Case study: Healthy High Streets Challenge and Tasters Fried Chicken Shop

Summary:

Tasters Fried Chicken Shop in Tottenham, London has been trialling healthier options, with support from Healthy High Streets, a programme initiated by the Healthy London Partnership.

What was involved

With over a third of children leaving primary school overweight or obese, the Healthy High Streets Challenge was designed to help children and young people access healthier food options on London’s high streets.

This is led by Healthy London Partnership, in partnership with Guy’s and St Thomas’ Charity, Battersea Power Station Foundation Innovation Unit and Southwark, Lambeth and Haringey councils. They invited people who work and live around participating high streets to submit their ideas for helping children and young people make healthier food choices. In Haringey, over 40 businesses in and around West Green Road submitted proposals.

In January 2018, Tasters Fried Chicken Shop on West Green Road in Tottenham was the winner of the Healthy High Streets Challenge in Haringey.

Tasters looks like an average London high street chicken shop, but its proprietor is on a quest to quietly shift the eating habits of his clientele, especially children and young people. Shahid Majeed, owner and manager of Tasters, has been developing and testing a new, healthier menu for children and learning how to nudge the after-school crowd into giving it a try.

What works well

Shahid’s winning idea has just been tested over a 4 week period of trading. The first week saw the launch of the new menu for children to rival an existing menu with its fried chicken favourites. The existing menu includes chicken nuggets, chicken strips, burgers and fries. The new, healthier menu features grilled chicken, salad and chunky chips (which are generally lower in calories than French fries) in controlled portion sizes and is pitched at the same price point (£1.30 to £2.50) as the existing fried chicken menu for children. Shahid knows that this is absolutely crucial to making a healthier option genuinely accessible.

Through the other weeks in the trial, staff at Tasters experimented with different nudging techniques, including offering special discounts during the after-school rush and recommending that customers consider the healthier menu for children at point of sale.

Sales of the healthier children’s menu have been strong. In the third week of the trial (when the ‘after school special’ was tested), sales of the healthier menu even surpassed the fried food menu (189 items versus 102).

Week 1: New menu

Kids’ grilled chicken menu sales – 33

Kids’ fried chicken menu sales – 93

Week 2: New menu

Kids’ grilled chicken menu sales – 124

Kids’ fried chicken menu sales – 139

Week 3: Promotion and nudging

Kids’ grilled chicken menu sales – 189

Kids’ fried chicken menu sales – 102

Week 4: Promotion and nudging

Kids’ grilled chicken menu sales – 114

Kids’ fried chicken menu sales – 133

Next steps

Shahid believes the early sales figures are extremely promising and he expects to see an even greater uptake of the healthier options over time. He said,

The regular, loyal customers know what they want. It will take time to shift behaviour, but what will happen in the future? Sales of the grilled chicken will continue to grow.

According to Shahid, crucial factors for success are an affordable price-point and selling something that looks and tastes good:

The main reason people will switch is because the alternative tastes good. The most important thing is you need to know how to cook healthier and tasty food.

Further information

maria.vidal-read@nhs.net

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/case-studies/healthy-high-streets-challenge-and-tasters-fried-chicken-shop
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Guidance: Newborn and infant physical screening: quality improvement

This document describes the joint work undertaken by the NHS newborn and infant physical examination (NIPE) screening programme national team and the screening quality assurance service (SQAS).

It includes:

• the background to NIPE screening incidents
• tools to assess maternity services against national NIPE screening pathways

It also includes guidance on identifying NIPE screening incidents in order to improve national consistency of response.

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News story: England’s poorest areas are fast food hotspots

New figures from Public Health England (PHE) reveal England’s poorest areas are fast food hotspots, with 5 times more outlets found in these communities than in the most affluent.

The data also suggests fast food outlets – including chip shops, burger bars and pizza places –account for more than a quarter (26%) of all eateries in England.

The local environment has a major influence on our behaviours and streets crowded with fast food outlets can influence our food choices – many of these currently have no or little nutrition information in-store. Children exposed to these outlets, whether out with friends or on their way home from school, may find it more difficult to choose healthier options.

The new figures also show a variation in the number of fast food outlets across England, ranging from zero in some wards to over 100 in others.

Many local authorities across England have taken action to address their food environment and PHE is encouraging them to learn from each other. At least 40 areas have developed policies to restrict the growth of new takeaways and fast food outlets, and PHE has helped develop stronger planning guidance to support other areas in doing this.

Some have developed ‘healthier zones’ to help tackle childhood obesity by limiting the number of outlets in areas with high concentrations of fast food outlets, high levels of deprivation, or where children gather – including near schools, community centres, parks, playgrounds and other open spaces.

While not all fast food is unhealthy, it is typically higher in salt, calories and saturated fat, all of which can cause serious health problems when consumed too often and in large quantities. Children with excess weight are consuming up to 500 extra calories per day, so creating healthier environments could play an important role in tackling obesity and health inequalities.

Over a third of children in England are overweight or obese by the time they leave primary school – this figure is even higher in some deprived communities. This increases their risk of being overweight or obese adults and suffering preventable diseases including type 2 diabetes, heart disease and some cancers.

Dr Alison Tedstone, Chief Nutritionist at Public Health England, said:

It’s not surprising some children find it difficult to resist the lure of fast food outlets when many neighbourhoods are saturated with them.

Local authorities have the power to help shape our environment and support people in making healthier choices. They need to question whether these fast food hotspots are compatible with their work to help families and young children live healthier lives.

Food outlets can make a contribution to our high streets. However, with the impact of obesity on local authority social care budgets estimated at £352 million per year, encouraging healthier choices can make a positive difference.

As part of its work to improve the local food environment, PHE supports local authorities’ work with small businesses to provide healthier options. This can be through using less salt, sugar and saturated fat in their products, as well as offering customers smaller portions and promoting healthier alternatives. Some areas have healthy catering schemes to recognise and support local retailers who are making such changes.

