Tag Archives: Work

Doctors told to think twice before signing patients off work or ordering x-rays

Doctors should rethink classifying patients as unfit for work and instead consider how work could benefit their recovery, an expert body has recommended.

The proposal is among the latest recommendations released on Monday by NPS MedicineWise, an Australian-based organisation led by medical experts and peak bodies to help doctors and patients avoid tests and medications that may be unnecessary or even cause harm.

The president of the Australasian Faculty of Occupational and Environmental Medicine, Associate Prof Peter Connaughton, said work-related injury and time off for illness cost the Australian economy an estimated $ 61.8bn each year directly and indirectly.

“The recommendation from our faculty provides an opportunity to emphasise the very important role good work has in contributing to the overall health and well-being of our country,” he said.

“On a personal level in my clinical experience, I see the emotional and physical impacts that not being able to work as a result of injury has on people’s lives, and people declared medically unfit for work experience isolation, loss of self-esteem, depression, poorer health and slower recovery times.”

Connaughton said his organisation had also recommended against unnecessary x-rays for those suffering lower back pain. A perspective piece published in the Medical Journal of Australia in 2016 described how lower back pain was the most common symptom seen in primary care, with the underlying injury often exacerbated by psychological and social stressors. Patients often had high expectations about what medicine could do to fix their pain, the authors wrote, and expected a surgical solution.

But Connaughton said there was no evidence that x-rays were effective for identifying the underlying cause of lower back pain unless there were very clear clinical indicators that something more serious might be going on.

“They expose workers to unnecessary radiation,” he said. “Backache is so common in our society and most are benign, self-limiting and do not warrant x-rays, which in fact can be harmful due to adverse health effects related to the radiation exposure, and incidental findings that might trigger anxiety and concern in patients and sometimes lead to more unnecessary further testing and investigation.”

The updated guidelines also caution that Australian children are having too many unnecessary diagnostic x-rays. The Royal Australasian College of Physicians [RACP] said x-rays should not be routinely used to diagnose children suffering bronchiolitis, asthma or nonspecific abdominal pain. The recommendation reflects clinical evidence that found chest x-rays significantly altered therapeutic management only in about one in 100 children with typical bronchiolitis. In more than 95% of cases, an abdominal x-ray offers no insight into the cause of non-specific abdominal pain in children.

“For any parents who might be concerned about the idea that ‘less can sometimes be more’, I would say to them we want to make sure we are only ordering a test when it is medically beneficial for your child,” said Dr Sarah Dalton, the president of the RACP’s paediatrics and child health division.

“In the case of abdominal x-rays, we know they actually have more radiation than chest x-rays and in some cases have been shown to be unnecessary for diagnostic purposes. This is why we’re calling attention to their use in children, and urging doctors to think twice before ordering their next one.”

Meanwhile, a new recommendation from the Internal Medicine Society of Australia and New Zealand targets Australians over 65 who are regularly taking five or more medications, including over-the-counter purchases such as vitamins.

The president of the society, Dr Robert Pickles, said those patients should ask their doctor whether their medication regime should be downgraded.

“We often forget our bodies change with age and out body’s responses tend to change with age,” Pickles said.

“Anti-diabetic drugs can become more potent as people age and as kidney function deteriorates and muscle bulk decreases, leading to low blood sugar, falling over and harm from falls.” Patients sometimes kept taking drugs that were needed only in the short-term, he added.

The medicines older Australians should consider avoiding include: benzodiazepines, anti-psychotics, hypoglycaemic agents, antithrombotic agents, anti-hypertensives and anti-anginal medicine, he said.

Doctors told to think twice before signing patients off work or ordering x-rays

Doctors should rethink classifying patients as unfit for work and instead consider how work could benefit their recovery, an expert body has recommended.

The proposal is among the latest recommendations released on Monday by NPS MedicineWise, an Australian-based organisation led by medical experts and peak bodies to help doctors and patients avoid tests and medications that may be unnecessary or even cause harm.

The president of the Australasian Faculty of Occupational and Environmental Medicine, Associate Prof Peter Connaughton, said work-related injury and time off for illness cost the Australian economy an estimated $ 61.8bn each year directly and indirectly.

