We have some important advice for dealing with norovirus, also known as the winter vomiting bug, after a recent increase in calls to the 111 service.
Norovirus is a stomach bug that causes vomiting and diarrhoea. While it can be very unpleasant, it usually goes away in about 2 days. Symptoms include:
Feeling sick (nausea)
Diarrhoea
Vomiting
High temperature
Headache
Aching arms and legs
Unfortunately, norovirus spreads easily and quickly. If you catch it, here’s what you should do:
Stay off work or school until at least 48 hours after symptoms have stopped.
Avoid visiting anyone in hospital during this time.
Wash your hands frequently and thoroughly with soap and water, especially after using the toilet and before handling food.
Remember, alcohol-based hand gels don’t kill the virus.
To prevent spreading norovirus, maintain basic hygiene and cleaning:
Disinfect surfaces and objects that could be contaminated using a bleach-based household cleaner.
Wash clothes and bedding separately on a hot wash (60°C).
Don’t share towels and flannels.
Clean toilets and surrounding areas with a bleach-based household cleaner.
Dr. Ron Cook, NHS 24’s Medical Director, advises: “If you experience sudden diarrhoea and/or vomiting, stay at home until you’re feeling better.
“There’s no treatment for norovirus, so you have to let it run its course. Drink plenty of fluids to avoid dehydration and avoid giving fizzy drinks or fruit juice to children as it can make their diarrhoea worse.
“Babies should continue to feed as usual. You don’t usually need medical advice unless there’s a risk of a more serious problem. Alleviate fever or aches with paracetamol and get plenty of rest.
“If you or someone you’re caring for shows signs of dehydration, use special rehydration drinks from your local pharmacy. Once you feel like eating, try plain foods like soup, rice, pasta, and bread.”
Don’t let the festive rush catch you out—check your repeat prescriptions and make sure you have enough medication to last through the festive period. Order only what you need, in plenty of time.
The tie-up will create up to 40 jobs and ‘make stop smoking services more accessible in communities across the country‘
VPZ, the UK’s leading vaping retailer, is set to open 10 new stores by December 2024 as part of a groundbreaking partnership with the supermarket chain Morrisons, with plans to expand further during 2025.
The new in-store outlets will expand the brand’s presence in communities throughout the UK, with seven key locations in Leeds Hunslet, Birmingham Stirchley, Glenrothes, Peterhead, Darlington, Stratford and Grantham.
The collaboration will also introduce a new innovative mobile pod concept for customer parking areas, with two planned for Nottingham and one in Rotheram.
The partnership will drive positive change by making stop smoking services more accessible in communities throughout the country, whilst educating smokers on the benefits of more sustainable vaping products.
The new sites will help expand and complement VPZ’s mission to help people on their journey to quit smoking by improving access to expert stop-smoking advice and education.
VPZ stores offer a dedicated one-to-one service to help smokers quit. VPZ specialists are trained and have expert knowledge, engaging with smokers to educate them on the health and financial benefits of switching to vaping.
Furthermore, as a part of their shared commitment to environmental responsibility, all new stores will include VPZ’s comprehensive recycling programme. The service is open to all vapers, as anyone can visit the new stores and dispose safely of their vaping devices or e-cigarettes.
Greig Fowler, Director at VPZ, said: “Our partnership with Morrisons to open 10 new stores is a pivotal step in our mission to transform the health of our nation by empowering more people to become smoke-free.
“I believe that together we will be making it easier for smokers to access the resources, help and education they need to quit smoking, while also offering a convenient and sustainable shopping experience.”
He added: “We are looking forward to launching our new in-store locations, pod concepts and exploring further growth in 2025.”
VPZ has recently voiced concerns that the newly announced vape tax increase will unfairly impact the most vulnerable and set back the UK’s 2030 smoke-free targets. As vaping remains one of the most effective methods to quit smoking, VPZ has warned that higher taxes on vaping products could discourage smokers from switching, undermining both health and financial benefits.
VPZ also supports plans to ban disposable vapes across the UK and Scotland by June next year, however they have highlighted the rise of ‘Big Puff’ disposable vapes which threaten to bring a new youth vaping epidemic and even greater damage to the environment.
