The Macmillan Information Materials Guide and the Directory of information materials for people with cancer have been designed to help those who work in the information field provide good quality, comprehensive and appropriate cancer information and support.

The revised Macmillan Information Materials Guide is a 'how to manage information materials' manual on all aspects of working with information materials from identifying needs; ensuring accessibility; choosing and managing cancer information; and developing new resources. Topics have been written as snappy colour-coded sections, with tips and sources of further information.

The Directory of information materials for people with cancer provides a source of reference to materials on treatment and living with different types of cancer. This new edition includes over 500 booklets and leaflets, plus an extended book section and international websites appraised by the Centre for Health Information Quality.

Both new resources are available free, one copy per service, from the Macmillan Resources Line: 01344 350310 or

www.professionalresources.org.uk/macmillan. The Directory is also available online at www.hfht.org/macmillan.

24 November, 2003
Visit
Education Secretary Charles Clarke and Food and Farming Minister Lord Whitty are to visit Thomas Fairchild School, Hackney, to see the school's catering operation.     The school sources much of its menu direct from farms in East Anglia, with an emphasis on nutrition and organic food.    Attendance at school meals has increased dramatically and produce and its origins is used as part of the curriculum.    The visit is timed to coincide with the first national conference on sustainable food procurement in the public sector, which is part of a cross-Departmental initiative launched by Lord Whitty in August.   Under the initiative, all Government departments and local authorities are reviewing their food purchasing taking into account wider Government objectives such as nutrition, environmental protection, animal welfare and local sourcing.

Hydrolysed infant formula prevents childhood allergies in high risk children
Research news from The Cochrane Library
Although breast-feeding is recommended to mothers as being the healthiest way to feed babies, it is not always possible. New evidence from a Cochrane review concludes that where exclusive breast-feeding is not possible for an infant, hydrolysed protein formulae in high-risk infants help prevent childhood allergies. Many young children who develop allergies don't have a family history of allergy. But, if a parent, brother or sister suffers from an allergy, a baby has a 1 in 3 risk of becoming allergic. The risk becomes as high as 2 in 3 if both parents suffer from allergic symptoms, such as asthma and hay fever. For those high-risk infants who cannot be exclusively breast-fed, specially adapted (hydrolysed) formulae, which were first developed to treat allergies, can be used to reduce this risk of developing allergic symptoms

In this new study , the results of eighteen separate pieces of research were brought together in a systematic review to determine whether hydrolysed protein formula had any positive effects compared to cow's milk or soy milk formulae. The hydrolysed formulae were shown to significantly lower the risk of allergies, including food allergy, asthma and eczema.   One of the authors of the Cochrane review, Dr John Sinn, said:

"By bringing together the worlwide evidence, we have shown how to reduce predisposition to allergies who cannot be exclusively breast fed. If they drink hydrolysed formula milk, instead of cow's milk or soy infant formulae, their chances of becoming allergic will be reduced."

Notes 
1. Osborn DA, Sinn J. Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants (Cochrane Review). In: The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd.
2. Systematic Reviews bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions. The Cochrane Collaboration is the world's leading producer of these reviews.

18 November, 2003
BMA urges Government to drop Foundation Hospitals from Bill
In a personal letter to John Reid, Secretary of State for Health, the Chairman of the BMA, Mr James Johnson, has called on the Government to drop the clauses on NHS foundation hospitals from the Health and Social Care Bill.

In his letter, the BMA Chairman says:
"When we met recently, I explained that the BMA is strongly opposed to the creation of NHS foundation trusts. I am in little doubt that their establishment will prove divisive, exacerbate inequalities in the NHS and encourage competition when there is an overwhelming need for cooperation and collaboration. Foundation trusts pose a real threat to the principles of equity and fairness on which, for good reason, the NHS has always been based. In addition, giving more power and a greater democratic element toproviders in principle appears to conflict with the aim of shifting power to commissioners and making primary care one of the government's priorities."

"The principle of the health service being accountable to the local population is admirable, but the proposed governance arrangements have not been thought through. Foundation trusts will not even be required to set up the new patient forums. It is unclear what responsibilities the board of governors will have, and what its relationship will be with the executive board. There is a danger that the only people to be elected to the board of governors will be those active in local special interest groups. It is entirely possible that less organised and less vocal groups in the community, including vulnerable groups who may have specific health needs, will be under-represented."

 "I urge you not to reinstate the clauses on NHS foundation trusts that were deleted in the House of Lords."

10 November, 2003
The coming flu epidemic
The Health Protection Agency believes that this winter could see the heaviest flu epidemic yet.

Following the deaths of two English children and three children in Scotland, Sir Liam Donaldson, Chief Medical Officer, sent a letter to all health care professionals on the 5 November (please see below), highlighting that after three relatively quiet years, influenza is appearing in communities somewhat earlier than normal seasonal patterns. The CMO is strongly emphasising the importance of immunising those over 65 and in the at-risk groups.

A brand new initiative; Westminster Flu Day, taking place on the 13th November, aims to publicise this call for action, with MPs and Peers receiving their winter flu jabs, leading their constituencies by example and supporting the Governments vaccination programme.

