Health E-News is a weekly update on policy and guidelines from organisations including NICE and individual Royal Medical Colleges, and news and views on health related subjects and research from trusted sources such as The King’s Fund, Cochrane, The Health Foundation, the NHS and the Department of Health and Social Care.
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COVID-19 guidance and policy
BSG issue two further guidance updates
The British Society of Gastroenterology (BSG), with input from organisations including the British Liver Trust and NHS Blood & Transplant, have provided guidance on patient groups who should be considered highly vulnerable, or advised to shield. In addition to this, guidelines for triage of patients referred for upper gastrointestinal (UGI) physiology investigations have also been made available. These latter guidelines apply to new referrals and referrals from prior to the pandemic.
Recent guidance from the Royal College of Paediatrics and Child Health (RCPCH), on COVID-19 shielding in children and young people, has now been adopted by the government. The guidance gives recommendations on which patients should continue to shield, and notes that patients should only be removed from the shielding patient list by their GP or specialist doctor, following consultation. The recommendations have been incorporated into Public Health England guidance on shielding.
COVID-19 related news
A new Cochrane Review explores the available evidence on the signs and symptoms of COVID-19, in an effort to inform timely and accurate diagnosis of the virus. The review considered studies published between January and April 2020, addressing the accuracy of any signs and symptoms, either alone or in combination, for the diagnosis of COVID-19. The 16 studies included, covering 27 signs and symptoms, so far provide little in the way of reliable evidence for diagnosis, and the authors conclude that “neither absence nor presence of signs or symptoms are accurate enough to rule in or rule out disease.” As with all COVID-19 related Cochrane Reviews, this one will be updated as new evidence becomes available.
Independent SAGE have released a report examining the question of why more people from black and ethnic minority (BME) backgrounds appear to be at greater risk of hospitalisation and deaths with COVID-19. As with previous reports on the topic, the evidence considered appears to point to a complicated picture involving interplay between socio-economic disadvantage in BME populations, high prevalence of chronic diseases and the impact of long-standing racial inequalities being key explanations.
Here, the Oxford based Centre for Evidence Based Medicine (CEBM) examine the latest Office for National Statistics (ONS) data on deaths. Looking at figures for the week ending 26 June (Week 26), as well as comparing data for this year so far against five year averages, they consider what the numbers of ‘excess deaths’ can tell us about the impact of COVID-19.
UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) have announced funding of a study into the long term health impacts of COVID-19. The PHOSP-COVID study will aim to recruit patients who have been discharged from hospital after having COVID-19, and will set out to determine the short to long terms health issues experienced and to explore the effectiveness of medicines, treatments and care pathways for particular disease characteristics.
The Mental Health Foundation have shared further findings from their ongoing Coronavirus: Mental Health in the Pandemic study. Exploring the divergent mental health experiences of different population groups, the report highlights those groups identified as being at high-risk from mental health problems, and the impact that the pandemic and the measures to manage it has had on these groups.
The Independent Medicines and Medical Devices Safety Review (IMMDR) has published its report, ‘First Do No Harm’, following a two year long examination of how the English healthcare system responds to reports from patients on the harmful side effects of medical devices and medicines. The report focuses on three interventions: Primodos, sodium valproate and pelvic mesh, setting out a series of recommendations for the support of those who suffered as a result of these, and to reduce the future risk of avoidable harms from medical interventions. The report also highlights some of the themes to come from patient evidence, relating to a lack of information enabling informed choices, and a struggle to be properly listened to by healthcare professionals, amongst others.
Charities and health organisations including the Faculty of Sexual & Reproductive Healthcare (FSRH), have written to the Secretary of State for Health and Social Care, Matt Hancock, to express concerns over the announcement that the budget for local authority implementation of HIV Pre-Exposure Prophylaxis (PrEP) is to be cut by £5 million this year, and to request that the decision be reconsidered. The cut represents a reduction of almost a third of the promised budget of £16 million. PrEP has proven to be highly effective in preventing HIV transmission, and signatories of the letter fear that the budget cut will hamper the delivery of equitable access of PrEP to all communities that might benefit.
The King’s Fund have published research, carried out before the pandemic, on three NHS case studies seeking to address workforce race inequalities and develop positive and inclusive working environments. The three trusts included in the research were selected on the basis of showing promising signs of positive change on inclusion and addressing race inequalities. Work in each of the three organisations included interventions such as establishing staff networks, ensuring safe routes for staff to raise concerns, and enabling staff development and career progression.
Medtech innovation briefing
- Potential Coronavirus (COVID-19) symptoms reported through NHS Pathways and 111 online
- Coronavirus (COVID-19) infections in the community in England: July 2020
- Weekly all-cause mortality surveillance: 2019 to 2020
- Weekly national flu reports: 2019 to 2020 season
- Ambulance Quality Indicators Systems Indicators for June 2020
- Waiting times for suspected and diagnosed cancer patients for May 2020 (Including October 2019 – March 2020, Q3 and Q4, 2019-20 revisions)
- Abortion statistics for England and Wales: 2019
- Referral to treatment waiting times statistics for consultant-led elective care for May 2020
- A&E attendances and emergency admissions for June 2020 and Quarterly report (Q1)
- Summary Hospital-level Mortality Indicator (SHMI) – Deaths associated with hospitalisation, England, March 2019 – February 2020
- Monthly hospital activity data for May 2020
- Psychological Therapies: reports on the use of IAPT services, England April 2020 Final including reports on the IAPT pilots
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