NHS "in perpetual winter of Narnia" as waiting list reaches record 3.9m

The NHS is missing so many of its key performance targets that it has entered “the perpetual winter of Narnia”, a medical leader has said, after figures revealed the highest ever number of patients on waiting lists.

Claire Marx, president of the Royal College of Surgeons, criticised the NHS’s failure to give patients planned care in hospital within the required 18 weeks, such as surgery for cataract removals, hernia repairs and hip and knee replacements.

The number of people in England who are awaiting such treatments has climbed to almost 3.9 million.

Hospitals are meant to treat 92% of patients on the “referral-to-treatment” (RTT) waiting list within 18 weeks, according to guarantees in the NHS constitution. However, they did so in just 91.3% of cases in July, NHS-wide performance data released on Thursday shows. It was the service’s worst RTT performance in more than five years.

Hospitals met the 92% target in nine categories of RTT patients, including those requiring treatment for eye problems (92.7%), cardiac care (92.7%) and gynaecological problems (92.3%). However, it missed the target in 10 other categories. It treated barely four of of five (81.7%) of all those awaiting neurosurgery within 18 weeks, 86.9% of those needing plastic surgery and 88.9% of trauma and orthopaedic patients.

“It feels as if the NHS has stepped through the wardrobe and into the perpetual winter of Narnia,” Marx said. “We cannot forget that behind these statistics are potentially very ill and anxious patients who are being made to wait far too long for treatment. This is the true impact of the serious financial pressure we’ve seen the NHS come under in recent months.”

The NHS also missed targets covering A&E, ambulance response times, diagnostic tests, two forms of cancer treatment and rapid first treatment for those experiencing psychosis for the first time.

Dr Mark Holland, president of the Society for Acute Medicine, said: “This data reflects a system which is close to breaking down.”

Bed blocking has reached record levels. In July a total of 184,188 bed days were lost to delayed discharges – when patients are fit to leave but social care support is not in place – up sharply from 147,376 in the same month last year, and the highest number since records began in August 2010.

At midnight on the last Thursday in July, 6,364 patients who were fit to leave were still in their beds, up from the previous record of 6,105 patients the month before.

“For every 100 people who come to A&E, around 30 are admitted and, of these, 20 come under acute medicine. That number is increasing and our front-of-house workforce is depleted”, Holland said.

“However, performance is most significantly hampered due to our inability to discharge people at the backdoor of our hospitals. Failure to get people home is, in my view, a national emergency.”

Medical leaders want ministers to urgently pledge more money for the NHS to tackle its growing problems.

Marx said: “The forthcoming autumn statement offers an opportunity for the government to provide more money for the NHS and social care, and to agree to a cross-party commission to review how we can make the NHS sustainable for the long-term. Without a serious look at what the NHS needs in funding, we will remain in a state of constant winter.”

NHS England said that despite missing so many targets, its performance was still very good by international standards.

“As the NHS responds to ever increasing care needs, hospitals are continuing to look after more than nine out of 10 A&E patients within four hours, and more than nine in 10 patients are waiting less than 18 weeks for their routine operations,” said Matthew Swindells, its national director of operations and information.

“While this is probably the best performance of any western nation, these figures underline the pressures facing the NHS, and the obvious risks to patient care posed by weeks of further drawn-out industrial action.”

NHS "in perpetual winter of Narnia" as waiting list reaches record 3.9m

FDA Once Again Reaches Conclusions At Odds With Its Personal Staff

As soon as again the FDA has reached a conclusion that is straight opposed by some of its very own scientists.  Last month the FDA affirmed the security of olmesartan, a well-liked blood pressure decreasing drug (sold as Benicar and other names). But that reassuring see is not shared by the  FDA scientists who performed the examine that provided the basis for the evaluation. And now outside authorities are also raising concerns about the drug.

Back in 2010 the FDA explained that it was initiating a security review of olmesartan due to troubling findings from 2 clinical trials that raised the chance that patients with kind 2 diabetes taking olmesartan might have an improved danger of cardiovascular death. Four many years later the FDA announced  that it had completed that review. The FDA said that it had “found no clear evidence of increased cardiovascular hazards associated” with olmesartan in diabetic sufferers. The FDA stated that it would not adjust the suggestions for the use of olmesartan but it would consist of new information about the drug in the drug’s label.