The imported products are exploiting a loophole in regulations to create a new and larger single-use vaping product ahead of the disposables vape ban.
Greig Fowler added: “These illegal ‘Big Puffs’ undermine our objectives and are poised to create a public health crisis with unregulated products flooding the marketplace.
“At the current moment, data shows that more than ever there is a need for the Government to step in to support trading standards and local authorities to keep up with the scale of the ‘Big Puff‘ epidemic.
“We urge for a better collaboration between the industry and regulatory bodies to address this arising issue promptly and ensure that these vapes do not flood the UK market even further and endanger the quit-smoking progress that has been achieved so far.”
To date, Edinburgh-based VPZ has already helped over 1 million smokers in the UK quit since it was established in 2012.
Four community nurses from across Lothian have received the prestigious title of Queen’s Nurse.
Fab Four Laura Miller, Mags Morrow, Ryan Bell and Louise Healey successfully completed the intensive programme to be awarded the Queen’s Nurse title at a special ceremony at the Grassmarket Community Project in Edinburgh.
They were chosen to participate in an intensive nine-month development programme, organised by the Queen’s Nursing Institute Scotland (QNIS).
The programme included residential workshops, online sessions, and one-on-one coaching to enhance their skills and expertise. Laura, works as the Clinical Team Lead for District Nursing and Mags is the Clinical Nurse Manager, Lead Advanced Nurse Practitioner, and CWIC Service Operational Lead in East Lothian Health and Social Care Partnership.
Ryan is the Team Lead at Midlothian Older Adults Mental Health and Dementia Team, while Louise is the Team Manager of the Midlothian Community Adult Mental Health Team and Intensive Home Treatment Team; in Midlothian Health and Social Care Partnership.
Alison Macdonald, Executive Director for Nursing at NHS Lothian, said: “Our nurses across Lothian consistently deliver outstanding care, and it’s wonderful to see their efforts celebrated through the prestigious Queen’s Nurse Awards.
“We are especially proud to have not one, but four exceptional individuals receive this esteemed recognition this year. Congratulations to each of them on this incredible achievement.”
The legacy of Queen’s Nursing in Scotland dates back to the late 19th century, when nurses underwent specialised training to serve as district nurses, providing essential care to the ‘sick poor’ in Scotland’s communities.
Until the late 1960s, the Queen’s Nursing Institute Scotland (QNIS) oversaw the training of District Nurses, who became known as Queen’s Nurses. These nurses played a vital role in delivering healthcare and health education directly to people in their homes, earning respect and trust within their communities.
The original Queen’s Nurse title was awarded until 1969, when the introduction of a national certificate for district nursing marked the end of QNIS’s training programs.
In 2017, the Queen’s Nurse title was reintroduced in Scotland. Each year, around 20 community nurses and midwives are selected to participate in the Queen’s Nurse Development Programme (QNDP). Upon completion of this rigorous program, they are awarded the title of Queen’s Nurse. Today, there are more than 170 contemporary Queen’s Nurses serving communities across Scotland.
Every year, the programme requires participants to choose an issue for development which will have a significant impact on those they care for, so that the learning during the nine months is applied in practice. There is an expectation that this work will have a focus on promoting equity and inclusion.
Community nurses and midwives play a crucial role in supporting their communities by delivering a broad range of services. Their work includes providing complex care for older adults, offering support for individuals struggling with substance misuse, and advocating for people with learning disabilities.
This dedicated group also encompasses professionals in community mental health, district nursing, school nursing, care home nursing, and health visiting, all of whom are essential to the health and well-being of the populations they serve.
Dr Sarah Doyle, QNIS Chief Executive and Nurse Director, said: “QNIS is delighted to award the Queen’s Nurse title to these fantastic nurses.
“Community nurses and midwives occupy a unique position in Scotland’s health service, working as they do in the heart of communities, championing the cause of those who are not heard, helping those facing real adversity.
“They do extraordinary work, every day. The Queen’s Nurse Development Programme supports participants to build their confidence, inspiring them to find and lead creative responses to the challenges faced by their colleagues and the communities they serve.”
Funding for NHS Lothian candidates to undertake the development programme was provided by NHS Lothian Charity.
The Royal College of Emergency Medicine has joined calls for the Scottish government to address ‘delayed hospital discharges’ in the upcoming budget announcement.
