NHS chiefs soften ‘brutal’ cost-cutting plan after huge backlash

NHS bosses have been forced to backtrack on controversial plans to impose “brutal” cost-cutting measures that involved delaying operations, denying patients treatment and closing hospital wards.

NHS Improvement (NHSI), the service’s financial regulator, has watered down proposals it drew up alongside NHS England after doctors, health charities and senior NHS staff in the 14 affected areas of England reacted with anger, amazement and warnings that patients would suffer.

The Guardian last week reported how leaked NHS documents showed that hospitals serving five north London boroughs were being pressed to ration care and make patients wait longer for operations as part of a plan to save £183.1m within nine months. And we disclosed that plans to cut the number of endoscopies – vital diagnostic tests – in Cheshire by 25% prompted fears this could lead to cancer patients being diagnosed later and dying sooner.

The backlash against the cuts envisaged under the “capped expenditure process” has prompted NHSI to write to hospital trusts in the 14 areas to clarify the initiative in a bid to lessen the hostility it has triggered. It has imposed the CEP on the 14 areas because they are due to record massive deficits this year, though they blame NHS underfunding for their problems.

In his letter Jim Mackey, NHSI’s chief executive, has told hospital bosses that the final version of plans to make greater savings this year than planned “must safeguard patient safety and quality”.

In addition, “providers need to ensure that CEP plans are consistent with constitutional rights for RTT [referral to treatment] and patient choice”. That appears to rule out plans, previously being discussed in some of the 14 areas, to make patients wait longer for a non-urgent operation than the maximum 18 weeks under the NHS constitution and also to deny them their right to be treated at the NHS’s expense in a private hospital if they chose to do so.

Trust bosses privately criticised NHSI and NHSE’s plans as “brutal”, “unrealistic” and “impossible to deliver”, given the pressures their hospitals are under from rising demand. NHSI has also almost halved the amount of savings it hopes the 14 areas will deliver through the CEP from £470m to £250m, according to NHS sources and the Health Service Journal.

Chris Hopson, chief executive of NHS Providers, which represents most NHS trusts in England, said: “We are pleased the approach has changed. The trusts involved were very concerned – not just in terms of the level and speed of savings required, but also the lack of proper debate and transparency in the process. We set out those concerns to NHS England and NHS Improvement. It’s clear they have listened. “However, let’s not forget that the underlying problem – the gap between what the NHS is being asked to deliver and the funding available – remains.”

Jonathan Ashworth, Labour’s shadow health secretary, said: “The capped expenditure process is in total chaos. The government are refusing to answer questions about it and Jeremy Hunt is trying to shirk responsibility for this scheme, which will see hundreds of millions of pounds cut from health budgets.”

Ashworth condemned the “scandalous lack of transparency around the whole affair”. The Department of Health, NHS England and NHSI have shrouded the CEP in secrecy and refused to answer questions posed by the Guardian, in breach of their duty to be open, honest and transparent.

Philip Dunne, the health minister, this week refused to answer a series of detailed parliamentary questions tabled by Ashworth. Instead he simply defended the thrust of the CEP and stated that: “It is unfair if a small number of areas in effect take more than their fair share of that [NHS] budget [for 2017-18] at the expense of other people’s hospital services, general practitioner care and mental health clinics elsewhere in the country”. The government’s mandate to the NHS for 2017-18 requires all 44 sustainability and transformation areas to stick to their budgets, he added.

But Ashworth said: “We still do not know who is charged with drawing up each local plan, who chose which local areas would have to make extra cuts, or when confirmation of the plans will be published. Jeremy Hunt needs to make clear whether and when he signed off this hit-list of NHS cuts which will devastating outcomes for people all across the country.”

Imelda Redmond, national director of the patient watchdog Healthwatch England, criticised the secrecy around the CEP.

She said: “It’s clear the health service faces deeply challenging times but the solutions don’t lie in closed rooms, rather in honest conversations with patients, carers and communities. The last thing we need is a chain of kneejerk reactions driving poor decisions that don’t make sense to people.

“Where difficult choices do have to be made, people need clear information explaining the rationale and outlining how the NHS will track the impact to ensure no one is left without the care they need.”

