Category Archives: Heartburn

Virus risk on planes is lower than you might think, study says

Flyers who live in fear of catching bugs on every flight, take heart: the risk of picking up respiratory infections while cruising at 35,000 feet may be slimmer than you think.

Scientists used a computer model to crunch information on how people moved around aircraft on flights lasting three-and-a-half to five hours. They found that passengers sitting one row in front, or one row behind, a person with flu had an 80% risk of catching the bug.

The same level of risk applied to those sitting one or two seats either side of the infectious traveller, but for all other passengers, the risk was less than 3%. An infected cabin crew member infected 4.6 passengers per flight, the model found.

“What we showed is that outside this perimeter there is very little probability of becoming infected on an airplane,” said Vicki Hertzberg, a professor of biostatistics and director of the Center for Nursing Data Science at Emory University in Atlanta. “You don’t have to worry about the coughing coming from the person five rows behind you.”

Health officials have recorded more than a dozen cases of bugs being spread on planes, ranging from instances of pandemic influenza to severe acute respiratory syndrome, or Sars. But despite the potential for passengers to fall ill, little has been known about the health risks that sickly flyers pose.

To find out more, researchers working with Hertzberg and Boeing in Seattle boarded 10 domestic US flights and took notes on how passengers and crew moved around the aircraft. The flights left Atlanta for San Diego, Los Angeles, San Francisco, Seattle or Portland, and all of the planes had two rows of three seats separated by a central aisle.

In total, the movements of 1,540 passengers and 41 cabin crew were plugged into the computer model, which assumed that flu-ridden passengers infected others at the rate of 0.018 per minute of contact. The infection rate, according to a report in Proceedings of the National Academy of Sciences, was chosen to produce something close to a worst-case scenario.

Hertzberg said the computer only modelled the risk from viruses spread by droplets sprayed out in coughs and sneezes, and did not take into account the potential for viruses to float around in the cabin’s air. Steven Riley, professor of infectious disease dynamics at Imperial College London, said that while the risk of picking up flu on any one flight was low, larger studies with enough passengers to reveal real infection rates were needed.

Asked if she had tips for flyers who find themselves next to a spluttering passenger, Hertzberg said people should wash their hands well and not touch their faces, because viruses can be picked up through the eyes, nose and mouth. As for requesting another seat, good luck with that. “Flights are so full these days, there would probably be no place to move to,” she said.

Report finds some NHS mental health trusts screen all patients for radicalisation

Four NHS mental health trusts are subjecting patients to blanket screening for radicalisation, with some referred to the Prevent programme for watching Arabic TV or going on pilgrimage to Mecca, a new report has revealed.

The Warwick University study surveyed 329 NHS staff on Prevent anti-radicalisation measures in the health service. With the UK the only country in the world to incorporate the duty to report signs of radicalisation into its healthcare system, NHS trusts are obliged to train staff to report patients or staff they suspect of being radicalised to safeguarding teams.

But according to study authors Charlotte Heath-Kelly and Erzsébet Strausz, less than half of the staff surveyed believe that Prevent belongs in the NHS or that it is intended as a safeguarding measure.

“There is evidence to suggest that the mentally ill are being inappropriately stigmatised as terrorism risks,” the report, called Counter-Terrorism in the NHS, states.

Heath-Kelly and Strausz sent freedom of information requests to all 54 NHS mental health trusts in England. Of the 49 that replied, four said that they assessed every patient for signs of radicalisation, while the others reported that they conducted radicalisation risk assessments on patients they had specific concerns about.

70% of NHS staff surveyed said they would be likely or very likely to raise a Prevent query on the basis of someone owning anarchist or Islamic philosophy books.

The staff surveyed also revealed a number of disturbing examples of what led to people being referred to Prevent by NHS staff, including:

  • A healthcare professional visiting a family at home who saw the child watching an Arabic TV channel with Arabic reading materials lying around.
  • An Asian man who was travelling to Saudi Arabia for the hajj.
  • A man who went to an accident and emergency department with burned hands, did did not provide an explanation for how he came by the burns, and was subsequently referred to police on suspicion of experimenting with bomb-making.

