Tag Archives: England

Government unveils plans to cut adult smoking rate in England to 12%

The government has announced plans to cut smoking rates among adults in England from 15.5% to no more than 12% by 2022.

Its long-awaited tobacco control plan, which was due to be published last summer, also targets a reduction in the number of 15-year-olds who regularly smoke, from 8% to 3% or lower; and a fall in the proportion of pregnant women smoking, from 10.5% to no more than 6% over the same period.

It also seeks to reduce the “inequality gap”, whereby smoking rates are highest and most damaging to health among the least well-off.

Doctors and healthcare experts had been urging Theresa May to publish the new plan for months, reminding her of her pledge to reduce the gap between rich and poor. Half of the nine-year difference in their life expectancy is caused by smoking.

In the foreword to the plan, published on Tuesday, Steve Brine, the parliamentary undersecretary of state for public health and primary care, writes: “This injustice in the variation in smoking prevalence can be seen across England; from places where adult smoking is as low as 5% to others where smoking remains above 25%. The prevalence remains even higher in people with mental health conditions, where more than 40% of adults with a serious mental illness smoke. We want to address this. Our vision is nothing less than to create a smoke-free generation.”

To achieve its objectives, the government says it will provide access to training for all health professionals on how to help patients quit, especially those in mental health services. It also wants to create a smoke-free NHS by 2020 by encouraging smokers using, visiting and working in the health service to give up. It calls for local solutions where prevalence is high and says high duty rates for tobacco products will be maintained.

Additionally, more information will be provided to the public on the safety of e-cigarettes and their effectiveness as smoking cessation aids.

Doctors and healthcare professionals welcomed the publication of the plan but said more investment was needed to bring smoking rates down further.

Prof Parveen Kumar, the chair of the BMA board of science, said: “If we’re to stop the 79,000 annual deaths in England attributed to smoking, smoking cessation services and tobacco control measures must be adequately funded. Yet local authorities are reducing smoking cessation budgets, merging services into unwieldy departments or cutting services altogether.

“Cuts to these highly cost-effective services will only increase health inequalities and demand on tomorrow’s GP surgeries and hospital wards.”

The British Lung Foundation said the targets for reducing smoking were ambitious but also cautioned about cuts to local smoking cessation services.

Cathy Warwick, the chief executive at the Royal College of Midwives, said training of staff was essential but added: “No matter how good the training, this cannot be fully effective if midwives cannot signpost women on to smoking cessation services. We are seeing cuts to public health budgets and smoking cessation services are being affected. This has got to be reversed and investment in smoking cessation services has to be stepped up.”

Smoking prevalence has fallen from 20.2% among adults in 2011 to 15% – the lowest level since records began. It still costs the economy in excess of £11bn per year, including £2.5bn that falls on to the NHS.

Simon Clark, the director of the smokers’ group Forest, urged the government to “stop lecturing smokers” and said the plan should have put “education and choice ahead of prohibition and coercion”.

Government unveils plans to cut adult smoking rate in England to 12%

The government has announced plans to cut smoking rates among adults in England from 15.5% to no more than 12% by 2022.

Its long-awaited tobacco control plan, which was due to be published last summer, also targets a reduction in the number of 15-year-olds who regularly smoke, from 8% to 3% or lower; and a fall in the proportion of pregnant women smoking, from 10.5% to no more than 6% over the same period.

It also seeks to reduce the “inequality gap”, whereby smoking rates are highest and most damaging to health among the least well-off.

Doctors and healthcare experts had been urging Theresa May to publish the new plan for months, reminding her of her pledge to reduce the gap between rich and poor. Half of the nine-year difference in their life expectancy is caused by smoking.

In the foreword to the plan, published on Tuesday, Steve Brine, the parliamentary undersecretary of state for public health and primary care, writes: “This injustice in the variation in smoking prevalence can be seen across England; from places where adult smoking is as low as 5% to others where smoking remains above 25%. The prevalence remains even higher in people with mental health conditions, where more than 40% of adults with a serious mental illness smoke. We want to address this. Our vision is nothing less than to create a smoke-free generation.”

To achieve its objectives, the government says it will provide access to training for all health professionals on how to help patients quit, especially those in mental health services. It also wants to create a smoke-free NHS by 2020 by encouraging smokers using, visiting and working in the health service to give up. It calls for local solutions where prevalence is high and says high duty rates for tobacco products will be maintained.

