January 2022 – Page 19 – The NEN

Health Emergency: Worst ever four-hour performance “must be a call to action”

“The health service is in the middle of the biggest crisis it has ever faced“

The latest monthly Emergency Department (ED) performance figures published by NHS England for December 2021 show that four-hour performance at major Emergency Departments reached its lowest since records began at 61.2%, meaning nearly two in five patients were delayed by four-hours or more and nearly 1 in 4 admissions experienced a wait of at least four hours from the decision to admit them to admission.

The data also show the highest number of 12 hour waits ever recorded: 12,986 patients spent 12 hours or more from decision to admit to admission. This is a 22% increase on the previous month, November 2021, and it is 250% higher than December 2020.

Responding to the publication of NHS England quarterly and monthly performance figures, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The situation on the ground is extremely bleak. Staff are overwhelmed and burned out; it is increasingly challenging to provide timely and safe patient care.”

Latest Quarterly performance figures published by NHS England show that in 2021-2022 there were a total of 43,218 12-hour delays which is more than all the 12-hour delays over the previous ten years put together (39,608).

The data does not paint the full picture as NHS England record 12-hour waits from decision to admit. Our Winter Flow project, which started at the beginning of October 2021, has so far recorded 71,965 12-hour waits from time of arrival.

It is critical that NHS England commit to reporting 12-hour data from time of arrival and implement the Clinical Review of Standards.

Dr Henderson said: “The health service is in the middle of the biggest crisis it has ever faced, and staff are working harder than ever before with fewer staff and fewer beds.

“When the health service is overwhelmed, it does not cease to function, it is the standards and quality of care that fall. The figures published today show the extent to which these standards have fallen already.

“Performance metrics are intended to hold clinical services to account. They are meant to identify areas in which services are failing with the aim of improving them quickly and effectively.

“The consistent and continuous decline of urgent and emergency care performance, standards, patient experience and patient safety show how this intended function is now entirely lost. With each publication around performance, we commentate with shock and dismay at the latest decline, but our comments are, more often than not, met with inaction or short-term fixes. There needs to be acknowledgment that there is a major public health crisis in emergency care.

“It is the core ability and function of the health and social care service to deliver high-quality and effective care to the acutely ill or injured that is at risk.

“We must now see a vision for recovery and a vision for the health service that includes a vital transformation of the urgent and emergency care system. There must be a plan to implement a framework that is centred around patient care, that drives action and improvement.

“The current framework is simply documenting the health system’s failure to deliver a quality service, and the failure of this framework leaves urgent and emergency care in a performance vacuum.

“We need a decision about either a phased implementation of the findings of the Clinical Review of Standards or an honest discussion about how we performance manage urgent and emergency care differently.

“The current challenges facing the health and social care service are the result of years of stagnation and decline, they are made worse by, but are not just a consequence of, the pandemic. Recognising this is vital to any step towards transformation.

“It is time we saw bolder political willingness to engage on these critical issues. Without action, performance will continue to decline, and this would be a disservice to patients and staff.”

Pocket garden challenge launched

Budding garden designers are invited to tell stories in exciting competition

A nationwide competition has been launched by environmental charity Keep Scotland Beautiful to find school pupils from across Scotland to participate in the seventh annual Pocket Garden Design Competition.

Following the huge success of the online showcase in 2021, when 38 design winners were displayed to allow a public vote, we are inviting children, from as young as three, to design a colourful and sustainable garden.

The best design entries will be selected, and entrants invited to build and grow their garden at school before photographing or filming it to be showcased as part of an online interactive garden which will allow everyone across Scotland to vote for their favourite from 8-19 June inclusive.

This year designs should interpret three interlinked themes: The Year of Stories, One Planet Picnic and Wildlife Gardening.

Stories are a vital part of culture and community from well-loved tales of family and friends to famous fictional characters: they all give a sense of place, history and belonging. There are fables, legends, folklore, news stories, novels, fairy stories, investigative journalism, and myths to draw inspiration from and this competition encourages young people to celebrate that through their designs.

Eve Keepax, Education and Learning Officer at Keep Scotland Beautiful , said: “We’re really excited to be able to announce the opening of our Pocket Garden Design Competition for 2022.