The Department of Health and Social Care recently announced the second chapter of its childhood obesity plan, including a trailblazer programme to help local authorities learn from each other. Another significant measure is a consultation on mandatory calorie labelling in the out of home sector, to help people make informed choices when eating out. These bold steps were announced as part of government’s ambition of halving childhood obesity by 2030.

PHE plays a significant role in achieving this ambition. It has challenged major players in the food industry to remove 20% of calories from popular foods – including chips, burgers, and pizzas – by 2024. This is in addition to its challenge to industry to reduce sugar in everyday products by 20% by 2020. With a quarter of our calories coming from food consumed outside the home, restaurants including fast food outlets and takeaways are expected to play their part.

As part of its One You campaign, PHE has also helped consumers find healthier options by partnering with major high street retailers, where millions of people buy their food every day.

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Open consultation: UK National Radon Action Plan

The UK needs to have a National Radon Action Plan (NRAP) under the Ionising Radiation (Basic Safety Standards) (Miscellaneous Provisions) Regulations 2018, SI 2018/482, which put into practice part of the Basic Safety Standards Directive 2013/59/EURATOM.

This consultation invites feedback on the draft NRAP which addresses the health risks from public exposure to radon. The NRAP describes the national radon strategy and arrangements for managing exposure to radon in homes and workplaces, including the arrangements and approaches used to communicate information and guidance on radon from government and private industry to relevant groups such as members of the public and local authorities.

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Research and analysis: Fast food outlets: density by local authority in England

This map, chart and accompanying data show the variation in density of fast food outlets in local authorities across England, ranging from 26 to 232 per 100,000 population.

There is strong evidence linking the density of fast food outlets to the level of area deprivation, and the data shows higher concentrations of fast food outlets in England’s most deprived communities.

This resource has been produced using the Food Standards Agency (FSA) Food Hygiene Rating Scheme (FHRS) dataset to help local authorities target resources and take action towards achieving a healthier food environment.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/fast-food-outlets-density-by-local-authority-in-england
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News story: Health advice for residents affected by Saddleworth Moor fire

With the fire at Saddleworth Moor still alight, Public Health England (PHE) has issued health advice to people affected by the smoke.

Residents in areas affected by smoke should stay indoors, keep their doors and windows closed and tune in to their local radio station for advice and information.

Motorists who have to travel through the smoke should keep windows closed and switch air conditioning systems to recycle or recirculate air. If people need to be outdoors, they should try to avoid areas affected by any smoke or ash, or to limit the time that they spend in them.

Smoke can irritate air passages, the skin and the eyes, leading to coughing and wheezing, breathlessness and chest pain. It can also worsen existing problems such as asthma so people should carry their inhaler with them at all times.

Anyone concerned about their symptoms should contact their GP or NHS 111.

In addition, PHE appreciates the hot weather is having a combined effect and also recommends:

• wearing lighter clothing
• keeping hydrated with cool drinks
• limiting activities that might contribute to emissions within the home, such as cooking
• setting any air conditioning to recirculate mode
• limiting the time you spend outdoors and avoiding strenuous physical activity
• once the smoke has moved away, consider opening doors and windows to allow the house to cool down.

Image courtesy of the University of Dundee.

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News story: Financial incentives effective at reducing antibiotic prescribing

Public Health England (PHE) has worked with Imperial College London to assess the impact of the Quality Premium on the rate of antibiotic prescribing, the result of which has been published in the Journal of Antimicrobial Chemotherapy. The results show that the number of patients prescribed antibiotics by their GP for common respiratory infections, for which antibiotics are generally not needed, decreased by 3% following the introduction of the national incentive scheme.

Taking antibiotics when they are not needed puts people at risk of a more severe or longer infection in the future as antibiotics may not work when they are really needed.

In England, respiratory tract infections, which include coughs, colds and sore throats, are one of the most common reasons for a visit to the GP, with many patients being prescribed antibiotics. However, the majority of respiratory tract infections are caused by viruses in which case antibiotics don’t actually work as they only attack bacteria. For most patients pain and other symptoms can be effectively reduced using drugs such as paracetamol and the infection will generally clear up without further treatment.

Professor Alan Johnson, Head of Surveillance HCAI and AMR at Public Health England, said:

As part of a national strategy to tackle antibiotic resistance, this is one of a range of successful interventions used to support GPs to reduce levels of prescribing. It is important that we continue to reduce the levels of inappropriate prescribing if we are to prevent further increases in drug-resistant infections.

The NHS England Quality Premium scheme was introduced to reward clinical commissioning groups (CCGs) for improving their services. It offers financial incentives to CCGs – which decide how funding is spent on health services in their area – for meeting a number of criteria. In 2015 to 2016 this included measures to reduce total antibiotic prescribing by 1%, as well as 10% reduction in prescriptions for broad spectrum antibiotics, used to tackle a range of bacterial infections.

The research was supported by the National Institute for Health Research.

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Press release: PHE and Disney UK launch Change4Life Train Like A Jedi programme

The new Change4Life Train Like a Jedi programme uses the excitement of Star Wars^TM and its characters – alongside Double Olympic Gold medallist Jade Jones – to encourage children to Train Like A Jedi and is designed to increase levels of physical activity amongst children in England.

It is recommended that children do at least 60 minutes of moderate to vigorous physical activity every day, yet just 23% of boys and 20% of girls aged 5 to 15 years currently meet this recommendation.

This year marks the fifth year PHE and Disney have worked together to inspire children to move more, with an estimated 300 million minutes of activity inspired to date.

A new survey from PHE and Disney found that over 4 in 5 children (82%) would be inspired to move more if they saw their favourite characters being active. With Star Wars characters ranking as key favourites amongst UK children aged 7 to 11, the programme aims to make physical activity fun and inspire children to move more.

