Press release: Poisons from cigarettes reach major body organs in seconds

Public Health England (PHE) releases a new TV advert highlighting the dangers of tar in cigarettes, as England’s 7 million smokers are urged to make a quit attempt with help from Smokefree this New Year. The latest campaign shows how poisons from tar in cigarettes enter the bloodstream, spreading around the body within seconds and causing damage to major organs.

To help explain the ongoing internal harm being caused, a group of 7 lifelong smokers - including TV presenter and entrepreneur Hilary Devey - declare their intention to quit in January after seeing the results of a lab demonstration. The test results show how their smoking has led to elevated levels of cadmium (a metal used in batteries), cancer-causing nitrosamines and carbon monoxide in their blood. These toxic substances are amongst over 4,000 chemicals released into the body with each cigarette smoked, including more than 70 known cancer-causing compounds.

Elevated levels of these substances were seen in the participants’ blood and can lead to an increased risk of major damage to the body.

Exposure to cadmium for a long period of time is associated with an increased risk of damage to the kidneys and bones and may lead to lung cancer. Research has shown that if you regularly smoke 20 or more cigarettes a day, you are twice as likely to develop kidney cancer compared with a non-smoker.

Tobacco-specific nitrosamines (TSNAs) are potent chemical compounds, many of which are carcinogenic (cancer-causing). They can cause DNA damage, cell death and are associated with cancers of the pancreas, mouth, respiratory and digestive tracts.

Carbon monoxide decreases the ability of the blood to carry oxygen and consequently puts a strain on the heart. Carbon monoxide is also associated with an increased risk of blood clots and coronary heart disease.

In the new film that supports the TV advert, Dr Dawn Harper, GP from Gloucester, explains the results of the tests to the smokers and how the quality of their blood would start to improve when they quit – ridding them of harmful poisons which cause major damage to the body. Dr Harper advises the smokers that there are many ways to quit, including free proven support from NHS Smokefree. People can choose what works best for them: face-to-face help, stop smoking aids, a quitting app, email, social media, and SMS support.

Professor John Newton, Director of Health Improvement at Public Health England says:

Smoking is a deadly habit. Each year it kills 79,000 people in England and for every death, another 20 smokers have a smoking-related disease. That means one person is admitted to hospital every minute of every day due to smoking.

Our new TV ad shows how every cigarette sends a flood of poisonous chemicals through the bloodstream in seconds. People know that tar damages the lungs, but it’s less well understood that the poisons also reach the other major organs in the body. We are urging every smoker to take advantage of the free Smokefree support and quit for good this New Year.

Dr Dawn Harper, GP and medical journalist says:

I see the damaging effects of smoking in my surgery almost every day. Tar from cigarettes causes damage to major organs, the bones and increases your risk of a range of cancers and diseases. But, the good news is that no matter how long you’ve smoked, quitting can reduce your chances of developing cancer, heart and lung disease and other serious smoking related illnesses. Some of the benefits are almost immediate, with improved energy and breathing within a matter of days.

I know how difficult it is to stop but the important thing is to commit to trying again, no matter how many times you might have tried and failed in the past – it’s never too late.

Hilary Devey, TV presenter, entrepreneur and lifelong smoker says:

I’ve smoked at least 20-a-day for over 40 years. Like many, I’ve been hooked on cigarettes and ignoring the damage – even though I know the harm I’m doing, I’ve found it extremely difficult to quit for good. Even a stroke 3 years ago only led me to stop temporarily.

Seeing the high levels of poisonous chemicals in my blood from these tests really hit home how dangerous continuing to smoke is – and for that reason, I’m done!

I’m absolutely determined to try again this New Year and I hope other smokers across the country will join me making full use of all the free help available at Smokefree - this time next year we could be celebrating one year smoke-free and feeling the benefits.

Smokefree provides motivation, information and support for smokers who want to stop. Just search ‘Smokefree’ for free support and advice to help you quit smoking.

Background

1. To find out more about the range of free support and tools available to help people quit smoking, please search ‘NHS Smokefree’ online.
2. Download all Smokefree films and images.
3. Carbon Monoxide, one of the toxic substances identified at elevated levels in the lab demonstration, is not contained in tar but is one of the most harmful elements in tobacco smoke.
4. PHE exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health, and are a distinct organisation with operational autonomy to advise and support government, local authorities and the NHS in a professionally independent manner. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

freuds

Email healthharms2018@freuds.com

Telephone 020 3003 6495

Mobile 07793 533774

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News story: Behind the headlines: calorie guidelines remain unchanged

Over the past couple of days, the national media has reported on Public Health England’s (PHE) upcoming campaign on calories. Much of the coverage suggests PHE is changing the guidelines on how many calories people should consume in a day. This is incorrect. Below are the facts about calorie guidelines and the campaign.

The government dietary recommendations on how many calories the population should consume in a day to maintain a healthy weight have not changed. Women should still aim to consume 2,000 calories a day from food and drink, men should aim for 2,500.

The new campaign, due to launch in the spring of 2018, aims to help people be more aware of and reduce how many calories they consume from the 3 main meals of the day, in particular when eating on the go. There will be a simple rule of thumb to help them do this: 400:600:600 – people should aim for 400 calories from breakfast and 600 each from lunch and dinner.

The rule of thumb is based on the principle that’s been in healthier and more sustainable catering: nutrition principles for years: on average, 20% of daily energy and nutrients should come from breakfast and 30% from both lunch and dinner. All other snacks and drink consumed between meals should make up the difference.

What is new about this campaign is that we are working with high street food chains to offer healthier choices and help get the message out there that many of the extra calories being consumed are out of the home.

We are absolutely not telling the public what to do but giving them the facts. One of these is that two thirds of us are overweight or obese and this is largely to do with eating too much. As we are the sixth most overweight nation on the planet, we believe it is a sensible thing to do.

