New Chief Medical Officer Announced

Peter Russell

June 07, 2019

Professor Chris Whitty has been appointed the new Chief Medical Officer for England and the UK Government's Chief Medical Adviser.

   

Prof Chris Whitty

Prof Whitty is a practising NHS consultant physician in acute medicine and infectious diseases at University College London Hospitals, and Gresham Professor of Physic.

He is currently Chief Scientific Adviser for the Department of Health and Social Care (DHSC), and professor of public and international health at the London School of Hygiene & Tropical Medicine.

Prof Whitty said: "It is a huge honour to be given the opportunity as Chief Medical Officer for England to be able to support colleagues in public health, the NHS, and social care around the country to improve the health of the nation."

Prof Whitty will take over from Prof Dame Sally Davies when she takes up a new role as master of Trinity College, Cambridge, in October 2019.

Walking to Work and Lunchtime Gym Sessions

Employers who encourage their workforce to be more active could see higher productivity and reduced absenteeism NICE, the National Institute for Health and Care Excellence said.

Offering the perk of a subsidised gym membership, or just drawing attention to lunchtime keep fit classes, could contribute to better employee health, it said in a final quality standard.

Local authorities should prioritise pedestrians, cyclists, and public transport users, NICE said, and employers could play their part by encouraging their workers to use active travel routes in preference to cars.

Encouraging children to come to school on foot, or by bicycle or scooter, could set a pattern of active travel for when they are adults, it said.

The guidance said that schools should develop, monitor, and update their travel plans each year.

Dr Andy Cope, director of insight at the cycling and walking charity Sustrans, said: "We encourage all employers and their workforces to embrace the NICE quality standard and make physical activity an easy, attractive and practical choice for everyone.

"To achieve a cultural shift towards walking and cycling, governments at all levels need to invest in dedicated cycle routes that connect people to everyday destinations."

Sarah Ruane, strategic lead for health at Sport England, said: "Research shows that to make getting active easy for people, we need to provide attractive and affordable opportunities that are easy to fit into their lives."

Figures from the Office for National Statistics suggest that more than 131 million working days were lost to sickness in 2017, including 13 million working days lost to stress, depression, or anxiety.

One in 6 deaths is caused by a sedentary lifestyle, according to Public Health England, and is estimated to cost £7.4 billion annually, including nearly £1 billion to the NHS alone.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: "If the United Kingdom's 5.7 million small and medium sized businesses encouraged their workforce to be more active, they are more likely to reap the benefits of having engaged employees who are more productive and are less likely to take time off sick.

"Simple things like providing secure bicycle storage, showers and changing facilities can go a long way to enabling people to cycle to work or to meetings.

"As a society we are facing an obesity crisis caused in part by people not exercising enough. We need people to change their lifestyle and to take more exercise. If they can do this during the working day, not only will they benefit, but so too will their employers and the NHS. It’s a win, win for everyone."

The Royal College of GPs said it would soon launch its own scheme to help tackle sedentary behaviour in the workplace.

Health Innovations

More people would benefit this year from new innovations in the NHS, Simon Stevens, NHS England's chief executive announced this week.

He said the new treatments and tests, which included 3D heart modelling for diagnosing coronary disease more rapidly, a new pre-eclampsia test, and a handheld gadget to reduce pain from cluster headache, were being delivered as part of the NHS' Innovation and Technology Payment programme.

New innovations had already reached 300,000 patients, Mr Stevens said, and would reach more than 400,000 more this year.

"We will build on this success with our commitments set out in the long-term plan, to support the latest advances and make it easier for even more patients to benefit from world-class technology," said Dr Sam Roberts, chief executive of the Accelerated Access Collaborative, and director of innovation and life sciences for NHS England.

Increase in Cases of STIs

Public Health England (PHE) called for people to practise safer sex after a 5% increase in sexually transmitted infections (STIs) was recorded in 2018.

