HIV in the UK

New report shows that HIV transmission in the UK has continued to fall | Public Health England

This report provides an overview of the HIV epidemic in the UK up until the end of 2018. The report shows that thanks to increases in HIV testing, fewer people remain unaware of their HIV status.

The drop in HIV transmission has been especially large among gay, bisexual and other men who have sex with men from an estimated 2,800 transmissions in 2012 to 800 in 2018, a 71.4% fall. The number of gay, bisexual and men who have sex with men living undiagnosed with HIV has halved since 2014 from an estimated 7,000 to 3,600 in 2018.

The scale-up of combination prevention (which includes the use of condoms, HIV testing in a wide range of settings, starting antiretroviral therapy (ART) as soon as possible if positive, and the availability of Pre-exposure Prophylaxis (PrEP) for those who are negative) across the UK is working.

This report also focuses on five strategies that are key to future HIV control and prevention:

  • HIV testing policies
  • Clinical Care and Treatment as Prevention (TasP)
  • Notification of partners of persons newly diagnosed with HIV (Partner Notification)
  • Pre-exposure prophylaxis (PrEP)
  • HIV prevention services for people who inject drugs.

Full report: HIV in the UK: towards zero HIV transmissions by 2030

Additional link: PHE press release

Finding a life-changing treatment for dementia

Alzheimer’s Research UK has called on government to invest in six priority research areas, which will help to deliver a life-changing treatment for dementia

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Image source: https://www.alzheimersresearchuk.org/

In their 2019 manifesto, the Conservative party pledged to launch a “Dementia Moonshot” to find a cure for dementia – doubling research funding and speeding up trials for new treatments.

Alzheimer’ Research UK are now calling for action to deliver on those commitments. In this publication, Alzheimer’s UK puts forward the steps government must take to deliver its Moonshot ambition of finding a life-changing treatment for dementia.

 

 

These are:

  1. Find ways to detect the diseases that cause dementia 10-15 years earlier, to broaden the search for new treatments and intervene with those most at risk of developing dementia.
  2. Find ways to more effectively validate novel targets in early drug development to maximise chances of successful clinical trials.
  3. Make the UK the best place to conduct clinical dementia research.
  4. Expand research infrastructure to maintain the UK’s position as a world leader in dementia research.
  5. Further our understanding of dementia risk reduction and prevention and dementia in the context of multi-morbidities.

Full document: Delivering the Dementia Moonshot: A plan to find life-changing treatments 

Mental health funding and investment

This briefing reflects on the progress that has been made to increase investment in mental health services and deliver on aspirations to improve service provision. It also gives NHS Providers’ view on the solutions needed to address the financial and investment challenges facing the sector.

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Mental health services have had a substantial cash injection in recent years. Following a decade of significant campaigning from the mental health sector, there is widespread support for greater investment in mental health services. In recent years aspirations to improve quality and access to services has taken shape with the development of a fully costed programme for mental health delivery with The Five year forward view for mental health. The NHS long term plan published since is clear that making further progress on improving people’s mental health and wellbeing is a priority for the next decade.

This briefing looks at the financial and investment challenges facing mental health providers. It digests the financial and funding issues facing mental health trusts, including their current financial position, the impact of stigma on investment in mental health provision, how mental health services are commissioned, contracted and paid for, the transparency and governance of funding flows, as well as setting out a number of solutions to financial problems mental health trusts face.

Full detail: Mental Health funding and investment | NHS Providers

See also: The mental health sector challenge: stigma and funding | NHS Providers blog

Pregnancy research review

This study examines the evidence base on UK pregnancy research needs and priorities and how it compares to the current funding landscape. The report indicates the NHS spends significantly less on pregnancy-related research compared with other health conditions.

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Image source: https://www.rand.org/

 

Funding for pregnancy research totalled £255 million from 2013 to 2017, or about £51 million a year. As pregnancy care costs the NHS £5.8 billion annually, this means that for every £1 spent on pregnancy care, less than 1 penny is spent on research.

The study found that this investment is much lower than for conditions such as heart disease – 7p for every £1 spent on care – and cancer – 12p for every £1.

 

The report, commissioned by the UK Clinical Research Collaboration, shows that the £255 million spent on pregnancy research accounts for about 2.4 per cent of all direct, non-industry health research.