Additionally, more information will be provided to the public on the safety of e-cigarettes and their effectiveness as smoking cessation aids.

Doctors and healthcare professionals welcomed the publication of the plan but said more investment was needed to bring smoking rates down further.

Prof Parveen Kumar, the chair of the BMA board of science, said: “If we’re to stop the 79,000 annual deaths in England attributed to smoking, smoking cessation services and tobacco control measures must be adequately funded. Yet local authorities are reducing smoking cessation budgets, merging services into unwieldy departments or cutting services altogether.

“Cuts to these highly cost-effective services will only increase health inequalities and demand on tomorrow’s GP surgeries and hospital wards.”

The British Lung Foundation said the targets for reducing smoking were ambitious but also cautioned about cuts to local smoking cessation services.

Cathy Warwick, the chief executive at the Royal College of Midwives, said training of staff was essential but added: “No matter how good the training, this cannot be fully effective if midwives cannot signpost women on to smoking cessation services. We are seeing cuts to public health budgets and smoking cessation services are being affected. This has got to be reversed and investment in smoking cessation services has to be stepped up.”

Smoking prevalence has fallen from 20.2% among adults in 2011 to 15% – the lowest level since records began. It still costs the economy in excess of £11bn per year, including £2.5bn that falls on to the NHS.

Simon Clark, the director of the smokers’ group Forest, urged the government to “stop lecturing smokers” and said the plan should have put “education and choice ahead of prohibition and coercion”.

Polluted air ‘poisoning thousands’ across north of England, warns report

Dangerous levels of air pollution in towns and cities across the north of England are threatening the health of hundreds of thousands of people and stifling economic growth, according to a new report.

The analysis by the Institute for Public Policy Research (IPPR) North describes air pollution as “the tobacco of the 21st century” and says that while there has been a growing concern about the problem in London, many residents in regional towns and cities are unaware of the threat to their health.

Darren Baxter, researcher at IPPR North, said it was time the government took radical action.

“Too often the attention focuses on unclean air in the capital, but the reality is that it’s poisoning thousands in our regional cities too,” said Baxter. “Michael Gove [the new environment secretary] must show that the government is not prepared to sit on its hands while up to 40,000 people are killed every year from dirty air. We need to see radical plans to ditch diesel, introduce incentives for electric cars and bring in clean air zones in our major cities.”

The government has suffered two legal defeats over its plans to improve air quality in the UK after judges ruled they were so poor as to be unlawful. The courts have given ministers until 31 July to publish a new plan.

Campaigners want Gove to introduce a range of measures including charging clean air zones in the worst hit areas and a diesel scrappage scheme to compensate drivers who bought diesel cars after being told they were better for the environment.

The government’s own figures show that although London has by far the highest level of nitrogen dioxide (NO2) pollution, many urban areas – including large swaths of the Midlands, the north-west, West Yorkshire and the northeast – suffer dangerous levels of pollution.

The scale of the air pollution crisis was revealed in a joint Guardian-Greenpeace investigation earlier this year, showing hundreds of thousands of children were being educated within 150 metres of a road where levels of NO2 from diesel traffic breached legal limits.

Figures obtained by Labour showed that more than 38 million people, representing 59.3% of the UK population, were living in areas where levels of NO2 pollution were above legal limits.

Baxter said: “This is the tobacco of the 21st century, and every single preventable death is a failure of government action. Gove must get a grip on this crisis which is killing literally thousands of children and adults a year.”

Tuesday’s report estimates that congestion in the north of England will increase by 3% annually. Estimates put the cost of congestion in Manchester and Liverpool alone at £2bn in 2015.

The study is the latest from IPPR North’s Northern Energy Taskforce, which has identified the energy sector as one of four key priority areas for the economy in northern England, along with manufacturing, health and digital.

“By taking the killer air crisis seriously, we can prevent many unnecessary deaths and ill-health, especially in our children, while preparing the way for a Northern green jobs revolution,” said Baxter.

The report calls for central government, councils and transport bodies to:

Radically improve green public transport links, especially rail connections, and to prioritise hydrogen-powered trains.

Pledge to phase out diesel cars over the coming years, in part to help spur the electric car market, in which sector the north is becoming a world leader.