Of the 447,694 diagnoses of STIs made at sexual health services in England:

  • 49% were for chlamydia (218,095)

  • 13% were first episode genital warts (57,318)

  • 13% were for gonorrhoea (56,259)

  • 8% were for genital herpes (33,867)

PHE said that the increase in the total number of new STIs was largely due to a 26% increase in cases of gonorrhoea.

In people over 65, gonorrhoea increased by 42%, and chlamydia by 24%, figures from the Sexually transmitted infections and chlamydia screening in England: 2018 report showed.

An action plan to address the increase in syphilis would focus on the main affected populations, PHE said. This would include helping ensure that frequent testing in high-risk men who have sex with men (MSM) was carried out uniformly.

Paclitaxel Drug-Coated Balloons Warning

The Medicines and Healthcare products Regulatory Agency (MHRA) cautioned against the routine use of paclitaxel drug-coated balloons (DCB) and implantable drug eluting stents (DESs) in the routine treatment of patients with intermittent claudication.

The action followed concerns raised last year over statistically significant increased all-cause mortality from use of the devices 2 to 5 years after treatment compared with plain balloons or bare-metal stents.

However, the use of paclitaxel DCBs and DESs in patients with critical limb ischaemia remained an appropriate option in accordance with NICE guidance, the MHRA said, as the benefits may outweigh the risks. This was because these patients generally had a higher risk of irreversible ischemic damage resulting from restenosis, and a lower life expectancy.

Lung Cancer Treatment Approval

Final guidance from the NICE recommended atezolizumab (Tecentriq, Roche) plus bevacizumab (Avastin, Roche), carboplatin and paclitaxel as an option for treating metastatic non-squamous non-small cell lung cancer (NSCLC) in adults.

An appraisal committee explained that an indirect comparison of studies suggested that people having atezolizumab plus bevacizumab, carboplatin and paclitaxel lived longer than those having pemetrexed plus carboplatin or cisplatin, with or without pemetrexed maintenance.

It said the treatment should only be offered to patients:

Who have not had treatment for their metastatic NSCLC before, and whose PD-L1 tumour proportion score was between 0% and 49%, or

When targeted therapy for epidermal growth factor receptor (EGFR)-positive or anaplastic lymphoma kinase (ALK)-positive NSCLC had failed

A commercial arrangement was in place with the manufacturer for both drugs.
 

Diabetes Treatment Go-ahead

Ertugliflozin (Steglatro, Merck Sharp & Dohme) with metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor was recommended as an option for treating type 2 diabetes in adults when diet and exercise alone do not provide adequate glycaemic control.

Final guidance from NICE said treatment with the drug was only appropriate if the type 2 diabetes was uncontrolled with metformin and a DPP-4 inhibitor, and if a sulfonylurea or pioglitazone was not appropriate.

Nusinersen for Spinal Muscular Atrophy

Draft guidance from NICE recommended nusinersen (Spinraza, Biogen Idec) as an option for treating 5q spinal muscular atrophy (SMA).

Appraisers said the decision reflected an unmet need to slow disease progression from the rare genetic condition which can most severely affect babies and young children.

Treatment was recommended for patients with pre-symptomatic SMA, or SMA types 1, 2, or 3.

Annual treatment cost for nusinersen is £450,000 for the first year and £225,000 for subsequent years. Over 5 years, the treatment costs per person would be £1.35 million pounds. However, the manufacturer has an agreement to supply the drug at a discount.

Endocuff Vision Approval for Colonoscopy

NHS adoption of Endocuff Vision (Norgine Pharmaceuticals) for assisting visualisation during colonoscopy was backed by NICE.

In final guidance, it said the single-use, disposable device, which fits over the end of most conventional colonoscopes, improved the adenoma detection rate during colonoscopy, particularly for people having a colonoscopy as part of bowel cancer screening. 

Photo credit: Department of Health and Social Care

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