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Dr. Mary Ramsay and Dr Sema Mandal
Immunisation, Hepatitis, Blood Safety and Countermeasures Response
There is a global shortage of hepatitis B vaccine which is currently impacting severely on the UK supply. The situation is particularly critical during August but limitations on supply are likely to continue until early 2018. To ensure that stock is available for those individuals at highest and most immediate risk of exposure to hepatitis B, Public Health England (PHE) has developed temporary recommendations to support clinicians undertaking an individual risk assessment.
PHE and Department of Health (DH) have been working with both vaccine manufacturers to institute ordering restrictions according to customer type. The allocation is based on an agreed assessment of the proportion of vaccines used by that provider type for individuals in the highest priority groups. As a consequence, some providers may not be able to order any stock and others will have limits applied to their orders. A mechanism will be in place, however, to allow for exceptional orders if there is an urgent and immediate need for an individual following an individual risk assessment.
NHS Hospital Trusts will get the highest allocation, but it has been agreed with the BMA's General Practitioners Committee that general practice will not be able to order any adult hepatitis B vaccine stock until further notice. Because of this, patients requiring post-exposure hepatitis B vaccination will be referred to urgent care or Accident and Emergency based in NHS trusts for an assessment. In addition, specialist services such as liver services, who may normally request that GPs offer hepatitis B vaccination to their patients should note that the GP may not be able to meet this request.
To sustain supply for those at greatest need, all services are being asked to:
- ensure that clinicians are aware of the temporary recommendations on prioritising vaccines
- only order essential vaccine stock (small amounts more frequently) and avoid stockpiling
- coordinate and monitor stock usage across the service to ensure that scarce stock is being used responsibly
- accept and use alternative products including combined hepatitis A and B vaccines, and other presentations (e.g. multi-dose packs)
Download the full list of recommendations here > Download Hepatitis B vaccine shortage PHE letter.pdf
Highlights from last year's BASL Annual Meeting can be found in this months edition of the Clinical Liver Disease (CLD) Journal.
Read the 'Best of BASL’ papers, view video presentations of the articles and watch interviews with the Authors.
View the CLD Journal Volume here.
The latest version of the Royal College of Physician’s (RCP) Medical Care has been published today.
Medical Care is a web based planning resource produced by RCP in partnership with UK’s medical specialty societies. The updated version includes further information on workforce and medical specialty specific job planning and additional content on diabetes and endocrinology services.
Medical Care is a valuable resource for clinicians and managers working in the NHS. The resource provides support for:
· Designing services – this includes a short description of the specialty and the patient population, and a summary of the workforce needs to support service provision
· Developing physicians – which includes information on the education, training and continuing professional development, workforce and job planning for physicians
· Improving quality and medical leadership – By exploring the latest ideas on how to develop physicians and teams.
For queries please contact email@example.com.
The Lancet Commission into Liver Disease in the UK has published 'The Financial Case for Action on Liver Disease' report.
Read the report here; Download Financialcaseforactiononliverdiseasepaper.pdf
The alcohol section contains new data on the impact of minimum unit pricing, outlining that within 5 years of introducing MUP in England there would be:
• 1,150 fewer alcohol-related deaths
• 74,500 fewer alcohol-related hospital admissions
• Savings of £325.7m in healthcare costs
• Savings of £710.9m in crime costs.
Read the advice for managing patients with PBC who are unresponsive to UDCA below.
Following the Clinical Consensus on HCV Therapies 2017 meeting held in Birmingham on 30th June 2017, the BVHG/BASL/BSG/BHIVA/BIA/CVN Guidelines for management of chronic HCV infection report is now available to download.
Just days before the UK Supreme Court hears a case to decide whether introducing a minimum unit price for alcohol is legal, a survey published today shows that cheap, strong alcohol continues to be sold for pocket money prices up and down the country.
One year ago, a survey of alcohol prices across the UK found an abundance of cheap drinks being sold in shops and supermarkets, with high-strength cider available at the lowest prices.