Mackey’s letter also makes clear that from now on NHS trusts should also consult the public and “ensure that patients and staff are engaged throughout the planning and implementation stages of CEP”, especially if plans ultimately involve the downgrading or closure of A&E or maternity units.

What You Need to Know About the Lone Star Tick, Which Is Giving People Red Meat Allergies

You already know that ticks pose a threat your health; these bugs, which thrive in the summer, can transmit Lyme disease, Powassan disease, and even a rare condition called tick paralysis.

If those illnesses aren’t enough to worry about, experts are sounding the alarm about another tick-borne condition that appears to be on the rise. A bite from the lone star tick has been leaving victims with a potentially dangerous allergy to red meat and sometimes even dairy products.

RELATED: Bug Bites: How to Prevent and Treat

Never heard of the lone star tick? Once mostly confined to the southeastern United States, it’s been stretching its boundaries over the last couple of decades, increasing in numbers and showing up from Maine to central Texas and Oklahoma, says the Centers for Disease Control and Prevention.

Along with that red meat allergy, this tick can also carry the bacteria that can cause monocytic ehrlichiosis (a rare infectious disease), Rocky Mountain spotted fever, and STARI, a rash that can be mistaken for Lyme disease, reports the University of Rhode Island’s TickEncounter Resource Center.

But it’s the risk of an allergy to bacon and burgers that has people most on edge right now. Here’s how it happens: just like other ticks, the lone star tick likes to feed on mammal blood, like deer and cow, explains Cosby Stone, MD, MPH, a clinical research fellow in allergy and immunology at Vanderbilt University Medical Center. When a ticks bites one of these animals, the tick can pick up a sugar called alpha-gal.

Then, the tick bites a human. The bite itself as well as the alpha-gal that is transmitted to the human host triggers a person’s immune system to make antibodies. “Because you don’t make this sugar in your body, it’s recognized as something foreign and you can become allergic to it,” Dr. Stone says. The result: an alpha-gal allergy.

Unfortunately, alpha-gal sugar is in a lot of foods and dishes you may eat all the time, like red meat, dairy, and gelatin. Once you have this allergy, your barbecue days might be over. You’ll react when you eat a steak, and a small cohort of victims will even react when they drink a glass of milk. For some people, gelatin in medications causes those antibodies to kick in and cause distress. “This can create a lot of trouble for people,” adds Dr. Stone. 

RELATED: Beat 16 Summer Health Hazards

The allergy might take months to develop after the tick bite. Yet typically it starts to present itself soon after you eat red meat. The signs are often hard to ignore and potentially serious: hives, shortness of breath, diarrhea, swelling of the face and hands, and/or low blood pressure. “There are plenty of stories where patients eat a burger at 6 p.m. and then wake up with anaphylactic shock at midnight,” says Dr. Stone. If that happens, seek medical attention ASAP.

Though the lone start tick seems to have hit the headlines out of the blue, experts have been noticing a rise in allergic reactions over the last decade. Tick-borne illnesses in general appear to be increasing; the National Pest Association stated that 2017 might be the worst season yet for ticks, due in part to mild winter conditions that allowed ticks to thrive.

To get our best wellness tips delivered to you inbox, sign up for the Healthy Living newsletter

As with all ticks, the advice remains the same when it comes to protecting yourself. Use a permethrin-based repellent on clothes, wear long pants when you’re out hiking or working in the yard (and tuck those socks in), and do a tick check on yourself, your kids, and dogs when you go back inside. If you spot one, remove it with tweezers ASAP and be alert for any kind of symptoms, from a rash to fever to fatigue or weakness.

NHS chiefs soften ‘brutal’ cost-cutting plan after huge backlash

NHS bosses have been forced to backtrack on controversial plans to impose “brutal” cost-cutting measures that involved delaying operations, denying patients treatment and closing hospital wards.

NHS Improvement (NHSI), the service’s financial regulator, has watered down proposals it drew up alongside NHS England after doctors, health charities and senior NHS staff in the 14 affected areas of England reacted with anger, amazement and warnings that patients would suffer.

The Guardian last week reported how leaked NHS documents showed that hospitals serving five north London boroughs were being pressed to ration care and make patients wait longer for operations as part of a plan to save £183.1m within nine months. And we disclosed that plans to cut the number of endoscopies – vital diagnostic tests – in Cheshire by 25% prompted fears this could lead to cancer patients being diagnosed later and dying sooner.

