CQC warns online doctor services may pose risk to public

Patients could be at risk from online companies offering doctors’ services, the Care Quality Commission has said.

The warning comes after investigators found two firms were putting patients at risk by failing to examine their medical history before prescribing medicines. There were also questions over whether clinicians had the relevant skills or qualifications to prescribe or diagnose illnesses.

The inspectors found there were no processes for contacting a patient’s GP, including when medication was prescribed that required monitoring or a follow-up. The medics failed to check patient identity before prescribing online and there was no way of checking if people lacked the capacity to consent to treatments.

The two online firms were MD Direct (which had traded through the website assetchemist.co.uk) and HR Healthcare Ltd (treated.com). The CQC said its inspection of HR Healthcare was influenced by an investigation by BBC Radio 5 Live, which looked at the site’s online sale of antibiotics.

Following this, the CQC suspended the registration of HR Healthcare Ltd. MD Direct voluntarily cancelled its registration; the site assetchemist.co.uk now uses a different online GP provider for its prescription service.

As well as these two inspections, a review of all 43 online services registered with the CQC revealed others were potentially posing a risk to patients.

The CQC has now brought forward a programme of inspections. It is particularly concerned about sites where patients can choose their own drug and select their symptoms or diagnosis from a drop-down menu. The prescription is then reviewed by a medic and passed to a pharmacist who processes it.

Steve Field, the chief inspector of general practice at the CQC, said: “The growth in online technology presents a real opportunity to improve people’s access to medical advice and treatment. It is important that healthcare services continue to innovate. However, in some cases we have found websites which in effect allow people to select their own medication, including medicines restricted as prescription-only, with little or limited clinical oversight.

“Patients can go online, self-diagnose their condition, order their own medicine and obtain a prescription from the online doctor service, with minimal checks on [their identity] and whether the medication is safe or appropriate for them, often within a matter of seconds. We know there are often inadequate identity checks, no checks on patient history or suitability, no checks with patients’ GPs and no follow-ups or monitoring.

“Following our review of all online services registered with CQC, we will now visit each provider, working closely in partnership with the relevant regulators and checking that providers are following the appropriate professional guidance. We will take action to cancel or suspend the registration of providers who are putting their patients at risk.”

Field said that, as with conventional GP surgeries, online companies and pharmacies were required to provide safe, high-quality and compassionate care. “They must not cut corners,” he said.

A further joint statement from four regulatory bodies – the CQC, the General Medical Council, the General Pharmaceutical Council and the Medicines and Healthcare products Regulatory Agency (MHRA) – reminds firms and their medics that they must provide safe and effective care, and follow professional guidelines.

Lord O’Shaughnessy, the health minister, said: “We have empowered the CQC to run a tough and comprehensive inspection regime and commend their work to uncover failings in digital care provision. Online providers can be a convenient option, but patient safety must always be the priority and we urge the public to follow CQC’s advice when buying medicines online.”

Gerald Heddell, the director of inspection, enforcement and standards at the MHRA, said: “Prescription-only medicines are prescription only for a reason and should only be taken under the supervision of a healthcare professional. A proper consultation with a medical professional is essential to ensure that an appropriate diagnosis of your condition can be made, your medical history can be reviewed, your recovery can be monitored and any adverse reactions can be dealt with.”

CQC warns online doctor services may pose risk to public

Herbal supplements" illegal ingredients pose health risk, experts warn

Many herbal supplements, including for obesity and erectile dysfunction, contain hidden unlicensed pharmaceutical ingredients that could endanger people’s health, experts have warned.

The research team, from Queen’s University Belfast, Kingston University in London and the life sciences testing company LGC, concluded that not only do such supplements often make unverified claims as to their benefits but some have illegal ingredients which could pose a threat – potentially causing low blood pressure or an increased risk of heart attacks.

The substances are unlicensed medicines as they are appearing in products classified as food supplements. Among the most common substances identified was sibutramine, according to the study, published in the Journal of the Association of Public Analysts.

Sibutramine was licensed as the medicine Reductil until 2010, when it was withdrawn across Europe and the US due to an increased risk of heart attacks and strokes associated with the use of the drug.

Tadalafil and sulfoaildenafil were among the most frequently undeclared ingredients in products for erectile dysfunction. When taken with other medicines containing nitrates, they can lower blood pressure drastically and cause serious health problems.

Emeritus professor Duncan Burns, from Queen’s University’s Institute for Global Food Security, said: “We have found that these supplements are often not what customers think they are – they are being deceived into thinking they are getting health benefits from a natural product when actually they are taking a hidden drug.