Introduce a new car scrappage scheme to encourage car owners to upgrade to electric vehicles.

Dementia and Alzheimer’s main cause of death for women, says Public Health England

Alzheimer’s disease and dementia are the biggest cause of death among women, according to a government report on the state of the nation’s health.

Public Health England (PHE)’s report, which uses population health data to produce a wide-ranging national report for the first time, suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are now spent in poor health.

Women can expect to live nearly a quarter of their lives in ill-health and men a fifth. The causes of death have shifted since the turn of the century, the analysis found, with the rise in deaths from dementia and Alzheimer’s the most significant features – alongside declines in other diseases.

Cause of death – women

“Since 2001, death rates from heart disease and stroke have halved for both males and females,” the report said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60% in males and have doubled in females.”

In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. These diseases are better diagnosed, while the prevention and treatment of heart disease have improved.

The report prompted warnings that investment in dementia research must not slow. Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “To achieve the same successes as we have with other health conditions like heart disease and cancer, we need dementia research to remain a national priority. We have been able to make promising steps forward, thanks to a renewed focus, but we are not there yet.”

Cause of death – men

The PHE report also sheds light on the ailments that afflict people in earlier years. Lower back and neck pain are the biggest cause of ill-health in England, while obesity is the biggest risk factor for becoming unwell.

Where you live and how you live make a big difference to the likely length of your life and chances of good or poor health. Men and women in the most deprived areas can expect to spend 20 years fewer in good health compared with those living in the least deprived areas.

The PHE director of health improvement, John Newton, said: “For both men and women, almost half the population live in areas where healthy life expectancy is slightly less than the current state pension [age]. It is a slightly larger proportion of men than women … [but] a significant proportion of our population cannot expect to live in their pension age in good health.”

Diabetes, most of which is type 2 and linked to being overweight, has for the first time become one of the top 10 causes of ill-health and disability. The bill has been predicted to potentially cripple the NHS, which spends £14bn a year on testing and treatment.

Leading cause of morbidity

But lower back pain and neck pain are ranked ahead of diabetes. Part of that is down to the ageing population, but excess weight and lack of activity are also factors.

Among men, skin disorders, such as acne and psoriasis, are the second most common cause of ill-health, although they are three times less common than lower back and neck pain. Third among men and second among women is depression.

Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. High BMI (body mass index, a measurement of obesity) can lead to heart disease, stroke, osteoarthritis, back pain, chronic kidney disease, diabetes and some cancers.

“Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.

Dementia and Alzheimer’s main cause of death for women, says Public Health England

Alzheimer’s disease and dementia are the biggest cause of death among women, according to a government report on the state of the nation’s health.

Public Health England (PHE)’s report, which uses population health data to produce a wide-ranging national report for the first time, suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are now spent in poor health.

Women can expect to live nearly a quarter of their lives in ill-health and men a fifth. The causes of death have shifted since the turn of the century, the analysis found, with the rise in deaths from dementia and Alzheimer’s the most significant features – alongside declines in other diseases.

Cause of death – women

“Since 2001, death rates from heart disease and stroke have halved for both males and females,” the report said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60% in males and have doubled in females.”

In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. These diseases are better diagnosed, while the prevention and treatment of heart disease have improved.

The report prompted warnings that investment in dementia research must not slow. Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “To achieve the same successes as we have with other health conditions like heart disease and cancer, we need dementia research to remain a national priority. We have been able to make promising steps forward, thanks to a renewed focus, but we are not there yet.”

Cause of death – men

The PHE report also sheds light on the ailments that afflict people in earlier years. Lower back and neck pain are the biggest cause of ill-health in England, while obesity is the biggest risk factor for becoming unwell.

Where you live and how you live make a big difference to the likely length of your life and chances of good or poor health. Men and women in the most deprived areas can expect to spend 20 years fewer in good health compared with those living in the least deprived areas.

The PHE director of health improvement, John Newton, said: “For both men and women, almost half the population live in areas where healthy life expectancy is slightly less than the current state pension [age]. It is a slightly larger proportion of women than men … [but] a significant proportion of our population cannot expect to live in their pension age in good health.”

Diabetes, most of which is type 2 and linked to being overweight, has for the first time become one of the top 10 causes of ill-health and disability. The bill has been predicted to potentially cripple the NHS, which spends £14bn a year on testing and treatment.

Leading cause of morbidity

But lower back pain and neck pain are ranked ahead of diabetes. Part of that is down to the ageing population, but excess weight and lack of activity are also factors.

Among men, skin disorders, such as acne and psoriasis, are the second most common cause of ill-health, although they are three times less common than lower back and neck pain. Third among men and second among women is depression.

Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. High BMI (body mass index, a measurement of obesity) can lead to heart disease, stroke, osteoarthritis, back pain, chronic kidney disease, diabetes and some cancers.

“Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.

1.2 million people in England and Wales will have dementia by 2040 – study

More than 1.2 million people are expected to be living with dementia in England and Wales by 2040, up from almost 800,000 today, research suggests.

Researchers say the predicted rise in the prevalence of dementia is largely down to people living longer, but add that the figures also show that the risk of developing dementia for each age group is falling – a finding they say suggests that preventive strategies are having an impact.

“The growth in numbers of cases of dementia is not as large as we once anticipated,” said Sara Ahmadi-Abhari, an epidemiologist and co-author of the research from University College, London. “But, nonetheless, the growth in the number of people with dementia is substantial.”

The team note that improved forecasts for the numbers of people expected to be living with dementia in the future are important to make sure support is available. At present the costs of dementia to the UK economy are estimated to be £23bn a year.

The latest figures, published in the British Medical Journal, are based on data from the English Longitudinal Study of Ageing (Elas) – an ongoing project that began in 2002 and is designed to look at a range of factors affecting people aged 50 and over, including their health.

Among the assessments carried out, participants were asked to complete memory tasks, solve maths problems and were asked about their ability to carry out daily activities, with any diagnosis of dementia also recorded.

The international team of researchers examined data from 18,000 men and women collected between 2002 and 2013, to look at trends in the proportion of new cases of dementia and the prevalence of the condition and cardiovascular disease over time. In addition, data from the Office for National Statistics was combined with data from the Elas to help the team to explore trends in mortality from both cardiovascular disease and non-cardiovascular causes.

“Dementia and cardiovascular disease share risk factors,” said Ahmadi-Abhar. “To be able to get a better picture of the health gains [of public health interventions], we need to model them together.”.

The team then fed the data into a computer-based model to predict figures for those living with dementia in England and Wales in the years to come.

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“There is very little doubt that we are going to see an increase in the actual number of people with dementia,” said Julie Williams, an associate director of the UK Dementia Research Institute at Cardiff University who was not involved in the study. But she adds there are signs of hope. “It is heartening that we see a reduction in the rate, which is likely to be due to healthy living,” she said.

Ramon Luengo-Fernandez of the Health Economics Research Centre at the University of Oxford who was not involved in the research, said that the study underscores the importance of central and local government tackling the social care crisis in older age.

“Although the pressures created by dementia to the NHS, social services and society in general – for example, impact on relatives who have to care for people with dementia in the community – might not be as bad as once feared, the study highlights that these pressures will still be considerable,” he said.

The research comes at the same time as a number of other investigations into dementia.

Among them, a small study published in the journal Neurology has found that among participants with an elevated risk of Alzheimer’s, those who reported poorer sleep quality had more biomarkers associated with the disease in their spinal fluid.

But, the authors note, it is not clear if the sleep problems are increasing the risk of developing the disease or vice versa.

Another study, published in the journal Nature, has unravelled the structure of filaments that are found tangled inside cells in the brain of those with Alzheimer’s, and are made of a protein known as tau.

By revealing the different structures of these tau filaments, researchers say they hope to be better able to understand how and why they tangle, which in turn could eventually lead to development of drugs to prevent such clumps developing.

John Hardy, professor of neuroscience at University College, London who was not involved in the research, welcomed the study. “This is a fantastic piece of work which will help us understand the pathogenesis of Alzheimer’s better,” he said. “It really is a tour de force.”

NHS attended to 9,000 FGM cases in England last year, report reveals

More than 9,000 attendances to NHS services in England last year involved the identification or treatment of female genital mutilation, a report has revealed.

The data, released by NHS Digital and covering the period from April 2016 to March 2017, includes figures from both NHS trusts and GP practices.

The findings show that in the last year there were 9,179 attendances in which FGM was either identified, treatment was given, or a woman with FGM had given birth to a baby girl.

In total, 5,391 attendances were recorded in the system for the first time – 114 of which were girls under the age of 16.

The report reveals only a slight drop on figures from 2016 in which 9,223 attendances were reported in total, of which 6,080 were newly recorded.

Wendy Preston, the head of nursing at the Royal College of Nursing, said that despite heightened discussion of FGM, “the number of women and girls subjected to it is not falling fast enough”.

Preston added that the fall in the number of school nurses in recent years was detrimental to efforts to tackle the issue, and called on the government to attract and retain school nurses.

“Mandatory reporting and compulsory sex and relationships education are important weapons in the fight against FGM, and school nurses play a vital role in both educating children and young women, and spotting those who may be at risk,” she said.

“Yet recent figures show the number of school nurses has fallen 16% since 2010, largely as a result of government cuts to local authority health budgets. It is not right that vulnerable children pay the price for funding reductions and poor workforce planning.”

While only 26% of women and girls involved in newly recorded cases reported the country in which the FGM took place, 1,229 of these cases took place in Africa, while 57 occurred in the UK.

Figures from 2015-16 showed that 18 of the newly recorded cases that year took place in the UK.

Meg Fassam-Wright, the acting director of the National FGM Centre, said that the data was helping to provide a clearer picture of FGM in England.

“It is important that the cases are being identified,” she said of the overall report. “These are often cases of women who have had FGM a number years ago and that their health needs and other needs are potentially being identified through the collection of this data, so we can plan for the future better because these women – some of them – will have long-term health problems as a result of FGM.”

Fassam-Wright added that the report showed that FGM is something which all statutory services need to respond to, both for girls and women.

The girl who said no to FGM

The FGM Centre, a partnership between Barnardo’s and the Local Government Association, was set up in 2015, but Fassam-Wright said it is in danger of closing.

“We’ve got a number of discussions which are taking place at the present time – we are in the position where unless we get decisions about our funding by 21 July then the centre will unfortunately have to close.”

The fears follow the news in January that the Acton African Well Woman Centre – a London-based clinic for women who have been subjected to FGM – was to be closed due to lack of funding.

A government spokesman said that funding for the National FGM Centre, which was part of the £200m Children’s Social Care Innovation Programme, was not intended to be ongoing, and was instead expected to help establish the service so that it became self-sustaining.

“Protecting women and girls from violence and supporting victims is a key priority for this government and a personal priority for the minister for women and equalities, Justine Greening,” he said.

“We have strengthened the law on this through the Serious Crime Act 2015. It is now an offence if you fail to protect a girl from FGM. We have also created a mandatory reporting duty requiring professionals to report known cases of FGM to the police and have provided lifelong anonymity for victims.”

NHS attended to 9,000 FGM cases in England last year, report reveals

More than 9,000 attendances to NHS services in England last year involved the identification or treatment of female genital mutilation, a report has revealed.

The data, released by NHS Digital and covering the period from April 2016 to March 2017, includes figures from both NHS trusts and GP practices.

The findings show that in the last year there were 9,179 attendances in which FGM was either identified, treatment was given, or a woman with FGM had given birth to a baby girl.

In total, 5,391 attendances were recorded in the system for the first time – 114 of which were girls under the age of 16.

The report reveals only a slight drop on figures from 2016 in which 9,223 attendances were reported in total, of which 6,080 were newly recorded.

Wendy Preston, the head of nursing at the Royal College of Nursing, said that despite heightened discussion of FGM, “the number of women and girls subjected to it is not falling fast enough”.

Preston added that the fall in the number of school nurses in recent years was detrimental to efforts to tackle the issue, and called on the government to attract and retain school nurses.

“Mandatory reporting and compulsory sex and relationships education are important weapons in the fight against FGM, and school nurses play a vital role in both educating children and young women, and spotting those who may be at risk,” she said.

“Yet recent figures show the number of school nurses has fallen 16% since 2010, largely as a result of government cuts to local authority health budgets. It is not right that vulnerable children pay the price for funding reductions and poor workforce planning.”

While only 26% of women and girls involved in newly recorded cases reported the country in which the FGM took place, 1,229 of these cases took place in Africa, while 57 occurred in the UK.

Figures from 2015-16 showed that 18 of the newly recorded cases that year took place in the UK.

Meg Fassam-Wright, the acting director of the National FGM Centre, said that the data was helping to provide a clearer picture of FGM in England.

“It is important that the cases are being identified,” she said of the overall report. “These are often cases of women who have had FGM a number years ago and that their health needs and other needs are potentially being identified through the collection of this data, so we can plan for the future better because these women – some of them – will have long-term health problems as a result of FGM.”

Fassam-Wright added that the report showed that FGM is something which all statutory services need to respond to, both for girls and women.

The girl who said no to FGM

The FGM Centre, a partnership between Barnardo’s and the Local Government Association, was set up in 2015, but Fassam-Wright said it is in danger of closing.

“We’ve got a number of discussions which are taking place at the present time – we are in the position where unless we get decisions about our funding by 21 July then the centre will unfortunately have to close.”

The fears follow the news in January that the Acton African Well Woman Centre – a London-based clinic for women who have been subjected to FGM – was to be closed due to lack of funding.

A government spokesman said that funding for the National FGM Centre, which was part of the £200m Children’s Social Care Innovation Programme, was not intended to be ongoing, and was instead expected to help establish the service so that it became self-sustaining.

“Protecting women and girls from violence and supporting victims is a key priority for this government and a personal priority for the minister for women and equalities, Justine Greening,” he said.

“We have strengthened the law on this through the Serious Crime Act 2015. It is now an offence if you fail to protect a girl from FGM. We have also created a mandatory reporting duty requiring professionals to report known cases of FGM to the police and have provided lifelong anonymity for victims.”

NHS attended to 9,000 FGM cases in England last year, report reveals

More than 9,000 attendances to NHS services in England last year involved the identification or treatment of female genital mutilation, a report has revealed.

The data, released by NHS Digital and covering the period from April 2016 to March 2017, includes figures from both NHS trusts and GP practices.

The findings show that in the last year there were 9,179 attendances in which FGM was either identified, treatment was given, or a woman with FGM had given birth to a baby girl.

In total, 5,391 attendances were recorded in the system for the first time – 114 of which were girls under the age of 16.

The report reveals only a slight drop on figures from 2016 in which 9,223 attendances were reported in total, of which 6,080 were newly recorded.

Wendy Preston, the head of nursing at the Royal College of Nursing, said that despite heightened discussion of FGM, “the number of women and girls subjected to it is not falling fast enough”.

Preston added that the fall in the number of school nurses in recent years was detrimental to efforts to tackle the issue, and called on the government to attract and retain school nurses.

“Mandatory reporting and compulsory sex and relationships education are important weapons in the fight against FGM, and school nurses play a vital role in both educating children and young women, and spotting those who may be at risk,” she said.

“Yet recent figures show the number of school nurses has fallen 16% since 2010, largely as a result of government cuts to local authority health budgets. It is not right that vulnerable children pay the price for funding reductions and poor workforce planning.”

While only 26% of women and girls involved in newly recorded cases reported the country in which the FGM took place, 1,229 of these cases took place in Africa, while 57 occurred in the UK.

Figures from 2015-16 showed that 18 of the newly recorded cases that year took place in the UK.

Meg Fassam-Wright, the acting director of the National FGM Centre, said that the data was helping to provide a clearer picture of FGM in England.

“It is important that the cases are being identified,” she said of the overall report. “These are often cases of women who have had FGM a number years ago and that their health needs and other needs are potentially being identified through the collection of this data, so we can plan for the future better because these women – some of them – will have long-term health problems as a result of FGM.”

Fassam-Wright added that the report showed that FGM is something which all statutory services need to respond to, both for girls and women.

The girl who said no to FGM

The FGM Centre, a partnership between Barnardo’s and the Local Government Association, was set up in 2015, but Fassam-Wright said it is in danger of closing.

“We’ve got a number of discussions which are taking place at the present time – we are in the position where unless we get decisions about our funding by 21 July then the centre will unfortunately have to close.”

The fears follow the news in January that the Acton African Well Woman Centre – a London-based clinic for women who have been subjected to FGM – was to be closed due to lack of funding.

A government spokesman said that funding for the National FGM Centre, which was part of the £200m Children’s Social Care Innovation Programme, was not intended to be ongoing, and was instead expected to help establish the service so that it became self-sustaining.

“Protecting women and girls from violence and supporting victims is a key priority for this government and a personal priority for the minister for women and equalities, Justine Greening,” he said.

“We have strengthened the law on this through the Serious Crime Act 2015. It is now an offence if you fail to protect a girl from FGM. We have also created a mandatory reporting duty requiring professionals to report known cases of FGM to the police and have provided lifelong anonymity for victims.”

Number of under-18s on antidepressants in England rises by 12%

Tens of thousands of young people in England, including children as young as six, are being prescribed antidepressants by their doctors. The figures have prompted concern that medics may be overprescribing strong medication because of stretched and underfunded mental health services.

Data obtained by the Guardian shows that 166,510 under-18s, including 10,595 seven-to-12-year-olds and 537 aged six or younger, were given medication typically used to treat depression and anxiety between April 2015 and June 2016. The figures, released by NHS England under the Freedom of Information Act, show a 12% rise in the numbers taking the drugs over the same time period.

graphics for piece

Dr Marc Bush, a senior policy adviser at the charity Young Minds, said the statistics were “substantial” and underlined the fact that large numbers of young people are experiencing mental health problems. “It is important that they can access the treatment and care they need. Antidepressants have a role to play, but are not the whole solution,” he said.

Bush said he was extremely worried at the prospect of children under six being prescribed antidepressants. “It feels quite difficult to comprehend, given what we know about the impact of pharmacology on people’s development,” he said.

Experts fear that some children and young people are given the drugs because they face such long waits for psychotherapy on the NHS.

Dr Antonis Kousoulis, a clinician and assistant director at the Mental Health Foundation, said the figures show “we are failing to provide a choice of age-appropriate psychological treatments at the point of the need”.

“GPs overprescribe antidepressants often because of the long waiting lists for specialist services,” he went on. “But the evidence that these medicines are effective in children is not as comprehensive as is it for‎ drugs for other conditions.”

Guidance from the National Institute for Health and Care Excellence (Nice) says antidepressants should be given only to teenagers and children with moderate or severe depression, when psychotherapy has failed. It also advises that such medication should be taken in concert with other support, such as counselling.

Fluoxetine, which is sold under the trade name Prozac, is the only drug recommended for younger people, but other medication can be used as second-line treatment if fluoxetine does not work.

According to Nice, fluoxetine should be “cautiously considered” for those aged five to 11, but notes that the evidence for its effectiveness in the age group is not established.

David Taylor, the Royal Pharmaceutical Society’s spokesman on mental health medicines and director of pharmacy and pathology at the Maudsley hospital, said: “Antidepressants are only used in children in circumstances where there is clear support from robust clinical trials. Adolescents with anxiety, obsessive compulsive disorder and post-traumatic stress disorder may be prescribed antidepressants, and fluoxetine is used in depression.”

A spokesperson for NHS England said: “Depression and anxiety can be debilitating, and while there are excellent psychological treatments for children and young people, in some cases it is medically appropriate to offer medication, usually in addition to any psychological therapy they are already having.”

Kousoulis said depression in childhood may be caused by a combination of genetic predisposition and personal circumstances. He cited family breakdown as one potential trigger.

Dr Jon Goldin, vice-chair of the child and adolescent faculty at the Royal College of Psychiatrists, said: “It’s not easy to be a child and teen in today’s society. There are lots of pressures. It’s partly the education system and the emphasis on testing and exams … Social media is also a problem in that children compare themselves unfavourably to images they see online.”

Experts noted that the figures for under-12s could include children given antidepressants for other problems. Tricyclic antidepressants are sometimes used to treat chronic pain and bedwetting in children, and may be prescribed to manage epileptic fits.

A major study published in the Lancet last year concluded that the majority of antidepressants do not work on children and teenagers, and that prescribing them could do more harm than good.

The new data is released as concerns grow about a lack of funding for mental health services. Norman Lamb, the Liberal Democrats’ health spokesman, said: “There is no doubt a significant link between the growing use of antidepressants and the immense pressure children’s mental health services are under.

“Children’s mental health services are in desperate need of more resources. The Conservative government has failed to invest properly and has failed to make good on the funding promises we made in the coalition. Money isn’t getting through to the frontline, and now we are seeing the consequences of this neglect.”

Goldin echoed calls for more resources. “There is also more awareness and people are more willing to talk about things. There is less stigma, but what we don’t want is people turning to adults for help and the help not being available,” he said.