New grip strength test could be used to identify patients at high risk of range of diseases

University of Glasgow | May 2018 | New grip strength test could be used to identify patients at high risk of range of diseases 

A new research study from  the University of Glasgow’ s Institute of Cardiovascular and Medical Sciences  has found that  high grip strength was linked to  a reduced risk of all causes of mortality. By contrast, a weak grip was associated with poorer health outcomes such as cardiovascular disease and cancer. The findings have now been published in the BMJ, where the paper can be read in full 


The full news item can be read at the University of Glasgow


Objective To investigate the association of grip strength with disease specific incidence and mortality and whether grip strength enhances the prediction ability of an established office based risk score.

Design Prospective population based study.

Setting UK Biobank.

Participants 502 293 participants (54% women) aged 40-69 years.

Main outcome measures All cause mortality as well as incidence of and mortality from cardiovascular disease, respiratory disease, chronic obstructive pulmonary disease, and cancer (all cancer, colorectal, lung, breast, and prostate).

Results Of the participants included in analyses, 13 322 (2.7%) died over a mean of 7.1 (range 5.3-9.9) years’ follow-up. In women and men, respectively, hazard ratios per 5 kg lower grip strength were higher (all at P less than 0.05) for all cause mortality  and cause specific mortality from cardiovascular disease, all respiratory disease, chronic obstructive pulmonary disease, all cancer, colorectal cancer, lung cancer, and breast cancer  but not prostate cancer. Several of these relations had higher hazard ratios in the younger age group. Muscle weakness (defined as grip strength less than 26 kg for men and less than 16 kg for women) was associated with a higher hazard for all health outcomes, except colon cancer in women and prostate cancer and lung cancer in both men and women. The addition of handgrip strength improved the prediction ability, based on C index change, of an office based risk score (age, sex, diabetes diagnosed, body mass index, systolic blood pressure, and smoking) for all cause and cardiovascular mortality and incidence of cardiovascular disease.

Conclusion Higher grip strength was associated with a range of health outcomes and improved prediction of an office based risk score. Further work on the use of grip strength in risk scores or risk screening is needed to establish its potential clinical utility.

Full reference: Celis-MoralesCarlos A. et al |Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants |BMJ 2018|361 |doi:

Prescribing indicators

A series of indicators to inform safer prescribing practice, helping pharmacists, clinicians and patients to review prescribed medication and prevent avoidable harm | Department of Health and Social Care

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The Department of Health and Social Care is introducing prescribing indicators to inform safer prescribing practice.  The experimental indicators link prescribing data from primary care with hospital admissions for the first time. The purpose is to identify prescribing that could potentially increase the risk of harm and that may be associated with hospital admission.  The first indicators focus on how different medicines may be contributing to people being admitted to hospital with gastro-intestinal bleeding. The programme will cover more medicines and associated conditions later in the year.

Additional link: DHSC news article

A new study looks at home treatment for children with Chronic Fatigue Syndrome (CFS)/ ME

NIHR | May 2018 | Worries that keep you awake at night

A new blog post on the NIHR blog, from  Professor Esther Crawley, Professor of Child Health, University of Bristol, highlights the impact of CFS or ME (myalgic encephalomyelitis) on condition.

Most of the children who attend Professor Crawley’s clinic are only attending school for two days a week. These patients have overwhelming fatigue and many are in constant pain. Because of their illness, they lose their friends, miss out on education and it causes almost unbearable stress and hardship on families. Now, a new randomised controlled trial led by Professor Crawley, the FITNET-NHS study, is comparing two treatments for children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) who do not have access to a local specialist CFS/ME service. The study will investigate whether FITNET-NHS, an online Cognitive Behavioural Therapy (CBT) program, is effective in the NHS, and whether it offers value for money compared to Activity Management (delivered remotely through Skype) (via NIHR).

Further information about the trial can be found from the University of Bristol here 

The hardest hit: addressing the crisis in alcohol treatment services.

