public health – Page 19 – The NEN

Campaigners call on Scottish Government to develop national strategy to prevent child sexual abuse

Stop It Now! Scotland and NSPCC Scotland are calling on the Scottish Government to develop a national strategy to tackle child sexual abuse that focuses on prevention to make the country a safer place to grow up.

The two charities hosted an event in partnership with the Scottish Parliament this week (Wednesday, March 15) with leading experts in the field.

They discussed the devastating harms and long-lasting impact that sexual abuse can have on victims, that punishment alone will not eradicate this problem and what we can do to prevent children being abused in the first place. They also talked about the next steps we need to take to guarantee Scotland is the safest country for children to grow up.

They are urging the Scottish Government to develop a comprehensive and coordinated national approachto prevent child sexual abuse, which involves health, police, education, community safety, children’s services, social services, housing and the wider community. The child protection charities say it is vital that everyone understands what child sexual abuse is and knows how they can be part of preventing it.

A review of UK data revealed that 15 per cent of females and 5 per cent of males will experience some form of sexual abuse before the age of 16.

This means at least 80,000 children in Scotland will have been affected by this issue before they leave high school. Although this is thought to be an under-representation of the scale of the problem and the actual number of children who have experienced sexual abuse in Scotland is not known.

The charities say that to understand the numbers of children in Scotland affected and the scale of the suffering it is crucial that a prevalence survey is conducted.

Professor Elizabeth Letourneau, Director of the Moore Centre for the Prevention of Child Sexual Abuse, School of Public Health, John Hopkins University, said: “Child sexual abuse affects about one in nine children – 12 per cent of all children – globally. Victims are at risk of immediate harms, such as fear, injury, and pregnancy, and a broad array of serious health problems can emerge and last across the lifespan.

“Only one in five cases of child sexual abuse are ever reported to the authorities. This means that we miss at least 80 per cent of cases, so punishment will never be enough if we are to effectively address this public health problem.

“I believe our failure to focus on prevention stems from a general misgiving that child sexual abuse really is not preventable. That people who are at risk of perpetrating abuse are monsters and their behaviour cannot be predicted or prevented, and they will only respond to punishment.

“But we know this is not true. We already have good evidence that we can effectively prevent child sexual abuse perpetration.”

Pat Branigan, Assistant Director of NSPCC’s Together for Childhood, said: “One of the most important messages from today is that child sexual abuse is preventable and not inevitable.

“The ultimate goal is to develop a framework, based on evidence of what we know already works, which can be used to support agencies and organisations to work together and prevent child sexual abuse in communities.

“We need to create strong local partnerships between social care, schools, health, voluntary groups, the police and communities that focus on preventing people from offending, and empower and educate children and adults to recognise the signs of abuse and how they can report their concerns.

“Ultimately it will not be governments, experts or professionals who eradicate child sexual abuse, it will be individuals, families and communities.”

Stuart Allardyce, Director, Lucy Faithfull Foundation / Stop It Now! Scotland, said: “Last year we helped 7,000 people across the UK through our Helpline. Not all were adults worried about their own sexual thoughts, feelings and behaviour, but around half of them were.

“We also had adults who were worried about another adult, or because they had found evidence their partner has been seeking out child sexual abuse material online.

“We believe that if you build prevention initiatives, people will come – professionals, protective adults, but also those who worried about the risk that they may present to children. We can no longer say that people won’t use self-help prevention resources, because the evidence is that they can and do and that prevention works.”

Childlight, based at the University of Edinburgh, also launched the first comprehensive global data repository this week, which will look at all forms of child sexual exploitation and abuse (CSEA), with the aim of being able to show the scale and nature of this abuse.

Children and young people can contact Childline for free, confidential support and advice 24 hours a day online at www.childline.org.uk or on the phone on 0800 1111

Anyone with concerns about a child’s wellbeing can contact the NSPCC Helpline on help@nspcc.org.uk. The NSPCC practitioners provide free and confidential help and advice and can take appropriate steps to help keep children safe. If a child is in immediate danger, please call 999.

The NSPCC also has advice and resources for parents, carers on how to have simple, age appropriate conversations with children to help prevent sexual abuse through their Talk PANTS campaign. This helps children understand that their body belongs to them and to recognise when something is not okay and how to tell someone.

NHS Lothian releases results of research into transmission of COVID-19 from hospitals into care homes

Scientists in NHS Lothian have helped to develop national infection controls after studying COVID-19 transmission between hospitals and care homes.

The teams found that 99 per cent of patients discharged from hospital into care homes during the first wave of the pandemic did not introduce COVID-19 into care homes.