“This competition over the years has inspired entries from across the country and we hope that in 2022 it gives educators and pupils a new focus that supports learning for sustainability, outdoor learning and the Curriculum for Excellence.

“What are the stories you and your pupils could tell through a garden design?”

Pupils are invited to submit their entries no later than 5pm on 25 February 2022 to oneplanetpicnic@keepscotlandbeautiful.org.

Further information and inspiration from past years can be found at:

www.keepscotlandbeautiful.org/pocketgarden

If you go down to Belleville today, you’re sure of a big surprise

Residents at an Edinburgh care home enjoyed a teddy bear takeover as they reminisced about childhood memories over a picnic.

Mansfield Care’s Belleville Lodge invited its residents to bring along their own teddy bears and soft toys for an afternoon of fun.

Along with the teddy takeover was an array of homemade cakes and tea as the residents discussed their favourite toys they, and their children, used to play with when they were younger.

While teddies were the most popular guests at the picnic, a toy dog and a knitted black cat called ‘Snuffles’ were also in attendance.

Belleville Lodge Matron, Margaret Russell, said: “There were lots of smiles and everyone enjoyed holding and touching the soft toys and passing them around for a cuddle.

“One of the highlights of the day that made everyone happy was to see all the teddies and soft toys lined up together for a portrait photo.

“We all joined in to sing along to “The Teddy Bears’ Picnic” and everyone, both staff and residents, agreed that we’d had a lovely afternoon.”

Operating 11 care homes across Edinburgh, the Borders and west of Scotland, Mansfield Care is designed to provide bespoke care to an exceptional standard with state-of-the-art facilities.

Specialising in small, friendly residential care homes, staff work under an ethos that is inspired by the kind of care we would wish for ourselves in later life – supportive, friendly, bright, positive, empathetic, respectful and homely.

The highly trained staff ensure a commitment and continuity of care to each resident with a dedicated home manager and wellbeing coordinator to plan activities according to resident’s wishes.

To find out more about Mansfield Care visit, https://www.mansfieldcare.co.uk/

More help for unpaid carers

Funding for wellbeing support and services

A £4million funding package will help provide support to unpaid carers, in recognition of the enormous role they play in looking after loved ones, and the added pressure many have faced during the pandemic.

Over the next few weeks, the additional winter funding will allow organisations working with unpaid carers to expand the services they provide to all groups of adult and young carers, including those looking after disabled children and young people and those caring for a friend or relative with dementia.

To help reach as wide a range of carers as possible, the funds will be shared between organisations who are already working with different groups of carers:

£3million for local carer centres across Scotland to expand their vital support for adult and young carers
£200,000 to expand the Young Carers Package delivered by Young Scot to provide additional break opportunities, support and activities for young carers
£377,000 to expand Family Fund support with breaks for parents and families looking after disabled children and young people
£590,000 to expand wellbeing support and services for unpaid carers looking after a family member with Dementia, including grants for short breaks

Minister for Mental Wellbeing and Social Care Kevin Stewart said: “Unpaid carers play a vital role in society and I know the pandemic has placed many additional pressures on Scotland’s carers.

“The Scottish Government has always been committed to improving carers’ rights and providing them with the support and extra help they deserve.

“The local services and third sector organisations that have been supporting carers during the pandemic have been exceptional. I am pleased to be able to announce this additional funding to allow them to continue their essential work.

“This support for carers comes on top of the Carer’s Allowance Supplement, the first payment made by Social Security Scotland, which increased Carer’s Allowance for eligible Scottish carers by around 13% compared to carers in the rest of the UK.

“In addition to this uplift to Carer’s Allowance, we made extra Coronavirus Carer’s Allowance Supplement payments in June 2020 and in December 2021 to support eligible carers.”

PM to chair new council with devolved governments

A landmark agreement setting out how the UK and devolved governments will work closely together to deliver for people across the whole of the United Kingdom has been published.

Landmark agreement on how UK government and devolved governments will continue to work together has been reached
New ways of working agreed by the UK government, Northern Ireland Executive, Scottish Government and Welsh Government
Reaffirmed principles agreed by all includes mutual respect, maintaining trust and positive working
Agreement formalises a PM led council, overseeing strengthened working

A landmark agreement setting out how the UK and devolved governments will work closely together to deliver for people across the whole of the United Kingdom was published yesterday (13 January 2022).