Delayed discharges are when people are considered medically fit enough to leave hospital but are unable to, often because the required social care support is not available.
This issue means that the whole system for admitting people grinds to a halt and people can end up stranded in A&Es often waiting hours and even days for a ward bed to become available.
The latest data release comes as the Auditor General of Scotland published a damning report into the state of the Scottish health system which concluded that the Scottish Government has no clear plan to reform the country’s NHS, or to address pressures on the service.
Auditors found:
commitments to reducing waiting lists and times have not been met
the number of people remaining in hospital because their discharge has been delayed is the highest on record
and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.
The issue of delayed discharges has also been highlighted by the Royal College of Physicians Edinburgh (RCPE) which has written an open letter to the First Minister calling on him to address this ‘urgent issue’ in his Government’s budget which will be unveiled tomorrow (4 December 2024).
Dr Fiona Hunter, The Royal College of Emergency Medicine’s Vice Chair for Scotland said yesterday: “Delayed discharges are a key reason that patients get stuck in Emergency Departments, often on trolleys in corridors – often experiencing extreme waits which are dangerous.
“So we join, and fully support, the calls from RCPE, and the Auditor General to address this issue. It must be prioritised as a matter of urgency.
“Today’s data is another timely reminder of scale of the issue. Just think about what it shows. More than 2,000 people every single day stranded in in hospital when they are well enough to go home.
“People – through no fault of their own, lying in beds which could be used for other patients who need to be admitted – who themselves are probably on a trolley in the Emergency Department, waiting for that bed to become available.
“We have to be able to move patients through our hospitals and out again when they are well enough. To do that takes a functioning and resourced social care system working alongside a functioning and resourced health system. They are inextricable.
Dr. Hunter concluded:“Tomorrow’s budget is an opportunity for the Government to #ResuscitateEmergencyCare, ahead of the depths of winter which is shaping up to be a gruelling several months ahead, for both patients and staff alike. They must take it.”
The Scottish Government needs a delivery plan that clearly explains to the public how it will reform the NHS and address the pressures on services.
Despite increasing funding and staffing, the NHS in Scotland is still seeing fewer patients than before the Covid-19 pandemic.
Auditors found that:
commitments to reducing waiting lists and times have not been met
the number of people remaining in hospital because their discharge has been delayed is the highest on record
and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.
Health accounts for about 40 per cent of the Scottish budget. Funding grew again in 2023/24 but has mostly been used to cover pay commitments and inflation. Costs are forecast to continue rising and making savings remains challenging. Work to build new healthcare facilities also remains paused.
The Scottish Government’s restated vision for health and social care is not clear on how these operational pressures on the NHS will be addressed or how reform will be prioritised. It needs to work with NHS staff, partners and the public to set out a clear delivery plan and make tough decisions about how it may change or potentially even stop some services.
Stephen Boyle, Auditor General for Scotland, said: “To safeguard the NHS, a fundamental change in how services are provided remains urgent. The Scottish Government needs to set out clearly to the public and the health service how it will deliver reform, including how progress will be measured and monitored.
“Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed. Taking those steps will require greater leadership from Scottish Government and NHS leaders than we’ve seen to date.”
Funding to help practices retain and recruit key staff
An additional £13.6 million will be invested in General Practice this financial year to support GPs to retain and recruit key staff, Health Secretary Neil Gray has announced.
Speaking at the annual conference of BMA Scotland’s Local Medical Committees, Mr Gray confirmed the immediate funding for 2024-25 will address known financial pressures, support staff costs and enable GPs to take on partners and salaried GP staff.
Mr Gray said: “I recognise the significant financial and workload challenges facing both the NHS as a whole and General Practice, especially during this period of high demand, and understand the significant strain this places on GPs.
“My focus remains firmly on finding ways to recruit more GPs, even within the constraints of the current financial climate, and that is why I am allocating an additional £13.6 million for General Practice this financial year to support staff costs. This additional funding will help GPs to underpin business decisions and provide high-quality patient care.
“Sustainable reform of the NHS means we must look to shift more care to primary and community care with a relentless focus on better outcomes for people.
The Scottish Government reform programme will develop the means to credibly restore, and further increase GP and wider primary care spend, within the overall health budget.
