One of the world’s first Omicron-specific COVID-19 variant vaccines is to be trialled at multiple sites across the UK, including Salford Royal Hospital in Salford, as the biotechnology company Moderna, Inc works alongside the NIHR.

The innovative study, led by a team based at St George’s, University of London, opens this week and will see nearly 3,000 participants receive a first or second booster with up to 100 volunteers in Salford to take part in the important vaccine study.

Half of the volunteers will receive a Moderna Omicron variant vaccine and the other half vaccinated with the commonly used standard Moderna COVID-19 vaccine (Spikevax).

It is the first commercially sponsored Moderna vaccine trial to take place in the UK, and demonstrates the appeal, support and expertise the NIHR and other research organisations in the UK can provide to the life sciences industry.

Professor Lucy Chappell, Chief Executive of the NIHR, said:

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“The last two years have demonstrated the vital importance of international scientific collaboration.

"So it is truly exciting to see the NIHR and Moderna working with research teams across the UK on Moderna's first major UK COVID-19 vaccine study.

“With world-leading researchers, and the unique infrastructure and delivery expertise the NIHR provides, the UK is well-positioned to host exactly these sorts of significant, innovative projects in a post-pandemic world.”

 

Moderna has stated that while a third shot of its original COVID-19 vaccine increased neutralising antibodies against the Omicron variant at the lower half dose (used in the UK rollout), levels declined six months after the booster dose was administered. However, neutralising antibodies remained detectable in all participants.

This is one of the first studies globally assessing the effectiveness of a fourth COVID-19 dose, however it is also recruiting people who are yet to receive their first booster dose - those who have received just two primary doses.

Stéphane Bancel, Chief Executive Officer of Moderna, said: 

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“The UK and NIHR have been pioneering in their work to study vaccines and therapeutics throughout the global pandemic and have built-up world class clinical research capabilities.

“This is the first Moderna-sponsored Phase 3 study to be conducted outside of the U.S. with our Omicron-specific booster candidate and we appreciate the collaboration with the NIHR. We thank the clinical trial teams and the participants in the study for helping to advance our understanding of this booster candidate.

“We look forward to continuing our work with the NIHR and engaging further with the life-sciences community in the UK.”

 

Health and Social Care Secretary Sajid Javid said:

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“The UK is a world leader when it comes to the research and development of vaccines and medicines, bolstered by our renowned life sciences industry.

“It’s fantastic to see these capabilities being put to good use, with almost 3,000 people expected to take part in this important clinical trial. I want this country to be the best place in the world to launch clinical trials.

“I urge anyone eligible to take part in this vital research and play their part in protecting the country for years to come as we learn to live with COVID-19.”

 

Participants will need to have not tested positive for COVID-19 since the beginning of November 2021, and had their last vaccine at least three months prior to joining the study, which is recruiting for the next four weeks.

Volunteers from 16 years old and above will be randomly selected to each arm of the study, and blinded to which they receive, with the study looking to evaluate the immune response and safety of the variant jab.

The study will take place at up to 29 research sites across England and Wales and Scotland, with the trial lasting up to 13 months and includes phone calls and visits to the research site.

The Moderna Omicron variant vaccine examined in the trial will also be used in a coinciding COV-Boost sub-study. The COV-Boost Omicron Variant Fourth Dose Booster Sub-Study will compare the results of Moderna’s Omicron variant vaccine with that of the standard Pfizer-BioNTech dose, both used as a 4th dose (second booster).

Professor Andrew Ustianowski, National Clinical Lead for the UK NIHR COVID Vaccine Research Programme said:

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“The NIHR and research teams across the UK are eager to begin working with Moderna on this cutting edge vaccine study. There are currently a number of variant and multivariant targeting vaccines in development - this was always likely to be one of the next steps in COVID-19 vaccine research, however the emergence of the recent variants has brought forward this process.

“We have seen from the Omicron variant how some existing vaccines may protect less well against new variants, and continued research into which vaccine combinations work best is vital to help us stay protected. I am so grateful to those that have previously volunteered in vaccine studies, and sincerely hope that others will continue to step forward to help us understand this latest  bespoke vaccine.”

 

Dr Catherine Cosgrove, Chief Investigator for the study and Adult Lead at the Vaccine Institute at St George’s, University of London and St George’s University Hospitals NHS Foundation Trust, said:

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"We know the impact to society and the huge costs to health that COVID-19 brings. Moderna’s Spikevax was the first COVID-19 vaccine to be in a clinical trial in the world and then authorised, with many millions now having received their vaccine globally.

“We are all so proud of the thousands of study volunteers in the UK that have come forward to help during this pandemic and without whom vaccine development would not have been possible.

"I am very excited to be leading this new study which looks into Moderna's Omicron variant vaccine and the impact of a fourth dose. We hope volunteers continue to step forward and help us show if additional boosters of Spikevax or the Omicron vaccine will increase protection."

 

A new tool based on military planning processes is helping NHS Trusts to manage and prepare for outbreaks of infection in hospitals.

The idea behind the new tool (known as the Infection Control Estimate, or ICE) was developed last year to help make sure that there was a standard response to outbreaks of infectious illness such as Covid-19 across the NHS. 

Now, one of the team who came up with the original idea, Matthew Wynn, Lecturer in Adult Nursing at the University of Salford, is leading a project to develop the concept and implement the process with clinical partners in the Northern Care Alliance (NCA) and Manchester University NHS Foundation Trust. 

This has included the development of an Excel based prototype for managing outbreaks. The ICE tool asks a series of questions to gather information about the outbreak, and then walks staff through the process of putting interventions in place and evaluating their effectiveness.

The tool is believed to be the first of its kind to bring together all the data related to the management of an outbreak, including information on what interventions were used, how the disease spread, and how effective the control measures were. It also provides a clear structure to support staff responsible for putting outbreak interventions in place.

Matthew, who is also a reservist with 207 (Manchester) Field Hospital, explains:

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“This tool provides a fantastic new resource for NHS Trusts and we hope it will help improve infection control practice going into the future. Being able to implement the process with clinical partners has given us some really valuable feedback, and we are keen to continue making improvements by developing the tool into a full software package.”

The new process was used for the first time to manage an outbreak of Covid-19 and was received very positively by NCA staff who have taken the lead on implementing the tool in clinical practice.

Image: The prototype tool showing graphical output of cases and interventions from a mock outbreak

Linda Swanson, Director of Nursing Infection Control for the NCA, said:

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“The Northern Care Alliance is delighted to have been part of the collaborative work with the ICE project team at the University of Salford. This tool has the potential to bring rapid resolution to outbreaks of infectious diseases, support clinical teams to effectively introduce proven control methods, and ultimately help to keep our patients safe.” 

Sandra Brady, Infection Prevention and Control Specialist, explained:

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“Although it has been a huge task, I am excited that we have created something that can be so easily applied and makes outbreaks and the learnings from them so visual. We believe that having this visual representation of an outbreak will reach our audience and staff more efficiently and effectively. It also saves time as everything is included in one document.”

It is hoped that using the ICE tool will help evaluate outbreak management to see what interventions are most effective, and how processes can be improved in future. 

Dr Ryan George, Clinical Scientist at Manchester University NHS Foundation Trust said:

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“Not only is this going to be useful from a documentation perspective, but review of the captured data will allow key insights into causes of outbreaks and risk factors, and will allow us to determine how successful commonly used interventions actually are.”

In future the tool could also help improve communication between clinical teams and support future training efforts in relation to outbreak management and infection control, in both hospital and community settings.

New guidance outlines free COVID-19 tests will continue to be available to help protect specific groups once free testing for the general public ends on 1 April

People at risk of serious illness from COVID-19, and eligible for treatments, will continue to get free tests to use if they develop symptoms, along with NHS and adult social care staff and those in other high-risk settings, Health and Social Care Secretary Sajid Javid announced today (Tuesday 29 March).

Free testing for the general public ends on 1 April as part of the Living with Covid plan which last month set out the government’s strategy to live with and manage the virus.

Although COVID-19 infections and hospitalisations have risen in recent weeks, over 55% of those in hospital that have tested positive are not there with COVID-19 as their primary diagnosis.

