DH launches antimicrobial resistance strategy

by JoelLane 12. September 2013 15:09

Anna Soubry (resized) The Department of Health has published a five-year strategy to counter antimicrobial resistance (AMR) through monitoring, treatment and education, both nationally and internationally.

Steps taken include tighter controls to ensure appropriate prescribing of antibiotics and the setting up of a new Health Protection Research Unit.

In addition, work is ongoing to add AMR to the Government’s long-term national security risk register.

The strategy follows the recommendations made in March by the Chief Medical Officer, Professor Dame Sally Davies, who warned that AMR posed a “catastrophic threat” to healthcare in the future.

The evolution of antibiotic-resistant strains of pathogenic bacteria, caused in part by overuse of standard antibiotics, threatens to increase the prevalence of hospital-acquired infections following operations.

The new DH publication highlights the importance of healthcare providers working with the pharmaceutical, food, farming and retail sectors, as well as academic researchers, to address the threat.

Public Health Minister Anna Soubry (pictured) said: “The Chief Medical Officer’s stark warning showed that bacteria are adapting fast and if we don’t take action, we could face serious problems in years to come.

“This is really a problem that society has to take on together, through better education, treatment and monitoring of bacteria. Whether you’re a patient, a doctor or a vet, we all have a role to play in prescribing and using antibiotics responsibly.”

The strategy includes measures to:

• Prevent and manage infections in people and animals better through improved hygiene and monitoring of bacteria in medical and community settings.

• Improve education and training on the prescribing of antibiotics to ensure patients receive the right antibiotics at the right times.

• Collect data on AMR to enable earlier intervention.

• Set up a new National Institute of Health Research (NIHR) Health Protection Research Unit to focus on AMR, with £4m funding.

• Encourage the development of new antibiotics and rapid diagnostics by working with industry.

Steve Bates, CEO of the BioIndustry Association (BIA), commented: “The vibrant UK bioscience base is eager to play its part in addressing this global challenge. UK biotech companies, such as Discuva and Cantab Anti-infectives for example, are using Biomedical Catalyst funding to discover and develop new antimicrobial classes for Gram-negative bacteria. At the same time, Redx Pharma has attracted significant backing from the UK Government’s Regional Growth Fund to support the creation of its Anti-infectives R&D subsidiary.

“However, getting the incentives right globally for investment in this is essential. For instance, we need incentives for pharmaceutical companies to develop drugs that will only be used infrequently and sparingly rather than paid for every pill used. I hope this strategy inspires discussion of new concepts around this agenda to enable commercial companies to fully engage on this vital challenge for society.”

Flu vaccination recommended for school-age children

by JoelLane 26. July 2013 16:06

Vaccination_of_girl_preview An extension of the NHS influenza vaccination programme to cover all children aged 5–16 has been recommended by the Department of Health.

According to the Joint Committee on Vaccination and Immunisation (JCVI), extending protection to all school-age children is “highly likely to be cost effective and well within accepted cost effectiveness thresholds.”

The JCVI also recommended extending the programme to children aged two to four years, though this age group are at less risk and so the overall benefit could be “relatively small”.

The decision reflects concern about the ease with which flu spreads through schools, and awareness that the ‘herd immunity’ effect of vaccinating more vulnerable people can protect the whole population.

It follows the decision in April to offer all children aged two years in England a nasal flu vaccine from September 2013.

The new vaccination programme could not be implemented until autumn 2014 or later, the JCVI said, and will need an extensive public information campaign as well as time to “ensure the large-scale supply, storage and distribution of vaccine”.

The vaccinations for children aged 5–16 should be delivered in schools, while younger children can be vaccinated in clinics or GP practices.

Sally Davies, Chief Medical Officer, said the recommendations would be followed, but noted: “There are significant challenges to delivering a programme that requires up to nine million children to be vaccinated during a six-week period.

“We will look at the recommendations in detail to decide how best to develop and deliver the programme.”

Tamiflugate blows open again in Parliament

by JoelLane 24. May 2013 11:43

Margaret Hodge web The public money spent on stockpiling the antiviral Tamiflu (oseltamivir) in 2009 has been described as “extremely worrying” by MP Margaret Hodge.

The House of Commons Public Accounts Committee, which Hodge chairs, will conduct a hearing into the £424m spent on Tamiflu during the influenza crisis.

