Tag: public health

Walking, wheeling and cycling to be offered on prescription in England

  • trials in 11 areas across England to help people’s mental and physical health
  • GPs will issue social prescriptions such as walking, wheeling and cycling, backed by £12.7 million
  • schemes will include cycling and walking groups, cycle training and free bike loans

Social prescriptions, including walking, wheeling and cycling, will be offered by GPs as part of a new trial to improve mental and physical health and reduce disparities across England, the government has announced today (22 August 2022).

The government has awarded £12.7 million in multi-year funding to 11 local authority areas in England. The funding will go towards several pilot projects in each location, including:

  • adult cycle training
  • free bike loans
  • walking groups

Other schemes include all-ability cycling taster days where people who may not have cycled before can try to in a friendly environment, or walking and cycling mental health groups where people can connect with their communities as they get active.

The pilots must be delivered alongside improved infrastructure so people feel safe to cycle and walk.

The 11 local authority areas that will trial social prescriptions are:

  • Bath and North East Somerset
  • Bradford
  • Cornwall
  • Cumbria
  • Doncaster
  • Gateshead
  • Leeds
  • Nottingham
  • Plymouth
  • Suffolk
  • Staffordshire

The pilots, a commitment in the government’s Gear Change plan published in 2020, aim to evaluate the impact of cycling and walking on an individual’s health, such as reduced GP appointments and reliance on medication due to more physical activity. For the first time, transport, active travel and health officials will work together towards a whole systems approach to health improvement and tackling health disparities.

Walking and Cycling Minister, Trudy Harrison, said:  ”Walking and cycling has so many benefits – from improving air quality in our communities to reducing congestion on our busiest streets.

“It also has an enormous positive impact on physical and mental health, which is why we have funded these projects which will get people across the country moving and ease the burden on our NHS.”

National Active Travel Commissioner, Chris Boardman, said: “As a nation we need healthier, cheaper and more pleasant ways to get around for everyday trips. Active Travel England’s mission is to ensure millions of people nationwide can do just that – so it’s easier to leave the car at home and to enjoy the benefits that come with it.

“Moving more will lead to a healthier nation, a reduced burden on the NHS, less cancer, heart disease and diabetes, as well as huge cost savings. This trial aims to build on existing evidence to show how bringing transport, active travel and health together can make a positive impact on communities across England.”

The pilots will be delivered between 2022 and 2025 with on-going monitoring and evaluation to support continued learning.

The project is bringing together a range of government departments and agencies including:

  • NHS England
  • Office for Health Improvement and Disparities
  • Sport England
  • National Academy for Social Prescribing
  • Defra
  • Department for Health and Social Care

NHS Lothian encourages parents to get children vaccinated against flu 

NHS Lothian is encouraging parents and carers to help keep children healthy over the school terms this winter by getting them vaccinated against flu. All primary and secondary school pupils are eligible for the vaccine, which is given in schools as a painless nasal spray.

Getting children vaccinated against flu reduces the chances of them missing class time and other activities due to illness and helps prevent them passing the illness to vulnerable family members.

Consent packs containing a letter, leaflet and consent form will be sent home to parents and carers of school children on return to school in August. Secondary pupils can self-consent, though they are encouraged to speak to a parent or carer first.

Letters with appointment details for children aged two to five years who are not yet at school will begin to arrive at homes from September.

Parents and carers should call the number on their child’s letter if their child has missed their appointment or needs to reschedule.

The nasal spray is a quick and painless way of delivering the flu vaccine to children and should start to provide protection within 10-14 days.

Pat Wynne, Nurse Director for NHS Lothian who is overseeing this year’s programme, said: “Getting the nasal spray flu vaccine is the best way to protect your child and those around them. The flu virus changes over time so your child needs to get the vaccine each year to help stay protected.

“Please look out for your child’s consent pack, which they will receive through school from August, and ensure that their completed consent form is returned on time if you wish them to receive the vaccine.”

Public Health Minister Maree Todd said: “Schools are back but we want to keep flu out, which is why all primary and secondary school children are being offered the free flu vaccine.

“Flu can be serious, even for healthy children, so the vaccine offers the best possible protection for your child and those around them who may be more vulnerable to flu. Getting your child vaccinated can help prevent them getting sick, from spreading flu, and requiring time off school and away from other activities.”

School children will receive the flu vaccine in school between September and December. Parents of two to five-year-olds who are not yet at school will be given information about where their child will be vaccinated in their appointment letter. In a small number of cases, the nasal spray may not be suitable, and the vaccine can be given as an injection in the arm instead.

