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Independent review of PAs launched by Health Secretary


An independent review of physician associates (PAs) and anaesthesia associates (AAs) has been launched by the Health and Social Care Secretary, Wes Streeting, to consider how these roles are deployed across the health system, in order to ensure that patients get the highest standards of care. The review will look into the safety of these roles,


how they support wider health teams, and their place in providing patients with good quality and efficient care. It will also look at how effectively these roles are deployed in the NHS, while offering recommendations on how new roles should work in the future. The review will seek evidence from a range of voices - including patients, employers


within the NHS, professional bodies and academics. Professor Gillian Leng CBE will independently lead the review. She is an experienced leader in the UK healthcare system who has championed patient safety and has a deep understanding of the British medical system. Health and Social Care Secretary, Wes Streeting, said: “Many physician associates are providing great care and freeing up doctors to do the things only doctors can do. But there are legitimate concerns over transparency for patients, scope of practice and the substituting of doctors. These concerns have been ignored for too long, leading to a toxic debate where physicians feel ignored and PAs feel demoralised. “This independent review, led by one of the UK’s most experienced healthcare leaders, will establish the facts, take the heat out of the issue, and make sure that we get the right people, in the right place, doing the right thing.” The review will consider the scope of PA and


AA roles, which currently include gathering medical histories, performing initial examinations, organising tests to support doctors and reviewing patients before surgery. To increase transparency in these roles, the review will also look into measures to ensure patients know when they are interacting with PAs or AAs, so they are clear on the type of clinician they are seeing and for what reason.


70% of young people with long COVID


recover in two years Most young people who were confirmed to have long COVID three months after a positive PCR test had recovered within 24 months, finds a new study led by UCL researchers. The researchers, led by Professor Sir Terence


Stephenson and Professor Roz Shafran, (both UCL Great Ormond Street Institute of Child Health) asked young people about their health three, six, 12 and 24 months after taking a PCR test for the COVID virus between September 2020 and March 2021. They found that around 25-30% of young people met the research definition of long COVID 24 months after their initial PCR test. Older teenagers and the most deprived were less likely to have recovered; and, strikingly, females were almost twice as likely to still meet the research definition of long COVID at 24 months, compared to males. Professor Sir Terence Stephenson, said: “Our findings show that, for teenagers who fulfilled our research definition of long COVID three months after a positive test for the COVID virus, the majority have recovered after two years. This is good news but we intend to do further research to try to better understand why 68 teenagers had not recovered.” Visit: https://journals.sagepub.com/ doi/10.1177/01410768241262661


Multidrug-resistant Enterobacterales in Europe


Two studies have indicated warning signs about the spread of bacteria resistant to carbapenems in both healthcare and community settings across Europe. Two studies published in Eurosurveillance have analysed new data on spread of CRE, namely Escherichia coli sequence type (ST)131 producing various carbapenemases and New Delhi metallo- beta-lactamase-1 (NDM-1)-producing Providencia stuartii to inform potential public health action. In a rapid communication, Kohlenberg et al assessed genomic and epidemiological data from 17 EU/EEA countries and observed an emergence ofEscherichia coli that produces carbapenemases. Worldwide, E. coli is the pathogen associated with most deaths attributable to antimicrobial resistance and the specific type of E. coli that the authors investigated in their study (ST 131) has been detected across the world and is frequently associated with multidrug-resistance. Kohlenberg et al analysed the sequencing and


12 www.clinicalservicesjournal.com I January 2025


epidemiological data of almost 600 E. coli ST131 isolates provided by national reference laboratories from Austria, Belgium, Czechia, Denmark, Finland, France, Hungary, Ireland, Germany, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Portugal, Slovenia and Sweden. Detection of E. coli ST131 isolates producing carbapenemases increased over time. One group of isolates stood out for potential association with urinary tract infections in the community inferred from the relatively low median age of patients (57 years), a high proportion of female patients and the frequent detection of isolates from urine samples. The authors note that “community-acquired urinary tract infections might only represent the tip of the iceberg in terms of patient colonisation in the community”. Kohlenberg et al argue that the results of their study across 17 EU/EEA countries “sends another warning about the worsening epidemiological carbapenemase-producing Enterobacterales situation in the EU/EEA. Further


spread of E. coli carrying carbapenemase genes would mean that carbapenems could no longer be consistently effective for empiric treatment of severe E. coli infections.” One type of CRE which has been very rare


in Europe thus far – New Delhi metallo-beta- lactamase-1 (NDM-1)-producing Providencia stuartii – has now been detected in several hospitals in Romania.


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