Researchers from NHS Lothian and the University of Edinburgh have conducted a clinical study to investigate the extent to which cancer and cancer treatment affects COVID-19 immunity.
Blood samples were taken regularly from over 760 consenting patients, most from Southeast Scotland, who were receiving routine treatments for cancer.
The samples were then tested for signs of an immune response to COVID-19 using an antibody test.
The study is the largest of its kind in the world with the first patients being recruited in May 2020, just months after the United Kingdom experienced its first lockdown.
Dr Peter Hall, Consultant Medical Oncologist at Edinburgh Cancer Centre, said: “Treatments such as chemotherapy can affect the immune system, so it was really important for us to understand the effects of COVID-19 on people undergoing anti-cancer treatment.
“We now have a better understanding of how the virus affects these patients in the short and long-term, and to what extent the vaccine had an impact on their antibodies.
“It’s very reassuring to see that most cancer patients can go ahead with their treatments without fear of excessive risk from COVID-19, and that vaccination offers an effective means of protection.”
The study found that COVID-19 infection rates in patients with cancer largely mirrored those of their local population and that treatment type did not impact the rate of their antibody response.
It also concluded that vaccination was effective in protecting people with cancer from COVID-19.
Dr Hall continued: “More research is needed, but this was an important step in understanding how people receiving anti-cancer treatment are impacted by the virus.
“It’s also another example of NHS Lothian and the University of Edinburgh working collaboratively to understand how best to care for some of the most vulnerable patients.”
You can read the Scottish COVID Cancer Immunity Prevalence Study in full in The Oncologist.
NHS Lothian Bereavement Service will be running the next Bereavement Support Group on Tuesday 31 January, from 2pm to 3.30 pm at Cameron House Education Centre.
The Health Foundation’s review shows over 15% of children in West Lothian are living in relative poverty compared to 11.3% in Edinburgh
The state of health and health inequalities in Scotland
A comprehensive independent review of health and health inequalities in Scotland led by the Health Foundation shows that the health of Scots living in the most deprived 20% of local areas are being left behind the rest of society.
Data shows that in West Lothian 15.5% of children are living in relative poverty compared to 11.3% in Edinburgh and 12.6% and 13.5% in East Lothian and Midlothian respectively. The national average is 15.1%.
Furthermore, in East and Midlothian the least deprived 20% of men can expect to live between six and seven years longer than the 20% living in the most deprived areas. In Edinburgh the difference in life expectancy between the richest and the poorest is almost 12 years and in West Lothian the poorest 20% will live nine years less than those in the least deprived areas.
The review found that trends in the socioeconomic factors that influence health provide little indication that health inequalities will improve in future, underlined by increasing rates of extreme poverty.*
The review consolidates research undertaken for the independent charity the Health Foundation by the MRC/CSO Social and Public Health Sciences Unit at University of Glasgow, the Fraser of Allander Institute at University of Strathclyde, Nesta in Scotland, and the Diffley Partnership.
The findings bring together evidence of trends in health inequalities and wider determinants of health over the past two decades since devolution and outline the consequences of worsening health in the most deprived areas.
Overall, stalled improvements in health mean that nationally, since 2013, expectations of how long people are expected to live have reduced by 4.4 years, from 90.4 to 86 years.
The findings show that across a range of measures, there is a wide gap between the health of people living in the most and least deprived areas with people living in the most deprived areas increasingly left behind the rest. The report raises a number of areas of concern which need immediate action, in particular, improving the health of children in their early years and the health of young to middle aged men.
Young to middle aged men are the most likely to suffer from deaths related to drugs**, alcohol or suicide, with the exponential rise in drug deaths concentrated among men in their mid-30s to early-60s. This group engages less with health services and is the most likely not to attend hospital appointments. Being younger, single, white and male is most strongly associated with experiencing severe multiple disadvantages, which are linked to greater risk of poor health.
Commenting on the findings, David Finch, Assistant Director of the Health Foundation, said:“Life expectancy varies greatly across Scotland. In the most deprived areas, men are dying over 13 years earlier than their peers in the least deprived areas– and women almost a decade earlier.
“A healthy community derives from a range of factors: stable jobs, good pay, quality housing and education. Poor health is almost inevitable when some or all of these factors are absent. Scotland’s wide and sustained health inequalities are being driven by the accumulation of severe multiple disadvantages, a lack of improvement in living standards and public service fragility due to the ongoing impact of austerity.