The backlash against the cuts envisaged under the “capped expenditure process” has prompted NHSI to write to hospital trusts in the 14 areas to clarify the initiative in a bid to lessen the hostility it has triggered. It has imposed the CEP on the 14 areas because they are due to record massive deficits this year, though they blame NHS underfunding for their problems.

In his letter Jim Mackey, NHSI’s chief executive, has told hospital bosses that the final version of plans to make greater savings this year than planned “must safeguard patient safety and quality”.

In addition, “providers need to ensure that CEP plans are consistent with constitutional rights for RTT [referral to treatment] and patient choice”. That appears to rule out plans, previously being discussed in some of the 14 areas, to make patients wait longer for a non-urgent operation than the maximum 18 weeks under the NHS constitution and also to deny them their right to be treated at the NHS’s expense in a private hospital if they chose to do so.

Trust bosses privately criticised NHSI and NHSE’s plans as “brutal”, “unrealistic” and “impossible to deliver”, given the pressures their hospitals are under from rising demand. NHSI has also almost halved the amount of savings it hopes the 14 areas will deliver through the CEP from £470m to £250m, according to NHS sources and the Health Service Journal.

Chris Hopson, chief executive of NHS Providers, which represents most NHS trusts in England, said: “We are pleased the approach has changed. The trusts involved were very concerned – not just in terms of the level and speed of savings required, but also the lack of proper debate and transparency in the process. We set out those concerns to NHS England and NHS Improvement. It’s clear they have listened. “However, let’s not forget that the underlying problem – the gap between what the NHS is being asked to deliver and the funding available – remains.”

Jonathan Ashworth, Labour’s shadow health secretary, said: “The capped expenditure process is in total chaos. The government are refusing to answer questions about it and Jeremy Hunt is trying to shirk responsibility for this scheme, which will see hundreds of millions of pounds cut from health budgets.”

Ashworth condemned the “scandalous lack of transparency around the whole affair”. The Department of Health, NHS England and NHSI have shrouded the CEP in secrecy and refused to answer questions posed by the Guardian, in breach of their duty to be open, honest and transparent.

Philip Dunne, the health minister, this week refused to answer a series of detailed parliamentary questions tabled by Ashworth. Instead he simply defended the thrust of the CEP and stated that: “It is unfair if a small number of areas in effect take more than their fair share of that [NHS] budget [for 2017-18] at the expense of other people’s hospital services, general practitioner care and mental health clinics elsewhere in the country”. The government’s mandate to the NHS for 2017-18 requires all 44 sustainability and transformation areas to stick to their budgets, he added.

But Ashworth said: “We still do not know who is charged with drawing up each local plan, who chose which local areas would have to make extra cuts, or when confirmation of the plans will be published. Jeremy Hunt needs to make clear whether and when he signed off this hit-list of NHS cuts which will devastating outcomes for people all across the country.”

Imelda Redmond, national director of the patient watchdog Healthwatch England, criticised the secrecy around the CEP.

She said: “It’s clear the health service faces deeply challenging times but the solutions don’t lie in closed rooms, rather in honest conversations with patients, carers and communities. The last thing we need is a chain of kneejerk reactions driving poor decisions that don’t make sense to people.

“Where difficult choices do have to be made, people need clear information explaining the rationale and outlining how the NHS will track the impact to ensure no one is left without the care they need.”

Mackey’s letter also makes clear that from now on NHS trusts should also consult the public and “ensure that patients and staff are engaged throughout the planning and implementation stages of CEP”, especially if plans ultimately involve the downgrading or closure of A&E or maternity units.

Suicide and self-harm in prisons hit worst ever levels

Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data.

Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012. Since 2010, when David Cameron became prime minister, funding of offender management has been reduced by 13%, while staff numbers have been cut by 30%, the report said.

Self-harm

“Prisons have struggled to cope with reduced resources. When prisons are short-staffed, governors run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services,” the report concluded.

The report covered prisons in England and Wales, although issues around healthcare are devolved, so the NAO examined only health services provided in England.

NAO chief Sir Amyas Morse said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.

“The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently, government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding, it is hard to see how government can be achieving value for money.”

