Services in all UK nations face hit, Northern Ireland an existential threat
The British Dental Association has warned the European Parliament’s vote to ban dental amalgam from 1 January 2025, will send shockwaves across the UK’s already struggling dental services.
Silver amalgam is the most common material for NHS permanent fillings across the UK. Fillings represent around a quarter of all courses of NHS treatment delivered in England, with amalgam used in around in around a third of procedures.
BDA estimate treatment times and costs of alternative materials are over 50% higher than those of amalgam. [1]
On 14 July, the European Commission adopted a proposal to revise the Mercury Regulation, to introduce a total phase-out of the use of dental amalgam and prohibit the manufacture and export of dental amalgam from the EU from 1 January 2025 – 5 years earlier than expected.
The vote will hit all four UK nations but will have a disproportionate impact on services in Northern Ireland, which has the highest proportion of filled teeth of any UK nation. [2] Under post Brexit arrangements, Northern Ireland will be expected to phase out dental amalgam on the same basis as EU member states. Divergence means the rest of the UK faces disruption and higher costs given the impact on supply chains, but not a formal ban.
In an open letter to all four UK Chief Dental Officers, the BDA stress there are currently no alternative restorative materials that compete with amalgam on speed of placement or longevity, meaning the ban will eat into clinical time and resource that are in short supply, likely creating further access barriers.
There are no indications where the millions in additional funding required will come from nor the workforce to carry out the tens of thousands of extra clinical hours.
MEPs also backed amendments stating that Member States need to “ensure appropriate reimbursement is made available for mercury-free alternatives” to limit the socio-economic impact. The BDA say the same approach is need from all UK Governments.
The Nuffield Trust warned in December that NHS dentistry was at the most precarious moment in its 75-year history. The BDA warn that without decisive action, this ban will only hasten the service’s demise.
While the BDA has long supported a phase-down in dental amalgam, it believes this rapid phase-out is neither feasible nor justifiable. Dental amalgam has been in use and extensively studied for 150 years as a restorative material. Its safety and durability are well established, and it remains the most appropriate material for a range of clinical situations.
BDA Chair Eddie Crouch said:“When we are set to lose a key weapon in the treatment of tooth decay all four UK Governments appear asleep at the wheel.
“When alternative materials can’t compete, this will add new costs and new uncertainties to practices already on the brink.
“Without decisive action this could be the straw that breaks the back of NHS dentistry.”
[1] BDA research on treatment times and costs, 2023. Figures are derived from a comprehensive research study into NHS dental treatment times. A unit price per treatment has been generated using official figures for dental expenses, courses of treatment and dentist earnings (available through NHS digital), supplemented by further BDA research.
[2] Total number of Teeth Filled per 100,000 population by UK nations and Financial Year, From Family Practitioner Services General Dental Statistics for Northern Ireland 2022/23
In Northern Ireland’s Item of Service Claims 2022/23, amalgam was used as a material in 153,000 of the 353,000 claims for permanent fillings on adults and children, or 46% of the total.
While amalgam use is not centrally recorded in England, the BDA understands these represent around a third of fillings placed in England on the NHS.
Miracle match pair share their story to highlight extraordinary impact of living kidney donation
A man with chronic kidney disease underwent a life-saving transplant with a kidney donated by his friend, after tests showed the pair were a 100 per cent match.
Sixteen months on, Calum Mitchell, 45, from Dunfermline, and his donor Ian Cameron, 41, from Edinburgh, are sharing their story as part of a campaign to highlight the benefits of living kidney donation.
Living kidney donation plays a vital role in increasing donation and transplantation rates in Scotland, with a kidney from a living donor generally offering the best outcomes for patients in need of a transplant. Since 1960 there have been 1905 kidney transplants from living donors in Scotland, with 95 taking place in 2023.
Calum, who underwent his first transplant aged 21, spoke of how Ian’s gift has given him his life back after the function of his first donated kidney from a deceased donor began to decline. Following his second transplant, bloods show that his kidney function is better now than it was aged 16.
Calum’s first transplant lasted 22 years, nine months and six days. By 2022, he describes himself as being ‘deep into overtime’ with his donated kidney.
Calum said: “My first transplant went ahead in January 2000 and the difference it made to my life is very hard to describe. Within a year I was back to doing all the sports I loved and it was amazing being freed from dialysis, thanks to my donor and their family.
