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“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.



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.



Clinical Waste Disposal: Reducing Single Use Plastic within the NHS

The environmental, legal and financial benefits of the switch to a clearly identifiable non-hazardous pharmaceutical waste stream have been appreciated by the trust for a number of years now. We were able to switch from rigid plastic to rigid board-based containment for this waste stream which has helped our trust address the requirement to improve our environmental performance, generate savings whilst continuing to move towards fulfilling our sustainability objectives

Jason Mitchell, Waste Manager
Newcastle Upon Tyne Hospitals NHS Foundation Trust

The challenge

Prior to this implementation several years ago, Newcastle Upon Tyne Hospitals NHS Foundation Trust did not have a fully defined process in place for segregating some elements of healthcare waste. Non-hazardous pharmaceutical waste was disposed of in the same bins as hazardous waste. As the disposal for hazardous waste is more expensive, their costs were being impacted. This practice was also non-compliant with HTM Guidance.

Following an internal review, the trust introduced blue-lidded plastic bins to allow pharmaceutical waste to be disposed of separately to other waste streams. With an increased focus on sustainability, they began looking at ways to reduce single use plastics; adopting board-based rigid containers for pharmaceutical waste. It was also apparent at the time that board-based alternatives were cheaper to purchase than plastic containers.

To successfully implement this new approach to clinical waste disposal, the Trust needed buy in from key stakeholders. There was a lack of awareness about the benefits of segregating pharmaceutical waste from its current method. Questions were raised regarding the quality and durability that board-based waste bins could provide when compared to plastic.

What were our objectives?
  • Raise awareness of the effective benefits when using board based clinical waste disposal streams, across key hospital departments.
  • Reduce the utilisation of single-use plastics when disposing of medical waste.
  • Generate savings on pharmaceutical waste disposal.
  • Successfully implement a segmented approach to waste disposal in line with Trust policy within 6 months of completing a successful product trial.
What is the process?
  1. Recognising the need to implement a more structured approach to waste segregation to reduce plastic usage in the waste process and to generate savings.
  2. Procurement and Waste Management worked together to identify opportunities and then engaged with stakeholders from across the Trust to increase awareness and adoption of waste segregation.
  3. Implemented a board-based blue non-hazardous pharmaceutical waste stream.
  4. Identified that board based bins offered a cost effective alternative – The specific products were selected due to in part the inclusion of an absorbent pad within the bin, allowing for medicinal waste to be added.
  5. Implemented to ‘friendly’ wards and departments including Pharmacy Stores, Clinical Research, specialist wards.
  6. Full implementation across 200 wards was achieved in a matter of weeks. Very straightforward roll-out.
What are the overall benefits?

Upon completion of the trial, 6 months implementation was anticipated – however uptake was very quick, and this was actually achieved within a matter of weeks.Jason Mitchell, Waste Manager
Newcastle Upon Tyne Hospitals NHS Foundation Trust

  • Board-based waste bins were successfully introduced in to 200 hospital wards across the Trust.
  • Based on current waste costs for the Trust 20% savings are achieved by having a separate channel for pharmaceutical waste disposal.
  • 29% of consumables saving were delivered by moving from plastic to board-based waste bins at the time of the trial.
  • There was a reduction in inventory usage due to the flat pack option available with board-based bins.
  • At the time of the trial an estimated 46% reduction in carbon emissions was achieved due to board-based bins being 96% more renewable than plastic.

A point to note is that there have been recent developments in the healthcare waste industry, particularly around incineration outlets which, has led to a reassessment of pharmaceutical waste disposal. As it is non-hazardous, the understanding is that it can be disposed of in permitted municipal incineration plants instead of specialist healthcare waste incinerators; providing it is clearly identified and appropriately labelled. For the most part, this will bring cost savings and be completely compliant if the receiving site is permitted for 18 01 09 waste.

The blue pharmaceutical waste stream was very easy to introduce once ward and department managers understood the need for a compliant and cost-effective system for waste containment and disposal. Introducing board-based containers can be the standard for this system in any hospital.Jason Mitchell, Waste Manager
Newcastle Upon Tyne Hospitals NHS Foundation Trust

Useful insights
  • Board-based clinical waste disposal should be considered when looking at the reduction of single-use plastics.
  • Implementing the change in a small number of departments before rolling out on a larger scale will enable any issues to be addressed early on.
  • Issues will need to be considered around, security of open containers, movement by porters and on-site storage prior to disposal.
  • Pharmaceutical waste does not have to be consigned to a clinical waste incinerator if an alternative permitted municipal waste recovery facility is available which can save a significant amount of money.
  • As board-based bins can’t be wiped clean, it may be that they aren’t be suitable for all Trust departments. Ensure that key stakeholders are identified and engaged with from the outset so that requirements can be captured.
  • Most suppliers provide Floor stands to accompany board-based bins; preventing the bin from splitting if the base becomes wet. This can be caused when floors are frequently mopped.
What is the NHS long term plan?

The NHS Long Term Plan was published in January 2019. It outlines some key commitments to help the NHS be a low carbon institution and lead by example in sustainable development. These commitments include:

  • Reducing carbon emissions
  • Improving air quality
  • Reduction of single use plastics
  • Improving efficiency and adopting new innovations to reduce waste, water and carbon.