The report, which says that in Prevent priority areas Home Office officials are embedded in the NHS, will add to concerns over the use of the programme. It has already faced controversy as a method of identifying people who may have become radicalised and is distrusted by some communities.

After the Manchester Arena terror attack in May 2017, NHS staff were asked to encourage anyone they saw who had been at the arena to phone the police terrorism hotline. They were told that if patients refused, then the NHS staff could call the terror hotline and give police information after the patient had gone.

Each NHS trust receives a daily counter-terrorism briefing from the Home Office. “It is unclear why the NHS would require daily briefings on international terrorism for its work,” the report states.

The Home Office also provides NHS staff with advice on how to counter negative media stories about the Prevent programme.

The report takes issue with the definition of Prevent in the NHS as a safeguarding measure, saying that safeguarding has shifted from a welfare-oriented to a security-oriented endeavour.

According to the NHS website, the Prevent programme is “designed to safeguard people in a similar way to safeguarding processes to protect people from gang activity, drug abuse, and physical and sexual abuse”, adding that radicalisation is seen as a type of harm or abuse.

But there are concerns that the definition is hazily applied and operating in a legal grey area. Heath-Kelly expressed particular alarm about the instruction from police to refer any cases NHS staff have concerns about, even if those concerns turn out to be unfounded. “This is a surveillance rationale, not a safeguarding rationale,” she said.

The role of NHS mental health trusts in making Prevent referrals is key. According to Sir Bruce Keogh, NHS England’s former national medical director, two-thirds of NHS Prevent referrals come from mental health trusts. Since last November, the government has produced separate Prevent guidance for NHS mental health trusts.

One forensic psychiatrist interviewed for the study said: “It’s going to be a bit Mickey Mouse … as I say, I’m ashamed, it’s totally unscientific and it’s going to be based on opinion, so it’s a bit crap really, but it’s just trying to get at what’s going on.”

The report urges the four NHS trusts who investigate all patients for signs of radicalisation to stop doing so.

Two-thirds of the NHS staff surveyed said they were not confident that they could distinguish someone who had been radicalised from someone who had an interest in Middle Eastern politics. Although the NHS philosophy is “no decision about me without me”, consent is rarely obtained before a Prevent referral is made, the report finds.

Heath-Kelly said: “Historically this kind of thing has existed in non-democratic societies and we know the history of where that leads. It becomes deeply concerning when you look at the real world of how it works for people being asked to do something they are not trained to do and identify people who might in the future become dangerous. There is deeply problematic mission creep here.”

Corbyn writes to May about man’s £54,000 NHS cancer bill

Jeremy Corbyn has written to Theresa May about Londoner Albert Thompson’s £54,000 bill for cancer treatment, saying the government risks allowing a patient to die because of difficulties proving immigration status.

Thompson, 63, who has lived continuously in the UK for 44 years since arriving from Jamaica as a teenager in 1973, is not receiving the radiotherapy he needs for prostate cancer because the London hospital where he was due to start treatment last November told him he needed to provide proof of residency or pay upfront for his care.

He was unable to supply officials with required documents, so he was told he needed to find £54,000. Thompson, who has asked for his real name not to be used, is increasingly worried about the potential impact on his health of the delay of more than four months. The Labour leader called on ministers to “intervene immediately in his case to ensure that this man gets access to the care that he needs”.

Corbyn said Thompson’s situation was not unique and he was dealing with a similar case in his constituency, which he had also raised with the Home Office. He said the cases were a direct result of new regulations introduced last October requiring hospital departments and community health services to check every patient’s paperwork, including passports and proof of address, and charge upfront for their healthcare if they did not have documentary proof of eligibility.