“The recommendation from our faculty provides an opportunity to emphasise the very important role good work has in contributing to the overall health and well-being of our country,” he said.

“On a personal level in my clinical experience, I see the emotional and physical impacts that not being able to work as a result of injury has on people’s lives, and people declared medically unfit for work experience isolation, loss of self-esteem, depression, poorer health and slower recovery times.”

Connaughton said his organisation had also recommended against unnecessary x-rays for those suffering lower back pain. A perspective piece published in the Medical Journal of Australia in 2016 described how lower back pain was the most common symptom seen in primary care, with the underlying injury often exacerbated by psychological and social stressors. Patients often had high expectations about what medicine could do to fix their pain, the authors wrote, and expected a surgical solution.

But Connaughton said there was no evidence that x-rays were effective for identifying the underlying cause of lower back pain unless there were very clear clinical indicators that something more serious might be going on.

“They expose workers to unnecessary radiation,” he said. “Backache is so common in our society and most are benign, self-limiting and do not warrant x-rays, which in fact can be harmful due to adverse health effects related to the radiation exposure, and incidental findings that might trigger anxiety and concern in patients and sometimes lead to more unnecessary further testing and investigation.”

The updated guidelines also caution that Australian children are having too many unnecessary diagnostic x-rays. The Royal Australasian College of Physicians [RACP] said x-rays should not be routinely used to diagnose children suffering bronchiolitis, asthma or nonspecific abdominal pain. The recommendation reflects clinical evidence that found chest x-rays significantly altered therapeutic management only in about one in 100 children with typical bronchiolitis. In more than 95% of cases, an abdominal x-ray offers no insight into the cause of non-specific abdominal pain in children.

“For any parents who might be concerned about the idea that ‘less can sometimes be more’, I would say to them we want to make sure we are only ordering a test when it is medically beneficial for your child,” said Dr Sarah Dalton, the president of the RACP’s paediatrics and child health division.

“In the case of abdominal x-rays, we know they actually have more radiation than chest x-rays and in some cases have been shown to be unnecessary for diagnostic purposes. This is why we’re calling attention to their use in children, and urging doctors to think twice before ordering their next one.”

Meanwhile, a new recommendation from the Internal Medicine Society of Australia and New Zealand targets Australians over 65 who are regularly taking five or more medications, including over-the-counter purchases such as vitamins.

The president of the society, Dr Robert Pickles, said those patients should ask their doctor whether their medication regime should be downgraded.

“We often forget our bodies change with age and out body’s responses tend to change with age,” Pickles said.

“Anti-diabetic drugs can become more potent as people age and as kidney function deteriorates and muscle bulk decreases, leading to low blood sugar, falling over and harm from falls.” Patients sometimes kept taking drugs that were needed only in the short-term, he added.

The medicines older Australians should consider avoiding include: benzodiazepines, anti-psychotics, hypoglycaemic agents, antithrombotic agents, anti-hypertensives and anti-anginal medicine, he said.

Pills prescribed for alcoholism might not work, study finds

There is no magic pill to cure alcoholism, according to a scientific review of the evidence of five drugs being prescribed by doctors.

None of the five drugs has a body of reliable evidence behind it, say the scientists, even though one of the drugs, nalmefene, has been approved for use in the NHS by Nice, the National Institute for Health and Care Excellence. Another, baclofen, has generated huge excitement, especially in France, but has been linked to deaths.

The pills have been developed for people who have not stopped drinking completely and are intended to help them cut down, with a view to reducing the harm they are doing to their bodies.

But at best, says the study in the journal Addiction, the pills had a low- or medium-level effect on the amount people were drinking. The scientists looked at 32 double-blind randomised controlled trials representing 6,036 patients, published between 1994 and 2015. None of them showed any improvement in the health of those taking the pills, because they measured only the reduction in the amount of alcohol drunk each day.

The researchers looked at the trials carried out on nalmefene, naltrexone, acamprosate, baclofen and topimarate against placebos. So many people dropped out of the trials that 26 of the 32 studies – 81% of them – had unclear or incomplete outcome data.

Lead author Dr Clément Palpacuer from Inserm, the French National Institute of Health and Medical Research, said: “Although our report is based on all available data in the public domain, we did not find clear evidence of benefit of using these drugs to control drinking. That doesn’t mean the drugs aren’t effective; it means we don’t yet know if they are effective. To know that, we need better studies. Researchers urgently need to provide policymakers with evidence as to which of these drugs can be effectively translated into a real harm-reduction strategy.”

