Category Archives: Health

Hospital targets missed en masse as performance slumps

Published by:

The performance of hospitals across the UK has slumped with targets for cancer, A&E and planned operations now being missed en masse, BBC research shows.

Nationally England, Wales and Northern Ireland have not hit one of their three key targets for 18 months.

Only Scotland has had any success in the past 12 months – hitting its A&E target three times.

Ministers accepted growing demand had left the NHS struggling to keep up as doctors warned patients were suffering.

The findings are being revealed as the BBC launches its online NHS Tracker project, which allows people to see how their local service is performing on three key waiting time targets:

  • Four-hour A&E waits
  • 62-day cancer care
  • Planned operations and treatment

If you can’t see the NHS Tracker, click or tap here.

The BBC has looked at performance nationally as well as locally across the 135 hospital trusts in England and 26 health boards in the rest of the UK.

Locally there is just one service in the whole of the UK – run by Luton and Dunstable NHS Trust – which has managed to hit all three targets each time over the past 12 months.

Hospital staff the BBC has talked to have described how shortages of doctors and nurses, a lack of money and inadequate room in A&E departments in particular was making it difficult to see patients quickly enough.

While overall the vast majority of patients are still being seen in time, the BBC investigation shows how declining performance is affecting patients.

For example, the chances of not being seen in four hours in A&E has actually more than doubled in the past four years, with one in nine patients now waiting longer than that.

The NHS on the slide

The BBC research has found:

  • Wales has consistently failed to hit its targets. In 2012-13 it did not hit any of its monthly key hospital targets and in 2016-17 it was the same. The last time a target was achieved nationally was 2010.
  • England has seen the biggest deterioration. In 2012-13 it hit its key hospital targets 86% of the time, but in the last year it has missed every monthly target.
  • Scotland is the only part of the UK to hit its targets during the last 12 months, but has only managed to hit do that three times over the summer in A&E when pressures tend to be at their lowest.
  • Northern Ireland is failing to hit its targets despite making it easier to hit the goal for planned operations and care. Since March 2015 it has gradually reduced the target from 80% to 55% but has still not hit it.
  • The north-east is the top performing region in England. Services have hit their key hospital targets 71% of the time in the past year.
  • Twelve out of 135 English hospital trusts, four out of five Northern Irish health trusts and five out of seven Welsh trusts have failed to hit any target in the past 12 months.

‘We don’t have enough doctors’

Prof Srinivasan Madhusudan, head of cancer at Nottingham University Hospitals NHS Trust, which has not hit the cancer target since April 2014, suggested there was simply not enough staff to cope.

“When I get to work I want to treat my patients as soon as I can. So do my colleagues.”

But he added there was a limit to what could be done, pointing out there are 5,000 new cases a year at his hospital trust.

“There are only so many patients that you can treat.

“We have a team of 22 fantastic oncologists who are working very hard to do the best they can under what is quite a stressful situation.”

Meanwhile, Ali Refson, an A&E consultant at London’s Northwick Park hospital, said demand was “incredibly high” which meant it was sometimes impossible to hit the four-hour target.

“We sometimes feel we can’t give the best care. We are working the hardest we can, but we are only human.”

What does this mean for patients?

Ministers across the UK have been quick to point out that most people are still being seen in time.

But the numbers waiting longer for care have been rising.

In A&E patients are now twice as likely to wait more than four hours than they were four years ago – 11% compared to 5%.

The proportion of people waiting over 62 days for cancer treatment has risen by a third in the past four years. Nearly one in five patients now wait longer.

The chances of delays before you have a planned operation or treatment, such as a hip replacement, has increased by nearly three-quarters in four years. Currently 12% of patients wait longer than they should.

It means there are now over 500,000 people on hospital waiting lists in England, Wales and Northern Ireland that have waited too long. That compares to nearly 230,000 four years ago.

British Medical Association chair Dr Chaand Nagpaul said the situation highlighted by the BBC was “unacceptable”.