The enquiry shows that despite Roche’s recent promise to release ‘redacted’ trial data to Cochrane researchers, the Tamiflugate scandal has not gone away.

Responding to information from the National Audit Office (NAO), Hodge commented that the decision to stockpile Tamiflu was questionable as NICE had been denied the clinical trial data it needed to make a decision.

The enquiry will question Chief Medical Officer Sally Davies and NICE Chief Executive Andrew Dillon among others.

According to the NAO, there is a “general consensus” that Tamiflu reduces the duration of flu symptoms, but not that it reduces hospitalisations or deaths.

Hodge said the decision to stockpile the Roche drug, given the limited evidence of its effectiveness, was “extremely worrying” – while the wastage of 6.5 million doses of Tamiflu (costing £7.4m) due to poor NHS record-keeping was “a shocking example of incompetence”.

The NAO recommended that “independent research” be commissioned in future to guide decisions over drug stockpiling.

It noted that NICE did not have the statutory power to demand data from manufacturers, so was at risk of making a poor decision in a crisis.

NICE should require manufacturers to confirm that the evidence they have submitted is complete, it said.

Roche has attempted to close Tamiflugate by offering ‘redacted’ clinical trial reports (with confidential commercial and patient data deleted).

However, Cochrane researcher Peter Gøtzsche has claimed the studies contain no confidential data and the condition is “smoke and mirrors”.

Liver disease is a public health priority

by JoelLane 21. November 2012 15:06

Prof. Dame Sally Davies, CMO web Urgent action by public health authorities is needed to address the rising prevalence of liver disease in England, the Chief Medical Officer has said.

Professor Dame Sally Davies noted that in the last decade, the incidence of liver disease has grown here by 20% while falling by a similar amount in Europe.

The CMO’s first annual report also highlighted the need for better access to healthcare and better public health surveillance as priorities.

The report is intended to guide and inform the public health strategies of local government and the new Health and Wellbeing Boards.

Drawing on international data, Davies commented that liver disease “is the only major cause of mortality and morbidity which is on the increase in England whilst decreasing among our European neighbours.”

The main causes are heavy drinking, obesity and undiagnosed hepatitis infection, but late diagnosis contributes to poor outcomes – so the report calls for a combined preventative and early intervention approach.

Variations in access to healthcare were also highlighted, with diabetes monitoring a particular area of concern – only 50% of people diagnosed with diabetes receive all nine NICE-recommended annual tests.

Public health surveillance was a third priority emphasised by Davies, who called for better information on significant but non-fatal diseases such as musculoskeletal and skin disorders, cognitive and sensory impairment, and incontinence.

In addition, she warned, cutting costs on public health surveillance could leave populations exposed: “The history of public health suggests that it is not enough to prepare for the health problems we already know about.”

Strikingly, Davies praised the contributions of the cancer registries and the Health Protection Agency – both due to be abolished in 2013.

All UK children to be offered flu vaccine

by JoelLane 25. July 2012 17:19

happy child Annual influenza vaccinations will be offered to all children aged two to 17 in the UK from 2014.

A nasal spray of the Fluenz vaccine will be used rather than an injectable form, except with children in high-risk groups.

The vaccination programme – the first of its kind in the world – is predicted to save 2,000 lives per year given only moderate uptake (30%).

As well as saving many children’s lives it could protect non-vaccinated people, especially elderly family members, through the ‘herd immunity’ effect.

The Joint Committee on Vaccination and Immunisation (JCVI) said the vaccine would be offered to nine million children in the UK, more than doubling the number of vaccinations available.

According to the Chief Medical Officer for England, Professor Dame Sally Davies, if only 30% of these children receive the vaccine there will be 11,000 fewer hospital admissions and 2,000 fewer deaths.

The vaccination will be optional and will depend primarily on GP surgeries, as there are too few school nurses to deliver the programme.

AstraZeneca’s Fluenz is a live attenuated vaccine sold in the US as FluMist. The UK contract could be worth £100m a year to the company.

Vaccinating children could also protect vulnerable family members, including babies and the elderly – an effect known as ‘herd immunity’.

Boost to UK dementia research funding

by JoelLane 27. March 2012 14:41

Andrew Lansley 2 (resized) The UK Government has committed to more than doubling the funding available for dementia research.

The combined annual funding for the National Institute for Health Research, the Medical Research Council and the Economic and Social Research Council will rise over the next three years from £30m to £66m.

