NEWS
Testing delays are keeping doctors away from work
Delays in accessing COVID-19 tests continue to cause disruption among hospital doctor teams. A survey of members by the Royal College of Physicians has found that few doctors are off work but, for 40% of those who are, it is because they are self- isolating while awaiting a test for someone in their household.
Among those doctors who have been able to access testing for themselves over the past two weeks, 80% were able to access testing within 24 hours, down from 88% in July. This comes as over half of doctors (53%) say COVID-19 admissions have increased in their hospital over the past fortnight. As the threat of a second wave of COVID-19 draws closer, almost half of doctors (47%) said they have been involved in conversations with their organisations about preparing for it, and 90% feel their organisation is at least somewhat prepared for a second wave. However, 35% of doctors were still unsure that their organisation would have the necessary PPE to cope with a second peak of the virus.
Despite Government guidance that all doctors should be formally assessed for their level of personal risk with regards to COVID-19, only 64% of doctors have had a formal assessment.
Commenting on the results of the survey,
Investment in hospital building
programme The Prime Minister, Boris Johnson, has announced that 40 hospitals will be built by 2030 as part of a package worth £3.7 billion, with eight further new schemes invited to bid. New standards will be developed over the coming months to help standardise the design of new hospitals and make use of modular construction methods to speed up the build.
Professor Andrew Goddard, president of the Royal College of Physicians, said: “These results show the NHS is geared up for the impact of a second wave of COVID-19, and it’s a relief to see that so many of our members and their organisations feel prepared. “However, testing remains an enormous
issue. We must ensure that rapid testing and results are available for health and social care staff or we’ll end up tackling winter and the second wave with one hand tied behind our backs. “The biggest issue is testing for household members. Delays in accessing these tests mean that hundreds of doctors are having to self-isolate while they wait, and are unavailable to provide care. As the infection rate rises, the need for tests will rise, and a large proportion of the workforce could be out of action simply for want of a test.”
The health infrastructure plan (HIP) is the biggest hospital building programme in a generation. It launched last September with a £2.8 billion investment that gave six new hospitals the funding to go ahead, alongside seed funding for Trusts to work up business cases. The Trusts that received seed funding will now all be fully funded to deliver 25 new hospitals. Commenting on the decision, the
Prime Minister said: “The dedication and tireless efforts of our nurses, doctors and all healthcare workers have kept the NHS open throughout this pandemic. But no matter what this virus throws at us, we are determined to deliver the biggest hospital building programme in a generation.”
Type 2 diabetes remission restores pancreas to near healthy size
Going into remission of type 2 diabetes through a low-calorie, weight management programme can restore the pancreas to a normal size, new research funded by Diabetes UK reveals. People with type 2 diabetes have a pancreas that is around 20-30% smaller than people without the condition, and it is more irregular in shape. But until now, it has never been clear if this is the cause of type 2 diabetes, or a result of having the condition, or whether it’s possible to restore the pancreas to a healthy size and shape. DiRECT, the landmark trial funded by Diabetes UK, has shown that more than a third (36%) of people with type 2 diabetes who took part in the low-calorie, weight management programme were still in remission two years later. To discover more about what happens inside the body when people go into remission, researchers tracked changes in the pancreases of 64 participants in the DiRECT trial. Using MRI scanners, the researchers were able to measure the volume, shape and amount of fat in the pancreases, and follow
these changes over two years. The researchers observed for the first time that the size of the pancreas in people who were in remission for two years had increased by 20%, returning to almost normal size. The researchers also saw that, along with a drop in the amount of fat in the pancreas, the very irregular borders of the pancreas returned to normal. In people who didn’t go into remission, their pancreas didn’t increase in volume to the same extent and they showed very little change in pancreas shape. This is the first evidence we have that remission from type 2 diabetes causes positive changes to the structure of the pancreas. Previously, work as part of the DiRECT trial at the Newcastle Magnetic Resonance Centre revealed that the function of the insulin- producing beta cells normalises as a result of remission of type 2 diabetes. However, beta cells make up only around 1% of the pancreas, and these latest findings about the whole of the pancreas organ show the extent of change associated with remission. This work highlights the importance of
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weight loss – specifically a weight loss of 10-15kg – in bringing about remission. We now know that this specifically reduces the amount of fat in the pancreas, leading not only to beta cell recovery and increased insulin production but also restoration of the whole organ. With NHS England this month launching a pilot remission programme inspired by DiRECT for 5000 people, and similar services available in Scotland, it is key that we understand more about the remission process, to make it a viable option for as many people as possible. Professor Roy Taylor of Newcastle
University, who led this work, said: “It will be enormously encouraging for anyone with type 2 diabetes to learn that their small pancreas can return to normal size. Knowing what a treatment actually does inside the body is both motivating and reassuring.” The findings were presented at the European Association for the Study of Diabetes Conference and will feature in The Lancet Diabetes & Endocrinology.
NOVEMBER 2020
©@Marco Taliani
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