He said while for some patients the delays were simply an “inconvenience”, for many more they would have a “real impact on their treatment and outcome”.

Time for ‘honest debate’

Scottish Health Secretary Shona Robison said record levels of investment were being put into the health service in Scotland.

She said efforts were being made to “shift the balance of care away from hospitals” and into the community that should make it easier to hit the targets.

And she added a ministerial working group had been established to improve cancer care.

A spokesman for the Department of Health in England said more money was being spent on services, and said despite the longer waiting times the majority of hospitals were still providing good or outstanding care, according to inspectors.

And he pointed out that because of the ageing population “health systems worldwide face similar pressures”.

A Welsh government spokesman acknowledged some people were waiting “too long”, but pointed to the rising demand being faced.

The number of A&E visits made each year across the UK has risen by a fifth in four years to top 30 million, while the number of cancer cases has risen by more than a quarter to top 170,000.

Nonetheless, Labour’s shadow health secretary in England, John Ashworth, called the decline in performance “staggering”.

Saffron Cordery, of NHS Providers, which represents hospital bosses, said it was time to consider whether these targets were still achievable unless more money was provided.

“It’s time for an honest debate about what we can realistically expect the health service to deliver in such difficult circumstances.”


The services where targets have been missed for whole year

England:

  • Basildon and Thurrock NHS Trust
  • Colchester Hospital University NHS Trust
  • Guy’s and St Thomas’ NHS Trust
  • University Hospitals of North Midlands NHS Trust
  • The Royal Wolverhampton Hospitals NHS Trust
  • Leeds Teaching Hospitals NHS Trust
  • Gloucestershire Hospitals NHS Trust
  • East Kent Hospitals University NHS Trust
  • Hull & East Yorkshire Hospitals NHS Trust
  • United Lincolnshire Hospitals NHS Trust
  • Maidstone & Tunbridge Wells NHS Trust
  • Worcestershire Acute Hospitals NHS Trust

Wales:

  • Betsi Cadwaladr University Health Board
  • Hywel Dda University Health Board
  • Abertawe Bro Morgannwg University Health Board
  • Cwm Taf University Health Board
  • Aneurin Bevan University Health Board

Northern Ireland:

  • Belfast Health Trust
  • South Eastern Health Trust
  • Southern Health Trust
  • Western Health Trust

Based on performance against the monthly or quarterly targets for A&E, 62-day cancer care and planned operations for the most recent 12 months for which there is data. The way the targets work is different across the UK so the BBC has simply looked at whether the key targets are being me in each nation.


Research by the BBC’s data journalism unit

Pre-sex HIV drug ‘no-brainer” for NHS

Published by:

A drug to dramatically cut the risk of HIV infection during sex would save the UK around £1bn over the next 80 years, say scientists.

The team at University College London says Prep, or pre-exposure prophylaxis, is a “no-brainer” for the NHS.

The study predicts that giving Prep to men who have sex with men would prevent one in four HIV cases.

NHS England is currently funding a trial of Prep in 10,000 patients, but does not offer the treatment routinely.

Prep is already available in Scotland. The health service in England fought against paying for Prep in the courts, but agreed to trialling it in selected clinics.

Media playback is unsupported on your device

Preventive pills

Prep disables HIV before it gets a stranglehold in the body and trials show it can cut the risk of being infected by up to 86%.

The financial analysis, published in the Lancet Infectious Diseases, looked at the cost-effectiveness of a national roll-out of Prep, focusing on the highest risk group – men who have sex with men.

It showed offering Prep would cost the NHS money initially as it paid for both Prep and lifelong care for people already infected with HIV.

It could take up to 40 years to become cost-effective, when savings from the falling number of new HIV cases equal the cost of Prep.

Eventually, after 80 years, the pills would deliver a saving of £1bn, say the researchers.

Dr Alison Rodger, part of the UCL team, told the BBC: “Not only is it a highly effective treatment, it will save money. It’s a no-brainer so it’s a good thing to do.”

