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  1. Overtime payments fuel consultant contract talks

    A hard-working consultant earned nearly £400,000 in overtime payments last year, it was revealed today.

    The doctor works at the Lancashire Teaching Hospitals NHS Foundation Trust - but has not been named or identified.

    The scale of the payments emerged from a BBC investigation, using Freedom of Information requests, into consultant overtime payments.

    Government sources seized on the revelations as indicating the need for changes to the consultant contract - the subject of a fresh round of negotiations.

    The investigation found that a consultant at East Kent Hospitals University received more than £200,000 in overtime payments in the last year.

    The third highest payment was a sum of £183,000 in Blackpool.

    Out of 140 trusts and health boards, two-thirds paid at least one consultant £50,000 or more in overtime. A quarter paid out at least one sum of £100,000.

    Radiologists, surgeons, urologists, anaesthetists and gastroenterologists were the most numerous recipients of "high cost" overtime.

    Professor Mark Pugh, medical director of the Lancashire Teaching Hospitals, said: "There is an acute shortage of consultants for some of these specialities and as we have not been able to source the additional staff we need as demand has risen, we have paid overtime to the existing workforce to deliver extra clinics so that patients can be seen and treated as quickly as possible."

    A government source said: "Consultants do a vital job and should be properly rewarded, but this analysis shows why we are working with the BMA to replace a unique evening and weekend 'opt-out' in the existing contract.

    "This will allow us all to promise patients urgent and emergency care of a consistently high standard across the week, and - as the hospitals themselves say - make better use of operating theatres while reducing big overtime bills."

    But BMA consultants' committee chair Dr Keith Brent said: "There are also lots of consultants working extra hours for nothing or for normal pay.

    "These payments are made because there simply are not enough doctors and hospitals are under pressure to meeting waiting time targets."

  2. Contract court campaigners announce next step

    The junior doctor legal campaign will continue to focus on the powers of health secretary Jeremy Hunt to impose a new contract, it was announced last night.

    Campaigners met their lawyers after successfully raising the money needed to fight a full case.

    After raising some £150,000 within a week, the group Justice for Health had the resources to extend their case.

    They revealed they were considering using law on competition - arguing that NHS trusts are individual employers and cannot collaborate to impose a contract on employees.

    Justice for Health says it will not follow this route now - leaving them with surplus funds in the bank to fight an appeal if they lose their judicial review.

    The review will be sought on the grounds that health secretary Jeremy Hunt did not have the power to impose a contract on junior doctors - and that he should have consulted before announcing a proposal to impose.

    The group will argue that his applied when Mr Hunt imposed the contract after junior doctors voted to reject proposals that had been negotiated.

    The group also explained that any surplus funds from the case would revert to their fundraising site - Crowdjustice. The funds are likely to be used to support other "pro-NHS" legal actions.

    A statement from the group said: "Thanks to your donations, the immediate financial restrictions in taking the competition law challenge forward were lifted and we had the freedom to give this option full consideration. We want to have the best possible chance of winning our judicial review.

    "The Health Secretary has tried everything to avoid this case being heard, and we will do everything we can to hold him to account for his actions."

  3. MND genes found

    People who develop motor neurone disease are victims of rare but specific gene variants, according to the findings of a major genetic study published last night.

    Researchers identified one gene variant that increases the risk of developing the disease by 65%.

    Reporting in Nature Genetics, researchers revealed a total of three new risk genes for the disease, also known as amyotrophic lateral sclerosis or ALS.

    The researchers said that each patient had one or two genes which played a key role in their development of disease. This is in contrast with many conditions which are caused by combinations of small effects from many genes.

    The findings come from an analysis of more than 15,000 patients from 15 countries, compared with another 26,000 healthy people.

    The researchers say C21orf2 is especially important.

    Researcher Professor Ammar Al-Chalabi, from the Institute of Psychiatry, Psychology & Neuroscience, King's College London, said: "This tells us that ALS is not the result of a few common gene variations that each contribute a little to the risk. Rather, any one of many rare gene variations contributes a large risk for ALS development.

    "This insight is crucial as it affects the types of treatment strategies that might be effective."

    Fellow researcher Professor Jan Veldin, from the University Medical Centre Utrecht, the Netherlands, said: "Most genetics studies in ALS focus on the familial form of the disease.

    "In this study we have found a total of three genomic regions where genetic variation in these regions increases the risk of ALS. One of these regions included a gene named C21orf2. This gene was subsequently shown to harbour rare mutations that directly increase ALS risk.

    "This makes the C21orf2 gene extremely interesting for future studies to shed light on the mechanisms that lead to ALS and possibly future therapeutic strategies."

    Nature Genetics 27 July 2016 [abstract]

  4. Lung test closely linked to mortality

    Poor fitness is a key factor in loss of life among middle-aged men, according to Swedish researchers.

    It is the second biggest factor in early death among middle-aged men, after smoking, has been found to be low physical capacity.

    The link between physical fitness and mortality was analysed using figures on 792 men from the Swedish "Study of Men Born in 1913". These men did an exercise test at 54 years of age (1967), and most of them also did a maximum-tolerated exercise test. Their oxygen uptake, or VO2 max, was measured using ergospirometry, a diagnostic procedure of the heart and lungs.

    The study continued for 100 years after the men were born. Their causes of death were taken from a national death registry.

    Those in the middle third for oxygen uptake had a 21% lower risk of death over 45 years than those in the middle third. The top third, in turn, had a 21% lower risk than the middle third.

    The research is published today (27 July) in The European Journal of Preventive Cardiology.

    Lead author Dr Per Ladenvall says: "The benefits of being physically active over a lifetime are clear. Low physical capacity is a greater risk for death than high blood pressure or high cholesterol.

    "VO2 max is a measure of aerobic capacity and the higher the figure, the more physically fit a person is. In 1967 it was difficult to do ergospirometry in large populations, so the researchers derived a formula using the measurements in the subpopulation, and then calculated predicted VO2 max for the remaining 656 men who had done the maximum exercise test."

    Dr Ladenvall added: "The effect of aerobic capacity on risk of death was second only to smoking. We have come a long way in reducing smoking. The next major challenge is to keep us physically active and also to reduce physical inactivity, such as prolonged sitting."

    Ladenvall, P. et al. Low aerobic capacity in middle-aged men associated with increased mortality rates during 45 years of follow-up. European Journal of Preventive Cardiology 27 July 2016 doi: 10.1177/2047487316655466


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