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Seriously ill wait more than hour for ambulance

Thousands of emergency calls are taking ambulance crews more than an hour to reach, a BBC investigation shows.

The delays – affecting one in 16 calls in England for conditions such as strokes, heart attacks and fits – are putting lives at risk, experts say.

It amounts to over 4,000 “unacceptably” long waits a week for the second-highest category 999 calls. Wales also reported significant problems.

NHS bosses blamed rising demand and delays handing over patients at A&E.

Many ambulance services have increased staffing – only to find the extra resource largely being swallowed up by the rise in delays faced by crews queuing outside hospitals.

This has meant they have had to prioritise the most serious immediately life-threatening cases, such as cardiac arrests.

But these represent just a small proportion of the high-priority 999 calls.

Some of the longest waits exceeded five hours – crews are meant to arrive within 18 minutes on average.

‘My partner died while waiting’

Derrin Cozart, 55, was at home in Northumberland on his own last year when he collapsed. He came to and rang 999.

That was the last time anyone spoke to him.

It was over an hour before an ambulance crew arrived. By the time they did, he was dead.

He had suffered a gastrointestinal haemorrhage, which causes internal bleeding.

Thirty minutes after his call the ambulance service had rung back, but could not get hold of him.

It took another 48 minutes for paramedics to reach him – two crews had to be diverted while they were on their way.

His partner, Mark Mitchell, was out of the country on business at the time.

“It was devastating. I’ve been left wondering if the ambulance had got there more quickly he may have survived.

“We just don’t know – and that’s heartbreaking.”

The North East Ambulance Service said a full investigation was being carried out into the case.

Patients ‘let down badly’

The BBC investigation, which used the Freedom of Information Act to obtain data, has also uncovered other worrying cases, including a 70-year-old man who waited more than two hours after suffering a heart attack – he was taken to hospital and then faced even more delays before he could be admitted on to a ward

Rachel Power, chief executive of the Patients Association, said patients were being “let down badly at their moment of greatest need” and getting a quick response could be “a matter of life or death”.

She said the delays were “undoubtedly” related to the sustained underfunding of the NHS.

Mark MacDonald, of the Stroke Association, described the findings as “alarming”, saying a quick assessment and transfer to hospital for brain scans was vital if a patient was going to make a good recovery.

“When stroke strikes, part of your brain shuts down. And so does a part of you. Around two million neurons are lost every minute that a stroke is untreated.”

How many long waits are there?

Chart showing regional ambulance performance

The BBC asked for long waits for the two highest priority groups of 999 calls – the immediately life-threatening category ones and the emergency category two cases – from the start of 2018 when a new system of measuring response times came in.

Two of England’s 10 ambulance services – the West Midlands and East of England – refused to provide the information.

Long waits for immediately life-threatening cases were unusual – just one in 270 cases took longer than 30 minutes to reach. That works out at less than 40 a week.

But the records for category two call logs showed long waits for these emergencies were much more common.

The data showed there were 385,000 waits of over an hour from January 2018 to September 2019 out of just over six million incidents responded to.

That works out at more than 4,000 a week on average – or one in 16 calls.

East Midlands Ambulance Service had the greatest number of long delays – one in eight calls took over an hour.

Director of operations Ben Holdaway said crews were often facing long waits at A&E to hand over patients which means they “haven’t been able to get back on the road quickly”.

“Every part of the system wants to tackle these issues, but it’s clear we need more staff and beds and well-functioning social care.”

In Wales there were more than 1,000 cases a week on average – nearly a quarter of callouts – although their second-tier emergency calls category is a little broader than England’s and includes less urgent cases like diabetes complications which could account for some of the long waits.

Lee Brooks, from the Welsh Ambulance Service, accepted that some patients were waiting too long, describing it as as “frustrating for staff as it is for patients”.

Ministers are in the process of setting up a taskforce to tackle the delays.

Comparable data was not available in Scotland or Northern Ireland.

NHS national ambulance adviser Anthony Marsh said: “It is not easy to reach everyone as quickly as we would all like. All our staff are working flat out.”

The Department of Health and Social Care in England said the government was increasing funding for the health service and had set aside a dedicated pot to invest in ambulance services.

It also said it was investing in the workforce – from September student paramedics will be entitled to a £5,000-a-year grant to support them during their studies.

Data analysis by Felix Stephenson and Christine Jeavans

 

Source: https://www.bbc.co.uk/news/health-51269618

“Potential to eliminate” cervical cancer in England thanks to NHS Long Term Plan

Hundreds of lives will be spared every year in England thanks to a more sensitive cervical screening test rolled out as part of the NHS Long Term Plan.

NHS experts said that there is “potential” to eliminate cervical cancer completely thanks to the change in primary test within the NHS Cervical Cancer Screening Programme, combined with the effectiveness of the HPV vaccine.

The new and more sensitive test now looks for traces of high risk Human Papillomavirus (HPV), which causes nearly all cases of cervical cancer. Any tests that are HPV positive are then checked for abnormal changes of the cervix.

