The London Assembly’s health committee recently published their report ‘Healthy minds, healthy Londoners: Improving access to mental health services for London’s Black, Asian and minority ethnic population’. This report summarises the committee’s review on mental wellbeing across London and the aims of their review were to:

• Examine the challenges facing people in accessing mental health services in London with a specific focus on young and Black, Asian and Minority Ethnic (BAME) individuals
• Explore and make recommendations on how the Mayor might support improved access to mental health services, particularly for young people and the BAME population in London

They found that over a million Londoners suffer from a mental illness at any one time and this affected their mood, physical health and their ability to work, study and develop and maintain relationships.  They stated that there is evidence to suggest that mental ill-health is more common in London than elsewhere in the UK. Additionally, they reported that mental health is a particular challenge in young people and the BAME community.

They highlighted that a major challenge is access to mental services with there being cultural and practical reasons why both young people and BAME individuals are reluctant to access mental health services in London. The health committee suggest that an effective way of increasing uptake of mental health services, particularly for young people, is for these services to become more integrated.  They state that many services are provided by multiple agencies and this is confusing for young people to navigate.

The health committee also stressed the need for mental health problems to be identified  and addressed as early as possible with a strategy and funding allocated to prevention and early intervention.

Seven recommendations were put forward to address the challenges that exist.

1. The Department of Health should commission a national mental health survey of children and young people at the earliest opportunity to update the 2004 survey. The Department, in response to this report, should set out its timetable for such a survey, and explain how it will address the needs of policy makers and commissioners in London – specifically around young people and Black, Asian and minority ethnic groups.
2. London boroughs and Clinical Commissioning Groups, supported by NHS England London and the Department of Health, should develop a more integrated approach to providing mental health services and support that will enable a shift in focus to early intervention and prevention provision, whilst greater pan-London strategic leadership should seek to facilitate greater cooperation across complex existing structures.
3. London boroughs, working with Clinical Commissioning Groups, should consider giving greater priority to children and young people’s mental health in local Health and Well Being Strategies when they are next refreshed.
4. Local Transformation Plans for Children and Young People’s Mental Health and Wellbeing – being drawn up by Clinical Commissioning Groups and others – must include ways to support the voluntary sector as a provider of mental health services for children and young people.
5. The NHS England Mental Health Task Force must examine ways to develop a sustainable model of community-based advocacy, as a means of improving access to mental health services and support for BME groups, in which the voluntary sector is an essential partner.
6. In response to this report, the London Health Board should set out an express commitment to a continued emphasis on mental health, in the confirmed areas of focus, to be agreed later this year.
7. In response to this report, the Mayor should set out what additional steps he (or a future Mayor) could take to promote good mental health in London, particularly with reference to London’s young people and Black, Asian and minority ethnic groups.

The Lake Foundation welcomes this report and its recommendations as there is an urgent need to address the mental health challenges the black community face.

You can download the full report below.

This week the UK’s Independent Cancer Task Force published its report ‘Achieving world-class cancer outcomes: a strategy for England 2015-2020’. In their report the task force sets out a number of recommendations but propose six strategic priorities for the next 5 years:

1. Spearhead a radical upgrade in prevention and public health
2. Drive a national ambition to achieve earlier diagnosis
3. Establish patient experience as being on a par with clinical effectiveness and safety
4. Transform our approach to support people living with and beyond cancer
5. Make the necessary investments required to deliver a modern high quality service
6. Overhaul processes for commissioning, accountability and provision

We welcome these recommendations as if implemented properly and with specific approaches for the BME community this will greatly benefit the black community who have been shown to have particular challenges when it comes to cancer. These include increased risk of prostate cancer, myeloma and cervical cancer in the over 64s; lower levels of awareness of symptoms; being more likely to be diagnosed at a late stage; and being less likely to access cancer screening services.

We were also happy to see in the full report that one of the recommendations focused on increasing BME representation in NHS England’s regular Cancer Patient Experience Survey. This will help create an understanding of why the BME community consistently report having a worse experience of care than their white counterparts.