In addition, the survey from PHE and Disney looking at the factors that influence children to be more active found:

• 59% of children say they would be more active if exercise felt fun
• children (58%) and parents (55%) ranked friends as the most influential figure in encouraging children to be more physically active
• 99% of children say they enjoy doing physical activity or sports with their parent or carer

Building a new generation of ‘Resistance’ recruits, British taekwondo athlete and double Olympic gold medallist Jade Jones, alongside a special appearance from BB-8, leads children through a series of Jedi-inspired moves in an exciting new play-along video.

Taking inspiration from the traits of iconic Jedi such as Luke Skywalker and Rey, Train like A Jedi helps children learn and master 6 key skills – technique, strength, stamina, speed, agility and mastery. The sequence of moves has been specially designed to increase children’s heart rates and benefit health.

The video is designed for children to play along anywhere – either in groups, with their friends, family, or by themselves – and will help children meet the daily recommended physical activity guidelines they need for healthy development and to maintain a healthy weight. The Train Like A Jedi activity can be done in 10-minute bursts throughout the day.

In addition to the video, the campaign will include regional events, advertising, social media activity and a free Star Wars themed pack with mini active challenges for the summer holidays. Packs will be made available through primary schools before the summer holidays.

Eustace de Sousa, National Lead for Children at Public Health England said:

Children’s physical activity levels are alarmingly low and are having a major impact on their physical and mental health – both now and into adulthood.

Getting into the habit of being regularly active will have lifelong benefits. Our Change4Life Train Like A Jedi programme is a great way for children, their friends and the whole family to get moving throughout the summer.

Double Olympic gold medallist Jade Jones comments:

Inspiring kids to get active is something I’m really passionate about, so I was thrilled to get the opportunity to help kids across the country with Change4Life and Star Wars.

It was great fun to create the Jedi-inspired moves which can be done anytime and anywhere – both at school and home. I hope that through this new programme we can inspire a new generation to move more by showing kids that physical activity can be really fun.

Mark Hamill, the actor best known for his portrayal of Luke Skywalker, offered his support to children taking part with some video messages, saying:

If you want to become a Jedi like Luke Skywalker or Rey, then you need to be fit, healthy and strong.

This summer, Change4Life can help you Train Like A Jedi. May the Force be with you.

Marianthi O’Dwyer, Vice President, Healthy Living, The Walt Disney Company UK, comments:

Using Star Wars characters and storytelling, we can help encourage children to be active by making it fun. With the huge popularity of Star Wars amongst UK kids aged 7 to 11, we believe this campaign will encourage children to get out and move like Jedi!

This is another great example of Disney’s healthy living commitment in action, where we use Disney’s characters and stories to encourage families and children to be more active together.

Last year, PHE and Disney helped more than 2 million children aged 3 to 11 get active with the 10 Minute Shake Up programme. This year, the Change4Life Train Like A Jedi programme will build on this success with all-new ways of getting children’s hearts pumping.

In the same way that mentorship plays a pivotal role for Jedi, schools have a major influence on children’s physical activity levels. Change4Life will provide schools with curriculum-linked teacher resources, including a Train Like A Jedi training video, to encourage their pupils to learn the Jedi-inspired moves and be active both in and outside the classroom.

The Change4Life Train Like A Jedi programme is also supported by Sport England.

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8400

Out of hours telephone 020 8200 4400

Background

The Opinium survey for Public Health England and Disney questioned 1,263 parents of children aged 5 to 11 in England and 783 children aged 5 to 11 in England about their attitudes to physical activity and took place in April 2018.

About Change4Life

Change4Life is PHE’s flagship social marketing programme which aims to help families to eat well and move more. PHE exists to protect and improve the nation’s health and wellbeing and reduce health inequalities. It does this through advocacy, partnerships, world-class science, knowledge and intelligence, and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Follow us on Twitter @PHE_uk.

About Disney’s Healthy Living Commitment

In 2006, The Walt Disney Company made a global commitment to support parents and create healthier families by using its stories and characters to make healthy living simple and fun. Since 2006, Disney has been offering different ways to support families to live more healthily. This includes introducing robust nutritional guidelines for food and drinks as well as their advertising, offering content that positively focuses on healthier lifestyles such as Disney Channel’s First Class Chefs, The Lodge and Aim High, and inspiring activity and healthier eating through programmes such as Change4Life ‘10 Minute Shake Up’, PHE, Disney and Swim England ‘Just Keep Swimming’ Finding Dory programme, the partnership with the Football Association and Girls’ Football Week, and Disney’s #HealthilyEverAfter marketing campaign.

About The Walt Disney Company UK & Ireland

The Walt Disney Company, together with its subsidiaries and affiliates, is a leading diversified international family entertainment and media enterprise. Disney is a Dow 30 company and had annual revenues of $55.1 billion in its last fiscal year (FY17).

The Walt Disney Company has operated in the UK and Ireland for over 80 years, employing more than 3,300 people, and is dedicated to creating innovative, entertainment experiences for children and families. The Disney brand is experienced in a number of ways across the UK and Ireland including in cinemas, on stage, via its streaming app DisneyLife, on TV screens with Disney-branded channels and through a wide range of consumer products that are sold at mass market retailers and in Disney Stores. Now in its fifth year, Disney’s partnership with Public Health England and the ’10 Minute Shake Up’ campaign has seen over 2 million kids get active with an estimated 300 million extra minutes of physical activity being completed.

About Sport England

Sport England is a public body and invests more than £300 million National Lottery and government money each year in projects and programmes that help people get active and play sport. It wants everyone in England, regardless of age, background, or level of ability, to feel able to engage in sport and physical activity. That’s why a lot of its work is specifically focused on helping people who do no, or very little, physical activity and groups who are typically less active - like women, disabled people and people on lower incomes.

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Guidance: Children’s public health 0 to 5 years: national reporting

This document explains in detail what analysts and commissioners in your local authority need to do to submit health visiting activity and outcomes data to Public Health England (PHE) for 2018 to 2019. Reading this guidance should give your local team all the technical detail they need to submit your aggregate data to the central system.

