- Imperial College London experts have recommended cost-cutting measures
- Report found 71 common, expensive procedures that bring little or no benefit
- Robotic surgery has 'little or no advantage' compared with keyhole operations
- 'No evidence' surgical masks – which cost £150,000 a year – prevent infections
- Comes after warning that hospitals are having to ration routine operations
- But patient group says patients who benefit from procedures would be denied
Published: 06:16 EST, 8 November 2017 | Updated: 06:36 EST, 8 November 2017
Surgical masks and robotic operations are a waste of NHS money and should be scrapped to help save the NHS £150million a year.
That's the view of Imperial College London experts who have carried out a review on cost-cutting measures the cash-strapped health service can make.
Researchers from the Department of Surgery and Cancer, found 71 commonly performed procedures or practices that are costly but make little or no difference to patients' safety.
It comes as the NHS's financial watchdog warned lives are being cut short because hospitals are having to ration routine operations.
It was reported yesterday that Jim Mackey, head of NHS Improvement, said the health service was 'juggling hand to mouth' and having to 'deprioritise' non-urgent surgery.
A team of university researchers
The team also advise that robotic surgery has 'little or no advantage' compared with traditional keyhole operations.
They recommend axing surgical masks to save the NHS £150,000 a year because there is 'no evidence' to show that they prevent infections.
Scrap hernias and other procedures
The study – published in the British Journal of Surgery – involved a review of 1,500 research papers into the benefits of procedures.
It also found hernia repair operations – costing the NHS £28 million a year – were being carried out for people with few symptoms who do not get much benefit from them.
Additionally, it suggested using CT scans to diagnose appendicitis could save the health service £4million.
The report said they had little benefit above and beyond the traditional blood tests and hands-on pressure checks by doctors.
The researchers found evidence that surgeons were overusing endoscopes, costing the NHS nearly £42 million a year.
They say the luminated, optical instruments are regularly used to check in the stomach, bowel or throat for evidence of cancer even when a diagnosis is improbable.
And stopping the use of enemas before colorectal surgery could reduce the annual budget by £100,000.
A further £72 million a year could be saved if doctors switched to a better method of gallstone removal called an index cholecystectomy, which is said to prevent complications and reduce hospital re-admissions.
IS THE NHS WASTING ITS OWN MONEY?
The NHS is struggling to meet the needs of the rising, ageing population on top of having to pay for more expensive new medicines and procedures.
Although the Government has recently injected more cash – an extra £8 billion was promised by 2020 – healthcare leaders say this wont be enough.
But the NHS has also been accused of wasting its money and figures only last week showed it was losing £1 billion to fraud.
A separate analysis last month showed hospitals' inefficient operating theatres were wasting £130 million a year.
The researchers said their findings highlighted 'significant' potential saving methods that had not previously been recognised.
Study author and surgeon Humza Malik wrote: 'An expected £30 billion funding gap is expected by 2020 in the NHS.
'This provides motivation to identify and reduce the use of healthcare interventions that deliver little benefit and which could be substituted with less costly alternatives without affecting safety, and quality of care.
'Stopping low-value services represents a significantly greater opportunity for efficiency savings than thought previously.'
Independent professional body The Royal College of Surgeons recognised the need for improved efficiency.
A spokesperson said: 'NHS finances are currently stretched to their absolute limits, so it is important that surgeons look carefully at how they can improve efficiency and scale back surgical interventions that deliver little benefit to patients.
'While the authors of this study have focused on general surgery, the principles could probably apply to every surgical specialty.'
Patient groups' concern
However a patients group said that while it too appreciated the pressures the NHS is under, it was concerned that cost-cutting recommendations would deny patients who genuinely benefit from these procedures.
Rachel Power, Chief Executive of the Patients Association, said: 'The NHS is currently in a phase of reducing what it offers as a consequence of underfunding by central government – while this paper is only an academic exercise so far, it is very possible that NHS England might find the idea of limiting "low value" surgery attractive.