Free universal testing has come at a significant cost to the taxpayer, with the testing, tracing and isolation budget costing over £15.7 billion in 2021-22. This was necessary due to the severe risk posed by COVID-19 when the population did not have a high level of protection.

Thanks to the success of the vaccination programme and access to antivirals, alongside natural immunity and increased scientific and public understanding about how to manage risk, the population now has much stronger protection against COVID-19 than at any other point in the pandemic.

This is enabling the country to begin to manage the virus like other respiratory infections.

From 1 April, updated guidance will advise people with symptoms of a respiratory infection, including COVID-19, and a high temperature or who feel unwell, to try stay at home and avoid contact with other people, until they feel well enough to resume normal activities and they no longer have a high temperature. Until 1 April individuals should continue to follow the current guidance.

From 1 April, anyone with a positive COVID-19 test result will be advised to try to stay at home and avoid contact with other people for five days, which is when they are most infectious.

Advice will be provided for individuals who need to leave their home when they have symptoms or have tested positive, including avoiding close contact with people with a weakened immune system, wearing a face-covering and avoiding crowded places.

Secretary of State for Health and Social Care Sajid Javid said:

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Thanks to our plan to tackle Covid we are leading the way in learning to live with the virus. We have made enormous progress but will keep the ability to respond to future threats including potential variants.

Vaccines remain our best defence and we are now offering spring boosters to the elderly, care home residents and the most vulnerable – please come forward to protect yourself, your family, and your community.

Under the plans set out today free symptomatic testing will be provided for:

Patients in hospital, where a PCR test is required for their care and to provide access to treatments and to support ongoing clinical surveillance for new variants;

People who are eligible for community COVID-19 treatments because they are at higher risk of getting seriously ill from COVID-19. People in this group will be contacted directly and sent lateral flow tests to keep at home for use if they have symptoms as well as being told how to reorder tests; and

People living or working in some high-risk settings. For example, staff in adult social care services such as homecare organisations and care homes, and residents in care homes and extra care and supported living services, NHS workers and those working and living in hospices, and prisons and places of detention (including immigration removal centres), where infection needs to be identified quickly to minimise outbreaks. People will also be tested before being discharged from hospital into care homes, hospices.

 

Asymptomatic lateral flow testing will continue from April in some high-risk settings where infection can spread rapidly while prevalence is high. This includes patient-facing staff in the NHS and NHS-commissioned Independent Healthcare Providers, staff in hospices and adult social care services, such as homecare organisations and care homes, a small number of care home visitors who provide personal care, staff in some prisons and places of detention and in high risk domestic abuse refuges and homelessness settings. In addition, testing will be provided for residential SEND, care home staff and residents during an outbreak and for care home residents upon admission. This also includes some staff in prisons and immigration removal centres.

Children and young people who are unwell and have a high temperature should stay at home and avoid contact with other people, where they can. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.

The internationally recognised Community Infection Survey delivered through the Office for National Statistics will continue to provide a detailed national surveillance capability in the coming year so the government can respond appropriately to emerging developments such as a new variant of concern or changing levels of population infection. Infections in health and care settings will also be monitored through bespoke studies including the Vivaldi study in residential care homes, the SIREN study in the NHS, and RCGP surveillance in primary care.

The government has retained the ability to enable a rapid testing response should it be needed, such as the emergence of a new variant of concern.

This includes a stockpile of lateral flow tests and the ability to ramp up testing laboratories and delivery channels.

The government’s Therapeutics Taskforce and Antiviral Taskforce will also be merged into a single unit which will continue to focus on securing access to the most promising treatments for COVID-19.

Dame Jenny Harries, Chief Executive of the UK Health Security Agency, said:

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As we learn to live with Covid, we are focusing our testing provision on those at higher risk of serious outcomes from the virus, while encouraging people to keep following simple steps to help keep themselves and others safe.

The pandemic is not over and how the virus will develop over time remains uncertain. Covid still poses a real risk to many of us, particularly with case rates and hospitalisations on the rise. That is why it is sensible to wear a mask in enclosed spaces, keep indoor spaces ventilated and stay away from others if you have any symptoms of a respiratory illness, including Covid.

Vaccination remains the best way to protect us all from severe disease and hospitalisation due to Covid infection. If you have not yet come forward for your primary or booster I would urge you to do so straight away – the NHS vaccine programme is there to help you and the sooner you are vaccinated the sooner you and your family and friends will be protected.

 

Most visitors to adult social care settings, and visitors to the NHS, prisons or places of detention will no longer be required to take a test. More guidance on what people should do when visiting adult social care settings will be published by 1 April.

A number of changes and new guidance is also being confirmed today for adult social care including:

From 1 April, those working in adult social care services will also continue to receive free personal protective equipment (PPE). Priority vaccinations and boosters for residents and staff will also continue

Updated hospital discharge guidance will be published setting out how all involved in health and social care will work together to ensure smooth discharges from hospital and people receive the right care at the right time in the right place

Designated settings will be removed. These were initially set up to provide a period of isolation to COVID-19 positive patients before they move into care homes and before routine point of care testing for COVID-19 was available. Restrictions on staff movement will also be removed

Streamlined guidance on infection and prevention control measures will be published to set out long-standing principles on good practice, and support consistency across the adult social care sector. This will include details on future measures for COVID-19 and other respiratory viruses to ensure providers have the latest information on best practice which will include information on admissions, visiting and PPE

Updated guidance for adult social care providers and staff to set out the current testing regime across adult social care

Outbreak management periods in care homes, which can include visiting restrictions, have been reduced from 14 to 10 days

People aged 75 and over, residents in care homes for elderly adults and those who are immunosuppressed are now eligible to receive a Spring booster jab to top up their immunity to COVID-19. Around five million people will be eligible for a Spring booster around six months after their previous dose, and the NHS has contacted over 600,000 people inviting them to book an appointment. Anyone who has not yet had a COVID-19 jab continues to be encouraged to take up the ‘evergreen’ offer.

The cost of these changes will be met within existing funding arrangements. As part of this, free parking for NHS staff introduced during the pandemic will also come to an end on 31 March. We are delivering on our the manifesto commitment to provide free hospital car parking to thousands more NHS patients and visitors - with over 94% of NHS trusts implementing free car parking for those who need it most, including NHS staff working night shifts.

Through the Health and Social Care Levy, funding will rise by a record £36 billion over the next three years. This is on top of the previous historic long-term settlement for the NHS, which will see NHS funding increase by £33.9 billion by 2023-24, which has been enshrined in law.

The success of the government’s Living with Covid plan, will enable the country to continue to move out of the pandemic while also protecting those at higher risk of serious outcomes from the virus through our testing regime.

British smart MedTech company NeedleSmart is at the forefront of helping the NHS radically reduce CO2 emissions in its clinical waste disposal by a staggering 95% as part of its Carbon Reduction Strategy, saving £10s of millions in clinical waste destruction.  

NeedleSmart is collaborating with the NHS, facilitated through the NHS Supply Chain innovation route, to drive a campaign forward to minimise single-use plastics and associated packaging. As of 1st April, and as part of the Government’s recycling policies, all plastic packaging must contain 30% recycled material or be subject to a levy of £200 per tonne.

The NeedleSmart technology is also part of an innovative programme to reduce and eradicate 100,000 needlestick injuries (NSI), which affect all healthcare workers across the NHS. This initiative alone will help save the NHS and its trusts more than £127 million each year. 

The Knowsley-based company has designed and developed a range of products, including the NeedleSmart Pro (NS PRO) a world-first in safe needle destruction and disposal. The ground-breaking technology is being pioneered in a partnership with the Innovation Centre at Alder Hey Children’s Hospital and piloted with a number NHS trusts across England as part of the NHS’s carbon reduction and sustainability programme.

As of 5th January 2022, the global COVID-19 vaccinations programme had delivered 134 million vaccinations in the United Kingdom, 513 million in the USA and 1.4 billion in India.

In the UK alone, using the NeedleSmart technology purely in relation to the vaccination programme would have saved the NHS 15,132 tonnes of CO2 annually.

This is equivalent to:

15,000 flights from London to New York

66 million miles in a family car

45,000 square metres of polar ice caps melting

39,600 trees storing atmospheric CO2 each year.