The researchers’ mathematical model predicted:

  • In the first year Prep was available, 4,000 men would start taking it, rising to 40,000 within 15 years
  • Men would take Prep for 4.5 years on average
  • Men would take two pills before sex, followed by one-a-day until they had gone two days without condom-less sex
  • Men would average five pills a week

It is still cost-effective with a daily Prep pill, but it takes longer to become cost-effective. Both options are being investigated as part of the NHS England trial.

The other major unknown is the long-term cost of the drugs, which may fall as cheaper alternatives become available.

Dr Michael Brady, medical director at the Terrence Higgins Trust, said: “It is important that all who need Prep can access it, and evidence like this reinforces the need for Prep to be fully commissioned and given a long-term, sustainable home on the NHS in England.”

Dr Paul Revill, from the centre of health economics at the University of York, said the NHS needed to be “far sighted [and] invest now and reap long-term gains”.

He added: “With a combination of frequent HIV testing, immediate treatment, and Prep availability, there is now the prospect of bending the curve of new HIV infections downwards in a way that did not seem feasible just a few years ago.”

A spokesperson for NHS England said: “The Lancet study makes an important contribution to the growing evidence for cost effectiveness of PrEP, highlighting the factors which will determine this, such as price and duration on PrEP.”

Follow James on Twitter.

‘Go to the dentist and get fined £100’

Published by:

Going to the dentist is something that many would want to avoid – but how about if you also faced a penalty fine?

More than 40,000 people a year in England are getting fines of £100 – from an automated system that dentists say is hitting the most vulnerable.

They warn that people such as dementia sufferers are unfairly getting caught up in a system meant to stop fraudsters from getting free treatment.

The NHS accepts there is a problem with errors and is promising changes.

The fines, about £4m per year, are being applied by a random screening process that checks on whether people going to the dentist are really eligible for free treatment.

But dentists say rising numbers of people with dementia, or those with learning difficulties, are being unfairly fined for something as simple as ticking a wrong box in confusing paperwork.

When these have been challenged, about 90% have been overturned as having been incorrectly applied.

The British Dental Association says the problem seems to be increasing and with an ageing population is only likely to get worse.


Why dentists are complaining

Charlotte Waite, a senior dentist working in Loughborough, Leicestershire, says this is a problem appearing on a “daily basis”.

“This has become a significant barrier to care. It can cause a lot of distress if people feel they are seen as fraudulent,” she says.

Mrs Waite, vice-chair of the British Dental Association’s England community dental services committee, is leading a campaign to stop a wave of fines for elderly and frail people, those with dementia or learning difficulties, who have made honest mistakes when filling in forms about free care.

She says even when patients are eligible for free treatment, an incorrect description of specific benefits or failure to renew documents can trigger a penalty fine, which rises to £150 if there is a delay in payment.

And she says because it typically affects vulnerable and often low-income families, there has been a lack of a “powerful advocate” to raise the issue.

Many such patients will be brought to the dentist by a carer, and Mrs Waite says they might not have the detailed information about types of benefit and exemption certificates.

She says this becomes a dilemma for dentists, whether to turn away patients or to treat them and then risk that they will face a fine.

Patients might turn up for the dentist and go away again without treatment because of confusion over benefits and entitlements and worries about being fined.

“I feel very strongly that clinical time should be spent on clinical work,” she says, rather then trying to navigate the benefits system.

“It’s an extreme waste of clinical time.

“We really need to sort this out now.”


What dentists say they’ve seen

  • “This patient has severe learning disabilities and cannot communicate verbally.

“They were fined twice over an 18-month period, due to the change in exemption and Mum accidently putting the wrong thing on the form.

“Mum was having a bad year and the patient had suffered a few health problems, and these fines were very upsetting and caused lots of anxiety.

“We did manage to get the fines turned around, but this took long periods of time and many phone calls and a letter. We were constantly up against a brick wall.”

  • “A vulnerable adult who has a valid certificate – which he brought in for us to see and the number was recorded correctly – was sent a fine for £100 saying he was claiming free treatment incorrectly.