We will monitor NHS England’s progress in implementing these recommendations and will play our part to ensure the black community benefits from this new strategy.

You can read the full report and executive summary below.

The British Medical Association (BMA) has recently published a report entitled Food for Thought which aims to provide recommendations on how to promote a healthy diet among children and young people. The report was conducted in recognition of doctors’ increasing concern about the impact of poor diet on the UK’s health with high levels of ill health and premature mortality which all significantly drain the NHS’s resources. The BMA’s report recommends the following:

Overall approach to diet-related ill health

• A strong regulatory framework should be central to the approach to reducing the burden of diet-related ill health in the UK, focused on interventions that limit commercial influences on people’s dietary behaviour and encourage healthy dietary patterns.

Improving attitudes and knowledge

• High-impact and sustained social marketing campaigns should be used to improve attitudes and knowledge about healthy dietary behaviour and the health risks of a poor diet.
• Local authorities should work with schools to achieve the wider implementation of the whole-school approach for promoting healthier diets throughout the UK.
• There should be adequate resources to support all healthcare professionals in addressing dietary behaviour where possible and clinically appropriate.

Restrictions on mass media advertising and other marketing communications

• Regulations should be developed to prohibit the marketing of unhealthy food and drink products to children and young people.
• The marketing of unhealthy food and drink products in schools should be prohibited.

Regulating industry practices and changing the retail environment

• The UK health departments should commission a review of how the regulation of sales promotions can be strengthened to ensure they favour healthy options and deliver public health benefits.
• Regulations should be developed that prohibit retailers from displaying and promoting unhealthy food and drink products at checkouts and in queuing areas.

The physical availability of unhealthy and healthy products

• Local authorities should be provided with the power to restrict the future number, clustering and concentration of fast-food outlets locally.

Food in schools

• Legislation should be introduced in England to ensure that mandatory school food standards apply to all academy schools and free schools.
• A free fruit and vegetable scheme should be available to all primary school children throughout the UK five days per week.
• Consideration should be given to extending the provision of free school meals in Northern Ireland and Wales to be universal rather than based on entitlement.

Hospital food standards

• The UK health departments should work together to develop and implement consistent and comprehensive hospital food standards, which should be introduced as a statutory requirement.

Other food available in the hospital environment

• The sale of all unhealthy food and drink products should be phased out in all NHS hospitals, supported by the development and implementation of UK-wide mandatory regulations.

Food standards in social care setting

• Nutritional standards should be developed and implemented for the provision of food in all care homes in the UK, and should be a statutory requirement.

Regulating the nutritional content of processed food and drink products

• A one-year target should be set for manufacturers, retailers and caterers to not produce or sell any food and drink products containing artificial trans fats in the UK.
• All manufacturers, retailers and caterers should prioritise action to systematically reduce salt levels in all food and drink products sold and produced in the UK.
• UK-wide targets, to be achieved by 2020, should be set for manufacturers, retailers and caterers to reduce calorie, fat, saturated fat and added sugar levels for certain product categories

Fiscal measures that favour healthy diets

• A tax should be introduced on all sugar-sweetened beverages, which increases the price by at least 20%.
• Consideration should be given to the introduction of fiscal measures to subsidise the sale of fruit and vegetables.

International cooperation on nutrition

• The UK Government should lobby for, and support the World Health Organization in developing and implementing an international treaty on food and nutrition in the form of a Framework Convention on Healthy Nutrition.

The BMA recognises that these recommendations will not sit well with the government strategy of working with the food industry and this is where organisations like The Lake Foundation can make a difference as we aim to work in the best interest of the public. We support these recommendations as they recognise the importance of making healthy eating more affordable and accessible whilst making unhealthy food less affordable and accessible. We believe this is very important as the black community is disproportionately affected by diet-related diseases such as diabetes and high blood, and thus these recommendations, if implemented, would be of great benefit to our community.

