that scientists are particularly interested in. It gives this spice its colour. It’s called curcumin.

Thousands of scientific papers have been published looking at turmeric and curcumin in the laboratory – some with promising results. But they’ve mainly been done in mice, using unrealistically high doses. There have been few experiments done in the real world, on humans.

This is exactly the sort of situation where we on Trust Me like to make a difference. So we tracked down leading researchers from across the country and with their help recruited nearly 100 volunteers from the North East to do a novel experiment. Few of our volunteers ate foods containing turmeric on a regular basis.

Then we divided them into three groups.

We asked one group to consume a teaspoon of turmeric every day for six weeks, ideally mixed in with their food. Another group were asked to swallow a supplement containing the same amount of turmeric, and a third group were given a placebo, or dummy pill.

The volunteers who were asked to consume a teaspoon of turmeric a day were ingenious about what they added it to, mixing it with warm milk or adding it to yoghurt. Not everyone was enthusiastic about the taste, with comments ranging from “awful” to “very strong and lingering”.

But what effect was eating turmeric having on them? We decided to try and find out using a novel test developed at University College, London, by Prof Martin Widschwendter and his team.

Prof Widschwendter is not particularly interested in turmeric but he is interested in how cancers start. His team have been comparing tissue samples taken from women with breast cancer and from women without it and they’ve found a change that happens to the DNA of cells well before they become cancerous.

The change is in the “packaging” of the genes. It’s called DNA methylation. It’s a bit like a dimmer switch that can turn the activity of the gene up or down.

The exciting thing is that if it is detected in time this change can, potentially, be reversed, before the cell turns cancerous. DNA methylation may explain why, for instance, your risk of developing lung cancer drops dramatically once you give up smoking. It could be that the unhealthy methylation of genes, caused by tobacco smoke, stops or reverses once you quit.

So we asked Prof Widschwendter whether testing the DNA methylation patterns of our volunteers’ blood cells at the start and end of the experiment would reveal any change in their risk of cancer and other diseases, like allergies. It was something that had not been done before.

Turmeric

•    Perennial herbaceous plant native to South Asia
•    Spice is gathered from the plants rhizomes (roots)
•    As well as being used in Indian food, turmeric is used in traditional medicine and as a dyeing agent

Fortunately he was very enthusiastic. “We were delighted,” he said, “to be involved in this study, because it is a proof of principle study that opens entirely new windows of opportunity to really look into how we can predict preventive measures, particularly for cancer.”

So what, if anything, happened?

When I asked him that, he pulled out his laptop and slowly began to speak.

“We didn’t find any changes in the group taking the placebo,” he told me. That was not surprising.

“The supplement group also didn’t also show any difference,” he went on.
That was surprising and somewhat disappointing.

“But the group who mixed turmeric powder into their food,” he continued, “there we saw quite substantial changes. It was really exciting, to be honest. We found one particular gene which showed the biggest difference. And what’s interesting is that we know this particular gene is involved in three specific diseases: depression, asthma and eczema, and cancer. This is a really striking finding.”

It certainly is. But why did we see changes only in those eating turmeric, not in those taking the same amount as a supplement?

Dr Kirsten Brandt, who is a senior lecturer at Newcastle University and who helped run the experiment, thinks it may have something to do with the way the turmeric was consumed.

“It could be,” she told me, “that adding fat or heating it up makes the active ingredients more soluble, which would make it easier for us to absorb the turmeric. It certainly gives us something, to work on, to try to find out exactly what’s happening.”

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The Health-Care Survivor’s Comment

Curcumin is a diarylheptanoid. It is the principal curcuminoid of the popular South Asian spice turmeric, which is a member of the ginger family. Turmeric’s other two curcuminoids are desmethoxycurcumin and bis-desmethoxycurcumin.

In October 2010, working with Indena S.p.A., the worldwide experts in botanical extract technology, Good Health Naturally, introduced CurcuminX4000, which includes an answer to better Curcumin absorption – phytosome technology.

Curcumin has continued to be an integral part of my own approach to naturally sustainable good health, since I learnt about it in 2006, as part of My Serrapeptase Adventure.