The study, conducted with the University of Edinburgh, focused on patients in Lothian discharged from hospital into 130 care homes from 1st March 2020 to 31st May 2020.

Of the 787 discharges in this time, the researchers found that the majority – a total of 776 – did not introduce COVID-19 into care homes as a result of their hospital stay.

Forty-one of the discharged patients had a positive COVID-19 test within two weeks of leaving hospital and genome sequencing was used to identify if these cases could be linked.

The study found that 30 patients likely contracted this in the care home or from the community.

The results of 10 patients were inconclusive and one patient was confirmed to have contracted COVID-19 during their stay in hospital.

Very sadly, this patient later passed away and a number of residents in their care home subsequently contracted COVID-19.

Dona Milne, Director of Public Health and Health Policy, NHS Lothian, said: “This study has shown that 99 per cent of hospital discharges didn’t introduce COVID-19 cases into Lothian care homes during the first wave of the pandemic.

“However, we’re able to say with certainty that one care home outbreak in this time originated from us. We are deeply saddened by this, and our heartfelt apologies and condolences are with the families and loved ones of those affected.

“We began testing symptomatic care home residents very early in the pandemic, so it’s been really important for us to use this information to find out what we can learn about how the virus was contracted and spread and how this linked to our hospitals.”

Before the nation went into its first lockdown when testing wasn’t widely available, NHS Lothian built capacity into its labs specifically to PCR test those who were symptomatic in hospitals and care homes.

Because of this early testing of symptomatic patients, in-depth data was available to the research team to enable them to genome sequence the transmission of the virus as part of the study.

Dr Kate Templeton, Head of Molecular Diagnostics for NHS Lothian who led the study, said: “Testing was a priority for us from the beginning and we were the first health board in Scotland to build capacity in our labs specifically for care home residents.

“This early testing has enabled us to genome sequence the virus and track where this was acquired and how this spread, leading to the creation of an outbreak methodology which has informed best practice at both Scotland and UK-level.

“This methodology not only has applications to COVID-19 but other viruses too and has been vital in learning lessons around infection control. It also clearly shows that the protection of the most vulnerable in society needs to involve not just health authorities but the community too.”

You can read the study in full here.

Next First Minister must halt exodus from NHS dentistry

The British Dental Association has warned the future of NHS dentistry in Scotland is in doubt, and action here must be high on the agenda for the next First Minister.

A devastating new survey of dentists across Scotland reveals:

An exodus is in motion. 59% of dentists say they have reduced the amount of NHS work they undertake since lockdown – by an average of over a fifth.This movement is going unseen in official data, which counts heads, not commitment, and gives the same weight to a dentist doing a single NHS check-up a year as an NHS full timer.
Over 4 in 5 (83%) now say they will reduce – or further reduce – their NHS commitment in the year ahead. Over a third (34%) say they will change career or seek early retirement.
Just 1 in 5 (21%) say their practices have returned to pre-COVID capacity. 61% cite recruitment problems as an issue, over two thirds (67%) cite treating patients with higher needs requiring more clinical time.
A sustainable model must be in place come October. 90% cite financial uncertainty as having a high impact on their morale.

Health Secretary Humza Yousaf recently stressed NHS staffing was “at a historically high level”, with ‘record’ numbers of dental staff in hospitals alongside medics and allied health professionals. However, NHS Education for Scotland data indicates an 8% drop in high street NHS dentists delivering care since lockdown, a fall from 3,038 in March 2020 to 2,791 in September 2022.

The BDA stress even this fall understates the full scale of losses in light of this new survey evidence. The Scottish Government has never attempted to make a ‘Whole Time Equivalent’ estimate of the NHS dental workforce. Most dentists combine NHS and private work, and the BDA warn that without these estimates movement to the private sector is going undetected, and workforce planning is effectively impossible.

NHS dental care free at the point of use remains a central Scottish Government policy. BDA Scotland has long warned that any return to the service’s ‘business as usual’ model – low margin and high volume – will put practices under huge financial pressure and will likely lead to closures or movement to the private sector, with many practices left delivering some NHS care at a loss.

The SNP leadership election has seen key deadlines to reform this broken system move. The profession had anticipated the Scottish Government would reveal changes to the payment model on 1 April, that would be rolled out from October.

The BDA stress a sustainable model must be in place come October, when the current bridging payments that uplifted NHS fees finally lapse, exposing many NHS practices to unsustainable costs.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee, said: “Behind hollow boasts on record workforce numbers is a service that is hollowing out.

“The majority of dentists have pared down their NHS work, and many more are set to follow. It’s an exodus that’s going untracked by government but is the inevitable result of working to a broken system.