Concerns have already been voiced about the drugs. The first to be licensed in Europe was nalmefene, an opioid antagonist that acts on the urge to consume alcohol. But critics pointed out that the trials had not proved it reduced the harm alcoholics were doing to themselves.

That drug was later endorsed for use in the NHS by Nice, but against protests. In August last year, a review of the trial evidence led by the University of Stirling also in Addiction said that “evidence for the efficacy of nalmefene in reducing alcohol consumption in those with alcohol dependence is, at best, modest, and of uncertain significance to individual patients”. This created a dilemma for GPs and commissioners, it said, “where nalmefene has been heavily promoted”.

Baclofen is even more controversial. The drug has been given a provisional licence in France, pending the results of more trials, because it is being widely used. Yet a Dutch study last year said it may work no better than counselling and there have been reports of deaths.

Baclofen took off in France after the cardiologist Olivier Ameisen wrote a book called The Last Drink, describing how he had treated himself with the drug and cured his addiction. But the drug is given to alcoholics in large doses and there are side-effects which can be severe.

One of the authors of the new study, Florian Naudet of Inserm and the University of Rennes, said there were pointers, though not conclusive evidence, to the dangers. “A recent study raised concerns regarding the safety of baclofen, with more deaths observed in the treated group (7 of 162) compared to the placebo group (3 of 158),” he said in an email. A subsequent study published by France’s medicines safety agency drew attention to the risk.

“In particular, the risk of intoxication, epilepsy and unexplained death [on the death certificate] increases with the dosage of baclofen,” it said.

What is it like to work for a private ambulance service?

Shortages of paramedics and rising demand means that the NHS is spending almost £80m a year hiring private ambulances to answer 999 calls, figures show.

England’s 10 NHS ambulance trusts to spend £78.4m in 2016-17 on help from non-NHS providers to supplement their own services, down from £79.7m in 2015-16 up from £64.2m in 2014-15.

The trust that spent the most on private services last year was South Central ambulance – £16.3m, up from its £13.6m the year before and £12.3m in 2014-15.

The news prompted fears that ambulances supplied by profit-driven firms may provide a lower standard of care when compared to NHS crews.

Share your experiences

We want to hear from those who work for private ambulances as well as people who have been treated by them. Is the standard of care different? Do you have any worries? What is it like to work for a private ambulance service? What qualifications do you need? What equipment do you have?

Please share your experiences, anonymously if you prefer, in the form below. The form is encrypted and your responses will only be seen by the Guardian.

Your stories will help our journalists have a more complete picture of the private ambulance service and we will use them in our reporting.

Want to be happier? First, work out if you’re an ‘upholder’ or a ‘rebel’

In the often-woolly world of personal development, Gretchen Rubin is a practical and grounded sort. She doesn’t even – shock – like meditation. Rubin has spent the past decade researching and writing about happiness. A former lawyer, it was her fifth book, The Happiness Project written in 2009 – for which she spent a year testing different theories about how to live a more fulfilled life – that became a bestseller and made her a star of the self-help world (she also runs a popular blog and podcast).

Her latest book, The Four Tendencies, develops ideas first explored in 2015’s Better Than Before, in which she looked at how happiness and habits were linked. “[People] wanted to run,” she says, “but for some reason they couldn’t make themselves exercise. Or they wanted to write a novel in their free time, but somehow they weren’t doing it. It was trying to figure out why people did and didn’t break habits.”

She came up with her own personality framework – the idea being that each of us fits into one of four characteristics she calls the four tendencies. Rubin claims it explains the reasons behind why we do what we do, based on how different people respond to expectations – either outer ones (from, for example, a boss at work) to inner ones (things you want to do for yourself). According to Rubin’s categories, “upholders” easily do what is asked of them by themselves and others, while “obligers” need accountability. “Questioners” need to know why they’re doing something and “rebels” resist expectations. She says she truly felt that “I’d uncovered a law of nature: human nature”.