A follow up review carried out this month in England, Scotland and Wales has found that these cheap prices remain largely unchanged, with products across the market still falling well below the 50p per unit mark recommended by health and alcohol bodies.
Both price reviews were carried out by the Alcohol Health Alliance UK (AHA), a group of medical royal colleges, alcohol organisations and health bodies. In this year’s review, the AHA found that cider continued to be sold at the lowest prices overall, with 3-litre bottles of 7.5% ABV cider (containing the equivalent of 22 shots of vodka) moving from £3.49 in 2016 to just £3.59 in 2017 (or 16p per unit).
At that price, for the cost of a small latte in Starbucks it is possible to buy more alcohol than the weekly recommended limit of alcohol.
The cheapest wine surveyed in 2016 was found to be even cheaper in 2017, and available for just 31p per unit.
Cheap, high-strength alcohol is known to be predominantly drunk by the most vulnerable groups, including children and the homeless, and a minimum unit price for alcohol of 50p per unit was passed by the Scottish Parliament in 2012, only to be held up by a legal challenge from sections of the alcohol industry. The Welsh government recently announced it will legislate for minimum unit pricing, and the Northern Ireland Executive has also expressed its desire to implement the policy.
The AHA said that today’s figures provide yet more evidence for the need for minimum unit pricing to be introduced across the UK.
Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:
“It is frankly unacceptable that it is possible to buy enough alcohol to exceed the new recommended alcohol guidelines for the price of a high street coffee. We need minimum unit pricing for alcohol so that the damage being done by the cheapest products to the most vulnerable in society can be brought to an end. We hope and expect that following the hearing on minimum unit pricing next week, Scotland will be given the green light to introduce the policy.
“With the recent announcement that the Welsh government also intends to legislate for minimum pricing, and a previous commitment to MUP from the Northern Ireland Executive, it is imperative that the UK government now legislates for MUP, so that England does not get left behind the rest of the UK. The Westminster government expressed its intention to introduce minimum pricing five years ago, but has still not delivered on this commitment.
“The evidence is clear – minimum unit pricing would save lives, reduce hospital admissions and cut crime. In addition, it would disproportionately benefit the poorest groups. Studies show that 8 out of 10 lives saved through minimum pricing would come from the lowest income groups.
“With alcohol-related hospital admissions at record highs, and liver disease rates on the rise, we can’t afford for alcohol to remain at such low prices.”
For further information, please contact Matt Chorley, the AHA’s Policy and Communications Officer, at firstname.lastname@example.org or on 0203 075 1726.
NICE are looking for experts on Black, Asian and other minority ethnic groups: promoting health and preventing premature mortality to join our Quality Standards Advisory Committee (QSAC).
• GP working with Black, Asian and other minority ethnic communities
• Health inequalities lead from Clinical Commissioning Group/Local Authority with a focus on ethnicity
• Community nurse working with Black, Asian and other minority ethnic communities
• Public Health consultant with a focus on ethnicity and health inequalities
• Local authority commissioner with experience of commissioning services for Black, Asian and other minority ethnic groups
Information on the posts is available on the NICE website here.
The deadline for applications is 4 August 2017 at 17.00.
The Royal College of Physicians (RCP) and NHS R&D Forum launches its new report Research for all: Sharing good practice in research management.
Following the publication of Research for all by the RCP in 2016 this follow up report outlines the conditions needed to support research directors, managers, clinical and non-clinical staff and, ultimately, patients.
By way of over 50 case studies the report builds upon the recommendations for collaboration and provides real world examples of good practice to inspire both doctors and researchers alike.
The examples of good practice from NHS organisations around the country aim to help build the knowledge base for all involved in research. By recognising and addressing barriers to pursuing research, the report encourages both doctors and R&D departments to underpin research as a core activity and demonstrate how it is everyone’s responsibility.
For more information please the RCP https://www.rcplondon.ac.uk/ .