Evaluating a hospital-based youth violence intervention programme

Kings Fund – 25th January 2023

Knife crime and other offences among young people are not just an issue for the criminal justice system, they can also affect the health of young people and the health services they use. As part of the RSET project, John Appleby describes the findings of an evaluation of a youth violence intervention programme run by the charity Redthread in collaboration with clinicians at University College London Hospital.

More information – Evaluating a hospital-based youth violence intervention programme

NHS in England will have one strategy for all major conditions, including cancer

BMJ – 25th January 2023

The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing
numbers of people in England with complex and often multiple long term conditions.
Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia,
mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer
have its own dedicated 10 year strategy

Further information – NHS in England will have one strategy for all major conditions, including cancer

Government Action on Major Conditions and Diseases – Statement made on 24 January 2023 – UK Parliament

NHS leaders will welcome government’s recommitment to narrowing the gap in Healthy Life Expectancy by 2030

NHS Confederation – 24 January 2023

Responding to the government announcement on the Major Conditions Strategy, Dr Layla McCay director of policy at the NHS Confederation said:

“Health leaders stand ready to input to this strategy and will welcome the focus on integrated, whole-person care as well as the emphasis on health and care services and local government working together.

“NHS leaders will welcome the government’s recommitment to narrowing the gap in Healthy Life Expectancy by 2030 – our members are passionate about working to reduce health inequalities and many are already undertaking innovative work to do so with local communities on this across the country.

Further information – NHS leaders will welcome government’s recommitment to narrowing the gap in Healthy Life Expectancy by 2030

Government Action on Major Conditions and Diseases – Statement made on 24 January 2023

UK Poverty 2023: The essential guide to understanding poverty in the UK

JRF – 26th January 2023

UK Poverty 2023 sets out recent trends in poverty across the UK, how levels of poverty differ between groups of people and regions, and the impact it has on people’s lives. These findings can help us to understand the current situation and future prospects for poverty in the UK.

Read the Report – UK Poverty 2023: The essential guide to understanding poverty in the UK

More than 400 people set to benefit after NICE approves ground-breaking CAR-T therapy to treat aggressive form of blood cancer

NICE news – 26th January 2023

Hundreds of people with an aggressive form of lymphoma are set to benefit from the first personalised immunotherapy treatment to be recommended for routine use in the NHS.

Axicabtagene ciloleucel (Yescarta, Kite) is a CAR-T therapy for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL) who have had two or more lines of systemic therapy.

CAR-T – chimeric antigen receptor T-cell – therapy takes a patient’s own immune cells and modifies them so that they attach to and kill cancer cells. It is administered as a one-off intravenous infusion.

NICE has today (Thursday, 26 January) issued final draft guidance recommending the treatment be made routinely available on the NHS for suitable patients. It was previously available through the Cancer Drugs Fund and will commissioned routinely to patients in England after the NHS Commercial Medicines Directorate struck a confidential commercial deal with the company.

Further information – More than 400 people set to benefit after NICE approves ground-breaking CAR-T therapy to treat aggressive form of blood cancer

You can read the full draft guidance on axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after two or more systemic therapies on the NICE website.

Report – We can end cervical cancer: The opportunities and challenges to eliminating cervical cancer in the UK

JO’S CERVICAL CANCER TRUST – January 2023

The UK is taking steps towards reducing the impact of cervical cancer, but we’re calling for that to happen faster. Crucially, we’re urging that no-one is left behind. To eliminate cervical cancer in the UK we need strategies that recognise the importance of the entire cervical cancer prevention pathway and commit to improvements and innovation throughout.

We spoke with professionals working in and alongside cervical cancer prevention and treatment and found that only 17% think enough is currently being done to eliminate cervical cancer in the UK. Only 20% think enough is being done to ensure high levels of HPV vaccine uptake, and just 16% believe that enough is being done to support cervical screening uptake.

When asked about the biggest challenges to elimination, workforce pressures and inequalities in uptake of HPV vaccination and cervical screening came out on top. HPV self-sampling, which allows women to test for HPV in their own home, was considered the top opportunity. 

