Professor McLellan’s lecture ‘Prevention, Treatment and Science in the Obama Administration’s National Drug Control Policy’, was received by a packed audience of leading research, policy, treatment and recovery professionals, including Professor Dame Sally C Davies, Director General of Research and Development and Chief Scientific Adviser, Department of Health; Professor John Strang, Head of Addictions, IoP; Professor Shitij Kapur, Dean and Head of School, IoP and Stuart Bell, Chief Executive, South London and Maudsley NHS Foundation Trust.

Professor McLellan was accompanied on his visit to the UK by his Senior Policy Advisor Dr Keith Humphreys, who also holds an Honorary Professorship in addictions at the IoP.

Professor Strang said: ‘Professor McLellan is an esteemed colleague whose work has impacted far and wide. He has a particular ability to bring people together to promote dialogue - in the political arena, respectful and productive dialogue between scientist and policymaker.’

Evidence-based treatments

Professor McLellan described the rationale and scientific underpinnings behind the demand reduction components of President Obama’s national drug control strategy. The new strategy was designed to focus on gaps in current provision with the emphasis on prevention as opposed to the majority of effort being placed on those requiring intensive treatment. Professor McLellan highlighted available evidence-based treatments which were very effective but not being made use of. He also pledged that treatment and prevention would be placed in the heart of healthcare and the heart of the community. 

The three themes which pervade the proposed strategy - evidence-based interventions, community-level involvement and shared responsibility, inform a five-fold demand reduction initiative: create a national system of evidence-based “Prevention Prepared Communities”; train mainstream healthcare workers to screen and intervene in emerging substance abuse problems; expand and incorporate addiction treatment into mainstream healthcare; create protocols for safe management of drug-related offenders within the community; and collect and report performance-oriented indicators of substance use and use-related problems.

Professor McLellan was en route to represent the United States at the Commission on Narcotics Drugs in Vienna.

The event was organised by the Conference Consortium, DrugScope and Drug and Alcohol Findings and hosted by King’s Health Partners.

One of the most neglected areas of healthcare research is the effects of physical illness on an individual’s mental health. Research suggests that more than ten percent of patients suffering from physical diseases also suffer from depression. For reasons that are not entirely clear, depression may amplify the symptoms of physical disease and increase the risk of these patients dying. Studies suggest that doctors are less likely to prescribe antidepressants to people who are physically ill because they are unsure if they are helpful for these patients. Therefore, it is important to know whether antidepressants can be effective in people with physical illness.

The review included 51 studies comparing antidepressants to placebos. Most studies trialled selective serotonin reuptake inhibitors or tricyclic antidepressants. A total of 3603 patients were involved, suffering from physical illnesses including stroke, HIV/AIDS, Parkinson’s disease and cancer. The researchers found that antidepressants were more effective than placebos, although patients receiving antidepressants were more likely to experience adverse effects, including sexual dysfunction and dry mouth. For every six people receiving treatment, one more could be expected to benefit at between six and eight weeks if they were taking antidepressants.

Lead author Lauren Rayner of King’s College London said, “Although trials were small, they do seem to indicate a genuine benefit associated with antidepressants. However, patients with more severe physical illness and more severely depressed patients were not included in the trials. It is possible that those with more severe illness don’t respond so well to treatment with antidepressants. This is something that should be addressed in further studies.”

Senior investigator Professor Matthew Hotopf, Institute of Psychiatry, King’s College London added: “As a clinician I see many patients struggling with the effects of physical disease on their mental health. Doctors should take into account patients’ preferences, symptoms and possible interactions with any other medications they are taking when prescribing antidepressants to physically ill patients”. He concludes: “This is a critical area of research which will help doctors maximise a patient’s treatment and recovery from the mental and physical symptoms of illness.”

“This research is very important for millions of patients and families who are experiencing physical illness, including the most advanced stages of disease,” said Professor Irene Higginson, senior investigator and Head of the Cicely Saunders Institute, King’s College London. “Until now many doctors and nurses were worried that these treatments did not work well in people with physical illness. This result shows that they are usually of benefit. Already we are using the results to inform a new European Guideline for doctors and nurses on the management of depression.”

Full citation:

Rayner L, Price A, Evans A, Valsraj K, Higginson IJ, Hotopf M. Antidepressants for depression in physically ill people. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD007503. DOI: 10.1002/14651858.CD007503.pub2

IoP researchers, part of King’s Health Partners Academic Health Sciences Centre, produced a comprehensive review of current research into the mental health of health care professionals for the Department of Health’s Health of Health Professionals framework. The evidence from this report contributed to their new framework for frontline services, ‘Invisible Patients’, published today, to help organisations to develop services for clinicians with health problems to get prompt help without fear or stigma.  The report outlines seven recommendations for organisations to improve the health of health professionals, including the need for long term studies.