Gretchen Rubin, author of The Four Tendencies


Gretchen Rubin, author of The Four Tendencies. Photograph: Michael Weschler Photography

After Better Than Before came out, Rubin says, she was, “deluged with questions” about this idea. Thousands took her online questionnaire to work out what type they were, and she started to wonder if our tendency had much more influence over our lives than whether or not we could stick to a diet. “It’s related to habits, but it’s much bigger than that,” she says on the phone from her home in New York. “It might also shape something such as having a fight with a co-worker, or having a better way to communicate with your child.”

The result is her new book, which explores her theory further, and provides advice on how to deal with the four types. She says the failure to understand other people’s tendencies can be responsible for everything from relationship breakdowns to failing public health campaigns, and that working with other people’s tendencies can improve the way bosses and employees relate; help doctors encourage their patients to take control of their health, and help teachers get the best from students.

The biggest thing she has learned in more than a decade of thinking and writing about happiness, she says, is that “there is no one-size-fits-all solution. We can only be happy, healthy, creative and productive if we take into account our own nature, our own values and interests. The question is: what kind of person am I, what works for me, what do I care about?” Even so, Rubin is game for creating rules and lists (she’s an upholder). What, then, are some of the things she has learned on her quest for a happier life?

Create your own principles

In The Happiness Project, Rubin created “12 commandments” by which to live her life, including “act the way I want to feel” and “enjoy the process” – but she stresses that someone else’s list will probably be different. “My first personal commandment is to ‘Be Gretchen’, because in the end there is no one best practice, there is no best way,” she says. “When I started, I thought I would find the secret [to happiness]. There are universal things – relationships make people happier. But in terms of should you get up early, or stay up late? Are you more creative if you’re in a messy environment or a simple environment? It’s so much about who you are.”

Test yourself

2009 study by San Francisco State University found that learning to do something new could be stressful and frustrating to begin with, but paid off in terms of greater overall happiness. “I thought ‘oh no, I like familiarity and mastery’,” says Rubin. “I just felt like it wouldn’t be true for me, but I have become a huge believer in the power of novelty and challenge and how this is a big engine of happiness.”

Declutter

“Another thing that surprised me is the degree to which outer order contributes to inner calm. Over and over people tell me that if they get control over the stuff of their life, they feel more in control of their life generally. They feel more energetic, creative, they can tackle bigger things. Somebody said to me: ‘I cleaned out my fridge, and now I know I can switch careers’. There does seem to be a connection for most people, but not everybody.But if you want to give yourself a boost, sometimes clearing clutter can help.”

Look after your body

“Your physical capacity matters – getting enough sleep, getting some exercise, getting natural light, not letting yourself get too hungry.” If you are starting from a position of feeling comfortable and rested, she says, “you give yourself a lot more wherewithal to tackle things such as staying patient, not losing your temper, eating right, going to the gym – all these things take energy and self-command, and they’re easier if you manage your body”.

Seeking happiness is not selfish

“This comes in two different varieties,” she says. “One is that you think: ‘My life is so full of comfort and security already so if I want to be happier, I really must be spoiled and self-indulgent because I already have so much.’ The other is to think, in a world full of suffering, that it’s not morally appropriate for people to seek to be happier. But research shows that happier people are more interested in the problems in the world and in the people around them. They’re more altruistic,they give away more money, they volunteer more time, they are more likely to help someone who needs a hand. They make better team members, they’re healthier, they suffer less burnout. When people are unhappy they tend to become isolated, defensive and preoccupied with their own problems. When you’re happier, you can turn outward and think about other people.”

The Four Tendencies is published by Hodder & Stoughton (£14.99).

Want to be happier? First, work out if you’re an ‘upholder’ or a ‘rebel’

In the often-woolly world of personal development, Gretchen Rubin is a practical and grounded sort. She doesn’t even – shock – like meditation. Rubin has spent the past decade researching and writing about happiness. A former lawyer, it was her fifth book, The Happiness Project written in 2009 – for which she spent a year testing different theories about how to live a more fulfilled life – that became a bestseller and made her a star of the self-help world (she also runs a popular blog and podcast).

Her latest book, The Four Tendencies, develops ideas first explored in 2015’s Better Than Before, in which she looked at how happiness and habits were linked. “[People] wanted to run,” she says, “but for some reason they couldn’t make themselves exercise. Or they wanted to write a novel in their free time, but somehow they weren’t doing it. It was trying to figure out why people did and didn’t break habits.”