The case raised the prospect that many undocumented British citizens were being denied free NHS treatment, and that the principle of the universal NHS, free at the point of need, was being eroded, he wrote.

“Every patient, including British citizens, can be asked about their residency status and made to prove they are entitled to free NHS care,” he said. He quoted concerns raised by the shadow spokesperson for health and social care, Philip Hunt, who said in the Lords last year that, as a result of the new regulations, “many people who legitimately live here and have every right to NHS treatment are going to be challenged by the NHS”.

Thompson, who worked as a mechanic before he became ill, has never applied for a British passport because he had no need to, but the Jamaican passport he arrived with was lost many years ago. In the tightened hostile immigration environment, launched by Theresa May in 2013, he has struggled to prove his eligibility for housing support and free healthcare.

A spokesperson for the hospital said Thompson “continues to be treated by his GP as directed by the cancer specialist. His radiotherapy is not urgent. We are very sorry this has caused Mr Thompson distress and uncertainty and are working hard to try to resolve this as quickly as possible.”

Thompson said he had not seen a GP about his prostate cancer treatment since early last year.

Doctors have expressed confusion at the decision to classify the radiotherapy as non-urgent. Joe Rylands, a spokesperson for Docs Not Cops, a group of healthcare professionals campaigning to protect free access to healthcare for all people, said: “I cannot foresee any circumstances whereby a patient has been deemed to need ‘discretionary’ radiotherapy for prostate cancer. Either they need it by team decision, when it is potentially life-saving, or they don’t. To withdraw it on the basis of nationality appears unethical and incompatible with the principles of the NHS.”

A Downing Street spokesperson said the prime minister had received the letter and would respond in due course. A Department of Health and Social Care spokesperson said: “Our guidance makes clear that urgent and immediately necessary care should never be withheld or delayed.”

Platypus milk: unlikely weapon in fight against superbugs

They are duck-billed, egg-laying, semi-aquatic mammals with poisonous spurs on their webbed feet: the Australian platypus is so weird that early European zoologists thought it must be an elaborate hoax.

But now a team of Australian scientists have found something else unique to the strange little animals: their milk has a novel chemical structure that could be used to fight superbugs.

Molecular biologists from Australia’s national science agency CSIRO have isolated the monotreme lactation protein structure for the first time, identifying a novel three-dimensional fold that the researchers say could lead to the creation of a new type of antibiotics.

“Platypus are such weird animals that it would make sense for them to have weird biochemistry,” said Janet Newman, CSIRO scientist and lead author on the research, which also involved scientists from Deakin University in Geelong, Victoria.

In 2010 scientists from Deakin discovered platypus milk contains a lactation protein with potent antibacterial properties.

“This special component has antibacterial properties against some of the nastier bugs you find in the environment but not against some bacteria found in the guts of the young,” Newman said.

Platypus and echidnas are monotremes, the only mammals that lay eggs instead of giving birth to live young. They don’t have teats, so the mothers express their milk onto their bellies for their young to feed.

The scientists hypothesise that the antibacterial properties are related to this milk delivery system, evolving in order to protect the young from the possibility of infection. When mammals evolved teats, a sterile delivery system for milk, the protein was no longer as important in an evolutionary sense.

The Deakin researchers approached specialists at CSIRO’s collaborative crystallisation centre to replicate the protein and decode its shape in the laboratory, to seek clues to understanding its potency.

The scientists dubbed it the Shirley Temple protein because of its ringlet-like formation. Most intriguingly, the protein has a novel fold in its structure that has not been identified in any of the more than 100,000 known protein structures, Dr Newman said.

“That’s interesting, because it’s the shape of proteins which dictate their function,” she explained.

“So the hope is that the novel structure, in the best possible world, would eventually lead to a therapeutic that is based on a completely different way of dealing with microbial infections than our current antibiotics,” she said.

The research identifying the new protein fold, which was published on Thursday in the journal Structural Biology Communications, will inform ongoing drug discovery work, Dr Newman said.