“NHS dentistry’s survival requires rapid action, with meaningful reform and sustainable funding.

“The steps taken in the next First Minister’s First Hundred Days will determine whether this service will have a future.”

Online poll of General Dental Practitioners in Scotland, Fieldwork February 2023, 526 respondents:

What changes in your working life do you anticipate in the next 12 months? % Net Likely n

I will reduce my personal NHS commitment 83% 439

I will change career/seek early retirement 43% 178

Approximately what proportion of your income was NHS based prior to March 2020?

% n

100% (exclusively NHS) 4% 23

90-99% (NHS) 43% 227

80-89% (NHS) 23% 122

70-79% (NHS) 13% 69

60-69% (NHS) 4% 22

50-59% (NHS) 4% 22

40-49% (NHS) 2% 11

30-39% (NHS) 1% 3

20-29% (NHS) 2% 12

10-19% (NHS) 1% 4

1-9% (NHS) 2% 9

0% (exclusively private) 0% 2

Approximately what proportion of your income was NHS based now?

% n

100% (exclusively NHS) 2% 8

90-99% (NHS) 25% 134

80-89% (NHS) 19% 98

70-79% (NHS) 14% 71

60-69% (NHS) 9% 48

50-59% (NHS) 11% 60

40-49% (NHS) 6% 32

30-39% (NHS) 4% 20

20-29% (NHS) 4% 20

10-19% (NHS) 3% 16

1-9% (NHS) 3% 16

0% (exclusively private) 1% 3

309 respondents reported a fall in NHS work between March 2020 and February 2023 – with an average drop of 22%.

Please estimate your practice’s current overall capacity compared to pre-COVID levels.

100% (my practice is at full capacity) 21% 111

90-99% 17% 91

80-89% 22% 116

70-79% 19% 102

60-69% 10% 54

50-59% 4% 21

40-49% 0% 2

30-39% 0% 2

20-29% 1% 4

10-19% 0% 2

1-9% 0% 2

0% (my practice is not operating) 0% 0

Don’t know 4% 19

What factors would you say are constraining your practice from operating at pre-COVID capacity (select any that apply)

% n

Recruitment and retention problems for dentists 61% 304

Patient cancellations/Did Not Attends 44% 220

Ongoing Infection Prevention and Control restrictions 18% 93

Staff sickness 43% 213

Higher needs patients requiring more clinical time 67% 336

For each of the statements below please rate the impact each currently has on your morale working as a dentist

Net High impact % n

Inability to provide pre-COVID levels of care 61% 321

Financial uncertainty 90% 472

Patient Anger/Abuse 67% 352

ASH Scotland urges more cessation support following dramatic drop in quit attempts

Health charity urges Scottish Government to increase cessation support for Scotland’s 730,000 smokers

ASH Scotland is urging the Scottish Government to boost specialist cessation services for the estimated 730,000 Scots who smoke, after it emerged that quit smoking attempts have dropped by more than a third compared to the year before the COVID-19 pandemic started.

The latest annual NHS Stop Smoking Services Scotland report (April 2021 to March 2022) published by Public Health Scotland today (Tuesday 21 February 2023) reveals there were 31,359 quit smoking attempts, around 17,000 fewer than the 48,749 in 2019/20.

With smoking continuing to cause 100,000 hospitalisations and 9,000 deaths in Scotland each year, and the 2034 target for the country to be tobacco-free on track to be missed by an estimated 16 years, ASH Scotland says it is vitally important that the Scottish Government and health boards consider the promotion and expansion of the country’s smoking cessation services as top priorities.

Sheila Duffy, Chief Executive of the health charity ASH Scotland, said: “It is alarming that these latest figures show stop smoking attempts with NHS support have fallen for the 10th consecutive year and by almost 75% since the peak of 121,385 attempts in 2011/12.

“At a time when the health service is under considerable pressure and smoking continues to be the biggest preventable cause of illness and death, swift action is required by the Scottish Government and health boards to ensure NHS Quit Your Way services are promoted and better resourced to reach more of the two-thirds of Scots who smoke and want to quit.

“Quit Your Way services, which provide specialist person-centred smoking cessation support, must be boosted as a matter of urgency to continue their critical role helping people who have the highest smoking rates, such as those living in our most deprived communities, and experiencing mental health problems, to leave tobacco behind.”

ASH Scotland research suggests that smoking prevalence for people experiencing mental health problems in Scotland’s poorest communities is between 40 to 50 per cent, comparable to the country’s general population smoking rates of the mid-1970s.

People aiming to give up smoking can call Quit Your Way’s free helpline on 0800 84 84 84 or create a quit plan at www.QuitYourWay.scot.