At a time when the flu season looks to be upon us, this timely initiative, aims to in order to prevent more deaths this winter by encouraging those at risk to get vaccinated. Presentations by a key member of the DoH and a leading GP and flu expert, highly involved in the monitoring of flu, will educate about the risks of flu, as according to the CMO, few realise that even in normal winters around 4,000 deaths are attributable to the complications of flu.

HEALTH AND SAFETY EXECUTIVE
HOW DO WE DETER EMPLOYERS FROM BREACHING HEALTH AND SAFETY IF NOT THROUGH PROPER ACTION AND TOUGHER FINES?
"More enforcement action in higher risk industries through the Health and Safety Executive's (HSE) more targeted inspection regime, aims to reduce instances of ill-health, serious injuries and needless fatalities. Why then do general levels of fines - the foremost deterrent - remain too low to deter companies from committing more serious breaches?" asks Timothy Walker, Director General of the Health and Safety Executive.  Prompted by the disappointing levels of fines published today in HSE's fourth annual Offences and Penalties report, Mr Walker continued: "It is incomprehensible that fines for especially serious big company breaches in health and safety are only a small percentage of those fines handed down for breaches of financial services in similarly large firms. I understand that financial service breaches can affect people's wealth and well-being, but breaches in health and safety can, and do, result in loss of limbs, livelihoods and lives."

The HSE's Offences and Penalties report provides details of enforcement action for 2002/03 and shows that 933 companies, organisations and individuals were convicted of health and safety offences. HSE targets its efforts on those risks and industry sectors that give rise to most injuries, instances of ill-health and deaths. The average fine for health and safety cases across the UK fell by 21 per cent, from #11,141 in 2001/02 to #8,828 in 2002/03 - partly because there were fewer of the larger fines. A copy of the Offences and Penalties report can be downloaded from the HSE website at: http://www.hse.gov.uk/off02-03.pdf

6 November, 2003
Health & Safety Executive
The HSE's Offences and Penalties report provides details of enforcement action for 2002/03 and shows that 933 companies, organisations and individuals were convicted of health and safety offences.  HSE targets its efforts on those risks and industry sectors that give rise to most injuries, instances of ill-health and deaths.   Enforcement has an important part to play and the most serious breaches face the toughest action. HSE issued a much larger number of improvement and prohibition notices in agriculture and construction this year - two of the Commission's priorities due to previously poor records in preventing accidents and controlling risks. This shows the determination of HSE inspectors to bring about improvements in the way serious risks aremanaged.

The average fine for health and safety cases across the UK fell by 21 per cent, from #11,141 in 2001/02 to #8,828 in 2002/03 - partly because there were fewer of the larger fines.   Speaking of the work of the HSE, Mr Walker commented: "The report shows the special attention HSE inspectors give to preventing serious risks in industries with poor records. Much of what HSE does is aimed at prevention, but enforcement has an essential part to play. In especially serious breaches, HSE will prosecute."

The Health and Safety Commission (HSC) Chair Bill Callaghan said: "The Government and HSC have set ambitious targets in the Revitalising Health and Safety strategy - designed to cut injuries, ill-health and deaths, by promoting partnerships with employers and others. The marked increase in improvement and prohibition notices shows HSE is pursuing the Commission's targets, which aim at preventing accidents and ill-health. However, society is poorly served, by inadequate fines that fail to mark the seriousness of health and safety convictions. Above all it is unfair to the businesses that are managing risks and safeguarding the health andsafety of their workforce."

4 November, 2003
Macmillan shows how to make cancer money pay
Secretary of State for Health, Dr John Reid will learn of Macmillan's four key recommendations for urgent Government action to make cancer money count for patients. This means not only getting money through to the frontline but also to services that make a difference to their daily quality of life.

There is at present a lack of transparency, widespread inconsistencies in how the money is allocated and tracked, poor investment in cancer services that improve the patient's experience and inadequate provision for meaningful patient involvement.

Only 11 out of 20 Strategic Health Authorities (SHAs) were able to provide details of their planned cancer spend for 2003-2004. Only five provided details for 2004-2005 and 2005-2006. In addition, where SHAs gave a breakdown of budget allocation, most of the money went on 'hard' targets, staffing, drugs and equipment - rather than improving quality of life for patients.

Macmillan is calling on the Government to:
· Commit to improving the way the NHS tracks investment in cancer services, institute a review and report its recommendations to Parliament within an agreed timeframe,
· Develop and introduce a mechanism for the routine and consistent tracking of investment in cancer services and progress made in improving the patient's experience,
· Require the NHS to publicise locally its plans for cancer services and how the investment is being spent,
· And ensure meaningful patient involvement in planning and tracking investment in cancer services at all levels, and measure outcomes through a new, improved National Cancer Patients' Survey.

1 November 2003
Self-testing by patients increases
A new report from Mintel claims an increasing number of people are opting for self-diagnosis and turning their backs on doctors.  In 2002 almost £55 million was spent on self-diagnostic products such as blood pressure monitors, blood glucose monitors and pregnancy tests. Five years ago this figure was just £40m. By 2007 Mintel expects this amount to rise to well over £60m.  Today 58 per cent of British people have at least one self-diagnostic product in their home. People aged between 25-34 are most likely to have three or more self-diagnostic products.