“Fifteen years post-surgery they told me my kidney function was gradually declining and by October 2021 a second transplant was raised. I knew this was ahead of me and never felt like the situation was out of control. I also felt hugely grateful my transplant had given me so many good years.”
Calum was listed for transplant and at that stage set up a WhatsApp group so his wife Kirsty could be supported by those close to her. This group included Ian’s wife Becky, which prompted Ian to email Calum in December 2021, broaching the subject of the donation.
Research conducted to support the living donation campaign shows almost half of those surveyed said they’d be likely to consider donating to a friend (48 per cent), but for Ian, the decision was made long before Calum’s first kidney transplant failed.
Ian said: “We were quite close and I had a good handle on the extent of Calum’s condition. I was always interested in how he was doing and years previously Calum mentioned he might need a new kidney.
“At that point, I spoke to my wife and we agreed we’d get tested as possible donors. So it was a kind of done deal at that point, in my head at least.
“I knew him well enough to know he wouldn’t be enthusiastic about the prospect. I’m a guy that likes to move quickly so I pushed him as I was resolute in my decision to donate. I think Calum thought I wouldn’t be a match so after a bit of back and forth, he eventually agreed to the initial tests.”
The testing started positively and went from strength to strength. Calum is a rare B negative blood type, as is Ian. At that point they had a serious discussion about Ian moving to the next stage of testing and whether Calum would accept the kidney. On Ian’s 40th birthday in April, the tests went ahead and everything was a match, with the pair being told they could be twins.
Calum said: “I’d left the ball in Ian’s court as I was grateful but that gratitude was tied up with concern and nervousness. I didn’t want to put any pressure on him, but when we got the test results it was hard to refuse as it definitely felt like it was meant to be.”
Calum went back on dialysis in June 2022 and the surgery was scheduled for September at the Royal Infirmary of Edinburgh.
Ian said: “I was pumped going in for surgery, so excited. I’d never had surgery in my life. We drove into hospital together and it felt like a very unique experience.
“Post surgery I was sore but I felt great, and ravenously hungry about an hour later. I was up and about in a couple of hours and in for two days with the soreness getting better reasonably quickly.
“The highest point of joy for me was when I was out of surgery and Calum was in theatre having the transplant. The surgeon came to see me, my wife and Calum’s wife Kirsty and told us the kidney had started working straight away. I burst into tears and I’m not a crier. It was so joyful for the three of us, such a high point and a real special time.”
Calum added: “Coming round from surgery, I knew I was immediately better, my extremities were warm, my head was clear, I had no central line in my neck which made me realise it had gone well. Compared to the last transplant, the recovery was so much quicker. I was home four days after surgery and taking the boys to football three weeks later.
“It’s like being given your life back. At the end I began to feel the decline and then felt really ill starting dialysis and the next minute I was fully alive. Life got back to normal so quickly and that is the difference. You go from one extreme to normality and normality is very, very special. I can’t really put into words what Ian has done. It’s a gift like no other.”
Ian added: “We very much feel like this was providential. When we started out on this journey we had no idea if we’d get past the first stage, but our identical results showed it was meant to be.
“Kidney donation changes lives, life expectancy and there’s a knock on effect beyond the recipient. There is no personal gain other than seeing that person doing better. That’s what makes the purity of that gift is so unique.
“To anyone considering donating, I would say it’s one of the most profound ways of changing someone’s life and I’ve personally found the entire experience hugely rewarding.”
Jen Lumsdaine, Lead Nurse for Living Donation Scotland and Living Donor Transplant Co-ordinator for NHS Lothian, said: “For those with kidney failure who are facing treatment choices, we know that talking about living donation with family and friends can be challenging. The more we can raise awareness of living kidney donation the easier it is to talk about it.
We also know that living kidney donation transforms lives – and we thank the donors and their support networks for this exceptional gift.”
Public Health Minister Jenni Minto said: “Living kidney donation plays a vital role in saving and improving lives. Calum and Ian’s story demonstrates how living donation can transform the life of someone living with kidney failure.
“A person can lead a completely normal life with one kidney, and anyone who is interested in volunteering can find out more about donating from livingdonation.scot.”
1905 people in Scotland have helped others by donating a kidney since the first pioneering surgery took place in Edinburgh over 60 years ago.
There were 95 living kidney donor transplants in 2023.