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Research and analysis: Reproductive health: what women say

Use these documents as the starting point to develop a 5-year cross sectoral action plan for reproductive health. They can also be used as a reference point for healthcare professionals to inform prioritisation and planning.

‘A consensus statement: reproductive health is a public health issue’ is an agreed statement between partners about a vision for reproductive health which is centred on the 6 pillars of reproductive health.

‘What do women say? Reproductive health is a public health issue’ reports on the findings of a large survey of more than 7,000 women and focus groups around the country.

‘What does the data tell us? Women’s reproductive health is a public health issue’ (available to download) provides a national overview of the current status of reproductive health based on routine and survey data.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/reproductive-health-what-women-say
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Press release: Survey reveals women experience severe reproductive health issues

In the first report of its kind, Public Health England (PHE) has revealed the impact of women’s reproductive health issues on the nation’s physical, mental and social wellbeing. The report combines women’s experiences, as reported in a new survey, with existing data to define reproductive health as a public health issue.

The report shows for the first time the extent of the impact these issues have on women’s ability to work and go about their daily lives and will form the basis of a cross-governmental 5-year action plan on reproductive health.

The survey of 7,367 women reveals that 31% had experienced severe reproductive health symptoms in the last 12 months, ranging from heavy menstrual bleeding to menopause, incontinence to infertility.

The hidden burden of reproductive health was particularly evident in the workplace. Focus groups undertaken as part of the study revealed that reproductive symptoms often affect women’s ability to carry out daily activities, but many conceal their symptoms from work colleagues.

Existing studies show that 12% of women have taken a day off work due to menopause symptoms and 59% have lied to their boss about the reasons for their absence. In addition, the PHE survey revealed that 35% of women have experienced heavy menstrual bleeding, which previous evidence shows is associated with higher unemployment and absence from work. Stigma surrounding reproductive health was a key concern for women taking part in the survey, with less than half of women seeking help for their symptoms, regardless of severity.

Overall, the report highlighted that women would like reproductive health issues to be normalised so that they can be discussed openly and self-managed where possible. It also underlines the need for more openness and support in the workplace around these issues.

Angela Kilcoyne, 44 and lives in Derbyshire, took part in a PHE focus group, said:

Since I was 13, I have felt embarrassed about having heavy menstrual bleeding – a health issue which has caused me debilitating pain and nausea.

I worked for years in banking, which was a very male dominated environment, and I never told my managers that I was off due to horrendous period pain. They would not have understood at all, so I would have to invent reasons month after month and soldier on. Or I would dose myself up and try and get through the day best I could, then collapse when I got home.

Reproductive health should be spoken about in the workplace in the same way as sickness or flu.

Dr Sue Mann, Public Health Consultant in Reproductive Health, from PHE said:

Women’s reproductive health concerns can fundamentally influence physical and mental well-being throughout their whole life course. Our research has highlighted that while individual reproductive health issues and concerns change throughout a woman’s life, the feelings of stigmatisation and embarrassment were almost universal.

The report reveals the need for an open and supportive approach in the workplace and in the health system. We encourage women to seek support from their workplace, and for workplace management to be aware of how reproductive health symptoms can affect women’s daily life.

A new consensus statement, which brings together 18 healthcare bodies, including Department of Health and Social Care, NHS England and the Royal College of GPs, has positioned reproductive health as a public health issue that needs to be addressed. Working with partners, PHE will create an integrated cross-governmental five-year action plan, informed by the best available data and women’s real life experiences of reproductive health symptoms.

Background

1. World Health Organisation defines good reproductive health as ‘A state of physical, mental, and social well-being in all matters relating to the reproductive system. It addresses the reproductive processes, functions and system at all stages of life and implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when, and how often to do so.’
2. This report was launched after Dame Sally Davies, Chief Medical Officer, called on ‘increased awareness, dissemination of information and person-centred care’ around reproductive health in her 2014 annual report The Health of the 51%: Women.

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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Research and analysis: Pertussis: laboratory confirmed cases reported in England 2018

Laboratory reports from the enhanced surveillance programme for Bordetella pertussis infection (whooping cough) in England, operated by Public Health England’s microbiology services.

Earlier years’ quarterly data

For reports from earlier years see:

• Pertussis: laboratory confirmed cases reported in England 2017
• Pertussis: laboratory confirmed cases reported in England 2016
• Pertussis: laboratory confirmed cases reported in England 2015
• Pertussis: laboratory confirmed cases reported in England 2014
• the UK Government Web Archive for Health Protection Reports on pertussis (see under ‘Routine data’) and other infection reports from 2013 and earlier years

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Guidance: Isle of Wight: breast screening programme

Quality assurance (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 collected during pre-visits to review pathology reports and slides, radiology and surgical performance and attendance at a multidisciplinary team meeting

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

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Guidance: Bolton: cervical screening programme

Quality assurance (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 shared with the North regional SQAS as part of the visit process

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Guidance: South Manchester NHS Trust: cervical screening programme

Quality assurance (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 North regional SQAS as part of the visit process

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Guidance: Colchester Hospital University: cervical screening programme

Quality assurance (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 Midlands and East regional SQAS as part of the visit process

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News story: Cancer patients at increased risk of suicide

Cancer patients in England are at increased risk of suicide compared to the general population, according to new figures from Public Health England (PHE).

The first national study of its kind in England reveals cancer patients have a 20% increased risk of suicide, with the highest risk seen within the first 6 months of diagnosis.

The findings of the study, presented at PHE’s Cancer Services, Data and Outcomes Conference, show cancers with poorer prognoses are associated with the highest risk, including:

• mesothelioma
• pancreatic cancer
• oesophageal cancer
• lung cancer
• stomach cancer

The reasons are complex and not fully understood, but may include fear of pain or treatment side-effects.