For more information about the flu vaccine, visit NHS Inform or call 0800 030 8013.

Winter Vaccines

Scotland’s Winter Vaccine Programme will see eligible groups invited forward for vaccination against flu and/or COVID-19.

Following advice from the Joint Committee on Vaccination and Immunisation (JCVI), the following groups will be offered both the flu and COVID-19 vaccines this year:

• aged 50 or over
• residents and staff working in a care home for older adults
• younger adults in long stay nursing and residential care settings
• frontline health and social care workers
• Those aged 5 to 49 years with an eligible health condition, including those with poorly controlled asthma
• Those aged 5 to 49 years who are:
– a household contact of someone with a weakened immune system
– an unpaid carer or a young carer (16 years or over)
– pregnant

The flu vaccine is also recommended for:

• people aged 16 to 49 years with an eligible health condition, including well controlled asthma
• children aged 6 months to 2 years with an eligible health condition
• all children aged 2 to 5 years (not yet at school)
• all primary and secondary school pupils
• nursery, primary and secondary school teachers and pupil-facing support workers in local authority and independent settings
• prison population and prison officers and support workers who deliver direct front-facing detention services.

Appointments for priority groups will be made available as the programme progresses – people in those groups should wait until they are contacted or called forward. Read the latest update from the Scottish Government here.

NHS Lothian: Winter vaccines

If you’re aged 65 and over, you’ll receive a letter in the coming weeks inviting you to get your flu vaccination and a COVID-19 booster.

It’s quick and safe to get both vaccinations at the same time, so you’ll only need one appointment. If you’re unable to attend, please let us know.

Appointments for all other priority groups will be made available as the programme progresses and eligible cohorts should wait until they are contacted or called forward.

Read more here 👉http://ow.ly/e17250KjVG5

Covid: UK is first country to approve dual-strain vaccine

The UK has become the first country to approve a dual vaccine which tackles both the original Covid virus and the newer Omicron variant. The vaccine will now be part of the autumn booster campaign.

The Joint Committee on Vaccination and Immunisation (JCVI) has published its advice on which vaccines should be used in this year’s autumn booster programme.

All of the available boosters provide good protection against severe illness from COVID-19 and the Committee has emphasised that getting a booster in good time before the winter season is more important for those eligible than the type of vaccine that is received.

The vaccines advised for use in the autumn booster programme are:

For adults aged 18 years and above:

  • Moderna mRNA (Spikevax) bivalent Omicron BA.1/Original ‘wild-type’ vaccine
  • Moderna mRNA (Spikevax) Original ‘wild-type’ vaccine
  • Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine
  • in exceptional circumstances, the Novavax Matrix-M adjuvanted wild-type vaccine (Nuvaxovid) may be used when no alternative clinically suitable UK-approved COVID-19 vaccine is available

For people aged 12 to 17 years:

  • Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine

For people aged 5 to 11 years:

  • Pfizer-BioNTech mRNA (Comirnaty) Original ‘wild-type’ vaccine paediatric formulation

‘Bivalent’ vaccines have been developed by global manufacturers since the emergence and dominance of the Omicron variant. These vaccines contain two different antigens (substances that induce an immune response) based on two different COVID-19 strains, or variants. The original mRNA vaccines contain one antigen (monovalent), based on the original ‘wild-type’ strain.

Studies indicate the Moderna bivalent vaccine produces a marginally higher immune response against some variants than the Moderna mRNA Original ‘wild-type’ vaccine. The clinical relevance of these small differences is uncertain.

The committee will consider further bivalent vaccines for use in the programme as they are approved by the MHRA.

In its latest advice the JCVI has stated that, where feasible, it would be preferable for a single type of booster vaccine to be offered throughout the duration of the autumn programme for simplicity of deployment.

Professor Wei Shen Lim, Chair of COVID-19 immunisation on the JCVI, said: “All of the available booster vaccines offer very good protection against severe illness from COVID-19. As more vaccines continue to be developed and approved, the JCVI will consider the benefits of including them in the UK programme.

“It is important that everyone who is eligible takes up a booster this autumn, whichever vaccine is on offer. This will increase your protection against being severely ill from COVID-19 as we move into winter.”

Dr Mary Ramsay, Head of Immunisation at UKHSA, said: “Although cases of COVID-19 are relatively low at present, we are expecting to see the virus circulating more widely during the winter months.

“The booster is being offered to those at higher risk of severe illness and by taking up the booster vaccine this autumn, you will increase your protection ahead of the winter months, when respiratory viruses are typically at their peak.”

E. coli investigations in East Lothian

An investigation is underway into a cluster of cases of E. coli at a nursery in East Lothian.