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Official Statistics: Legionnaires’ disease in England and Wales: 2016

Legionnaires’ disease is a severe but uncommon form of pneumonia associated with exposure to water systems (natural or man-made) colonised by legionella bacteria.

This report presents the epidemiological data on cases of Legionnaires’ disease reported in residents of England and Wales where symptoms started during 2016. Comparative data from previous years are included where appropriate.

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Research and analysis: Salmonella Typhi resistant to third-generation cephalosporins

In December 2017, PHE’s Antimicrobial Resistance and Healthcare Associated Infections reference unit issued an alert urging public health laboratories to screen all presumptive isolates of S. Typhi and S. Paratyphi for resistance to third-generation cephalosporins and to refer presumptive isolates to the Gastrointestinal Bacteria Reference Unit to enable continuous surveillance of genetic resistance markers.

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Guidance: PHE Employer Based Awards: analysis of 2016 to 2017 round

This report analyses the Employer Based Award (EBA) scheme applications and results, comparing them with previous years, to identify any areas of inequality that PHE needs to address.

PHE runs the scheme to reward eligible medical and dental consultants working for PHE, local authorities and universities, who have demonstrated excellence in leadership, research, innovation, developing and delivering high-quality services, teaching and training.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/phe-employer-based-awards-analysis-of-2016-to-2017-round
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Press release: Shingles vaccine programme reduces cases and chronic complications

First evidence of the shingles vaccine programme shows a substantial reduction in cases and long-term complications.

A new study in the Lancet Journal of Public Health shows a substantial decrease in shingles cases and associated complications in the first 3 years since the introduction of the shingles vaccination programme by Public Health England (PHE).

Despite these very positive results, uptake of the vaccine has declined, with a 13% decline in people aged 70 since the start of the programme and an 8.4% decline in people aged 78 years since 2014.

PHE is urging adults aged 70 and 78 to protect themselves by taking up the offer for vaccination from their GP or booking an appointment if they missed out. Shingles is a painful condition and can be especially debilitating for older people.

The new analysis of the shingles vaccine programme, which was introduced in England in September 2013, estimated that the vaccine was 62% effective against shingles and between 70 to 88% effective against post-herpetic neuralgia (PHN), or long term pain, which is one of the main complications associated with shingles.

The study estimated that GP visits for shingles and PHN reduced by 35% and 50% respectively, in those aged 70 during 2013 to 2016.

An estimated 17,000 GP visits for shingles were avoided amongst the 5.5 million individuals who were given the vaccination in the first 3 years of the programme across England.

Dr Mary Ramsay, Head of Immunisations at PHE, said:

I encourage all those who are 70 and 78 to make an appointment with their GP practice to get the shingles vaccine, as well as those under 80 who previously missed out. It’s the best way to avoid this very nasty disease and the long-term complications that can develop from having it.

Our population is aging and the risk from getting shingles and complications is higher as you get older. Immunisation is the best way to protect yourself from this painful, sometimes debilitating condition. Taking up the vaccine is an important part of staying healthy as you age.

Shingles is characterised by a skin rash on one side of the body resulting from reactivation of chicken pox virus that has been lying dormant in the body. It can last on average for 2 to 4 weeks and be significantly debilitating, causing loss of sleep and and interference with day-to-day activities. Symptoms can include sharp stabbing pain and burning of the skin in the affected area, feeling unwell, a bad headache and a fever.

Over 50,000 cases of shingles occur in people aged 70 years and over each year in England and Wales, with approximately 50 cases being fatal.

The likelihood of getting shingles increases with age and adults aged 70 and above are more at risk of developing serious complications from it, such as PHN, a severe nerve pain that lasts for several months or more after the rash has gone.

Though many recover from PHN, symptoms can last for years or can become permanent. It is therefore vital for every individual eligible to get their vaccine.

In England, the shingles vaccination programme now targets adults aged 70 and 78 with a catch up programme for those aged 71 to 79.

PHE is encouraging healthcare professionals and the public to be aware of the complications surrounding shingles and to encourage those within the eligible groups to get vaccinated.

Background

1. Those who are eligible for the free shingles vaccine include people in their 70s who were born after 1 September 1942 and people aged 79 years.

2. To get your vaccine, contact your GP or pharmacist for more information. If you are within the eligible group, your doctor will recommend the shingles vaccine during general GP visits or your annual flu appointment. Further details on the shingles vaccination programme are available on NHS Choices.

3. PHE’s shingles eligibility calculator can help determine whether or not you are eligible for the vaccine.

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8400

Out of hours telephone 020 8200 4400

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Case study: Medicine technicians deliver IBA to all hospital inpatients

Summary

Medicine management technicians (MMTs) (also known as pharmacy technicians) at University Hospital Southampton NHS Foundation Trust are delivering alcohol identification and brief advice (IBA) to all inpatients on medical wards within 48 hours of admission, with the plan to extend this across the trust by April 2018. Delivery occurs alongside routine medicines reconciliation and is now embedded in the standard operating procedure for all medicine management technicians. Regular face-to-face and online training is offered to staff, the activity is consistently and systematically recorded in information systems (and meaningfully coded), and results are fed back to staff members. Screening all patients using AUDIT-C has enabled the trust accurately to code more patients to HRG4, which has increased monthly income by approximately £20,000.

Background

University Hospital Southampton NHS Foundation Trust provides services to some 1.9 million people living in Southampton and south Hampshire, plus specialist services such as neurosciences, cardiac services and children’s intensive care to more than 3.7 million people in central southern England and the Channel Islands. It admits approximately 1,200 patients each month.

In 2015, as part of the development of the trust’s alcohol strategy, it was noted that patients weren’t systematically being asked about a known health risk – alcohol use – and that the hospital had no good data on this factor. A commitment was made to improve screening of inpatients across all wards and to ensure systematic capturing of alcohol consumption data that would enable better coding.

What was involved?

MMTs were identified as being in an ideal position to ask all inpatients about their alcohol consumption. MMTs see all eligible patients within 48 hours of admission in order to carry out medicine reconciliation (the process of confirming what medications a patient is taking) and it was felt that IBA could be incorporated into this process.

