NHS risking people"s health by rationing test strips, Diabetes UK says

The NHS is putting diabetic patients at risk of serious illness by rationing test strips that monitor blood glucose levelsin an attempt to save money, a charity claims. A survey carried out by Diabetes UK found that one in four complained of restrictions placed on the number of test strips they were prescribed by GP practices.

People with diabetes need to test their blood glucose regularly to monitor the condition. If not managed properly, diabetes can lead to health complications such as heart disease, strokes, blindness and amputations.

More than half of those professing problems had type 1 diabetes. Government guidance says this group should test themselves at least four times a day. Older people and those on low incomes were also affected, the charity found. Many said they felt they needed to buy test stripsonline, where quality cannot always be guaranteed.

People with diabetes were given a variety of reasons for the reduced number of strips prescribed, according to the charity. Some respondents to the survey said they had been told they should test less often. Some were told there were “budget constraints”, while others were told it was because they were testing too frequently.

“They said I had my allowance for the month,” said one respondent. Another said: “I was told they were expensive and we should test less. Only need to test four times a day. We use a pump, so need to test every two hours.”

Some said they were having to ask for repeat prescriptions more often. “I now need to order and collect a prescription monthly, or sooner, depending on any issues that crop up,” wrote one. Often when people complained to the practice, their normal prescription was reinstated. But Diabetes UK said they were concerned that people had to challenge the GP practice to get an essential piece of equipment.

Many clinical commissioning groups (CCGs), which have come under fire for rationing other NHS services, have guidance on how often people should test their blood glucose levels and how many boxes of strips should be issued each month. They have also urged GPs to switch patients to cheaper blood glucose meters and strips, sometimes against the patient’s wishes.

Diabetes UK said the rationing was a false economy because the cost of dealing with complications caused by poorly managed diabetes is far higher.

The findings came just weeks after Simon Stevens, the chief executive of NHS England, announced that the health service would stop prescribing some drugs and gluten-free foods to cut spiralling costs.

Diabetes UK’s policy manager, Nikki Joule, said: “These shortsighted cost savings cause people real anguish and potential financial distress. It also means people are struggling to manage their diabetes, which can lead to serious consequences for their health.”

Norman Lamb, the Liberal Democrats’ health spokesman, agreed. “This is more evidence of an insidious creeping retreat of the NHS without any public debate,” he said. “It makes no sense to undermine good preventive care in this way. More people will end up unnecessarily with their health deteriorating.”

It makes no sense to undermine good preventive care in this way

Norman Lamb, Lib Dem health spokesman

Testing strips are part of a kit used to check the condition. Diabetics prick their finger and put drops of blood on a strip, which then goes into a meter that measures blood glucose levels.

Dr Stephen Lawrence, clinical lead for diabetes for the Royal College of GPs, said: “£24m of the scarce NHS budget is spent on diabetes care every day, and it would be irresponsible not to make the most appropriate use of limited resources.”

He added that the need for strips varied between individuals and that doctors should sit down and discuss appropriate treatments with patients. “We urge NHS England to deliver on the pledges made in its GP Forward View for greater investment in general practice – including more GPs – so that we can give more time to all our patients, including those with diabetes,” Lawrence said.

The charity agreed that decisions on testing and access to strips should be made jointly between a patient and their GP. But their research suggested this did not always happen.

Colin Frampton, an 86-year-old pensioner with type 2 diabetes from Winchester, Hampshire, told Diabetes UK he was paying for test strips out of his pension after being restricted to 50 for the year – enough to test his blood glucose just once a week. He said: “If I didn’t challenge my GP, I’d still have to take money out of my pension to help me manage my condition.”

One pregnant woman, who is type 1 diabetic, saw her strips reduced from 300 to 50 a month, although the National Institute of Health and Clinical Excellence (Nice) guidelines suggest testing for pregnant women of 10 times a day or more.

The report also found that family doctors were overburdened and that receptionists and other surgery staff were increasingly preparing prescriptions. Some of these lacked the necessary understanding of diabetes. When a prescription was restricted, it was usually reinstated once challenged.

The charity said it was concerned that some people with type 2 diabetes who would have benefited from testing had been advised they did not need it, and called for a review of government guidance on this.

Professor Jonathan Valabhji, NHS England’s national clinical director for diabetes and obesity, said: “Ultimately, these are decisions for CCGs, but should be informed by best evidence and national guidance where appropriate. We need to ensure adequate provision and that clinicians take into account widely recognised Nice guidelines, which are clear about the need for test strips to support people in particular with type 1 diabetes.”

NHS risking people"s health by rationing test strips, Diabetes UK says

By ignoring sex education, ministers are risking children’s safety | Joan Smith

It’s a long time since Theresa May and most of her cabinet were at school. When she was doing her O-levels, no one was sexting and teenage boys weren’t goggling at violent porn on smartphones. I think it’s unlikely that the future prime minister had to wear shorts under her school skirt to protect herself from being groped, as some teenage girls have taken to doing. But that doesn’t mean May and her colleagues have any excuse for ignoring what’s going on in schools today, from sexual harassment to homophobic bullying.