She came up with her own personality framework – the idea being that each of us fits into one of four characteristics she calls the four tendencies. Rubin claims it explains the reasons behind why we do what we do, based on how different people respond to expectations – either outer ones (from, for example, a boss at work) to inner ones (things you want to do for yourself). According to Rubin’s categories, “upholders” easily do what is asked of them by themselves and others, while “obligers” need accountability. “Questioners” need to know why they’re doing something and “rebels” resist expectations. She says she truly felt that “I’d uncovered a law of nature: human nature”.

Gretchen Rubin, author of The Four Tendencies


Gretchen Rubin, author of The Four Tendencies. Photograph: Michael Weschler Photography

After Better Than Before came out, Rubin says, she was, “deluged with questions” about this idea. Thousands took her online questionnaire to work out what type they were, and she started to wonder if our tendency had much more influence over our lives than whether or not we could stick to a diet. “It’s related to habits, but it’s much bigger than that,” she says on the phone from her home in New York. “It might also shape something such as having a fight with a co-worker, or having a better way to communicate with your child.”

The result is her new book, which explores her theory further, and provides advice on how to deal with the four types. She says the failure to understand other people’s tendencies can be responsible for everything from relationship breakdowns to failing public health campaigns, and that working with other people’s tendencies can improve the way bosses and employees relate; help doctors encourage their patients to take control of their health, and help teachers get the best from students.

The biggest thing she has learned in more than a decade of thinking and writing about happiness, she says, is that “there is no one-size-fits-all solution. We can only be happy, healthy, creative and productive if we take into account our own nature, our own values and interests. The question is: what kind of person am I, what works for me, what do I care about?” Even so, Rubin is game for creating rules and lists (she’s an upholder). What, then, are some of the things she has learned on her quest for a happier life?

Create your own principles

In The Happiness Project, Rubin created “12 commandments” by which to live her life, including “act the way I want to feel” and “enjoy the process” – but she stresses that someone else’s list will probably be different. “My first personal commandment is to ‘Be Gretchen’, because in the end there is no one best practice, there is no best way,” she says. “When I started, I thought I would find the secret [to happiness]. There are universal things – relationships make people happier. But in terms of should you get up early, or stay up late? Are you more creative if you’re in a messy environment or a simple environment? It’s so much about who you are.”

Test yourself

2009 study by San Francisco State University found that learning to do something new could be stressful and frustrating to begin with, but paid off in terms of greater overall happiness. “I thought ‘oh no, I like familiarity and mastery’,” says Rubin. “I just felt like it wouldn’t be true for me, but I have become a huge believer in the power of novelty and challenge and how this is a big engine of happiness.”

Declutter

“Another thing that surprised me is the degree to which outer order contributes to inner calm. Over and over people tell me that if they get control over the stuff of their life, they feel more in control of their life generally. They feel more energetic, creative, they can tackle bigger things. Somebody said to me: ‘I cleaned out my fridge, and now I know I can switch careers’. There does seem to be a connection for most people, but not everybody.But if you want to give yourself a boost, sometimes clearing clutter can help.”

Look after your body

“Your physical capacity matters – getting enough sleep, getting some exercise, getting natural light, not letting yourself get too hungry.” If you are starting from a position of feeling comfortable and rested, she says, “you give yourself a lot more wherewithal to tackle things such as staying patient, not losing your temper, eating right, going to the gym – all these things take energy and self-command, and they’re easier if you manage your body”.

Seeking happiness is not selfish

“This comes in two different varieties,” she says. “One is that you think: ‘My life is so full of comfort and security already so if I want to be happier, I really must be spoiled and self-indulgent because I already have so much.’ The other is to think, in a world full of suffering, that it’s not morally appropriate for people to seek to be happier. But research shows that happier people are more interested in the problems in the world and in the people around them. They’re more altruistic,they give away more money, they volunteer more time, they are more likely to help someone who needs a hand. They make better team members, they’re healthier, they suffer less burnout. When people are unhappy they tend to become isolated, defensive and preoccupied with their own problems. When you’re happier, you can turn outward and think about other people.”

The Four Tendencies is published by Hodder & Stoughton (£14.99).