Since 2014 the World Health Organisation has warned of a potential “post-antibiotic era” where antibiotics are no longer effective against common infections and minor injuries.

Superbugs are bacteria that were once responsive to antibiotics but have built up resistance to them, leading to ineffective treatments and more persistent infections and sometimes to fatalities.

It’s ironic, but under Trump abstinence-only sex education is back | Jessica Valenti

There is something perfect about the irony of Donald Trump – a man who bragged about the size of his penis during a debate and who is currently being sued by a porn actress – advocating for abstinence-only education. But here we are, in the upside down.

Politico reports that Valerie Huber, a longtime abstinence-only activist turned Department of Health and Human Services (HHS) staffer, will be making decisions about federal family planning funds. Huber, who was suspended from her position at the Ohio Department of Health after a state ethics investigation in 2006, is founder of the National Abstinence Educators Association, which later became Ascend. (The name change was part of a broader move by the abstinence-only movement to seem more credible.)

This comes on the heels of a leaked White House memo and HHS guidelines showing the administration plans to teach teenagers “fertility awareness methods” – otherwise known as the rhythm method – in lieu of birth control. Teens can barely get their homework in on time but somehow we’re expected to believe that they’re going to prevent pregnancy by tracking their periods.

While there is no lack of outrageous acts generated by the Trump administration these days, the idea that abstinence-only education is making a comeback cannot get lost in the muck.

Nearly a decade ago, I wrote a book about abstinence-only education. The lies told by federally funded “educators” to students across the country ranged from inaccurate to astounding.

I spoke to young people who were taught they could be arrested for having premarital sex, and others who were warned birth control pills would make them infertile. Students in Montana were told condoms could give them cancer. A widely used textbook taught that Aids is be transmitted by skin-to-skin contact. Another said that a girl who has had sex is no longer “fresh.”

Young people were given false and dangerous information about their health

These classes didn’t stop at inaccurate health information – they also promoted outdated gender roles, such as telling students that boys are wired for science while girls are “feelings” oriented and claiming that girls don’t like sex as much as boys so they need to be the ones to “put the brakes on” to stop intimacy. (These kinds of lessons were directly mentioned by young rape victims I spoke to while writing my book. They believed if they were assaulted it was because they didn’t do enough to stop it, or that they “tempted” their attacker.)

This was a generation of students failed by their country – young people given false and dangerous information about their health who had to un-learn everything they were taught about sex.

Under the Obama administration, we started to undo some of that damage. Teen pregnancy rates finally went down, contraceptive use was up. We cannot afford to go backwards.

The truth is that a majority of Americans want their children taught accurate and comprehensive information about sex that will make them safer – 93%, in fact, want kids taught about abstinence and contraception.

What teenagers learn about sex – or don’t learn – can quite literally impact their health and lives. They cannot afford to be lied to.

  • Jessica Valenti is a Guardian US columnist

Some Chinese ready meals found to have more salt than 11 bags of crisps

Chinese takeaways and ready meals should carry compulsory health warning labels on menus and packaging to alert consumers to “astonishing and harmful” salt levels, UK health experts have recommended.

The worst-offending Chinese takeaway dishes in a survey published on Tuesday by Action on Salt were found to contain as much salt as five McDonald’s Big Macs, while many had more than half an adult’s entire daily allowance.

Supermarket Chinese ready meals were also laden with salt, with some containing more than the amount found in two Pizza Express margherita pizzas, the report reveals. Some rice dishes contained more salt than 11 bags of ready salted crisps.

Action on Salt is leading a group of health experts in calling on Public Health England to set tough new salt targets, make front-of-pack labelling mandatory and to follow New York’s lead by requiring chains to put warning labels on high-salt dishes. They are also urging the food industry and restaurants to reduce salt by reformulating takeaways and ready meals.

