Gerry Bolgers' RCN Blog

The danger and cost of climate change to the health of Europeans is at the forefront of the debate as the fifth Ministerial Conference on Environment and Health begins today in Parma, Italy.

The conference, organised by the World Health Organisation, will include representatives from across Europe and is an important forum on how to tackle cross-cutting environment and health issues such as climate change.

Minister for Public Health, Gillian Merron said:

“This conference will highlight the risk global warming poses to the health of our communities”.

“Moves to improve public health can help tackle climate change. The Government’s Change4Life movement, which is focused on fighting obesity, also improves the environment by encouraging people to walk and cycle more.

“There is already good work going on but more needs to be done”.

The significant risks to human health in the UK from unmitigated climate change are clear:

·        heatwaves will result in an increase in heat-related deaths (over 35,000 excess deaths were reported from 12 European countries in the 2003 heatwave);

·        increased coastal and river flooding will have major impacts on health – as well as threats to physical health, flood victims can also experience significant mental health problems as a result of personal and economic loss and stress; and

·        episodic higher concentrations of ground-level ozone, caused by air pollution and often associated with heatwaves, could lead to an increase in respiratory problems and incidence of allergies.

The impact of climate change on health will be felt around the world. The densely populated coastal areas of the world are at risk from rising sea-levels, whilst malnutrition in arid areas may be exacerbated by drought.

However, many measures to combat climate change also bring benefits to health:

·        reducing motor vehicle use cuts carbon dioxide emissions, which helps mitigate global warming, and also reduces respiratory problems caused by particulate pollution;

·        more walking and cycling brings substantial health benefits including reduced cardiovascular disease and reduced dementia;

improved housing insulation will reduce deaths from both extreme cold and heat;
in poorer countries, a reduced need to burn solid fuel indoors could have a significant impact on child and maternal health by cutting air pollution.

The UK is committed to tackling the effects of climate change. The health impacts of climate change, both in the UK and around the world, are an increasingly important justification for ambitious and urgent global action on climate change.

Frank discussions about the importance of being tested for sexually transmitted infections (STIs) such as chlamydia are an important indicator of a lasting relationship, according to a surprising new survey out today.

A Populus poll of over 1,000 young adults found that nearly three quarters (70 per cent) rank discussing STI tests together as the most important sign that a new relationship will last. This has overtaken more traditional milestones such as meeting the parents (66 per cent) or friends (40 per cent).

The research was conducted on behalf of the Chlamydia. Worth Talking About campaign* which encourages sexually active under-25-year-olds to say ‘yes’ to chlamydia testing.

The results provide a snapshot of modern relationships in the UK, with young adults indicating that they thought getting past the following milestones would lead to long-lasting relationship success:

1.      Talking openly about sexual history and discussing STI tests together – 70 per cent
2.      Meeting the parents – 66 per cent
3.      Not always having to wear makeup – 47 per cent
4.      Meeting friends – 40 per cent
5.      Being given space in the cupboard to leave clothes – 30 per cent

However, while respondents aspire to have open and honest conversations with new sexual partners, many get tongue-tied.  The majority (73 per cent) have never raised the subject of STIs with a new partner before having sex for the first time, while a third (30 per cent) feel uncomfortable asking a new partner to use a condom.

Lack of confidence is the problem, with more than one in four respondents (27 per cent) admitting that they are too embarrassed to talk to their partner about subjects including safe sex, STIs and contraception.

Public Health Minister Gillian Merron said:

“STIs can be a difficult subject to talk about, but it’s encouraging that young couples are starting to see beyond that. The Government’s Chlamydia. Worth Talking About campaign aims to get young people discussing STIs and saying “yes” to chlamydia tests.”

Sex and relationship expert Dr Catherine Hood, said:

“These findings reveal much about the modern relationship game. While many young couples realise the significance of being able to talk openly about accepting tests for STIs, sheer embarrassment is preventing them from doing so, and potentially risking their sexual health as well as the future of their relationship.”

The research identifies a critical window of opportunity during the start of a relationship to get things right. Almost a third of respondents (29 per cent) believe that for a relationship to last, new couples need to have had an open discussion about STIs, including chlamydia, within the first three months of making it official. Half of respondents (48 per cent) were clear that a new partner who was unwilling to discuss these topics would not be around for long.

“Chlamydia often doesn’t have any symptoms, and so the only way for young people to find out if they have it is to say ‘yes’ to a free chlamydia test if they are offered one by a healthcare professional.  If left untreated, chlamydia can lead to infertility and other serious health problems, and so it’s vital that new couples take responsibility for their own sexual health by talking openly about safe sex,” concludes Dr Catherine.

