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Opinion: Consultants are not being supported to deliver the long-term plan
National leaders must act faster to change the payment mechanisms in the NHS, to allow more respiratory care to be delivered in the community, writes Binita Kane, respiratory specialist and co-chair of Respiratory Futures Integrated Care Network, a national group of consultants, GPs, nurses and allied health professionals.
“Outcomes for respiratory disease across the UK are amongst the worst in Europe. We recognize that people with long-term respiratory conditions are often diagnosed late and not supported to engage in the lifestyles that will keep them well.
“In addition, it is well documented that tobacco addiction, mental health problems, loneliness and other social determinants of health are major drivers of healthcare utilisation in this population.
“The long-term plan states that integrated care systems will be central to its delivery and that by April 2021 ICSs should cover all of England. We wish to support NHSE in realising this vision by changing the current medicalised reactive model of care, which is no longer fit for purpose, to a continuous community team-based proactive system that can work with patients and communities to self-manage.
“There is also a lack of core training in integrated care, population health and leadership training within medicine such that development of integrated care is reliant on enthusiastic individuals rather than because the system demands or drives it.
“We welcome the LTP, which has given a blueprint for addressing all aspects of suboptimal care for people with long-term respiratory conditions and a vision of how to enable us to have the best respiratory care in the world, but are concerned that progress will be thwarted unless cross-boundary working is facilitated... We ask that acute trusts are incentivised specifically to anticipate the LTP ambitions and to give us the support and tools we need to deliver the changes required. Unless this can be achieved, delivery of the plan may simply be a pipe dream.”
Source: Health Services Journal, 3 December 2019
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North West: Dad and daughter shop workers busted with illicit cigarette stash
A dad and daughter shop management team were caught out with thousands of fake cigarettes after an undercover sting by Trading Standards.
Trading Standards officers and a search dog identified 7,140 cigarettes and 3,400 grams of hand rolling tobacco concealed in three separate locations in the shop and stock rooms. On examination, the cigarettes and hand rolling tobacco were all seized as they failed to comply with essential packet labelling requirements and some were found to be counterfeit.
Warrington Borough Council’s Public Protection Unit Manager, Dave Watson, said: "This successful partnership operation is part of our ongoing work to clamp down on traders who supply illegal and counterfeit tobacco products. The sale of illegal tobacco is linked to wider criminal activity. It also undermines efforts to help people to stop smoking and increases the risk of children taking up smoking by providing a cheap source of tobacco - so it’s very important we take these products off the streets.”
Source: Liverpool Echo, 5 December 2019
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Canada: Newfoundland & Labrador bans sales of cannabis vapes
Newfoundland and Labrador became the first Canadian province on Wednesday to ban cannabis vape products, just weeks before sales of marijuana-based derivatives are expected to start.
“The intent of the decision is to protect the health of the people in this province until there is more evidence about the connection between cannabis vaping products and severe lung disease,” the provincial government said in a statement on its website.
The province said it commits to reviewing the decision as clinical evidence emerges and added that there have been no cases of lung illness related to vaping in Newfoundland and Labrador.
Source: Reuters, 4 December 2019
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US: Cannabis vaping blamed for woman’s lung disease
An unnamed woman, 49, in the United States has been diagnosed with a rare lung disease called “hard-metal pneumoconiosis” which researchers believe to have been caused by her vaping. She was vaping cannabis, which has been implicated in most of the serious harm linked to vaping. The researchers from the European Respiratory Society (ERS) said that her illness could come from “from the heating coils in vaping devices”.
Professor John Britton, director of the UK Centre for Tobacco & Alcohol Studies, said the “extreme rarity” of bad reactions among those vaping nicotine rather than cannabis showed vaping was a relatively safe way to quit smoking.
Dr Nick Hopkinson, a respiratory specialist at Imperial College London and Chair of Action on Smoking and Health (ASH) said cannabis had to be vaped at higher temperatures, increasing the risk of inhaling metal from the coil.
Source: The Times, 5 December 2019
Editorial note:
Full quote from Dr Nick Hopkinson: "Following on from the outbreak of lung disease in the US that has been linked to vaping cannabis oil, this case provides further reason to avoid it.
“The higher temperature involved in vaping cannabis oil compared to normal products may increase the risk that metal from the heating element is inhaled.
“People who are vaping should only use products regulated by the MHRA. Although vaping is much safer than smoking cigarettes people who do vape should try to quit that too in the long term but not at the expense of going back to smoking.”
See also:
European Respiratory Journal: Giant cell interstitial pneumonia secondary to cobalt exposure from e-cigarette use
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For more information call 020 7404 0242, email [email protected] or visit www.ash.org.uk
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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