The statement was completely overhadowed by the ongoing brouhaha over the Prime Minister’s attendance at lockdown Downing Street parties (or work events!) At time of writing Boris Johnson’s political future remains very much in the balance.

The Intergovernmental Relations (IGR) Review sets out new structures as to how the UK government, Northern Ireland Executive, Scottish Government and Welsh Government will work to deliver for people across the UK – based upon on the existing values of mutual respect, maintaining trust and positive working.

The new system will be a three-tiered structure and will formalise a new council, chaired by the Prime Minister, made up of Heads of the Devolved Governments.

The Prime Minister-led council and Ministerial groups will oversee and strengthen relations between all of the UK’s governments. They will discuss issues that affect people across the UK, particularly where they cut across reserved and devolved policy – or are of shared responsibility.

Strong working and close co-operation has been vital in the response to the COVID-19 pandemic, including coordinating the response to new variants and the rollout of the COVID-19 vaccine. Other examples of joined-up work include investment through Growth Deals and the Afghanistan resettlement programme.

The new structures will be supported by an independent secretariat made up of civil servants seconded from all four governments and will serve the UK government and devolved governments equally.

Beleaguered Prime Minister Boris Johnson said: “When team UK pulls together in common cause, spirit and endeavour we will always be at our very best.

“We’ve shown time and time again the combined strength we have in facing off the shared challenges before us, while also seizing the opportunities ahead for the benefit of the whole United Kingdom.

“Today’s announcements build upon that strength as we all continue to work together to deliver for the British people.”

Minister for Intergovernmental Relations Michael Gove said: “Devolution has empowered communities and resulted in huge benefits across the United Kingdom.

“Today’s landmark agreement will build on the incredible amount of collaboration already taking place between the UK government and the devolved administrations.

“By working together even more effectively, we can better overcome the challenges we face, create greater opportunities and improve people’s lives for the better.”

The new structures are based on a three tier levels for ministerial engagement – alongside a new mechanism for avoiding, escalating and resolving disputes; supported by joint or independent secretariats and based upon consensus.

Sitting below the Prime Minister-chaired council, the second tier will consist of two Interministerial Standing Committees, one chaired by the Minister for Intergovernmental Relations and one on finance.

There will also be the option of time limited committees agreed by consensus to deal with specific issues as required.

The third tier will be made up of Interministerial Groups (IMG) led by individual departments, which will cover a wide range of policy issues within a given minister’s or department’s portfolio.

These will include regular meetings between devolved and UK government ministers on issues such as Health, Transport and Education.

The new structures and processes announced yesterday are underpinned by a reaffirmed set of principles for collaborative working. These are:

Maintaining positive and constructive relations, based on mutual respect for the responsibilities of the governments and their shared role in governance of the UK
Building and maintaining trust, based on effective communication
Sharing information and respecting confidentiality
Promoting understanding of, and accountability for, their intergovernmental activity
Resolving disputes according to a clear and agreed process

The new structures create a ‘more equal, transparent and accountable system to support collaboration and information sharing between the UK government and the devolved governments and continue to deliver for citizens across the UK‘.

Scottish Secretary Alister Jack said: “Scotland has two governments, and people want to see them continue to work together to tackle covid and drive our recovery.

“Throughout the pandemic, the Scottish and UK governments have worked closely together, to keep people safe, protect public services, and support businesses and jobs in Scotland.

“This important agreement will build on that and help strengthen cooperation further – as we work together to deliver the priorities of people in Scotland on jobs, prosperity and economic recovery.

“It also reflects the increased powers of the Scottish Parliament since 2016 and the UK’s vote to leave the EU.”

Secretary of State for Wales Simon Hart said: “People in Wales want to see politicians working together to defeat the pandemic and focus on our recovery and throughout the past two years the UK government has worked with the Welsh Government more closely and productively than ever.

“This agreement will strengthen these relationships still further as we work together to deliver the priorities of the people of Wales like jobs, prosperity and economic recovery.”

Secretary of State for Northern Ireland Brandon Lewis said: “Today’s agreement will enhance the positive working relationship between the UK government and the Northern Ireland Executive, to the benefit of everyone in Northern Ireland.