NHS Lothian, along with local and national partner agencies, is investigating 28 cases of the infection linked to Church Street Pear Tree Nursery in Haddington.

Although most cases have had mild symptoms and have not required hospital treatment, a small number of confirmed cases have been admitted to hospital. Some of these have been admitted as a precaution and all are in a stable condition.

Investigations so far have not yet revealed a specific source, but advanced microbiological testing is underway to identify the strain of the infection and any links. Those that have been affected have already been excluded and have submitted samples for testing.

Cases, so far, have been confined to the nursery, respective households, or other close contacts. The nursery has been closed as a precautionary measure while the investigations continue.

A small number of people at a partner nursery in the same town reported having symptoms of vomiting and diarrhoea, which have resolved without requiring medical treatment. As a precaution, Meadowpark Pear Tree Nursery in Haddington has also been closed. All parents and carers have been notified.

Dr Richard Othieno, Chair of the Incident Management Team and Public Health Consultant, NHS Lothian, said: “We know that this will be an anxious time for many of those who are directly affected by the infection.

“We have written to parents and carers of the children affected and to staff at the nursery to provide the most up to date information and ongoing health advice.

“NHS Lothian has a robust surveillance system in place to identify E. coli cases which helped us to identify these cases early and put in place essential control measures to prevent further spread.

“This outbreak reinforces the importance of washing hands regularly, particularly before eating or preparing food, and after going to the toilet.”

“We continue to provide support to the nursery and those parents and carers who have been directly affected. We have encouraged parents to keep their children away from other children and those at higher risk until their negative results have been received”.

E. coli is a bacterial infection that causes illness in people. The symptoms range from mild loose stools to severe bloody diarrhoea. The most serious complications can lead to blood poisoning and kidney failure

There is no specific treatment for the infection and most people who are infected will get better without medical treatment. However, those who have symptoms, or are concerned, are advised to contact their GP or NHS 24 on telephone number 111.

All children aged 1 to 9 in London to be offered a dose of polio vaccine

As further poliovirus has been detected in sewage, JCVI recommends that polio vaccine booster doses should be offered to children across London.

Following the discovery of type 2 vaccine-derived poliovirus in sewage in north and east London, the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a targeted inactivated polio vaccine (IPV) booster dose should be offered to all children between the ages of 1 and 9 in all London boroughs.

This will ensure a high level of protection from paralysis and help reduce further spread of the virus.

Nationally the overall risk of paralytic polio is considered low because most people are protected from this by vaccination.

Many countries globally provide an additional dose of polio-containing vaccine as part of their childhood vaccination schedule. The NHS in London will contact parents when it’s their child’s turn to come forward for a booster or catch-up polio dose – parents should take up the offer as soon as possible.

The programme will start with the areas affected, where the poliovirus has been detected and vaccination rates are low. This will be followed by rapid rollout across all boroughs.

This booster dose will be in addition to the NHS childhood vaccination catch-up campaign across London, where childhood vaccination uptake is lower than the rest of the country. It’s important all children aged 1 to 9 – even if up to date with their vaccinations – accept this vaccine when offered to further strengthen their protection against the poliovirus.

Following the findings earlier this year of type 2 poliovirus (PV2) collected from the Beckton sewage treatment works, further upstream sampling undertaken by the UK Health Security Agency (UKHSA) and the Medicines and Healthcare products Regulatory Agency (MHRA) has now identified at least one positive sample of the poliovirus, currently present in parts of the following boroughs:

  • Barnet
  • Brent
  • Camden
  • Enfield
  • Hackney
  • Haringey
  • Islington
  • Waltham Forest

The sampling has also detected the virus in lower concentrations and frequency in areas adjacent to the Beckton catchment area to the South (immediately below the Thames) and to the east of Beckton. However, it is not clear whether the virus has established itself in these areas or if the detections are due to people from the affected area visiting these neighbouring areas.

The level of poliovirus found and the high genetic diversity among the PV2 isolates suggests that there is some level of virus transmission in these boroughs which may extend to the adjacent areas. This suggests that transmission has gone beyond a close network of a few individuals.

A total of 116 PV2 isolates have been identified in 19 sewage samples collected in London between 8 February and 5 July this year, but most are vaccine-like virus and only a few have sufficient mutations to be classified as vaccine derived poliovirus (VDPV2).

VDPV2 is of greater concern as it behaves more like naturally occurring ‘wild’ polio and may, on rare occasions, lead to cases of paralysis in unvaccinated individuals.

UKHSA is working closely with health agencies in New York and Israel alongside the World Health Organisation to investigate the links between the poliovirus detected in London and recent polio incidents in these 2 other countries.