Public Health Scotland’s 2021/22 Annual Stop Smoking publication can be found at https://beta.isdscotland.org/find-publications-and-data/lifestyle-and-behaviours/smoking

ASH Scotland’s Closing the Inequality Gap: Smoking and Mental Health report, published in 2022, can be downloaded at www.ashscotland.org.uk/mentalhealth

Local Well pharmacies prepare to support patients affected by Lloyds Pharmacy supermarket closures

Local Well pharmacies in Edinburgh have geared up to support patients affected by the closure of the Lloyds pharmacies in the following Sainsbury’s supermarkets:

Abbeyhill, Moray Park, Meadowbank, EH7 5TS (Well Edinburgh – Stenhouse Cross, Well Edinburgh – Mayfield Road)
Murrayfield, Westfield Road, EH11 2QW (Well Edinburgh – Lochend Road South, Well Edinburgh – Restalrig Road, Well Edinburgh – Craigentinny Road)

Patients worried about the closure of their local Lloyds Pharmacy in Sainsbury’s are being invited down to meet the team one of their local Well pharmacies, which are just down the road.

Well Pharmacy, the UK’s largest independent pharmacy chain, has taken steps to make sure that its pharmacies across the country could add the capacity to support former Lloyds Pharmacy patients, including offering roles to some staff displaced by the closures.

And the CEO of the chain, Seb Hobbs, has urged locals to pop into any of the pharmacies to have a chat with the team about their healthcare needs the next time they are passing.

He said: “We were all really sorry to hear about the closures, as we know people really rely on having a local pharmacy that they can depend on.

““We want to make sure patients know there is an established and trustworthy pharmacy nearby that can support their healthcare needs, dispense their prescriptions and provide a full array of community pharmacy services. Our local team would be delighted to meet you, so please pop in anytime.”

Lloyds revealed recently that it planned to close all 237 of its pharmacies within the retailer’s stores, meaning that local patients will need to find a new pharmacy and its many members of staff now face an uncertain future.

NHS Lothian publishes new annual Public Health report

NHS Lothian has released a new annual report which looks to provide an in-depth analysis into the health of Lothian.

The report, from NHS Lothian’s Director of Public Health, seeks to outline health and social inequalities, as well as their current and predicted impact on mental and physical wellbeing.

Public Health specialists work to protect and enhance the health of everyone in Lothian, informing local and national policy to improve outcomes for both the individual and community.

Dona Milne, Director of Public Health for NHS Lothian, said: “Understanding our population as it is now and how this is predicted to look is vital to reduce inequalities and improve health outcomes for everyone in Lothian.

“This report highlights and reaffirms what the evidence tells us about the socio-economic factors impacting health the most. When designing and delivering health and social care, we must be able to understand and address those wider factors which lead to poorer outcomes for people.”

The new report brings together evidence and research from a variety of sources, addressing systemic inequalities and the impact of recent seismic events such as the COVID-19 pandemic.

The report also predicts population trends and the expected health impact of the cost-of-living crisis and increasing child poverty on those already living in more deprived communities.

Dona continued: “We are endeavouring to share this report widely with partners to help inform the collaborative work we need to do to make long-lasting and meaningful changes to public health in Lothian.

“With the cost-of-living crisis and increasing child poverty expected to exacerbate pre-existing inequalities, it’s more important than ever to understand what is needed as part of a whole system approach to ensuring better health outcomes for all.”

Jane Ferguson, Director of NHS Lothian Charity, said: “As the official charity of NHS Lothian, we have a key role to play in supporting Public Health in their work to reduce health inequalities and prevent ill health in all our communities.

“Through our strategic partnership with the health board, we have provided five years of funding for income maximisation services that can be accessed by patients and their families to help mitigate against both the immediate impact of the current cost-of-living crisis and the ongoing impacts of poverty on overall physical and mental health.

“We will continue to work closely together to support Public Health to tackle health inequalities that exist as a result of poverty so that we can improve the health and wellbeing of people across Edinburgh and the Lothians, now and in the future.”

You can read the report in full on NHS Lothian’s website.

NHS-Lothian-Public-Health-Annual-Report-2022-final Download

Getting better: NHS Lothian moved to Stage 2 for paediatric audiology

NHS Lothian will move to Stage 2 of NHS Scotland’s national performance framework for paediatric audiology following improvements.

The health board has made significant progress, completing almost 81% of the recommendations outlined by the British Academy of Audiology (BAA) following an independent review of services in 2021. This includes improvements in governance and culture.