Drop in UK suicide rate linked to prevention work in England

The suicide rate in Britain fell by 4.7% last year to the lowest level since 2011, with prevention work in England credited for the drop.

The rate fell in England and Wales, although the rate in Wales is generally more erratic because of its smaller population, but increased slightly in Scotland. Overall there were 10.1 suicides per 100,000 in 2016, compared with 10.6 in the previous 12 months.

It was the third consecutive year in which suicide rates have fallen in Britain as the number registered dropped by 202 or 3.4% to 5,688.

A spokeswoman for the Office for National Statistics (ONS) said: “The recent decline in the suicide rate is likely to be due to the suicide prevention work in England by the government, the NHS, charities, the British Transport Police and others.

“The national suicide pevention strategy for England has included work to reduce the risk of suicide in high-risk groups. These include young and middle-aged men, people in the care of mental health services, and those in the criminal justice system.”

The proportion of male suicides was 75% last year, which has remained broadly consistent since the early 1990s. Middle-aged men remain the group at greatest risk.

Citing research by the Samaritans, the ONS says relationship breakdown can contribute to suicide risk, which is greatest among divorced men, who are almost three times more likely to end their lives than men who are married or in a civil partnership.

The suicide rate for males fell by 3.1% to 15.7 per 100,000 males last year, while the rate for females decreased 9.4% to 4.8 per 100,000 after the latter hit a 10-year high in 2015.

Suicide rates
Suicide rates

Inequality is another major risk factor, with people among the most deprived 10% of society more than twice as likely to kill themselves than the least deprived 10%, according to the ONS.

Suicide rates generally fell between 1981 and 2007 before rising again to hit a peak of 11.1 deaths per 100,000 in 2013, although that was still substantially lower than the rates in the 80s and 90s.

The Samaritans chief executive, Ruth Sutherland, welcomed last year’s fall but said the number of deaths was still too high. “Every suicide is a tragedy leaving devastation in its wake,” she said.

“These figures emphasise the urgency with which we as a society need to work together to prevent needless loss of life.”

The charity is campaigning for every area to have an effective suicide plan. The government’s latest progress report on preventing suicide in England, published in January, found that 95% of local authorities “have plans in place or in development”.

Sutherland said: “Suicide is not inevitable, it’s preventable, and politicians, employers, health bodies and educators all have a role in identifying and supporting those most at risk.”

The chair of the Local Government Association’s community wellbeing board, Izzi Seccombe, said a commitment was needed to invest in local government to help tackle mental illness and prevent suicide.

“Suicide is preventable, but it needs to be everybody’s business to work together to tackle this tragic loss of life,” she said.

The suicide rate in England dropped from 10.1 per 100,000 people in 2015 to 9.5 last year, a decrease the ONS described as statistically significant. In Wales it fell from 13.0 to 11.8, but in Scotland it rose from 14.0 to 15.0.

The ONS says differences in Scotland’s coroner system and the way that suicides are certified and registered there make comparisons with the rest of Britain inappropriate.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.

Drop in UK suicide rate linked to prevention work in England

The UK suicide rate fell by 4.7% last year to the lowest level since 2011, with prevention work in England credited for the drop.

The rate fell in England and Wales – although the rate in Wales is generally more erratic because of its smaller population – but increased slightly in Scotland. Overall there were 10.1 suicides per 100,000 in 2016, compared with 10.6 in the previous 12 months.

It was the third consecutive year in which suicide rates have fallen in Britain as the number of suicides registered dropped by 202 (3.4%) to 5,688.

A spokeswoman for the Office for National Statistics (ONS) said: “The recent decline in the suicide rate is likely to be due to the suicide prevention work in England by the government, the NHS, charities, the British Transport Police and others.

“The national suicide pevention strategy for England has included work to reduce the risk of suicide in high-risk groups. These include young and middle-aged men, people in the care of mental health services, and those in the criminal justice system.”

The proportion of male suicides was 75% last year, which has remained broadly consistent since the early 1990s. Middle-aged men remain the group at greatest risk.

Citing research by the Samaritans, the ONS says relationship breakdown can contribute to suicide risk and the greatest risk is among divorced men, who are almost three times more likely to end their lives than men who are married or in a civil partnership.