Alcohol Concern & Alcohol Research UK|May 2018 |The hardest hit: Addressing the crisis in alcohol treatment services

The report highlights how severe funding cuts, rapid re-tendering cycles, loss of qualified staff and lack of political support are impacting on some of the most vulnerable people in society. It also highlights the  need for action to ensure that treatment services do not enter a cycle of disinvestment, staff depletion, and reduced capacity.

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Key findings from the report show:

  • Only 12% of respondents felt that resources were sufficient in their area;
  • Respondents reported cuts of between 10% and 58%, with one treatment provider saying local areas were ‘paring back to a skeleton service’;
  • 59% of respondents felt that aspects of services in their area had worsened in the last three years, with particular threats to community detox and residential rehabilitation facilities;
  • 62% of respondents said that in their area appropriate care is not available for people with both a mental health and an alcohol problem, with many told they must resolve their alcohol problems before they can access mental health services;
  • Only 7% described the quality of engagement between JobCentre Plus and local alcohol services as ‘good’.

To address the issue, the report sets out several key recommendations, including:

  • The Government must develop and implement a National Alcohol Strategy, with treatment at the heart of a broader suite of interventions to reduce alcohol harm.
  • The Government must urgently plug the gap in treatment funding and reduce health inequalities arising from local funding structures. The report contains recommendations for how this might work.
  • There must be a national review of commissioning of alcohol services, and the balance of staffing in the alcohol field.

    Source: Alcohol Concern 

A press release can be read here

The full report is available from Alcohol Concern 

Transformational change in health and care

Transformational change in health and care: reports from the field | Kings Fund

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This report presents stories of transformational change from 42 people who were involved in leading, supporting, delivering, receiving or witnessing changes from four sites that have been recognised as successful transformation initiatives:

  • The Bromley by Bow Centre: an innovative community organisation in East London that works with its Health Partnership to transform the lives of people in one of the UK’s most deprived boroughs.
  • Birmingham and Solihull NHS Mental Health Trust: Rapid Assessment, Interface and Discharge (RAID) is a multidisciplinary mental health service that has been transforming liaison psychiatry across the acute hospitals in Birmingham.
  • Northumbria Healthcare NHS Foundation Trust: Northumbria Specialist Emergency Care Hospital is a purpose-built facility that opened in 2015 to transform emergency care across a large geographical area.
  • Buurtzorg Nederland: a novel care model that has received international acclaim for transforming community care through its nurse-led, cost-effective approach.

Full report: Transformational change in health and care. Reports from the field

What value do parkland and green spaces add to the UK’s wellbeing?

Fields in Trust |  May 2018 |Revaluing Parks and Green Spaces Measuring their economic and wellbeing value to individuals

The report is the first of its kind to use a welfare weighting  methodology, which according to the report’s authors, allows for “more informed evidence-based policy decisions”.  The report not only provides an economic valuation of parks and green spaces in the UK but it also values the benefits to health and wellbeing associated with such spaces. The report estimates that such spaces save the NHS £11 million annually, as they reduce the number of visits to GPs.  (Fields in Trust). 

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The full report can be downloaded from Fields in Trust

In the media:

The Telegraph | Campaigners warn against sale of fields and green spaces which ‘save NHS more than £100 million a year’


NHS England pledges specialist mental health services for new mums in every part of the country

NHS England & NHS Improvement | The Perinatal Mental Health Care Pathways | May 2018

NHS England has confirmed that new and expectant mums will be able to access specialist perinatal mental health community services in every part of the country by April 2019. The second wave of community-perinatal is now being rolled out to areas of the country that are currently underserved; with full geographical coverage  anticipated.

This £23 million  funding forms part of a package of measures, altogether worth a total of £365m by 2021, to transform specialist perinatal services so that 30,000 additional women can access evidence based treatment that is closer to home and when they need it, through specialist community services and inpatient mother and baby units (NHS England).

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NHS England & NHS Improvement have published guidance to provide services with evidence on what works in perinatal mental health care, as well as case studies describing how areas are starting to make this a reality.

The full release can be read at NHS England 

The full guidance can be downloaded here

In the media:

BBC News Improved mental health care funding for new mums

The Guardian NHS to make perinatal mental health available across England