For straightforward information and advice about sex, relationships and contraception, young adults should visit www.nhs.uk/worthtalkingabout.go.uk: http://www.nhs.uk/worthtalkingabout.go.uk.

A package of tough new actions to ensure that NHS patients can get the medicines they need was agreed at a summit to discuss concerns about current difficulties with the supply of medicines, hosted by Health Secretary Andy Burnham and Health Minister Mike O’Brien.

The actions that were jointly agreed between the delegates include:

·        A more explicit duty for manufacturers and wholesalers to ensure that sufficient stocks of medicines are available to NHS patients;

·        A series of targeted inspections by the Medicines and Healthcare Products Regulatory Authority;

·        Tougher standards for the issue of licences for medical wholesalers; and

·        Development of best practice guidance on how supply difficulties should be dealt with by doctors, pharmacists, manufacturers and wholesalers.

The targeted inspections mean that manufacturers and wholesalers will risk losing their licences and face prosecution if they breach legal duties on supply of medicines. Pharmacists and doctors risk being called to account by their professional bodies for breaching their ethical obligation to put patients first.

Ministers met with a number of pharmaceutical supply chain stakeholders from across the UK – including the Association of the British Pharmaceutical Industry, the British Association of Pharmaceutical Wholesalers, the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee  and the Medicines and Healthcare products Regulatory Agency – to discuss the nature and scale of medicines supply problems and how the issues can be tackled collaboratively.

The issue of medicine shortages was raised publicly last year when some pharmacists and patients found it difficult to get hold of certain drugs, as a result of a number of unscrupulous traders exporting medicines meant for NHS patients to Europe for profit, because of the cheaper pound.

Health Minister Mike O’Brien said:

“We have reached agreement on a way to help NHS patients get the medicines they need.  Manufacturers, wholesalers, pharmacy bodies, regulators and Government all agreed to work together to resolve the issue.

“The lower value of Sterling has resulted in some medicines destined for NHS patients being sold abroad for extra profit by a small number of unscrupulous speculators.  Some pharmacists have had trouble getting hold of certain drugs because of this. For months, I have been seriously concerned about the potential impact of this on patients. It is unacceptable that some people have already had to wait longer than they should have to get their medication. Patients must come before profits.

“This new package of measures will help to ensure that NHS patients do not suffer and get the care they need when they need it.”

Richard Barker, Director General, Association of British Pharmaceutical Industry, said:

“Getting vital medicines to NHS patients is the job of all of us in the medicines supply chain and so we welcome the collaborative approach being taken by the Forum. We also strongly support the proposal to raise the standards to be applied to the licensing of wholesalers, to reinforce their mission to deliver medicines to meet the needs of UK patients, who should be at the centre of all of our activities.”

Sue Sharpe, CEO of the Pharmaceutical Services Negotiating Committee, said:

“Nothing is more important to community pharmacists than obtaining and dispensing the medicines patients need. A collaborative approach is crucial to addressing this issue, and we are pleased that all parts of the supply chain are committed to working collectively and constructively. The robust package of measures that has now been agreed, including supporting all parts of the supply-chain with best practice guidance, will be instrumental in addressing this continuing problem.”

New guidance has been produced to help GPs identify symptoms and diagnose young women with cervical cancer early, Health Minister Ann Keen announced.

The guidance was produced after a working group of the Advisory Committee on Cervical Screening (ACCS) was set up to look at the management of young women with gynaecological symptoms.

The working group found that women that visited their GP with abnormal bleeding experienced delay in diagnosis because they did not receive a full pelvic examination.

The guidance provides GPs with an easy to follow algorithm to help in the management of these young women and re-emphasises existing NICE guidelines around gynaecological symptoms.

Health Minister Ann Keen said:

“Over the past year I have met with a number of young women who have had cervical cancer. I have been touched by their stories and have resolved to do everything I can to help prevent and treat cervical cancer in young women.

“The independent Advisory Committee on Cervical Screening (ACCS) told us that screening women under the age of 25 did more harm than good but that more work needs to be done to ensure patients with symptoms are treated correctly.

“That is why this new guidance will support GPs and practice nurses to identify symptoms and refer where necessary to specialist services.”

National Clinical Director for Cancer Sir Mike Richards said:

“We have heard from a number of young women under the age of 25 who developed cervical cancer and they all had symptoms but did not receive a full pelvic examination to check for abnormalities in the cervix.