“These products are unlicensed medicines and many people are consuming large quantities without knowing the interactions with other supplements or medicines they may be taking. This is very dangerous and there can be severe side effects.”

The research team analysed adverse findings recorded by the European Union’s rapid alert system for food and feed (RASFF) between 2009 and 2016 inclusive. The database is designed to inform member states who can then take appropriate action locally. Consumers can access the database but, unlike authorities in member states, they often cannot see the product names.

The experts believe the pharmaceutical ingredients are sometimes added accidentally but on other occasions deliberately in an attempt to enhance products.

They identified 63 instances of food supplements containing sibutramine between 2009 and 2016, including 47 after 2010, when Reductil was withdrawn. There were 29 instances of tadalafil being found in food supplements in the eight-year period examined and 68 of sulfoaildenafil and chemical substances similar to it.

People suffering from conditions such as diabetes and hypertension are frequently prescribed nitrate-containing medicines. Erectile dysfunction is often associated with these conditions, raising the prospect that patients may be tempted to try herbal supplements, which they do not know contain tadalafil or sulfoaildenafil, which can interact negatively with the nitrates.

Burns said: “People who take these products will not be aware they have taken these substances and so when they visit the doctor they may not declare this and it can be difficult to determine what is causing the side effects. It is a very dangerous situation.”

Another common substance was yohimbine, found in 30 supplements, which has been said to have aphrodisiac-like effects but has been known to increase blood pressure and induce anxiety.

Burns said the RASFF list was unlikely to be comprehensive “unless they went to every health food shop and every herbalist in the country”.

He advised consumers: “Be cautious about supplements you buy and use reputable websites. Discuss any concerns with your GP and always tell them what you’re taking.”

Herbal supplements" illegal ingredients pose health risk, experts warn

MDMA may pose greater danger to women than men, say scientists

Women are more likely to end up in emergency rooms than men after taking ecstasy, scientists say, with research suggesting this may because of the way the drug interacts with the body’s chemistry.

According to this year’s Global Drugs Survey, there has been a four-fold increase in British female clubbers seeking emergency medical treatment after taking MDMA in last three years, and women are now two to three times more likely to seek emergency treatment than men.

Dr Adam Winstock, the founder of the Global Drugs Survey that investigates drug use habits, said that gender differences in the effects of the drug were becoming increasingly clear.

“What I would say to female ecstasy users is that you need to more careful than men,” he said. “Women appear to be more at risk of harm. Everyone has to be careful, but I think women need to pay extra attention to things like how much they are using, how they are mixing, where they are and who they’re with.”

One theory is that MDMA, the active ingredient in ecstasy, causes users’ bodies to retain more water, which in some cases can lead to dangerous brain swelling. Oestrogen, the female hormone, impairs cells’ ability to release water, meaning that women are particularly at risk from the effect.

The warnings come after 10 young women died this year having taken ecstasy pills or MDMA powder – more than double the number last year – as high-strength products swamp the market after a drought that lasted several years.

The effects of MDMA doses are less predictable than other drugs, Winstock said. Even a small dose could, in the wrong set of circumstances, kill a user. However, he was keen to stress that the risk posed by the drug could be minimised by careful use.

With an estimated 200,000 Britons using ecstasy every weekend, overstating the harms of the drug was simply not realistic, he said.

Fiona Measham, a professor of criminology at Durham University, said that whereas previous deaths linked to ecstasy were the result of adulterated pills, problems now were more likely to be the result of users accidentally taking more MDMA than they intended.

Measham is the founder of the drug-testing charity The Loop, which checks the strength and content of drugs handed in by users at nightclubs and festivals across the UK.

She said: “With ecstasy-related deaths approaching the highest they have ever been, alongside some of the highest and most variable strength ecstasy pills in circulation, it’s more important than ever this coming party season to take extra care.”

MDMA may pose greater danger to women than men, say scientists

Stars pose with pants on their head to assist bone marrow patient Hollie Clark

When Hollie was recovering from her very first round of blood transfusions in hospital the only way a lot of her family members could talk with her was employing FaceTime.

Her uncle Matthew Clark put his underwear on his head to make her laugh even though he was talking to her on FaceTime and it sparked an notion for the campaign which is gathering tempo on Twitter.

^{Matthew Clark, Hollie’s uncle (Twitter)}

Welsh rugby player Sam Warburton kickstarted the viral trend when he tweeted a image of himself with pants on his and his puppy Ledley’s head.

^{Sam Warburton (Twitter)}

Athlete Jamie Baulch and sports commentator Jonathan Davies have also lent help, tweeting pictures and urging people to sign up to the Anthony Nolan donor register.