Key Findings

  • £51m per year is invested in pregnancy research in the UK.
  • For every £1 spent on pregnancy care in the NHS, around 1p is spent on research.
  • Mental health research is the top priority for all stakeholders and is likely underfunded.
  • Other priority topics are varied, spanning stillbirth, preterm birth, inequalities, postnatal support, and safety of medications during pregnancy. The level of funding currently provided differs across the topics identified as priorities.

Full document:  Pregnancy research review | The RAND Corporation

Additional link: RAND press release

Primary Care Networks

PCNs (primary care networks) could make a positive difference if given resources, time and practical support – but workload has proven unmanageable for a significant proportion, a British Medical Association (BMA) survey has revealed

This report sets out the findings of a survey of clinical directors about their experience of being involved in the creation of PCNs, the recruitment of a new workforce, the delivery of new services and also their views on the future of PCNs.

The report found that 63 per cent of respondents said they were confident in providing strategic and clinical leadership to their network.

However, almost half, 49 per cent, of clinical directors classed their workload as unmanageable. And almost two thirds, 63 per cent, said the same about the workload of practices in their network.

The survey also revealed a majority of clinical directors, 57 per cent, feel confident in developing relationships and working collaboratively with local medical committees but 53 per cent described their relationships with local integrated care systems or sustainability and transformation partnerships as ‘poor’.

Full document: Exploring the early challenges facing Primary Care Networks. Survey of PCN Clinical Directors | BMA

See also: Workload undermines PCNs, finds survey

New heart disease drug to be made available for NHS patients

Up to 30,000 lives could be saved over the next decade thanks to a proposed pioneering government collaboration with pharmaceutical company Novartis to tackle heart disease – a leading cause of death in the UK.

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The yet to be approved drug inclisiran, a treatment to lower cholesterol, will be studied in UK patients as part of a large-scale NHS clinical trial expected to start later this year.

Early results from clinical trials suggest that if inclisiran is given to 300,000 patients annually, it could help prevent 55,000 heart attacks and strokes, and has the potential of saving 30,000 lives in the next 10 years.

Full story at Department of Health and Social Care

NHS funding bill enters Parliament

The NHS Long Term Plan Funding Bill will enshrine in law an extra £33.9 billion a year by 2024 for the NHS | via Department of Health and Social Care

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The Secretary of State for Health and Social Care will introduce the NHS Long Term Plan Funding Bill to Parliament. The bill will enshrine in law an extra £33.9 billion every year by 2024 for the NHS to transform care. It will not seek to limit the NHS in deciding how funding is spent and where – a decision that is made by local clinicians for their local populations.

The bill provides safeguards that mean the Treasury will be required to ensure the annual supply estimates for the department’s NHS budget cannot be reduced, creating a legal exception that protects frontline NHS funding for the first time.

This comes on top of recent pledges:

  • to build 40 new hospitals up and down the country, backed by £2.8 billion
  • an extra £1.8 billion for capital spending, including £850 million for 20 hospital upgrades and urgent infrastructure projects
  • £450 million for new scanners and the latest in AI technology

Full story at Department of Health and Social Care

Improving care by using patient feedback

Improving care by using patient feedback | The National Institute for Health Research (NIHR)

This themed review features nine new research studies about using patient experience data in the NHS which show what organisations are doing now and what could be done better. The evidence ranges from hospital wards to general practice to mental health settings. There are also insights into new ways of mining and analysing big data, using online feedback and approaches to involving patients in making sense of feedback and driving improvements.

Full document: Improving care by using patient feedback

Public health reforms: an independent assessment

This report, commissioned by the Local Government Association, assesses the success of the 2013 reforms to public health in England, which were part of the Coalition government’s wider health reform programme | The Kings Fund

These reforms, which saw the responsibility for many aspects of public health move from the NHS to local government, involved transition of staff and services and required the formation of new relationships to ensure public health was embedded across local government services.

The report looks at the effects of the reforms in both the short and longer term and looks at the impact of the changes, which have brought opportunities for innovation and integration, as well as challenges, at a time when funding for public health has been cut. The author then takes a look into the future and the implications for public health in the context of the NHS long term plan, the government’s prevention consultation and the wider shift to population health systems.

Full report: The English local government public health reforms: an independent assessment | The Kings Fund