A 2 week pilot was run to test acceptability and feasibility of delivering IBA across the hospital. The pilot covered all patients and all wards (excluding maternity and paediatric wards). MMTs were trained to deliver IBA and used AUDIT-C to screen all patients. Patients who were identified as increasing or higher risk drinkers were informed about the risk to their health and given an information leaflet. Patients who were identified as potentially alcohol dependent were offered a referral to the trust alcohol care team, who made an assessment and where appropriate referred on to community teams as per usual practice. Information on patients’ alcohol consumption, the advice given, and whether a referral was offered and made, was recorded to evaluate the pilot.

Results of the pilot were exceedingly positive. In the 2-week period 789 patients were assessed by 36 MMTs across 56 wards, with approximately one quarter of patients identified as drinking alcohol at above low risk levels and provided with an appropriate intervention. On average, the process took six minutes per patient to deliver.

Before the pilot, some staff expressed reluctance to talk to patients about alcohol (perception captured via a staff survey), due to fears it may offend patients and concerns were expressed about whether it was the role of MMTs to do this work. However, these concerns were unfounded, with some patients expressing appreciation for the advice that had been provided.

Following the success of the pilot, a business case was put together for an extended pilot period of 6 months to integrate the project within hospital systems with the aim to fully implement the initiative across the hospital by April 2018. IBA is becoming part of the usual quality care given to patients as a routine part of MMTs’ role, and defined within their standard operating procedure. Managers feedback regularly to staff on their performance as part of monitoring procedures. The target is for 100% of inpatients receiving medicines reconciliation to receive IBA.

Importantly, hospital information systems are being developed to support delivery of IBA. Patients’ AUDIT-C scores are captured in systems seen by the clinical team. AUDIT-C scores and information about the intervention given are automatically pulled through to the patient discharge summary and sent to the GP. Consistent recording of AUDIT-C scores (rather than free text descriptors about alcohol use) has substantially enhanced the coding team’s ability to accurately code levels of alcohol use, with the unintended consequence of increasing income by £20,000 per month due to more patients being correctly coded under HRG4. Increased revenue will enable the employment of a total of three additional MMTs, prior to implementation of the Preventing ill health CQUIN in 2018 as a result of the cost effectiveness of this system, and potential for further benefit on patient outcomes.

Training continues to be regularly offered to MMTs and other frontline staff by the Alcohol Care Team, and staff members are encouraged to complete IBA e-learning and use the Know Your Numbers alcohol app to improve accuracy of screening. Staff champions of this initiative frequently attend team meetings to answer questions, address concerns and show support to frontline staff.

The role of screening being undertaken by MMTs has enabled the alcohol specialist nurses within the team to prioritise clinical management of more complex patients as well as onward referral to community substance misuse services where appropriate and available.

Unsurprisingly, there is strong senior leadership support for the trust to continue to prioritise its action on alcohol related harms.

What works well?

Piloting the project

Running a pilot gave staff an opportunity to express concerns, and build their confidence talking to patients about alcohol. It also enabled the team to work with key stakeholders across the system (especially IT, coding managers and divisional leads) to ensure it was fit for purpose and supported across the trust. The pilot had the effect of improving staff attitudes towards delivery of IBA as staff came to realise that patients expect to receive this advice when in hospital. One staff member commented that the pilot had helped her to realise that her concern about raising alcohol with patients was a personal worry and nothing to do with the perspectives of her patients.

Stable staff group

MMTs have so far been found to be a stable staff group, with approximately 60% of those involved in the pilot still employed by the trust today. The stability of this staff group means that the culture of delivering IBA as part of usual care is maintained. It also reduces the need for intensive training and facilitates peer-to-peer learning.

IBA written into Standard Operating Procedures for MMTs

Embedding IBA into Standard Operating Procedures for MMTs formalised the expectation that delivery of IBA forms part of the MMT role. It means that everybody knows who is responsible for IBA and improves accountability.

Systems that enable accurate reporting

Consistent use of AUDIT-C has enabled more accurate coding of patients whose alcohol use is at levels likely to be harmful to health and who are alcohol dependent. It helps to identify patients whose alcohol consumption may be having an impact on their presenting condition. Good information systems have enabled benefits to be evaluated, the prevalence of the problem to be better understood and reported in a way that improves outcomes to patients and makes the financial case visible to senior leaders.

What could be better?

One challenge is deciding how to organise data items in a way that ensures that clinicians can easily access important information about a patient. For example, if a patient is drinking alcohol at harmful levels and would benefit from more acute management of their alcohol-related harm, then it is useful to have this information in a position that is immediately visible to the clinician. However, for the majority of patients, whose alcohol consumption is at lower risk levels, the same information is less important for the clinician to see and putting it in a prominent position might risk obscuring other important information about the patient.

Next steps

In preparation for the delivery against the Preventing ill health CQUIN in 2018, tobacco very brief advice (VBA) will be incorporated into the current IBA approach. MMTs will be trained to deliver VBA and information systems will be checked to ensure all relevant information can be captured and the system evaluated for ongoing benefit to patients and sustainability of the system

Further information

Lindsay Steel, Principal Medicines Management Technician, University Hospital Southampton

Julia Sinclair, Associate Professor of Psychiatry, Faculty of Medicine, University of Southampton, Honorary Consultant in Alcohol Liaison, University Hospital Southampton

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Guidance: North Middlesex University NHS Trust: cervical screening programme

Quality assurance (QA) aims to maintain national standards and promote continuous improvement in screening. This is to ensure that all eligible people have access to a consistent high quality service wherever they live.

QA visits are carried out by the Public Health England screening quality assurance service (SQAS).

