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  1. New bid to reopen junior talks

    Junior doctor leaders were put under pressure to return to negotiations last night after health secretary Jeremy Hunt set out some possible concessions.

    Mr Hunt wrote to BMA junior doctors committee chair Dr Johann Malawana in a letter which, he claimed, summarised what the pair had discussed last week.

    He said it would be possible to discuss what hours on Saturday might be counted as "unsocial", attracting premium payments.

    Mr Hunt said the government had no intention of making savings on junior doctors pay.

    He said the "great majority" of junior doctors would at least be as well paid as they are now.

    Mr Hunt sought to tackle concerns that GP trainees could lose pay, suggesting that "flexible pay premia" might be used to attract doctors to the specialty.

    But he repeated an accusation that a pay calculator published by the BMA had "misled" doctors.

    He said: "I hope this letter makes clear what was discussed at the meeting – that we want to work with you, in good faith, to develop a new contract which is better for both patients and junior doctors."

    Dr Malawana last night said he was "urgently seeking clarification" on points raised in the letter.

    But several royal colleges urged the junior doctors to return to negotiations.

    The Royal College of GPs said Mr Hunt had listened to its concerns and the chair, Dr Maureen Baker, said she hoped the letter would "unblock the current impasse."

    The president of the Royal College of Physicians, Professor Jane Dacre urged "both sides to return to meaningful negotiation."

    The Royal College of Emergency Medicine said it "sincerely" hoped that both sides could now negotiate.

    A statement said: "The clarification of intent and the tone of the letter suggest the current impasse can be resolved."

    Jeremy Hunt's letter - pdf file

    Junior doctors blog

  2. Flu drugs need more trials - experts

    Antivirals should not be routinely used for seasonal flu - but may be critical in tackling pandemics, according to an expert report published yesterday.

    The experts at the Academy of Medical Sciences say it is time to conduct randomised control trials of the drugs, such as Tamiflu.

    The trials would involve patients admitted to hospital with flu, they say.

    The study says the drugs seem to achieve a significant reduction in deaths among patients in hospital - and can cut the length of flu symptoms by between 14 and 17 hours.

    The report says: "This could be critical in a flu epidemic situation, and the report supports the use of antivirals to treat patients who require hospitalisation."

    But it goes on to say that an opportunity was missed during the 2009 swine flu pandemic to conduct trials of the drugs.

    Professor Sir Patrick Sissons, who led the investigating group, said: “Given the huge impact an influenza pandemic could have on the nation, we want to be sure we have access to the best available options for treating influenza and preventing its spread.

    "After reviewing the recent major analyses of the evidence for the impact of the two most commonly used antivirals, we can conclude that the current treatments do reduce deaths from flu in seriously ill patients requiring hospitalisation. There is evidence of some benefit in patients with seasonal influenza who are not severely ill, however this benefit is modest and may not support the routine use of antivirals in this setting. There is some, but as yet limited, evidence to support the use of antivirals for prophylaxis of influenza.

    "However we emphasise that decisions about the widespread use of antivirals in a new pandemic setting must take into account factors such as the virulence of the circulating strain, cost-effectiveness, distribution and the risk of resistance.

    "Since these may be different from previous situations, it can be difficult to apply evidence collected in one outbreak to another, and very important to learn as much as possible from any new outbreak."

  3. Mental health dignity call

    "Dignity" is to be the theme of tomorrow's World Mental Health Day, it was announced yesterday.

    People with mental illness faced discrimination, stigma and marginalisation, the World Health Organisation said.

    They are also subject to emotional and physical abuse - in mental health facilities as well as in the community, WHO said.

    WHO called for training of health professionals, policy and law to incorporate human rights and respect for informed consent to treatment.

    Patients should also be included in decision making, it says.

    It also calls for public information campaigns to tackle stigma and discrimination.

  4. New police probe at troubled hospital

    England's most troubled hospital is facing a new police investigation over allegations of a cover-up over the death of a baby, it was reported last night.

    Police have become involved after the baby's parents produced evidence of alterations to medical records and statements after the death at Stafford Hospital.

    The inquiry centres on the death of Jonnie Meek, who died in August 2014, at the age of three, a few hours after being admitted to hospital.

    He had gone into hospital to test a new feeding system. His parents say their concerns were ignored when the child reacted badly to the feeding system.

    One healthcare assistant told the Health Service Journal that she did not "recognise" a statement in her name made to the statutory child death panel.

    The assistant Lauren Tew had been providing care for the child at home.

    She told the journal: "I find it really hard to believe that someone has put a statement in on my behalf. It makes me quite angry because nobody has ever contacted me.

    “There is someone who has done something wrong and instead of owning up to what’s happened they are trying to cover it up.”

    The death took place while the hospital was still part of the troubled Mid Staffordshire Foundation Trust. The problems at the hospital earlier this century led to a major public inquiry and a massive shake-up of patient safety issues in the NHS.

    Last year the trust was ruled to be no longer viable and shortly after the child's death, the hospital moved to the management of a new North Midlands NHS Trust, based in Stoke-on-Trent.

    Detective superintendent Mark Dean, from Staffordshire Police’s public protection safeguarding department, told the journal: “In the light of concerns we have commissioned an independent review and assessment of the information provided to the child death overview panel.”


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