'If it goes down that road, we would offer the same caution as we have for its current initiative on "low value" medicines: in principle this could be a sensible matter of "good housekeeping", but any changes must be undertaken with the full involvement of patients, and without accidentally limiting access to effective treatments that meet patients' needs.'
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Sydney seaplane crash: Exhaust fumes affected pilot, report confirms
The pilot of a seaplane that crashed into an Australian river, killing all on board, had been left confused and disorientated by leaking exhaust fumes, investigators have confirmed.
The Canadian pilot and five members of a British family died in the crash north of Sydney in December 2017.
All were found to have higher than normal levels of carbon monoxide in their blood, a final report has found.
It recommended the mandatory fitting of gas detectors in all such planes.
British businessman Richard Cousins, 58, died alongside his 48-year-old fiancée, magazine editor Emma Bowden, her 11-year-old daughter Heather and his sons, Edward, 23, and William, 25, and pilot Gareth Morgan, 44. Mr Cousins was the chief executive of catering giant Compass.
The family had been on a sightseeing flight in the de Havilland DHC-2 Beaver plane when it nose-dived into the Hawkesbury River at Jerusalem Bay, about 50km (30 miles) from the city centre.
The final report by the Australian Transport Safety Bureau (ATSB) confirmed the findings of an interim report published in 2020.
It said pre-existing cracks in the exhaust collector ring were believed to have released exhaust gas into the engine bay. Holes left by missing bolts in a firewall then allowed the fumes to enter the cabin.
“As a result, the pilot would have almost certainly experienced effects such as confusion, visual disturbance and disorientation,” the report said.
“Consequently, it was likely that this significantly degraded the pilot’s ability to safely operate the aircraft.”
The ATSB recommended the Civil Aviation Safety Authority consider mandating the fitting of carbon monoxide detectors in piston-engine aircraft that carry passengers.
It previously issued safety advisory notices to owners and operators of such aircraft that they install detectors “with an active warning” to pilots”. Operators and maintainers of planes were also advised to carry out detailed inspections of exhaust systems and firewalls.
Read from source: https://www.bbc.com/news/world-australia-55862128
Australia unlikely to fully reopen border in 2021, says top official
Australia is unlikely to fully open its borders in 2021 even if most of its population gets vaccinated this year as planned, says a senior health official.
The comments dampen hopes raised by airlines that travel to and from the country could resume as early as July.
Department of Health Secretary Brendan Murphy made the prediction after being asked about the coronavirus’ escalation in other nations.
Dr Murphy spearheaded Australia’s early action to close its borders last March.
“I think that we’ll go most of this year with still substantial border restrictions,” he told the Australian Broadcasting Corporation on Monday.
“Even if we have a lot of the population vaccinated, we don’t know whether that will prevent transmission of the virus,” he said, adding that he believed quarantine requirements for travellers would continue “for some time”.
Citizens, permanent residents and those with exemptions are allowed to enter Australia if they complete a 14-day hotel quarantine at their own expense.
Qantas – Australia’s national carrier – reopened bookings earlier this month, after saying it expected international travel to “begin to restart from July 2021.”
However, it added this depended on the Australian government’s deciding to reopen borders.
Australia’s tight restrictions
The country opened a travel bubble with neighbouring New Zealand late last year, but currently it only operates one-way with inbound flights to Australia.
Australia has also discussed the option of travel bubbles with other low-risk places such as Taiwan, Japan and Singapore.
A vaccination scheme is due to begin in Australia in late February. Local authorities have resisted calls to speed up the process, giving more time for regulatory approvals.
Australia has so far reported 909 deaths and about 22,000 cases, far fewer than many nations. It reported zero locally transmitted infections on Monday.
Experts have attributed much of Australia’s success to its swift border lockdown – which affected travellers from China as early as February – and a hotel quarantine system for people entering the country.