^{Jamie Baulch (Twitter)}

^{Johnathon Davies (Twitter)}

Mrs Clark said: “We’ve been completely thrilled by how a lot assistance we have previously had for this campaign.

“We’ve had responses from all over the planet currently.

“Obviously we’re desperate to find a donor for Hollie but this is not just for her, we realise the influence this can have for other households in the same situation.

“Even a single additional donor signing up could transform someone’s daily life.”

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Hollie, of Roath Park, Cardiff, at first had to have two blood transfusions a week to improve her issue but she has now stabilised.

Mrs Clark, a GP, mentioned: “The only achievable treatment method is a bone marrow transplant, we can’t do something else other than preserve Hollie stable with blood transfusions until we locate a donor.

“They are currently seeking the registers but we considered we cannot just sit waiting and not do anything.”

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Her parents’ concern was first raised when Hollie started out building mystery bruising.

Her mother took her to their physician who ran exams and sent Hollie to hospital that night.

“It was an absolute shock, it is virtually the worst point as a mother or father you could be told,” Mrs Clark mentioned.

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“We are keen to uncover a donor while Hollie remains fairly stable, we do not want it to get to a stage where she is very unwell once again which will make the method more difficult.”

Stars pose with pants on their head to assist bone marrow patient Hollie Clark

Overworked physicians pose threat to patient security

“Not every person has 70, but most people are looking following nicely over 20,” added the RCP president, whose college represents most of the UK’s 30,000 hospital medical professionals, except those in Scotland.

“If you have got more than 20 it gets to be impossible. The care gets thinner and thinner. It implies the consultant can not see the patient as significantly or certainly as early as they must do, so obviously the common of care is going to fall.”

Widespread understaffing, particularly overnight and at weekends, is posing a direct risk to patients’ security, he warned.

Acute medication consultants are supposed to see newly-admitted patients inside a number of hours, he stated.

“So you can think about that some thing might be missed simply because a person has not been there to lead the crew and to consider a suitable determination, so you can nicely think about items going wrong” due to the fact they have not seen them speedily ample, Sir Richard said.

Doctors under continual “strain and tension” end up spending as little as five minutes with some individuals, he mentioned, incorporating that when that happens “yes, you miss things”.

He accused the Coalition of cutting the NHS spending budget despite repeated pledges, including from David Cameron, to protect it from the austerity programme.

“In spite of what weaselly phrases people at the leading say, money’s been taken out of the NHS.” He highlighted the £2.8bn that has been provided to social care in the past three many years.

“The NHS is below-doctored, beneath-nursed, under-bedded and beneath-funded. There are too couple of doctors to do the increasingly huge job to a higher common, and securely, and compassionately,” he stated.

A worrying quantity of hospitals, especially smaller sized ones, face “severe” gaps in their health-related rotas, explained Sir Richard.

He explained health secretary Jeremy Hunt’s target that each and every patient has secure, substantial-quality care is unachievable since the NHS has neither the assets nor the workforce essential.

Sir Richard said the NHS requirements “billions” of pounds more a year to perform correctly.

The leader of the British Health-related Association, Dr Mark Porter, told the newspaper: “Several of Thompson’s comments will be recognised by those doing work in the NHS.

“Doctors are working more difficult than ever prior to as all NHS solutions come below enormous strain from a combination of growing workload, falling sources and workers shortages in important specialities.”

A Division of Overall health spokesman responded, saying: “Patient safety and care is a priority for the government and it is proper that we have large expectations for our NHS.

“While the NHS is 1 of the safest, most productive healthcare programs in the globe we should by no means shy away from striving to enhance standards for patients.”

The NHS now has the highest ever quantity of professionally experienced clinical staff considering that census data began, with plans to improve it even more, he said, adding that there are now far more than seven,500 more doctors doing work in the NHS than in 2010.

Overworked physicians pose threat to patient security

UN: cannabis law modifications pose "very grave danger to public health"

A cannabis smoker in Uruguay, where cultivation, sale and consumption, inside of permitted limits, is legal. Photograph: Nicolas Celaya/Xinhua Press/Corbis

The UN has launched a counter-offensive against moves to liberalise drug laws close to the globe, warning that cannabis legalisation poses a grave danger to public health.

The UN body for enforcing international drug treaties, the Global Narcotics Control Board (INCB), voiced concern over “misguided initiatives” on cannabis legalisation in Uruguay and the US states of Colorado and Washington that fail to comply with international drug conventions.