“This will be a long-term endeavour but this strategic shift is crucial. Our reform plans over the next period will look to explore this in partnership with key stakeholders including the GP profession.”
Addressing the separate issue of next year’s UK National Insurance contribution increases, Mr Gray added: “The UK Government’s decision to increase national insurance contributions will have a major financial impact on GPs.
“I have been very clear that this is completely unacceptable and the UK Government must fully cover the costs. Scotland’s GPs should not be paying the price for UK Government decisions.”
The Scottish Budget for 2025-26 will be published on 4 December.
Health and Social Care Secretary will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well
Wes Streeting to reveal package of reforms and announce new league table of NHS England providers, with top talent attracted to most challenging areas and persistently failing managers to be sacked
Turn around teams sent into struggling hospitals, while best performers given greater freedoms over funding to modernise technology and equipment
No more rewards for failure, with reforms to ensure every penny of extra investment into NHS is well spent and waiting times for patients slashed
NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a tough package of reforms to be announced by the Health and Social Care Secretary Wes Streeting today (Wednesday 13 November).
Addressing the nation’s health leaders at the NHS Providers’ annual conference in Liverpool, he will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well and get better value for money.
NHS England will carry out a no holds barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised.
Persistently failing managers will be replaced and turn around teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service.
High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers can’t benefit from it. The reforms today will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment and technology.
The government will deliver a health service fit for the future, fixing the foundations while delivering change with investment and reform to deliver growth, get the NHS back on its feet, and rebuild Britain.
Health and Social Care Secretary Wes Streeting said: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.
“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”
Amanda Pritchard, NHS chief executive said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.
“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”
The NHS Oversight Framework which sets out how trusts and integrated care boards are best monitored – will be updated by the next financial year to ensure performance is properly scrutinised.
Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.
Louise Ansari, Chief Executive of Healthwatch England: “People value the hard work of NHS staff, but it’s frustrating when services fail to operate effectively. So, a fresh approach to improving NHS performance is welcome.
“Currently, living in an area with either an outstanding or poorly performing NHS trust feels like a postcode lottery. When a service is underperforming, it often takes far too long for patients to see the necessary improvements.
“This is because the current system focuses on evaluating service performance based on the number of tasks it completes and it does not do enough to measure patients’ overall outcomes and experiences.
“Establishing a better system that encourages NHS managers to focus on delivering the best care as efficiently as possible, and leads to quicker changes at struggling trusts, would be good news for everyone.”
NHS senior managers who fail to make progress will also be ineligible for pay increases. There will be financial implications for Very Senior Managers (VSMs) such as Chief Executives if they are failing to improve their trust’s performance, or letting patients down with poor levels of care.
A new pay framework for VSMs will be published before April 2025. Senior leaders who are successfully improving performance will be rewarded, to ensure the NHS continues to develop and attract the best talent to the top positions.
The changes are made in response to Lord Darzi’s investigation into the NHS, which found that: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”
The cost to the health service of hiring temporary workers sits at a staggering £3 billion a year. Under joint plans to be put forward for consultation in the coming weeks, NHS trusts could be banned from using agencies to hire temporary entry level workers in band 2 and 3, such as healthcare assistants and domestic support workers. The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.
Rachel Power, Chief Executive, Patients Association: “We welcome today’s commitment to improving NHS performance and accountability. These reforms signal an important drive for positive change in our health system. The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.
“At the same time, we know from the experience of patients, that real transformation comes through genuine partnership with patients. We look forward to working with NHS England to ensure patient voices help shape how any league tables are developed and how success is measured.
“The proposed support teams for struggling trusts could be particularly effective if they include patient representatives and focus on building a culture of patient partnership. This is an opportunity to combine better management with deeper patient involvement – creating an NHS that is both more efficient and more responsive to people’s needs.
“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services. These are the things that matter most to people using the NHS.”
Lord Darzi’s investigation into the NHS found that hospital productivity has ‘nosedived’ in the past five years. During that time resources have increased by 20%, but the number of patients treated has only increased by 3%.
This comes a month after the Health and Social Care Secretary kicked off the biggest national conversation about the future of the NHS since its birth, calling on the entire country to share their experiences of our health service and help shape the government’s 10 Year Health Plan.