The suicide rate for males fell by 3.1% to 15.7 per 100,000 males last year, while the rate for females decreased 9.4% to 4.8 per 100,000 females after the latter hit a 10-year high in 2015.

Inequality is another major risk factor, with people among the most deprived 10% of society more than twice as likely to kill themselves than the least deprived 10% of society, according to the ONS.

Suicide rates generally fell between 1981 and 2007 before rising again to hit a peak of 11.1 deaths per 100,000 in 2013, although that was still substantially lower than the rates in the 80s and 90s.

The Samaritans chief executive, Ruth Sutherland, welcomed last year’s fall but said the number of deaths was still too high. “Every suicide is a tragedy leaving devastation in its wake,” she said.

“These figures emphasise the urgency with which we as a society need to work together to prevent needless loss of life.”

The charity is campaigning for every area to have an effective suicide plan. The government’s latest progress report on preventing suicide in England, published in January, found that 95% of local authorities “have plans in place or in development”.

Sutherland said: “Suicide is not inevitable, it’s preventable, and politicians, employers, health bodies and educators all have a role in identifying and supporting those most at risk.”

The suicide rate in England dropped from 10.1 per 100,000 people in 2015 to 9.5 last year, a decrease described by the ONS as “statistically significant”. In Wales it fell from 13.0 to 11.8, but in Scotland it rose from 14.0 to 15.0.

The ONS says differences in Scotland’s coroner system and the way that suicides are certified and registered there make comparisons with the rest of Britain inappropriate.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.

Drop in UK suicide rate linked to prevention work in England

The UK suicide rate fell by 4.7% last year to the lowest level since 2011, with prevention work in England credited for the drop.

The rate fell in England and Wales – although the rate in Wales is generally more erratic because of its smaller population – but increased slightly in Scotland. Overall there were 10.1 suicides per 100,000 in 2016, compared with 10.6 in the previous 12 months.

It was the third consecutive year in which suicide rates have fallen in Britain as the number of suicides registered dropped by 202 (3.4%) to 5,688.

A spokeswoman for the Office for National Statistics (ONS) said: “The recent decline in the suicide rate is likely to be due to the suicide prevention work in England by the government, the NHS, charities, the British Transport Police and others.

“The national suicide pevention strategy for England has included work to reduce the risk of suicide in high-risk groups. These include young and middle-aged men, people in the care of mental health services, and those in the criminal justice system.”

The proportion of male suicides was 75% last year, which has remained broadly consistent since the early 1990s. Middle-aged men remain the group at greatest risk.

Citing research by the Samaritans, the ONS says relationship breakdown can contribute to suicide risk and the greatest risk is among divorced men, who are almost three times more likely to end their lives than men who are married or in a civil partnership.

The suicide rate for males fell by 3.1% to 15.7 per 100,000 males last year, while the rate for females decreased 9.4% to 4.8 per 100,000 females after the latter hit a 10-year high in 2015.

Inequality is another major risk factor, with people among the most deprived 10% of society more than twice as likely to kill themselves than the least deprived 10% of society, according to the ONS.

Suicide rates generally fell between 1981 and 2007 before rising again to hit a peak of 11.1 deaths per 100,000 in 2013, although that was still substantially lower than the rates in the 80s and 90s.

The Samaritans chief executive, Ruth Sutherland, welcomed last year’s fall but said the number of deaths was still too high. “Every suicide is a tragedy leaving devastation in its wake,” she said.

“These figures emphasise the urgency with which we as a society need to work together to prevent needless loss of life.”

The charity is campaigning for every area to have an effective suicide plan. The government’s latest progress report on preventing suicide in England, published in January, found that 95% of local authorities “have plans in place or in development”.

Sutherland said: “Suicide is not inevitable, it’s preventable, and politicians, employers, health bodies and educators all have a role in identifying and supporting those most at risk.”

The suicide rate in England dropped from 10.1 per 100,000 people in 2015 to 9.5 last year, a decrease described by the ONS as “statistically significant”. In Wales it fell from 13.0 to 11.8, but in Scotland it rose from 14.0 to 15.0.

The ONS says differences in Scotland’s coroner system and the way that suicides are certified and registered there make comparisons with the rest of Britain inappropriate.

In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.