The study, in collaboration with University College London, looked at adults diagnosed with malignant cancer over a 20-year period from PHE’s National Cancer Registration and Analysis Service (NCRAS), compared with mortality data from the Office for National Statistics (ONS). It identified 2,491 cancer patients whose cause of death was recorded as suicide or an open verdict.

Advances in care and treatment mean more people with cancer are surviving and living longer; however, this study suggests many are struggling with their diagnosis.

This highlights the need for emotional support – including targeted psychological screening – to be integrated early into cancer care, alongside diagnosis and treatment. It is important for health professionals to consider the risk of suicide to help avoid potentially preventable deaths.

Dr Jem Rashbass, Cancer Lead at Public Health England said:

Receiving a cancer diagnosis can be devastating, which is why it’s so important for every patient and their carers to get the support they need. This study shows how critical the first 6 months are to quality of life and reducing the risk of suicide.

Health professionals play a vital role in offering emotional support to cancer patients at this most difficult time. It is important that they recognise the signs of depression, especially when their patients may often have many other physical needs.”

Andrew Kaye, Head of Policy at Macmillan Cancer Support, said:

Being told you have cancer is like being plunged into the unknown and can be an incredibly difficult and frightening time. That’s why it’s so important that people are given the right support to find their best way through from the moment they’re diagnosed.

Empowering people with cancer to have difficult conversations about how they are feeling and providing vital support are critical to avoiding potentially preventable deaths. Mental health should be taken just as seriously as physical health when looking at a patient’s holistic needs.

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Guidance: Bowel cancer screening: bowel scope standard operating procedures

These standard operating procedures (SOPs) help commissioners and providers in establishing and implementing bowel scope screening.

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Press release: Measles and summer travel to Europe

Young people are encouraged to make sure they have had both doses of the MMR vaccine before going on holiday to Europe where there are large outbreaks of measles.

Cases of measles also continue to rise across England in unvaccinated people of this age.

The vaccine is available free to anyone who has not received both doses as a child. It protects against measles, mumps and rubella, all of which can be very serious diseases and are highly infectious.

While vaccine uptake levels in the UK in young children are currently very high, coverage levels dipped to a low of 80% in 2003. This means that there are significant numbers of unprotected teenagers and young adults who could catch measles both in England, particularly in environments of close mixing such as summer festivals and when they travel abroad for the summer holidays.

Measles is a highly infectious viral illness that can sometimes lead to serious complications and can be fatal in very rare cases so getting protected by taking up the offer of vaccination is crucial.

Between 1 January 2018 and 18 June 2018 there have been 643 laboratory confirmed measles cases in England. Cases were reported in most areas with London (225), the South-East (137), West Midlands (82), South-West (79), and Yorkshire and Humberside (74) reporting the most cases (based on provisional figures).

The World Health Organization (WHO) recommends that to prevent outbreaks of disease, 95% of people need to have received the MMR vaccine.

Dr Mary Ramsay, Head of Immunisation at Public Health England (PHE), said:

In the early 2000s there was a fall in MMR vaccination coverage in children and as a consequence, we are now seeing measles cases in young adults. Measles can be more serious in adults with a higher likelihood of hospitalisation and complications arising.

Measles is circulating in England and the rest of Europe. We often think about what travel-related vaccines we might need before going on holiday, but it’s also important to check that we are up to date with routine vaccinations like MMR.

If you are unsure if you have had 2 doses of MMR call your GP practice to check and catch up if needed.

Parents are also urged to take up the offer of MMR vaccination for their children at 1 year old and as a pre-school booster at 3 years and 4 months old.

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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Guidance: UK SMI: report on survey into susceptibility testing methodology

Until EUCAST provide updated guidance to fill the areas of non-alignment, UK SMIs recommend that laboratories may continue testing using the BSAC disk method and breakpoints, or perform EUCAST disk method then extrapolate zone sizes from related species.

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Press release: HPV vaccine reduces cancer-causing infection by 86 per cent

Human Papilloma Virus (HPV) 16 and 18 infections, which cause the majority of cervical cancer cases, decreased by 86% in women aged 16 to 21 who were eligible for the vaccination as adolescents between 2010 and 2016.

The surveillance data from England was published today (Monday 18 June 2018) in the Journal of Infectious Diseases. Overall, declines were seen across 5 high-risk HPV types, which together cause around 90% of cervical cancer cases, as well as low-risk HPV types.

The results suggest that the HPV vaccination programme will bring about large reductions in cervical cancer in the future. Cervical cancer is currently the most common cancer in women under 35, killing around 850 women a year.

In addition, the programme has led to a marked decline in genital wart diagnoses. The number of genital wart diagnoses in sexual health clinics fell in girls aged 15 to 17 by 89%, and in boys of the same age by 70%, between 2009 and 2017 as a result of herd immunity. Genital warts are caused by some low-risk strains of HPV, which the current vaccine also protects against.

Mary Ramsay, Head of Immunisations, Public Health England (PHE), said:

These results are very promising and mean that in years to come we can expect to see significant decreases in cervical cancer, which is currently one of the biggest causes of cancer in women under 35.

This study also reminds us how important it is to keep vaccination rates high to reduce the spread of this preventable infection. I encourage all parents of girls aged 12 to 13 to make sure they take up the offer for this potentially life-saving vaccine.

As well as seeing a significant reduction in the high-risk types 16 and 18, the study also showed clear declines in the prevalence of HPV31, HPV33 and HPV45, which are not included in the current vaccine. This builds on existing evidence which suggests the vaccine also offers some cross-protection to unvaccinated women against related HPV types that can also cause cervical cancer.

Robert Music, Chief Executive, Jo’s Cervical Cancer Trust:

It is extremely positive to see the impact that the vaccination has had on prevalence of cervical cancer causing HPV infection among vaccinated women. One day we hope to see cervical cancer become a disease of the past and it is only through high vaccination rates that we will get there. For women who have had the vaccine, it is important to remember it does not offer full protection against cervical cancer so attending cervical screening when invited is still important.

