Debi Evans Blog: 4 October 2022

Another week has been filled with a never-ending supply of real-world drama. The week behind us has been dominated by the state of the national economy, raised mortgage rates, and the self-inflicted financial crisis that our brand new Government has managed to achieve in just one week. This week, I will as usual focus on the NHS and all matters health-related, with a splash of what appears to be coming down the road in some other areas that you may have missed along the way. 

 

NHS ‘services’ you may not know exist but that will affect you

Has the NHS been privatised? Perhaps we already know the answer to that. But how will the transformation affect you? Do you have your NHS account set up? According to the NHS website, anyone over the age of 13 who is registered with a GP can apply for an NHS account. 

The NHS has changed how it talks about accessing certain services online. The procedure now is to log into an NHS account through the NHS App or the NHS website in order to be able to access a plethora of other health services, including maternity services, prescriptions, and advice platforms. Here, we can see how the NHS is transforming our GP (family doctor) services and what it is doing to entice you to re-register online—for that is what it is: deregister from your existing surgery and then re-enter the NHS differently.

Let’s look at some of these services. For those of you who wish to see the whole list, please click here.

 

Ask First — Sensely — a short YouTube video on this can be found here. Ask First provides patients with “trusted” advice when a patient needs help from their GP. Patients can be triaged and signposted to the right pathway, such as a clinician callback, physio, or other specialist services. Is this to replace the doctor’s receptionist forever? 

 

Evergreen Life — an online GP service. Save time and book a GP appointment, organise repeat prescriptions and download your GP record, and while you are at it, you can get a DNA test! Apparently, by discovering your genetic tendencies you will have the information to boost your health and wellbeing. Grab the opportunity to “gift” your loved ones an Evergreen Life DNA Test.   Discover the “inner you” for just £69.99.

 

Ox Digital Health — Fed up with crowded waiting rooms, and wondering why the person who arrived last was seen before you? Fret no more, as the NHS introduces a virtual waiting room. Wanting to push the agenda forward more quickly, senior medical leaders from the University of Oxford met with Oxford University Hospitals NHS Foundation Trust (one of the largest teaching hospitals in the UK and one of Europe’s biggest hospitals), representatives of Microsoft’s Health and Life Sciences team, and the subsequent Founders of Oxford Digital Health. Accelerating the development of a scalable digital-native platform, with patients at its heart, was the core of the discussion. What a trinity: the NHS, Oxford and Microsoft. 

 

Virtually.Healthcare — a perfect example of how the NHS is encouraging you to leave your GP practice and sign up with a ‘virtual’ service. Completely NHS-funded and run by a physical NHS GP practice, it is free of charge. Once you are registered, a virtual appointment will be offered. Whether it’s contraception advice, mental health referrals, physiotherapy or a specialist referral to a ‘hospital’, nothing is too much trouble for the virtuals. An express service with a GP is offered, but it will be a pharmacist you see:

Our GP express service enables you to have a walk-in consultation with a specially trained pharmacist and leave the pharmacy with prescription medication.

 

Engage Health — another online patient-to-doctor, non-emergency engagement platform, built to enable patients to get faster and easier access to a ‘self-help’ information service 24/7. Conveniently and crucially, it will allow much needed time to be available for clinical and administrative teams. The rather comprehensive service includes primary care, social care, secondary care and community care. 

 

GP healthcare is rapidly moving towards a two-tier system as private providers fill NHS gaps, medics are warning. Clearly, from that article in the Independent, this is what is happening by stealth in the UK. Dr Lizzie Toberty, the GP lead with the grassroots lobbying group Doctors’ Association UK, warned last week in a letter to Health Secretary Thérèse Coffey that up to 16 million patients (roughly a quarter of the British population) could lose their GP over the next decade in an irreversible loss of primary care capacity. A blended system involving virtual appointments online will inevitably lead to a two-tier GP system that outsources to private providers to fill the gaps in physical availability.

 

Death of the NHS hospital ward 

As we have been warning, the hospital ward is all but gone. During an NHS Integration Board meeting it was discussed that in Leicester, glass cubicles were being trialled in order to separate patients. Nursing is being transferred to glass boxes. It appears from this Daily Mail article that a full rollout is imminent. The reason? To prevent Covid, flu and Norovirus spreading.