Dr Vanessa Saliba, Consultant Epidemiologist at UKHSA, said: “No cases of polio have been reported and for the majority of the population, who are fully vaccinated, the risk is low.

“But we know the areas in London where the poliovirus is being transmitted have some of the lowest vaccination rates. This is why the virus is spreading in these communities and puts those residents not fully vaccinated at greater risk.

“Polio is a serious infection that can cause paralysis but nationally the overall risk is considered low because most people are protected by vaccination. The last case of polio in the UK was in 1984, but decades ago before we introduced the polio vaccination programme around 8,000 people would develop paralysis every year.

“It is vital parents ensure their children are fully vaccinated for their age. Following JCVI advice all children aged 1 to 9 years in London need to have a dose of polio vaccine now – whether it’s an extra booster dose or just to catch up with their routine vaccinations. It will ensure a high level of protection from paralysis. This may also help stop the virus spreading further.”

Jane Clegg, Chief Nurse for the NHS in London said: “While the majority of Londoners are protected from polio, the NHS will shortly be contacting parents of eligible children aged 1 to 9 years old to offer them a top-up dose to ensure they have maximum protection from the virus.

“We are already reaching out to parents and carers of children who aren’t up to date with their routine vaccinations, who can book a catch-up appointment with their GP surgery now and for anyone not sure of their child’s vaccination status, they can check their Red Book.”

UKHSA, working with MHRA, has already increased sewage surveillance to assess the extent of spread of the virus and are currently sampling 8 sites across London.

A further 15 sites in London will start sewage sampling in mid-August, and 10 to 15 sites will be stood up nationally to determine if poliovirus is spreading outside of London.

Stay safe in the sun – summer health advice from NHS 24

With more hot weather forecast this week, NHS 24 are offering advice on how to stay safe in the sun as part of their summer health campaign ‘Hello Summer.’

Dr Laura Ryan, a GP and NHS 24’s Medical Director said: ‘We’ve had a few really hot and sunny days in Scotland this summer, which is brilliant for everyone to spend a lot of time outdoors.

‘Unfortunately, the hot weather isn’t good news for everyone, and it’s really important we follow some simple rules to ensure we avoid becoming unwell.

‘When it comes to being safe in the sun, prevention is definitely better than cure. It is best to avoid being in the sun between 12 noon and 3pm if possible. If you need to be outdoors, we advise that everyone, uses a high factor sun protection cream. The best quality lotions block both UVA and UVB rays. Also wear loose-fitting, light-weight clothing that covers your body.

‘If you’re unfortunate to become sunburnt, there’s simple steps to take to lessen the discomfort. The most obvious piece of advice is to avoid being in the sun at all until the redness subsides and don’t burst any blisters. Cool showers or applying cool towels to your body can provide some relief, using moisturiser which contains aloe vera after your shower, or taking painkillers can help with any painful or tight skin. However please check that pain relief such as paracetamol or ibuprofen is safe for you to take.

‘Another weather-related condition which I wish to draw attention to is heat exhaustion or heat stroke.’

Signs or symptoms of heat stroke can include headache, feeling confused or dizzy, rapid pulse or fast breathing, body cramps (in the arms, legs and stomach), sick or vomiting, feeling dehydrated or thirsty, pale, sweaty or clammy skin, a high temperature of 38C or above.

Dr Laura Ryan continued: ‘If someone is showing signs of heat exhaustion, they need to be shaded from the sun and cooled down. Heat exhaustion is not normally serious if the person is treated within 30 minutes and symptoms begin to improve.

‘If there is no improvement in the person’s condition, but they are conscious, alert and responding normally call your local GP during opening hours for further advice. If your GP is closed, call NHS 24 on 111. If you feel their condition is in any way life-threatening, dial 999 and ask for an ambulance.

‘I really encourage everyone to visit NHS inform as it has some great advice on how to stay safe in the sun. By being prepared and following these simple tips, I hope more people will be happy and healthy this summer.’

Heat-health alert issued by the UK Health Security Agency in England

The UK Health Security Agency’s (UKHSA) heat-health alert service is designed to help healthcare professionals manage through periods of extreme temperature. The service acts as an early warning system for periods of high temperatures that may affect the public’s health.

The alert will be in place from midday Tuesday 9 August to 6pm on Saturday 13 August for all regions of England.

Temperatures are not forecast to reach the record-breaking levels of the most recent heatwave but are expected to rise throughout the week, potentially reaching mid-30 degrees Celsius on Friday and Saturday in the South East, London, the South West, and the East and West Midlands.