“Understanding the causes are not enough; a radical shift in approach is needed. The Scottish government, local authorities, businesses and the third sector must come together and collaborate closely with communities. Without action, Scotland’s most deprived communities are likely to continue suffering from poor quality of life and die younger.”
Chair of the Health Foundation’s Expert Advisory Group, Chris Creegan added: “This review is the most comprehensive study of health inequalities in Scotland since devolution, and while the findings are complex, what they clearly illustrate is that inequality in health is stubbornly high in Scotland.
“The public is receptive to longer term preventative interventions aimed at tackling the fundamental causes of health inequalities, rather than short term measures. They will support a bold, collective response.
“We need actors across economic, financial, social and health systems in Scotland to take note of these findings and use them to build on the strong policy intent we already have to reverse these trends and improve health outcomes for the future. But there is no need for a new strategy; over the last decade, several policy plans and strategies have focused on tackling health inequalities, most recently, 2018’s Public Health Priorities for Scotland. We have the policies, we now need action.”
NHS Lothian laboratory teams are the first in Scotland to develop and use PCR testing to detect Group A Strep illnesses among those admitted to hospital.
The tests are proving vital in helping to identify and reduce onward spread of these infections, which are particularly dangerous for children, the elderly and those with underlying health conditions.
Patients who are suspected of having a Group A Strep illness are typically treated swiftly with antibiotics, but this treatment impacts the success of more traditional testing methods, meaning an accurate diagnosis is more difficult and can take longer.
The introduction of the PCR testing, which is not affected by antibiotics, means patients are being diagnosed more accurately and much more quickly. A quicker diagnosis means treatments can be tailored, and the potential for onward spread of infection can be significantly reduced.
Dr Kate Templeton, Head of Molecular Diagnostics, NHS Lothian explained, “While the ongoing impacts of COVID are still being felt across healthcare, and society more generally, a more positive outcome of the pandemic has been the wealth of research and innovation within laboratory testing and diagnostics.
“Within NHS Lothian, we are taking the experience and knowledge gained throughout the pandemic and applying that to other health conditions. The development and use of the PCR test, which had more commonly been used in response to COVID, for Group A Strep illnesses is hugely important. Not only is it providing quicker diagnosis, but it is helping to reduce the spread of these infections and ultimately it is saving lives.”
The Lothian labs team is now processing PCR tests for suspected Group A Strep illnesses for all Health Boards across Scotland, a vitally important role, amid the ongoing surge in respiratory illness that is being seen across the country, and which is hugely impacting levels of hospital presentations and admissions.
Calum Campbell, Chief Executive, NHS Lothian said, “The NHS Lothian laboratory teams did incredible work throughout the pandemic, but they haven’t stopped there.
“This new development, which builds on their immense knowledge, and the investment we have made in this area, is now proving vital as Scotland’s healthcare system responds to increased and sustained levels of respiratory illnesses.
“The introduction of the PCR test will mean Scotland’s hospitals can diagnose Group A Strep illnesses more quickly, improving treatment options for patients and minimising the potential spread of infection. This innovation is proving invaluable now, but will continue to play a vital role in future years.
“I am immensely proud of the laboratory teams for their ongoing work in this area, and as they continue to support not just NHS Lothian, but Scotland’s other Health Boards throughout this particularly difficult winter.”
Ageing Well, run by Edinburgh Leisure in partnership with NHS Lothian is seeking new participants to join various city-wide activities which support people to become, and remain, active in later life.
Available to join are Buddy Swim sessions, a 19-week cycle skills course and a two-week technical skills Nordic Walking course, which is followed by four weeks of walking around Edinburgh.
Cat Wilson, Active Communities Project Officer at Edinburgh Leisure said: “Ageing Well activities have been developed to cater for a wide range of tastes and abilities. All activities are either led by or supported by fully trained volunteers, who are all older adults themselves.
“The emphasis is on meeting new people whilst making physical activity accessible and enjoyable. For anyone who has made a promise to themselves, or their family, to improve their fitness in the new year, now is the time to walk the talk and to register their interest in any of our Ageing Well programmes.
“I can guarantee it will be a lot of fun, will improve their wellbeing and fitness, and all our activities are sociable, with plenty of opportunities to make new friends.”