Most HPV infections are cleared by the immune system with no symptoms, but some high-risk types of HPV (16 and 18) cause cervical cancer.

The HPV vaccination programme was first introduced in 2008. Over 80% of people aged 15 to 24 have now been vaccinated in the UK and 80 million have received the vaccine worldwide.

The study reminds us of the importance of maintaining high take up amongst girls who are offered the vaccine through the school vaccination. The vaccine was found to be less effective in females who receive it in later adolescent years, due to an increased likelihood of prior exposure to the virus through sexual activity.

All girls can get the HPV vaccine free from the NHS from the age of 12 up to their 18th birthday. The vaccination programme is delivered through schools, but if girls miss out they can request it from their GP surgery.

Background:

1. Read the paper published in the Journal of Infectious Diseases.
2. In England, girls aged 12 to 13 years are routinely offered the first HPV vaccination when they’re in school year 8. The second dose is normally offered 6 to 12 months after the first (in school year 8 or year 9). It’s important to have both doses to be protected.
3. Men who have sex with men (MSM) do not benefit in the same way from the girls’ programme. From April 2018, MSM up to and including the age of 45 are eligible for free HPV vaccination on the NHS when they visit GUM (genitourinary medicine) clinics and HIV clinics in England.
4. For more information, comment or media interviews, please contact the PHE press office:

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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Correspondence: Vaccine update: issue 280, June 2018

The June issue features:

• leaflets and posters for the children’s flu vaccination programme 2018 to 2019
• MMR travel alert for young people
• Purified Protein Derivative PPD 10TU Immform ordering now closed
• change to presentation of Subgam (Human Normal Immunoglobulin)
• vaccine supply for the routine and non routine programme
• unused Fluenz Tetra® vaccine flu season
• Hepatitis A vaccine

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Guidance: Norovirus and hepatitis A virus scheme: sample schedule

This norovirus and hepatitis A virus scheme sample schedule is for the period 1 April 2018 to 31 March 2019.

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Guidance: People with dementia and learning disabilities: reasonable adjustments

This guide is part of a series of guides looking at reasonable adjustments in a specific service area.

It is intended to help staff in public health, health services and social care to ensure that their services are accessible to people with learning disabilities who may have, or be developing, dementia. The guide can also be of use to family and friends of people with learning disabilities.

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Guidance: Sexual health, reproductive health and HIV services: evaluation resources

These documents are for public health practitioners evaluating interventions in sexual health, reproductive health and HIV services.

The 3 resources are designed to be used together and consist of:

• an introductory guide
• an evaluation workbook with proformas and guidance
• a list of standards and metrics

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Research and analysis: Gastrointestinal infections and foodborne outbreaks in humans, England and Wales

These data reports are monthly unless otherwise indicated. They comprise:

• general outbreaks of foodborne illness (including causative organism and number of people ill)
• laboratory reports of cases of common enteric infections (Campylobacter, STEC O157, Salmonella, Shigella sonnei, Shigella flexneri, rotavirus, norovirus, Cryptosporidium and Giardia), with weekly and cumulative totals, reported to PHE’s Second Generation Surveillance System (SGSS), including stratification by serovar and/or species where appropriate, for Salmonella spp. and Shigella spp.
• laboratory reports on other enteric diseases, with cumulative totals (quarterly)

For previously published data reports, see:

• Salmonella and shigella laboratory reports 2018
• Common GI infections: laboratory reports
• Less common GI infections: quarterly laboratory reports

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Research and analysis: Diabetic eye screening: 2016 to 2017 data

The data tables in this document cover:

• programme size and uptake of routine digital screening
• programme size and uptake of routine digital screening by clinical commissioning group
• percentage of new additions to the service register who are offered an appointment within 3 months of notification to the service
• rate of ungradable images and diabetic retinopathy referrals per 100,000 screens
• rate of ungradable images and referrable diabetic retinopathy grades per 100,000 screens
• timeliness of routine digital screening results letters to patients and GPs
• referral to and attendance for consultation at hospital eye services

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Official Statistics: Cancer survival in England: adult, stage at diagnosis and childhood – patients followed up to 2017

Official statistics are produced impartially and free from political influence.

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Promotional material: Healthier weight promotion: consistent messaging

Resources to help the health and social care workforce provide a consistent set of healthier weight messages for children, young people and families.

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Official Statistics: NHS Health Check quarterly statistics: June 2018

This update contains data from 152 local authorities for January to March 2018 (quarter 4 for 2017 to 2018) and cumulative data from 1 April 2013 to 31 March 2018.

The cumulative data also includes amended statistics for:

• 21 local authorities for April to December 2017 (quarters 1, 2 and 3 of 2017 to 2018)

For more information about NHS Health Check data contact PHE.enquiries@phe.gov.uk.

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Guidance: Work, worklessness and health: local infographic tool

The work, worklessness and health local infographic tool has been developed from the national work and health infographics, published in 2016.

This new tool includes a slide set for each county or unitary authority in England.

The slides present regional and local-level data to help local stakeholders raise awareness of work, worklessness and health issues and embed them into policy planning.

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Guidance: East Lancashire Hospitals NHS Trust: cervical screening programme

Quality assurance (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 north west regional SQAS as part of the visit process

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Research and analysis: PHE heatwave mortality monitoring

Public Health England’s (PHE’s) heatwave mortality monitoring helps to provide information on excess deaths observed during heatwaves each year to inform public health actions. As per the annual heatwave plan, this is carried out each time the Met Office issues a Level 3 heatwave alert.

During period of Level 3 heatwaves in the summer months, we estimate excess daily mortality levels using the baseline death registration data from the General Register Office (GRO). At the end of the summer, excess daily mortality levels for the heatwave periods is estimated using death registration data from the Office for National Statistics (ONS) and summarised in the attached reports.

