Casebook September 2023

Casebook September 2023

Posted: September 20th 2023


This month Covid, Alzheimers, 999 calls from within a hospital and a worrying escalation of levels of ill health in young people. Plus the Centre is close to unveiling its new Chair and releases a response to the NHS Long Term Workforce Plan. Read on!

Should we be worried about Covid this winter?

With a higher proportion of the most vulnerable groups in rural setting this article gives pause for thought. It tells us:

The nights are drawing in, the schools are going back and a new Covid variant is circulating. It all sounds very familiar.

But we are a long way from the autumn of 2020 when the coronavirus dominated our lives and there were different "levels" of lockdown across Scotland.

So, as we head into this autumn what should we expect?

Firstly, the new variant. EG.5 - dubbed Eris - is an offshoot of Omicron. The World Health Organization currently classifies it as a variant of interest.

The MRC-University of Glasgow Centre for Virus Research has played a key role in monitoring new variants of the disease throughout the pandemic.

Prof Massimo Palmarini, who heads the centre, says he is not too worried about what he is seeing but it is important that surveillance continues.

"The new variant doesn't seem to have dramatic differences from the previous one but it doesn't mean that it is not important," he says.

He says there is a concern that if surveillance is cut back too much it will be hard to predict which variants might emerge and which ones will be more worrying than others.

According to Scotland's national public health body the pandemic is now in a "quieter phase".

Full article:

Scientists discover how brain cells die in Alzheimer’s

The higher proportion of over 75s as a percentage in rural settings makes this an article of insights and interest. It reveals

Scientists in the UK and Belgium think they have figured out how brain cells die in Alzheimer's disease.

It has been a mystery and a source of scientific debate for decades.

But the team, writing in the journal Science, connect the abnormal proteins that build up in the brain with "necroptosis" - a form of cellular suicide.

The findings have been described as "cool" and "exciting", as they give new ideas for treating the disease.

It is the loss of brain cells, called neurons, that lead to the symptoms of Alzheimer's, including memory loss.

And if you look inside the brains of people with the disease you'd see the build-up of abnormal proteins called amyloid and tau.

But scientists have not been able to join the dots between these key traits of the disease.

This is what the researchers - at the UK's Dementia Research Institute at University College London and KU Leuven in Belgium - now think is happening.

They say abnormal amyloid starts to build up in the spaces between neurons, leading to brain inflammation, which the neurons do not like. This starts to change their internal chemistry.

Tangles of tau appear and the brain cells start producing a specific molecule (it's called MEG3) that triggers death by necroptosis. Necroptosis is one of the methods our bodies normally use to purge unwanted cells as fresh ones are made.

The brain cells survived when the team were able to block MEG3.

"This is a very important and interesting finding," researcher Prof Bart De Strooper, from the UK's Dementia Research Institute, told the BBC.

Full article:

Kent woman called 999 from hospital over care concerns

An astonishing story about the challenges faced by some residents experiencing secondary care particularly in smaller hospital settings.

A woman said she feared for her life after a nurse allegedly ignored a heart monitor showing her heart was beating irregularly.

Ava Stanley, 63, from Higham, Kent, was admitted to the Medway Maritime Hospital in Gillingham for chest pains last month.

She said she called 999 from her hospital bed to force the nurses to take action.

Medway NHS Foundation Trust apologised and said it was investigating.

Mrs Stanley said: "I actually called 999 from my bed because I really thought that I was going to die and I might not make it."

She said her heart rhythm became erratic before dropping to zero, causing the monitor alarm to sound.

Mrs Stanley added that it happened four times within a 40-minute period but each time "the alarm was ignored".

Full article:

Sick children’s health worsening as record numbers wait for NHS care in England

We don’t think enough about young people in rural settings but this article must be a real concern to rural places. It tells us:

Sick children’s health problems are getting worse as record numbers wait up to 18 months for NHS care, doctors treating them have warned.

The number of under-18s on the waiting list for paediatric care in England has soared to 423,500, the highest on record. Of those, 23,396 have been forced to wait over a year for their appointment.

Delays facing children and young people are now so common that Dr Jeanette Dickson, the chair of the Academy of Medical Royal Colleges, the body representing all UK doctors professionally, warned that children are “the forgotten casualties of the NHS’s waiting list crisis”.

Fewer than three-fifths (57%) of children are now seen within 18 weeks, even though NHS treatment targets say that 92% should be. The number on the waiting list has jumped by 52% since 2021.

Full article:

Patients Association's Patient Partnership Week 25-29 September 2023

Back by popular demand, Patient Partnership Week returns on 25th September 2023.

Join the Patients Association for a series of enlightening webinars featuring healthcare experts and patient advocates. Don't miss discussions on tackling health inequalities, enhancing outpatient experiences, social prescribing benefits, and more. Secure your spot now!

The Patient Partnership Week is packed with examples of how patient engagement improves outcomes for patients and the system. 

Already on the agenda are: 

All webinars are free to attend and held on Zoom. Follow the links to read more and book your place. 

AstraZeneca, Eli Lilly and Company and Novartis have provided sponsorship funding to support Patient Partnership Week and have had no input into or influence over any of the related activities.

NHS Long Term Workforce Plan Response

This week we published our response to the government’s NHS Long Term Workforce Plan, click here to read. We welcome the opportunities set out in the Plan but feel that there is a risk that rural areas could miss out. We stress the distinct challenges facing rural and coastal communities when it comes to health and call on responsible organisations to ensure there is not a ‘one-size-fits-all’ approach to their plans.

Our proposals include the development of Rural Clinical Schools which should recruit from local communities; links to or the creation of rural academic campuses; ‘in-reach’ attachments; universal opportunities for rural experience; and potential for additional rural qualifications.

We also state that special rural GP training programmes would promote the opportunities and benefits of a career in rural areas but appropriate training facilities and training, support and recompense for tutors will be needed. Shared-learning, flexible working practices and peer support, including use of comprehensive clinical networks, will also be essential in retaining health and care professionals.

Our response highlights the government’s focus on digital solutions and acknowledges the important role technology must play in this field. However, it highlights the connectivity issue in many rural communities and the growing digital divide in these areas.  The organisations responsible for implementing the NHS Workforce Plan have a great opportunity to tackle the longstanding rural workforce issues by adopting these and other initiatives.

Chair of the NCRHC, Jan Sobieraj says:

“With growing rural populations and associated ageing and morbidity, rural communities are often distant to services; their hospitals regularly struggle to recruit to characteristically small teams and experience greater costs by virtue of their size. This means rural communities can receive an inferior service to urban ones. However, rural primary care is uniquely placed to support the local health and care system but needs a new approach if their full potential is to be realised. Through enhancing these and other roles, we can harness and support health and care provision in rural communities.  This is an opportunity we cannot afford to squander.”

New Executive Chair

Following the retirement of Professor Richard Parish as our Executive Chair and Jan stepping up in the interim, we anticipate announcing a replacement at the beginning of October – watch this space!!!

Care Worker Pipeline

The Centre has become the recipient of a package of grant aid to work with Community Catalysts to develop a network of new micro-care businesses on the Lincolnshire Coast. We anticipate 40 micro care businesses staring up through the initiative over the next 2-3 years. The project will be housed in the Campus for Future Living our flagship capital project.