As a personal comment from this old-school nurse, before the erection of tower blocks and concrete jungles, hospitals were always designed to allow windows to be opened and fresh air to be circulating through the building, and this freshness was reinforced by a scrupulous hospital laundry for staff uniforms—which were never allowed to be worn outside the premises when you went off shift—and strict infection control policies. We never seemed to have the volume of nosocomial infections seen today.

 

NHS staff told to take extra caution extracting organs after ‘brain-dead’ baby starts breathing

After a senior doctor admitted her shock when a baby who was declared brain dead started breathing. The Academy of Royal Medical Colleges (ARMC), which sets the test for declaring brain death, said it would rewrite the code of practice on brain stem testing after this case came to light. An interim safety alert has been sent to NHS Blood and Transport staff, calling for “extra caution in any infant when diagnosing death using neurological criteria — paying particular attention to pre-conditions and red flags”. 

 

Stoptober launches to give smokers the confidence to quit

Smokers in England are being urged to stub out the habit as part of the annual Stoptober public health campaign that launches this month, as latest statistics show that smoking costs the NHS £2.4 billion a year and causes at least fifteen types of cancer, including lung cancer and acute myeloid leukaemia. 

Lung cancer has been identified as one of the top priorities in the 2019 NHS Long Term Plan, although it is interesting to note that the lead expert in this field is Professor Robert West, University College London, husband of Professor Susan Michie (nicknamed Stalin’s Nanny), who as most of our readers will know is head of the UK Government's Behavioural Insights Team and was recently also appointed a World Health Organisation expert board member. Her husband, Professor West, is funded by Pfizer and other pharmaceutical giants. 

 

Giant lung roadshow launched by NHS

As of 30 September, you can expect to start seeing twelve-foot-high pairs of lungs in British neighbourhoods near you! Supermarkets, shopping centres and high streets will be transformed, as the inflatable lungs are big enough to step inside, allowing the curious to learn about how our lungs work and the effects of smoking.

Specialist volunteers will be touring England’s “cancer hotspots” in an attempt to catch cancer earlier (and to use pharmaceutical products earlier). The UK Column has been warning for many months about the repercussions of campaigns to test for cancer early.  We also expect to see breath-testing units placed at strategic places in the near future. We saw above that the NHS Long Term Plan is making a great deal of tackling lung cancer. The cancer detection company, Grail, which was founded by Bill Gates and Jeff Bezos, has been contracted by the NHS to carry out tests for Stage I cancer on symptomless people. 

 

Over 40,000 nurses leave the NHS

UK Column News has been observing a mass exodus of highly trained and experienced doctors and nurses from the NHS. The resignation letter of one of them is forthcoming as a publication on ukcolumn.org. The main reason given is that they are quitting over concerns over workloads and mental health. A report released by the Nuffield Trust reveals many nurses feel undervalued and are under too much pressure and feeling exhausted.

Retention is the most significant area of uncertainty across the [50,000 Nurses] programme. It is also the area of greatest complexity, with a multitude of contributory factors. Some of these, such as working conditions, are within the control of the NHS. Others, such as the attractiveness of outside careers, are not.

Department of Health and Social Care, 50,000 Nurses Programme: delivery update, 7 March 2022

A negative workplace culture was an important factor, with 13% citing this as one of their top three reasons. 10% reported experiencing discrimination, and 22% of nurses reported experiencing bullying or abuse from colleagues in the previous twelve months.

The UK Column has heard from many highly trained and experienced British nurses who have not only left the NHS, but who also vow never to set foot in it again. The trickle of those speaking out about what has been going on behind ward doors is now surging into a flood. Watch UK Column News in the very near future for much more on this story. If you are a health care worker and too afraid to say anything at work, UK Column guarantees you sensitive and confidential communications, and it may be that you can come to see us in Plymouth.

 

Prescription charges for the over-60s 

As the UK Column has previously warned, a proposal to charge the over-60s for prescriptions is very much on the horizon. Millions of women have already been affected by the decision to move the state pension age up from 60, first to 65 and then to 66. Many have argued they were not provided with ample notice regarding these changes and have been adversely affected as a result. An alternative option being considered is to spare those already in their sixties and only introduce the rule for new over-60s. The decision is expected to be made soon.

 

NHS prescription errors

A warning has been issued after 29 people died following mistakes to their medication. 6,000 people have been harmed and 29 killed as a result of human error and miscommunications. Despite the NHS having been transformed into a digital front end, one in six NHS Trusts still do not have a fully-funded plan to introduce electronic prescribing and are still using paper notes.