The FDA announcement was somewhat perplexing, nevertheless, as I reported last month. The FDA said that despite the fact that it did not locate clear proof of enhanced cardiovascular danger it also did not locate clear proof of security. There was only one research examined by the FDA that  focused on the “subgroup of interest, i.e., diabetic individuals taking high-dose olmesartan,” and it did not supply any reassurance.

Here is the FDA’s description of the review:

A massive (a lot more than 300,000 patient-many years) observational research of Medicare individuals 65 years and older examined the rate of death in patients taking olmesartan in contrast to other ARBs. In a picked group of diabetic patients―patients who obtained only the highest dose of olmesartan (forty mg day-to-day) for longer than 6 months―olmesartan was linked with an enhanced chance of death (HR two., 95% confidence interval: one.one to 3.8) compared to related patients taking other angiotensin receptor blockers. In contrast, the identical examination in non-diabetic patients located that higher-dose olmesartan was associated with a decreased threat of death (HR .46, 95% self-assurance interval: .24 to .86) compared to equivalent sufferers taking other ARBs. The conflicting benefits in diabetics and non-diabetics are tough to reconcile and increase uncertainty about the credibility of the findings in both group. Furthermore, no variations have been identified between the groups getting lower doses of olmesartan and groups acquiring other angiotensin blockers or in those acquiring treatment for less than 6 months.

And right here is the FDA’s conclusion about the examine:

The final results appear to support the finding in ROADMAP however, there are worries regarding the credibility of the outcomes of the Medicare review simply because of the discrepant findings in diabetics and non-diabetics. The observation of a large decrease in survival in individuals with diabetes taking high doses of olmesartan, coupled with a large boost in survival in non-diabetic individuals taking olmesartan—all relative to other drugs of the exact same class—is not a plausible finding.

In my authentic story I offered the following comment:

This FDA communication is very odd, in my view. It does not sound like there is significantly strong evidence either way in this situation. But it looks to me that if the FDA will take 4 years to conduct a security evaluation, and if the only relevant evidence it analyzes appears to assistance the earlier worries, then it shouldn’t just conclude the safety review. If something the safety concern has enhanced, not decreased.

Then last week I obtained a message from a leading hypertension skilled about the published paper of the Medicare review cited by the FDA. He wrote: “The curious factor is that five of the review authors  are personnel of the FDA however the FDA did not accept the conclusion of the study authors suggesting that olmesartan, specifically at substantial doses, need to not be utilised in diabetics.”

Certainly, the conclusion of the paper is strikingly diverse from the FDA communication. At the end of their paper the authors compose:

In conclusion, use of high-dose olmesartan for six months or longer in patients with diabetes was connected with a twofold boost in mortality risk. This supports the mortality discovering from the ROADMAP trial and suggests that olmesartan, specially at higher doses, need to not be utilised in patients with diabetes.

It must be mentioned that this is not the very first time the 1st writer of the paper, David Graham, has publicly opposed FDA positions. He played a prominent position in the Vioxx and Avandia affairs in the previous. Despite the fact that he is occasionally imagined to be a bit of a maverick, in this situation Graham’s position appears to be strengthened by the presence of four co-authors who are FDA scientists.

I asked Sanjay Kaul, a cardiologist and regular FDA advisor, for his point of view. Though he does not dispute the FDA’s decision, his place can not be regarded as an endorsement of olmesartan:

I agree with the FDA’s position that the evidence of harm, while suggestive, is not conclusive adequate to be ‘actionable’. In this kind of conditions, the FDA generally informs the public about the findings. Nevertheless, the FDA’s tone could be interpreted to come across as somewhat reassuring which is not justified by the published report. Offered the uncertainty in proof and other treatment alternatives obtainable, a prudent program of action, in my viewpoint, is being quite selective in prescribing this drug.