HPV is a group of viruses with more than 100 types, but 14 types can cause cervical cancer as well as some head and neck cancers.

It means that any sign of infection will be spotted at an earlier stage before it could potentially develop into cancer.

Since the beginning of December, every part of the country has had the new way of screening in place.

There are 2,500 new cases of cervical cancer in England every year but research says that a quarter of those could be prevented with this new way of testing.

The introduction is part of the NHS Long Term Plan’s ambitions to catch tens of thousands more cancers earlier, when it is easier to treat and the chance of survival is higher.

Professor Peter Johnson, national clinical director for cancer said: “Screening is one of the most effective ways of protecting against cervical cancer and there is no doubt this new way of testing will save lives. It is vitally important that all eligible people attend for their screening appointments, to keep themselves safe.

“Combined with the success of the HPV vaccine for both boys and girls, we hope that cervical cancer can be eliminated altogether by the NHS in England. The chances of surviving cancer are at a record high, but there is always more we can do, as we continue to deliver our Long Term Plan.”

Professor Johnson added that cervical cancer often causes no symptoms during the early stages of the disease, which is why it is “especially important that people attend their tests and that those who are eligible get vaccinated against HPV.”

Robert Music, Chief Executive, Jo’s Cervical Cancer Trust said: “It is exciting that we are seeing advances in cervical cancer prevention and must continue to look to the future to make sure our cervical screening programme continues to adapt and evolve.

“The day that cervical cancer is a disease of the past is one we should be aiming to get to as soon as possible. Cervical screening is such an important test, but there are many reasons it can be difficult to attend. We must continue to understand and tackle these to ensure as many women benefit from this far more sensitive test and we save as many cancers diagnoses and lives as possible.”

Professor Anne Mackie, Director of Screening at Public Health England said: “With HPV vaccinations for all year 8 pupils and HPV testing available nationally, cervical cancer promises to become very rare indeed. This is a truly momentous achievement, but to ensure we consign this disease to the past we must keep vaccination rates high and continue to provide safe and acceptable screening for all women.”

Jo Churchill, Public Health Minister said: “Thousands fewer women will be diagnosed with cervical cancer as a result of improved screening services and the HPV vaccine and it’s incredible to think that cervical cancer could be eradicated for good.

“The NHS Long Term Plan has committed to an overhaul of screening programmes, new investment in state of the art technology and a boost in research which will help more people survive cancer each year. I encourage all women to attend screening appointments.”

Joanna Gray, 30 from Manchester said: “I still remember being told that I had HPV and cell changes. It was really scary and made me panic. The doctor at the hospital told me that if I’d left this for another three years then it could have been very, very different. However now I’m all clear and am really grateful that it was caught so early. I think it’s amazing that smear tests prevent cervical cancer before it even has a chance to begin”

The latest figures show that seven in 10 people attended their cervical screening appointment last year but that one million people didn’t attend their appointment.

Women and people with a cervix aged between 24.5 and 49 are eligible for screening every three years, whilst those aged between 50 and 64 should be screened every five years.

The NHS Long Term Plan will transform cancer care across the country with a renewed focus on improved screening to catch three quarters of all cancers at stages one and two.

 

Source: https://www.england.nhs.uk/2020/01/potential-to-eliminate-cervical-cancer-in-england-thanks-to-nhs-long-term-plan/

Could running a marathon make your blood vessels ‘younger’?

“First-time marathon runners can ‘reverse ageing’ on blood vessels by four years,” reports the Daily Mirror.

The headline follows a UK study that recruited 138 healthy adults with no previous marathon experience. The participants then spent 6 months training for the London Marathon.

At the start of the study, researchers used a type of heart scan that measures the stiffness of the aorta – the major artery that takes blood from the heart to supply the rest of the body.

Increased artery stiffness is linked with increased risk of high blood pressure and heart disease. It’s also considered to be a sign of ageing. The researchers repeated these scans after the participants completed their first marathon.

The study found that training was associated with decreased stiffness of the aorta. This was calculated to be the equivalent of up to 4 years’ decrease in the “biological age” of the blood vessel. The effect seemed to be greater in:

  • older participants who had stiffer arteries to start with
  • those with slower marathon running times

It’s worth noting that we do not know the health outcomes of the participants in the longer term, so we do not know if the decreased artery stiffness definitely translated into improved heart health and longevity. However, we do know that regular physical activity boosts health.

Running is not for everyone, and just over half of the people who signed up completed the study. Other forms of exercise such as cycling, swimming or walking may be just as beneficial. The important thing is to do regular physical activity in line with current recommendations.

If you are planning to get fit for the new year, running a marathon may be a little too ambitious as your first exercise goal. Other ways you can gradually increase your fitness levels include running shorter distances, swimming and cycling.

 

Source: https://www.nhs.uk/news/lifestyle-and-exercise/could-running-marathon-make-your-blood-vessels-younger/

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