Dr Agostinho Sousa, Head of Extreme Events and Health Protection at the UK Health Security Agency (UKHSA), said: “Temperatures will feel very warm again this week, particularly in southern and central parts of the country.

“We want everyone to enjoy the warm weather safely when it arrives but remember that heat can have a fast impact on health. It’s important to ensure that people who are more vulnerable – elderly people who live alone and people with underlying health conditions – are prepared for coping during the hot weather.

“The most important advice is to ensure they stay hydrated, keep cool and take steps to prevent their homes from overheating.”

Met Office Deputy Chief Meteorologist, Tony Wardle, said: “Heatwave criteria look likely to be met for large areas of the UK later this week, with the hottest areas expected in central and southern England and Wales on Friday and Saturday. Temperatures could peak at 35⁰C, or even an isolated 36⁰C on Saturday.

Elsewhere will see temperatures widely into the high 20s and low 30s Celsius later this week as temperatures build day-on-day through the week due to an area of high pressure extending over much of the UK.

Coupled with the high daytime temperatures will be continued warm nights, with the mercury expected to drop to only around low 20s Celsius for some areas in the south.

Read more on the forecast from the Met Office.

The top ways for staying safe during hot weather:

  • look out for those who may struggle to keep themselves cool and hydrated – older people who may also live alone, and those with underlying conditions are particularly at risk
  • stay cool indoors by closing curtains on rooms that face the sun – and remember that it may be cooler outdoors than indoors
  • drink plenty of fluids and avoid excess alcohol
  • try to keep out of the sun between 11am to 3pm, when the UV rays are strongest
  • walk in the shade, apply sunscreen and wear a wide-brimmed hat, if you have to go out in the heat
  • avoid physical exertion in the hottest parts of the day
  • make sure you take water with you if you are travelling
  • check that fridges, freezers and fans are working properly
  • check medicines can be stored according to the instructions on the packaging
  • never leave anyone in a closed, parked vehicle, especially infants, young children or animals
  • take care and make sure to follow local safety advice if you are going into the water to cool down

High temperatures also present a risk of wildfires, especially after long dry periods. People with pre-existing heart and lung conditions such as asthma are most susceptible as breathing wildfire smoke may worsen their symptoms. Children and older people may also be susceptible to health impacts.

If wildfire smoke affects your area, avoid or reduce your exposure to smoke by staying indoors with the doors and windows closed.

Where possible avoid smoky areas. If you should travel through a smoky area, ensure that the vehicle windows are closed and the air conditioning is switched to recycle or recirculate if possible.

Listen out for local news reports and information from the emergency services who will provide advice on the precautions you should take.

Further information:

Read the UKHSA blog on staying safe in extreme heat.

UKHSA’s Beat the heat checklist identifies suitable actions people can take to protect themselves during periods of hot weather.

For more information on the common signs and symptoms of heat exhaustion and heatstroke, visit NHS.UK.

UKHSA has also published advice for the public on how to stay healthy during periods of drought.

UK monkeypox case numbers begin to plateau

The UK Health Security Agency (UKHSA) has published the latest technical briefing, which shows early signs that the outbreak is plateauing.

As of 4 August, there are 2,859 confirmed and highly probable cases of monkeypox in the UK.

Analyses of the current UK outbreak shows that monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM). The median age of confirmed cases in the UK was 37 years old. In England, 73% are known to be London residents over the course of the outbreak.

In the past few weeks, there have been a small number of women confirmed to have monkeypox but there is not enough evidence currently to suggest that there is sustained transmission outside of interconnected sexual networks. Twenty-two cases in women have been identified and 99% of all UK cases are male.

A small number of cases with no known travel history during their incubation period have been detected prior to 6 May, pre-dating the previous first-known report of a monkeypox case in the UK. This is not unexpected given our understanding of the outbreak to date.

Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA, said: “While the most recent data suggests the growth of the outbreak has slowed, we cannot be complacent. Be vigilant of and check yourself for monkeypox symptoms, including rashes and blisters.

“If you are concerned that you may have monkeypox symptoms, take a break from events, meeting with friends or having sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice.

“The smallpox vaccine is being offered to individuals at higher risk of coming into contact with monkeypox in order to offer them protection and to reduce the spread of disease.”

The briefing now includes monkeypox genomic surveillance data from the UK. As is described globally, the majority of outbreak cases in the UK belong to a distinct genetic lineage (B.1) which has mutations of unknown significance when compared with the closest previously characterised monkeypox virus genomes.

UKHSA will continue to publish regular technical briefings as the response to the outbreak continues.