“To help GPs follow the correct procedure we have produced a pathway which maps the steps they need to take when women aged 20-24 present with post-coital bleeding and bleeding between menstruation.”

Chairman of the RCGP Professor Steve Field said:

“The cervical screening programme is helping us save thousands of lives every year.

“We welcome this new guidance; it is a really positive step that will assist us in making earlier diagnoses for younger women aged 20-24, which will in turn improve the outcomes for those at risk, and ultimately save lives.”

Director of cervical cancer charity Jo’s Trust, Robert Music, said:

“The impact of cervical cancer on a woman’s life and that of her family cannot be overstated.

“Sadly we hear too often of devastated parents losing daughters, of children losing mothers and husbands losing wives.

“And if they survive, they may have to go through invasive and painful treatments and lose their ability to have children.

“We hope this guideline will result in earlier recognition of symptoms, earlier diagnosis and a better outcome for women diagnosed with cervical cancer. “

Contacts:

When it comes to our health and wellbeing, Britain is a nation of ‘all talk and no action’ according to a survey for new online service NHS MidLifeCheck (www.nhs.uk/midlifecheck: http://www.nhs.uk/midlifecheck).

Despite almost half of adults (46 per cent) believing they need to think more about leading a healthy lifestyle, the same amount (47 per cent) admit to spending a lot more time talking about getting healthy than actually doing anything about it. And a third of adults (33 per cent) say they wouldn’t even know where to start.

Women own up to being the worst offenders with one in two (48 per cent) of 45-64-year-olds saying they are more inclined to give advice about being healthy than take it (31 per cent for men of the same age).

The survey also revealed that although people around the 40 year old mark are much less knowledgeable about their own health and fitness than their parents – 69 per cent having no idea about their blood pressure, compared to 27 per cent of people over 65 – they spend more time worrying about it. Top of the list of concerns for mid-lifers* as they get older is keeping fit and active (81 per cent), with staying slim at 73 per cent and 70 per cent worrying about their emotional wellbeing.

NHS MidLifeCheck (www.nhs.uk/midlifecheck: http://www.nhs.uk/midlifecheck) has been launched to help people over 40 turn their good intentions into reality. The free, confidential website is easy to use and supports people in planning for changes they choose to make. Following a simple multiple-choice lifestyle questionnaire, the site gives personal results and advice. Users can create an individual plan, set goals, track their weight and sign up for free emails, texts or letters to help them along the way.

Public Health Minister, Gillian Merron, said:

“It’s really important to take steps to manage our health and set goals to ensure we live life to the full.

“The Government has a responsibility to help people make healthier choices that are simple and easy to do. NHS MidLifeCheck is a free and confidential service for the over 40s covering important topics from healthy eating and physical activity, to emotional well being. It’s all about helping people make small changes to their lifestyle which could help to make a big difference to the quality and length of their lives.”

Sir Liam Donaldson, Chief Medical Officer, said:

“Most people in their 40’s generally enjoy good health, however for some people certain chronic health issues can start at this age – with cancer, heart disease and diabetes being some of the biggest causes of death. We all need to be aware of how to help prevent potential health problems.

“NHS MidLifeCheck, the third stage of NHS LifeCheck, is new for prevention in the NHS. It has been designed, in consultation with health professionals, to cover a wide range of topics such as smoking, diet and exercise, and emotional wellbeing – to provide those in their mid-life with the information and opportunity, to better understand how their current choices could affect their long-term health and well-being.”

talkSport presenter, Mike Parry, has been using NHS MidLifeCheck for
the last few weeks and sharing his progress with listeners. He said:

“Having had serious heart problems in my late 40’s, I now know just how much a healthy lifestyle can help to prevent disease. You don’t have to join a gym or start eating seeds – it’s just about making a few small changes. I have cut down on the amount I drink and walk a lot.

“NHS MidLifeCheck is something anyone can use. It gives you straight-forward information and helps you to focus on what you really want to achieve. My goals are to push myself harder when I’m walking and really think about the food I’m putting into my body.”

Other key highlights from mid-lifers* surveyed include:

·         Over two-thirds (68 per cent) of women are often more concerned about their family’s wellbeing than their own as they get older, more so than men of the same age (52 per cent).

·         People of mid-life age were less worried about how much alcohol they drink, with nearly two thirds (61 per cent) of 45-64 year olds not worried about it at all.