“He contacted me in quite a panic and I had to reassure him and request that he brought in the paperwork to me to see, I completed the appeal form for him as he was entitled to claim free dental care.

“The appeal form that needed sending back was quite a complex letter, and I think our patient would have struggled to respond to it without help.

“I felt it was most unfair for him to have to go through that.”

  • “I had a patient whose parents didn’t realise her exemption certificate had expired, only to be fined.

“I phoned on her behalf, but they would not accept my word regarding the patient’s special needs and wanted a letter from the patient’s doctor.

“It took three weeks for the patient to get in to see the doctor as it wasn’t urgent. All I could get was a deferral in increasing the fine [for non-payment] while the patient waited for a letter from her doctor.”


What the NHS wants to do in response

The NHS Business Services Authority, which oversees the fining system, accepts there is a problem and is looking for a way to make improvements.

A spokeswoman says no-one wants vulnerable people to be unfairly fined or for dentists to waste valuable clinical time.

The checks have an important role in making sure free treatment isn’t being unfairly accessed by those who should pay.

The screening system compares what people have put on forms at the dentist against two databases of information about benefits and entitlements – and if these do not match, the fining system generates a penalty notice.

The most recent figures suggest almost 120,000 fines have been issued over the past three years.

But the British Dental Authority says when 30,000 of these fines were checked, almost 90% were overturned, suggesting the scale of the error in the system.

  • The NHS says it will run a national awareness-raising campaign, so people will have a much better understanding of who is entitled to free dental treatment
  • There are plans for simpler forms and clearer information, particularly for vulnerable patients

“We want to make sure that patients, particularly those who struggle with literacy, understand if they are entitled to receive free dental treatment or if they should pay,” says a NHS Business Services Authority spokeswoman.

“We recognise the importance of information and access to it for everyone.”

NHS surgery waits run into years in Northern Ireland

Published by:

Patients in Northern Ireland are waiting three years to see a consultant about having surgery following a GP referral.

The BBC has obtained exclusive figures showing long waiting times before a decision to operate.

In Northern Ireland, targets say most patients should be seen within 9 weeks and none should wait over 15 weeks.

Yet some patients are waiting 155 weeks or more to see a specialist for spinal conditions.

A spokesman for the Health and Social Care board said it was ‘unacceptable’ that waiting lists had grown so long.

Longer and longer waits

The health service has not met the targets for several years.

Figures obtained by Freedom of Information requests in April this year and seen by the BBC show that in one of Northern Ireland’s five healthcare trusts, the minimum waiting time for an appointment with an orthopaedic consultant specialising in spinal conditions was 155 weeks.

For upper limb conditions, the minimum wait was 127 weeks.

By June, waits for spinal appointments at the same trust had risen to 159 weeks.

Megan’s story

Megan Fleming, who is 14 years old, needs an urgent operation to correct a curvature, or scoliosis, of her spine.

Her health is deteriorating fast, and she has trouble breathing. Despite her condition, the teenager from Carrickfergus continues to go to dance classes, but says her future is on hold until her operation, which surgeons have told her will be a year away.

Her mother Karen said: “Megan loves dancing. It’s just her life at the minute. She just wants to dance.

“But at the minute she needs the surgery to help her. You could see the consultant was absolutely gutted and you could see it was hurting to say a year, but it’s out of his control.

“I’ve paid taxes, I’ve paid national insurance. So why can’t I get the surgery that she deserves?”

Megan and Karen are now trying to raise the £50,000 that her surgery will cost privately, fearing that the long wait will put Megan’s long-term health at risk.

Dr Ursula Brennan, a GP in Belfast, said that seeking private healthcare was a decision more and more patients were having to make in the current climate.

“You’re going to have to wait, and it may be several months. It may be into 52 weeks, or 80 weeks, or beyond.

“It’s very difficult to turn this conversation to – and these are our elderly folk – that you may have to use your life savings to actually improve your quality of life.”