NS PRO destroys a contaminated hypodermic needle in a sealed chamber in just six seconds. The NeedleSmart device heats the needles inserted into the chamber to 1,300 degrees celsius, which will kill potential harmful pathogens, viruses and bacteria adhering to the needle. Within seconds, the needle is compressed into a tiny cold ball and released from the NS PRO device as a safe sphere of metal at the tip of the syringe.

This not only safely destroys the needles, converting them into safe clinical waste and allowing for recycling, but also hugely decreases the amount and level of clinical waste disposal, along with the huge carbon emissions associated with disposing of that clinical waste and its incineration. Previously, the entire needle would have had to be disposed into a plastic sharps box, which carried a limit on how many intact needles could be disposed of.

Now the clinical waste can be split into two parts, with the molten metal ball part of the clinical waste recycled as safe waste and the plastics recycled into the system. This represents a huge advancement for the NHS ­– which is one of the UK’s biggest producers of carbon – in reducing its carbon emissions and recycling its clinical waste.

The NS PRO device can help the NHS save money and cut costs in a number of ways, including:

• NSI are estimated to cost each NHS trust £500,000 each year*** and an estimated £127 million across England ****.

• The NS PRO device will play a major role in significantly reducing and eradicating the 100,000 NSI that occur every year.

• NeedleSmart aims to offer the use of a 96% recycled cardboard clinical waste box (when NS PRO is used) as a viable alternative to the current single-use sharps bins.

• The Government plans to add a plastic tax of 20% per tonne on single-use plastic packaging as of April this year, meaning the NS PRO and its clinical waste box presents a real reduction opportunity in this tax levy to the NHS.

NeedleSmart CEO and smart MedTech disruptor, Cliff Kirby, said:

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“By adopting the NS PRO device, the NHS will enjoy a whole host of efficiencies in cost-savings and reduction in carbon emissions, in addition to crucial safety aspects. 

Using the NS PRO for the safe disposal of hypodermic needles can radically reduce the 100,000 needlestick injuries that occur each year to surgeons, doctors, clinical staff and hospital porters.

But the even greater capability for reducing carbon emissions lies in the fact that using the technology means we can reduce the carbon emissions that the NHS produces by 95%. Using the NS PRO to safely dispose of the needles and put these into our biogenic carboard disposal boxes has major savings. The use of the NS PRO offers substantial savings to the NHS and the environment. 

“This means more clinical waste can be stored in each NS PRO disposal box, which reduces the number of trips to empty and dispose of clinical waste. It also reduces the single use of plastics waste and allows for greater recycling of non-hazardous waste materials against the existing approach of incineration, which creates more emissions with carbon pollution. Finally, it reduces carbon emissions of associated logistics – be that manufacture or disposal.

As a UK SME, it is fantastic to work and collaborate with the NHS directly to drive forward innovations that will have a real and meaningful impact on climate change.”

 

NeedleSmart has recently achieved FDA approval as a Class II medical device, making it the first UK company to achieve FDA 510(k) approval (Class II for Sharps Needle Destruction Device (NDD)) and allowing the MedTech disruptor to expand into the US market and other global territories.

Claire Liddy, Managing Director of Innovation at Alder Hey Children’s NHS Foundation Trust, said:

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“At Alder Hey, we have been innovating for the past 100 years. We want to ensure that we are always standing at the leading edge of clinical innovation, sustainability and the green tech space.

“The technology presents lots of opportunities for us to also reduce waste and carbon ,which is a huge agenda for the NHS and Alder Hey as part of the NHS Carbon Reduction programme. We really want to be a hospital that is pioneering in the space of green tech. We think the NHS has a long way to go in the clean, green agenda, but we see the relationship between Alder Hey and NeedleSmart as being a great platform to achieve this as we work towards carbon net zero.

“The partnership between Alder Hey Innovation Centre and NeedleSmart has a common purpose to innovate and disrupt. One of the biggest safety concerns for us across the NHS is needlestick injuries. So, we are excited to see how the technology can not only reduce those injuries, but also eliminate them all together.”

 

Alder Hey is widely recognised for its cocreation and adoption of new innovative technologies and boasts the largest hospital-based Innovation Centre in the UK, with 25+ full time innovation experts working out of a 1,000 square-metre innovation hub in the heart of the hospital. Through this alliance, Alder Hey will work directly with NeedleSmart as it brings its multi-faceted hardware and software solutions to the healthcare markets.

Salford Clinical Commissioning Group (CCG) has been ranked number one in a national survey of NHS organisations, with 95% of staff recommending it as a place to work.

Conducted every year since 2003, the NHS Staff Survey is the largest survey of staff opinion in the UK. It gathers views on staff experience at work around key areas including appraisals and development, health and wellbeing, staff engagement and raising concerns. It helps the NHS organisations who participate in the survey to understand and compare their performance through the eyes of their workforce.

Of the 39 CCGs who took part in the 2021 survey, Salford CCG is ranked first for overall positive score, up from second place last year.

91% of the Salford CCG workforce completed the survey, the highest rate in the country, compared to the national average of 79%.

Steve Dixon, Chief Accountable Officer, said:

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“I am thrilled that Salford CCG has been ranked best in the country based on positive feedback from the survey.

“Staff wellbeing and development are extremely important to us so it’s fantastic to see this reflected in the results.

“2021 was another year of challenges for staff working in health and care. Our teams worked tirelessly with GP practices to keep primary care open, providing the highest standards of care, and with partners to deliver the largest vaccination programme in the history of the NHS.

“I’m really pleased so many staff took the time to give their views and we will continue to provide excellent support as we move into NHS Greater Manchester Integrated Care from July."

 

Highlights from the survey

The results showed that:

95% of staff would recommend Salford CCG as a place to work. This is well above the national average of 66%

95% of staff believe the care of patients is the organisation’s top priority, compared to the national average of 79%

88% of staff believe the teams work well together within the organisation to achieve objectives, again well above the national average of 53%

83% of staff report feeling supported to reach their potential, compared to the national average of 58%

Key improvements from 2020 include:

100% of staff reporting that they have not felt any pressure from their manager to come to work when they have not felt well enough, up from 86% of staff last year

95% of staff reporting that their line manager takes a positive interest in their health and wellbeing, increasing from 90% last year

88% of staff reporting that they believe their immediate manager asks for their opinion before making decisions that affect their work, compared to 79% last year

85% of staff reporting that they believe the CCG acts fairly with career progression, up from 80% last year

Salford CCG’s core strengths as an organisation are highlighted as:

effective and cohesive team working

kindness and compassion amongst colleagues

exceptionally strong working relationships between line managers and employees

a positive overall approach towards health and wellbeing

excellent opportunities for flexible working

a culture which prioritises safety and speaking up

For the full results please see https://www.nhsstaffsurveys.com/results.

Researchers from the University of Bristol have found that there have been increases in incident prescribing of most anti-anxiety medications (called anxiolytics) in recent years, which have been substantial in young adults (aged under 25).

This may reflect better detection of anxiety, increasing severity of symptoms, increasing acceptability of medication, or an earlier unmet need. While overall incident benzodiazepine prescribing has fallen over time, prescribing has increased in those aged under 35. In 2017, 44 per cent of benzodiazepine prescriptions were longer than the NICE recommended maximum of four weeks.

Some of this prescribing is not based on robust evidence of effectiveness, such as the use of beta-blockers, some may contradict guidelines, such as anti-psychotics, and there is limited evidence on the effect of taking antidepressants long-term. As such, there may be unintended harm. 

Prior to this research, previous studies had found substantial increases in the prescribing of antidepressants for any indication, and for depression, over the past two decades. However, little was known about trends in the prescribing of anxiolytics (antidepressants, benzodiazepines, beta-blockers, anticonvulsants, antipsychotics) for the treatment of anxiety. Several changes may have affected prescribing in recent years, including changes in clinical guidance.

Dr Charlotte Archer, an NIHR-funded Senior Research Associate in Primary Care Mental Health at Bristol Medical School (PHS), said:

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“The increases in the number of new patients starting anxiolytic treatment may reflect better detection of anxiety by GPs. The increase in new prescriptions was substantial in those aged 18-34, particularly in recent years, and this may also reflect an earlier unmet need for young adults.