The report noted that the prison system was “under considerable pressure, making it more difficult to manage prisoners’ mental wellbeing”, but acknowledged that the government had promised an “ambitious reform programme” to address this.

The National Offender Management Service (Noms), which was replaced by HM Prison and Probation Service (HMPPS) in April, had suffered funding cuts of 13% from 2009 to 2017, the NAO said, with a 30% fall in staff numbers in jails over the same period.

Staff numbers

Responsibility for mentally unwell prisoners should fall upon the Ministry of Justice, HMPPS, Department of Health, NHS England and Public Health England, the report said. The NAO also noted delays in transferring inmates to secure hospitals for treatment; just 34% of eligible prisoners were transferred within the 14-day target in 2016-17.

Peter Dawson, director of the Prison Reform Trust, said the report showed a familiar tale of admirable policy objectives not being delivered on the ground. “This report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment.”

Lib Dem health spokesman Norman Lamb called for a legal maximum time between diagnosis and transfer for prisoners who need hospital treatment. He said: “The mental health crisis is threatening the very fabric of our prisons. Too many prisoners with serious mental health problems are being allowed to slip through the cracks, often with tragic consequences.”

Self-inflicted death

A government spokesperson said support available to vulnerable offenders had increased, including investment in specialist mental health training for prison officers. “We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons.

“But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system,” the spokesperson said.

For professional advice on suicide prevention in young people, or if you are concerned about someone who may be suicidal, or are at risk yourself, contact Papyrus on 0800 068 4141 or text 07786 209 697 or email pat@papyrus-uk.org. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Suicide and self-harm in prisons hit worst ever levels

Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data.

Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012. Since 2010, when David Cameron became prime minister, funding of offender management has been reduced by 13%, while staff numbers have been cut by 30%, the report said.

Self-harm

“Prisons have struggled to cope with reduced resources. When prisons are short-staffed, governors run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services,” the report concluded.

The report covered prisons in England and Wales, although issues around healthcare are devolved, so the NAO examined only health services provided in England.

NAO chief Sir Amyas Morse said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.

“The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently, government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding, it is hard to see how government can be achieving value for money.”

The report noted that the prison system was “under considerable pressure, making it more difficult to manage prisoners’ mental wellbeing”, but acknowledged that the government had promised an “ambitious reform programme” to address this.

The National Offender Management Service (Noms), which was replaced by HM Prison and Probation Service (HMPPS) in April, had suffered funding cuts of 13% from 2009 to 2017, the NAO said, with a 30% fall in staff numbers in jails over the same period.

Staff numbers

Responsibility for mentally unwell prisoners should fall upon the Ministry of Justice, HMPPS, Department of Health, NHS England and Public Health England, the report said. The NAO also noted delays in transferring inmates to secure hospitals for treatment; just 34% of eligible prisoners were transferred within the 14-day target in 2016-17.

Peter Dawson, director of the Prison Reform Trust, said the report showed a familiar tale of admirable policy objectives not being delivered on the ground. “This report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment.”

Lib Dem health spokesman Norman Lamb called for a legal maximum time between diagnosis and transfer for prisoners who need hospital treatment. He said: “The mental health crisis is threatening the very fabric of our prisons. Too many prisoners with serious mental health problems are being allowed to slip through the cracks, often with tragic consequences.”

Self-inflicted death

A government spokesperson said support available to vulnerable offenders had increased, including investment in specialist mental health training for prison officers. “We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons.

“But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system,” the spokesperson said.

For professional advice on suicide prevention in young people, or if you are concerned about someone who may be suicidal, or are at risk yourself, contact Papyrus on 0800 068 4141 or text 07786 209 697 or email pat@papyrus-uk.org. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

What You Need to Know About the Lone Star Tick, Which Is Giving People Red Meat Allergies

You already know that ticks pose a threat your health; these bugs, which thrive in the summer, can transmit Lyme disease, Powassan disease, and even a rare condition called tick paralysis.

If those illnesses aren’t enough to worry about, experts are sounding the alarm about another tick-borne condition that appears to be on the rise. A bite from the lone star tick has been leaving victims with a potentially dangerous allergy to red meat and sometimes even dairy products.

RELATED: Bug Bites: How to Prevent and Treat

Never heard of the lone star tick? Once mostly confined to the southeastern United States, it’s been stretching its boundaries over the last couple of decades, increasing in numbers and showing up from Maine to central Texas and Oklahoma, says the Centers for Disease Control and Prevention.