The IoP review highlighted a number of areas of concern including higher rates of depression, anxiety and substance misuse in health professionals than in other groups of workers.  Health professionals were less likely to seek help for problems and there was a culture of ‘presenteeism’ - coming to work and performing at less than full capacity as a result of ill health.  Risk factors for mental ill health were identified in the way health services were structured at an individual and organisational level.

Matthew Hotopf, Professor of General Hospital Psychiatry and co-author of the report said:

“We know many of these conditions influence performance and can impact on the quality of care provided to patients. One of the problems is that health professionals do not seek treatment soon enough - we need studies to identify effective interventions which can be employed at an early stage.

He continues:  “Furthermore, there is a need for more research to establish how the individual and workplace risk factors interact to see which affects which. Specialised services should be developed to offer health professionals confidential and accessible help.

He concludes: “Nurses particularly are under-represented in research.  As the single largest group of employees in the NHS they should be a priority.”

Professor Robert Lechler, Vice-Principal (Health) and Executive Director, King’s Health Partners said:

“King’s Health Partners welcomes the government’s ‘Invisible Patients’ strategy.  The NHS is the largest employer in Europe and has a duty of care to staff and patients.  Additionally, investment in research would lessen the cost to the tax payer through health professionals’ sickness absence and presenteeism.

“King’s Health Partners has a track record of world-class research in this area and is uniquely placed to conduct long term studies into the health and well-being of different groups of health professionals in different health care settings.”

King’s Health Partners Academic Health Sciences Centre (AHSC) is a pioneering collaboration between King’s College London, and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts.

To view The Mental Health of Health Care Professionals please click here:  http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_113540

For further information:

1. Institute of Psychiatry King’s College London Louise Pratt 020 7848 5378 louise.a.pratt@kcl.ac.uk www.iop.kcl.ac.uk
2. King’s Health Partners Kami Paulson or Clair McInally 0207 188 4043/4058 Email: kingshealthpartners@kcl.ac.uk http://www.kingshealthpartners.org/khp/

The King’s Health Partners name and visual identity - a rainbow representation of genetics and the multi-cultural people of London - supported by the phrase ‘Pioneering better health for all’ - is truly ground-breaking in its field.

Sally Lingard, Director of Communications at King’s College Hospital NHS Foundation Trust, commented; “We wanted the King’s Health Partners brand to be distinctive in both the academic and healthcare fields and to reflect the values of the organisation - its unique population and its bench to bedside translational research approach.  Further’s design, with its references to DNA, was a perfect fit and will definitely help build awareness of our new Academic Health Sciences Centre. ”

Further’s client partner Chris North commented; “King’s Health Partners is a uniquely comprehensive Academic Health Sciences Centre. We are proud to have created an equally powerful and unique brand for this great organisation.”

For further information about the Transform awards visit: www.communicatemagazine.co.uk

Ends

Notes to editors

For more information, please contact Anna Mitchell at Further on 0207 543 2000 or email: anna.mitchell@furthercreative.co.uk or Kami Paulson at King’s Health Partners on 020 7188 4058 or email: kingshealthpartners@kcl.ac.uk

King’s Health Partners

King’s Health Partners Academic Health Sciences Centre (AHSC), is a pioneering collaboration between King’s College London, and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts.

King’s Health Partners is one of only five AHSCs in the UK and brings together an unrivalled range and depth of clinical and research expertise, spanning both physical and mental health. Our combined strengths will drive improvements in care for patients, allowing them to benefit from breakthroughs in medical science and receive leading edge treatment at the earliest possible opportunity.

For more information, visit www.kingshealthpartners.org

About Further

Further is the new name for the recently merged branding and reporting agency, FHD, part of Fishburn Hedges Group, and specialist corporate reporting firm, Pauffley.  Aiming to help clients go further by communicating better, Further builds brands, reports on performance and makes communications work harder for many leading businesses and public sector bodies.

About the Fishburn Hedges Group

The Fishburn Hedges Group includes Further, corporate PR business Fishburn Hedges, consumer PR business Seventy Seven and digital marketing agency Brew.  It is a wholly-owned subsidiary of advertising and marketing services group Abbott Mead Vickers Group and of Omnicom, the US-quoted communication group. The firm has achieved a top 20 placing in the Financial Times’ ‘Best Companies to work for’ for each of the last seven years.

For more information about Further, please see www.furthercreative.com

Clinical research is often costly and slow. It is difficult to find suitable subjects and time consuming to follow them up. TRANSFoRm will facilitate both these activities using routine healthcare data.

Robert Lechler, Vice-Principal (Health) and Executive Director King’s Health Partners comments: ‘TRANSFoRm is an informatics project that helps achieve the aims of King’s Health Partners to increase the amount of clinical research taking place in South East London, particularly in general practices. 