Doctor Urges Compulsory Mediation In Patient Care Rows

The NHS could save millions of pounds if families and doctors were offered mediation when they disagreed on a treatment, a leading consultant said.

Dr Chris Danbury, an anaesthetist at Reading’s Royal Berkshire Hospital, said it should be made a legal requirement in England and Wales.

Examples of when mediation should be used include disagreements in whether to turn off life support, he said.

This would avoid a case going to the Court of Protection.

Another instance where mediation could be used was when a patient who is mentally competent did not want to accept a treatment they medically needed.

But one mother, whose son died of a brain tumour, said she was not sure mediation was the best form of persuasion for parents at a vulnerable time.

Dr Danbury, a consultant intensive care physician, said it was not just the cost of going to court that was the problem.

He said the legal route could have a damaging effect on the relationship between the medical team and the family involved.
‘Immense savings’

Speaking at Euroanaesthesia 2016, Mr Danbury said of mediation: “This can be done informally, perhaps by getting another clinician within the institution to act as an ‘honest broker’.

“If this fails, then a formal mediation process can be initiated with legal representation on both sides.

“Mediation costs a great deal less than going to court and often preserves the relationship between clinical team and their patient/representatives, which can otherwise be severely damaged by the rigors of court proceedings.”

He highlighted one example in which a Jewish family refused to accept their family member had no hope of recovery.

They were offered mediation with the help of a local rabbi, which led to an improved relationship between them and the medical team and the family agreed to switch off the patient’s life support machine.

“Sometimes misunderstandings can occur very easily – one doctor may not explain something very well to a family, but then once a colleague intervenes, the situation can be calmed down very quickly,” he said.

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Around The Clock Care For Dying ‘Not Good Enough’

A national review of end-of-life care has found most hospitals are failing to provide face-to-face palliative care specialists around the clock.

The review shows only 16 of 142 hospital sites in England offer specialists on site 24/7.

NHS experts acknowledge steady improvements in the last two years, but warn there is still work to do.

It’s the first review since the controversial Liverpool Care Pathway was scrapped.

‘Major Deficiencies’

The Liverpool Care Pathway was phased out amid criticisms it had been misused as a tick-box exercise, leaving some patients without food and water.

In its place a series of guidelines has suggested moving away from a one-size-fits-all approach, instead focusing on individual care.

This report, led by the Royal College of Physicians, shows there have been improvements in all areas.

Researchers found, for example, that communication with patients and relatives had improved.

But there were still a number of concerns.

In 18% of more than 9,000 patient notes researchers examined, there was no written evidence to suggest that do-not-resuscitate decisions had been discussed with relatives or friends.

And in around 3,000 notes there was no evidence that the patient’s ability to eat and drink had been assessed on the last day of life.

But the researchers’ main concern was that many patients and doctors did not have full access to on-site palliative care specialists at evenings and weekends.

Out Of Hours

The majority of hospitals did offer a specialist telephone helpline at all times and 53 of 142 hospital sites offered face-to-face palliative care on Monday to Sunday between 9am to 5pm.

But for 26 trusts there was no record of face-to-face specialist palliative care involving doctors at any time.

Study-lead Dr Sam Ahmedzai said: “We know that most front-line doctors and nurses giving end-of-life care do it to a very good standard.

“But the problem happens when things start to go wrong and often they go wrong out-of-hours in the middle of the night and at weekends.

“Then doctors and nurses who may be inexperienced need to be able to access specialists in palliative care.”

He says without this, patients with complex problems may not get the care they need.

Julie Coombes’ father found out he had bowel cancer in May 2015. He was in and out of hospital for three months. But Ms Coombes, 33, from Plymouth, says her father didn’t feel he had good care there. She says his symptoms and sickness couldn’t be controlled, so the family decided to take him out of hospital to die at home.

She said: “While he was in hospital the palliative care team came for about five minutes, while he was in his bed with everyone around and just said you are going to die.

“Apart from that we did not get any leaflets or any help… It is not something I would want anyone else to experience.”

‘Not Right’

Dr Kevin Stewart of the Royal College of Physicians said he was encouraged by the improvements.