Along with that red meat allergy, this tick can also carry the bacteria that can cause monocytic ehrlichiosis (a rare infectious disease), Rocky Mountain spotted fever, and STARI, a rash that can be mistaken for Lyme disease, reports the University of Rhode Island’s TickEncounter Resource Center.

But it’s the risk of an allergy to bacon and burgers that has people most on edge right now. Here’s how it happens: just like other ticks, the lone star tick likes to feed on mammal blood, like deer and cow, explains Cosby Stone, MD, MPH, a clinical research fellow in allergy and immunology at Vanderbilt University Medical Center. When a ticks bites one of these animals, the tick can pick up a sugar called alpha-gal.

Then, the tick bites a human. The bite itself as well as the alpha-gal that is transmitted to the human host triggers a person’s immune system to make antibodies. “Because you don’t make this sugar in your body, it’s recognized as something foreign and you can become allergic to it,” Dr. Stone says. The result: an alpha-gal allergy.

Unfortunately, alpha-gal sugar is in a lot of foods and dishes you may eat all the time, like red meat, dairy, and gelatin. Once you have this allergy, your barbecue days might be over. You’ll react when you eat a steak, and a small cohort of victims will even react when they drink a glass of milk. For some people, gelatin in medications causes those antibodies to kick in and cause distress. “This can create a lot of trouble for people,” adds Dr. Stone. 

RELATED: Beat 16 Summer Health Hazards

The allergy might take months to develop after the tick bite. Yet typically it starts to present itself soon after you eat red meat. The signs are often hard to ignore and potentially serious: hives, shortness of breath, diarrhea, swelling of the face and hands, and/or low blood pressure. “There are plenty of stories where patients eat a burger at 6 p.m. and then wake up with anaphylactic shock at midnight,” says Dr. Stone. If that happens, seek medical attention ASAP.

Though the lone start tick seems to have hit the headlines out of the blue, experts have been noticing a rise in allergic reactions over the last decade. Tick-borne illnesses in general appear to be increasing; the National Pest Association stated that 2017 might be the worst season yet for ticks, due in part to mild winter conditions that allowed ticks to thrive.

To get our best wellness tips delivered to you inbox, sign up for the Healthy Living newsletter

As with all ticks, the advice remains the same when it comes to protecting yourself. Use a permethrin-based repellent on clothes, wear long pants when you’re out hiking or working in the yard (and tuck those socks in), and do a tick check on yourself, your kids, and dogs when you go back inside. If you spot one, remove it with tweezers ASAP and be alert for any kind of symptoms, from a rash to fever to fatigue or weakness.

Suicide and self-harm in prisons hit worst ever levels

Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data.

Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012. Since 2010, when David Cameron became prime minister, funding of offender management has been reduced by 13%, while staff numbers have been cut by 30%, the report said.

Self-harm

“Prisons have struggled to cope with reduced resources. When prisons are short-staffed, governors run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services,” the report concluded.

The report covered prisons in England and Wales, although issues around healthcare are devolved, so the NAO examined only health services provided in England.

NAO chief Sir Amyas Morse said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.

“The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently, government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding, it is hard to see how government can be achieving value for money.”

The report noted that the prison system was “under considerable pressure, making it more difficult to manage prisoners’ mental wellbeing”, but acknowledged that the government had promised an “ambitious reform programme” to address this.

The National Offender Management Service (Noms), which was replaced by HM Prison and Probation Service (HMPPS) in April, had suffered funding cuts of 13% from 2009 to 2017, the NAO said, with a 30% fall in staff numbers in jails over the same period.

Staff numbers

Responsibility for mentally unwell prisoners should fall upon the Ministry of Justice, HMPPS, Department of Health, NHS England and Public Health England, the report said. The NAO also noted delays in transferring inmates to secure hospitals for treatment; just 34% of eligible prisoners were transferred within the 14-day target in 2016-17.

Peter Dawson, director of the Prison Reform Trust, said the report showed a familiar tale of admirable policy objectives not being delivered on the ground. “This report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment.”