You can download the BMA’s complete report below.

In June, the Basil Skyers Myeloma Foundation officially launched their report ‘Listen Up!  – Multiple Myeloma in Black Communities: An Unequal  Burden’. This was a very interesting report that aimed to provide a comprehensive view of how myeloma (a cancer that starts in the bone marrow) affects the black community.

From their work the authors found that myeloma disproportionately affects the black population with black people being 2-3 times more likely as white people to be diagnosed.  Specifically,  this disease is a challenge for black men with black men having the highest incidence and mortality than any other group.  In addition, black people affected by myeloma are likely to develop it at a slightly younger age and are on average four years younger than white people when diagnosed.  The reason why myeloma is more common in the black community is unknown and the report stresses the importance of further research to fully understand myeloma and its effects on the black community.

The report makes the following recommendations:

1. The improvement of the collection and interpretation of data on myeloma including ethnicity data.
2. Race and ethnicity should be consistently taken into account in clinical research in order to inform the development of clinically and culturally appropriate healthcare services.
3. Studies should be commissioned to understand the differences in diagnosis, survival and mortality between black and white groups, and to understand the efficacy of treatments
4. Wider attention should be given by local authorities, clinical commissioning groups and other public sector partners to the specific  health needs of the black community.

This is an interesting report that clearly highlights how myeloma affects the black community and the steps that need to be taken to start addressing the inequalities that exist in this disease area. The Lake Foundation  will aim to play its part in assisting in addressing some of these issues.

You can read the full report below.

 

This week The Lake Foundation became a member of the Croydon BME Forum and thus will be part of a growing alliance of black community groups working together to improve the lives of the BME community in Croydon.

The Croydon BME Forum is the umbrella organisation for Croydon’s BME voluntary and community sector. It engages with members of the community, building capacity and promoting equality and cohesion. It was established to give the BME community a voice ensuring key issues affecting residents of Croydon are raised with decision makers.

Specifically the forum works to:

• Ensure that they are involved in local policy and decision making; regeneration and neighbourhood renewal.
• Facilitate joint-working among BME communities to develop best practice and provide a unified BME voice within local strategic partnerships.
• Promote networking, collaboration and partnership between the BME voluntary sector and mainstream agencies building their organisational capacities.
• Engage with BME communities in all aspects of Croydon life.
• Encourage good race relations, community cohesion and equality of opportunity for all throughout Croydon.

We’re looking forward to being a part of this forum and are already very impressed with the first event we attended which was a Meet the Funder session with the Big Lottery Fund. This was a very informative session that discussed what makes a good grant application.
For more information on the Croydon BME Forum please visit their website here

A study published in the journal Circulation has estimated the number of global deaths per year that are associated with sugar-sweetened drinks, what diseases sugar-sweetened deaths are linked to and where in the world these deaths are occurring. They estimated that 184,000 deaths per year are associated with consuming sugar-sweetened drinks and when they broke these numbers down by disease area most of the sugar-sweetened drink deaths were associated with diabetes  (133,000 death per year).  Cardiovascular disease was associated with 45,000 of these deaths and cancers 6,450.

The study also found that the majority of sugar-sweetened drink deaths occur in middle-income countries  (71%) whilst 24% of these deaths occur in high-income countries and 5% in low-income countries.

This is a very important study as it yet again provides more evidence of the effect of sugar on our health. It shows the clear need for all of us to reduce our sugar consumption and this is particularly important for the black community who are 3 times more likely to have diabetes and therefore are more likely to be affected by sugar-sweetened drink death.

This week the National Institute for  Health and Care Excellence updated its suspected cancer GP guidelines and in doing so hopes to provide GPs with clear guidance to facilitate early diagnosis and  therefore a reduction in cancer deaths.

The guidelines use a new approach that focuses on patients’ symptoms rather than a particular cancer.  This means that patients who have  symptoms that relate to multiple cancers will be  investigated more appropriately as their symptoms will be brought together to determine all the potential cancers it could be rather than just looking at one cancer.