The evidence for this report comes from:

• routine monitoring of data collected by the NHS screening programmes

• evidence submitted by the provider

• information shared with SQAS London as part of the visit process

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Guidance: Somerset and North Devon: abdominal aortic aneurysm screening

Quality assurance (QA) aims to maintain national standards and promote continuous improvement in abdominal aortic aneurysm screening. This is to ensure that all eligible people have access to a consistent high quality service wherever they live. QA visits are carried out by the Public Health England screening quality assurance service (SQAS).

The evidence for this report comes from:

• routine monitoring data collected by the NHS screening programmes

• data and reports from external organisations

• evidence submitted by the provider(s), commissioner and external organisations

• information shared with the South regional SQAS as part of the visit process

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Collection: Alcohol and drug misuse treatment core dataset collection guidance

Alcohol and drug misuse service providers can use these guidance documents and information to help with inputting data into the NDTMS. The documents provide guidance for adult, young people and secure-setting based treatment providers.

Visit Alcohol and drug misuse prevention and treatment guidance for information and other resources to help with providing and improving alcohol and drug misuse treatment services.

Visit Alcohol and drug misuse and treatment statistics for reports and datasets on the prevalence and treatment of alcohol and drug misuse treatment in England.

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Collection: Alcohol and drug misuse and treatment statistics

Healthcare professionals can use the statistics published by Public Health England (PHE) to support improvements in decision making when planning alcohol and drug misuse treatment services.

Visit Alcohol and drug misuse prevention and treatment guidance for information and other resources to help with providing and improving alcohol and drug misuse treatment services.

Visit Alcohol and drug misuse core dataset collection guidance for information and other resources to support alcohol and drug service providers collect and submit data.

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Collection: Alcohol and drug misuse prevention and treatment guidance

Healthcare professionals can use these guidance documents, information and resources to help with providing and improving alcohol and drug misuse prevention and treatment services.

Visit Alcohol and drug misuse and treatment statistics for reports and datasets on the prevalence and treatment of alcohol and drug misuse treatment in England.

Visit Alcohol and drug misuse core dataset collection guidance for information and other resources to support alcohol and drug service providers collect and submit data.

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News story: Changes imminent to how ARSAC licenses research

The Administration of Radioactive Substances Advisory Committee (ARSAC) is urging researchers who administer radioactive substances to read up on imminent changes to the way that approvals are granted.

New regulations under The Ionising Radiation (Medical Exposure) Regulations 2018 (IR(ME)R), due to come into force on 6 February 2018, will replace the current process for the administration of radioactive substances with a new licensing system for practitioners and employers.

Public Health England will manage all applications for licences. Fees may be charged depending on the type of licence applications for employers and research approval. There will be no fees for practitioner licences.

ARSAC will still need to approve research studies involving the use of radioactive substances. There will be no change for research sponsors, such as a pharmaceutical company or university, who should continue to apply to ARSAC for authorisation.

Submit all applications for site-specific research certificates by 16 January 2018.

Nasreen Parkar, Scientific Adviser to ARSAC said:

When the new regulations come into force early next year, any valid research certificates will be considered to be a licence for both the practitioner and the employer at the identified installation. This will allow administrations of radioactive substances to continue in line with the research study protocol.

New or uncertificated research studies will require both the employer and practitioner to have an appropriate licence that includes the procedures within the research protocol.

Currently each research study requires a research ARSAC site certificate. Under the new system, this will no longer be the case.

Once an employer has a licence in place and there are licensed practitioners entitled under the employer’s procedures, administrations can be performed under the procedures detailed in any ARSAC-approved research study within the scope of the licences.

Installations that currently submit more than one research certificate application a month may need to apply early for employer licences and practitioner licences. There is nothing in the new regulations to stop employers or practitioners applying for licences any time after the new regulations come into force.

At present 80% of research studies involve the use of bone scans, MUGA scans, GFR studies and FDG tumour imaging. Once these and any other routine procedures have been included on employer and practitioner licenses, no further amendment is required to take part in a research. Researchers will need to notify practitioners about the research protocol and the employer will need to confirm that each installation has the capacity to perform the procedures.

Louise Fraser said:

It’s really important that research sponsors and sites understand how these changes will affect their local processes. We encourage everyone to look into what the changes will mean for them so that they are aware of what, if anything, they will need to do.

For further information please subscribe to our bulletin.

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Correspondence: Vaccine update: issue 273, December 2017

The December 2017 issue features:

• ensure you’re up to date with the MMR jab if travelling to Romania, Italy and Germany
• have they had their MenACWY vaccination?
• MMR vaccine, who is eligible and can I use stock from Immform to catch up adults?
• NIN 2018 keynote speaker and booking opens soon
• winter sun and foreign travel – be rabies aware!
• annual HPV vaccination coverage in girls in England for the 2016 to 2017 academic year
• herpes zoster (shingles) immunisation programme: September 2016 to August 2017
• COVER report
• flu vaccine information and availability 2017 to 2018 for the children’s national immunisation programme
• order controls for Fluenz Tetra®
• giving a second dose of LAIV
• influenza vaccines for the 2017 to 2018 influenza season
• Hexavalent (DTaP/IPV/Hib/HepB) vaccine for infants
• vaccine supply for non routine programmes
• change to Revaxis® packs
• Christmas and New Year bank holiday deliveries
• free training event
• new training slides

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Guidance: Breast screening: women wanting to attend service out of area

This guide outlines policy on the screening of women at a different NHS breast screening unit from the one the screening provider invites her to attend. Attending an alternative screening unit is called ‘out-of-area screening’.

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Guidance: HAIRS risk assessment: West Nile virus

West Nile virus (WNV) infections have long been recognised in Europe where there is annual surveillance for human and equine disease. There is no evidence that WNV is present in the UK and very few travel-related cases have been reported to date. Populations of competent mosquitoes (Culex modestus) - capable of transmitting the virus - have, however, been detected in areas of Essex and Kent.

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Promotional material: Breast screening: partial or incomplete mammography

Breast screening services can download and print off this information leaflet to give to women who have had partial or incomplete mammography.

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Transparency data: PHE government procurement card spend over £500: October 2017

These files show all purchases on Public Health England held government procurement cards (GPC) over £500 in October 2017.