Minimising selection and dispensing errors is critical. The work of the MHRA has included highlighting some of the more recent drugs that have been confused and are encouraging individuals to report such incidents in an effort to promote shared learning.

Perhaps staff at MHRA may like to familiarise themselves with the UK Government document quoted above?

 

Novavax should not be given together with flu jabs 

A 2022 study has revealed that co-administration of Novavax Covid-19 vaccine with inactivated influenza vaccine reduces the antibody response to Covid-19. A seven-day gap between jabs is recommended. The UK Health Security Agency has said tha “the clinical significance of this is unclear”. It appears that much is unclear, yet the advice is always to disregard qualms and carry on regardless. Other Covid-19 and influenza vaccines may supposedly be administered at the same time where “operationally advantageous”. Advantageous to whom, we might ask?

 

RSV clinical trial on babies in the West Country 

A new drug trial in the South-West of England is targeting babies who suffer from Respiratory Syncytial Virus (RSV), which is the most common cause of bronchiolitis. The ‘ground-breaking’ study hopes to reduce the number of babies needing hospital treatment for respiratory infections by up to 75%. The Harmonie study is being run across Europe, following up on single immunisations given to babies up to one year old.

The participating St George’s Vaccine Institute is an independent, non-commercial, academic institution, part of St George’s University Hospital NHS Trust in Tooting, London. It focuses on human clinical trials of paediatric, pregnancy and adult vaccines.

Perhaps it is worth remembering that virtually all children get an RSV infection by the time they are two years old. The majority make an unremarkable recovery and have never in the past required a ‘vaccine’. Currently, there is no vaccine available to prevent RSV, but as you can expect, scientists are working hard to develop one. Moderna appears to be first out of the block, with its new mRNA RSV vaccine currently in Phase 3 of clinical trials.

 

Germ defence

Protect your home from Covid! According to the Universities of Bath, Southampton and Bristol, where the advice has been developed, people who read the advice in Germ Defence are less likely to catch viruses—and if they do, catch it they are less likely to be quite as ill!

To see the advice, you have to complete a ten-minute ‘questionnaire’, which I chose not to do. Developed as it is in partnership with the National Institute for Health and Care Research's Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation and with the UKHSA, it would appear that the above ‘advice’ comes at a cost.

 

MHRA

An Innovation Passport has been granted by the MHRA to Pfizer’s Multiple Myeloma (MM) candidate medicine, Elranatamab (bear in mind that any treatment ending in -mab indicates a monoclonal antibody). What is an Innovation Passport? This short video will explain more. 

It may be worth noting that clinical trials for Elranatamab are still in Phase 2 in China and are not due to finish until 2025.

The Innovative Licensing and Access Pathway (ILAP) was launched in January 2021 by the MHRA to speed up the development and access to innovative medicines in the UK after Brexit.

Perhaps unknown to many, the MHRA has an ‘Innovation Office Accelerator’. It can provide free advice and confidential expert regulatory information, advice and guidance to organisations of all backgrounds and sizes based either in Britain or abroad, and to academics, not-for-profit organisations and patient groups (involved in research and industry). The cost to access this scheme is £3,624, with a Target Development profile costing a further £4,451. 

Patient engagement plays a key part in the ILAP, and patient views on the benefits and risks of medicines are to be integrated at every stage of the pathway. The ILAP scheme demonstrates the innovative steps being taken by the UK in providing access to ‘cutting-edge’ medicine following Brexit and is proclaimed as a positive move toward ensuring that the UK remains an attractive location for those in the life sciences sector.  

Though acceleration of the approval of new drugs may be what some would describe as ‘cutting-edge’, others may call it ‘cutting corners’—on safety. 

 

MHRA response to UK Column received

Recently, we featured in UK Column News a single paragraph of a comprehensive reply sent to the UK Column in response to many questions that had been unanswered. This paragraph has had over 1,000 retweets and a mountain of comments. Has the MHRA thrown GPs under the bus?

Here is the paragraph (here split into two for greater readability, and with added emphasis) that is causing all the concern:

A key role of the MHRA is to provide healthcare professionals with advice on the safe use of medicines and vaccines so that they are able to discuss the benefits and risks of a treatment with their patient. Information on the possible risks associated with medical products can be found in the Summaries of Product Characteristics, the Patient Information Leaflets and the Public Assessment reports (links to which can be found within the response referenced GENQ-00148928 (sent on 01/11/2021 and provided in Annex 1)).