But he added: “We are disappointed that there are still major deficiencies in the provision of specialist palliative care at nights and weekends by many trusts; patients and their families deserve the same level of service whatever the day of the week.”

Dr Adrian Tookman, clinical director of the charity Marie Curie, which part-funded the review, said: “We can’t ignore the fact that the vast majority of dying people and those close to them still have limited or no access to specialist palliative care support when they need it in hospital. This is not right, nor good enough.

“Care of the dying has no respect for time, so if we are to deliver a consistent seven-day service by 2020, it is critical that funding is directed towards recruiting and training doctors and nurses to provide specialist care now.”

Dr Tookman told BBC Breakfast there was also “an organisational issue”, over how managers supported services within hospitals.

He acknowledged the difficulties for families of patients but said they had to “speak up and demand the right care”.

Amanda Cheesley of the Royal College of Nursing told BBC Radio 4’s Today programme that end-of-life care raised complex issues and among nurses there was “still a fear of doing the wrong thing”.

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Cancer Is not Just ‘Bad Luck’ But Down To Environment, Study Suggests

Cancer is overwhelmingly a result of environmental factors and not largely down to bad luck, a study suggests.

Earlier this year, researchers sparked a debate after suggesting two-thirds of cancer types were down to luck rather than factors such as smoking.

The new study, in the journal Nature, used four approaches to conclude only 10-30% of cancers were down to the way the body naturally functions or “luck”.

Experts said the analysis was “pretty convincing”.

Cancer is caused by one of the body’s own stem cells going rogue and dividing out of control.

That can be caused either by intrinsic factors that are part of the innate way the body operates, such as the risk of mutations occurring every time a cell divides, or extrinsic factors such as smoking, UV radiation and many others that have not been identified.

The argument has been about the relative importance of intrinsic and extrinsic factors.

In January, a report in the journal Science tried to explain why some tissues were millions of times more vulnerable to developing cancer than others.

Their explanation came down to the number of times a cell divides, which is out of our control and gave rise to the ‘bad luck’ hypothesis.

In the latest study, a team of doctors from the Stony Brook Cancer Centre in New York approached the problem from different angles, including computer modelling, population data and genetic approaches.

They said the results consistently suggested 70-90% of the risk was due to extrinsic factors.

Dr Yusuf Hannun, the director of Stony Brook, told the BBC News website: “External factors play a big role, and people cannot hide behind bad luck.

“They can’t smoke and say it’s bad luck if they have cancer.

“It is like a revolver, intrinsic risk is one bullet.

“And if playing Russian roulette, then maybe one in six will get cancer – that’s the intrinsic bad luck.

“Now, what a smoker does is add two or three more bullets to that revolver. And now, they pull the trigger.

“There is still an element of luck as not every smoker gets cancer, but they have stacked the odds against them.

“From a public health point of view, we want to remove as many bullets as possible from the chamber.”

There is still an issue as not all of the extrinsic risk has been identified and not all of it may be avoidable.

‘Convincing’

Kevin McConway, a professor of applied statistics at the Open University, said: “They do provide pretty convincing evidence that external factors play a major role in many cancers, including some of the most common.

“Even if someone is exposed to important external risk factors, of course it isn’t certain that they will develop a cancer – chance is always involved.

“But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against cancers.”

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Mental Health Equality Call Gets High Profile Backing

A campaign calling for an increase in funding for mental health services in England has been launched.

Over 200 celebrities have backed the push for mental health to be treated as seriously as other illnesses.

It was launched by former mental health minister Norman Lamb, Conservative MP Andrew Mitchell and former Labour spin doctor Alastair Campbell.

Health Secretary Jeremy Hunt said treatment had made “great strides” but more could be done to improve services.

The government increased overall mental health funding to £11.7bn in 2014/15.

But Mr Lamb said people with mental ill health “don’t get the same right to access treatment on a timely basis that everyone else gets”. He called it a “historic injustice.”

His son was diagnosed with obsessive compulsive disorder at the age of 15 and Mr Campbell has spoken about his battle with depression.
Inequality in care

The NHS became officially responsible for ensuring the standard of care for the mentally ill was equal to that of physically ill people in 2012.