“By ensuring that we work together in the best way possible, we will build on the fantastic collaboration which has stood us in good stead as we continue to deliver together for local people.”

So the PM will chair the new council with devolved governments – but will Boris Johnson still be that Prime Minister, or is the party over? The picture may perhaps become clearer early next week.

See the written ministerial statement

Healthy Heart Tip: Dry January

This month is Dry January, which sees many people across the UK take on the challenge of curbing their drinking habits for a whole month.

We know that drinking too much alcohol can lead to increased blood pressure, some types of cancer and weight gain. If you think you could benefit from taking on this challenge or would like to take steps to reduce your alcohol intake, try out some of the below tips this month to get you started!

Know Your Numbers

Knowing how much alcohol you are consuming can be the first step towards making a change. It is recommended to drink less than 14 units of alcohol per week, which is equivalent to approximately seven medium glasses of wine, or six pints of regular strength beer.

You can calculate your exact intake at www.drinkaware.co.uk

Find Alternatives

Most of the time we can satisfy a craving with an alternative option. Try buying some alcohol-free beer or soft drinks to have when you’re next craving an alcoholic drink.

Replace Habits

It can be useful to distract yourself with another activity at the time when you would usually drink. Try going for a short walk or organise to speak with a friend at a time when you would usually drink alcohol.

Be Smart

We can still enjoy alcohol whilst reducing our overall consumption. Some great tactics you can use to reduce your intake include:

having a soft drink for every other drink
adding one or more alcohol-free days to your week
opting for lower strength drinks such as a single spirit mixer instead of a glass of wine, which has over half of the units and calories when you opt for a low-calorie mixer!

For more tips on how to stay healthy, sign up for our weekly healthy tips at www.heartresearch.org.uk/healthy-tips

To help keep your heart healthy, why not try out some of our Healthy Heart recipes from our website: https://heartresearch.org.uk/heart-research-uk-recipes-2/

Or have a look through our Healthy Heart cookbook filled with recipes from top chefs, celebrities and food bloggers:

https://heartresearch.org.uk/heart-research-uk-cookbook/

New blood cancer gene defect can be treated with existing drugs

A defective gene, normally found in blood cancers, could be treated with drugs already available for cancers with similar gene defects, scientists at Queen’s University Belfast and the University of Birmingham have revealed.

The research team, funded mainly by Cancer Research UK and the Medical Research Council, found that tumours with mutations in the SF3B1 gene respond to PARP inhibitors, a type of drug used to treat cancers which have similar mutations in the BRCA1 and BRCA2 genes.

The researchers believe that PARP inhibitors could be used to treat patients with tumours carrying the defective SF3B1 gene. This mutation is most often found in blood cancers, including chronic lymphocytic leukaemia, as well as some rare cancers like uveal melanoma.

Dr Kienan Savage, lead author and Reader at the Patrick G Johnson Centre for Cancer Research at Queen’s, (above) said: “Our findings have clinical implications for the treatment of many cancers.

“We specifically focused on this genetic mutation as it is found in several difficult to treat leukaemias and other cancers, and it affects so many cancer patients. By deepening our understanding of this gene mutation, we have identified new ways of treating these cancers that could improve survival rates.”

PARP inhibitors, which include olaparib and rucaparib, are used to treat some patients with ovarian, breast, prostate and pancreatic cancers – usually patients who have inherited a faulty BRCA1 or BRCA2 gene. Around 1 in 400 people have a faulty BRCA1 or BRCA2 gene.

The research, published today in Cancer Research, a journal of the American Association for Cancer Research, found that the SF3B1 mutation produces similar effects to the faulty BRCA1 gene by damaging DNA, preventing it from being repaired properly, and stopping it from making normal copies of itself. PARP inhibitors target the cell’s DNA repair tools by locking them in place on the DNA. This stops DNA repair, causing the cancer cells to die.

The scientists found that cancer cells with the SF3B1 mutation were sensitive to olaparib, the most common PARP inhibitor, some specific chemotherapies and to radiotherapy. The scientists believe that the SF3B1 mutation disrupts the cell’s ability to make DNA repair proteins, leaving it vulnerable to drugs which target these proteins.

