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Do more to help improve community’s oral health

2 February 2017

Do more to help improve community’s oral health

Leading health charity, the Oral Health Foundation, is calling on local authorities to improve their oral health services and the signposting of available dental services to local communities, following the publication of new NICE (National Institute for Health and Care Excellence) guidance on oral health promotion in the community. 

The new guidance outlines how local authorities can identify the oral health needs of people in local communities and also put in place steps they can take to address oral health inequalities in those communities.

As a result, the charity is calling on local authorities, working in collaboration with the NHS and dental profession, to do more to identify the needs of their communities and offer them advice and guidance towards dental services which many people are currently missing out on.

Dentist, Dr Ben Atkins, who is a Trustee of the Oral Health Foundation said: "We have to let people who are in need of help know that help is available for them.

"One of the first steps towards this is for local authorities to ensure they understand the needs of their communities when it comes to oral health and put in place the necessary interventions to address any problems.

"Some local authorities already run excellent and effective oral health services, work done in areas such as Tower Hamlets and the London borough of Hammersmith and Fulham should be held up as a benchmark of what authorities can achieve if they put more focus on oral health.

"But, there are still some regions in the UK where oral health promotion is not treated with the priority that it deserves and as a result many people feel disillusioned with the help they can get. "But this NICE guidance includes some very common sense information for local authorities which can help change this. Including carrying out oral health needs assessments in their communities to identify groups at high risk of poor oral health as part of joint strategic needs assessments.

"Half of all adults are failing to visit the dentist each year, and the figures are even lower for children, this is something that we have to change through positive action. Without this we are seriously concerned that oral health inequalities will continue to grow across the country."

As well as carrying out oral health assessments of communities, the NICE guidance also advises local authorities to ensure that health and social care services include oral health in care plans of people who are receiving health or social care support and are at high risk of poor oral health. 

They also recommend that local authorities provide oral health improvement programmes in early years services and schools in areas where children and young people are at high risk of poor oral health.

Dr Atkins continued: "These are two of the most 'at risk' groups which we are currently seeing, by addressing these areas local authorities can really make a statement about how serious they are taking oral health in their communities.

"In targeting early years' services and schools they are also helping to improve the future of oral health for the public.

"Learning good oral health behaviour at a young age is proven to reduce the risk of oral health problems in later life. This activity should include educating children about their diets effect on their oral health as well as clear advice on tooth brushing and any dental treatments which are available to children to reduce their risk of tooth decay.

"As part of this, one area which they should address is to ensure they healthy food and drink options are displayed prominently in local authority and NHS venues, including early years services and schools."

To read the full NICE guidance please visit: https://www.nice.org.uk/guidance/qs139/resources/oral-health-promotion-in-the-community-75545427440581

 

Sudden death warning over faulty heart gene

An estimated 620,000 people in the UK have a faulty gene that puts them at risk of developing coronary heart disease or sudden death, and most are unaware, a charity has warned.

The British Heart Foundation said the figure was 100,000 more than had been thought and could be even higher.

It said there was now a better grasp of the prevalence of inherited conditions.

A child of someone with an inherited heart condition can have a 50% chance of inheriting it themselves.

The charity warned that the overall figure for those with the faulty gene could be much higher because of as yet undiscovered faulty genes and under-diagnoses.

Each week in the UK, around 12 seemingly healthy people aged 35 or under are victims of sudden cardiac death with no explanation, largely due to undiagnosed heart conditions.

Former England and Nottinghamshire cricketer James Taylor had to retire last year, at the age of 26, after he was diagnosed with the serious heart condition arrhythmogenic right ventricular cardiomyopathy.

He told BBC Radio Four's Today programme that he had been warming up for the first game of the season in Cambridge when his heart started "going mental in my chest".

He said: "You could see my shirt moving, that's how hard my heart was beating inside my chest...

"I went off, I had some oxygen, then I went to hospital some hours later.

"When I walked in to hospital they said it was a miracle I was able to walk in.

"My heart rate was going at 265 beats per minute."

A normal resting heart rate is 60 to 100 beats a minute, but Taylor's remained at 265 for six to seven hours - "the equivalent of doing five, six marathons."

He now treats the condition with medication and said he was fortunate to survive.

"I'm still alive. I should have died - that's the scary thing about these inherited heart conditions.

"A lot of people don't get the opportunities I had and it's often too late."

The Birk family, from Hounslow, in west London, were tested for the faulty heart gene after Maninder Birk collapsed at home on his 16th birthday.

The results showed that Maninder, his younger brother Manvir and his mum Inderdeep all had the faulty gene hypertrophic cardiomyopathy (HCM).

Inderdeep said it was "completely devastating" to discover her sons had inherited it from her.

She says the heart condition has presented itself differently in each of them.

"Maninder had to give up a promising career in rugby, but is now leading a relatively normal life. But Manvir and I struggle day-to-day with our health.

