News round-up (15 December 2023)

Inequality is in the news this week, as a major study by Imperial College researchers finds that the risk of dying from cancer is much greater in some areas of the country than in others. Public health campaigners will also be concerned to learn that the rate of decline in the numbers of adult smoking has slowed since the pandemic. There is good news, however, as scientists believe they have found the cause of severe sickness in pregnancy, while NICE’s new guidance on statins will, it hopes, save thousands of lives.

Scientists discover cause of hyperemesis in pregnancy

Scientists believe they have discovered why some women experience hyperemesis, or severe sickness, during pregnancy.

The study, which was published in Nature, was carried out by scientists at the University of Cambridge in collaboration with researchers from  Scotland, the USA and Sri Lanka. It found that the degree of sickness was related both to the amount of a particular hormone, GDF15, produced in the womb and to prior exposure to the hormone.

Prof Sir Stephen O’Rahilly, from the University of Cambridge, said: “The more sensitive a mother is to this hormone, the sicker she will become.”

The researchers studied women at the Rosie Maternity Hospital in Cambridge and found that those with a genetic variant putting them at a greater risk of hyperemesis gravidarum had lower levels of the hormone, while women with the blood disorder beta thalassemia, which causes very high levels of GDF15 before pregnancy, experienced very little nausea or vomiting.

The scientists hope that by exposing women to the hormone before pregnancy it may be possible to reduce the likelihood of women experiencing hyperemesis.

Decline in smoking has stalled since the pandemic

The rate of decline in the numbers of people smoking has slowed since the pandemic, research has found.

Based on surveys with 101,960 adults, University College London researchers estimated that 16.2% of adults smoked in June 2017. At this point, the proportion of adults smoking had fallen for several years. The proportion fell again to 15.1% at the start of the pandemic, in March 2020. By August 2022, however, the number had only dropped to 15%. Since then the slower rate of decline has remained consistent.

The study suggests that during the pandemic there was a a 120% rise in the proportion of people giving up, and a 40% rise in the number of attempts to quit.

These were offset, however, by a rise in the number of people taking up the habit, including an increase among 18- to 24-year-olds.

Millions of people will be told to increase statins dose

New guidance from the National Institute of Health and Care Excellence (NICE)  will lead to two million people being advised to increase their statin dose to reduce their cholesterol levels.

NICE said the guidance could mean 145,000 fewer heart attacks, strokes and other cardiac incidents in the next decade. For the first time, NICE has set specific cholesterol targets for those who have already suffered a cardiovascular event, such as a heart attack or stroke.

GPs will be told to offer higher doses to such patients during their check-ups. Previously, NICE  had only called for such patients to aim for at least a 40% reduction in non‑high-density lipoprotein (non-HDL) cholesterol.

Under the new guidance, approximately two million people already taking statins will be advised to take higher doses, or to cut their risk by taking prescribed additional drugs.

Police urged to investigate thousands of deaths of mental health patients

Campaigners have written to the chief constables of Norfolk and Suffolk calling for an investigation into thousands of patient deaths at the local mental health trust.

A report by independent auditors found that 8,440 patients at the trust had died unexpectedly over three years. Coroners have raised concerns about safety issues in mental health services in the two counties.

Norfolk and Suffolk NHS Foundation Trust said it had started a review of patient deaths, and had responded to all coroners’ reports raising concerns about the risk of future deaths.

The Campaign to Save Mental Health Services in Norfolk and Suffolk said, however, that the same mistakes were being made repeatedly. It called for a police investigation, claiming there was a criminal case to answer.

The campaigners said that delays to treatment, lack of patient follow-ups, chaotic record keeping and disorganised communication between teams had been raised in several reports.

Risk of dying of cancer varies greatly between regions in England

The risk of dying from cancer in England “varies massively” depending on where a person lives, according to new research.

The Imperial College research, published in Lancet Oncology, found strong geographical differences in an analysis of data spanning two decades. In the poorest areas, the risk of dying from cancer was more than 70% higher than the wealthiest areas.

The likelihood of dying from cancer has fallen significantly over the last 20 years thanks to greater awareness of signs and symptoms, and better access to treatment and care. The proportion dying from cancer before the age of 80 between 2002 and 2019 fell from one in six women to one in eight, and from one in five men to one in six.

Some regions, however, experienced a much larger decline in risk than others. The highest risk of dying from cancer was in northern cities such as Liverpool, Manchester, Hull and Newcastle, as well as in coastal areas to the east of London.

NHS spending on agency staff soars

The amount that NHS trusts spent on agency staff last year increased to £3.5bn, according to new figures.

Accounts data published by NHS England shows that the figure rose from £3bn in 2021-22 and £2.4bn a year in the four years before that.

The amount spent on agency staff last year nearly equalled the amount spent in 2015-16, which led to intervention from regulators to reduce spend. The reductions in the following years were praised by regulators as a “huge achievement”.

A spokesman for NHS England said: “The NHS will continue to reduce reliance on agencies in the coming years by training more NHS staff domestically and retaining more existing staff, as part of the NHS long-term workforce plan.”