Members of the public, as well as NHS staff and experts, are sharing their experiences, views and ideas for fixing the NHS via the Change NHS online platform, which will be live until the start of next year, and available via the NHS App.
Alarm Bells: Alan Milburn joins the Department of Health and Social Care’s board to ‘support the government’s ambitious plans for reform’
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
Mr Milburn ‘brings experience at the highest levels to help transform the health and care system‘
This (Labour) government is determined to work with experts who can provide the best advice to help rebuild an NHS fit for the future
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
The former New Labour Health Secretary has a ‘proven track record of reducing waiting lists and improving satisfaction in the NHS’.
Milburn is also a strong advocate of private healthcare involvement in the NHS. Back in 2015, Milburn intervened in the British election campaign to criticise Labour’s health plans, which would limit private sector involvement in the NHS. Milburn was criticised for doing so while having a personal financial interest in the private health sector.
The current Labour government says the NHS is broken and it is the mission of this government to fix it and make the health service fit for the future. As part of this national mission, experts are being brought in to help develop policy, and NHS staff and patients have been invited to share their experience and ideas to change the NHS at Change.NHS.gov.uk.
Members of the department board provide independent advice and expertise to inform the department’s strategy, performance and governance and the Lead Non-Executive Member provides additional support to the Secretary of State for Health and Social Care in his role as Chair of the board.
The Labour government says that, as a former Secretary of State, Alan brings experience at the highest levels of helping transform the health and care system – but health trade unions will be very wary of Milburn’s appointment.
Health and Social Care Secretary Wes Streeting said: “As Secretary of State, Alan made the reforms which helped deliver the shortest waiting times and highest patient satisfaction in the history of the NHS.
“This government has inherited a broken health service with some of the longest waiting times and lowest patient satisfaction in history. I am delighted to welcome Alan to the department board, where he will offer advice on turning the NHS around once again.
“His unique expertise and experience will be invaluable and he has an outstanding track record of delivering better care for patients.”
Lead Non-Executive Director Alan Milburn said: “I am delighted to be appointed to this role.
“Having spent three decades working in health policy, I have never seen the NHS in a worse state. Big reforms will be needed to make it fit for the future.
“I am confident this government has the right plans in place to transform the health service and the health of the nation. I’m looking forward to working with them to achieve that mission.”
Due to ‘the requirements of the role and the unique expertise and experience Alan Milburn brings’, he was appointed directly by the Secretary of State on following consultation with the Commissioner for Public Appointments, and in compliance with the Governance Code on Public Appointments.
The Department of Health and Social Care would like to thank Samantha Jones for all her work and support as non-executive director since February 2023.
An awareness campaign is underway to ensure people know the best place to access healthcare this winter.
Right Care Right Place helps the public decide the most appropriate service for their healthcare needs – whether they should contact their GP or pharmacy, call NHS 24 on 111 or use self-help guides on the NHS Inform website. Hospital emergency departments should only be visited for critical emergencies.
The campaign features targeted advertising on television, radio and online and aims to help alleviate pressures on the NHS and social care ahead of an expected seasonal increase in demand.
Health Secretary Neil Gray visited East Lothian Community Hospital to hear about work being undertaken to address delayed discharges. The hospital supports patients leaving acute hospitals who require intermediate care before returning home.
Mr Gray said: “We have been working closely with colleagues across the NHS and social care to make sure we are as prepared as possible ahead of winter.
“Public information and awareness of the treatment options and how to access them when needed is key to ensuring services are directed where they are most needed.
“This will help everyone to get the right care, in the right place as quickly as possible while helping alleviate pressures on the rest of the NHS. People can also help by making sure they receive their Respiratory Syncytial Virus (RSV), Covid-19 and flu vaccinations if eligible.”
Self-help guides can be found on NHS inform and include advice on the most common winter illnesses.
How to Cope with the Winter Vomiting Bug 
Diarrhoea
Vomiting
High temperature
Headache
Aching arms and legs
Stay off work or school until at least 48 hours after symptoms have stopped.
Don’t let the festive rush catch you out—check your repeat prescriptions and make sure you have enough medication to last through the festive period. Order only what you need, in plenty of time.