Heatwaves are predicted to increase in frequency and intensity as a result of climate change. The health impacts of these events can be significant particularly for vulnerable populations when excess mortality can occur.

The Heatwave Plan for England, produced jointly by PHE, the Department of Health and Social Care and NHS England is intended to protect the population from heat-related harm to health.

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Guidance: IDPS: template result letter after pregnancy loss

Trusts can download and adapt this Infectious diseases in pregnancy screening (IDPS) template letter with their trust branding and service contact details.

Remember to discuss this with your local screening board and to get the template signed off by your head of midwifery as per local governance arrangements.

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Open consultation: Public health practitioner level 6 apprenticeship standard

Public Health England is inviting comments on the content of the standard. Do you think that we are asking for the right knowledge, skills and behaviours? Are there any missing? Are we describing these at the right level for your practitioner at work?

Please read the standard document and then follow the survey link below to respond.

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Research and analysis: Potential impact of changes to exemption and clearance

In 2015 The Department of Energy & Climate Change (DECC) commissioned Public Health England (PHE) to undertake a review of the potential impact to the UK from the implementation of the exemption and clearance criteria given in 2013/59/Euratom.

This review was limited to a specified set of radionuclides (both artificial radionuclides and naturally occurring radioactive material) and industry sectors. This review considered the implementation of 2013/59/Euratom Directive criteria within the framework of the Environmental Permitting (England and Wales) (Amendment) Regulations 2011, and the equivalent legislation in the devolved administrations.

The potential changes were presented to a list of industry contacts in the specified sectors, who were invited to assess the practical impacts (positive and negative) of these changes. This report presents the responses received and provides a summary of the overall industry views.

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Official Statistics: Musculoskeletal diseases profile: June 2018 update

The musculoskeletal diseases profile tool has been updated.

This update includes 4 new indicators to the profiles and an update of 4 existing indicators. See the attached indicator updates document for full details of the indicators being added or revised.

The musculoskeletal diseases profile tool has been designed to bring together meaningful data on a single platform, to enable the commissioning of high value musculoskeletal services. Data are provided in a user-friendly format to help local government and health services:

• understand the health needs of their populations
• see how many people are accessing services in their areas
• find out the cost and outcomes of services

View the musculoskeletal diseases profiles

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Press release: New data reveals 420,000 cases of STIs diagnosed in 2017

The increase in syphilis follows a 10-year trend, with 78% of diagnoses in gay, bisexual and other men who have sex with men (MSM). Public Health England (PHE) is working with partner organisations to develop an action plan to address this rise. The plan aims to increase numbers and frequency of tests in populations at higher risk of infection, to promote early detection and treatment.

Across all sexually transmitted infections (STI), the highest rates of diagnoses continue to be seen in 16 to 24 year olds. It is important to increase condom use and encourage testing following changes in partners, in order to drive down the transmission of infections. This is why PHE launched Protect Against STIs in December 2017 ‒ a sexual health campaign aimed at promoting condom use in this important demographic.

Dr Gwenda Hughes, Consultant Scientist and Head of Sexually Transmitted Infection Section at PHE, said:

Sexually transmitted infections pose serious consequences to health – both your own and that of your current and future sexual partners. The impact of STIs can be considerable, with some causing infertility, pelvic inflammatory disease and harm to unborn babies.

Consistent and correct condom use with new and casual partners is the best defence against STIs, and if you are at risk, regular check-ups are essential to enable early diagnosis and treatment.

Other data published in the report show a fall in rates of genital warts, reflecting the widespread uptake of the Human Papilloma Virus (HPV) vaccine in girls aged 12 to 13. The report also indicates an 8% decline in chlamydia testing and 2% drop in chlamydia diagnoses in 15 to 24 year olds. However, there was a 22% rise in cases of gonorrhoea in 2017 compared to 2016.

Those at risk of STIs can access services through sexual health or genitourinary medicine clinics. PHE recommend regular HIV and STI testing for those with new or casual partners. MSM who are having condomless sex with new or casual partners should seek testing every 3 months. Local STI services can be located online via NHS Choices.

Important statistics:

In 2017, there were approximately 422,000 diagnoses of sexually transmitted infections (STIs) made in England, around the same number that was reported in 2016.

There were 7,137 diagnoses of syphilis reported in 2017, a 20% increase (from 5,955) relative to the year prior and a 148% increase relative to 2008.

There were 44,676 diagnoses of gonorrhoea reported in 2017, a 22% increase (from 36,577) relative to the year prior.

There were 441 diagnoses of first episode genital warts in 15 to 17 year old girls in 2017, a 90% decrease relative to 2009 and an early expression of the success of the national HPV immunisation programme.

Over 1.3 million chlamydia tests were carried out and over 126,000 chlamydia diagnoses were made among young people aged 15 to 24 years. There was an 8% decline in the number of chlamydia tests in 2017 compared to 2016.

The impact of STIs remains greatest in young heterosexuals 15 to 24 years; black ethnic minorities; and gay, bisexual and other MSM.

Background

1. Read the full report and breakdown of data.
2. To support sexual health services and work to reduce STI transmission in communities PHE:
   • launched a sexual health campaign in December 2017, called Protect Against STIs, which targets 16 to 24 year olds to promote condom usage as they experience the highest STI diagnosis rates
   • provide Local Authorities with data on local service activity – including clinical attendance, testing rates, and epidemiology (whether STIs are increasing or decreasing at a low level) – and an epidemiology report at the end of each year providing key information for commissioners
   • is developing a syphilis action plan to address the increase in cases
3. Find out more about the signs and symptoms of STIs on NHS Choices or Sexwise.