Hypertension experts Franz Messerli and Sripal Bangalore also have been reluctant to endorse olmesartan:

The Medicare data does not deliver any clarity about the situation. In fact, figure 2 of the Medicare information would also propose that irbesartan and losartan in individuals without diabetes are killing men and women when compared with olmesartan. The FDA states that this safety review supposedly was prompted by the benefits of the ROADMAP trial. Nonetheless, none of these analyses addresses the query regardless of whether the increased mortality in ROADMAP was possibly a reflection of the J-curve romantic relationship with BP BP. Provided that no pathophysiologic explanation of these findings has been put forward, the FDA obviously decided in dubio pro reo [when in doubt, for the accused], i.e. olmesartan stays protected. This seems surprising because normally the company reacts promptly every time there is even a remote question of harm. In view of the Medicare information the FDA’s verdict might turn out to be wishful thinking far more than anything.

FDA Once Again Reaches Conclusions At Odds With Its Personal Staff

Bucket-record teen reaches £2m for cancer charity

“Hi everyone, it’s Stephen here – still here and still fighting!!!” he wrote.

“Throughout the whole journey I’ve been realistic about my position and at my last post I genuinely thought I was a goner…. But hey, I’m still here!!

“Sunday morning my right lung collapsed: I had a full emergency team surrounding me and in all honesty was probably not too far from nearly leaving you all.

“I survived, but the following day I woke up and felt very weak – the worry was that whatever was left of my health would just continue to deteriorate.

“However, from that point on my recovery has been positive and quite unexpected.

“One doctor while seeing me even said how my medical notes and how I was actually doing didn’t quite seem to match up.

“The progress since has continued to be good but steady.

“I am still in a very vulnerable position.

“I am very limited in what I can do and am still permanently hooked up to oxygen.

“But I am in high spirits and blessed to have so much love and support around me.

“To get to see the million pound fund-raising target being reached was just phenomenal!”

Mr Sutton, from Burntwood, Staffordshire, added that he planned to take things day by day “but I am happy – and that’s the main thing!”

A host of celebrities have taken to Twitter to help the cause, posing for pictures with the hashtag thumbsupforstephen and holding signs urging the public to donate.

The teenager was diagnosed with what was initially bowel cancer, when he was 15.

Despite surgery, the aggressive cancer spread to different parts of his body and, after further treatment and operations, doctors concluded it was incurable.

Fighting the disease, Mr Sutton decided to set up a bucket-list of 46 things to do before he dies along with the fundraising campaign, setting an initial target of £10,000 before it was smashed by the huge number of public donations as publicity around his cause spread.

The campaign is also being backed by comedian Jason Manford, who said he had previously met the teenager at charity gigs.

Appearing on ITV’s Daybreak, Manford said he and others were inspired to get involved by the teenager’s positive attitude as he strove to make the best of his situation.

He said: “That’s what got their imaginations going really. It was that he just had such joy for life.

“He wasn’t bitter about leaving the party early, he was just happy that he was ever invited at all. He’s 19, which is no age at all.

“There’s so many things he’s not going to be able to do, but there’s something he said on his Facebook page and on his website – he said that life shouldn’t be measured in time, it should be measured in achievements you’ve accomplished and I thought ‘This guy’s 19′, and it really got to me.”

Mr Sutton set up his charity fund-raising website and blog on Facebook in January last year to keep people up to date with his progress.

On Tuesday he wrote that his condition had worsened, adding “unfortunately I haven’t got much time left”.

Thanking family, friends and fundraisers, he said: “That’s it from me. But life has been good. Very good.”

Siobhan Dunn, chief executive of the Teenage Cancer Trust, praised the inspiring teenager and ambassador for the charity.

She said: “I’ve had the privilege of meeting him and his positivity is always remembered by all that meet him or hear him speak.

“Stephen is making the biggest possible difference to Teenage Cancer Trust and the young people who need our help.”

Speaking previously, Mr Sutton said he disliked the term “dying from my cancer – I am living with my cancer, despite it being there”.

His bucket-list included things like hugging an elephant, crowd-surfing in a rubber dinghy, playing the drums at a Wembley cup final, getting a tattoo and appearing on BBC drama Doctors.