“It is also important to consider that some of this prescribing is not based on robust evidence of effectiveness and some may contradict guidelines. There is also limited evidence on the effect of taking antidepressants long-term, so there may be unintended harm to those that are be being prescribed this medication for a long time.

“The information from this study has allowed us to gain a better understanding of primary care prescribing for anxiety, and how trends have changed over the study period. Going forward, we need research to improve our understanding of why we are seeing this increase in prescribing, especially in young adults, and to provide interventions that can reduce the growing reliance on medication for this age group.”

 

The world’s largest study of the genetics of critical COVID-19, involving more than 57,000 people, including Royal Free London patients, has revealed new details about some of the biological mechanisms behind the severe form of the disease.

Some 16 new genetic variants associated with severe COVID-19, including some related to blood clotting, immune response and intensity of inflammation, have been identified.

These findings will act as a roadmap for future efforts, opening new fields of research focused on potential new therapies and diagnostics with pinpoint accuracy, experts say. 

Researchers from the GenOMICC consortium – a global collaboration to study genetics in critical illness – made these discoveries by sequencing the genomes of 7,491 patients from 224 intensive care units in the UK, including 153 patients from Barnet Hospital and 22 from the Royal Free Hospital. 

Their DNA was compared with 48,400 other people who had not had COVID-19, participants in Genomics England's 100,000 Genomes Project and that of a further 1,630 people who had experienced mild Covid.

Determining the whole genome sequence for all participants in the study allowed the team to create a precise map and identify genetic variation linked to severity of COVID-19. The team found key differences in 16 genes in the ICU patients when compared with the DNA of the other groups. 

They also confirmed the involvement of seven other genetic variations already associated with severe COVID-19 discovered in earlier studies from the same team.

The findings included how a single gene variant that disrupts a key messenger molecule in immune system signalling – called interferon alpha-10 – was enough to increase a patient’s risk of severe disease. 

This highlights the gene’s key role in the immune system and suggests that treating patients with interferon – proteins released by immune cells to defend against viruses – may help manage disease in the early stages.

The study also found that variations in genes that control the levels of a central component of blood clotting – known as Factor 8 – were associated with critical illness in COVID-19.
This may explain some of the clotting abnormalities that are seen in severe cases of COVID-19. Factor 8 is the gene underlying the most common type of haemophilia. 

Dr Rajeev Jha, the principal investigator at Barnet Hospital for the study and a consultant anaesthetist and intensivist, said:

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“These results have helped give us a deep understanding of the process of the disease and will help us to find more effective treatments. I am so proud of our patients for taking part and for our staff for all their recruitment and research efforts. This massively improves our understanding of how our genetic makeup influences being severely affected by COVID-19. Our successful recruitment here at Barnet Hospital was thanks to the hard work of research nurses Vinod Krishnamurthy and Lai Lim.”

In a letter of thanks to staff at the Royal Free London, Dr Kenneth Baillie, chief investigator for the trial, said:

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“Thanks to your efforts, GenOMICC is the largest consented research study in the history of UK critical care medicine …. more importantly it has already informed the selection of drugs in large scale clinical trials and continues to find new insights into the molecular mechanisms of disease.”

Staff who took part in the trial from RFH included research nurses Christine Eastgate and Sara Mingo Garcia, as well as Amitaa Maharajh, senior research nurse, Glykeria Pakou, clinical trial practitioner and Mark de Neef, principal investigator and ITU consultant, (formerly led by Daniel Martin, ITU consultant).

A patient at Manchester University NHS Foundation Trust (MFT), living with an ulcer on the same area of his foot since 2011, is the first person in Europe to trial a new treatment for long-term (chronic) wounds.

Nigel Rooke, 56, is retired and lives in Moston in North West Manchester. He is the first patient to take part in the 12-week study, which will follow the healing progress of exuding (oozing) chronic wounds by using two consecutive dressing types.

Chronic wounds usually produce excessive wound fluid, known as exudate. Wound exudate is produced as a normal part of healing and is mainly water, but also contains proteins, enzymes, cells and waste products. In a wound that is progressing normally, exudate production generally reduces over time, but in chronic wounds exudate is believed to prolong inflammation and to be detrimental to healing.

At least 80,000 people in the UK have an open, complex wound and the NHS spends approximately £3bn annually on wound care.

The Exuflex study is taking place at North Manchester General Hospital, (NMGH) and Manchester Local Care Organisation North Manchester Community Podiatry, both part of MFT, and is funded by Molnlycke Health Care AB.

Nigel Rooke, said:

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“I have diabetes, and foot ulcers can be a complication of this condition. I have tried all sorts of treatments to date, including other dressings, specialist slippers, and creams.

“My wife used to be a nurse and has been fantastic in helping me to manage daily life with this ulcer.

“Due to my diabetes, I do not have any sensation in my feet. I can be unaware if I am aggravating the ulcer and causing further damage, because I don’t feel any irritation or pain, so I do have to be very careful.

“I enjoy going to watch Manchester City and there have been times when it’s been raining, and my shoes and feet have become wet. This has made the wound worse, but I haven’t been aware of the damage at the time.

“I hope this treatment could offer a long term solution for myself, or others living with a chronic wound.”

 

Kimberley Wilde, Advanced Podiatrist at Harpurhey Health Centre and lead investigator for the study at MFT, said:

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“These dressings are designed to be gentle to apply and remove, as reduction in trauma to the healing skin should result in better wound healing.

“However, alongside faster healing I hope there may be other potential benefits to this new treatment. While due to the nature of certain conditions that some patients have, they do not experience a lot of pain, others can find the experience – particularly for dressing and re-dressing the wounds – from uncomfortable, to extremely painful.

 “Also, with less trauma to the wounds it is easier for patients to self-manage at home. Supported self-management has the potential to relieve pressure on health and social care services and allows patients to be involved in their care as much as possible.”

 

More about this research

The Exuflex study involves two types of dressing. The first type of dressing Exufiber, is designed to absorb and retain high amounts of wound fluid. In contact with wound fluids it transforms into a gel that helps both wound healing and ease of removal during dressing changes. Easy removal helps to protect the new skin from trauma.

As wounds heals a dressing that absorbs high volumes of wound fluids is not optimal so a second type of dressing Mepilex Border Flex will be used, which is also designed for easy removal.

Greater Manchester Mental Health NHS Foundation Trust (GMMH)’s Recovery Academy is back this Spring, with the launch of their latest term, including new face-to-face courses and more student places available.

The new term will run from April to September 2022; and will feature a range of brand-new courses including Yoga and Wellbeing; Hepatitis ? Enhancing Testing, Prevention and Care; and Comedy and Wellbeing.

Booking will be open from 04 April 2022.

From 04 April, to make enquiries or book a place on a course please contact the Recovery Academy team at recoveryacademy@gmmh.nhs.uk or telephone 0161 358 1771.

Individual course bookings can be done directly from 04 April at www.gmmh.nhs.uk/free-courses where you can create your own personal account and explore everything on offer.

With over 65 courses on offer, the term will also feature many tried and tested favourites, on topics such as Trauma, Personality Disorder, Addiction, Depression, Sleep, Dementia, and many more.

Face to face courses are available at various locations across Manchester, Bolton, Salford, Trafford and Wigan.

GMMH Recovery Academy was launched in 2013 and offers people  learning opportunities to help them manage and promote good mental health and wellbeing.

All courses and resources are created and delivered  by professionals alongside people with lived experience, to make sure they are relevant, well-informed and based on real experiences.

Courses and resources are aimed at those looking to increase their knowledge and understanding in mental health and/or addiction, improve their wellbeing, or support someone else’s - or those who simply want to learn something new.

The Academy is free to join and available to:

1.       Anyone who is experiencing mental health or addiction problems (you do not have to be under NHS mental health services).

2.       Their supporters (family, friends and loved ones).

3.       GMMH staff members, volunteers, and students on placement.

4.       Any healthcare professionals.

 A student who attended the ‘Let’s Talk About Suicide’ course earlier this year said:

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 “I really enjoyed the delivery approach, this can be a sensitive subject and the course was well thought out and everyone was made to feel comfortable. I found the course really engaging and would recommend the course to everyone”.