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Transparency data: PHE spend over £25,000: October 2017

Details of Public Health England transactions over £25,000 in October 2017.

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Press release: Campaign to protect young people from STIs by using condoms

Public Health England had launched ‘Protect against STIs’, a new campaign that aims to reduce the rates of sexually transmitted infections (STIs) among 16 to 24-year-olds through condom usage. The campaign is the first government sexual health campaign in 8 years.

To coincide with the launch of the campaign, a new YouGov survey of 2,007 young people reveals current attitudes towards condom use and what prevented them from using protection.

Shockingly, the findings revealed that almost half (47%) of sexually active young people said they have had sex with someone new for the first time without using a condom; whilst 1 in 10 sexually active young people said that they had never used a condom.

The new research also revealed that sexual health is a challenging topic for young adults to discuss, as 56% of men and 43% of women said that it is difficult to talk about STIs with friends. Furthermore, 58% said that if they had an STI they would find it difficult to talk to their sexual partner about it.

In 2016, there were over 141,000 chlamydia and gonorrhoea diagnoses in people aged between 15 and 24 in England and almost 6 in 10 (59%) of all those diagnosed with an STI were among this age group.

‘Protect against STIs’ aims to raise awareness of the serious consequences of STIs, which can cause infertility, pelvic inflammatory disease (PID - an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries), swollen or painful testicles and even meningitis. Gonorrhoea is a particular concern because it is becoming increasingly resistant to antibiotics, and may become untreatable in the future. The campaign will be highlighting the increased likelihood of contracting an STI if having sex without a condom and that many STIs are symptomless, including 7 in 10 cases of chlamydia.

Despite the rates of STIs remaining consistently high among young people, currently, twice as many young people say that the main reason for using condoms is to avoid pregnancy (58%), rather than to avoid getting an STI (29%).

The campaign aims to help normalise and encourage condom use in young people, as it was revealed that 1 in 3 (32%) young adults said that they have never seen a condom mentioned in sex scenes on TV or in films.

‘Protect Against STIs’ launches on 15 December 2017 with a nationwide digital advertising campaign targeting young people. The new advertising hears from real people talking about their own personal experiences of having an STI. The identities of the individuals will not be shown but will be animated by emojis. The campaign is being supported by a range of partners, including the Family Planning Association (FPA), Durex and British Association for Sexual Health and HIV (BASHH).

Gwenda Hughes, Head of STI Surveillance at Public Health England comments:

Rates of STIs among young people continue to be too high and it is concerning that many sexually active young people are not using condoms with new partners. Six in 10 chlamydia and gonorrhoea diagnoses are in those under 25 years of age, so we need to remind young people of the importance of using condoms with a new or casual partner to help prevent infection.

Dr Sara Kayat, TV doctor and campaign supporter comments:

Using a condom is the safest way to ensure that you avoid contracting STIs, such as chlamydia or gonorrhoea. Whilst many STIs are symptomless, contracting them can have serious health consequences if left untreated and even lead to infertility. As I tell patients in my clinic every week, it’s just not worth putting yourself at risk by not using a condom.

Tom Haywood, Senior Brand Manager at Durex UK, said:

STI rates remain high amongst young people in England and we want young people to know that sex can be fun and safe, if you wear a condom. There is still a perception for many that condoms reduce pleasure and fun, but condoms should be a key part of positive sexual activity as they help protect against STIs. Through this campaign, Durex wants to help educate young people around condom use and help reduce levels of STIs.

Visit the campaign website for more information.

Background information

Additional quotes

Dr Elizabeth Carlin, President of the British Association for Sexual Health and HIV (BASHH) comments:

BASHH are delighted to support this important new campaign from Public Health England. It is both timely and crucial given the high rates of sexual infections in young people, many of whom do not have symptoms. Condoms remain essential in the fight against STIs, as well as HIV, and we recommend using them for sex with any new or casual partners. We urge anyone who is concerned about their sexual health, or risks they have taken, to have a check-up and be tested - it is quick and easy to do.

Jesse, aged 24 from London who contracted chlamydia and gonorrhoea in the past comments:

I’ve had both chlamydia and gonorrhea in the past when I didn’t use a condom and it wasn’t a nice experience. They caused pain in my groin and discomfort when urinating. The worst of it though was having to tell my previous and current sexual partner that I had contracted the STIs, so they also needed to get checked and treated. I had symptoms, but I know there are so many people who don’t, so now when having sex with someone new I will definitely use a condom.

1. Campaign advertising and images can be downloaded online.

2. Dr Sara Kayat is a GP at Grays Inn Road Medical Practice. Her main areas of expertise are sexual and reproductive health, as well surgical specialties like ENT and orthopaedics. Interviews available upon request.

3. Public Health England Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Twitter: @PHE_uk, Facebook: www.facebook.com/PublicHealthEngland.

4. The Family Planning Association (FPA) is supporting the ‘Protect against STIs’ campaign by helping to deliver sexual health information and support to key audiences via their Sexwise website.

freuds

Email laurel.eveleigh@freuds.com

Telephone 07912 515 997

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Research and analysis: Sexually transmitted infections: East Midlands data

This report provides a summary of 2016 data for STIs in the East Midlands, along with charts, tables and map. It also explains the data sources used.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/sexually-transmitted-infections-east-midlands-data
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Research and analysis: Herpes zoster (shingles) immunisation programme 2016 to 2017: evaluation report

The shingles vaccination programme aims to reduce the incidence and severity of shingles in those targeted by the programme by boosting individuals’ pre-existing varicella zoster virus immunity.

This report highlights the lower coverage achieved in the routine and catch-up cohort in 2016 to 2017 compared with previous years. GPs are urged to continue to offer vaccinations to these cohorts as per current guidance, to improve protection in these age groups.