The SF3B1 mutation occurs in up to 30% of blood cancers called myelodysplastic syndromes, where blood cells don’t form properly. They are difficult to treat as they occur predominantly in older patients who may not be considered fit for treatment. The mutation is also common among uveal melanoma or cancers of the eye, which currently have limited treatment options.

Dr Katrina Lappin, from Queen’s and first author of the study, added: “Our research shows that cancers with these specific mutations, may be treated effectively with PARP inhibitor therapy drugs, which are less toxic, better at killing cancer cells with these mutations and can be taken at home in tablet form. This could have huge implications for improving outcomes and quality of life of people with these cancers.”

“This work will pave the way for clinical trials using PARP inhibitors for the treatment of patients with this commonly associated cancer mutation, allowing a more personalised approach to the treatment of these cancers.”

The researchers now want to test PARP inhibitors in clinical trials with patients who have the SF3B1 mutation to see if they can stop their cancer from spreading.

Co-author Professor Grant Stewart, of the University of Birmingham, said: “Our work demonstrates that a molecular understanding of how a specific gene mutation affects a cancer cell’s ability to repair damaged DNA can be exploited clinically to specifically tailor the anti-cancer therapy used to treat an individual’s tumour.

“This will increase the effectiveness of the therapy and hopefully, reduce the chances of re-occurrence.”

Michelle Mitchell, Chief Executive of Cancer Research UK, said: “Our scientists helped to discover the BRCA gene over 25 years ago and since then we’ve led the way in developing PARP inhibitors to treat cancers with BRCA gene faults.

“It’s really exciting to hear about a new mutation, which behaves like the BRCA1 mutation and could in the future be treated in the same way. With PARP inhibitors already widely available, there is huge potential to help people with some of the rarest and most difficult-to-treat cancers known to us.

“Over the past two decades, PARP inhibitors have saved thousands of lives worldwide, and it will be interesting to see if this research in the future could lead to a similar impact for people with rarer cancers.”

The research was funded by the UK Medical Research Council, Cancer Research UK, Blood Cancer UK, Leukaemia and Lymphoma NI and Great Ormond Street Hospital Children’s Charity.

Mary’s Meals starts feeding hungry children in Yemen

Charity brings hope to 4,000 children amid ongoing humanitarian crisis in Yemen

Mary’s Meals has today (Thursday, 13 January) announced that it is now working in Yemen in the Middle East. The global charity is serving nutritious food at school to children affected by one of the biggest humanitarian crises in the world, with conflict devastating the country for several years.

Mary’s Meals, which was founded in a shed in Argyll, provides school meals for children living in some of the world’s poorest countries – including Malawi, Haiti, Ethiopia, Syria and South Sudan. The promise of a daily meal attracts hungry children to the classroom, where they receive an education that can, in the future, be their ladder out of poverty.

Life is very difficult for people in Yemen, with ongoing conflict heavily impacting the country’s economy and causing high levels of poverty and food insecurity – approximately 21 million people (or 70% of the population) are in need of humanitarian assistance. This includes more than 11 million children.

Millions of people have had to flee their homes in search of safety and many children are malnourished. Since the conflict began in 2015, the number of school-age children not in education has doubled and many have to work to survive.

Magnus MacFarlane-Barrow, founder of Mary’s Meals, says: “Mary’s Meals always has a desire to support those in the greatest need. Given that Yemen can be described as the biggest humanitarian crisis in the world, and so many children are suffering, we are delighted to begin serving our daily school meals there – meeting the immediate need of the hungry child and, crucially, at the same time, enabling their education.”

In Yemen, Mary’s Meals is serving substantial and nutritious pitta bread sandwiches, filled with various ingredients to suit local tastes alongside fruit and vegetables, to more than 4,000 children at four schools every school day.

The charity is working in partnership with established international NGO, Yemen Aid, to reach children living in the Al Mansoora district of Aden. This district is particularly vulnerable as it is home to a large number of internally displaced people and other marginalised populations, who all experience high levels of hunger.

Mary’s Meals began in 2002 by feeding 200 children in Malawi. It now reaches more than two million children every school day in 20 countries around the world.

The charity is currently running a match funding campaign, Double The Love. Donations made to Mary’s Meals until 31 January 2022 will be doubled by a group of generous supporters, with up to £1.6 million available.