Claire Watson, Head of Service User/Carer Engagement & Improvement, with responsibility for the Recovery Academy, said:

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 “We are so excited to be back and bigger than ever! The easing of Covid-19 restrictions has meant we can offer more places on our taught courses. That said, we are still very committed to keeping everyone safe and you can read more about our safety measures at www.gmmh.nhs.uk/recovery.

“Although the pandemic was a traumatic time for many of us, it did allow the team time to develop more resources, so we really are back bigger than ever, with more face-to-face courses than ever before, and additional self-help resources, e-learning packages and radio podcasts.

 “We work with partners like Open Awards, Lancashire Wildlife Trust, University of Law, United Response, and the Laughing Horse to continually develop the provision of courses. We hope everyone enjoys everything we have to offer and if you think of anything else the Recovery Academy can do then let us know!

 “The Recovery Academy also offers bespoke training packages for other organisations and has successfully delivered trauma informed mental health training to various partners in the past 12 months including, Metrolink, Greater Manchester Supported Housing Providers and Greater Manchester Faith Leaders. If you are interested in bespoke training for your organisation, please don’t hesitate to reach out to us.”

To make enquiries or book a place on a course please contact the Recovery Academy team at recoveryacademy@gmmh.nhs.uk or telephone 0161 358 1771.

Individual course bookings can be done directly at www.gmmh.nhs.uk/free-courses where you can create your own personal account and explore everything on offer.

Photo: Claire Watson

Cancer data from NHS Digital has now been made available in a secure environment to enable researchers to understand the impact of COVID-19 on people affected by cancer.

DATA-CAN, the UK’s Health Data Research Hub for Cancer, has worked with NHS Digital to provide timely and secure access to cancer specific data, curated by NHS Digital’s National Disease Registration Service, alongside national population health datasets in the NHS Digital Trusted Research Environment (TRE).

TREs are secure spaces where authorised researchers can access the data they need for approved projects. The de-identified data is analysed in a secure environment without being downloaded, to provide safe and secure data for analysis and research.

This partnership will provide researchers with timely data access to improve our understanding of the current impact of COVID-19 on the referral, diagnosis, treatment, and outcomes of patients with cancer, and those who may become unwell in the future. The ambition is to look at how this information can help develop new services, tests and treatments and ultimately save lives.

NHS Digital's TRE is supported by the recent announcement by the government of up to £200 million being invested to enable more secure and efficient access to NHS data through TREs and digital clinical trial services.

This will ensure that the NHS will be able to deliver new treatments faster and improve patient care and will develop the NHS Digital TRE to allow it to be made available to larger numbers of users in due course. 

Professor Geoff Hall, DATA-CAN’s clinical lead, professor of digital health and honorary consultant in medical oncology at the Leeds Cancer Centre, said,

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“As a cancer doctor with a specialist interest in health data research, utilising this national Trusted Research Environment allows us to better understand the impact that COVID-19 has had on NHS cancer services. The same data, used effectively and responsibly and with the support of patients and the public, has the potential to drive research into new, more effective ways to diagnose cancer early and could support the development of new treatments to improve people’s lives. It is a really exciting development and has the potential to be a real game-changer.”

Michael Chapman, NHS Digital Director of Research and Clinical Trials said,

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“Safe access to data is absolutely vital in helping medical researchers explore the impact of COVID-19 on cancer services and outcomes, and more widely to understand the causes of cancer and how best to diagnose, prevent and treat it. NHS Digital is committed to making data accessible to researchers in a safe and trusted environment that safeguards patient data at the same time as allowing for world-class research.”

The response to COVID-19 has shown that timely and appropriate access to high quality data and the right technology can help reshape the health and social care system for the better. This includes NHS DigiTrials which provides data services to support clinical trials, reducing the time, effort, and cost of developing new drugs, treatments, and services for patients.

Professor Mark Lawler, Professor of Digital Health at Queen’s University Belfast, Scientific Director of DATA-CAN and Chair of the Scientific Steering Group of this new initiative said,

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“This is a very exciting development as it allows us to produce precise scientific evidence of the continuing impact of COVID on cancer patients and cancer services. This cancer intelligence will empower us to address the cancer backlog that COVID has precipitated and build back both better and smarter, in order to deliver the enhanced cancer services that our patients deserve” 

Alison Allam, DATA-CAN Patient and Public Involvement and Engagement Group, said,

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“Patients and carers understand the benefits of earlier and more accurate diagnosis and smarter, kinder treatments for cancer and the important role that health data research plays in this. However, we want to be reassured that our medical data will be treated confidentially and responsibly by those carrying out research. We therefore welcome the improved safety and reassurance from such data remaining within NHS Digital’s Trusted Research Environment, whilst still allowing access to approved researchers to help improve outcomes for patients.”

Greater Manchester Mental Health NHS Foundation Trust (GMMH) has joined a supported internship scheme which helps young people with learning disabilities to access support, education and work experience with the end goal of progressing into permanent employment.

GMMH are working with Pure Innovations as a partner on their Greater Manchester Supported Internship programme, to provide a variety of work placements.

The Supported Internship programme is a collaboration between Supported Employment Specialist, Pure Innovations, and a range of partners which either act as ‘Host Employer’ or ‘Educational Provider’. Partners include Elms Bank College, Trafford College, Fairfield Hospital (Northern Care Alliance) and Trafford Hospital (Manchester Foundation Trust).

Through the scheme, individuals are offered opportunities to gain practical work experience in a variety of different roles at their Host Employer, whilst studying for an accredited qualification through the Education Provider in subjects such as Employability Skills and Customer Service.

Individuals are offered up to three different placements over one academic year, to make sure they gain a wide-ranging set of skills and experience. Throughout the process, they are provided with expert support from the Supported Employment Specialist’s Job Coaches and Employment Officers to make sure they settle in and progress well.

Natalie Irvine, Senior Employment Officer at Pure Innovations said:

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“It is absolutely vital that we are offering equal opportunities to all young people in our communities. People with learning disabilities have the skills, drive and passion to succeed in a variety of roles, just like their peers.

“Through the supported internship scheme, we match individuals with roles that are right for them, and make sure that any extra support for both the individual and the employer is put in place. It is amazing to watch them go from strength to strength, gaining valuable experience, skills and confidence, whilst adding great value to the workplace.”

 

This support can include facilitating reasonable role adjustments to accommodate for their disability, or even carving out new, custom roles that meet the needs of both the individual and employer.

Regular one-to-one catch up sessions allow for progress to be closely monitored, and for any issues to be highlighted and resolved quickly, to ensure the whole process goes as smoothly as possible.

Staff disability awareness training is also provided, to adopt an open and inclusive environment and ensure colleagues and teammates understand how best they can communicate and work together with their interns.

Throughout the programme, the Supported Employment Specialist also helps the interns to take the next steps in their employment journey, including taking part in permanent role and salary negotiations with the employer, and offering ongoing coaching.

GMMH has now joined The Greater Manchester Supported Internship scheme, offering a variety of work placements in partnership with the lead providers. So far, six interns have been placed into roles within their Facilities department in areas such as Catering, Administration, Transport & Logistics and Domestic Services; and one has been offered a permanent position.

Joshua joined the scheme after hearing about it in his last year of high school. He said:

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“I have autism and I knew that going to a big college with large class groups wouldn’t be best for me. I spoke to my teachers and parents and we agreed an internship would be a great choice, because I would be in smaller groups and be able to get practical experience, which I enjoy.

“I knew I wanted to find a role where I could help people, and where I could be around other people – and in the NHS, I could do just that.

“My first placement was at Fairfield Hospital in Administration, which was lots of fun in a really supportive team. I’m now in a role at GMMH in the Logistics Department, working with the team to deliver post all across the Trust. From the get-go, the team have been so welcoming and supportive. We have a laugh, and if I ever need help, I always feel comfortable speaking up. The extra support from Natalie at Pure Innovations has been so useful too.

“It’s hard to think about the future, and it does take a while to choose which career you’d like to get in to, but these different placements have really helped me understand my options. It’s been such a great experience so far, and a really good way to progress into what I’d call ‘adulthood’.