Manford tweeted a picture of himself visiting Mr Sutton in hospital yesterday.

He wrote on Twitter: “Amazing @-StephensStory is up & chatting after his brush with death. He’s so happy that we are close to £2million!”

To donate, visit www.justgiving.com/Stephen-Sutton-TCT

Bucket-record teen reaches £2m for cancer charity

Bucket-list teen reaches £2m for cancer charity

“Hi everyone, it’s Stephen here – still here and still fighting!!!” he wrote.

“Throughout the whole journey I’ve been realistic about my position and at my last post I genuinely thought I was a goner…. But hey, I’m still here!!

“Sunday morning my right lung collapsed: I had a full emergency team surrounding me and in all honesty was probably not too far from nearly leaving you all.

“I survived, but the following day I woke up and felt very weak – the worry was that whatever was left of my health would just continue to deteriorate.

“However, from that point on my recovery has been positive and quite unexpected.

“One doctor while seeing me even said how my medical notes and how I was actually doing didn’t quite seem to match up.

“The progress since has continued to be good but steady.

“I am still in a very vulnerable position.

“I am very limited in what I can do and am still permanently hooked up to oxygen.

“But I am in high spirits and blessed to have so much love and support around me.

“To get to see the million pound fund-raising target being reached was just phenomenal!”

Mr Sutton, from Burntwood, Staffordshire, added that he planned to take things day by day “but I am happy – and that’s the main thing!”

A host of celebrities have taken to Twitter to help the cause, posing for pictures with the hashtag thumbsupforstephen and holding signs urging the public to donate.

The teenager was diagnosed with what was initially bowel cancer, when he was 15.

Despite surgery, the aggressive cancer spread to different parts of his body and, after further treatment and operations, doctors concluded it was incurable.

Fighting the disease, Mr Sutton decided to set up a bucket-list of 46 things to do before he dies along with the fundraising campaign, setting an initial target of £10,000 before it was smashed by the huge number of public donations as publicity around his cause spread.

The campaign is also being backed by comedian Jason Manford, who said he had previously met the teenager at charity gigs.

Appearing on ITV’s Daybreak, Manford said he and others were inspired to get involved by the teenager’s positive attitude as he strove to make the best of his situation.

He said: “That’s what got their imaginations going really. It was that he just had such joy for life.

“He wasn’t bitter about leaving the party early, he was just happy that he was ever invited at all. He’s 19, which is no age at all.

“There’s so many things he’s not going to be able to do, but there’s something he said on his Facebook page and on his website – he said that life shouldn’t be measured in time, it should be measured in achievements you’ve accomplished and I thought ‘This guy’s 19′, and it really got to me.”

Mr Sutton set up his charity fund-raising website and blog on Facebook in January last year to keep people up to date with his progress.

On Tuesday he wrote that his condition had worsened, adding “unfortunately I haven’t got much time left”.

Thanking family, friends and fundraisers, he said: “That’s it from me. But life has been good. Very good.”

Siobhan Dunn, chief executive of the Teenage Cancer Trust, praised the inspiring teenager and ambassador for the charity.

She said: “I’ve had the privilege of meeting him and his positivity is always remembered by all that meet him or hear him speak.

“Stephen is making the biggest possible difference to Teenage Cancer Trust and the young people who need our help.”

Speaking previously, Mr Sutton said he disliked the term “dying from my cancer – I am living with my cancer, despite it being there”.

His bucket-list included things like hugging an elephant, crowd-surfing in a rubber dinghy, playing the drums at a Wembley cup final, getting a tattoo and appearing on BBC drama Doctors.

Manford tweeted a picture of himself visiting Mr Sutton in hospital yesterday.

He wrote on Twitter: “Amazing @-StephensStory is up & chatting after his brush with death. He’s so happy that we are close to £2million!”

To donate, visit www.justgiving.com/Stephen-Sutton-TCT

Bucket-list teen reaches £2m for cancer charity

Bucket-listing teen reaches £2m for cancer charity

“Hi everyone, it really is Stephen right here – still right here and nevertheless fighting!!!” he wrote.