Buddy Swimming is aimed at older adults, who perhaps lack confidence, to get back in the water. Participants are met and greeted by Edinburgh Leisure’s volunteers and ensure they have the support they require in the water, followed by that all-important chat and cup of tea afterwards.
Ageing Well’s Buddy Swimming takes place in three Edinburgh Leisure venues across the city, moving to four, when Warrender Swim Centre, reopens in early 2023.
Tuesday – Glenogle Swim Centre – 10.00 – 10.45am
Wednesday – Warrender Swim Centre – 10.00am – 11.00am (date of Warrender reopening is still to be announced)
Thursday – Drumbrae Swim Centre – 10.30am – 11.15am
Thursday – Royal Commonwealth Pool – 12.05pm – 12.45pm
The 19-week Cycle Skills course will start at the beginning of March 2023 and takes place on a Monday at 10am.
The initial level 1 course, based on Cycling Scotland’s Bikeability material is an 11-week course, which will get participants comfortable again on a bike, developing skills, at a pace that suits them, in a dedicated area at Saughton.
Level 2 lasts 8-weeks and gives participants the opportunity to explore Edinburgh’s extensive cycle path network, from the leisure centres at Ainslie Park and Meggetland.
Suitable for anyone who hasn’t been on a bike for ages or for those that don’t currently own one, Edinburgh Leisure can provide bikes, helmets, and hi-viz vests, but people are welcome to bring their own.
Ageing Well’s six-week Nordic Walking course launched in March 2022 and will start again in Spring 2023, day and date to be decided.
Nordic Walking is for everyone. Its origins are Finnish and it provides a total-body version of fitness walking with specially designed poles, not to be confused with trekking poles. It can be enjoyed at many levels, at low, medium, or high intensity. The poles mean that effort is shared between the upper and lower body, so it feels easier than normal walking, particularly uphill. More than 10 million people globally enjoy this outdoor activity all year round.
Participants will meet at Brighton Park in Portobello and would be expected to attend the first two technical sessions to graduate. Each session will last 1-hour, and poles will be provided, if people do not already have their own.
Once group members have graduated from the 2-week introductory course, they will be eligible to join the Nordic Walking 4-week course, visiting various locations. These walks would take between 1.5 – 2 hours.
The Nordic Walking course complements Ageing Well’s already popular regular walks which take place in different locations around the city each week.
Ageing Well relies on external funding and donations to deliver its programmes across Edinburgh. A contribution of £3 per week for each activity is appreciated. This can be paid in one go or each week. People’s generous support means Edinburgh Leisure can provide a range of activities to reach more older adults in need of their support, protecting their health and wellbeing and improving their quality of life.
In 2018 the Ageing Well programme was awarded the Queen’s Award for Voluntary Service (QAVS), which is the highest award given to UK volunteer groups and is the equivalent of an MBE. The award reflects the tremendous contribution of Edinburgh Leisure’s Ageing Well volunteers and the positive difference they make to the lives of participants.
To find out more about any Ageing Well activities, visit:
NHS Lothian has published the findings of a research project, funded by NHS Lothian Charity, to learn about the Royal Infirmary of Edinburgh’s historical ties with the enslavement of African people and people of African descent.
The main findings include:
From 1729 to 1850, the Royal Infirmary of Edinburgh (RIE) received at least £28,080 from 43 individuals with ties to Atlantic slavery. These donors included physicians, surgeons, politicians, colonial officials, bankers, and a range of merchants, both in Britain and its colonies, who were connected to the enslavement of African people in the British West Indies and America.
From 1749 to 1892, the RIE owned and leased an estate in Jamaica called Red Hill pen, bequeathed in the will of the Scottish surgeon and enslaver Dr Archibald Kerr. Until the abolition of slavery in Britain’s colonies in 1834, the RIE owned and leased the enslaved people, drawing substantial rents from the property. After Abolition, the estate employed ‘apprentice’ Black labourers.
Between 1773 and 1801, the RIE was involved in requests for the manumission (the granting of freedom) of an enslaved Black woman (Juliet) and later her two enslaved children (John and William Moodie) on Red Hill at the request of their father, Dr John Moodie, a White man.
Through a complex series of events, the RIE eventually received approximately £832 from the British Government after the abolition of slavery (1834) as ‘compensation’ for the loss of the labour of the enslaved people at Red Hill.