 

GMMH joined the internship scheme in line with the Trust’s Equality and Diversity Strategy for 2019-2021, which pledged to prioritise a representative and supported workforce. It comes in anticipation of GMMH’s new Equality, Diversity and Inclusion (EDI) strategy, due to be launched later this year, which will build upon this work.

Michelle Clarkson, Chair of the GMMH Staff Disability Network said:

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“We are so delighted that the Trust has joined the Greater Manchester Supported Internship scheme, which demonstrates a real commitment to equality, diversity and inclusion. This was spearheaded by our Facilities department, who worked with the lead providers to identify a variety of placements in order to develop a more diverse and represented workforce, and foster an inclusive culture.

“People with learning disabilities are a diverse group that have so much to bring to the table, and as an organisation we have so much to benefit from the wide-ranging skills and experiences that they bring. The impact of the scheme has been amazing, and now as we see how well our first cohort of interns are doing, our next step is to roll out the scheme across GMMH, with the aim to progress as many individuals into permanent employment as possible.”

 

Joanne McIntyre, Facilities Manager at GMMH said:

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“It has been a pleasure to work with Pure Innovations and the other lead providers to offer a number of work placements through the scheme. All our interns have settled in so well and have become well-loved members of our teams. To see their confidence and skills grow over time, with the support of their job coaches and colleagues, has been rewarding, and we are so impressed by their hard work. They are real assets to the organisation and we are very much looking forward to growing the number of placements available soon.”

Orienne Langley-Sadler, Headteacher at Elms Bank College said:

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“Elms Bank are exceptionally grateful of our links with our colleagues in the NHS who are driving the internship for our young people. So many of our young people never imagined that they could transition into work, but the internship and the support and care from their colleagues enables them to do so. This goes on to have huge benefits for our young people as they move into adulthood with a greater sense of self and worth in their community. Independence of our young people develops into other areas of their life with many learning to drive, living independently from family and sustaining their own social lives.

“The internship changes lives: for the individual, for the family members and for the aspirations of future cohorts onto the programme.”

 

A new study conducted at the University of Worcester and published in the academic journal: Nutrition and Health, has found high protein diets decrease men’s testosterone by 37%.

For the average man, this would cause medically low testosterone (hypogonadism), substantially increasing the risk of infertility, low sperm counts, and erectile dysfunction. Low testosterone levels are linked to a higher risk of chronic diseases such as heart disease, diabetes, and Alzheimer’s. Moreover, healthy testosterone levels are vitally important for strength, muscle building, and athletic performance.

"For the average man, this would cause medically low testosterone."

This finding was part of a large study, which complied the results of 27 studies, with a total of 309 men. The research also found low-carbohydrate diets, especially high protein ones, increase the hormone cortisol. This is commonly known as the body’s stress hormone, and is released during the ‘fight or flight’ response. High levels of cortisol suppress the immune system, making people more susceptible to catching viral and bacterial infections such as colds, flus, and Covid-19.

High protein diets can induce a phenomenon known as ‘rabbit starvation’. This was first discovered by the Romans, when soldiers were forced to survive on large quantities of rabbits (i.e. lean meat), during the siege of Villanueva del Campo, many of which developed severe diarrhoea and died. In the body, protein breaks down into ammonia, which at high levels becomes toxic. This results in a number of adverse effects including diarrhoea, nausea, and ultimately death. This new research indicates low testosterone is another symptom of rabbit starvation, also known as protein poising.

Joseph Whittaker the lead researcher, said:

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“Most people eat about 17% protein, and the high protein diets which caused low testosterone were all above 35%, which is very high. So for the average person, there is nothing to worry about, however for people on high protein diets, they should limit protein to no more than 25%.”

Bodybuilders, weight lifters, and those on extreme weight loss diets are most at risk of excessive protein intakes. Typically, this is achieved by eating lot of lean meats, white fish, and protein shakes. People have a natural aversion to consuming large quantities of lean meat, for this very reason. It is the body’s way of warning us against very high protein intakes.

The finding that low carbohydrates diets increase cortisol is very interesting, as these diets have become incredibly popular over recent years, with many celebrities such as Kim Kardashian, LeBron James, and Meagan Fox, promoting them. However, the researchers stress further work needs to be done in this area, to know if this is necessarily bad.

Earlier this month, Greater Manchester launched a new campaign to improve mental wellbeing and raise awareness of self-harm in older people.

Recent research shows that older people who self-harm are at 67 times greater risk of suicide than the general older population and almost three times greater than the relative risk of suicide among younger people who self-harm.

The new campaign ‘Don’t Brush It Under the Carpet’, which was launched at the Greater Manchester Ambition for Ageing celebration event, aims to reach and support older residents who may be feeling depressed and alone and guide them to the right support for them. The campaign also aims to raise awareness of the issue of self-harm and older people, amongst carers, family members and health professionals to enable them to support residents who may be struggling.

The campaign, which has been funded by the Greater Manchester Health and Social Care Partnership and builds on their existing Shining A Light on Suicide Campaign, has been created by a working group made up of representatives from the Shining a Light on Suicide Campaign, Greater Manchester Older People’s Network, Greater Manchester Ageing Hub, health professionals and a focus group of older residents. This campaign’s concept is themed around common phrases and sayings that residents would be familiar with and relate to including don’t brush it under the carpet and a problem shared is a problem halved.

Polly Kaiser, Consultant Clinical Psychologist Oldham and Clinical Lead Older Peoples' psychological therapies, Pennine Care said:

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“These shocking statistics debunk any myths that self-harm is an issue only for young people. We know that recovery statistics are positive for older people. Poor mental wellbeing is not an inevitable part of ageing and this campaign is integral in raising societal awareness of this and encouraging older people to seek help and not ‘brush it under the carpet’.”

Gillian Stainthorpe, Greater Manchester Older Peoples Network Steering Group Member said: “This new campaign is really important because it is helping to break the taboo around older people’s mental wellbeing and encouraging them to seek support. The campaign’s strength has been the involvement of older people working on equal terms with professionals from the very beginning. Their voices have been crucial in shaping the direction of the campaign and raising awareness of self-harm and older people.”

 

Accessing support

• Talk to someone Tell a friend, family member or someone you trust how you are feeling.
• Speak to your GP Your GP can arrange for you to receive support from the right services. If you need support out of hours call NHS 111
• Text Shout If you prefer to talk to someone over text message, Shout offer confidential support 24/7. Text: SHOUT to 85258
• Join an online community Join Mind’s online community Side by Side, it’s an online space where you can listen, share and be heard. Visit sidebyside.mind.org.uk
• Call the Samaritans on 116 123 Whatever you are going through, a Samaritan will face it with you. They are there 24 hours a day, 365 days a year.

You can find out more about the campaign and the support available to residents on the campaign webpage: Older People | Shining a Light on Suicide

If you would like to help support in promoting this campaign, please get in touch by emailing Suziee.cassels@greatermanchester-ca.gov.uk to receive a Campaign Toolkit.

NIHR Manchester Clinical Research Facility (MCRF) has received a £15.5 million award, further enabling it to provide opportunities for people of all ages and backgrounds across Greater Manchester to take part in research.

Nationally, the NIHR has announced nearly £161 million to fund 28 NIHR Clinical Research Facilities (CRFs), expanding the delivery of early phase clinical research in NHS hospitals across England.

NIHR CRFs are a key part of the UK’s leading early stage clinical research infrastructure and play an important role in making the country a global hub for life sciences.

They support the delivery of early translational and experimental medicine research, from studies testing new treatments in patients for the very first time (first-in-human trials) through to early safety and efficacy trials (Phase IIa trials). They provide dedicated purpose-built facilities and expertise for the delivery of high-intensity studies funded by the NIHR, the life sciences industry and other organisations.

A total of 28 NIHR CRFs have been awarded funding in this latest round – five more than previously. These CRFs, which will run from 2022 to 2027, will play a key role in realising the ambition in the vision for the future of UK clinical research delivery to bolster the delivery of innovative trials across all phases, all treatment types and all conditions.

