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** 15 November 2022
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** UK
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** NHS doesn’t need more cash says health secretary (#1)
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** UK breakthrough on lung cancer helps target patients (#2)
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** Calls for COPD awareness as quarter of sufferers wait more than five years for diagnosis (#3)
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** Scotland: Former First Minister calls for end to alcohol adverts in sport (#4)
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** International
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** Opinion: Post-cancer smoking cessation and the role of GPs in Australia (#5)
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** UK
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** NHS doesn’t need more cash says health secretary

Rishi Sunak faces a new battle with the NHS after his health secretary said he could do without extra cash.

Steve Barclay astonished Treasury officials when he told Jeremy Hunt, the chancellor, that he would not ask for more money to offset the effects of inflation next year, promising to find efficiencies and savings instead.

His remarks started “robust” negotiations with NHS England, which has warned that cancer care, GPs and mental healthcare face cutbacks without £6 billion to £7 billion more to deal with surging inflation and pay rises.

Amanda Pritchard, chief executive of NHS England, said in a warning to Barclay that savings from bureaucracy could “only be a margin of an already small margin”.

After Sunak promised to prioritise the NHS, Pritchard may yet get more money from savings elsewhere in the Department of Health budget as public health and infrastructure budgets are possible pots to be raided. Sources close to Barclay acknowledged that he was accepting of the difficult fiscal situation facing Hunt, who is trying to find £55 billion in tax rises and spending cuts.

Talks between NHS England and Barclay’s team have started and Pritchard is making the case that key programmes to improve care will be scaled back if more money is not found.

Source: The Times, 12 November 2022

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** See also: The Health Foundation- public health grants ([link removed])
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** UK breakthrough on lung cancer helps target patients

Seven years ago, Kelly Harrop was diagnosed with lung cancer: “It was a shock. I was fit, healthy and had never smoked”. Kelly had surgery to remove the tumour, followed by chemotherapy. But doctors knew there was a risk of the tumour reappearing, so they enrolled her in a new research programme, TRACERx. Funded by Cancer Research UK, the £14m project was set up 10 years ago to investigate how lung tumours arise and evolve. A total of 850 patients with early-stage lung cancer were studied and followed from diagnosis to treatment.

“After surgery and chemotherapy, around 70% of lung cancer patients are cured. However, the rest will relapse due to metastatic spread” said project leader Prof Charles Swanton, of London’s Francis Crick Institute. Only 10% of those who suffer such relapses will be alive after five years, added Swanton.

Returning tumours could then be spotted long before symptoms appeared, buying patients crucial time. “In the very early stages of a lung cancer’s return, the disease burden is much lower and actions taken then will have a much greater impact,” said Swanton.

The TRACERx team succeeded, developing a technique that can segregate patients who will definitely relapse from those who are far less likely to. One of the first patients to be involved in trials of the new technique was Kelly Harrop.

But Kelly’s case raises an important issue. She had never smoked but still developed lung cancer. The disease is closely linked to smoking, but “never smokers” account for 10-20% of cases. Research funded by TRACERx has since uncovered a key risk.

The new technique, which is still completing its clinical trials, provides early warnings of a cancer’s return while freeing recuperating cancer patients who are not at risk of a tumour’s return, such as Kelly from undergoing unnecessary additional treatments. “It means we can target patients that are most at need when they are most receptive to treatment,” said Swanton.

Source: The Guardian, 12 November 2022
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** See also: TRACERx ([link removed])
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** Calls for COPD awareness as quarter of sufferers wait more than five years for diagnosis

Chronic obstructive pulmonary disease (COPD) causes severe breathlessness, coughing and frequent chest infections. It affects around 1.4 million people in the UK and late diagnosis can increase the risk of life-threatening flare-ups.

A report released by Asthma + Lung UK ahead of World COPD day on Wednesday warns 23 percent of sufferers surveyed had waited at least five years for a diagnosis and 12 percent waited a decade.

The charity’s CEO, Sarah Woolnough, said: “We are hearing shocking stories of people spending years, even a decade of their lives, sometimes struggling to breathe, unaware that they have a lung condition which could be managed with the right treatment and support.

“Diagnosis of COPD needs to be faster and more accurate and there needs to be greater awareness of the seriousness of lung conditions and the signs and symptoms to look out for. To achieve this, we are calling on the government to ensure the NHS is equipped to restart diagnostic tests for lung conditions, like spirometry.”

Source: Express, 15 November 2022
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** Scotland: Former First Minister calls for end to alcohol adverts in sport

Henry McLeish has urged the Scottish government to end alcohol advertising in sports.

New research found the country has more drink-related adverts in top level football than most European leagues. Half of the country's premiership teams have at least one alcohol company as a main sponsor or partner.

The Scottish government confirmed a public consultation on possible restrictions to alcohol advertising and promotion will be launched soon.

Mr McLeish's intervention comes after the Scottish Health Action on Alcohol Problems (Shaap) found only Belgium had a higher proportion of such adverts than Scotland.

The ex-professional footballer, who was first minister from 2000 to 2001, added: "We must find a better way to finance Scottish football, finding sponsors with values that align with sports and community, and that's why I support today's call for a ban on alcohol sponsorship of sports."

Source: BBC news, 14 November 2022
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Read here ([link removed])


** International
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** Opinion: Post-cancer smoking cessation and the role of GPs in Australia

Writing in the RACGP’s newsGP, Dr Eileen Cole, GP programme advisor for the Quit Centre in Australia, argues that much greater emphasis should be placed on smoking cessation in the early stages of diagnosis and treatment for cancer patients and that this could be instrumental in facilitating quitting.

Dr Cole writes that smoking cessation treatment for patients with cancer should be a top priority because quitting can improve the prognosis and continued smoking after diagnosis has been associated with adverse health outcomes.

She also notes evidence that suggests a causal relationship between smoking and poorer response to treatment and increased treatment-related toxicity in cancer patients and survivors. Furthermore, she points to evidence that pre-operative smoking is linked to greater risk of post-operative complications for oncology patients, including delayed wound healing.

Dr Cole concludes that when compared with continued smoking, smoking cessation following a cancer diagnosis reduces all-cause mortality and increases survival rates even for cancers not traditionally associated with smoking, such as breast cancer and prostate cancer.

Source: newsGP, 15 November 2022
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**
See also: Surgeon General's report- the health consequences of smoking ([link removed])
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