News round-up (12 May 2023)

The long-anticipated NHS workforce plan intends to tackle the deepening shortage of NHS staff by allowing school leavers to train as doctors and nurses without attending university. Another proposal will see pharmacists offer prescriptions for common conditions, to alleviate pressures on primary care. Artificial intelligence (AI) continues to make the headlines: while one research trial shows that AI could help speed up diagnosis of a leading cause of childhood blindness, some doctors and health experts have expressed concern that the rapid development of AI could harm people’s health.

Poor diabetes care may have caused 7,000 excess deaths

An extra 7,000 deaths in England last year may have been caused by delayed health checks among people with diabetes, according to the charity Diabetes UK.

People who have diabetes regularly undergo routine checks to cut the risk of serious complications such as amputations and heart attacks. There are more than five million people in the UK living with diabetes, but 1.9 million missed out on routine checks in 2021-22, which may have led to higher number of deaths than usual.

The backlog in routine checks is likely to have been caused, at least in part, by the disruption in care during the Covid pandemic. NHS England said that it was prioritising the return of care to pre-pandemic levels and that local areas had been given £36m to help restore diabetes services.

Lack of evidence to back use of antidepressants for chronic pain

There is very little scientific proof that antidepressants can help address chronic pain, a new review of research has found.

Many patients are prescribed antidepressants such as amitriptyline to treat chronic pain, yet the Cochrane review, which looked at 176 studies covering 30,000 patients, found that very few looked at patients’ long-term experience. The review found evidence in support of only one drug, duloxetine, and even then only for short-term pain relief.

Professor Tamar Pincus of the University of Southampton, who co-authored the study, said: “It’s really shocking that we don’t have any evidence for long-term use of even duloxetine. This is a global public-health concern. Chronic pain is a problem for millions who are prescribed antidepressants without sufficient scientific proof they help, nor an understanding of the long-term impact on health.”

Pharmacies in England will offer prescriptions for seven conditions

Pharmacies in England will be able to provide prescriptions for seven common conditions, as well as offer blood pressure checks and the contraceptive pill, under government plans to ease the pressures on GP surgeries.

People with earache, a sore throat, sinusitis, impetigo, shingles, infected insect bites and uncomplicated urinary tract infections (UTIs) in women will be able to go to their pharmacist to ask for a prescription without seeing their GP or nurse first.

The changes, proposed in a joint primary care plan from the government and NHS England, are designed to free up 15m GP appointments over the next two years.

Thorrun Govind, chair of the Royal Pharmaceutical Society in England, called the proposals a “real game-changer” for patients.

New AI tool could detect leading cause of childhood blindness

A new artificial intelligence (AI) model could be an effective way of identifying retinopathy of prematurity, the leading cause of childhood blindness, a new study led by researchers from University College London UCL and Moorfields Eye Hospital has found.

The tool was developed to help identify which at-risk children have retinopathy of prematurity (ROP) and to improve access to screening. The researchers trained the AI algorithm on a sample of 7,414 images of the eyes of 1,370 newborns who had been admitted to the Homerton Hospital, London, and assessed for retinopathy of prematurity by ophthalmologists.

The tool’s performance was assessed on its ability to identify ROP in another 200 images and compared to the assessments of senior ophthalmologists. Researchers then employed the tool on datasets sourced from Brazil, Egypt and the US. The AI tool was found to be as effective as senior ophthalmologists in discriminating between healthy eyes and those with ROP.

NHS to allow school leavers to train as doctors without going to university

School leavers will be able to start working as doctors without going to university, under new NHS plans to address the workforce shortage.

The apprenticeship scheme could allow one in 10 doctors to start work without a traditional medical degree, straight after their A-levels. A third of nurses could also be trained this way.

The plans form part of the long-awaited NHS workforce strategy. Amanda Pritchard, the head of NHS England, said: “This radical new approach could see tens of thousands of school-leavers becoming doctors and nurses or other key healthcare roles, after being trained on the job over the next 25 years.” She added that the plans offered “once-in-a-generation opportunity to put the NHS on a sustainable footing”.

Experts warn that AI poses risk to health of millions

Doctors and public health experts from around the world have said that AI could harm the health of millions.

Writing in BMJ Global Health, they called for a pause on the development of artificial general intelligence until it is regulated. The risks associated with medicine and health care “include the potential for AI errors to cause patient harm, issues with data privacy and security and the use of AI in ways that will worsen social and health inequalities”, they wrote.

AI, the doctors wrote, could harm the health of millions through the control and manipulation of people, the use of lethal autonomous weapons and the mental health effects of mass unemployment if  AI-based systems were to displace large numbers of workers.