NIHR Manchester (MCRF) was founded in 2017 and is hosted by Manchester University NHS Foundation Trust (MFT). This new funding award – A 24 per cent uplift on 2017-2022 – will allow MCRF to further grow its experimental medicine provision across Greater Manchester during the next five years, along with partners at The Christie NHS Foundation Trust and Northern Care Alliance NHS Foundation Trust.

Professor Smith said:

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“We are absolutely delighted to receive this funding award – which includes a £3 million uplift – and is testament to the world-class staff and facilities we have within NIHR Manchester CRF.

“We now look forward to offering opportunities to take part in early phase clinical research to a broader range of our diverse communities across our region, as part of our aim to reduce health inequalities.

“I would like to extend my thanks to the NIHR and everyone involved in our MCRF funding bid.”

 

Professor Lucy Chappell, Chief Executive of the NIHR and Chief Scientific Adviser to the Department of Health and Social Care, said:

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“NIHR’s CRFs scheme has been a key force in translational research across England, helping to position the nation as internationally competitive in early stage clinical research.

“This new funding, a 43 per cent increase, will allow the CRFs to continue to drive forward innovation in experimental medicine and support translation of exciting discoveries into new treatments for patients.”

 

Two year after leaving the NHS following a high-profile case involving The Christie Hospital Trust, medical oncologist and leading breast cancer expert Professor Andrew Wardley is setting out to transform cancer care through strategic site management services and clinical healthcare consultancy. The Manchester Breast Centre Co-Founder today heads up the Outreach Research & Innovation Group; a national oncology centre that works alongside the NHS to enable, support, and facilitate innovations and improve access to vital cancer care. 

Professor Wardley has spent 25 years working in cancer services, and since 2001 has been dedicated to leading improvements in breast cancer treatments through partnerships with NICE and the NHS England chemotherapy clinical commissioning group. However, having noticed inequalities in cancer care and witnessing barriers to accessing advanced treatments, Professor Wardley formed Outreach Research & Innovation Group to work more closely with communities and tackle these challenges. 

Outreach Research & Innovation Group is striving to support oncology teams nationwide to deliver more anti-cancer therapy trials to registration standard in the original spirit of the NHS. The aim is to improve cancer awareness, open up trials to more communities, lowering cancer mortality rates in the UK while improving access to treatments closer to home. 

Professor Andrew Wardley says

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“It’s no secret that cancer care in the UK is in a state of crisis. Evidence shows that we have a similar rate of cancer diagnosis as other European countries, yet a notably higher mortality rate. We are lagging behind, and it is clear that more needs to be done”.

“I am excited to be heading up Outreach Research & Innovation Group, which is rapidly being recognised as the go to organisation for driving the required improvements in cancer care. Following a disruption to the improvement of equitable access to cancer treatments due to the situation with The Christie Foundation Hospital, I am absolutely delighted to be able to continue my efforts into further developing community care services and doing my part to ease the burden on cancer patients and staff treating them”  

 

While Professor Wardley’s efforts were delayed following the NHSI review into The Christie Hospital, the former NCRI Breast Research Group Chair is once again making huge strides towards improving cancer treatment access diverse groups and patients. The overall aim of Outreach Research & Innovation Group is to tackle the health inequalities that exist across the North West in accessing cancer treatments, supporting the NHS to deliver improved cancer services through the integrated care systems while leading the way in oncology innovation.

To find out more about the Outreach Research & Innovation Group, visit http://www.outreach-research-innovation.com or follow them on social media. 

An Out of Hospital Care Model is being piloted as part of the wider Salford Dual Diagnosis Homeless Team (SDDHT) at Greater Manchester Mental Health NHS Foundation Trust. SDDHT is a partnership team that has close working relationships with the Inclusion Health GP Service. The new model aims to support patients and service users coming out of hospital who are at risk of homelessness.

A full time Dual Diagnosis Practitioner working in partnership with a Housing Officer, based full time on an acute ward allows for joint working and a more holistic approach to discharge from hospital. Since the launch of the pilot in June 2021, five individuals have already benefited from the new pathway.

Emma Dallyn, Dual Diagnosis Practitioner from the Salford Dual Diagnosis Homeless Team said:

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“We are aware that for people experiencing homelessness it can be a real struggle to access healthcare, unlike the general population, so health outcomes are often very poor. We are hoping that this pilot will mean fewer repeat admissions to Salford Royal Hospital and generally improved health outcomes for this extremely vulnerable group of individuals.”

“I started in post at the end of 2021 and in this time, through working closely with the wards at Salford Royal Hospital, we have successfully identified and housed one rough sleeper into out of hospital accommodation in Eccles who is continuing to do well with our support in his new accommodation.”

“My role is to help ensure that homeless people coming through Salford Royal Hospital are getting all their care needs met. This includes getting the right support for substance misuse, mental health and social care, as well as their physical health care needs.”

 

One patient who received help through the model said:

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“After two years of being homeless, sleeping on the streets, I got fobbed off so many times trying to get help, I was ready to give up. The help I have received from Emma and her colleagues has been brilliant. From going into hospital to coming out I have felt so well supported, I can’t thank them enough for all the help they have given me. So many people could benefit from this type of service.”

A housing worker colleague said:

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“Having Emma as a point of contact from the hospital has been amazing and makes things so much easier for me to get access to help for my clients if needed.”

The pilot draws on already established partner relationships to set up discharge pathways for homeless people at Salford Royal Hospital. The pathways will create a smoother transition to the community after discharge from hospital and prevent readmissions to A&E. Along with Salford Primary Care Together, the Out of Hospital Care Model hopes to improve health and social care outcomes in the community.

The work is part of a wider national research project and builds on partnerships formed from the GM Housing programme and the established Dual Diagnosis Team.

New research from World Cancer Research Fund (WCRF) reveals that 97% of Brits already own the foods that could help to prevent cancer

• Brits who spend the least on their weekly food shop own the most cancer preventative staple foods
• Nation’s favourite staples revealed as tinned tuna and pasta
• Nation’s least favourite voted as dried pulses, seeds and tinned carrots

This Cancer Prevention Action Week (21^st – 27^th February) World Cancer Research Fund, the leading authority on cancer prevention, is urging people to look in the back of their cupboards and make heroes of their forgotten basics.

While 40% of cancers could be prevented by lifestyle changes including diet, only 10% of Brits realise this, and 7% of people think that no cancers can be prevented.*

However, you don’t need to eat goji berries or other ‘superfoods’ every day to help prevent cancer. The basic foods that often languish in our cupboards can hold the key to improving our health. Even better, most of us already own them.

Respondents were asked to select from a long list of common, nutrient rich staple foods including tinned tomatoes, rice and pulses, that all aligned with one of the charity’s key cancer prevention recommendations: ‘Eat a better diet’. 97% of people owned at least one of these items.

The nation’s most loved staples were revealed as tinned tuna and pasta (both 27%), while the nation’s least loved foods included dried pulses (4%), seeds and tinned carrots (both 6%).

To help people make the most of these ingredients, the charity has developed a Cupboard Heroes recipe generator where people can type in their cupboard (or fridge, or freezer) basics and discover an array of delicious and healthy recipes that can also help reduce the risk of cancer.

Interestingly, the research shows that the majority (42%) of people spend £20-30 per person on their weekly shop. And it’s those who spend under £30pp who were shown to own the most cancer preventative foods, proving that eating a healthy diet doesn’t have to break the bank.

Bestselling author, chef and ambassador for Cancer Prevention Action Week 2022, Phil Vickery, said,

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“I’m thrilled to be partnered with World Cancer Research Fund to raise awareness of these important findings. Eating fuss-free staple foods has so many benefits, particularly in the current context. It’s never too late to change your diet and improve your health and you really can make showstopper meals which are full of flavour using unexpected ingredients.”

Rachael Gormley, CEO of World Cancer Research Fund said,

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“We have seen the power of prevention first-hand. Healthy eating can often feel unattainable, but our evidence shows we don’t need to rely on heavily marketed, expensive ‘superfoods’. Whilst canned, dried and frozen items often get a bad rap, the good news is they are also packed full of vital nutrients and can help to reduce your risk of cancer. This Cancer Prevention Action Week, we want to provide people with the tools and information that can help them reduce their cancer risk. Our latest research shows that people already have the right ingredients they just need some inspiration to turn them into delicious dishes.”