Local outbreaks have been caused by hotel quarantine breaches, including a second wave in Melbourne. The city’s residents endured a stringent four-month lockdown last year to successfully suppress the virus.
Other outbreaks – including one in Sydney which has infected about 200 people – prompted internal border closures between states, and other restrictions around Christmas time.
The state of Victoria said on Monday it would again allow entry to Sydney residents outside of designated “hotspots”, following a decline in cases.
While the measures have been praised, many have also criticised them for separating families across state borders and damaging businesses.
Dr Murphy said overall Australia’s virus response had been “pretty good” but he believed the nation could have introduced face masks earlier and improved its protections in aged care homes.
In recent days, Australia has granted entry to about 1,200 tennis players, staff and officials for the Australian Open. The contingent – which has recorded at least nine infections – is under quarantine.
Read from source: https://www.bbc.com/news/world-australia-55699581
Covid: Brisbane to enter three-day lockdown over single infection
The Australian city of Brisbane has begun a snap three-day lockdown after a cleaner in its hotel quarantine system became infected with coronavirus.
Health officials said the cleaner had the highly transmissible UK variant and they were afraid it could spread.
Brisbane has seen very few cases of the virus beyond quarantined travellers since Australia’s first wave last year.
It is the first known instance of this variant entering the Australian community outside of hotel quarantine.
The lockdown is for five populous council areas in Queensland’s state capital.
Premier Annastacia Palaszczuk announced the measure on Friday morning local time, about 16 hours after the woman tested positive.
Ms Palaszczuk said the lockdown aimed to halt the virus as rapidly as possible, adding: “Doing three days now could avoid doing 30 days in the future.”
“I think everybody in Queensland… knows what we are seeing in the UK and other places around the world is high rates of infection from this particular strain,” she said.
“And we do not want to see that happening here in our great state.”
Australia has reported 28,500 coronavirus infections and 909 deaths since the pandemic began. By contrast, the US, which is the hardest-hit country, has recorded more than 21 million infections while nearly 362,000 people have died of the disease.The lockdown will begin at 18:00 on Friday (08:00 GMT) in the Brisbane city, Logan and the Ipswich, Moreton and Redlands local government areas.
Residents will only be allowed to leave home for certain reasons, such as buying essential items and seeking medical care.
For the first time, residents in those areas will also be required to wear masks outside of their homes.
Australia has faced sporadic outbreaks over the past year, with the most severe one in Melbourne triggering a lockdown for almost four months.
A pre-Christmas outbreak in Sydney caused fresh alarm, but aggressive testing and contact-tracing has kept infection numbers low. The city recorded four local cases on Friday.
Prime Minister Scott Morrison’s government has pledged to start mass vaccinations in February instead of March as was planned.
Lockdown interrupts ‘near normal’ life in Brisbane
Simon Atkinson, BBC News in Brisbane
At 8:00 today I popped to the local supermarket for some bread, milk – and because it’s summer here – a mango. I was pretty much the only customer.
When I went past the same shop a couple of hours later it was a different story – 50 people standing in the drizzle – queuing to get inside as others emerged with bulging shopping bags. “Heaps busier than Christmas,” a cheery trolley attendant told me. “It’s off the scale”.
Despite the “don’t panic” messages from authorities, pictures on social media show it’s a pattern being repeated across the city.
While shutdowns are common around the world, the tough and sudden stay-at-home order for Brisbane has caught people on the hop here after months of near normality.
But while such a rapid, hard lockdown off the back of just a single case of Covid-19 will seem crazy in some parts of the world, I’ve not come across too many people complaining.
And I don’t think that’s just because Aussies love to follow a rule. This is the first time the UK variant of the virus has been detected in the community in Australia.
And nobody here wants Brisbane to go through what Melbourne suffered last year. Even if it means going without mangoes.
Read from source: https://www.bbc.com/news/world-australia-55582836
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