The INCB annual report published on Tuesday claims that the introduction of a extensively commercialised “health-related” cannabis programme in Colorado has led to increases in automobile accidents involving “drug drivers”, cannabis-relevant remedy admissions, and optimistic drug exams for cannabis.

“Drug-traffickers will pick the path of least resistance, so it is crucial that worldwide efforts to tackle the drug problem are unified,” mentioned Raymond Yans, INCB president.

“When governments consider their potential policies on this, the main consideration ought to be the prolonged-phrase overall health and welfare of the population.”

He mentioned the UN was concerned about some initiatives aimed at the legalisation of the non-medical and non-scientific use of cannabis that posed “a extremely grave danger to public health and wellbeing” – the quite items international drug conventions had been developed to safeguard.

The UN’s warning follows the vote by Uruguay’s parliament in December to approve a bill to legalise and regulate the sale and manufacturing of marijuana.

The sale of cannabis by licensed suppliers to adults aged more than 21 became legal in Colorado in January, and is due to comply with this summer season in Washington state. This is in spite of it remaining illegal underneath US federal law to cultivate, sell or possess cannabis.

Uruguay’s president, José Mujica, has stated his country’s initiative was an try to undermine the black industry, and find an alternative to the “war on drugs”, which he says has created far more troubles than it solves.

But the INCB report argues against such “alternative drug regimes”, claiming legalisation would not collapse “underground markets”, but rather would lead to much better use of this kind of drugs and larger ranges of addiction.

Pointing to the history of alcohol and tobacco markets, the report says that regardless of legalisation there is still a thriving black marketplace for cigarettes in several countries. It says up to twenty% of Britain’s domestic cigarette industry consists of smuggled cigarettes, whilst they represent 33% of all domestic cigarette consumption in Canada.

Alcohol, despite getting legal, is also responsible for far a lot more arrests than unlawful drugs. In the US there had been 2m alcohol-associated arrests in 2012 in contrast with 1.6m connected to illegal medicines.

“One explanation for these higher alcohol-connected charges is that in numerous countries alcohol abuse is far more prevalent than the abuse of substances below international handle,” the report says.

The UN remains most concerned about the scale of illicit opium poppy cultivation in Afghanistan, which set information in 2013 reaching 209,000 hectares, a 36% increase compared with 154,000 hectares in 2012.

“The nation stays the centre of the illicit manufacture of heroin and its significance as a source of cannabis resin for the planet markets is developing. The situation significantly endangers the aims of the global drug manage treaties,” the INCB report says.

It repeats its warnings on legal highs or new psychoactive substances as they are officially recognized, and says unprecedented numbers and types of these synthetic chemical substances are getting offered in the establishing globe as nicely as Europe.

The UN medication report also highlights the significance of widespread prescription drug abuse in the US and says that “takeback” days selling their secure disposal are not adequate to tackle this expanding trend.

UN: cannabis law modifications pose "very grave danger to public health"

NHS admits new health-related information database could pose privacy threat

Health researchers and personal companies will be in a position to access information from the information if they can demonstrate it will advantage patient care or enable more scientific advances.

Nevertheless, there has been a developing backlash towards the scheme with family members medical professionals and privacy campaigners raising fears that data could be misused. On Sunday night patients’ and privacy groups stated the analysis document, which specifics a host of likely dangers, “confirms some of our worst fears”.

NHS officials have repeatedly sought to assure the public that the dangers are minimal, stating that the bulk of details passed on to third parties will be anonymised or “pseudonymised” — that means it is practically extremely hard for patients to be identified.

But the chance assessment by NHS England, the physique behind the scheme, warns that individuals could be “re-identified” if database information is mixed with other information.

It says: “While there is a privacy risk that the analysts granted accessibility to these pseudonymised flows could possibly re-recognize individuals maliciously by combining the pseudonymised data with other obtainable datasets (a method recognized as a jigsaw assault) such an attack would be illegal and would be topic to sanction by the Info Commissioner’s Workplace.”

The report also warns that sufferers could endure and the all round good quality of information held could be eroded. “The extraction of individual confidential information from providers without having consent carries the threat that sufferers could get rid of believe in in the confidential nature of the well being support,” it says.

“This risk is two-fold firstly, individuals will not get optimum healthcare if they withhold details from the clinicians that are treating them and secondly, that this reduction of trust degrades the quality of data.” Those internet hosting the database want to protect its confidentiality and “guard against threats from within and outside the organisation”, the report’s authors say.

The document continues: “The risks described contain threats associated with ‘cyberspace’ this kind of as hackers attempting to access the information illegally.”

