Professor Grant McIntyre, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons of Edinburgh, said: “At a time when dentistry is under significant pressure, the details of a £350million underspend, representing 10 per cent of the total dental budget for England, is very concerning.
“This shortfall is undoubtedly directly impacting patients and dental teams nationwide.
“The disparity in underspend across different regions exacerbates an already troubling ‘postcode lottery’ in dental care access. It is evident that the current system is not working for patients or dentists, with some practices receiving unjustifiably little support.
“This will not only compromise patient care but also place undue strain on dental professionals, adding to the existing workforce problems that the profession has endured in recent years.
“We must rectify the underlying issues, ensuring suitable working arrangements for professionals and fair access to quality NHS dental care for all patients.”
A cross-border trial has improved care for patients prescribed multiple medicines.
The iSIMPATHY project, funded by the European Union’s INTERREG VA Programme, worked with professionals in Scotland, the Republic of Ireland and Northern Ireland to comprehensively review patient medication.
Taking multiple medicines can be problematic if the increased risk of harm from interactions between drugs, or between drugs and diseases, outweighs the intended benefits.
Interim findings showed these interventions potentially prevented major organ failure, adverse drug reactions, avoided hospital admissions and saw patients moved to more appropriate medication.
Project funding, managed by the Special EU Programmes Body (SEUPB), was match funded by the Northern Ireland Executive, the Irish Government and the Scottish Government.
Scotland’s Public Health Minister Maree Todd said: “This project looked at some of our most vulnerable patients taking more than five medications. The reviews have avoided adverse combinations of drugs and hospitalisations while also reducing prescriptions and drugs costs.
“We will know more when the full evaluation is published in June, we will work with partners to see how we can these improvements can be applied more widely, potentially saving lives and money.”
Ireland’s Minister for Health, Stephen Donnelly said: “Medicines are the most common healthcare intervention used within the health system, and the use of the right medicine for the right patient at the right time is central to this.
“In the delivery of this project, pharmacists were strategically and ideally placed as medicines experts within a multidisciplinary team framework working to maximise therapeutic outcomes for optimal patient benefit.
“I’d like to thank all the partners involved in the iSIMPATHY project for their work to achieve this.”
Northern Ireland Department of Health Chief Pharmaceutical Officer, Mrs Cathy Harrison said: “I’m pleased to see the impact on patients and service users who have taken part in iSIMPATHY who are at the heart of the project’s aim to ensure the best and most sustainable use of medicines.
“iSIMPATHY has achieved this through training pharmacists and other healthcare professionals to deliver medicine reviews and embed a shared approach to managing multiple medicines. Northern Ireland has been delighted to collaborate with our partner regions to build on the success of previous projects dedicated to improving medicine safety.”
Gina McIntyre, SEUPB CEO said: “Thanks to projects such as iSIMPATHY, we can understand the importance of cross-border cooperation, and how they are playing a major role in the efficient delivery of health services, in the border regions, alongside addressing challenges brought about by rising demand within a constrained budget environment.
“Health is an important precondition for economic growth, while also fostering social cohesion. I am delighted to see just how effective this project has been in improving the lives of people in the region.”
New research published today in a leading GP journal shows that large parts of Scotland do not have an effective way of identifying people with liver disease, resulting in late diagnosis.
The research, produced from a survey undertaken by the British Liver Trust, used a Freedom of Information request, and shows for the first time how many areas across the country have little or no formal structures in place for detecting and managing liver disease and liver cancer.
The mapped survey results (see below) also show huge swathes of the UK (marked in red) do not have any effective patient pathway in place. This is in sharp contrast to other chronic conditions such as diabetes and heart disease, where patients receive standardised care.
Figure 1 Areas in red have no pathway in place. Amber denotes areas with a partial pathway or pathway in development. Green areas have a full pathway in place. Areas in black did not respond.
Three quarters of people in the UK are currently diagnosed when it is too late for effective intervention or treatment and one in four people diagnosed late in hospital sadly die within a couple of months.
The charity is now calling for earlier detection of liver disease and better patient care across all regions of the UK to be prioritized, and is working to influence healthcare commissioners.
Dr Helen Jarvis, Clinical Advisor for the British Liver Trust and lead author of the research, says: “Anyone who has liver disease, or is at risk of getting it, should get the medical care and advice they need no matter where in the country they live.
