New breed of surgeon training to save rural hospitals - The Herald
Uncertainty has surrounded emergency medical care in the Highlands and islands for years as health boards have struggled to fill vacancies.
Now a long-awaited report commissioned by the Scottish Government on safeguarding the future of hospitals in these scattered communities has been submitted.
It recommends new training programmes to prepare consultants for the wide-ranging demands of working in small hospitals hours from specialists in city centres.
Hiring people to jobs perhaps a year in advance and honing their skills for the exact role is also suggested. There are six rural general hospitals in Scotland, covering communities from Fort William to Orkney and serving more than 150,000 residents, as well as holidaymakers.
However, as doctors have specialised in narrower medical fields NHS managers have struggled to replace consultants who leave. This and rules on doctors working hours have already threatened services in Fort William, Oban and Wick.
A working group was set up to examine the issues in 2005 and it is understood discussions about how to staff rural hospitals have at times been tense.
The finished report states rural general hospitals should have at least three consultant surgeons, a three-strong consultant-led anaesthetic team and three medical specialists.
It also lists the core services patients can expect to have in their nearest rural general. These include resuscitation, initial fracture management, Caesarean sections, appendix removal and diagnostic tests such as CT scanning.
David Sedgwick, consultant surgeon at Belford Hospital in Fort William, said: "What this report does is define the rural general hospital. In particular, it confirms they have the vital 24:7 consultant-led service in medicine, surgery and anaesthesia."
Programmes for teaching staff the necessary skills have already been devised.
The report says anaesthetists should have experience in a range of areas including niches such as transporting very ill adults and children and resuscitating newborn babies. Surgeons should also study a broad spectrum of medical fields including gynaecology, ophthalmology and neurosurgery.
Mr Sedgwick said: "For the first time a blueprint for training consultants and GPs has been devised so that appropriately trained doctors can be recruited to provide community and hospital health care to these communities."
Professor Neil Douglas, chairman of the Academy of Medical Royal Colleges in Scotland, which brings health professional bodies together, warned there were still issues to be addressed.
He said: "We have a major job to do to make sure people want to work in these locations. One of the things that requires quite a lot more work is not only to make sure medical students get exposed to these settings but also trainees (junior doctors), because it is less likely you will want to work in these places if you have not enjoyed working there before."
Community health care is also examined in the report. It describes GPs, who can be isolated, joining forces to arrange the kind of pro-active care which can prevent people falling ill.
A Scottish Government spokeswoman welcomed the report, saying it "presents a model of safe and sustainable services for patients living in rural areas".
DH to fund ‘revolutionary’ new diabetes transplants – UK Pharma Times
UK patients with type 1 diabetes have been offered a new ray of hope after the government gave the green light yesterday for a revolutionary transplant treatment at specialist centres across the country.
The transplant procedure, discovered through research funded by Diabetes UK, basically involves the injection of pancreatic cells from a donor to stimulate the production of insulin, and takes just 45 minutes to complete.
Patients undergoing the treatment will have to take immunosuppressant drugs to suppress the body’s immune response to these ‘foreign’ cells, but will no longer need to take daily injections of insulin to control their disease, and should be free of the risk of dangerous blood sugar lows.
The Department of Health is stumping up £2.34 million in the first year and a maximum of £7.32 million thereafter to enable six centres in the UK - Kings College Hospital NHS Foundation Trust and Royal Free Hampstead, Oxford Radcliffe Hospitals, Newcastle-upon-Tyne Hospitals, North Bristol, Central Manchester and Manchester Children's NHS Trusts - to offer the procedure to patients at greatest risk from blackouts and hospital admissions associated with hypoglycaemia.
80 transplants a year
Around 12 patients in England have already been given such transplants to date under funding from charities, but with the government’s new cash it is expected that, in the first twelve months from April 1, around 20 transplants will take place, and that this will expand to around 80 in subsequent years to meet the annual demand.
Commenting on the programme, health minister Ann Keen said it will “ensure that people who have been unable to treat hypoglycaemia with conventional therapies will benefit from significant improvements to their quality of life”, while Diabetes UK chief executive Douglas Smallwood added: “The decision to fund this programme will be life-changing for some people”.
Furthermore, it is hoped that resolving the worst cases of hypoglycaemia will also help to reduce some of the burden on the NHS, given that “hypoglycaemic attacks cost £15 million a year in hospitalisations and ambulances alone,” as Smallwood pointed out
NHS Procurement Calendar issued – BiP Solutions
The NHS has released details of its Procurement Calendar, which provides an update on the renewal dates of existing, transferred contracts.
This is not the full procurement workplan, which continues to be developed, and which will be communicated and discussed, with NHSBSA and other interested parties as it is finalised.
The Procurement Calendar can be viewed at:
http://www.supplychain.nhs.uk/portal/page/portal/Public/Procurement%20Calendar/Procurement%20Calendar%20Feb%2008.xls
Genes to blame for childhood obesity – The Independent
Fat children are born, not made, a study of twins has found. Instead of blaming parents of overweight children, we should accept that factors which determine body size are largely outside their control, researchers say.
A survey of 5,000 pairs of twins found variation in the children’s waist measurement and body mass index was 77 per cent attributable to genes and 23 per cent to environment. Researchers compared identical pairs of twins, who share the same genes, with non-identical twins who share only half of their genes.
Jane Wardle, director of Cancer Research UKs Health Behaviour Research Centre, said: "Contrary to the widespread assumption that family environment is the key factor in determining weight gain, we found this was not the case. The study shows it is wrong to place all the blame for a child’s excessive weight gain on parents; it is more likely to be due to the child’s genetic susceptibility."
The findings are reported in The American Journal of Clinical Nutrition.
One third of British children are overweight or obese, a figure projected to rise to two thirds by 2050 if nothing is done. Overweight children are more likely to become overweight adults with higher risk of diabetes, heart problems and cancer.
GPs turn to exercise for treating depression – The Daily Telegraph
One in five GPs prescribes exercise to treat depression as an alternative to drugs, a survey has disclosed.
This represents a four-fold rise in three years. However, two thirds of doctors who would like to offer exercise as part of a treatment programme for depression say there is no scheme in their area.
The findings, from the Mental Health Foundation, come after successive research papers have shown that exercise can be as effective as some drugs in the treatment of mild to moderate depression.
A survey of GPs found that 22 per cent prescribe exercise as one of the three most common treatments for depression, compared with just five per cent three years ago.
The Mental Health Foundation has been campaigning to increase the use of exercise referrals for depression. However, the foundation warned that it is still not widely available - with less than half of GPs able to access a scheme.
There are around 1,300 exercise referral schemes in Britain, where after assessment patients are given discounted access to swimming, gym sessions, yoga or dance classes.
Two thirds of GPs who do not have access to an exercise referral scheme say they would use one if it were available.
Sixty-one per cent of GPs believe that a supervised programme of exercise is "very effective" or "quite effective" in treating mild to moderate depression, compared with 41 per cent three years ago.
Andrew McCulloch, the chief executive of the Mental Health Foundation, said: "Depression is a complex illness - it is important that GPs have a range of treatments to offer and that people with depression have a choice."
Watchdog approves epilepsy drug – The Herald
A drug that can significantly improve life for patients with epilepsy was approved for use in Scotland. Keppra has been found to reduce seizures in children and adults by as much as 30 per cent. Last year the Scottish Medicines Consurtium (SMC), which determines if new drugs should be prescribed by the Scottish NHS, rejected Keppra. However, after receiving more information they have given doctors the green light to prescribe it to patients.