“Throughout the total journey I have been sensible about my place and at my final post I genuinely believed I was a goner…. But hey, I’m still right here!!

“Sunday morning my right lung collapsed: I had a complete emergency team surrounding me and in all honesty was most likely not too far from almost leaving you all.

“I survived, but the following day I woke up and felt very weak – the be concerned was that whatever was left of my health would just carry on to deteriorate.

“Even so, from that point on my recovery has been constructive and really unexpected.

“One doctor while seeing me even said how my healthcare notes and how I was really performing didn’t really seem to match up.

“The progress given that has continued to be excellent but regular.

“I am still in a very vulnerable place.

“I am extremely limited in what I can do and am even now permanently hooked up to oxygen.

“But I am in higher spirits and blessed to have so significantly really like and help all around me.

“To get to see the million pound fund-raising target being reached was just phenomenal!”

Mr Sutton, from Burntwood, Staffordshire, added that he planned to get items day by day “but I am happy – and which is the primary point!”

A host of celebrities have taken to Twitter to help the cause, posing for photos with the hashtag thumbsupforstephen and holding indicators urging the public to donate.

The teenager was diagnosed with what was initially bowel cancer, when he was 15.

In spite of surgical procedure, the aggressive cancer spread to diverse parts of his physique and, following further remedy and operations, medical professionals concluded it was incurable.

Fighting the ailment, Mr Sutton made the decision to set up a bucket-checklist of 46 items to do before he dies along with the fundraising campaign, setting an original target of £10,000 just before it was smashed by the massive amount of public donations as publicity all around his lead to spread.

The campaign is also getting backed by comedian Jason Manford, who stated he had previously met the teenager at charity gigs.

Appearing on ITV’s Daybreak, Manford mentioned he and others had been inspired to get concerned by the teenager’s good attitude as he strove to make the ideal of his situation.

He said: “Which is what acquired their imaginations going truly. It was that he just had this kind of joy for existence.

“He was not bitter about leaving the get together early, he was just happy that he was ever invited at all. He’s 19, which is no age at all.

“There is so many things he’s not going to be in a position to do, but there’s something he explained on his Facebook web page and on his site – he said that daily life shouldn’t be measured in time, it must be measured in achievements you’ve achieved and I believed ‘This guy’s 19′, and it genuinely acquired to me.”

Mr Sutton set up his charity fund-raising internet site and website on Facebook in January final 12 months to hold folks up to date with his progress.

On Tuesday he wrote that his problem had worsened, adding “unfortunately I haven’t acquired significantly time left”.

Thanking loved ones, friends and fundraisers, he said: “That is it from me. But daily life has been very good. Quite good.”

Siobhan Dunn, chief executive of the Teenage Cancer Trust, praised the inspiring teenager and ambassador for the charity.

She stated: “I’ve had the privilege of meeting him and his positivity is usually remembered by all that meet him or hear him communicate.

“Stephen is producing the largest feasible big difference to Teenage Cancer Trust and the young people who require our support.”

Speaking previously, Mr Sutton explained he disliked the phrase “dying from my cancer – I am residing with my cancer, despite it being there”.

His bucket-record included factors like hugging an elephant, crowd-surfing in a rubber dinghy, playing the drums at a Wembley cup final, receiving a tattoo and appearing on BBC drama Doctors.

Manford tweeted a picture of himself going to Mr Sutton in hospital yesterday.

He wrote on Twitter: “Incredible @-StephensStory is up &amp chatting soon after his brush with death. He’s so pleased that we are near to £2million!”

To donate, go to www.justgiving.com/Stephen-Sutton-TCT

Bucket-listing teen reaches £2m for cancer charity

Terminally unwell teenager posts "final thumbs up" as he reaches £1m target

The teenager later tweeted from his hospital bed after he heard his campaign had reached £1million.

Mr Sutton, from Burntwood, Staffordshire, was diagnosed with bowel cancer at the age of 15 but this spread to other components of his physique.

He created a bucket-list of 46 issues he wished to do ahead of he died, setting up a charity fundraising website and a website on Facebook in January last 12 months to maintain individuals up to date with his progress.