Lib Dem health spokesman Norman Lamb called for a legal maximum time between diagnosis and transfer for prisoners who need hospital treatment. He said: “The mental health crisis is threatening the very fabric of our prisons. Too many prisoners with serious mental health problems are being allowed to slip through the cracks, often with tragic consequences.”

Self-inflicted death

A government spokesperson said support available to vulnerable offenders had increased, including investment in specialist mental health training for prison officers. “We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons.

“But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system,” the spokesperson said.

For professional advice on suicide prevention in young people, or if you are concerned about someone who may be suicidal, or are at risk yourself, contact Papyrus on 0800 068 4141 or text 07786 209 697 or email pat@papyrus-uk.org. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Suicide and self-harm in prisons hit worst ever levels

Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data.

Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012. Since 2010, when David Cameron became prime minister, funding of offender management has been reduced by 13%, while staff numbers have been cut by 30%, the report said.

Self-harm

“Prisons have struggled to cope with reduced resources. When prisons are short-staffed, governors run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services,” the report concluded.

The report covered prisons in England and Wales, although issues around healthcare are devolved, so the NAO examined only health services provided in England.

NAO chief Sir Amyas Morse said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.

“The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently, government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding, it is hard to see how government can be achieving value for money.”

The report noted that the prison system was “under considerable pressure, making it more difficult to manage prisoners’ mental wellbeing”, but acknowledged that the government had promised an “ambitious reform programme” to address this.

The National Offender Management Service (Noms), which was replaced by HM Prison and Probation Service (HMPPS) in April, had suffered funding cuts of 13% from 2009 to 2017, the NAO said, with a 30% fall in staff numbers in jails over the same period.

Staff numbers

Responsibility for mentally unwell prisoners should fall upon the Ministry of Justice, HMPPS, Department of Health, NHS England and Public Health England, the report said. The NAO also noted delays in transferring inmates to secure hospitals for treatment; just 34% of eligible prisoners were transferred within the 14-day target in 2016-17.

Peter Dawson, director of the Prison Reform Trust, said the report showed a familiar tale of admirable policy objectives not being delivered on the ground. “This report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment.”

Lib Dem health spokesman Norman Lamb called for a legal maximum time between diagnosis and transfer for prisoners who need hospital treatment. He said: “The mental health crisis is threatening the very fabric of our prisons. Too many prisoners with serious mental health problems are being allowed to slip through the cracks, often with tragic consequences.”

Self-inflicted death

A government spokesperson said support available to vulnerable offenders had increased, including investment in specialist mental health training for prison officers. “We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons.

“But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system,” the spokesperson said.

For professional advice on suicide prevention in young people, or if you are concerned about someone who may be suicidal, or are at risk yourself, contact Papyrus on 0800 068 4141 or text 07786 209 697 or email pat@papyrus-uk.org. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Suicide and self-harm in prisons hit worst ever levels

Prisons have “struggled to cope” with record rates of suicide and self-harm among inmates following cuts to funding and staff numbers, the public spending watchdog has said. The National Audit Office said it remains unclear how the authorities will meet aims for improving prisoners’ mental health or get value for money because of a lack of relevant data.

Auditors said that self-harm incidents increased by 73% between 2012 and 2016 to 40,161, while the 120 self-inflicted deaths in prison in 2016 was the highest figure on record and almost double that for 2012. Since 2010, when David Cameron became prime minister, funding of offender management has been reduced by 13%, while staff numbers have been cut by 30%, the report said.

Self-harm

“Prisons have struggled to cope with reduced resources. When prisons are short-staffed, governors run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services,” the report concluded.

The report covered prisons in England and Wales, although issues around healthcare are devolved, so the NAO examined only health services provided in England.

NAO chief Sir Amyas Morse said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.

“The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently, government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding, it is hard to see how government can be achieving value for money.”

The report noted that the prison system was “under considerable pressure, making it more difficult to manage prisoners’ mental wellbeing”, but acknowledged that the government had promised an “ambitious reform programme” to address this.

The National Offender Management Service (Noms), which was replaced by HM Prison and Probation Service (HMPPS) in April, had suffered funding cuts of 13% from 2009 to 2017, the NAO said, with a 30% fall in staff numbers in jails over the same period.