Our recommendations

We are calling for:

UK governments to commit to eliminating cervical cancer and develop strategies that are ambitious, forward looking, and evidenced.
Cervical cancer could be the first cancer in the world to be eliminated, but we should not be complacent, or assume this is inevitable. Data modelling must be at the heart of any strategy setting out realistic but ambitious targets. UK targets should reflect the current state of the programmes in the UK and be more ambitious than those set by the WHO.
Workforce planning, including as part of cancer and cancer workforce strategies, which recognises the needs of the different workforces across cervical cancer prevention.
Workforce planning must look to the needs of the programmes of the future and include the training and retention of staff. Changes to one part of the pathway should be made in conjunction with other areas where a knock-on effect may be felt. 
Everyone to have equal opportunity to reduce their risk of cervical cancer.
Identifying opportunities to increase access and reduce inequalities to the prevention programmes should be prioritised. We need research to better understand barriers, outreach to communities less likely to engage in screening and vaccination programmes, support to help attendance, and speed in developing an HPV self-sampling programme that could provide an opportunity to attend for those currently unable to access screening.
Research to close the gaps in understanding across the programmes.
We need more research and greater speed in adopting innovations. There are opportunities to improve programmes, such as moving to HPV primary screening in Northern Ireland, and developing AI and digital cytology technology, that the UK should take advantage of. Work is needed to reduce inequalities, with opportunities including HPV self-sampling. Research into non-HPV cervical cancers is crucial if we are ever to truly make this a disease of the past. 
Investment in technology.
The workforce should be operating on systems which are fit for purpose, provide a complete picture of patient history, facilitate greater targeting of interventions, and do not hold up progress. We need data to measure progress and inform action, and these data must be clearly and consistently recorded on up to date and accessible systems.
Increased public awareness.
Using a life course approach to information and education across the cervical cancer prevention programme, from vaccination to exiting screening. With accessible, patient-centred information at every step, everyone should be aware of their risk and understands what it means to take part.
Those with cancer to be included.
The development of any strategies and actions to eliminate cervical cancer must not side-line those living with and beyond diagnosis. There will always be cases that cannot, and have not, been prevented. When looking to eliminate cervical cancer, we should also be looking to reduce the impact for those affected. This means investment in better and less invasive treatments, greater provision of care for those affected by the side effects of cervical cancer, and more treatment options for those with advanced cervical cancer. The closer we get to elimination, the more important it is that the needs of this group are not overlooked.

Full Report – We can end cervical cancer

    Mental health first aid law proposed in parliament

    BBC / 25th January 2023

    A new law requiring businesses to offer mental health first aid training has been presented to parliament.

    Tory MP Dean Russell told the Commons the move will lead to more people spotting the early signs of mental health issues in the workplace.

    Many businesses already offer mental health training to first aiders, but it is not a legal requirement.

    Mr Russell told MPs that requiring mental health first aid training in the workplace would save lives.

    “People do not always wear bandages to show where they have anxiety and depression,” he told MPs.

    “This Bill will simply mean that workers have a person to signpost them to the help and support they need, when they need it.”

    The idea has been discussed for several years.

    In 2018, a petition for the “Where’s Your Head At!” campaign for a mandatory mental health first aider in every place of work attracted more than 200,000 signatures.

    The extra training would come at a cost to businesses, but campaigners highlight the growing number of workdays lost to poor mental health.

    The Health and Safety Executive estimates that mental illness accounted for around half of all cases of sick leave last year…

    Full text: Mental health first aid law proposed in parliament

    NHS in England will have one strategy for all major conditions, including cancer

    BMJ / 25th January 2023

    The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long term conditions.

    Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy….

    Full text by subscription: NHS in England will have one strategy for all major conditions, including cancer

    Tackling Adverse Childhood Experiences (ACEs)State of the Art and Options for Action

    WHO – 20th January 2023

    Reducing the on-going toxic impacts of Adverse Childhood Experiences (ACEs) across Europe is possible through prevention, building resilience, and engaging in trauma-informed practice, highlights a new report from Public Health Wales, in conjunction with the World Health Organization (WHO) Regional Office for Europe and Liverpool John Moores University. 

    Child abuse, exposure to domestic violence and other ACEs can leave people with health, social and economic problems throughout life. Across Europe, an estimated 319 million people have suffered at least one type of ACE, and 142 million have suffered multiple types of ACEs.  

    For the first time, this new report brings together evidence on ACEs across Europe and internationally, and highlights effective action to address their burden. 

    Full Report – Tackling Adverse Childhood Experiences (ACEs)State of the Art and Options for Action