They’ve been warned by MPs on the women and equalities committee, in an excoriating report that revealed the “shocking scale” of sexual harassment in schools. They’ve been told by the campaigning organisation Stonewall, which published a survey three years ago in which 86% of secondary teachers said they had encountered bullying of gay pupils. They follow the news, like the rest of us, and they must know about dreadful cases in which girls and boys have been tricked into meeting paedophiles who disguised themselves as teenagers online.

They have also been told by just about everyone that the best way to keep children safe is to insist that every school in the country teaches high-quality sex and relationships education (SRE) and the broader subject of personal, social, health and economic (PSHE) education – no ifs, no buts, and no exemptions for faith schools. Teachers’ or parents’ embarrassment is not a reason to deny children absolutely essential information about how to avoid sexual predators, online or in real life.

After the “grooming” scandals in Rotherham, Rochdale, Oxford and other cities, you might think this was a no-brainer. Yet ministers have done everything but stand on their heads to avoid it. Last week Conservatives in the House of Commons were accused of filibustering a bill sponsored by Green co-leader Caroline Lucas, calling for PSHE to be made compulsory in all state-funded schools, by making lengthy speeches about the bill that preceded it. A change in the law isn’t necessary, ministers have claimed, because Ofsted is checking that the subject is being covered and will pick up any inadequacies during inspections. Just over a year ago a Home Office minister, Lord Bates, said: “We expect sex and relationships education to be taught in all schools. In fact, it is inspected by Ofsted as such.” A similar point was made last year by Lady Evans, then a government whip and now leader of the House of Lords.

Presumably they had in mind Ofsted’s latest inspection framework, introduced in 2015, which made considering the effectiveness of PSHE “more crucial than ever” to the judgments made by inspectors. Now, though, that argument (like all previous ones) has been blown out of the water. It turns out that Ofsted is barely looking at SRE when it inspects schools, according to a detailed analysis by the British Humanist Association.

The headline finding, from a study of more than 2,000 primary and secondary school inspection reports for 2015-16, is that sexual health, safe sex and related subjects were almost entirely absent. Sexual harassment and sexual violence were not mentioned at all, while sexting appeared in just 17 reports, despite having been identified as an area of major concern by the government. Porn was mentioned in a single report, as was HIV/Aids, which appeared in relation to “emerging economies” in a geography lesson. Only one in seven reports referred to LGBT issues.

Back in 2013, Ofsted said that the provision of PSHE was “not yet good enough” in 40% of schools. It is hard to believe there has been a massive improvement in the meantime, yet fewer than 1% of the inspection reports examined by the BHA made any criticism of schools’ coverage of the subject. To be fair to Ofsted, it should never have been given the job of making up for the government’s failure in this area. If SRE isn’t compulsory, some schools will say they don’t want to divert scarce resources from other subjects or that they can’t find room in the timetable. Others will use it as an excuse to avoid topics, such as homosexuality and safe sex, that they find uncomfortable for religious or ideological reasons.

What all this means, in blunt terms, is that the government is coming up with one excuse after another to avoid doing one of its most basic jobs: protecting the next generation. We know girls are being sexually harassed at school, pressured into posing for photos that may be used to threaten or humiliate them, and suffering abuse from boyfriends whose expectations have been warped by online porn. We know that gay kids are being bullied, and children of both sexes are vulnerable to predatory sex offenders.

For several years now, senior police officers in London have been telling me that compulsory sex education is vital to keep children safe. A few months ago, I heard a senior civil servant talk about the staggering number of crimes against children that are being facilitated by the internet. This is not the cosy world May grew up in, when sex and reproduction were covered in biology lessons and mobile phones didn’t exist.

It is not even the world of 17 years ago, when the government published its outdated official guidance on SRE. Children are encountering sex at a much younger age than in earlier generations, but a head-in-the-sand government is refusing to make sure they are well-informed and safe.

By ignoring sex education, ministers are risking children’s safety | Joan Smith

Folks sleeping two hrs much less than in 1960s risking critical overall health problems

Prof Russell Foster, at the University of Oxford, told the BBC: “We are the supremely arrogant species we really feel we can abandon four billion years of evolution and ignore the fact that we have evolved beneath a light-dark cycle.

“What we do as a species, possibly uniquely, is override the clock. And long-term acting towards the clock can lead to critical well being difficulties.”

Modern day engineering is 1 of the most significant triggers of diminished sleep, proof suggests, due to the substantial ranges of light in the blue finish of the spectrum emitted by computer systems and tablets. This variety of light, which is also emitted by power productive light bulbs, is “correct in the sweet spot” for disrupting the entire body clock.

“Light is the most effective synchroniser of your inner biological clock,” Prof Charles Czeisler, from Harvard University, said.

“Light exposure, especially short wavelength blue-ish light in the evening, will reset our circadian rhythms to a later on hour, postponing the release of the rest-selling hormone melatonin and generating it more tough for us to get up in the morning.

“It really is a large concern that we’re currently being exposed to a lot more light, sleeping less and, as a consequence, may endure from numerous continual illnesses.”

Prof Andrew Loudon, from the University of Manchester, urged governments to get the issue a lot more critically.

He explained: “Governments need to take this critically, starting possibly with reviewing the wellness consequences of shift function, and society and legislators requirements to take this on board.”

Folks sleeping two hrs much less than in 1960s risking critical overall health problems