·         A third (34 per cent) only think about their health when they become ill or are feeling down.

Over three in four women (76 per cent) worry about their emotional wellbeing as they get older, more than men of the same age (63 per cent).

Prime Minister’s Commission on the Future of Nursing and Midwifery in England sets out the way forward for the future of the professions.

Nurses and midwives must renew their pledge to society to deliver high quality, compassionate care – and must be better supported to do so by their employers, according to a new report on the future of nursing and midwifery in England published today.

The Prime Minister’s Commission on the Future of Nursing and Midwifery in England believes that a strong statement of commitment to high quality care from all concerned would help to restore public trust. Front-line staff and their employers should state how nurses and midwives will enact their values of compassion, maintain their competence, and become champions of care in hospitals and the community.

Ann Keen, Chair of the Commission on the Future of Nursing and Midwifery said:

“Nurses and midwives are the lifeblood of the NHS and have always been at the heart of good health care. As a nurse, I know their great power and potential to improve the experiences of patients and influence the standard of care in a wide range of settings.

“The Commission is clear that high quality, safe and compassionate care must rise to the top of the agenda for a 21st century world-class NHS. Nurses and midwives must renew their pledge to deliver this and employers must take responsibility for supporting them in this.

“If we are to build on the successes of the NHS and improve health and wellbeing, then we must ensure that nurses and midwives take their proper place as valued professionals at the heart of health care – delivering, leading and shaping care now and for future generations.”

The Commission warns that this issue must move to the top of the NHS agenda in the challenging times ahead. Among its 20 recommendations, it highlights the need to prepare nurses to meet the growing need for highly skilled care for people with long-term conditions and the complex needs of ageing.

It sees nurses as centre stage to deliver this care, both in hospitals and in people’s homes, but they must be properly equipped and supported to do so. It also stresses the importance of skilled midwifery to meet the challenges of a rising birth rate and persistent health inequalities.

The Commission reached these conclusions following an extensive engagement exercise with the public, service users, staff and other stakeholders.

The Commission said:

“As was proposed to us, we want a future where patients, relatives and carers are at the centre of service development and design, and compassionate care is delivered by technically competent nurses and midwives who maintain a person’s dignity. This is the key to a positive experience for service users.”

Last year the Prime Minister asked the Commission to advise him on how to build the future of health care, and give nurses and midwives a bigger say in service design and leadership as well as care delivery. The Commission proposes a number of specific ways to bring this about.

One key proposal is that ward sisters, charge nurses and equivalent team leaders in the community and midwifery should be restored to their former traditional positions of authority as visible care champions. To do so they need optimum support and training.

The Commission makes it clear that responsibility for high quality and compassionate care starts at the front line and goes right up to board level.  To ensure accountability all boards should include a Director of Nursing.

The report highlights that these recommendations will help the largest group of registered professionals in the NHS to maximize their contribution to health and wellbeing.

One in three (32 per cent) people are uncomfortable around people with dementia according to new research. Care Services Minister Phil Hope said as he launched a new awareness campaign.

The new “Living Well” campaign employs real people with dementia who declare ‘I have dementia – I also have a life’ to educate the public about the condition and demonstrate the simple things everyone can do to help people live well with dementia.

The new MORI poll found that:

·        a third (32 per cent) of those surveyed said ‘I would find it difficult to spend much time with someone who has dementia’;
·        fifty-three per cent said they do not know enough about dementia to help someone who has it; and
·        81 per cent agreed that some people with dementia can still take part in normal activities.

People with dementia today challenged public perceptions by ballroom dancing at the campaign launch event at Pasha, the London nightclub.

Phil Hope said:

“Dementia doesn’t discriminate and neither should we. Our research shows that too often people fear dementia and this causes them to avoid people with the condition, making them feel isolated and stigmatised.

“We want to start to break down this stigma and show the simple things you can do to help people live well with dementia.

“Some people face great difficulties living with dementia – the ‘Living Well’ campaign is not meant to downplay their experiences. We want to show that, with the right support, people can live well with the condition and continue to do the things they enjoy for a number of years following diagnosis.”

The campaign will appear on TV, radio, online and in print across England.  It asks people to take a moment to find out more about dementia and provides five simple ways to help someone living with the condition.

1.      Respect and dignity – focus on what the person can do, not what they can’t.
2.      Be a good listener and be friendly – Support and accept the person, be patient.
3.      Do one little thing – cook a meal or run an errand, it all helps.
4.      Make time for everyone – partners, children and grandchildren will be affected.  Could you do something to help one of them?
5.      Find out more  – Understanding dementia makes living with it easier.