There are a number of additional routes through which we communicate safety information to healthcare professionals which include our website, social media channels, our monthly Drug Safety Update Bulletin, which contains information about COVID-19 vaccines and medicines, and our Summary of Yellow Card reporting for all COVID-19 vaccines. However, the final responsibility for the clinical care of the patient remains with the healthcare professional given their clinical expertise and knowledge of the medical history of their patient.

Dr Alison Cave, Chief Safety Officer, MHRA

 

Using the metaverse to save lives 

2B3D is not a robot from Star Wars, it is a dedicated virtual reality platform to help veterans combat mental illness in their own decentralised metaverse. It purports to succeed where video conference calls fail. Veterans will be able to reach out to mental health professionals using a customised avatar for a more personalised online interaction. Veterans can rally, regroup, play games and spend time with friends and family no matter where they are: a new metaverse community with personal ‘home rooms’. 2B3D also aims to reduce veteran suicide in the metaverse using virtual mental health therapies. 

 

Optimus — Elon Musk’s Robot Army

Dubbed the Tesla bot, the I-Robot or Optimus, these 5’ 8”, 125-lb robots are designed to complete menial, boring or dangerous tasks. Built on Tesla’s own assembly lines, the robots are designed to work closely with both humans and other machines. So if you want a robot to go to the shops to buy your groceries, look no further. Personally, I would rather walk myself to the shop—as long as they exist; soon, I am sure, we will be doing our shopping in the metaverse. 

 

NHS e-learning programme

As virtual wards are rolled out all over the country, an e-learning programme has been launched which consists of the Covid Oximetry At-Home Pathway, enabling people to be confidently monitored in community settings, such as care homes. Covid Vvirtual Wards (CVWs) enable patients with proven positive diagnosis of Covid-19, but who are not unwell enough to continue as a hospital inpatient, to access oximetry and be monitored for up to a 14-day period at home or in their usual place of residence. This offers a step-down mechanism for clinicians.

Perhaps you will remember the time that Sajid Javid ordered a review of medical device racial bias

Oximeters are not reliable and can vary from device to device. They can be bought on most high streets and are inexpensive. The only reliable way to calculate oxygenation levels in the blood is to take a blood sample and have a lab analysis conducted for blood gases. Would you feel confident being cared for remotely, by staff trained in a webinar, who are using a gadget that may not be as scientific as you had been led to believe?  

 

Panic buttons installed in ambulances 

London Ambulance Service (LAS) has been forced to fit its ambulances with panic buttons to deter violence after hundreds of emergency workers reported being physically assaulted while on the job. LAS has invested more than £3 million in acquiring and installing the new technology.

The new safety measures, which have already been fitted in 500 ambulances, include panic buttons linked to a recording device, new monitors to help staff stay aware of the outside of their vehicle, and electronic tracking to help police arrive faster. The cameras in particular will help emergency workers if they are forced to take refuge inside the ambulance while under threat. 

This comes after more than 260 ambulance staff and volunteers reported being physically assaulted in the first six months of 2022, being subjected to kicking, punching, or being threatened with a weapon. During the same time period, there were also more than 420 reports of non-physical assaults, such as verbal abuse, threats of violence or anti-social behaviour. 

 

Test, test, test

And the hunt is on. As the UK enters an era of testing healthy people, we will begin to see, as predicted on UK Column News, rapid diagnostic testing centres springing up in high streets, shopping centres and football stadiums. One-stop shops offering a range of ‘diagnostic’ checks, scans and tests closer to home will become the new normal. Our high streets have changed forever.

Intended as this initiative is to relieve pressure on the NHS ahead of a challenging winter, we know this has been planned for a very long time. The ambition is to deliver 9 million tests, checks and scans a year, and it is backed by an enormous £2.3 billion of diagnostic investment. That’s a large amount of money to lose; no wonder the UK is keen on becoming the global leader in life sciences, the laboratory of the world—with us as the lab rats.


Get your children jabbed — the message from the UKHSA

The agenda to jab children is far from over. Now that the ‘pandemic’ is being blamed for a decrease in childhood vaccinations—with parents not being able to access appointments—measles and polio outbreaks are ‘now likely’, according to ‘experts’.  Currently, uptake is beneath the 95% threshold for all routine child vaccinations. Take-up has hit a record low, as parents are reluctant to come forward. 

It has been reported that “more than 40% of under-5s in parts of England were left unprotected against serious illnesses by March 2022”. Whilst it is pleasing and a relief that Covid-19 injection offers for 5–11-year-olds has now been withdrawn, it is worth noting that the UKHSA is driving forward an aggressive immunisation advertising campaign and is encouraging parents to book their children in for the latest round of needlework.