Of 141 supermarket Chinese ready meals analysed, nearly half (43%) were high in salt – containing more than 1.5g/100g, or 1.8g per portion – which would trigger a red “traffic light” label.

Chines food graphic.

“Salt is the forgotten killer as it puts up our blood pressure, leading to tens of thousands of unnecessary strokes, heart failure and heart attacks every year,” said Graham MacGregor, the chairman of Action on Salt and a professor of cardiovascular medicine at Queen Mary University of London.

“Reducing salt is the most cost-effective measure to reduce the number of people dying or suffering from strokes or heart disease. We are now calling on Public Health England to take immediate action.”

Accompanying rice dishes, spring rolls and prawn crackers – and soy sauce – can pile on the salt in a Chinese meal. Iceland’s takeaway egg fried rice has a “shocking” 4.1g salt per 350g pack – more than in 11 bags of ready salted crisps.

Dishes from six Chinese restaurants were also analysed, with 97% found to contain 2g of salt or more. More than half (58%) contained in excess of 3g of salt per dish – half an adult’s maximum recommended daily intake.

At the start of salt awareness week, Action on Salt is calling on Public Health England to revive the UK’s salt reduction programme. The last set of salt targets drawn up under the Department of Health’s responsibility deal was published in 2014.

“The findings from the survey are very concerning,” said Hemini Bharadia of Blood Pressure UK. “We are all eating too much salt. This can lead to high blood pressure causing strokes and heart attacks, most of which could be avoided through better lifestyle choices.”

Quick guide

Processed foods

These are some of the UK’s best-selling ultra-processed foods

Mr Kipling Angel slices

Batchelors Super Noodles

McVitie’s digestive biscuits

Kelloggs Rice Krispies

Walkers cheese and onion crisps

Cadbury’s Crunchie

Haribo sweets

These are the ingredients in Mr Kipling Angel slices

Sugar Listed first, so it is the biggest ingredient. Each slice contains 13.2g of sugar, which is 15% of an adult’s recommended daily intake

Vegetable oils (rapeseed, palm) Rapeseed oil is healthy, but palm oil is a highly saturated fat, widely used in industrially-produced foods because of its very low cost

Wheat flour (with added calcium, iron, niacin, thiamin) Added vitamins but this is finely milled white flour


Glucose syrup Another form of sugar, made from maize in the USA, where it is called corn syrup, or from potatoes and wheat

Humectant (vegetable glycerine) Reduces moisture loss

Dextrose Another form of sugar

Dried egg white

Whey powder (milk) Gives texture

Vegetable fat (palm) Cheap form of saturated fat

Maize starch Often used as an anti-caking agent in sugars

Skimmed milk powder

Raising agents (disodium diphosphate, sodium bicarbonate)

Emulsifiers (mono- and diglycerides of fatty acids, sorbitan monostearate, polyglycerol esters of fatty acids, soya lecithin, polysorbate 60) Emulsifiers are additives used to stabilise processed foods

Tapioca starch Thickening agent derived from cassava roots


Stabiliser (xanthan gum) Made from fermented sugars. Prevents ingredients from separating

Preservative (potassium sorbate)

Milk protein Can be used in industrially-made sponge cakes to replace egg, giving volume, elasticity and texture


Gelling agent (sodium alginate) This is E401, extracted from brown seaweed and used as a stabiliser in cream

Colours (titanium dioxide, cochineal, lutein) Titanium dioxide is an additive used in paint but also massively in food to give a white colour. Cochineal is the red colouring derived from insects. Lutein is yellow colouring extracted from marigolds

Acid (acetic acid) A leavening ingredient in baked goods when combined with baking soda

Alison Tedstone, the chief nutritionist at Public Health England, said: “Our salt consumption has decreased over the last decade – a loaf of bread has 40% less than it used to. However, some products are still too high in salt and we know this can be reduced further.”

Pro-choice campaign calls 40,000 Irish expats home for abortion vote

Up to 40,000 Irish citizens living abroad are being urged to return home to cast crucial votes in a historic referendum in May that could overturn the country’s ban on abortion. A campaign, Home to Vote, is calling on the Irish diaspora in the UK, Europe, north America and elsewhere to book flights and ferries to Ireland to exercise their democratic right.

Three years ago thousands of Irish citizens returned home to vote on same-sex marriage legislation, boosting the remarkable two-thirds majority for changing the law. Campaigners now hope to repeat the feat.

More than three-quarters of a million Irish-born people live in other countries – a significant number set against the resident population of 4.8 million. Only those who have been abroad for 18 months or less and intend to return to Ireland are eligible to vote. Those qualifying must register in advance and vote in person.

The referendum will ask whether article 40.3.3 of the Irish constitution – known as the eighth amendment – should be repealed. This gives a foetus the same rights to life as a pregnant woman, and has been in place since 1983, enshrining in the constitution a ban on abortion, even in cases of rape and fatal abnormality of the foetus.

If it is overturned in a referendum expected on 25 May, legislation giving women an unrestricted right to abortion up to the 12th week will be introduced. Since 1983 an estimated 170,000 Irish women have travelled to the UK to terminate their pregnancies, incurring high costs, logistical difficulties and emotional strain. In addition, up to 2,000 women a year end pregnancies by taking the abortion pill, illegally obtained online.

No one under 52 has had a chance to vote on this before. It’s a once-in-a-generation opportunity

Cara Sanquest, campaigner

Polls have shown a majority in favour of repeal, especially among young people, who form the majority of recent emigrants. The referendum is seen as another litmus test of liberalising social attitudes in Ireland and the declining influence of the Catholic church. “Lots of people have already pledged on Twitter to come home, saying they are booking annual leave and saving money for fares,” said Cara Sanquest of the London-Irish Abortion Rights Campaign, which is spearheading the effort.

“There is a huge Irish population in London but this is a global call for people to have their say in shaping the future of Ireland, a place where many will return to live at some point. No one under 52 has had a chance to vote on this before. It’s a once-in-a-generation opportunity. We’re asking people to make a journey in reverse that thousands of women are forced to make every year to have abortions.”

The Home to Vote website advises Irish citizens abroad of their rights and suggests ways of helping the campaign for those ineligible to vote. It also plans to raise funds for those struggling with travel costs.

Lianne Hickey, 26, who has been living and working in London for the past five months, has already booked flights and time off work. “Every vote counts, but it’s also important to send a message that Irish people want a fairer, safer world for Irish women, and are prepared to travel home for that,” she said.

“The referendum is just a recognition of reality: 11 women a day are forced to travel. We need to remove the shame and stigma, and allow women who need it to have a safe procedure in a familiar environment.”

In May 2015, Irish citizens travelled from as far as Australia to cast their votes in the equal marriage referendum. Hundreds posted pictures and accounts of their journey on social media under #HomeToVote, the same hashtag being used in the 2018 campaign.

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh

Join the debate – email

Read more Guardian letters – click here to visit

NHS survey reveals staff are determined to make the best of tough conditions

The latest NHS staff survey – the world’s biggest workforce study – is both shocking and uplifting. It highlights appalling communication by senior managers, increasing anger about pay and signs that discrimination is on the increase. But it also reveals extraordinary resilience under pressure.

Almost half a million staff responded to the questionnaire last autumn. The growing pressure for action on pay is clear, with just 31% saying they were satisfied with their pay. This is a fall of 6% since 2016, one of the biggest changes in the survey.

The number of organisational “never events” remains stubbornly high. Around one in 50 staff experienced physical violence from other staff in the last year and around one in four reported harassment, bullying or abuse from staff. Around one in eight experienced discrimination – and more of it came from colleagues and managers than patients and service users.

Just over 84% believe their organisation provides equal opportunities in careers, a figure that has declined steadily over the past five years.

One of the most worrying revelations is that the poor performance of ambulance trusts evident in the 2016 survey continues. Compared with other types of trust, as well as clinical commissioning groups (CCGs), their training and development is strikingly poor, they are far worse than other NHS organisations for discrimination and equal opportunities, worst for illness due to work-related stress, worst for organisational and management interest in their health and wellbeing, worst at giving staff appraisals, worst for appraisal quality, worst for team working and worst for staff engagement. Ambulance trust staff are far behind everybody else in feeling their managers and organisations recognise their value.

Communication from senior managers across the sector is awful

There are clearly fundamental problems with the resourcing and management of ambulance trusts. These weaknesses have long been evident in response-time data and Care Quality Commission inspections. NHS leaders need to get a grip on this, to understand the root causes of the problems and how local leaders can be supported in addressing them.

The results for CCG staff are intriguing. They had by far the highest response rate to the survey, at 80%. They come top for staff recommending the organisation as a place to work and they feel the most valued. They are well ahead in being able to contribute to quality improvements. But they come bottom for satisfaction with the quality of work they are able to deliver and are well behind every type of trust in feeling they make a difference to patients.

So commissioning organisations are well led and run, but there is doubt about the point of it all.

Communication from senior managers across the sector is awful. Only a third of staff believe communication is good, although this represents a steady improvement from the 2013 survey, when fewer than 30% of staff said it was good. Even the best-performing trusts are struggling to get above 50%. With so many communication tools available to managers (including talking to people), this figure should be a lot higher.

Two-thirds of staff say they are able to deliver the quality of care they aspire to, fewer than in 2016. Staff engagement has declined for the first time since 2014.

But despite many areas of concern, the staff survey demonstrates extraordinary resilience. There have been small declines in satisfaction with resourcing and support, motivation and recommending their organisation as a place to work or be treated, but the fact these results are holding up pretty well under intense pressure across the system shows a determination to make the best of tough circumstances.

Many trust board meetings now begin with a patient story, intended to illuminate systemic issues the leadership needs to address. Perhaps the occasional story from a staff member would help NHS leaders understand what it feels like to be part of their team.

  • Richard Vize is a public policy commentator and analyst

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Energy drinks: MPs investigate popularity among young people

MPs have launched an investigation into energy drinks and their popularity with young people in the UK, amid growing concerns about negative health outcomes due to their high caffeine and sugar content.

The Commons science and technology committee will question why, when most UK supermarkets have introduced a voluntary ban on their sale to under-16s, there are no similar restrictions in many convenience stores, newsagents and smaller retailers.

Evidence is being invited on the potential physical and mental health effects of energy drinks on children and young adults, as well as how marketing affects consumption – for example through big brands’ sponsorship of gaming.

Drinks such as Red Bull, Relentless, Monster Energy and Rockstar are now more popular with children and teenagers than with adults, even though EU labelling guidelines state that any soft drink with more than 150mg of caffeine per litre must carry a warning about its high caffeine content and is not recommended for children.

A study carried out by the Centre for Translational Research in Public Health found that young people in Britain consume more energy drinks than those in other European countries, with consumption in the UK soaring by 185% between 2006 and 2015. In addition, a report by the European Food Safety Authority (EFSA) found that 68% of children aged 10-18 and 18% of those aged three to 10 regularly drank them.

The EFSA estimates that an adult can consume up to 200mg of caffeine without adverse health impacts. A Food Research Collaboration study has highlighted that the EFSA’s guideline limit for children is exceeded by drinking a single can of some branded drinks.

“We know that young people in the UK are the biggest consumers of energy drinks in Europe for their age,” said the Liberal Democrat MP Norman Lamb, chair of the science and technology committee. “We need to understand how the caffeine and sugar in energy drinks might cause negative health outcomes.

“Meanwhile, some retailers have chosen to ban their sale and some have not. Should it be for retailers to decide which products can be sold on health grounds? Our inquiry will consider the evidence and set out what needs to be done by the government, the industry and others.”