The risk evaluation emerged right after NHS statistics, uncovered more than the weekend, showed that wellness providers had been dropping or breaching the safety of two,000 patient information every single day. More than 2 million critical data breaches by the NHS have been logged given that the start off of 2011, the figures reveal, with data dumped in landfill web sites, left in shops and even offered on eBay.

Final week the Royal School of Standard Practitioners — which represents 46,000 GPs — mentioned there was a “crisis of public confidence” more than programs which have not been properly communicated to the public.

The intervention came as 5 key charities, including Mencap, the finding out disability organisation, and the Royal National Institute of Blind Men and women, accused NHS officials operating the scheme of unfair remedy of those with disabilities, who they say are much more very likely to be identified yet are less most likely to opt out, due to the fact they have not been told about it.

Nick Pickles, director of Large Brother View, questioned on Sunday night no matter whether the public had been “deliberately stored in the dark” about risks which are not explained in public data leaflets currently being sent to each home.

He stated: “Medical data hold some of our most delicate info and the threat to people’s privacy of them being maliciously stolen or re-recognized have to not be underestimated. From blackmailers to analysis firms, the worth could be considerable.” Fears have been raised information could be utilised by healthcare firms to target the sale of items or could fall into the hands of insurers. Roger Goss, from Patient Concern, mentioned: “This document confirms every little thing we have warned about — the human expense of placing all patients’ health-related historical past into this database is possibly disastrous.”

The Privacy Influence Assessment by NHS England suggests that the hazards of hacking and identification of sufferers should be mitigated by safeguards to manage the use of the data. Tim Kelsey, nationwide director for individuals and information at NHS England, stated: “The Privacy Influence Evaluation is a dwell document, which will be constantly updated as our drive for better data continues, and as we continue our conversations with the public about how the NHS employs data.

“On legal troubles this kind of as risks of hacking and information misuse by folks, the document sets out plainly the substantial-level technical and contractual safeguards towards them. On ethical problems like patient believe in in the system, the document exhibits we have pledged to ensure public awareness of the scheme, its rewards, its hazards, and patients’ rights to register objection.”

NHS admits new health-related information database could pose privacy threat

Mobile phones "pose no wellness risk" in accordance to report

“This independent programme is now complete, and in spite of exhaustive investigation, we have discovered no evidence of dangers to well being from the radio waves developed by mobile phones or their base stations.

“Thanks to the investigation carried out within the programme, we can now be a lot a lot more confident about the security of present day telecommunications systems.”

The £13.six million MTHR programme has been jointly funded by the Uk government and the telecommunications market.

All through its existence, the programme has been overseen by an independent committee to make certain that none of the funding bodies could influence the outcomes of the study.

Despite the findings, Professor Coggon warned that there are nevertheless some queries to be answered about the impact of mobile phone use on well being.

He mentioned: “There is much less uncertainty linked to mobile mobile phone use now so we have much significantly less reason to be concerned.

“Even so you are not able to rule out the posibility both that something may happen in the long term but not be manifested in the early years of mobile phones, or that there us something subtler that does not display up in the research that have been completed up right up until now.”

The MTHR has offered funding to set up a new research which will seem at long-phrase mobile phone use.

The COSMOS research will stick to a hundred,000 long-term mobile cellphone users to see if there are any delayed adverse results linked to mobile cellphone use.

Mobile phones "pose no wellness risk" in accordance to report

Mobile phones "pose no well being risk"

“This independent programme is now complete, and despite exhaustive analysis, we have identified no evidence of risks to wellness from the radio waves created by mobile phones or their base stations.

“Thanks to the analysis performed inside the programme, we can now be a lot much more assured about the safety of present day telecommunications methods.”

The £13.6 million MTHR programme has been jointly funded by the United kingdom government and the telecommunications sector.

All through its existence, the programme has been overseen by an independent committee to guarantee that none of the funding bodies could influence the outcomes of the analysis.

In spite of the findings, Professor Coggon warned that there are even now some inquiries to be answered about the affect of mobile phone use on well being.

He explained: “There is significantly less uncertainty linked to mobile telephone use now so we have much less cause to be concerned.

“Even so you cannot rule out the posibility both that something may possibly happen in the prolonged phrase but not be manifested in the early years of mobile phones, or that there us something subtler that doesn’t show up in the studies that have been carried out up right up until now.”

The MTHR has supplied funding to set up a new research which will search at long-term mobile cellphone use.

The COSMOS research will follow one hundred,000 long-phrase mobile phone consumers to see if there are any delayed adverse effects linked to mobile mobile phone use.

Mobile phones "pose no well being risk"