Staff numbers

Responsibility for mentally unwell prisoners should fall upon the Ministry of Justice, HMPPS, Department of Health, NHS England and Public Health England, the report said. The NAO also noted delays in transferring inmates to secure hospitals for treatment; just 34% of eligible prisoners were transferred within the 14-day target in 2016-17.

Peter Dawson, director of the Prison Reform Trust, said the report showed a familiar tale of admirable policy objectives not being delivered on the ground. “This report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment.”

Lib Dem health spokesman Norman Lamb called for a legal maximum time between diagnosis and transfer for prisoners who need hospital treatment. He said: “The mental health crisis is threatening the very fabric of our prisons. Too many prisoners with serious mental health problems are being allowed to slip through the cracks, often with tragic consequences.”

Self-inflicted death

A government spokesperson said support available to vulnerable offenders had increased, including investment in specialist mental health training for prison officers. “We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons.

“But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system,” the spokesperson said.

For professional advice on suicide prevention in young people, or if you are concerned about someone who may be suicidal, or are at risk yourself, contact Papyrus on 0800 068 4141 or text 07786 209 697 or email pat@papyrus-uk.org. In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

What You Need to Know About the Lone Star Tick, Which Is Giving People Red Meat Allergies

You already know that ticks pose a threat your health; these bugs, which thrive in the summer, can transmit Lyme disease, Powassan disease, and even a rare condition called tick paralysis.

If those illnesses aren’t enough to worry about, experts are sounding the alarm about another tick-borne condition that appears to be on the rise. A bite from the lone star tick has been leaving victims with a potentially dangerous allergy to red meat and sometimes even dairy products.

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Never heard of the lone star tick? Once mostly confined to the southeastern United States, it’s been stretching its boundaries over the last couple of decades, increasing in numbers and showing up from Maine to central Texas and Oklahoma, says the Centers for Disease Control and Prevention.

Along with that red meat allergy, this tick can also carry the bacteria that can cause monocytic ehrlichiosis (a rare infectious disease), Rocky Mountain spotted fever, and STARI, a rash that can be mistaken for Lyme disease, reports the University of Rhode Island’s TickEncounter Resource Center.

But it’s the risk of an allergy to bacon and burgers that has people most on edge right now. Here’s how it happens: just like other ticks, the lone star tick likes to feed on mammal blood, like deer and cow, explains Cosby Stone, MD, MPH, a clinical research fellow in allergy and immunology at Vanderbilt University Medical Center. When a ticks bites one of these animals, the tick can pick up a sugar called alpha-gal.

Then, the tick bites a human. The bite itself as well as the alpha-gal that is transmitted to the human host triggers a person’s immune system to make antibodies. “Because you don’t make this sugar in your body, it’s recognized as something foreign and you can become allergic to it,” Dr. Stone says. The result: an alpha-gal allergy.

Unfortunately, alpha-gal sugar is in a lot of foods and dishes you may eat all the time, like red meat, dairy, and gelatin. Once you have this allergy, your barbecue days might be over. You’ll react when you eat a steak, and a small cohort of victims will even react when they drink a glass of milk. For some people, gelatin in medications causes those antibodies to kick in and cause distress. “This can create a lot of trouble for people,” adds Dr. Stone. 

RELATED: Beat 16 Summer Health Hazards

The allergy might take months to develop after the tick bite. Yet typically it starts to present itself soon after you eat red meat. The signs are often hard to ignore and potentially serious: hives, shortness of breath, diarrhea, swelling of the face and hands, and/or low blood pressure. “There are plenty of stories where patients eat a burger at 6 p.m. and then wake up with anaphylactic shock at midnight,” says Dr. Stone. If that happens, seek medical attention ASAP.

Though the lone start tick seems to have hit the headlines out of the blue, experts have been noticing a rise in allergic reactions over the last decade. Tick-borne illnesses in general appear to be increasing; the National Pest Association stated that 2017 might be the worst season yet for ticks, due in part to mild winter conditions that allowed ticks to thrive.

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As with all ticks, the advice remains the same when it comes to protecting yourself. Use a permethrin-based repellent on clothes, wear long pants when you’re out hiking or working in the yard (and tuck those socks in), and do a tick check on yourself, your kids, and dogs when you go back inside. If you spot one, remove it with tweezers ASAP and be alert for any kind of symptoms, from a rash to fever to fatigue or weakness.