In the fourth year of the programme (2016 to 2017), the vaccine was offered to adults:

• aged 70 years on 1 September 2016 (born between 2 September 1945 and 1 September 1946)
• aged 78 years on 1 September 2016 (born between 2 September 1937 and 1 September 1938)

The eligibility criteria for shingles vaccine changed from 1 April 2017.

Last year’s report for comparison.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/herpes-zoster-shingles-immunisation-programme-2016-to-2017-evaluation-report
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Official Statistics: Annual HPV vaccine coverage 2016 to 2017: by local authority, local team and area team

Human papillomavirus (HPV) vaccine coverage data for vaccinations received by Year 8 and Year 9 females to 31 August 2017 by local authority, local team and area team.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/statistics/annual-hpv-vaccine-coverage-2016-to-2017-by-local-authority-local-team-and-area-team
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Guidance: Royal Cornwall Hospitals: antenatal and newborn screening programme

Quality assurance (QA) aims to maintain national standards and promote continuous improvement in screening. This is to ensure that all eligible people have access to a consistent high quality service wherever they live.

QA visits are carried out by the PHE screening quality assurance service (SQAS).

The evidence for this report comes from:

• routine monitoring of data collected by the NHS screening programmes

• data and reports from external organisations as appropriate

• evidence submitted by the provider(s), commissioner and external organisations as appropriate

• information shared with the screening QA service as part of the visit process

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/royal-cornwall-hospitals-antenatal-and-newborn-screening-programme
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Guidance: East Berkshire: breast screening programme

Quality assurance (QA) aims to maintain national standards and promote continuous improvement in screening. This is to ensure that all eligible people have access to a consistent high quality service wherever they live.

QA visits are carried out by the Public Health England screening quality assurance service (SQAS).

The evidence for this report comes from:

• routine monitoring of data collected by the NHS screening programmes
• data and reports from external organisations
• evidence submitted by the provider(s), commissioner and external organisations
• information collected during pre-visits to review pathology reports and slides, attend a multidisciplinary team meeting, and peer review for radiology/ surgical performance
• information shared with the South regional SQAS as part of the visit process

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/east-berkshire-breast-screening-programme
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Press release: PHE gets permission for public health science campus and HQ

PHE has been given planning permission to create a world-leading public health science campus at Harlow in Essex.

The landmark decision helps secure PHE’s role as a global leader in applying cutting-edge science to protect and improve the public’s health for the next generation through the creation of a ‘state-of-the-art’ centre of national and international scientific expertise.

PHE Harlow, as the site will be known, is expected to employ up to 2,750 people by 2024, with scope for further expansion.

The campus is critical to the future of PHE, ensuring we will be able to use the latest scientific advances to deliver our world-leading science and evidence for issues such as smoking, alcohol, diabetes, dementia, infectious diseases, environmental hazards and climate change nationally and internationally.

PHE was given the go-ahead to create the campus at a meeting of Harlow District Council’s Development Management Committee today (13 December 2017). Approval is for outline planning with more detailed applications to follow for elements including an arrivals area and car parking. It follows government approval of £400 million capital support for the scheme.

The campus will allow PHE to fully embrace the new technologies of whole genome sequencing, public health interventions and ‘big data’ and transform the delivery of public health science for many years to come.

It means that PHE will relocate from facilities at Porton in Wiltshire, Colindale in north London, as well as its central London headquarters to a single centre of excellence for public health research, health improvement and protection. PHE Harlow will support PHE’s teams that cover the whole country and its work around the world.

PHE Harlow will be built at a site previously owned by GlaxoSmithKline at their New Frontiers Science Park on the Pinnacles Industrial Estate in Harlow.

As well as providing a significant permanent economic and employment boost to the local economy, the campus will see thousands of construction-related jobs being created.

The next step in 2018 will be the preparation of the site for the construction. Building work is expected to start in 2019 with phased occupation starting in 2021.

Richard Gleave, PHE Deputy Chief Executive, said:

This landmark decision is one of the most important not just for PHE but also for the nation’s health. It allows us to build on the incredible work we already do to deliver some of the best public health science in the world.

PHE Harlow will be a world-leading national and international resource and this approval could not come at a better time. Every year we face new challenges both at home and abroad and the public should rest assured that this decision will see us even better prepared to tackle these head on.

The site is within the ‘London Cambridge corridor’ – one of the leading life sciences research zones in Europe - and provides opportunities for PHE to collaborate with commercial, academic and public sector partners.

Steve Brine MP, Minister for Public Health, said:

We’re now one step closer to achieving our vision of a campus that sets the world-standard for public health science. This is a significant step not only for PHE but for public health nationally and internationally.

Councillor Jon Clempner, Leader of Harlow Council, said:

This decision signals a key moment in building Harlow’s tomorrow. PHE’s move is part of the regeneration of Harlow - making it a better place to live, work and visit. This development and investment in our town, and the investment which will follow, will play a major part in Harlow’s bright future.

New jobs and opportunities for local people and local businesses will be created and Harlow will be placed on the world map. Together, we are committed to ensuring that local people and local businesses take the opportunities the public health science campus will bring to Harlow.

View the full application online.

Background

1. PHE submitted an outline business case to government in July 2014. An interim decision was taken in September 2015 to move the majority of PHE functions from Porton to Harlow. In November 2015, the government supported a further proposal to move PHE science facilities at Colindale to Harlow to create a single integrated campus. It has committed £400 million capital investment for the project.

2. It is hoped the public health science campus will be fully operational by 2024, with the first building work expected to start in 2019 and a phased occupation from 2021.

3. The planning application, consisting of 3,000 pages and nearly 300 drawings and images, was submitted in August following extensive consultation with stakeholders and the local community.

4. The application also includes a travel and visitor plan which outlines car parking provision and sets out sustainable travel and transport plans for the site. These include shuttle buses to and from Harlow Town railway station as well as car-share and cycle-to-work schemes.

5. PHE is committed to being a good neighbour. The planning application outlines PHE’s longer term commitments to Harlow, through investment in highways and public transport, early years childcare and contribution to Harlow’s important history of public art and sculpture.