These new recommendations hope to ensure that GPs act faster when a patient has specific types of symptoms and give clear steps on what a GP should do to make a prompt diagnosis.
This is good news for patients as it means that GPs will now look at all symptoms together to get a full picture of what’s happening to their patient rather than looking at symptoms in isolation. Ultimately this should mean less visits to the GP, a quick referral and hopefully an early diagnosis.

This week doctors representing the Academy of Medical Royal Colleges have written an article in the BMJ about the problem of overdiagnosis which is where “individuals are diagnosed with conditions that will never cause symptoms or death”. The article explains that overdiagnosis is a direct result of the medical profession aiming to achieve early diagnosis but this drive to ensure that we diagnosis more diseases earlier means that in some situations we are creating more harm than good.  Another consequence of endeavouring to ensure an early diagnosis is that many doctors are using treatments where there is no evidence of clinical benefit, just so they are seen to be taking action. All of this means that in many patients are treated unnecessarily, resources are being wasted and we’re increasing patient anxiety, for no reason.

The issue of overdiagnosis has been recognised worldwide with the formation of Choosing Wisely in Canada and the USA which aims to advance dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures. The Academy of Medical Royal Colleges in the UK will be launching a UK Choosing Wisely programme and have put forward to following changes that need to take place if this type of programme is to be successful in addressing over diagnosis and overtreatment.

1. Doctors should provide patients with resources that increase their understanding about potential arms of interventions and help them accept that doing nothing can often be the best approach.
2. Patients should be encouraged to ask questions such as, “Do I really need this test or procedure? What are the risks? Are there simpler safer options? What happens if I do nothing?”
3. Medical schools should ensure that students develop a good understanding of risk alongside critical evaluation of the literature and transparent communication. Students should be taught about overuse of tests and interventions. Organisations responsible for postgraduate and continuing medical education should ensure that practising doctors receive the same education
4. Commissioners should consider a different payment incentive for doctors and hospitals.

The Lake Foundation is happy to see Choosing Wisely being introduced in the UK and we look forward to seeing this project develop over the next couple of years.

For more information read the BMJ article here

Ovarian cancer can be a very challenging cancer to diagnose at an early stage because the symptoms are hard to recognise as they are similar to a number of non-serious conditions and have been described by many as “vague” and “non-specific” symptoms. Additionally, unlike breast cervical and bowel cancer there is no national screening programme for women because there currently isn’t a test that is accurate, specific and sensitive enough to be used as a national screening test.  This means that the majority of patients are diagnosed with late stage disease which is hard to treat.

This week scientists have published very encouraging data from a large 14-year study that shows that a test based on determining a woman’s CA125 (a protein found in the blood) profile is effective at detecting ovarian cancer. In fact it was found to identify 86% of ovarian cancers. This data could mean that we are one step closer to a screening test for ovarian cancer. The full data from the trial will be published at the end of the year and will tell us whether this test actually detects ovarian cancer early enough to save lives.

One of the lead investigators in this trial Prof Usha Menon said:

“These results are therefore very encouraging. They show that use of an early detection strategy based on an individual’s CA125 profile significantly improved cancer detection compared to what we’ve seen in previous screening trials.”

If the full results at the end of the year show that lives were actually saved through earlier detection of ovarian cancer, this will be one of the biggest breakthroughs in the detection of ovarian cancer and would for the first time enable a significant improvement in survival rates.

May is National Walking Month and organisers, Living Streets, are encouraging the general public to get out of their car, get off public transport and walk everywhere in an effort to get more active this month.

You can get involved in this fun campaign by taking part in the many activities that are planned for this month such asWalk to School Week from 18^th to 22^nd May and Walk to Work Week from 11^th to 15^th May. They have lot of resources to get you started such as a carbon buster calculator, walking report cards, walking tips, posters, flyers and an events calendar. Visit their website for more information.

Get involved for a fun way to get some exercise and improve your health. #WalkThisMay!