When asked about the long waits, which are far higher than in other parts of the UK, the deputy chief executive of the Health and Social Care Board, Michael Bloomfield, said: “That is absolutely unacceptable, and that’s why we need to clearly illustrate the need for reform.

“There are about 35,000 more surgical procedures required than the health service currently has capacity for.

“Without the additional funding to see those patients or have them treated in different ways, it is regrettably inevitable that waiting times will increase to the position that they are now in.”

Political vacuum

The political commentator Deirdre Heenan is working on a report with the Nuffield Trust into the emerging healthcare crisis in Northern Ireland.

She said: “In the last nine months we’ve had no government in Northern Ireland. We’re in a political vacuum.

“This system reverts to keeping the show on the road, and any ideas about transformation or change are simply mothballed.”

In a blog co-authored with health economist John Appleby, she writes: “There is a difficult backdrop: austerity, increasing demand, rising expectations, and political uncertainty.

“It is not clear that the public are in a position to call for change. They may not have good information about how well the service meets their needs, and have not necessarily been made part of the long conversations about change, which as a result can sound like it brings bad news.

“But the impact on patients of the current impasse in implementing necessary changes is stark. In June this year, for example, one in six of the entire Northern Ireland population was currently on an outpatient or inpatient waiting list. In England the figure is one in 14.

“And over 64,000 people had been waiting over a year for their first outpatient appointment – a quarter of all those on the waiting list. In England, by contrast, around 1,500 people were still waiting over a year – just 2 per cent of the number in Northern Ireland for a population over 30 times larger.”

On Wednesday, the BBC will be publishing its NHS tracker, which allows users to look at how their local hospitals are performing on waiting times for A&E, cancer and planned operations.

Drug therapy ‘restores breathing’ after spinal injury

Published by:

A drug-based therapy appears to restore breathing in rats paralysed from the neck down by a spinal injury, according to scientists.

They hope their “exciting but early” findings could ultimately help free patients from ventilators.

The pioneering work, in Cell Reports, suggests the brain may not be needed for respiration if a nerve pathway in the spine can be awakened.

More studies are now needed to better understand and exploit this system.

‘No brain’ breathing

Normally, messages to and from the brain control breathing.

If the spinal cord is damaged high up in the neck, these messages can’t get through and a person will need mechanical assistance or a ventilator to breathe.

Experts have been looking at ways to repair spinal cord damage to reconnect with the brain, but the latest therapeutic approach, being explored at Case Western Reserve University, is entirely different.

Dr Jerry Silver and colleagues believe they have found an alternative nerve pathway for breathing in the spinal cord itself.

The researchers used a drug and a light therapy known as optogenetics to dial up this spinal system.

It appeared to control the body’s main muscle of respiration – the diaphragm, a dome-shaped sheet of muscle that sits underneath the lungs, separating the chest from the abdomen.

The live adult rats that they studied had severed spinal cords, meaning the brain could not be the source of the diaphragm movement or breathing that the researchers saw after they administered the therapy.

They believe the treatment works by stopping other nerve signals that would normally silence the spinal system that they found.

Dr Silver said: “This is a primitive response that has been kept in the spinal cord for emergencies, like gasping and screaming in response to danger.”

Although the researchers say the movements they saw resembled breathing, it’s not clear yet if it would be enough to sustain life. They plan more animal studies to check.

Dr Silver said: “Ultimately, the goal of this research would be to free people with these neck injuries from having to use mechanical ventilators.

“Infections and other complications from mechanical ventilators are a leading cause of death after spinal cord injuries.”

Dr Thomas Becker, an expert in neuroregeneration at Edinburgh Medical School, said: “This is an important discovery on the fundamental working of the spinal cord.

“Understanding the spinal network is the first step toward future therapies.

“This knowledge could be used for future therapies to restore breathing in patients who lost nerve connections from the brain as a consequence of spinal cord injury.”

Concern over norovirus increase by Betsi Cadwaladr health board

Published by:

The largest health board in Wales is urging people to be alert to the symptoms of norovirus, amid concerns over a rise in cases this year.

Last November, a major outbreak of the winter vomiting bug hit Wrexham Maelor Hospital and two community hospitals run by Betsi Cadwaladr health board.

The outbreak closed nine hospital wards in north Wales alone.

The sickness bug costs the UK economy £15m every year, according to researchers at Bangor University.

More than 130 patients were affected in north Wales last November and the outbreak resulted in 192 “lost bed days” – occasions where beds were unavailable to new patients.

Tracey Cooper, assistant director of nursing for infection prevention at the health board, said there were already reports of norovirus cases at care homes in north Wales.

“Estimates of the number of people affected are difficult to get because most people who have norovirus stay at home,” she said.

‘2.9m cases annually’

“We monitor what’s happening in the southern hemisphere through the summer, because their summer is our winter and vice versa.

“What we’ve seen this summer is they’ve had increasing numbers of norovirus and also increasing numbers of flu and very severe flu.

“Usually what they get in our summer, we then get in winter.

“So we are expecting to see an increased number of people affected by norovirus and an increasing number of people with flu and severe flu.”

Researchers at Bangor University in Gwynedd have estimated there are 2.9m cases of norovirus in the UK annually.

They calculate the cost to the economy is £15m every year, although other estimates place the cost much higher.

Humans do not develop immunity to norovirus, meaning people can catch it repeatedly.

It spreads easily, and can be transferred to different surfaces by touch.

Restaurant chain ‘cut sugary drink sales’ with price rise

Published by:

An increase in the price of sugary drinks in restaurants and the offer of healthier alternatives could encourage customers to cut back on sugar, a study suggests.

In Jamie’s Italian restaurants, sales of sugar-sweetened soft drinks declined by 9% following a 10p price rise.

The chain also redesigned the menu and explained that money from the levy would go to charity.

Experts said more research was needed to pin down what measures worked.

Consuming too many sugary soft drinks has been linked to a higher risk of serious health problems such as obesity, type-2 diabetes, heart disease, stroke and tooth decay.

Sugar tax

To help tackle obesity, the UK government is introducing a tax on high-sugar soft drinks such as Coca-Cola, Pepsi and Irn-Bru in April 2018 – and Jamie Oliver had been vocal in his support of the plan.

This study, in the Journal of Epidemiology and Community Health, analysed sales of sugary non-alcoholic beverages at 37 of Jamie Oliver’s national chain of restaurants after a 10p levy was introduced in September 2015.

Low-sugar fruit spritzers (fruit juice mixed with water) were also added to the menu, which clearly explained why the levy was being introduced.

After 12 weeks, sales of sugary drinks per customer had declined by 11%, and after six months they had gone down by 9.3%.

But the study did not look at any other restaurant chains to compare sales figures.

The study also showed there was a general decrease in the number of soft drinks sold per customer, including diet drinks and bottled waters.

The researchers, from the London School of Hygiene and Tropical Medicine (LSHTM) and the University of Cambridge, said more people could have chosen tap water, but these figures had not been recorded.

Sales of fruit juices had increased by 22% six months after the changes were introduced.

Changing behaviour

Prof Steven Cummins, lead study author and professor of population health at LSHTM, said: “A small levy on sugar-sweetened drinks sold in restaurant, coupled with complementary activities [such as redesigning the menu], may have the potential to change consumer behaviour.”

But he said it was not possible to say that the price increase alone had caused the decline in sales of sugar-sweetened drinks.

There was also no separate data on what adults and children ordered.

Prof Kevin McConway, emeritus professor of applied statistics at the Open University, said it was plausible that the levy “played an important role” but he also called for “more investigation, in other restaurants, and with a longer follow-up period, to try to pin down more clearly what really works”.

Prof Susan Jebb, professor of diet and population health at the University of Oxford, said the findings were “encouraging news for public health”.

But she said there was a disappointing lack of data on alcohol sales, which could have increased over the same period.

Mental health care for new mothers in Wales ‘unacceptable’

Published by:

Calls have been made for a specialist mother and baby unit to open in Wales to help those suffering mental illness.

The lack of in-patient care for women suffering from severe perinatal mental health illnesses has been described as unacceptable by a committee of AMs.

The Children and Young People’s committee of the assembly supported calls for the re-opening of a specialist mother and baby unit (MBU).

Wales’ own unit was closed in 2013 with mothers sent to units in England.

The Welsh Government said it was committed to providing specialist inpatient care.

The committee’s report recommended that a MBU be established in south Wales to provide an all-Wales service.

Given this may not be suitable for mothers and families in mid and north Wales, the committee also called for the Welsh Government to discuss with NHS England setting up a cross-border service in north east Wales.

Medical guidelines state women who need inpatient care for mental health should normally be admitted to a MBU.

Beds are sought in units in England but officials told AMs the process was fraught with difficulties.

About 60-80 women a year are also treated in adult psychiatric wards, the report said, but AMs heard the wards were “not suitable” to treat perinatal mothers given it requires the separation of mother and baby.

“We believe that the provision of inpatient care to mothers with severe cases of perinatal mental illness is wholly inadequate,” the report said.

“While we accept that the most specialist of services will sometimes require patients to travel, the current uncertainty of arrangements with England is unacceptable,” the report said.

It added: “To minimise the distances women and their families need to travel to access the care they need, specialist in-patient provision needs to be developed within Wales.”

Media playback is unsupported on your device

The Welsh Government has announced £1.5m for community-based services in the Welsh NHS – but the committee heard that services among its seven health boards varied.

Staci Sylvan, from Carmarthen, has suffered with mental health problems after both of her pregnancies.

She told BBC Radio Wales’ Good Morning Wales programme: “I went from being really happy to have a baby to not really knowing who I was, what I was doing, feeling very scared and not knowing where I could go for help.

“It did develop into having hallucinations after a couple of weeks.”

She said she felt health visitors were not properly trained to recognise her symptoms and she reached “crisis point” before being offered a stay at the MBU unit at Cardiff’s University Hospital of Wales – which has since closed.

‘Developing options’

Sally Wilson, 36, who lives near Bangor, Gwynedd, suffered with post-partum psychosis and was treated in the community after she was discharged from an adult psychiatric unit.

Ms Wilson was offered a MBU bed in Manchester but little information was given to her about the benefits of such treatment.

“I think ideally my family and friends should have had enough information to make an informed decision about whether I should have gone into a mother and baby unit, and enough staff and resources to have specialist perinatal mental health professionals working with people that are that ill,” Ms Wilson said.

A Welsh Government spokeswoman said: “The Welsh Health Specialised Services Committee has been developing options this year to improve perinatal mental healthcare in Wales and we are committed to providing specialist inpatient care in Wales.

“There are now community teams in each health board in Wales,” she added.

‘I felt so low, I couldn’t see a way out’

Published by:

“To get to my school I had to cross a railway bridge and I would just stand there and think ‘I could just jump off’.

“It felt overwhelming and like I was alone. I just felt so, so low, I couldn’t see a way out.”

Calleigh, now 18, was self-harming when she was 11 and first thought about taking her own life when she was 13.

“I didn’t want to tell my parents because I thought they would be worried and disappointed or not understand.”

Calleigh’s story comes as the charity Childline says it has carried out its highest number of counselling sessions with young people having suicidal thoughts and feelings.

But the helpline says it can answer only three out of every four calls and urgently needs more volunteers.

In 2016-17, a total of 22,456 sessions were given to children in the UK thinking about taking their own life – up from 19,481 the year before.

More than 2,000 contacts were with young people who had already taken steps to end their lives, such as writing a note, giving meaningful items away or even planning their death.

For Calleigh, a perfectionist nature, coupled with extensive pressure from a high-achieving school, meant she sank to a very low point.

But making contact with Childline proved to be a lifeline – literally.

  • 22,456 sessions about suicidal thoughts

  • 72% of those who had this counselling were girls

  • 13,746 sessions about anxiety

  • 295,202 counselling sessions in total

Jupiter Images

“I was able to talk to someone, they were able to say, ‘OK, what’s making you feel like this? Take one step at a time’ and they’re just so supportive.

“I’d call them when I wanted to self-harm. I would message them – they’ve got amazing messageboards – it’s like a forum but it’s safe, you’re not going to get bad messages and there are so many other people that are feeling the same way.”

What should you do if you feel like this?

Calleigh says it’s important to seek help – and to remember that there doesn’t always have to be a reason for feeling at breaking point.

“I’d say you definitely can’t bottle it up, because that makes it so much worse – just talk to someone, even if it’s online.

“Talking to someone who’s not in the problem, who you know is not going to judge you or worry – because my main problem was ‘I don’t want my parents to worry, there’s so much stress’ – and just knowing that you’re not alone and that it’s not your fault.

“And there doesn’t have to be a reason, it doesn’t have to be that you were bullied, it doesn’t have to be pressure, it could just be you feel numb because you feel numb.”

What does the future hold?

Childline founder and president Dame Esther Rantzen says it’s vital to find out why so many young people are feeling so desperate.

“When Childline launched over 30 years ago, I remember children usually felt suicidal because they were being hurt by someone.

“Now young people tell us they are overwhelmed by mental health issues taking them to the brink of suicide.

Media playback is unsupported on your device

“We must discover why so many of our young people feel so isolated they turn to Childline, because they believe no one else cares about them.”

Calleigh wants to see much more done to raise the profile of mental health issues.

“I strongly feel that teachers, parents and support staff need to know more about mental health and they need to look out for the signs.”

In the meantime, Dame Esther is urging members of the public to come forward as volunteer counsellors for Childline.

“Anyone who can lend a few hours to this vital service could end up saving a child’s life.”

Help can be found by ringing the Childline helpline on 0800 1111 or via the Childline website.

AI used to detect breast cancer risk

Published by:

US scientists are using artificial intelligence to predict whether breast lesions identified from a biopsy will turn out to cancerous.

The machine learning system has been tested on 335 high-risk lesions, and correctly diagnosed 97% as malignant.

It reduced the number of unnecessary surgeries by more than 30%, the scientists said.

One breast cancer specialist said that the research was “useful”.

The machine learning system was trained on information about such lesions, the system looks for patterns among a range of data points, such as demographics, family history, biopsies and pathology reports.

“Because diagnostic tools are so inexact, there is an understandable tendency for doctors to over-screen for breast cancer,” said Regina Barzilay, MIT’s Delta Electronics Professor of Electrical Engineering and Computer Science, and a breast cancer survivor herself.

“When there’s this much uncertainty in data, machine learning is exactly the tool that we need to improve detection and prevent over-treatment.”

First study

In the US alone, 40,000 women die from breast cancer each year, but when cancers are found early enough they can often be cured.

Mammograms play a crucial role in detecting such cancers but they also throw up false positives, such as lesions that appear suspicious.

Once operated on, many such lesions turn out to be benign.

“To our knowledge, this is the first study to apply machine learning to the task of distinguishing high-risk lesions that need surgery from those that don’t,” said Constance Lehman, professor at Harvard Medical School and chief of the Breast Imaging Division at MGH’s Department of Radiology.

“We believe this could support women to make more informed decisions about their treatment, and that we could provide more targeted approaches to health care in general.”

Debashis Ghosh, a consultant breast surgeon based at the Royal Free London hospital, said the technology was good but may be of more use in the US than in the UK.

“Here we have less than 5% of patients who have these surgeries, whereas it is 30% in the US.

“We try to make a definite diagnosis before we operate but this technology is definitely useful where there is a lack of expertise.”

The research is being conducted by scientists at Harvard Medical School, the Massachusetts Computer Science and Artificial Intelligence Lab, and Massachusetts General Hospital.