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  1. NHS gets "fundamental standards"

    An updated version of the NHS Constitution with new provisions about duty of candour and protecting patients from harm was unveiled yesterday.

    According to the Department of Health, the new constitution reflects "fundamental standards" of care which must not be breached.

    It promised "decisive action" against institutions which fail to meet the standards.

    The changes are intended to reflect proposals that arose from the public inquiry into Mid-Staffordshire in 2013.

    The constitution now states that health services must give patients priority and protect them from avoidable harm. It also says staff should provide the "assistance" that patients need.

    It also states that physical and mental health are "equally important."

    And it gives patients a "right to candour" in their dealings with NHS workers.

    The new constitution also includes the Armed Forces Covenant that promises members of the armed forces equal access to services.

    Sir Robert Francis, who chaired the inquiry into Mid-Staffordshire, said: "The Constitution is an immensely useful tool not only for patients but for NHS staff at all levels. So I look forward to it being fully integrated into everything the NHS does.

    "It is important not only that everyone is familiar with the rights and responsibilities in the Constitution, but that they are a reality for everyone who offers or receives healthcare."

  2. MERS scare in Manchester

    A hospital had to close its accident and emergency department after two patients were tested for the deadly MERS-CoV virus.

    The patients arrived at Manchester Royal Infirmary yesterday and led to temporary closure of the department.

    The hospital said both patients had been placed in isolation and one moved to the North Manchester General Hospital.

    MERS - the Middle Eastern Respiratory Syndrome Coronavirus Infection - has proved highly infectious in countries such as Saudi Arabia where it is thought to have been spread by camels.

    It has a high fatality rate and has infected a number of health care workers in its countries of origin.

    Most recently there has been an outbreak in South Korea, where 138 people have been infected and 14 have died after the disease was thought to have been brought to the country by a single traveller. Today the country declared its outbreak to be over.

    A spokesman for Manchester Royal Infirmary said it was still waiting for the results of tests.

    A spokesman said: "We would like to reassure our patients and the general public that there is no significant risk to public health."

  3. Child cancer genes cracked

    A European team of researchers has been unravelling the secrets of an incurable form of childhood leukaemia.

    The researchers reported deciphering the genetic code of the sub-type of acute lymphoblastic leukaemia.

    And they also reported ideas for possible drug treatments.

    The work has been led by doctors at the University Children's Hospital, Zurich, Switzerland, and at Hannover Medical School, Germany.

    The disease was known to involve the fusion of two genes, TCF3 and HLF and the latest research identifies other changes to DNA involved in the disease.

    This showed that the disease involves modifications to B-lymphocytes that play a role in defending the blood, the researchers report in Nature Genetics.

    There is also a "previously undetected" change to leukaemia cells so they revert to an early but conceal developmental stage, the researchers say.

    The researchers say their laboratory tests suggest that several new drugs have a "very positive" effect.

    Researcher Professor Martin Stanulla, from Hannover, said: “This form of leukaemia might be described as a kind of ‘wolf in sheep’s clothing."

    Fellow researcher Marie Laure Yaspo, of the Max Plank Institute for Molecular Genetics, Berlin, Germany, added: “These key findings could be made, in particular, by reading out the messenger molecules synthesised in the tumour cells, a powerful technique allowing not only a deeper understanding of the genetic program specifying the behaviour of tumour cells, but also of therapeutic entry points.

    Ute Fischer Genomics and drug profiling of fatal TCF3-HLF−positive acute lymphoblastic leukemia identifies recurrent mutation patterns and therapeutic options. Nature Genetics 27 July 2015; doi: 10.1038/ng.3362.

  4. Depression key reason for assisted dying requests

    Many of those seeking assisted dying in Belgium are suffering from depression, researchers say today.

    It was the most common mental illness reported among a group of 100 patients who sought to undergo euthanasia for psychiatric reasons in a five year period.

    Some 35 of these patients went on to have their lives ended using the legal process allowed in Belgium.

    Researchers say their findings highlight the difficulty of defining the "unbearable suffering" deemed a reason for Belgian health services to support euthanasia.

    Some 58 had depression and 50 had personality disorders. 12 patients were later diagnosed with Asperger's syndrome.

    The study, conducted in the country's Dutch-speaking region and reported in BMJ Open, also found that 70 had been medically unfit for work while 59 lives alone.

    By the end of 2012 a total of 43 had died as six committed suicide - one because of her family's objections to euthanasia. One died from anorexia and one from palliative sedation.

    The researchers say that 30 patients died surrounded by family and friends "in a serene and positive atmosphere".

    In just two years, 2010 and 2011, some 2,086 people died from euthanasia - 1% of the country's deaths. 90% of these were terminally ill, the researchers say.

    Researcher Dr Lieve Thienpont, of University Hospital, Brussels, warns: "As yet, there is no consensus on what constitutes unbearable suffering nor are there any guidelines in Belgium on how best to deal with requests for help to die from those who are mentally ill.

    "Taking into account the ongoing fierce ethical debates, it is essential to develop such guidelines, and translate them into clear and detailed protocols that can be applied in practice."

    Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study BMJ Open 28 July 2015; doi 10.1136/bmjopen-2014-007454 [abstract]


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