NHS Lothian is committed to eliminating unlawful discrimination and harassment, advancing equality of opportunity, and fostering good relations between the different groups of people working for the organisation and using its services.
Throughout January, a series of public engagement events, led in partnership between the project’s independent Advisory Group and researcher, will be held in Edinburgh and online.
The purpose of these events is to start a conversation about what we have learned, the lasting impact, and the changes NHS Lothian can make today.
We are particularly interested in hearing from those groups who are most adversely affected by this history of slavery, including NHS Lothian BME staff and the wider ethnically diverse communities across Lothian. The Advisory Group will then make recommendations to the NHS Lothian Board to suggest how the organisation might correctly and appropriately learn from its past and act to tackle the modern-day racism and racial inequalities experienced by the people who work for NHS Lothian and use our services.
Two open sessions will also take place at the Centre for Research Collections, University of Edinburgh. During these sessions, relevant eighteenth and nineteenth century records used in the historical report will be available for people to view with the guidance of staff at Lothian Health Services Archive.
Talking about the importance of this charity-funded project, NHS Lothian Chief Executive, Calum Campbell said: “It is essential that our health and care system is truly inclusive so that everyone in Lothian lives longer, healthier lives, with better outcomes from the care and treatment we provide.
“We also strive to be an inclusive employer where everyone who works with and for us has better experiences. This work to acknowledge and tackle racism and racial inequality is vital to delivering this ambition.
“This project was fully funded by NHS Lothian’s official charity, NHS Lothian Charity. An independent researcher was contracted by NHS Lothian Charity to undertake the research and will lead the subsequent public engagement work.
“We hope that the public will get involved in conversations about this important work, helping us to understand and consider different reflections and viewpoints that will inform the independent Advisory Group’s final recommendations.”
Director of NHS Lothian Charity, Jane Ferguson said: “This is an important piece of work that we are serious about working in partnership on with NHS Lothian and we are providing charitable funding to take it forward.
“Reducing health inequality is one of the Charity’s priority objectives and this research helps both us and NHS Lothian understand what more we can do to help improve the health outcomes of our ethnically diverse communities.”
A list of FAQs has been provided to help with any questions that you might have about this project.
An increasing number of respiratory viruses in Lothian is heaping extra pressure on the hospital system.
Cases of Flu are surging and there are still high levels of COVID andRespiratory Syncytial Virus (RSV), as well as norovirus, causing hospitals and GPs in Lothian to be stretched beyond capacity.
Calum Campbell, Chief Executive, NHS Lothian, said the sector as a whole was already experiencing significant pressures because of an increase in emergency patients and large numbers of delayed discharge patients, before this latest increase in infection rates.
He added: “Our teams across the health and social care system are facing sustained and relentless challenge. The system is under horrendous pressure and the challenges our teams are facing are uncharted.
“We are experiencing more cases of infection – flu, COVID and RSV, as well as norovirus – than ever before.
“In order to maintain our patient flow through the hospital and retain beds for the most urgent of cases, we need to support people to go home quicker after their treatment and reduce any preventable admissions. That is where the public can help.
“Please take sensible precautions to prevent infection, especially if you have underlying health conditions or plan to be with those that do””
The Royal Infirmary of Edinburgh, St John’s Hospital, the Western General Hospital and the Royal Hospital for Children and Young People are all at full capacity.
Dona Milne, Director of Public Health and Health Policy, NHS Lothian, urged people to help reduce the spread of infections to protect themselves and the most vulnerable in their communities.
She said: “Although they can be mild infections for many, RSV and Flu can be extremely serious for some people causing them to require urgent hospital treatment. We have now reached extraordinary levels of flu in Scotland that we haven’t seen for many years.”
“We are asking anyone who has cold or flu like symptoms to help limit the spread of infection and reduce the chances of passing it to someone who will become very unwell.
“Stay at home if you feel unwell. And if you do have to go out, please wear a mask. People should also remember to wash their hands, and cough or sneeze into a tissue and bin it.”
People in Lothian are also being reminded to stock up their medicine cabinets with paracetamol and cold remedies so they can treat common illnesses at home.
Anyone who has cold type symptoms, such as a runny nose or mild cough, or who has a sore throat without a temperature and can eat and drink, is likely to have a viral illness and does not need to contact their GP. They should drink plenty of fluids and rest and get additional help and advice from NHS Inform or their local pharmacy.
The most up to date information on Strep A can be found at:
