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** 27 January 2022
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** UK
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** Staff will quit if not given “time to recover,” says NHSE director (#1)
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** Widening health inequalities between rich and poor a human rights breach (#2)
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** Glasgow’s stop smoking services are most successful in Scotland (#3)
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** New national body to take powers from HSIB’s maternity investigation programme (#4)
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** International
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** US government fails when it comes to tobacco reduction, American Lung Association report says (#5)
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** US Study reveals the major contributors to the $300 billion cost of smoking (#6)
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** UK
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** An NHS England director and trust chief says he “fears [the NHS] will see increasing numbers of resignations” unless more is done to ensure burnt-out staff are given sufficient leave to recover mentally and physically.

Matthew Winn, NHSE’s director of community health and Cambridgeshire Community Services Trust chief executive, set out his concerns in a paper for discussion at his trust’s board meeting yesterday (26 January). While the service is grappling to keep tabs on the number of staff it is losing because of compulsory vaccination plans, the issue of staff leaving because of burnout is harder to quantify but a huge concern to NHS leaders. Nearly two years of tackling coronavirus has taken a huge emotional and physical toll on a large proportion of the workforce, and burnout was a growing issue even before the pandemic.

Mr Winn’s paper says: “As the NHS starts to focus on recovering from the current covid pressures, it is vital that the national, regional and local planning must take into consideration that our staff need time to recover and that they cannot (for example) be expected to catch up on the waiting lists that have accrued, without time and resources to support them. In the absence of such an approach, I fear that we will see increasing numbers of resignations, and the care we will be able to provide will be far short of the standards we set ourselves and that the public expects from us.”

In response to Mr Winn’s comments, NHS Providers chief Chris Hopson said, “a failure to [ensure staff have a reasonable workload] runs the very real risk that staff will leave the profession. It is vital that national leaders take a longer-term approach to workforce planning and commit to a fully costed and funded workforce strategy across the NHS. This needs to run alongside further investment in wellbeing initiatives to support staff.”

Danny Mortimer, chief executive of NHS Employers, said: “NHS organisations are committed to innovation and working in different ways to cut waiting lists and deliver more services to meet demand, but we also need politicians to be realistic about what can be achieved by a stretched and depleted workforce.”

Source: HSJ, 26 January 2022
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** According to one of Scotland’s leading clinicians, widening inequalities in life expectancy and health between rich and poor is a “breach of human rights.” David Kerr, a professor of cancer medicine at Oxford University, said deprived communities have “suffered disproportionately” from Covid and the measures intended to control its spread have “accelerated and exposed” pre-existing health inequalities.

The Glasgow-born academic, writing for Gordon Brown’s Our Scottish Futures think tank, backs the creation of a UK-wide network of “Marmot Cities” with their own powers to set health, housing, early years, employment and education policies, and where health and wellbeing is prioritised “at the centre of civic politics.” The framework was devised by Sir Michael Marmot, who has spearheaded research into the causes of the UK’s stalling life expectancy.

In Scotland, the gap in premature mortality between those living in the richest and poorest areas is the widest since 2007, while men living in the most affluent neighbourhoods can expect to live 26 years longer in good health compared to the most deprived males – the widest gap ever. “These are health policy failures of such magnitude that they represent a breach of human rights,” said Prof Kerr. Prof Kerr said the “fundamental challenge” was to “reverse the longer trend towards a more unequal Britain”. He said this should include devoting more healthcare spending on prevention, which is “significantly underfunded.”

Prof Kerr added that central governments at Westminster, Holyrood, Cardiff, and Stormont must provide Marmot Cities with the “powers to act by devolving down control on health, employment services, housing, early years and education policies.”

Source: Techiai, 27 January 2022
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** According to a new report, Glasgow’s stop smoking teams were the best performing in Scotland. Figures from Public Health Scotland show NHS Greater Glasgow and Clyde’s (NHSGGC) Quit Your Way staff supported nearly 9000 quit attempts. And more than a quarter of those gave up smoking for good.

Geraldine Lucas, Health Improvement Lead for Tobacco at NHSGGC, said: “The pandemic brought with it a number of challenges, not least with social distancing and the impact that had on our services. We worked quickly, adapting our services so that we could continue to provide support to people who had made the decision to quit. Our message is that even during the most difficult times, our stop smoking services are there to help support you to quit your own way.”

Smoking is linked to many illnesses and long-term conditions, substantially increasing the risk of heart disease, diabetes, emphysema, chronic bronchitis, stroke and cancer.

Source: Yahoo News, 27 January 2022
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** The health secretary has announced a new national body to carry out “independent” and “family-focused” investigations of maternity services. Sajid Javid told the Commons today that a new special health authority would be established to run the national maternity investigation programme, which is currently a responsibility of the Healthcare Safety Investigations Branch (HSIB).

HSIB became responsible for conducting independent investigations relating to intrapartum stillbirth, early neonatal death, or severe brain injury diagnosed in the first seven days of life, and maternity deaths, in April 2018. The new health authority, which has not been given a name, will:

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** Provide independent, standardised, and family-focused investigations of maternity cases that provide families with answers to their questions about why their loved ones died or were seriously injured;
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** Provide learning to the health system at local, regional and national level via reports for the purpose of improving clinical and safety practices in trusts to prevent similar incidents and deaths occurring;
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** Analyse the incoming data from investigations to identify key trends and provide system-wide learning in these areas
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** Be a system expert in standards for maternity investigations and support trusts to improve local investigations;
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** Collaborate with system partners to escalate safety concerns and share intelligence.
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It will be established for up to five years from 2022-23 to “enable maximum learning to be achieved and to equip NHS trusts with the expertise, resources, and capacity to take on maternity safety incident investigations in the future.”

Source: HSJ, 27 January 2022
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** International
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** According to a new report from the American Lung Association, the federal government gets “mostly failing grades on its efforts to prevent and reduce tobacco.” The 20th annual “State of Tobacco Control” report calls for an end to manufacturing flavoured tobacco, saying flavoured tobacco products and e-cigarettes jeopardise the progress made by tobacco control policy.

According to the report, more than 2 million high school and middle school students used e-cigarettes in 2021.

The 2022 “State of Tobacco Control” gave the federal government the following grades:
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** D for regulating tobacco products
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** D for federal coverage of quit smoking treatments
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** F for the level of federal tobacco taxes
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** A for mass media campaigns designed to prevent and reduce tobacco use
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** And an incomplete grade for raising the minimum age of sale for tobacco products to 21
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According to the report, smoking among adults has declined, but smoking remains high among Native America, Alaskan Natives, and lesbian, gay and bisexual adults. Additionally, menthol cigarettes are a “key factor for tobacco-related death and disease in Black communities.”

This year, the Lung Association is calling on the US Food and Drug Administration to quickly finalise proposals introduced in April 2021 that would remove flavoured cigars and menthol from the marketplace by April 2022. They are also urging the government to limit health plans that are not required to cover treatment to help people quit tobacco use as well as ask Congress to pass the “Quit Because of COVID-19 Act.” This legislation would give all Medicaid enrolees access to a tobacco cessation benefit.

Source: CNN, 26 January 2022

See also: American Lung Association - State of Tobacco Control 2022 ([link removed])
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** With more than 34 million tobacco users in the United States, the estimated financial cost of smoking over a lifetime has reached above $2.3 million per smoker.

According to a new report from the Washington, D.C.-based financial planning website WalletHub, the average out-of-pocket cost per smoker stands at $133,911 over a lifetime. An analysis revealed that smokers in the District of Columbia would pay the highest cost, $197,801, two times higher than in Missouri, where smokers will pay the lowest price at $96,535. Further, each smoker will incur an average of $545,166 in income loss over a lifetime. In the District of Columbia, those who smoke will lose the highest amount, $746,669, or 1.9 times higher than in Mississippi, where smokers will spend the lowest amount at $389,500.

Experts said each smoker would incur an average of $177,599 in smoking-related healthcare costs over a lifetime. Since 1964, smoking-related illnesses have claimed over 20 million lives in the US, 2.5 million of which belonged to nonsmokers who developed diseases merely from secondhand smoke exposure. However, the report revealed that the economic and societal costs are just as huge. Every year, smoking costs the US more than $300 billion, including medical care and lost productivity.

Dr Steven A. Schroeder, the director of Smoking Cessation Leadership Center, said most smokers want to quit. “But it often takes multiple attempts before quitting is achieved, often up to 20 or more. But the good news is that there are now more ex-smokers than current smokers. In addition, the odds of quitting are increased if the smoker gets counselling combined with smoking cessation medications such as nicotine replacement therapy and varenicline [...].”

Source: Amsterdam News, 26 January 2022
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.

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