In the spring, the government pledged an extra £1.25bn largely for children’s mental health over the next five years.

In the modern NHS, a hip replacement is a pretty routine operation. More than 50,000 are carried out each year.

People normally get a referral from their GP and then go on to a waiting list. The majority go under the knife within a few months and are able to plan and prepare for the surgery to try to avoid too much disruption to their everyday lives. For most, it’s a pretty easy experience compared with other operations.

But for people with mental health problems, it’s a completely different picture. Four in 10 get a hip replacement only after being admitted as an emergency, according to a recent study published by the Nuffield Trust.

Consider that for a moment: their health – and presumably pain – has deteriorated so much that they are rushed in and operated on immediately.

What causes this? Experts suspect it’s just another sign of how mental health patients lose out.

It also introduced the first waiting time targets in mental health, guaranteeing treatment within 18 weeks.

But the campaign says not enough has been done to address a continuing inequality in care standards and funding.

‘Break The Stigma’

The campaign highlights a lack of access to treatment, with three out of four mentally ill children receiving no treatment at all.

There are also concerns that people are moved around too much, including placing children in adult wards.

The life expectancy for people with mental health problems remains 20 years lower than for the general population.

A change of mindset is needed, Mr Lamb insists: “If we talk about it and treat it like any other illness, we can start to break the taboos, break the stigma.”

Comedian Frank Skinner, former footballer Ian Wright and presenter Graham Norton are also among the high profile names to back the campaign along with a number of supporters who have spoken up about their own experiences with depression, including Ruby Wax and Emma Thompson.

‘Historic Injustice’

While accepting that the NHS is under pressure at the moment, Paul Farmer, Chief Executive of the charity Mind, said: “When people don’t get the right help at the right time, the risk is that they become more unwell and need more intensive – and expensive – treatment further down the line.”

The cost is estimated at billions of pounds a year in “loss of work, in payment of benefits, and the impact on families,” Mr Lamb said.

While campaigners acknowledge that progress has been made in this area, they say the levels of investment are not being matched with that of physical health.

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NHS And Care Sector: Safety A ‘Big Concern’ In England

Safety across the NHS and care sectors in England is a “significant concern”, with particular problems in hospitals, inspectors are warning.

The Care Quality Commission found three-quarters of the 79 hospital trusts visited under its new inspection regime so far had safety problems.

Over 40% of care and nursing homes and home care services and one in three GP services also had problems with safety.

Lack of staff – in terms of skills and numbers – was identified as a major issue.

The way medicines were managed and how mistakes were investigated and learnt from were also highlighted.

Among the individual cases flagged up were:

  • A&E patients being kept on trolleys overnight in a portable unit without proper assessment
  • Staff at a GP surgery not undergoing basic life-support training in the past 18 months
  • Medication mistakes at a care home – including delays giving drugs and signs of overdoses

The findings – contained in the CQC’s annual report – are effectively a mid-term update of the new tougher Ofsted-style inspection regime.

They cover the first 14 months of the inspection programme, which was launched in April 2014 and is expected to be largely completed by April 2016.

So far more than 5,000 organisations have been inspected – nearly half of hospitals, 17% of care services and 11% of GP surgeries and out-of-hours providers.

However, those deemed most at risk have been predominantly targeted first, so the level of failure is not necessarily representative of the overall sector.

  • 47% of hospitals inspected
  • 17% of social care services
  • 11% of GP services

During the inspections, CQC experts look at a range of different issues, including the quality of management, whether staff are caring and safety.

Each organisation – from GP surgery to hospital – gets a rating for each, resulting in an overall rating of inadequate, requires improvement, good or outstanding.

The results of these are widely published throughout the year, whereas this report looks at some of the common problems identified during the whole process.

Of all the issues looked at, the CQC said most concerns had been raised about safety.

Some 13% of hospitals were judged unsafe, 10% of social care services and 6% of GP services.

Once those judged to be not safe enough are included, it brings the numbers with safety problems to 74% for hospitals, 43% for social care services and 31% for GPs.