“The publication of this new data shows that, unfortunately, in the UK this is not yet the case. There are pockets of good practice, but there are also many areas that do not have a consistent approach to testing for and diagnosing liver disease. It shouldn’t be a postcode lottery.
“GPs and other healthcare professionals in primary care are doing a fantastic job under a lot of pressure, but in many areas, they’re working within a system that doesn’t allow them to detect and treat liver disease effectively.
“Unfortunately, many GPs also report a lack confidence and knowledge when it comes to managing the condition. Sadly, this means that in many cases, people with liver disease are diagnosed far too late when treatment options are limited. This had led to thousands of avoidable deaths.
“The liver is an incredibly resilient organ, but only up to a point. Symptoms of liver disease often only appear once damage has progressed and the liver is starting to fail. However, 90% of liver disease is preventable and, in many cases, it’s reversable if caught in time. That’s why early detection and prevention are key.”
Pamela Healy OBE, Chief Executive of the British Liver Trust, said: “Shockingly, deaths due to liver disease have more than doubled in the last 20 years and the condition is expected to overtake heart disease as the biggest cause of premature death in the UK in the next few years.
“Obesity, alcohol and viral hepatitis are the three main risk factors for preventable liver disease.
“We need to take urgent action to stop this silent killer in its tracks. Although the results of our research are very concerning, we do know that there are areas of good practice and that the changes we’re calling for are entirely possible and will save many lives.
“We now need to take what’s working well in those areas with good liver patient care and apply them in others so that every person with liver disease gets the best possible care, no matter where in the UK they live.”
The latest data released yesterday by the Scottish Government for May 2021 show that attendances at Emergency Departments have risen significantly.
In May 2021 there were 112,563 attendances to major Emergency Departments across Scotland. This is a 12% increase compared to April 2021, a 24% increase when compared to March 2021, and a 45% increase compared to May 2020.
Following this increase, four-hour performance deteriorated, 86% of attendances to major Emergency Departments in Scotland were seen within four hours. 15,706 patients were delayed by four-hours or more in an Emergency Department, this is the highest figure since January 2020, and it is the highest figure ever recorded for the month of May. This means one in seven patients were delayed by four hours or more before being seen.
In May 2021, 393 patients spent 12 hours or more in an Emergency Department, this is double the figure for April 2021. This is the highest number of 12-hour delays for the month of May ever recorded, and it is more than double the previous highest May figure of 189 12-hour delays that was recorded in 2019.
Data also show that 1,680 patients spent eight hours or more in a major Emergency Department, this is an increase of nearly 50% compared to April 2021 and it is the highest figure ever recorded for the month of May.
Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said:“The data is deeply concerning and very much reflects what is happening on the ground. Departments are busier than ever, especially for the summer period with some record-breaking figures for the month of May, and it is becoming increasingly challenging.
“These figures come at a time when reports suggest Scotland has the highest covid infection rate in Europe. We are battling community admissions, elective care patients seeking treatment, as well as increasing covid patients attending our departments, all within the context of reduced bed-stock.
“Departments are filled with patients, some who may have covid, waiting to be seen. While long-stays alone can put patient safety at risk. This risk is increased as some patients could contract the disease in a busy Emergency Department.
“The College’s recent Emergency Medicine workforce census in Scotland revealed an Emergency Medicine workforce that was not adequately staffed to deliver the highest quality patient care in Emergency Departments in Scotland.
“We have shortages across the board, but particularly among consultants and senior decision-making clinicians. These shortages are currently exacerbated by the soaring covid infection rate, meaning there are a large number of absent NHS staff due to covid in Scotland.
“We are doing all we can to maintain flow and maximise patient safety, but the pressures are increasingly intense and are faced by the existing but short-staffed workforce that are facing continued burnout and exhaustion.
“The data show the growing demand for urgent and emergency care, Emergency Departments are where people turn to for treatment when there is nowhere else to go, so they must be adequately staffed with trained Emergency Medicine staff, properly funded, and equipped with enough capacity and resources to cope with severe demand.”
“We urgently need the Scottish Government to support the urgent and emergency care system to cope with these pressures.”
Two NHS Grampian hospitals have announced this week that they are at capacity as Covid cases rise.
Scotland was expected to move to level zero on 19 July, with remaining legal restrictions lifted on 9 August, but First Minister Nicola Sturgeon conceded yesterday that th planned dates are not “set in stone”.
She will be holding a media briefing at lunchtime today:
