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The NHS workforce is under more pressure than ever. But there is hope

If we really want to deliver the high quality patient care we all want in the NHS, we must change our approach to the workforce so that we have the right number of staff, with the right skills, in the right place.

In our report, There For Us: A Better Future for the NHS Workforce, we diagnose the problems and challenges facing the NHS workforce and then offer some solutions.

More people than ever are using NHS services provided by hospitals, mental health trusts, community services and ambulances. Demand is very high and growing fast. We need more staff than we have to meet that need: emergency admissions are up 10%, ambulance calls are up 15% and diagnostic tests up 19%. Yet the workforce has only grown by 6% since 2014.

There is a gap, and it’s one that is growing and increasingly hard to fill. Recruiting new staff and keeping existing staff is more difficult because jobs on the frontline are getting harder and more pressurised.

“I have worked in the NHS for 45 years and I have never seen so many staff work under such pressure for so long.” These are the plain-speaking words of a trust chief executive talking about the workforce situation in their organisation.

Another trust leader told us: “In particular services, people are leaving because the pressure is so great they are unable to cope.”

Money is a major issue. Many staff have not received a pay rise for many years, despite having seen their jobs become more demanding and their hours longer. And funding is an issue more generally because even if the workforce were available, many trusts cannot afford to recruit more staff. Although the government is shifting on public sector pay, it does need to be delivered without strings attached and with additional money so that trusts themselves aren’t footing the bill.

Right now, according to a trust leader, “the NHS is significantly dependent on the heroic efforts of clinical and non-clinical colleagues”. Relying on discretionary effort is not sustainable. Indeed, 59% of NHS staff, for example, said in the last staff survey that they are working unpaid overtime each week.

It’s finally been recognised that we need to grow the domestic workforce, and the government has plans to expand medical education, boost the number of nurses and look at apprenticeships, for example. However we don’t know if this is enough, and it won’t happen tomorrow. It’s certainly not a quick fix.

In the meantime we must acknowledge that we rely on staff from beyond our shores. Thirteen per cent of NHS staff are from outside the UK. They make a welcome contribution and are helping to plug that gap, and we need them to continue to do so. The uncertainty created by Brexit and issues such as language testing and immigration policy is making this much harder. As one leader put it: “We would not be able to maintain high quality care for the people we serve without our diverse workforce. The current lack of progress in the Brexit negotiations is creating unhelpful uncertainty in an already challenging environment.”

Something that is in trusts’ power is to make their organisations, and the NHS generally, a great place to work. That means going all out to create a positive environment, improving the day-to-day experience for black and minority ethnic staff and adopting a zero tolerance approach to bullying and harassment. Obviously external pressures cut across this, but there is still much that trusts can do.

Everyone in government and the many other national organisations with responsibility for the NHS must acknowledge the scale of the challenge in terms of pay, recruitment, retention, rising demand and the impact of pressurised working conditions on frontline morale. “Staff are the most important factor in delivery – and sustainable staffing is the greatest challenge facing my organisation,” says one trust leader. “I have no real sense that the scale of the challenge is truly understood nationally.”

Even more importantly, they must speak clearly, with one voice, about how to overcome it. It may surprise many to know that there is no single workforce strategy for the NHS, despite its strategic importance.

There is hope and much of it lies in recognising that while they cannot solve things alone, if local organisations had more control and greater room for manoeuvre they could get on with the task in hand, backed up by greater support from the centre.

Yet we also must not ignore the central issue: having enough staff is central to the NHS. It cannot function without them.

Saffron Cordery is director of policy and strategy at NHS Providers

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.

Drug use more likely than smoking among secondary school pupils

Secondary school children in England are now more likely to have tried drugs than cigarettes, according to a national survey. The statistics, from NHS Digital, found 24% of 11-15-year-olds saying they had tried recreational drugs at least once in their lives, a nine percentage point rise on the last survey, in 2014.

The survey also found 19% of respondents saying they had smoked cigarettes at least once, a proportion roughly level with 2014 but well below the figure for 1996 when almost half of pupils questioned had tried smoking. And, in 2016, only 6% of pupils were classified as current smokers.

Drugs use among youngsters was shown to have been declining over the past 15 years, and Paul Niblett, the statistician responsible for the report, said another survey would be needed to establish whether the figures constituted a change in trend.

Niblett said the rise could be partly explained by new questions on the survey asking youngsters about their use of laughing gas (nitrous oxide) and novel psychoactive substances, which were banned last year under sweeping new legislation.

However, even after stripping out the results from these questions, the survey of 12,000 school children carried out under exam conditions in 177 English schools in 2016, still registered a rise in the proportion admitting using drugs, to 21% – a six percentage point increase on the previous survey.

The survey also found that 44% of secondary school pupils said they had drunk alcohol at some point. There had been a steady decline in the proportion admitting to ever having had an alcoholic drink, since the early 2000s until 2014, when 38% said they had tried alcohol. However, those responsible for the survey said the new figure was not comparable to previous years due to a change in the survey question.

In 2016 the survey found consumption of alcohol related to the age of the children questioned; it ranged from 15% of the 11-year-olds having had a drink, to 73% of those aged 15. Girls were slightly more likely to have ever had a drink than boys, at 46% to 43%.

The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once.


The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once. Photograph: Ian West/PA

The headline figure of drug use also disguises differences in age. While only about one in 10 of the 11-year-olds reported ever having taken drugs, 37% of respondents aged 15 said they had.

Black pupils were the most likely to have taken drugs, followed by those of mixed ethnicity, followed by Asians, then white pupils, then others. The picture for drinking prevalence varied; white pupils were the most likely to have ever had an alcoholic drink, followed by mixed, then black, “other” and Asian.

Black girls were far more likely to have tried drugs than black boys, and mixed ethnicity girls were slightly more likely to have taken drugs than boys of that group. Among white children, Asians and others, boys were more likely to have tried drugs.

About half of the pupils questioned had acquired their drugs from a friend on the most recent occasion, with most of those being a friend of the same age. Just over a quarter said they had bought their drugs from a dealer, a proportion that increased with age.

Cannabis was the most commonly used drug, with just over 9% admitting ever having used it, followed by volatile substances (a category including glue, gas, aerosols and solvents) for which just under 9% admitted at least one use.

About 6% admitted having used nitrous oxide, some 3.5% admitted taking stimulants (mostly cocaine and ecstasy), and 2% said they had used psychedelics. Only about one in 200 had ever tried heroin.

Steve Rolles, senior policy analyst at Transform Drug Policy Foundation, which calls for drug law reform, said the findings showed the success of the public health approach to drinking and smoking, compared to the failure of the prohibitory approach towards drug use. “We are actually seeing success of effective regulation of tobacco, relative to failure of the total absence of regulation of drugs. It shows that regulation can work and it shows that public health education can work. So why do we have this wildly different approach for drugs? Effective education has actually denormalised tobacco use.”

Drug use more likely than smoking among secondary school pupils

Secondary school children in England are now more likely to have tried drugs than cigarettes, according to a national survey. The statistics, from NHS Digital, found 24% of 11-15-year-olds saying they had tried recreational drugs at least once in their lives, a nine percentage point rise on the last survey, in 2014.

The new survey also found 19% of respondents saying they had smoked cigarettes at least once, a proportion roughly level with 2014 but well below the figure for 1996 when almost half of pupils questioned had tried smoking. And, in 2016, only 6% of pupils were classified as current smokers.

Drugs use among youngsters was shown to have been declining over the past 15 years, and Paul Niblett, the statistician responsible for the report, said another survey would be needed to establish whether the figures constituted a change in trend.

Niblett said the rise could be partly explained by new questions on the survey asking youngsters about their use of laughing gas (nitrous oxide) and novel psychoactive substances, which were banned last year under sweeping new legislation.

However, even after stripping out the results from these questions, the survey of 12,000 school children carried out under exam conditions in 177 English schools in 2016, still registered a rise in the proportion admitting using drugs, to 21% – a six percentage point increase on the previous survey.

The survey also found that 44% of secondary school pupils said they had drunk alcohol at some point. There had been a steady decline in the proportion admitting to ever having had an alcoholic drink, since the early 2000s until 2014, when 38% said they had tried alcohol. However, those responsible for the survey said the new figure was not comparable to previous years due to a change in the survey question.

In 2016 the survey found consumption of alcohol related to the age of the children questioned; it ranged from 15% of the 11-year-olds having had a drink, to 73% of those aged 15. Girls were slightly more likely to have ever had a drink than boys, at 46% to 43%.

The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once.


The NHS 2016 survey said 73% of respondents aged 15 reported having drunk alcohol at least once. Photograph: Ian West/PA

The headline figure of drug use also disguises differences in age. While only about one in 10 of the 11-year-olds reported ever having taken drugs, 37% of respondents aged 15 said they had.

Black pupils were the most likely to have taken drugs, followed by those of mixed ethnicity, followed by Asians, then white pupils, then others. The picture for drinking prevalence varied; white pupils were the most likely to have ever had an alcoholic drink, followed by mixed, then black, “other” and Asian.

Black girls were far more likely to have tried drugs than black boys, and mixed ethnicity girls were slightly more likely to have taken drugs than boys of that group. Among white children, Asians and others, boys were more likely to have tried drugs.

About half of the pupils questioned had acquired their drugs from a friend on the most recent occasion, with most of those being a friend of the same age. Just over a quarter said they had bought their drugs from a dealer, a proportion that increased with age.

Cannabis was the most commonly used drug, with just over 9% admitting ever having used it, followed by volatile substances (a category including glue, gas, aerosols and solvents) for which just under 9% admitted at least one use.

About 6% admitted having used nitrous oxide, some 3.5% admitted taking stimulants (mostly cocaine and ecstasy), and 2% said they had used psychedelics. Only about one in 200 had ever tried heroin.

Steve Rolles, senior policy analyst at Transform Drug Policy Foundation, which calls for drug law reform, said the findings showed the success of the public health approach to drinking and smoking, compared to the failure of the prohibitory approach towards drug use. “We are actually seeing success of effective regulation of tobacco, relative to failure of the total absence of regulation of drugs. It shows that regulation can work and it shows that public health education can work. So why do we have this wildly different approach for drugs? Effective education has actually denormalised tobacco use.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A drug commonly used to treat acid reflux is linked to a more than doubled risk of developing stomach cancer, researchers have claimed.

Proton pump inhibitors (PPIs) reduce the amount of acid made by the stomach and are used to treat acid reflux and stomach ulcers.

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death.

A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a bacteria suspected of fuelling the illness’s development.

Research by the University of Hong Kong and University College London found that after the Helicobacter pylori was removed, the risk of developing the disease still rose in line with the dose and duration of PPI treatment.

They compared the use of PPI against another drug which limits acid production known as H2 blockers in 63,397 adults. The participants selected had been treated with triple therapy, which combines PPI and antibiotics to kill off the H pylori bacteria over a week, between 2003 and 2012.

Scientists then monitored them until they either developed stomach cancer, died or reached the end of the study at the end of 2015.

During this period, 3,271 people took PPIs for an average of almost three years, while 21,729 participants took H2 blockers. A total of 153 people developed stomach cancer, none of whom tested positive for H plyori but all had long-standing problems with stomach inflammation, the study found.

While H2 blockers were found to have no link to a higher risk of stomach cancer, PPIs was found connected to an increased risk of more than double.

Daily use of PPIs was associated with a risk of developing the illness that was more than four times higher (4.55) than those who used it weekly. Similarly, when the drug was used for more than a year, the risk of developing stomach cancer rose five-fold, and as high as eight-fold after three or more years, the findings showed.

The study concluded no firm cause and effect could be drawn, but doctors should “exercise caution when prescribing long-term PPIs … even after successful eradication of H plyori”.

Responding to the study, Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said: “Many observational studies have found adverse effects associated with PPIs.

“The most plausible explanation for the totality of evidence on this is that those who are given PPIs, and especially those who continue on them long-term, tend to be sicker in a variety of ways than those for whom they are not prescribed.”