6. Planning approval has been given subject to a Section 106 agreement being signed by PHE and Harlow District Council. This agreement is expected to be signed in the next few weeks.

7. Whole genome sequencing is the mapping out of a person’s unique DNA and enables more accurate, sophisticated and cost-effective genetic testing.

8. Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health, and are a distinct organisation with operational autonomy to advise and support government, local authorities and the NHS in a professionally independent manner. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

Matthew Cooper

Email Matthew.Cooper@phe.gov.uk

Direct line 0207 654 8069

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/phe-gets-permission-for-public-health-science-campus-and-hq
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Guidance: Public Health England: approach to surveillance

Surveillance ensures that PHE has the right information available at the right time to inform public health decisions and actions.

This guide focuses on the need for high quality evidence from our surveillance systems and sets out how strategies can be developed for surveillance of both infectious and non-communicable diseases.

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Guidance: Breast screening: interval cancers and duty of candour toolkit

These documents are a toolkit of guidance on interval breast cancers for healthcare professionals to use when applying the duty of candour.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/breast-screening-interval-cancers-and-duty-of-candour-toolkit
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Detailed guide: NHS population screening: education and training

Use this guide to:

• download tools to help explain screening
• access e-learning
• access programme specific training
• sign up for screening training

E-learning

Most e-learning for the NHS screening programmes is available on the e-Learning for Healthcare (e-LfH) website.

Read about the screening courses available and sign up for e-LfH.

Screening programme resources

Read further training information on GOV.UK about the:

• abdominal aortic aneurysm (AAA) programme
• bowel cancer screening (BCSP) programme
• breast screening (BSP) programme
• cervical screening (CSP) programme
• diabetic eye screening (DES) programme
• fetal anomaly screening programme (FASP)
• infectious diseases in pregnancy screening (IDPS) programme
• newborn and infant physical examination (NIPE) screening programme
• newborn blood spot (NBS) screening programme
• newborn hearing screening programme (NHSP)
• sickle cell and thalassaemia (SCT) screening programme

Screening timeline

The NHS Screening Timeline is a visual representation of all national screening programmes available in the English NHS.

It sits alongside the antenatal and newborn timeline, which shows optimum times for NHS antenatal and newborn screening tests to take place.

Download the:

• NHS Screening timeline (PDF)
• Antenatal and newborn screening timeline (PDF)

Watch an animated antenatal and newborn screening timeline.

Events and face to face training

PHE Screening works with Health Education England and other educational bodies to deliver events and face to face training.

Warwick health screening module

The Warwick Medical School health screening module looks at how:

• to determine when screening is an appropriate intervention, through the analysis of ethical, performance and economic issues
• screening programmes can be effectively monitored and improved

The course is available as a postgraduate award or part of the masters in Public Health programme

Apply to attend the module

Funding

PHE Screening is pleased to be able to offer limited funding to support 4 students to undertake the above module in screening.

A core team working in screening will review all applications and inform you of the outcome by email.

Apply for funding

Warwick health screening one day workshop

Warwick University also run a one day health screening workshop. On this day delegates explore:

• how we decide to introduce a new screening programme
• the ethics and economics of screening
• the quality assurance of programmes.

This workshop is suitable for any staff involved in providing NHS screening programmes. This includes:

• screening technicians
• commissioners
• quality assurance and failsafe staff
• GPs
• midwives
• public health managers
• practice managers

Download the one day workshop course flyer and an example of the agenda for the day.

Screening masterclass

The screening masterclasses are for staff working in public health and commissioning who are responsible for commissioning, managing or delivering national screening programmes for their local populations.

Screening Leads within NHS provider trusts may also find the day of value.

The UK NSC Director of Programmes, Dr Anne Mackie, will often attend for part of the day to answer questions.

Course content

The day sessions include a basic refresher on:

• what screening is and is not
• defining a high quality screening service
• public health skills and tips for commissioning high quality screening programmes
• how to identify common problems and share experiences
• the role and remit of the UK National Screening Committee
• an overview of policy and practice of current NHS screening programmes

The days are interactive and use a mixture of teaching methods, including case studies and practical exercises.

The case studies include:

• commissioning new services
• assessing appropriateness and quality of services
• accountability for screening services
• managing clinicians and patient expectations.

Download a flyer and example agenda for further information.

Places are limited and will be allotted on a first come first served basis. A £48 fee is charged to cover the venue and catering.

Email the course administrator to apply for a place on the screening masterclass.

Neonatal and paediatric intensive care units: learning resource

Download the NICU and PICU resource if you work in a:

• neonatal intensive care unit (NICU)
• paediatric intensive care unit (PICU)

To support you in ensuring the infants and babies in your care are offered screening in a timely manner, use this self directed tool to:

• get an overview of screening within the NICU and PICU environment
• work through scenarios and examples

When you’ve used the resource, make sure to reflect on your learning and use it as evidence of continuing professional development.

Resource cards

Download the NHS antenatal and newborn screening programmes factual resource cards.

Use this pocket sized resource is to help:

• discuss screening with women and their families
• facilitate informed choices.

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Detailed guide: Sickle cell and thalassaemia screening: education and training

This guide sets out education and training resources available to healthcare professionals working in the sickle cell and thalassaemia (SCT) screening programme.

E-learning

Most e-learning developed by the NHS screening programmes is available on the e-Learning for Healthcare (e-LfH) website.

Read about SCT e-learning and sign up for e-Learning for Healthcare.

E-learning for GPs

Complete the British Medical Journal’s antenatal and newborn screening module to learn about:

• the principles of screening and how they are applied in practice
• what screening programmes are available
• how to advise patients about the timing of screening tests

Training courses

Read about the training courses available to healthcare professionals working in the SCT programme. Both King’s College courses are accredited by the Royal College of Midwives.