Living donation can not only lead to better outcomes for patients, but one donor can trigger a ‘chain’ of transplants for up to three people. This is co-ordinated through the UK Living Kidney Sharing Scheme (UKLKSS), which is managed by NHS Blood and Transplant (NHSBT).
Over 400 people in Scotland are currently waiting for a kidney transplant.
Approximately 600 people in Scotland start kidney replacement treatment per year, with the majority starting dialysis.
Last year 247 people in Scotland received a kidney transplant. 57 of these people received their new kidney before it was necessary to start dialysis.
Since 2006, over 100 people in Scotland have altruistically donated a kidney.
A kidney transplant is a treatment, not a cure, however kidney transplants from living donor are very successful, with over 80% of transplants still functioning at 10 years.
Living donor transplantation offers the best short-and-long term outcome for recipients. It is also by far the most cost-effective treatment and a significantly more environmentally sustainable option than dialysis.
Three-minute bouts of yoga have been found to significantly lower blood glucose levels and reduce the risk of diabetes, a study from Glasgow Caledonian University has revealed.
The research carried out by a team of physiotherapists, including NHS Greater Glasgow and Clyde team member, Alex Colvin, investigated the effects of breaking up sedentary behaviour with short bouts of yoga and tai-chi on glycaemic control, concentration, and wellbeing in healthy individuals.
The study, which involved 15 adults aged 26-28, found that the effects of short bouts of yoga to break up the working day significantly lowers glucose levels to reduce the risk of diabetes without compromising concentration or wellbeing.
However, tai-chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and wellbeing. The research concluded that these interventions provide effective ways to combat the harmful effects of prolonged sitting while maintaining concentration and wellbeing.
Alex, also lead author of the study, said:“Through this research, I want to make people aware that you can break up your sedentary time with things that are good for your mental and physical wellbeing, and to reduce the risk of diabetes.
“There has been a lot of research into the benefits of yoga and tai-chi, which show favourable effects, but this is the first research that I am aware of that investigates the use of shorter three-minute bouts to break up a working day and shows results that this can help to reduce the risk of diabetes.
“This is also good news for employers who dislike the use of physical activity to break up sedentary time because they have this misplaced perception that it will negatively impact on production, as we have found it’s quite the opposite. We measured concentration and wellbeing throughout the study. Although there wasn’t a change with yoga and tai-chi, at least it didn’t get any worse, which disproves that doing these types of things is bad for worker productivity.”
Alex graduated with a Masters in Physiotherapy in 2020 from Glasgow Caledonian and became an NHS Greater Glasgow and Clyde specialist physiotherapist. He began the research during his studies with fellow students Lynne Murray and Jillian Noble, under the supervision of Professor Sebastien Chastin, but results were delayed due to the COVID-19 pandemic.
Alex explained more about the methods used in the two-year study: “We took finger-prick glucose readings every half an hour throughout a seven-hour working day and standardised the participants’ diet as much as we could, along with that we broke up the sedentary time and the groups with either three minutes of yoga or tai-chi, or just sitting for the whole time and measuring their glucose.
“Although the study involved a small number of 15 mostly healthy adults aged between 26-28, it doesn’t change the fact that the glucose levels were still lowered. By using this group it might even be more beneficial to people who are prediabetic and the results might even be more significant.”
Professor of Health Behaviour Dynamics Sebastien Chastin, from the University’s School of Health and Life Sciences’ Research Centre for Health (ReaCH), highlighted the benefits of this research study.
He said: “Clearly we all spend far too much time sitting in the office or working from home. This shows that short bouts of yoga that can be done anytime during the day and it has the impact we expected that it can be turned into one of the interventions or reduce the risk of diabetes.
“What’s also really important about this research is that it demonstrates that it doesn’t reduce the productivity of workers. That’s always the worry of the bosses. Allowing them to have that time shows that it actually doesn’t reduce productivity at all, if anything it probably increases productivity so there’s not just a health incentive for the workers to do it but also for the employers to support that and implement it.”
You might be surprised by someone from Alcohol Change UK advocating this, but we’re more than half-way through Dry January® – so maybe it’s time to head to the pub!
Giving up alcohol shouldn’t mean giving up socialising. Pubs are increasingly supportive of Dry January®, and for good reason. Our research shows that 44% of those going alcohol-free this month are more likely to visit a bar or pub if it serves a good selection of alcohol-free beers, wines or spirits.
