Published on 14th March 2019 by Maria Correa

a female nurse talks to a senior patient at an a&e clinic, medical news

Welcome to this week’s medical news round up! In our latest edition, we bring you the healthcare topics that have been under the microscope over the past week, just in time for your med school applications. 

Joining us this week: A&E targets, blood pressure medication and health in schools.

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A&E Targets

NHS England announce plans that signal an end to the four-hour A&E target.

This medical news makes headlines this week as the NHS reveals changes to targets for A&E, cancer, mental health and planned operations.

The current target for A&E expects 95% of patients to undergo assessment, treatment or admission within four hours.  This target, introduced in 2004, has not been met since July 2015. In February 2019, only two hospital trusts hit the target.

NHS plans now acknowledge this target is becoming outdated. The new targets aim for the prioritization of the sickest patients, including caring for those with heart attacks, acute asthma, sepsis and stroke within an hour.

This year acts as a pilot for the new plan, with the hope of official introduction of the target in 2020 if successful.

What can we learn from this?

NHS England has said that the current targets distort priorities, meaning hospitals have become motivated to hit targets rather than acting in patient’s best interests.

The current target does not distinguish between illnesses, meaning someone with a sore thumb is treated the same as someone who had a heart attack. Of course, in reality, A&E departments prioritize the sickest patients for care, but this is not made explicit in public records.  

The new target will put pressure on hospitals to see the sickest patients quickly, but it could mean a longer wait for patients with less critical needs.

Question to think about- What are the implications of setting targets for waiting times?

Read: NHS Hot Topics– Waiting Times

Blood Pressure Medication

Thousands of patients eligible for treatment after changes in blood pressure guidelines.  

One in four adults in England have high blood pressure, accounting for 10% of GP visits and contributing to 75,000 deaths every year, according to the latest statistics reported in the medical news. 

The current guidelines recommend that patients under 80 with a blood pressure of 140/90 mmHg or above, plus a 20% risk of cardiovascular disease over 10 years, are to be offered treatment.

The National Institute for Health and Clinical Excellence (NICE) have announced draft guidelines that recommend patients with a 10% risk should qualify for treatment.

The assessment of a person’s cardiovascular risk includes blood tests and lifestyle factors such as smoking, obesity, alcohol and age.

720,000 patients in total could be eligible for treatment under the new guidelines. Health bosses hope this would help decrease the number of heart attacks and strokes.

What can we learn from this?

The NHS long-term plan includes a commitment to earlier diagnosis of high blood pressure in a bid to save more lives from heart attacks and strokes.

The new NICE guidelines target this, pleasing those who believe blood pressure medication is required early on to achieve the greatest reduction in cardiovascular risk.

However, some GPs are concerned about over-diagnosis and the effectiveness of drugs, arguing lifestyle factors such as diet and exercise have an important role in blood pressure management too.

Question to think about- Describe your understanding of the pressure and demand on primary care services.

Read: NHS Hot Topics – Primary Care Pressures

Health in Schools

Schools begin to integrate health and education.

The story made the medical news this week after the announcement of the NHS 10-year plan, which focuses on prevention and equality.

The idea of integrated health centres (IHC) first appeared over 10 years ago, sparked by concerns about children’s life expectancy and health in Cornwall.

The IHCs are specialist health centres on school sites, allowing young people to access services such as contraception advice, mental health counselling, substance misuse support and much more.

Three schools received funding for health centres and have since been hugely successful. There has been a direct positive effect on attendance and a reduction in youth offenders. Students see the centre as a safe space and a first port of call.

As a result, the NHS has now committed to opening three more centres in Cornwall.

What can we learn from this?

The schools involved are currently isolated to Cornwall as IHCs help specific problems for the county, including accessibility to services and the presence of an ‘everyone-knows-everyone’ culture.

The difficulty of applying this scheme across the country is not just about money. Some schools may feel education should be separate from health services, or they may fear a loss of control.

Schemes like the IHCs could play a fantastic role in the NHS, beneficial to students, schools and the health services. However, schools were not a big feature of the 10-year-plan.

Question to think about- How can we improve services for young people?

Read: NHS Hot Topics – Mental Health

Words: Katie Burrell

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