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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Official Statistics: Pregnancy and birth profiles: 2018 update

The pregnancy and birth profiles include the breastfeeding indicators. The profiles bring together a range of data indicators by local area related to:

• conception
• pregnancy and delivery
• breastfeeding
• maternity
• teenage conceptions

The pregnancy and birth profiles provide information to help improve decision making when planning local services for pregnant women or to support new mothers and their children.

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News story: Update to Parliament on breast screening incident

The update provides information on progress contacting the women concerned and arranging screening for those who have requested it. The statement also provides an update on the numbers of women affected and includes the terms of reference for the independent review.

In response to the statement, Duncan Selbie, Chief Executive of Public Health England, said:

Our priority throughout has been the wellbeing of affected women and giving them the support they need.

I would like to reiterate our heartfelt and unreserved apology that this has happened. We welcome the terms of reference of the independent review and we will work fully with them to ensure it cannot happen again.

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Press release: Focus on brisk walking, not just 10,000 steps, say health experts

With an estimated 3 million middle-aged adults physically inactive across the country,[1],[2] Public Health England (PHE) and the Royal College of General Practitioners (RCGP) are encouraging adults to incorporate brisk walking into their days as a way to improve their general health and wellbeing.

As part of the push to get adults doing more moderate intensity physical activity each day, health experts are encouraging people to increase the intensity of their walking, rather than just focus on the distance or number of steps.

Moderate intensity physical activity means getting the heart rate up and breathing faster. Just 10 minutes of brisk walking a day is an easy way for adults to introduce more moderate intensity physical activity into their day and reduce their risk of early death by up to 15%.[3]

To help adults do this, PHE’s ‘Active 10’ app has been created and it is the only app of its kind that combines intensity and time, rather than just distance.

Taking a 10 minute brisk walk each day can help build up towards the UK Chief Medical Officers’ (CMO) recommendation of at least 150 minutes per week of moderate to vigorous physical activity. This has been linked to health benefits including a lowered risk of type 2 diabetes, cardiovascular disease and some cancers.

A new survey by PHE looking at people’s perceptions of physical activity found that:[4]

• many adults struggle to fit in exercise. Not having enough time (31%) was the main reason cited, followed by not feeling motivated (27%) and being too tired (25%)

• half of these adults (50%) think more than 240 minutes of exercise per week is required to see general health benefits, nearly double the recommended guidance of at least 150 minutes – and 1 in 7 (15%) think that more than 420 minutes per week is required (an hour per day)

• nearly nine in 10 (87%) say they walk more than 10 minutes per day, however, this drops to just over half (54%) who say they walk briskly for this amount of time

The current physical inactivity crisis also has a societal impact. In adults, physical inactivity contributes to1 in 6 deaths in the UK[5] and costs the NHS over £0.5 billion per year.[6]

Professor Paul Cosford, Medical Director at PHE, said:

Managing all the pressures of everyday life can mean that exercise takes a back seat, but building a brisk walk into your daily routine is a simple way to get more active.

The Active 10 app gives you a clear picture of the intensity of your walk. Taking a brisk 10 minute walk each day will get your heart pumping, improve your mood and lower the risk of serious health issues like type 2 diabetes, heart disease and some cancers.

Professor Sir Muir Gray, Clinical Adviser for the Active 10 app and One You campaign, said:

The additional health benefits that can be achieved by walking at a brisk pace for periods of 10 minutes or more – as opposed to totting up a certain number of steps throughout the day – are undeniable.

I’d advise anyone of any age and activity level to start to fit in at least one 10 minute brisk walk a day as a simple way to get more active, especially those who may be taking medication for a long term health condition – you will receive even more benefits from walking briskly for 10 minutes or more a day.

Dr Zoe Williams, GP and RCGP Clinical Champion for Physical Activity and Lifestyle, said:

GPs want their patients to be healthy and enjoy life, and there are simple ways in which we can all improve our health. I often encourage my patients to take up more daily physical activity, which can start with just a 10 minute brisk walk – it would be great to see more people doing this across the country.

Moving more is an important step forward to improving the health of the nation and looking after our NHS, which is often overburdened by lifestyle related illness.

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said:

Small, often simple, lifestyle changes can have a really positive impact on our health and wellbeing, so anything that encourages patients to live better, and move more is a good thing. There has been a substantial rise in the number of patients who have developed multiple, long-term conditions in recent years, and many of these, including type 2 diabetes and heart disease, are linked to not being active enough.

While GPs and our teams will always encourage patients to make lifestyle changes that could potentially benefit their long-term health and wellbeing, the responsibility cannot solely lie with healthcare professionals, and patients must also play their part. The RCGP is really pleased to have endorsed the Active 10 app, which empowers patients to make basic lifestyle changes around diet and exercise, such as taking a brisk walk for 10 minutes a day and suggests ways for patients to easily incorporate these into their lives.

Already 600,000 people have downloaded the ‘Active 10’ app. In a single month, approximately 2 million ‘Active 10s’ (10-minute brisk walks) were completed by Active 10 users.

‘Active 10’ is supported by the RCGP and was developed by PHE in collaboration with The University of Sheffield, Sheffield Hallam University and the National Centre for Sport and Exercise Medicine.

Join the 600,000 people who have downloaded ‘Active 10’ and make the first step towards a healthier you. Search ‘Active 10’ to download the app for free.

Background

1. ONS Mid year Population estimates, mid-2016
2. Public Health England, Active Lives, 2016 to 2017
3. 10 minutes brisk walking each day in mid-life for health benefits and towards achieving physical activity recommendations.
4. YouGov surveyed 3007 adults in England aged 40 to 60. Fieldwork was undertaken online between 10 and 16 May 2018. The figures have been weighted and are representative of all English adults (aged 40 to 60).
5. Lee I-M, and others. (2012) Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet 380: 219 to 229.
6. PHE, Physical inactivity: economic costs to NHS clinical commissioning groups, 2016.
7. 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 Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

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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National Statistics: Cancer registration statistics, England: 2016

Official statistics are produced impartially and free from political influence.

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