Despite a 27% increase in activity, the carbon footprint of health and social care has reduced by 19% since 2007. This still leaves a significant challenge to deliver the Climate Change Act target; the target of which is 34% by 2020 and 51% by 2025. The NHS as an organisation has a huge carbon footprint. A large percentage of which is from the procurement of goods and services. Waste is a contributor to that carbon footprint. In addition, the plan responds to the global concern over single use plastics. Any activity which reduces plastic and reduces waste will be helping the NHS to deliver on its carbon reduction commitment. This will help make the NHS an anchor institution in sustainable development.



Mindray Medical introduces new point-of-care ultrasound system

China-based medical device company Mindray Medical has launched the TE7 ACE point-of-care ultrasound system to deliver targeted solutions in various point-of-care scenarios, such as anaesthesia, critical care and emergency.

The touchscreen ultrasound system comprises complete disinfection solution, smart fluid management tools and safe needling toolkit, offering seamless data connectivity.

Mindray medical imaging system business unit general manager Xujin He said: “Having identified the clinical challenges, Mindray developed this solution to empower clinicians with more confidence to focus on patient care.”

Mindray states that early assessment will help execute the fluid therapy plan and save lives by managing patient body fluid.

The advanced fluid measurement tools of the system speeds-up patient assessments accurately and efficiently based on deep learning algorithms.

Mindray’s system features Smart VTI that can automatically calculate the velocity-time integral, cardiac output and stroke volume variation. The trending graph assists in efficient recording and guides fluid therapy.

The Smart IVC can automatically trace the IVC diameter change, as well as calculate the collapsibility index or distensibility index and IVC variation to evaluate volume status and responsiveness.

The Smart B-line can automatically calculate -lines number, percentage and distance. It offers a visual scoring map for intuitive overall lung water assessment, helping to guide fluid infusion and prevent pulmonary oedema.

The newly introduced L12-3VNs with three programmable buttons brings together eSpacial Navi and remote controls to helps clinicians carry out puncture without touching the system.

Furthermore, the eGateway connectivity solution allows TE7 ACE to fit into the existing hospital network and integrate patient’s clinical data collected from both ultrasound equipment and patient monitors. Due to the paperless process, productivity becomes enhanced and the risk of transcription errors minimise.



Kirstine Morris on Orthopaedic growth in the UK

The UK is home to 62 million people, of which 16% are aged 65 and above. By 2050, this will grow to an estimated 77 million. As a sizable chunk of this population continues to age a surge in the incidences of chronic diseases is also expected. This, coupled with a sustained rise in benefits provided by payers and providers is expected to boost demand for medical devices and supplies. Many manufacturers and healthcare providers are spending heavily in raising awareness through direct-to-consumer advertising, and this is further boosting the country’s demand for healthcare.

One area set for rapid growth is the orthopaedic industry. According to a new report by GBI Research market sector growth between now and 2016 will be 7.8 per cent taking the total value of the world wide orthopaedic industry to $41.8 billion by the start of 2016. In the UK alone the orthopaedic devices market was valued at $997m in 2009 and is forecast to grow by 8% annually for the next seven years to reach $1.7bn in 2016. GBI Research claims that joint reconstruction will remain the largest orthopaedics sector accounting for $22.9 billion of the total.”The market will be driven by the aging population, technological advancements in implant designs and materials which are resulting in improved durability and younger patients undergoing surgery in the future,” the report claimed.
An estimated 539,000 people reported work-related musculoskeletal disorders in the UK in 2007-08. An increasingly sedentary lifestyle coupled with increasing cases of arthritis, has led to high incidences of back pain and joint afflictions being recorded. A trend driving demand for spinal implants, joint implants and other products indicated to treat musculoskeletal disorders. Arthritis currently affects one in every five adults in the UK. In 2007, an estimated 4.4 million people were found to have X-ray evidence of moderate to severe osteoarthritis in their hands, 550,000 people with moderate to severe osteoarthritis in knees and 210,000 people with moderate to severe osteoarthritis of the hips.

Overall the UK medical devices industry was valued at £8.2bn ($12bn) in 2009. Driven primarily by an increase in the ageing and unhealthy population pool, the market is forecast to grow by 8.2% annually for the next seven years to reach £14.4bn ($21bn) in 2016. As well as the orthopaedic sector the growth will also be driven by an increasing demand for cardiovascular and diabetes care devices. The increased affordability, particularly during the last decade, coupled with rapid industrialisation has led to significant lifestyle changes among healthcare consumers in the UK, a trend that has resulted in a huge pool of patients suffering from lifestyle and work-related disorders such as diabetes and cardiovascular diseases.
The flip side to this growth is the severe budgetary constraints that the NHS will face in the next few years. Publicly financed healthcare expenditure has contributed to most of the increase in health spending for almost a decade. The NHS total expenditure of amounted to $153bn (£98.3bn) in 2009-10. While the NHS continues to suffer from underfunding, a bigger concern is an estimated £2.6 billion ($4bn) cost savings that the NHS is expected to contribute. Consequently, the funding to NHS for 2010-11 was reduced to £102.3bn ($160bn) from the £104.6 billion ($163bn) originally planned in last year’s budget. Reportedly NHS trusts are expected to deliver efficiency savings in the range of £15 billion ($23bn) and £20bn ($31bn) over three years from 2011 to 2014. While there are growth obstacles that do not seem to leave the horizon any time soon, the fact that the underlying demand drivers remain in place, should make the UK industry stakeholders happy.

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