"Manvir can't finish a whole day at school. He is constantly tired and his energy levels are very low. He is mainly home-schooled now as it is hard for him to keep up with his work.

"He also misses out on seeing his friends as he can't do the normal activities most 15-year-olds can do."

They have both had implantable cardioverter defibrillators (ICD) fitted to prevent their hearts from stopping suddenly.

Inherited heart conditions: What you need to know

  • Many people with an inherited heart condition have no symptoms, but some can develop some warning signs including dizzy spells, palpitations and blackouts
  • Screening and genetic testing can help identify problems
  • Doctors will suggest you be tested if a family member has been diagnosed with an inherited heart condition, there is a family history of premature deaths or you have been diagnosed with angina or had a heart attack at a young age
  • If you are diagnosed with an inherited heart condition, monitoring and treatment can reduce the risk of a sudden heart attack or cardiac arrest
  • Speak to your GP if you are concerned

Research has helped to discover many of the faulty genes that cause inherited heart conditions.

This has led to the development of structured genetic testing services for those at highest risk for some of these conditions.

However, the British Heart Foundation says more research is urgently needed.

Prof Sir Nilesh Samani, BHF medical director, said: "The reality is that there are hundreds of thousands of people across the UK who are unaware that they could be at risk of sudden death.

"If undetected and untreated, inherited heart conditions can be deadly and they continue to devastate families, often by taking away loved ones without warning.

"We urgently need to fund more research to better understand these heart conditions, make more discoveries, develop new treatments and save more lives."

 

Cancer drugs price rise 'costing NHS millions'

UK prices for generic cancer drugs have risen sharply in the past five years, restricting their use in treating NHS patients, research from the European Cancer Congress has found.

Drugs such as tamoxifen and bulsufan are now 10 times more expensive despite no longer being under patent.

The British Generic Manufacturers Association said trusts often paid much less than the list price.

The Department for Health said it has plans to cut generic drug costs.

The UK researchers said NHS negotiations with drug companies were failing to contain costs, and getting access to cheaper drugs would allow more people to be treated with more modern medicines.

They estimated that the cost of these price rises to the NHS in England was around £380m a year - which only included community-based prescribing, not hospital prescribing.

Drugs start off being on-patent, and their high prices allow pharmaceutical companies to profit from their investments in research and development.

After patents have expired and generic versions are sold, the theory is that drug prices should fall close to the cost of production.

However, because of high drug prices, the NHS is often not able to approve some new cancer drugs for use.

New treatments then have to be rationed.

Dr Andrew Hill, senior research fellow in pharmacology and therapeutics at the University of Liverpool, and Melissa Barber from the London School of Hygiene and Tropical Medicine, collected prices on medicines available on the NHS for their presentation at the cancer conference.

They discovered that busulfan, which is used to treat leukaemia, cost 21p per tablet in 2011 and £2.61 in 2016.

Tamoxifen, used to treat breast cancer, cost 10p per tablet in 2011 and £1.21 in 2016.

Of 89 cancer medicines looked at in the analysis, 21 showed price rises from 2011 to 2016 - with 17 of those classified as generic.

Fourteen generic cancer drugs showed price rises of more than 100%.

And compared with prices for the same drugs in India, the UK drugs were roughly 20 times more expensive.

Dr Hill said he was surprised to find several companies had consistently raised the prices of cancer treatment.

"We have found that some companies take over the supply of some generic cancer medicines and then raise the price progressively," he said.

He said this was "worrying", particularly when the Cancer Drugs Fund is under pressure from high prices.

But Warwick Smith, director-general of the British Generic Manufacturers Association, said the actual prices paid by hospitals were usually much lower than the list prices.

He said the tendered price paid by hospitals for tamoxifen 10mg tablets is £4.85 for a pack of 30, or 16p per tablet.

"Generic competition in the oncology market has produced very significant savings for the NHS and generated access for patients to medicines such as tamoxifen which can be used to reduce the risk of breast cancer and not just to treat it.

"In the case of generic medicines used in hospitals, it is important to distinguish between the actual price paid by trusts and the much higher list prices often quoted."

The Health Services Medical Supplies (Costs) Bill, currently going through Parliament, is designed to allow the NHS to regulate prices in the future.

As a result of the bill, companies found to be raising prices with no clear justification will be referred to the Competition and Markets Authority, and could face fines.

A Department of Health spokeswoman said: "We will continue to work closely with the pharmaceutical sector to make a success of these new measures, and all the money saved will be invested in the NHS to help provide the highest quality of care for patients."

Other European countries have taken similar measures.

In Spain and Italy, failure to accept the high prices demanded for some generic treatments has led to warnings from companies that they could stop their supply.

"At a time when cancer patients are living longer and better lives due to effective treatments, this situation is particularly worrying," Dr Hill said.

 

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