So how about seeing what’s behind the bar at your local? You might find a range of good options already on offer – there’s been a huge increase in the quality and availability of alcohol-free products over recent years. And they can help us cut down the amount of alcohol we drink, while making nights out more inclusive.
But they’re still not universally easy to find. You can help change that. In fact, many of our supporters have told us that speaking to the landlord of their local has resulted in better alcohol-free options being stocked year-round.
Of course, some of us doing Dry January® will feel less comfortable in a pub because it might trigger cravings. Alcohol-free alternative drinks are not right for everyone, and that’s fine. But if you’d like to see improved options behind the bar, why not pop into your favourite pub and start a conversation with the staff? Your encouragement might just help make your local even better!
Heart Research UK Healthy Heart Tip, written by the Health Promotion and Education Team at Heart Research UK
Healthy Heart Tip: Dry January
Dry January is back, challenging you to become alcohol-free for one whole month. Drinking alcohol on a regular basis can increase your risk of developing heart diseases, increase your blood pressure and cause weight gain.
Getting used to a new alcohol-free lifestyle can be hard, see our tips below to help you this January:
Changing your behaviour
Changing your behaviours can be difficult and it may be beneficial to find alternative habits to distract you when you would usually be drinking.
You might find it useful to try cooking healthy meals or go for a walk in the local park instead of having a drink. You could even take up a new hobby or sport!
Finding alternatives
Finding an alternative drink to the alcoholic one you usually have will help you to refrain from drinking.
There are many non-alcoholic options for you to try mocktails, alcohol-free beer or soft drinks are a few.
Knowing the benefits
There are a number of benefits to reducing your alcohol intake, you will be reducing your calorie intake which could help you to lose weight, lower your blood pressure and cholesterol levels, and ultimately reduce your risk of developing heart diseases.
You may also feel improvements in your sleep quality, mental health and energy levels.
Reducing your intake
It is perfectly acceptable to enjoy an alcoholic drink from time to time but by reducing your overall consumption you will be benefitting your health.
Below are some tips to help you:
Have a glass of water after every alcoholic drink Have smaller drinks or bottled beer Have lower-strength drinks Have several alcohol-free days each week Cut down with your friends and family by supporting each other.
A patient at the Princess Alexandra Eye Pavilion, has come forward to offer their insight into the shocking failings in the hospital.
Peter Scobie has been attending the Eye Pavilion for 18 years, after being diagnosed with Lebers hereditary optic neuropathy (LHON).
He lost his sight just before the pandemic and has been blind for 4 years now.
Peter has revealed the absence of specialists in the hospital, as his specialist is a paediatric doctor from the sick kids, who only comes to the Pavilion on Tuesdays.
A further issue with the hospital comes down to geographic issues, as he has previously been sent to Newcastle for an appointment while the closest specialist is even further south in Cambridge.
He has also highlighted the absurd situation of those needing to receive sight loss assessments must go to the most inaccessible part of the building to receive the check.
Campaigners for a new Eye Pavilion, based at the Royal Infirmary were disappointed when the Scottish Government made no mention of the project in the budget late last year.
This is despite Michael Matheson telling campaigners that a decision would be made around the budget.
Health boards then discovered that there would be a two-year freeze on all capital spending and projects. They are also required to make 6.8% savings.
If this stays in place, there is no way that the Eye Pavilion will be built in the near future. This will force Peter, and other patients like him, to rely on services that the NHS themselves deemed not fit for purpose 10 years ago.
Commenting on Peter’s case, Labour Lothians MSP Sarah Boyack said: “Peter has helped to highlight the unacceptable condition of the current Princess Alexandra Eye Pavilion.
“Patients should have facilities that support them through their difficulties, not hinder them further.
“Eye Pavilion staff do their best but without a new building and facilities they have one hand tied behind their back.
“The Scottish Government needs to listen to patients like Peter and realise that maintaining the current building is bad for patients, bad for NHS Lothian, and bad for Edinburgh.”
Sight Scotland added: “In Peter’s case, an absence of specialist doctors that are trained in his condition means it is difficult for him to get the correct treatment he needs.
“With the closest specialist for his condition based in Cambridge, a new eye hospital could be an opportunity to provide a training ground for ophthalmologists.
“The hospital’s inaccessible layout means that Peter and many others seeking essential services, such as collecting prescriptions and visiting patient support on the top floor, struggle to do so.