His ‘bucket list’ incorporated hugging an animal larger than himself, which noticed him embrace an elephant at West Midlands Safari Park. He also played the drums in front of 90,000 individuals at last year’s at final year’s Bayern Munich v Borussia Dortmund Champions League ultimate at Wembley.

Mr Sutton set an original fund-raising target of £10,000 for the Teenage Cancer Believe in but as this was exceeded he set a new aim to increase £1 million, which he accomplished on Wednesday morning.

On Tuesday he was rushed to hospital and posted a “last thumbs up” picture on his Facebook web page.

He wrote: “I’ve carried out nicely to blag issues as effectively as I have up until now, but regrettably I consider this is just 1 hurdle also far.

“It’s a shame the finish has come so suddenly- there is so several people I have not got round to properly thank or say goodbye as well. Apologies for that.

He said that future messages would probably be posted from a family members member, and extra: “I will proceed fighting for as lengthy as I can, and whatever takes place subsequent I want you all to know I am at present in a good spot mentally and at ease with the scenario. “That’s it from me. But life has been very good. Extremely good.

“Thank you to my mum and the rest of my family for almost everything. Thank you to my close friends for getting wonderful.

“Thank you to my medical group for the hard work and energy they’ve continually they’ve place towards me. And thank you everyone else for sharing this superb journey with me.”

Mr Sutton’s story attracted the focus of celebrities which includes Jason Manford, John Bishop and Piers Morgan who publicised his fundraising efforts on Twitter.

The teenager achieved his target at eleven.13am on Wednesday and tweeted shortly afterwards: “But seriously… Wow. Just wow. Thank you all so significantly :)”

Comedian Jason Manford posted a screen-grab of a text from his dad which revealed his authentic response to the news had just been: “Awesome.”

A £10 donation by a individual identified only as Jilly tipped the figure past the £1 million mark with the message: “Seems like your wish will come correct, ideas are with you and your loved ones”.

The Teenage Cancer Trust tweeted: “BREAKING: you have completed it! £1 million! We really cannot thank you all enough!!”

To make a donation go to Justgiving.com/Stephen-sutton-TCT.

Terminally unwell teenager posts "final thumbs up" as he reaches £1m target

FGM petition calling on Michael Gove to act reaches 200,000 signatures

Fahma Mohamed, 17, who is major the campaign backed by the Guardian towards FGM. Photograph: Patrick Hoeschler

The campaign to persuade the training secretary, Michael Gove, to support finish female genital mutilation by telling headteachers in England to educate mothers and fathers and kids about the practice has gathered more than 200,000 signatures in eight days.

The Modify.org website says a petition on the situation, backed by the Guardian, is one particular of the quickest developing it has seen in Britain. Thirty-3 MPs have so far supported the campaign by way of an early-day movement in the Property of Commons. The Scottish government has already promised to create to heads.

Gove has agreed to meet the campaign leader, the 17-year-old student Fahma Mohamed, a Bristol teenager from a Muslim Somali loved ones, who would like the concern to be flagged up in schools just before this summer’s “cutting season”. Though many girls are currently being taken abroad to be lower, others are becoming mutilated in Britain, according to campaigners.

Teachers and former teachers are presently urging Gove to stick to suit. Heather Sidery Clarke, from Hastings, explained: “Apart from being such needless and primitively barbaric behaviour, genital mutilation is, in this day, a violent crime.

“I have witnessed the results of this assault on children, as they would return to school in the Uk soon after a ‘trip home’ throughout summer season break.

“The minor women had been transformed from currently being satisfied, confident individuals to sullen and uncomfortable with themselves … A kind of ‘shame’ overhanging them. Not conducive to learning and downright unhealthy.”

Kate, who described herself as a headteacher in London, wrote: “I truly feel genuinely strongly about supporting this campaign to keep girls safe. I am in the method of beginning that discussion with workers and households that I work with and agree that this requirements to be addressed and schools can be instrumental in this.”

FGM petition calling on Michael Gove to act reaches 200,000 signatures