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The Health-Care Survivor’s Comment

Regular readers will not be surprised that I find this report, both deeply disturbing, and yet unsurprising. My life’s story has been intimately entwined  with that of the NHS. I have said before, that I have benefited and suffered, in equal measure, from the medical systems of the three countries in which I have lived.

Over the last decade, I have noticed a clear shift of focus, within the structure of the NHS, away from individual interactions between clinicians and patients, at a human level, towards the implementation of processes, and inflexible protocols. From a personal perspective, this has been most noticeable, and regrettable, in my experience of receiving nursing care.

When human collaboration, and compassion are being timed-out, and actively discouraged by the drive for cost-cutting, dressed up as efficiency, it cannot be a coincidence that patients have become, and certainly feel, less safe.

‘Transmittable Alzheimer’s’ Concept Raised

People may be able to contract Alzheimer’s during certain medical procedures in the same way as the brain disease CJD, say researchers.

Contaminated surgical instruments or injections, such as human growth hormone, may pose a rare but potential risk, they speculate in Nature.

The theoretical hunch comes from post-mortem brain studies in eight patients.

The UK experts stress that their findings are inconclusive and do not mean Alzheimer’s is infectious.

People cannot catch Alzheimer’s from coming into contact with other people with the condition.

Brain Changes

Alzheimer’s is a type of dementia that is more common with increasing age. People with a family history of the condition are also at increased risk of developing it.

In Alzheimer’s, brain cells die off and, over time, the brain shrinks, affecting many of its functions.

Scientists can also see the effects of the disease under the microscope.

There are two telltale signs – abnormal clusters of protein fragments, called amyloid plaques, and tangles of another protein known as tau.

It was when Dr John Collinge and colleagues from University College London were studying the brains of recently deceased CJD (Creutzfeldt-Jakob disease) patients that they stumbled across one of these Alzheimer-like signs.

Seven of the eight patients they studied had amyloid deposits in the brain, which was surprising given their relatively young ages (between 31 and 51) and the fact that they had no family history of Alzheimer’s.

All of the deceased had caught their CJD from contaminated human growth hormone injections, given to them as children.

Animal Studies

This treatment was withdrawn in the UK in 1985 once the risk of CJD infection became clear. Extra checks and measures, such as using disposable surgical instruments, are now carried out in NHS hospitals to minimise the risk.

Dr Collinge believes amyloid could be spread accidentally during medical and surgical procedures in the same way as CJD, via contaminating protein “seeds” or prions that grow in the brain.

Animal studies support this idea, but caution is needed.

None of the eight autopsy patients had full-blown Alzheimer’s disease and it is not clear if they would ever have developed dementia.

There is no proof that the growth hormone injections were the cause of the amyloid.

Analysis

Perhaps research papers like this one should come with their own health warning: “may cause unnecessary alarm”.

That’s not to discredit their scientific worth, the findings are interesting and important for furthering understanding.

But they must be interpreted with caution.

There are too many ‘ifs’ to draw any firm conclusions.

The observations are from a small number of deceased patients who had a treatment that hasn’t been used for years.

Although it’s still not clear exactly why some people develop Alzheimer’s while others do not, experts agree that you can’t “catch it” like a cold.

Dr Collinge says more research is needed. He has already contacted the Department of Health to see if it has any old stocks of human growth hormone that he can check for the presence of amyloid “seeds”.

He said: “I do not think there is any cause for alarm. No-one should delay or not go for surgery because of this.”

The chief medical officer for England, Prof Dame Sally Davies, added: “I can reassure people that the NHS has extremely stringent procedures in place to minimise infection risk from surgical equipment, and patients are very well protected.”

Dr Eric Karran, director of research at Alzheimer’s Research UK, said: “While the findings sound concerning, it’s important to remember that human-derived hormone injections are no longer used and were replaced with synthetic forms since the link to CJD was discovered in the 1980s.”

“Current measures in place to limit contamination with the prion protein and minimise CJD risk from hospital procedures are very rigorous and the risk of developing CJD from surgical contamination is extremely low.

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