The extra investment includes £36m over the next five years for a new NIHR translational research collaboration to help convert medical discoveries into new treatments.

Four new NIHR biomedical research units specialising in dementia treatment will share their resources and expertise.

Biomedical researchers will be encouraged to offer more opportunities for people with dementia to be involved in research.

The MRC will invest further in the BioBank, a long-term global study of the effects of genetic factors on ageing in over 500,000 people.

Health Secretary Andrew Lansley (pictured) said: “Dementia is one of the biggest challenges we face as a society and we are determined to transform the quality of dementia care for patients and their families.”

Professor Dame Sally Davies, the UK’s Chief Medical Officer, commented: “The UK is a world leader in dementia research. This significant funding boost will allow us to push ahead with a comprehensive programme to increase the volume of dementia research.

“This will accelerate the identification of causes, cures and better ways of caring for a disease that is such a burden on patients, carers and society.”

Shirley Cramer, Chief Executive of Alzheimer’s Research UK, called the funding increase a “turning point in our battle to defeat dementia”. Research was the long-term key to treating dementia, she said. “UK dementia scientists lead the world in terms of research quality and impact.”

Public ignoring flu jab

by emma 3. October 2011 15:37

Pf NHS News

The Government has claimed people who ignore receiving the seasonal flu vaccine are playing “Russian roulette with their lives”.

A DH survey found that 87% of holidaymakers get the necessary injections to combat tropical diseases, but separate figures reveal that less than half under-65s advised to get the flu jab were vaccinated.

Chief Medical Officer, Professor Dame Sally Davies, says there is “no reason not to get vaccinated” and urged those eligible to get the jab as soon as possible.

Pregnant women, patients with long-term conditions such as diabetes and asthma, and anyone with a neurological condition can get the vaccination free of charge.

Frontline health and social care workers, carers, pensioners and those in nursing homes are also encouraged to get vaccinated. But the survey found that only a third of frontline doctors and nurses opted to have the flu jab last winter.

More than 600 people died with flu in Britain last year, the majority of whom were young or middle aged. But the Chief Medical Officer says this number could be reduced if people took just a matter of minutes to get vaccinated.

“A five-minute appointment to have the flu jab could save your life,” said Professor Davies. “Flu can be a serious illness – particularly for those in at risk groups. It can result in a spell in hospital, and sadly, flu can kill. The best way to protect yourself is to be vaccinated.

“It takes five to ten days for the vaccine to take effect so I’d urge everyone in an at risk group to get vaccinated as soon as they are able.”

The National Director of Immunisation, Professor David Salisbury, added that it was equally as important to be covered against tropical diseases as it is the flu and the sooner they do the better.

“It is very important that people in these groups get vaccinated early in the flu season so they are protected before flu starts to circulate.

“About three-quarters of older people get their flu vaccine each year, but only around half of younger people in at risk groups get vaccinated. Seasonal flu is not the same as getting a cold – it can seriously affect your health.”

Emergency stock of flu jabs ready for winter

by emma 23. September 2011 15:57

An emergency stockpile of 2 million flu vaccines has been set up in preparation for the UK flu season.

Professor Dame Sally Davies, Chief Medical Officer for England, said that the extra supplies will “smooth things out”, in contrast to the shortages reported in certain areas of the country last year, with older jabs being used to fill the gap.

This winter’s stock consists of 16.7 million vaccines compared to 14.7 million last year.

Once again, there will be no promotion of the jabs in England, but Scotland and Northern Ireland will raise awareness through advertising. Professor Davies said that she relies on charities, health workers and pharmacies to spread the word.

Professor David Salisbury, the Government’s Director of Immunisation, warned that it would be taking a risk to miss the vaccination this year: “You need it just as much as last year.”

He warned there was no evidence that last year's vaccination would still offer protection and criticised healthcare workers for avoiding the shot, saying they were “selfish” for neglecting the importance of their patients’ health and of those around them.

Professor Salisbury claimed that healthcare staff are being encouraged to get the shot, but also said that hospitals need to make it easier for workers to get vaccinated.

Last year, 35% of healthcare employees were vaccinated with the flu shot, an increase of 26% from the year before.

The jab will protect against swine flu (H1N1) as well as the H3N2 and Flu B strains. These are the same three viruses that were covered by the vaccine last year.

Read more of the story on the BBC website.

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