World Cancer Research Fund’s recipe generator enables people to input up to two basic ingredients and discover an array of nutritious meal ideas at the click of a button. Recipes include lentil & tuna salad - mixing the nation’s least favourite store cupboard staple with one of its favourites, vegetable pasta bake - a simple and budget conscious option from the charity’s Family Flavours cookbook, and a chickpea & bean casserole. For all recipes fresh ingredients can also be swapped for tinned.

Find out more at www.wcrf-uk.org/cpaw and watch the campaign video here.

1.19m women aged 45 and over were screened for breast cancer in 2020-21, a 44.1% decrease on 2019-20 (2.12m) 1.

For women aged 50 to 70, the number of women screened decreased by 39.1%, from 1.84m in 2019-20 to 1.12m in 2020-212.

The Breast Screening Programme, England, 2020-21 provides information on the coverage, screening activity, number and uptake of invitations, as well as the outcome of screening and the rate of cancer detection of the NHS Breast Screening Programme3.

Coverage

Coverage4, which is measured for women aged 53-70, dropped around ten percentage points to 64.2% at 31 March 2021, from 74.2% at 31 March 2020.

Coverage figures are based on the proportion of the eligible population screened within the last three years.

Therefore, coverage is affected by population fluctuations and screening activity over a three-year period - so changes in coverage may not directly mirror changes in the number of invites or screens in a given year.

Uptake

Uptake5 of routine invitations for women aged 50 to 70 was 61.8% in 2020-21 (1.08m6 women attended from 1.75m invitations), down from 69.1% in 2019-20 (1.79m women attended from 2.60m invitations).

The report shows that uptake was highest in the East Midlands and South East regions at 65.0% and lowest in London at 54.1%7.

Outcomes

In 2020-21, 47,198 women aged 45 and over were referred for assessment following screening. The total proportion of women aged 45 and over that were referred for assessment8 rose from 3.6% in 2019-20 to 4.0% in 2020-21.

Cancer detection

Overall, the number of women aged 45 and over with cancers detected decreased from 17,771 in 2019-20 to 10,813 in 2020-21, a decrease of 39.2%. 

There was, however, an increase in the rate of cancers detected, from 8.4 cases per 1,000 women screened in 2019-20 to 9.1 cases per 1,000 women screened in 2020-21.

This pattern remains consistent in the core cohort of women aged 50-70.  While the number of women screened fell, there was an increase in rate of cancers detected from 8.0 cases per 1,000 women screened in 2019-20, to 8.9 cases per 1,000 women screened in 2020-21. 

Under the NHS Breast Screening Programme, eligible9 women will usually receive their first routine invitation for breast cancer screening between the ages of 50 and 53 and will normally be invited every three years until they are 70.

Two thirds of people are diagnosed with ovarian cancer too late when the cancer has already spread. This Ovarian Cancer Awareness Month, campaigner's are saying enough is enough. 

Women are being failed as the awareness crisis in ovarian cancer deepens. Symptoms of ovarian cancer are being ignored – both by those experiencing them and their GPs.

In 2010 the TV Presenters mother, the actress Marjie Lawrence, was diagnosed with ovarian cancer just three weeks before she died. Had her family and her doctors been aware of the symptoms, Marjie might be alive today. If diagnosed at the earliest stage, 9 in 10 women will survive. But two thirds of women are diagnosed late, when the cancer is harder to treat

This March, for Ovarian Cancer Awareness Month, Target Ovarian Cancer is urging the public to sign open letters to governments across the UK and tell them what is needed to combat the crisis. As a nation we desperately need to make progress in people's knowledge of the symptoms. 

There is an awareness crisis in ovarian cancer. With no viable screening tool, it is vital that everyone is aware of the symptoms if more are to be diagnosed early. Ovarian cancer is much more treatable when it is caught early. But right now, two thirds are diagnosed late.

New data from Target Ovarian Cancer has highlighted the severity of the situation in England. Only 21 per cent of women are able to name bloating as a symptom, 32 per cent abdominal pain, 2 per cent feeling full and just 1 percent urinary urgency. There is also confusion around cervical screening, with 40 per cent of women in England wrongly believing that a cervical screening test detects ovarian cancer. 

NHS England’s inclusion of abdominal symptoms in the ‘Help Us Help You’ campaign is a positive step. But much more needs to be done to tackle this crisis.  

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"We need to see the current diagnostic pathway for ovarian cancer shortened. Ovarian cancer is diagnosed with a CA125 blood test and an ultrasound, however these tests are carried out separately leading to a longer wait time for diagnosis."  

Enough is enough – urgent action is needed, now. We the undersigned call on the government to: 

Ensure continued and sustained investment in awareness campaigns. 

Shorten the diagnostic pathway, with a CA125 blood test and ultrasound carried out at the same time.  

To sign the open letter please follow this link: Sign our open letter to UK governments (targetovariancancer.org.uk)

Baxter Healthcare Ltd announced the opening of the residential education training centre in Swinton back in 2018, it has since been slammed as inadequate and now placed in special measures by watchdogs following a catalogue of failures involving the safety of patients.

The facility taught people from around Greater Manchester suffering with kidney failure, how to manage their health at home.

The report said:

Due to the issues found, the service was issued two warning notices relating to the safe care and treatment of patients and the governance of the service. These require the service to make immediate improvements.

Following an inspection carried out in December 2021, the Care Quality Commission (CQC) has rated Baxter Education Centre Northwest, inadequate overall and placed it in special measures, after finding significant issues regarding patient safety.

Following this inspection, CQC rated the service inadequate overall, as well as for being safe and well-led. It is rated requires improvement for being effective and responsive, and good for being caring.

The service is run by Baxter Healthcare Limited and is a residential training facility where staff teach NHS patients how to manage their own peritoneal dialysis, which is a treatment for kidney failure.

Karen Knapton, CQC’s head of hospital inspection, said:

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“When we inspected Baxter Education Centre Northwest, we had serious concerns about patients not receiving the safe care and treatment they should be able to expect. The governance of the service concerned us; leaders didn’t always have the skills and abilities to run the organisation well. Also, there was a lack of effective systems and processes in place to identify and mitigate risks to people using the service.

“We were not assured that incidents were being reported or that internal investigations were being carried out to identify areas for learning. Leaders need to ensure staff learn from incidents to prevent them from happening again. Additionally, the service wasn’t gaining people’s consent for treatment and complaints processes weren’t adequate and must be improved.

“The service didn’t always use systems and processes to safely record and store medicines and it was concerning that dialysis fluid wasn’t always stored at the right temperature, which could have an impact on its effectiveness.

“People with specialist nutrition and hydration needs were not monitored by staff which could put them at serious risk. In addition, people’s allergies, dietary requirements, next of kin and their resuscitation status details weren’t always recorded which could also put them at risk. Staff didn’t have the required level of safeguarding training and the service’s safeguarding policy wasn’t fit for purpose. This meant staff might not be able to recognise, and report patients if they are at risk of abuse.

“However, staff told us they felt supported, and we saw they were discreet and responsive when caring for patients. The service had picture guides available for patients who could not read, or whose first language was not English, and staff took time to interact with people and those close to them in a respectful and considerate way.

“Due to significant concerns found, we issued two warning notices to Baxter Education Centre Northwest to make sure immediate improvements are made to ensure patients are safe. We will continue to monitor the service closely and will return to check on progress.”

 

Inspectors found:

Leaders did not always have the skills and abilities to run the service well

Leaders did not operate effective governance systems and processes to identify, assess and mitigate risks to the health, safety and welfare of people

Safety was not given sufficient priority, making people who used the service at risk of potential harm and the service did not always meet people’s needs

Managers did not monitor the effectiveness of the service and make sure staff were competent

The service did not have robust systems in place to assess the risk of, prevent, detect and control the spread of infections

The service must ensure care and treatment is provided with the consent of the relevant person.

However:

Staff worked well together for the benefit of patients

Staff treated patients with compassion and kindness and respected their privacy and dignity

People did not have to wait too long for treatment.

Image: Stock