“More needs to be done to ensure accessible access to quality eye healthcare.”
In Scotland, over 70,000 people have a ‘silent killer’ which is one of the leading causes of serious strokes – and many more may be unaware that they have it.
Atrial fibrillation – or AF – is a cause in around one in five strokes and these are often more severe, with higher mortality and greater disability.
AF is when your heart beats with an irregular rhythm. When this happens, your heart won’t empty all of the blood out of its chambers with every beat. Then, if your heart chambers aren’t empty, the leftover blood can form clots which travel from your heart into the brain, blocking off blood flow and causing a stroke.
AF sometimes has symptoms including palpitations – feeling as if your heart is fluttering, thumping or skipping a beat – fatigue, feeling breathless or having chest pain. But often it’s symptomless, which is why it often goes undiagnosed, until it’s too late.
The good news is that AF can be picked up and treated after a simple check.
So, on Stroke Prevention Day, Thursday 25 January, we are encouraging the public to check their own pulse at home.
A video on our website shows how you can quickly and easily test yourself by placing two fingers on your wrist or neck www.stroke.org.uk/spd24.
Normal heart rate: your pulse should feel regular. Most people have a resting heart rate between 60 and 100 beats per minute (bpm).
Abnormal heart rate: your pulse may feel uneven or skip a beat. Your resting heart rate could be over 120 bpm.
If your pulse is irregular, or very fast when you are at rest, you should contact your GP.
Edinburgh Leisure responses to misleading media articles re venue closures
There have been several misleading media articles regarding venue closures at Edinburgh Leisure (NOT NEN – Ed.!) The charity is facing significant financial challenges next year (2024/25) due to several factors, including further increases in energy costs.
Information was prepared on venue closures to illustrate the scale of these challenges and the potential impact on services. Unfortunately, several media articles omitted to cover these all-important points in favour of reporting ‘venue closures’.
Work is ongoing with our funding partner, the City of Edinburgh Council, as to how we might address the financial challenges and ensure our work to support the citizens of Edinburgh to be active and well continues!
There are no venue closures planned for at this time and customers should feel confident that we are doing everything we can to maintain all our venues.
It is very much business as usual so please keep using and supporting us!
Labour Lothians MSP, Sarah Boyack highlighted deeply distressing figures about the fall in GP surgeries in Edinburgh.
The latest figures by Public Health Scotland show that from 2010-2022, the number of Edinburgh’s GP surgeries dropped from 75 to 72. However, over the same period Edinburgh’s population skyrocketed from an estimated 480,000 to 548,000.
Edinburgh recorded the third highest population growth in Scotland, according to the most recent statistics.
This all comes as it was revealed the city of Edinburgh’s average practice list size has jumped from 7,074 in 2012, to 8413 – the 5th highest in Scotland.
In May 2023, the BMA warned that there was a sustainability crisis in Scottish general practice, in part due to the closing of surgeries.
A fall in GP surgeries will leave more and more communities without the adequate facilities to cope with their population increase.
This follows on from the Scottish Government’s decision to freeze capital projects for health boards, as well as freezing the ability to hire new staff.
The Scottish Government also requires health boards to require savings of 6.8%.
These moves will only increase pressures on NHS Lothian to provide adequate healthcare services with diminishing resources.
Commenting on the findings, Sarah Boyack said: “These figures are deeply distressing but will come as no surprise to patients in Edinburgh.
“The Scottish Government’s underfunding has left Edinburgh’s GPs unable to keep up with the city’s population growth.
“If the Scottish Government goes ahead with its budget plans, this will only exacerbate the problem.
“GP surgery staff do amazing work, but they need the funding to fulfil their potential.
“Allowing GP surgeries to close merely aggravates the sustainability crisis we are facing in general practice.
“If we are to tackle this issue, we need investment and strategy from the Scottish Government, not freezes and delays.”
The myth that the third Monday of January is the ‘most depressing day of the year’ seems to pop up every year and we’ve honestly had enough of it. It’s just a completely made up marketing gimmick – there’s no science to back it up!
Our bad days aren’t for the calendar to decide and people can feel low any time of the year, but checking in with our friends and having a proper chat can make a real difference. It’s a small but mighty way we can all look out for each other
Get your cuppas at the ready, and help us kick the myth of ‘Blue Monday’ to the curb where it belongs by joining us for Brew Monday instead.
Brew Monday 
instead.