NEWS New test could lead to early
detection of cortisol deficiency A new breakthrough test offering a potentially more convenient and less invasive way to diagnose adrenal insufficiency - a decrease in cortisol production - is to be pioneered in a clinical trial at Sheffield Teaching Hospitals NHS Foundation Trust. Dr Miguel De Bono, consultant endocrinologist at Sheffield Teaching Hospitals and Professor Richard Ross, professor of endocrinology at the University of Sheffield, have been awarded £205,000 from the National Institute for Health Research’s prestigious Research for Patient Benefit programme to develop the test with a view to it being available on the NHS within the next three years. The test offers a simpler and less invasive way to detect adrenal insufficiency by measuring levels of cortisol in saliva as opposed to in the blood. The research being undertaken could lead to the development of an everyday test that can be performed at home by patients and used by all doctors when they suspect adrenal insufficiency. This has the potential to save lives by earlier diagnosis as well as providing a more cost effective test for the NHS. Adrenal insufficiency occurs when the body is no longer able to make cortisol – a major hormone that helps the body overcome stress, infections and regulates body sugars, proteins and fats. Currently, adrenal insufficiency is diagnosed through a complex blood test which
has to be undertaken in a hospital setting. During the study the researchers will look to establish what levels of cortisol insufficiency need to be present in saliva to give a definitive diagnosis of the condition. They will do this by comparing the saliva test with the blood tests, with patients having the waking salivary cortisol at home and then travelling to hospital immediately afterwards to get the blood tests. The researchers estimate that the test could dramatically reduce the number of complex investigations for adrenal insufficiency in England from approximately 92,000 per year to just 23,000 per year. Dr Miguel De Bono said: “Through this research we hope to provide a patient-friendly and more convenient, salivary test to reduce and replace the use of the complex tests for the majority of patients. Adrenal insufficiency may be difficult to diagnose, particularly as symptoms are non-specific, so as well as providing a more patient-friendly testing option, patients living with this potentially devastating condition will receive quicker diagnosis whilst also helping the NHS to save money because the new test is less costly.”
The study will open for recruitment in October 2019, and will involve 200 patients who are referred for an assessment for adrenal insufficiency at Sheffield’s Royal Hallamshire Hospital.
NHS’‘significant’ plans for Brexit no deal
Simon Stevens, chief executive of the National Health Service, said "significant planning" has started to ensure medicines are still supplied to patients if the government fails to negotiate a Brexit deal with the European Union.
Stevens, said Britain's health department was working with pharmaceutical companies to make sure there will be no breakdown in supply if there is no deal with the EU. "There is now significant planning going on around all the scenarios including these medicines supply scenarios," he told the BBC's Andrew Marr Show.
"There's extensive work under way now between the department of health, other parts of government, the life sciences industry, the pharma companies. Nobody is pretending this is a desirable situation but if that's what we get to then it will not have been unforeseen."
The EU has warned Britain that time was running out to negotiate a deal and stop the country from crashing out of the bloc. There have been promises from the Prime Minister to thrash out an agreement with a top team of ministers at a meeting, with the intention of presenting a policy document, or white paper, setting out the government's aims for a future partnership. The Department of Health and Social Care (DHSC) is leading the response to EU Exit across the health and care sector. DHSC is also the key contact for the sector with the Department for Exiting the EU (DExEU) and the Cabinet Office. NHS England and NHS Improvement are working closely with DHSC to best prepare the NHS.
DHSC has produced EU Exit Operational Guidance which outlines the actions that providers and commissioners of health and social care services should take to prepare for, and manage, the risks of a no-deal exit scenario.
Professor Richard Ross and Dr Miguel De Bono outside the Royal Hallamshire Hospital with the research team
The guidance can be viewed at
www.tinyurl.com/y2plc4cd
NHS health information available through Amazon's Alexa
The NHS is collaborating with Amazon to provide reliable health information from the NHS website through voice-assisted technology.
The technology will help patients, especially the elderly, blind and those who cannot access the internet through traditional means, to get professional, NHS-verified health information in seconds, through simple voice commands. Amazon’s algorithm uses information from the NHS website to provide answers to voice
AUGUST 2019
questions such as: “Alexa, how do I treat a migraine?”
The technology has the potential to reduce the pressure on the NHS and GPs by providing information for common illnesses. Voice search has been increasing rapidly. By 2020, half of all searches are expected to be made through voice-assisted technology. NHSX will look at ways of making more NHS services available to all patients through digital technology. The announcement
supports the commitment in the NHS Long Term Plan to make more NHS services available digitally. Secretary of State for Health and Social Care Matt Hancock said: “We want to empower every patient to take better control of their healthcare and technology like this is a great example of how people can access reliable, world-leading NHS advice from the comfort of their home, reducing the pressure on our hardworking GPs and pharmacists.”
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