Ruth Sutherland, Acting Chief Executive of Alzheimer’s Society said

“People with dementia tell us that, once diagnosed, others begin to act differently or avoid them altogether. This has a huge impact on their lives, but we know that with the right support people can continue to enjoy a good quality of life.

“Alzheimer’s Society has been delighted to support this first step to tackling fear and misunderstanding that surrounds dementia. One in three people over 65 will develop dementia so it is vital we all understand how to better support those living with the condition.”

Also attending the launch was the recently appointed National Clinical Director for Dementia , Prof Alistair Burns who said

“Despite the fact that most people will be touched by dementia at some point in their lives, understanding of the condition, and how it is managed, is poor. We want to start to increase understanding, break down stigma and show some simple things you can do to help people live well.

“What’s good for your heart is good for your head and for your mind.  Dancing is particularly good for people with dementia as it can help increase coordination and keep people active.  It is a skill that people may remember when their memory starts to deteriorate.”

Dementia.  The more we understand, the more we can help.

The health sector has exceeded its aim to recruit 5,000 public sector apprentices, Health Secretary Andy Burnham announced

Last year both the NHS and social care services agreed to provide a major contribution to the Prime Minister’s commitment, made in February 2009, to increase the number of apprenticeships by 21,000 across the public sector.

Speaking before the NHS National Apprenticeship Conference at Westminister Hall, Andy Burnham said:

“I am delighted that we have hit the target to create an extra 5,000 apprentices.  Apprenticeships are an excellent way of giving young people the chance to learn life-changing skills and offer a genuine opportunity to train clinical staff.

“We must do all we can to provide high quality routes into jobs so that we can ensure we have a highly skilled and highly motivated NHS workforce for future generations.”

Minister for Further Education and Skills Kevin Brennan said:

“The NHS has shown fantastic support for Apprenticeships, and these figures are a timely reminder of the great success we have seen across the board.

“There is now an all-time high completion rate of 71%, with  a record 240,000 people starting an Apprenticeship in 2008/9. This is a real sign of confidence in our workforce and shows the great progress we are making on improving skills throughout the country.”

Jemima Tevendale, 22, from Kettering, was an NVQ2 apprentice in    business administration through Kettering Borough Training’s      Apprenticeship Scheme and now works full time at the Trust, and has recently completed her NVQ3.

Jemima said:

“Completing my NVQ with Kettering General Hospital gave me confidence in the workplace. I have become aware of the huge amount of effort it takes to run a hospital and I think it’s a great place to work in.”

Current available NHS Strategic Health Authority figures show:

·        There is an even balance between clinical and non-clinical roles – just under 50% of apprentices engaged in the NHS are providing key clinical roles such as maternity support workers and clinical support roles.  The remainder are non-clinical roles such as estates and administration.

·        Around 50% of the apprentices are newly recruited staff.

The Department has also been working with Skills for Care and several local authorities in London to create around 1,300 new apprenticeships in social care this year. These schemes have been aimed at groups that have been traditionally hard to reach such as young people not in education, employment or training, lone parents and men.

Older people needing care and support will benefit from new and refreshed local housing strategies that promote dignity, respect and choice, Care Services Minister Phil Hope said

Speaking at a Laing and Buisson conference, he announced a £3.5 million innovation fund and urged councils to “act now and act decisively” to improve the quality and range of housing options for older people.

Every Council with Adult Social Care responsibility will be awarded approximately £20,000 to develop or update its extra care housing strategy. Councils will be expected to showcase their strategies, promote good practice and exchange ideas on innovative approaches to housing with care on a new on-line web-resource.

Extra Care Housing provides the best housing design features for older people alongside personal care. The Department has invested £227 million in Extra Care housing since 2004. However, there are still approximately 38,000 units of accommodation compared to 10 times that for retirement housing and also residential care

Care Services Minister Phil Hope, said,

“Innovative houses that meet the needs and aspirations of older people are vital to the future of care and support. They are at the heart of the technological change that will define our ageing society, enable more people to live well and live independently in their own home for longer.

I am launching this new fund to help councils develop the next generation of homes Now I want to see councils act now and act decisively to improve the quality and range of housing options for older people.

It is another example of how we’re helping more people to live well in their own homes, supporting our Personal Care at Home Bill, which will offer free care for 280,000 people with highest needs and help thousands more who are receiving home help for the first time.”