 

UK Government — folic acid added to flour from 1 September

The deadline has come and gone. The UK Government consultation has now amended the regulations on bread and flour from 1 September.  

Following a wider British public consultation carried out in September 2021, the UK Government and devolved administrations announced their intention to proceed with arrangements to require the mandatory fortification of non-wholemeal wheat flour with folic acid to help prevent neural tube defects in foetuses.

To minimise the impact of this requirement on industry, multiple changes should, where possible, be incorporated under a single set of amendments. Thus, the addition of folic acid to the list of nutrients, which must by law be added to non-wholemeal wheat flour is being co-ordinated as part of this wider review of the regulations. 

Over 99% of British households buy bread, and one quarter of all groceries bought from the four biggest British supermarkets contain flour.

It is worth remembering that the effects of mRNA therapy on pregnant women and their unborn babies are as yet unknown owing to lack of data. Yet the authorities are very keen to encourage and administer an experimental, untested, novel injection to as many pregnant mothers as they can reach. 

Furthermore, what will be the outcome of offspring from mothers who received COVID-19 vaccines, and will this depend on gestational stage of exposure? With recent evidence of decreased vaccine efficacy against new SARS-CoV-2 variants and immunity waning over time, addressing vaccine safety during pregnancy is becoming increasingly important, as efforts are already underway in some countries to administer more booster immunizations. Since epigenetic mechanisms are believed to contribute to the risk of DOHaD systems biology approach to addressing these questions is warranted, and we believe that the ovine model offers unique advantages for assessing the long-term impact of maternal COVID-19 vaccination on offspring health

 

The Daily Mile, supported by INEOS

Sign up and enrol your school; it’s free! The Daily Mile is the latest innovation from the Daily Mile Foundation, which is responsible for overseeing the worldwide rollout of this initiative to promote children’s health. The Foundation appears to be supported by the global petrochemical manufacturer, INEOS (familiar to our long-term viewers from the late Ian R. Crane's coverage of the fracking issue and associated policing and legal battles); operates 194 sites across 29 countries; generates $61 billion annually; and employs over 26,000 people.

INEOS, we are told, makes an impact across a range of élite sports; and it appears to be embedded in our education system. The Daily Mile supports over 3 million children in improving their health and wellbeing and developing positive habits for life by running a daily mile at school. This has already been taken up in 80 countries. 

The Forgotten Forty Project is a scheme headed by INEOS, working with some of the most disadvantaged primary schools in the United Kingdom, that helps head teachers and community leaders to make a difference to the lives of thousands of children living in poverty.

The INEOS Oxford Institute for Antimicrobial Research announced in 2021 the launch of the Antimicrobial Resistance (AMR) research facility. UK Column News has reported frequently on the huge latent issue of AMR and the gradual disappearance of all the antibiotics we have become so familiar with, which apparently do not work any more. We will continue to monitor this very important topic.

 

Divorce rates soar

Rising to their highest level in a decade, divorce applications have increased substantially. The ‘no-fault’ laws introduced in England and Wales on 6 April this year, which deny the spouse who thought a contract had been entered into and who wished to preserve the marriage any opportunity to contest the divorce, are thought to be the cause. New figures from the Ministry of Justice published last month revealed that between April and June 2022, there were more than 33,500 divorce applications. This is an increase of 22% from the same period last year. The law can change behaviour remarkably.

 

Protecting mental health after flooding events 

This is a particularly poignant article for me, given my personal history of 102 house floods and still counting over the last twenty years. Despite twelve letters to South West Water from my GP concerning the conditions I was having to live in and the impact on both my mental and physical health, I can say with confidence that there has never been any support from either the NHS, the UKHSA or my water company. Then why, all of a sudden, should we be prepared for a substantially increased mental health burden in communities affected by flooding? Does the UKHSA know something we don’t? 

 

Thank you for reading and thank you for all your wonderful e-mails. Whilst I get many individual requests for help, I am afraid I’m not able to give medical advice, but will do all I can to highlight in this blog some trends that I note. I will leave you with a few articles below that may be of interest.

 

Articles of interest

 

UK childhood immunisation schedule

 

How to Care for Transgender Patients

 

Department of Work and Pensions cuts Universal Credit benefits

 

Government may consider benefits cut to help fund tax breaks for rich, economists warn