As part of the Stage 2 escalation level, robust measures will remain in place, ensuring that Scottish Government officials continue to provide direct support to NHS Lothian.

Health Secretary Humza Yousaf said: “The de-escalation of NHS Lothian to Stage 2 for paediatric audiology is a positive step forward and highlights the significant progress the board has made towards the BAA’s recommendations.

“I would like to thank all staff at the board for their hard work to implement robust and sustainable changes, to continue to improve the service and to deliver high quality patient care. I want to ensure families across Scotland are assured their child is getting the best possible audiology support.

“We will work closely with and support the board over the coming months as it continues to provide high quality services. A wider Independent review of audiology services in Scotland is on-going and due to report to the Scottish Government this Spring.”

NHS Lothian was moved to escalation Stage 3 in December 2021 on the NHS Board Performance Escalation Framework for Paediatric Audiology.

An independent audit and governance review into the Paediatric Audiology service at NHS Lothian was established following the Scottish Public Services Ombudsman Investigative report into Child A’s audiology care at the health board. Following that publication, the BAA was commissioned by NHS Lothian to help fulfil recommendations from that report.

The decision on a board’s Stage 3 Escalated position sits with the Director General for Health and Social Care.

The BAA report and recommendations is here.

Scotland Emergency Department performance drops to reach new record low

Responding to the latest Emergency Department performance figures for Scotland for December 2022 Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said: “December was the most challenging month the NHS in Scotland has ever faced.

“Staff faced increasingly difficult conditions, with huge numbers of patients facing long and dangerous waits throughout the system. We know these long waits are associated with patient harm and even patient deaths, it is increasingly distressing for staff and patients.

“Exit block – where patients are unable to be admitted to a bed because other patients are unable to be discharged – was the worst it has ever been, meaning the entire Emergency Care system has been gridlocked – like a traffic jam.

Patients spending far longer in Emergency Departments than they should be, often in inappropriate or inadequate areas, on trolleys in corridors, in small, cramped spaces with a lack of privacy and lack of dignity.

“We welcome the gravity with which the First Minister and the Cabinet Secretary are taking the current crisis in Emergency Care. We have had constructive meetings with the Cabinet Secretary and do feel that there is recognition of the root of the issues and a political will to tackle it.

“We especially welcome the focus on social care and the whole system capacity. It is critical that we sort out discharges, ensuring patients who are medically fit to leave are able to return home or to the community in a timely way. We must continue to focus on this to free up beds so we can increase flow throughout hospitals and admit patients from Emergency Departments into a bed on wards.

“While these are the right initiatives, the green shoots of hope are not translating to big enough or fast enough improvements. Without significantly increasing capacity across Scotland, we will continue to borrow from tomorrow to cover today.

“This means cancelling elective surgery so we can admit Emergency Care patients to a bed, but at the cost of further delaying what may be serious surgery for patients who have already waited for a long time. We should not be in a position where decisions like these need to be made.

“It is wrong for specialties to compete for beds for their patients. What is better is to increase the number of staffed beds throughout the system, where safely possible, so we do not need to compromise on which patients are able to be treated.”

Edinburgh Cancer Centre investigates COVID-19 immunity in cancer patients

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.

Back to school advice issued amid high levels of flu, COVID and scarlet fever

As pupils and students return to school following the Christmas break, UKHSA is reminding people that winter illnesses continue to circulate at high levels.

Following simple steps can help protect children, minimise the spread of illness in education and childcare settings and protect wider communities.

Flu and coronavirus (COVID-19) are currently circulating at high levels and are likely to continue to increase in coming weeks. High numbers of scarlet fever, which is caused by group A streptococcus, also continue to be reported.

Professor Susan Hopkins, Chief Medical Adviser at the UK Health Security Agency (UKHSA), said: “It’s important to minimise the spread of infection in schools and other education and childcare settings as much as possible. If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved.

“Helping children to learn about the importance of good hand hygiene is also key, so practice regular handwashing at home with soap and warm water. Catching coughs and sneezes in tissues then binning them is another simple way to help stop illness from spreading.

“Adults should also try to stay home when unwell and if you do have to go out, wear a face covering. When unwell don’t visit healthcare settings or visit vulnerable people unless urgent.

“Remember that flu vaccination is still available for all eligible groups and is the best protection against the virus. We have seen good uptake in older age groups but vaccination among young children remains low. Flu can be very unpleasant and in some cases can lead to more serious illness. Getting your child vaccinated protects them and others they come into contact with, and it’s still not too late.”

Eligible children include:

those aged 2 and 3 on 31 August 2022
all primary school-aged children
some secondary school-aged children

You can get more information getting your child vaccinated against flu on NHS.UK.