Haemoglobinopathies: SCT screening programme update

The SCT programme is pleased to provide funded places for eligible professionals to attend this study day for:

• non specialist nurses
• midwives
• health visitors

Read about the screening programme update course and how to apply on the King’s College London website.

Haemoglobinopathies: specialist counsellors update

This free one-day update is for practitioners who have previously undertaken the Professional Education for Genetic Assessment and Screening (PEGASUS) course or an alternative Sickle Cell and Thalassaemia related module.

Read about the specialist counsellors update course and how to apply on the King’s College London website.

Genetic risk assessment and counselling module

This 4-day course is for NHS staff delivering counselling to ‘at risk’ couples as identified by the NHS SCT screening programme. The course covers:

• haemoglobin disorders

• practical applications of genetics in health care

• genetic testing

• prevention of genetic disorders

• prenatal diagnosis and genetic counselling

Read about course dates on the King’s College London website.

Sign up and bursary

The SCT programme offers a number of course fee bursaries for eligible professionals. To obtain for a bursary you must apply to both King’s College London and the SCT programme.

1. Apply to King’s College London for a place on the course.
2. Apply for funding from the SCT programme.

This bursary is not applicable for practitioners who have already undertaken the PEGASUS course or a Sickle Cell and Thalassaemia related masters module.

Laboratory training days

This training day for bench level staff, haematology laboratory managers and consultant haematologists. It takes place from 9am to 5pm and includes:

• a laboratory handbook update
• a programme and laboratory standards update
• data trends
• a UKAS update
• measurements and proportions for Haemoglobin A2, Haemoglobin variants and Haemoglobin disorders
• a clinical talk about sickle cell disease
• interactive case studies
• an open forum

Sign up for the training day

Book your place for the Leeds training day.

Book your place for the London training day.

There is no cost for this training day. For further details please contact the SCT programme team.

Counselling competences

Families at risk of specific inherited conditions should have access to appropriate genetic counselling. Read the counselling competences document on the national archive for:

• counselling competencies
• learning resources
• pathways and failsafes
• an example job description for counsellors

Watch videos supporting the competences on Vimeo.

Education and training: all programmes

Read and download education and training resources for all screening programmes. This includes:

• midwife resource cards
• the screening timeline
• events

Health Knowledge: screening overview

The interactive learning on screening available from Health Knowledge is helpful for new and non clinical staff or those returning after a long period absent.

from Public Health England - Activity on GOV.UK https://www.gov.uk/guidance/sickle-cell-and-thalassaemia-screening-education-and-training
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Detailed guide: Newborn blood spot screening: education and training

This guide sets out education and training resources available to healthcare professionals working in the newborn blood spot screening programme.

E-learning

Most e-learning developed by the NHS screening programmes is available on the e-Learning for Healthcare (e-LfH) website.

Read about NBS e-learning and sign up for e-Learning for Healthcare.

E-learning for GPs

Complete the British Medical Journal’s antenatal and newborn screening module to learn about:

• the principles of screening and how they are applied in practice
• what screening programmes are available
• how to advise patients about the timing of screening tests

Failsafe videos

The newborn blood spot failsafe solution (NBSFS) helps ensure that all babies born in England are offered screening.

Watch this series of video user guides to learn how to use the NBSFS.

Avoidable repeat rate

Good quality blood spot samples are vital to ensure babies with rare but serious conditions are identified and treated early. If samples are not taken properly they will need to be taken again, this is known as an avoidable repeat.

Watch a video of a community midwife discussing how she improved her practice to lower her avoidable repeat rate.

Education and training: all programmes

Read and download education and training resources for all screening programmes. This includes:

• midwife resource cards
• the screening timeline
• events

Health Knowledge: screening overview

The interactive learning on screening available from Health Knowledge is helpful for new and non clinical staff or those returning after a long period absent.

from Public Health England - Activity on GOV.UK https://www.gov.uk/guidance/newborn-blood-spot-screening-education-and-training
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Detailed guide: Newborn and infant physical examination screening: education and training

This guide sets out education and training resources available to healthcare professionals working in the newborn and infant physical examination (NIPE) programme.

E-learning

Most e-learning developed by the NHS screening programmes is available on the e-Learning for Healthcare (e-LfH) website.

Read about NIPE e-learning and sign up for e-Learning for Healthcare.

E-learning for GPs

Complete the British Medical Journal’s antenatal and newborn screening module to learn about:

• the principles of screening and how they are applied in practice
• what screening programmes are available
• how to advise patients about the timing of screening tests

Specialist training

Specialist training for midwives in the physical examination itself is offered by a number of educational institutions throughout England. Contact the NIPE team via the screening helpdesk for more details.

Education and training: all programmes

Read and download education and training resources for all screening programmes. This includes:

• midwife resource cards
• the screening timeline
• events

Health Knowledge: screening overview

The interactive learning on screening available from Health Knowledge is helpful for new and non clinical staff or those returning after a long period absent.

from Public Health England - Activity on GOV.UK https://www.gov.uk/guidance/newborn-and-infant-physical-examination-screening-education-and-training
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Detailed guide: Infectious diseases in pregnancy screening: education and training

This guide sets out education and training resources available to healthcare professionals working in the infectious diseases in pregnancy screening (IDPS) programme.

E-learning

Most e-learning developed by the NHS screening programmes is available on the e-Learning for Healthcare (e-LfH) website.

Read about IDPS e-learning and sign up for e-Learning for Healthcare.

E-learning for GPs

Complete the British Medical Journal’s antenatal and newborn screening module to learn about:

• the principles of screening and how they are applied in practice
• what screening programmes are available
• how to advise patients about the timing of screening tests

Education and training: all programmes

Read and download education and training resources for all screening programmes. This includes:

• midwife resource cards
• the screening timeline
• events

Health Knowledge: screening overview

The interactive learning on screening available from Health Knowledge is helpful for new and non clinical staff or those returning after a long period absent.

from Public Health England - Activity on GOV.UK https://www.gov.uk/guidance/infectious-diseases-in-pregnancy-screening-education-and-training
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