Magnus adds: “Feeding children in Yemen is an important moment in our mission but we are always thinking of the next child waiting for our nutritious meals.

“That’s why I’m so pleased that donations made to Mary’s Meals this winter are being doubled by a group of generous supporters – meaning we can reach even more hungry children around the world with a life-changing meal at school.”

For more information on the work of Mary’s Meals and to donate to Double The Love, please visit marysmeals.org.uk

National debt charity urges those who are struggling to seek help

As the cost of living increases and energy prices set to soar, debt charity encourages those who are unable to pay bills to seek support

As we start this new year, many people across Scotland are struggling with the increased cost of living impacting all areas of life. The cost of a food shop has increased alongside significantly higher fuel and energy costs. The upcoming removal of the energy price cap is set to see prices soar.

Christians Against Poverty (CAP) Scotland is deeply concerned that many low income families will see their debts rocket as they struggle to afford the basics. CAP surveyed around 900 clients across the UK during the pandemic and over a third (37%) said they regularly had to go without meals. Over half (56%) had borrowed money to pay for food, clothing and other essential living costs.

TIME TO SEEK FREE DEBT HELP

CAP Scotland is encouraging more people to seek help with problem debt now and not to wait until things get worse. Their message is clear, it is never too early or too late to get debt help.

CAP Scotland’s National Director, Emma Jackson, explains why this is so vital: “Over the past year we’ve seen the devastating impact of the cost of living increase hitting low income families hard. Before getting debt help, many of our clients were having to prioritise which bills to pay.

“No one should have to make the impossible choice between whether to heat their home or feed their children but sadly too many people in Scotland are having to do this right now.

“Too often shame and stigma keep people trapped in problem debt, 50% of CAP clients wait for over a year to get debt help. We are urging everyone who is struggling with problem debt not to wait until things hit crisis point.

“CAP Scotland provides free, professional and community based debt help. Our Debt Coaches can meet you in the comfort of your own home and stay with you every step of the way until you become debt free.

“Many other trusted debt help charities are also offering vital support with free debt help. The most important thing isn’t which charity someone chooses to call, it’s just making the call for help as soon as possible.”

Local charity Granton Information Centre is one of the organisations that are here to help.

Email info@gic.org.uk or telephone 0131 551 2459 or 0131 552 0458 to make an appointment or enquire about our outreaches.

Increasing mental health support in GP practices

Funding to reach £40 million a year

More mental health and wellbeing services will be provided within GP practices and community settings, backed by investment of up to £40 million a year.

Under the new system, patients who need mental health support will find a range of professionals available through their doctor’s surgery, rather than having to rely solely on their GP or a referral elsewhere. These could include mental health nurses, psychologists, peer support workers, occupational therapists, and link workers.

Funding of £1.5 million has already been made available from the Mental Health Recovery and Renewal Fund. This will increase annually to support implementation of the new Mental Health and Wellbeing Primary Care Services, reaching an expected £40 million per year by 2024-25.

This could amount to more than £100 million by the end of this Parliament, substantially increasing the mental health workforce and transforming how support is delivered.

Minister for Mental Wellbeing Kevin Stewart said: “Mental ill health is one of the major public health challenges in Scotland. We know the pandemic has had a significant impact, which is why mental health has remained a priority throughout our response to COVID-19.

“Around a third of all GP consultations now has a mental health component. But the range and complexity of issues requires a more varied and comprehensive response.

“This new multi-disciplinary model will deliver our commitment to provide 1,000 additional dedicated mental health staff by 2026, supporting communities to improve their mental health.”

Deputy chair of BMA Scotland’s GP Committee Dr Andrew Cowie said: “Scotland’s mental health has suffered significantly throughout the COVID19 pandemic, and we welcome the additional mental health staff that will allow for our patients to access support within their communities.

“GP practices are most people’s first point of contact and it is important that there is a range of help and services available there. This is a welcome initiative and we look forward to working with the Scottish Government to develop the scheme and ensure all patients in Scotland can access better mental health in their communities.”

Local Planning Guidance, to support integration authorities and local partners to plan and implement the new services, will be published on the Scottish Government’s website this week.

Services will also link to community support such as addiction services, food banks and benefit support, through a link worker dedicated to each GP practice.