Professor Brendan Delaney, the Guy’s and St Thomas’ Charity Chair in Primary Care Research is the project lead as well as a practising GP in London. Professor Delaney says: “TRANSFoRm is an informatics project that helps achieve the aims of King’s Health Partners to increase the amount of clinical research taking place in SE London, particularly in general practices.”

TRANSFoRm will demonstrate the use of routine healthcare data in clinical research using two exemplar problems, one in the management of Gastroesophageal Reflux Disease, the other in Diabetes.

Supporting diagnosis in General Practice

The project will aid General Practitioners in diagnosis by integrating decision support directly into their electronic records systems.

Dr Olga Kostopoulou (Senior Lecturer) will be studying how different types of diagnostic prompts and alerts might influence the diagnostic performance of GPs. King’s College London and Birmingham University will be developing a generic interface to allow GPs using different record systems to use TRANSFoRm, seamlessly integrated into their existing system.

Dr Kostopoulou says: “Prompt diagnosis is a fundamental task for GPs, as they are in many countries the gatekeepers to specialist care and see patients with early disease. The challenge is to identify patients with serious disease such as cancer or heart disease without over-investigating the much larger numbers of patients without serious disease. The symptoms and signs of serious disease are often non-specific and can be attributed to more common and less serious conditions.”

Peter Hewitt, Chief Executive of Guy’s and St Thomas’ Charity said: “We are delighted that the Charity’s support is enabling Professor Delaney and his team to spearhead such significant work in the field of health informatics. These two initiatives will not only improve the level of care provided to patients, but will also drive the scale and quality of primary care research across Europe.”

Online provision is required for those who, for whatever reason, are unable to access training via traditional routes and wish to continue their employment as a dental nurse. To provide a viable alternative to traditional teaching methods, the course was developed to meet the Quality Assurance criteria set out in the NEBDN standards document. This was successfully achieved and Provisional Accreditation* was awarded by NEBDN in 2009.

An initial pilot of the programme provided training for six DDS employed civilian dental nurses who successfully completed the course. To date five of the six participants have entered NEBDN National Certificate examination. The results of the examination were received in January 2010, and we are pleased to be able to report that a 100% pass rate was achieved. This outcome is considered to be a great credit to the programme participants and confirmation that the online programme developed by KCH DNETC may be found to be highly effective.

Clare Roberts, the course co-ordinator and Head of Research and Development at DNETC, commented, “We are thrilled with the success of the online course and proud of the 100% pass rate achieved. To be the providers of the first online course leading to the NEBDN National Certificate and to achieve such a success is excellent. The second cohort of 20 students are already enrolled and participating online and we hope their success is as great as that of the first group. Other online courses for dental nurses have already been developed and are available via the Dental Nurse Education & Training Centre.”

For further information please visit www.kch.nhs.uk/dnetc/

*Provisional Accreditation - Training providers in their first year of offering the National Certificate for Dental Nurses are required to submit documentary evidence to meet the majority of the standards listed in the NEBDN’s standards booklet. For provisional accreditation, providers do not have to produce evidence of annual evaluation, action planning or examination pass rates.

This event is taking place in the Lilac Room at Avonmouth House, 6 Avonmouth Street, London SE1 6NX from 6pm to 9pm on Thursday, 25 February 2010.

Please find attached an invitation with the programme for the day.

Renewing an existing 10 year partnership between THET and King’s College Hospital NHS Foundation Trust, (one of the founding members of King’s Health Partners) this new partnership will allow King’s Health Partners and THET to take steps to develop further their shared agenda and create a new centre of activity within King’s Health Partners.

The new partnership aims to expand delivery of the ‘Health Systems Strengthening’ work, as well as to promote greater involvement of younger members of the health profession by creating further opportunities to be engaged in and learn about global health.

The launch saw guest presentations and speeches from representatives of the existing partnership organisations as well Edna Adan Ismail, former Foreign Minister for Somaliland and Professor Christopher Whitty, Chief Scientific Advisor and Director of Research at the Department for International Development.

The event was held at the Weston Education Centre based on the King’s College Hospital site, which will now be the home of the Somaliland team from THET, to strengthen the joint working on this partnership.

Robert Lechler, Executive Director of King’s Health Partners said; “We view Global Health as an important part of the work we are doing across clinical care, research, and education and training. As an Academic Health Sciences Centre, we aim to influence healthcare both nationally and internationally. This new partnership with THET will play a key role in our aspirations to be a leader in global healthcare education, and is soon to form part of a wider Institute of Global Health Education and Training at King’s Health Partners.”

Pia McRae, Chief Executive at THET said; “We are delighted to be extending our collaboration with King’s Health Partners, following ten years of successful partnership in Somaliland supporting both the training of health professionals, as well as the development of a health infrastructure.  We share some key values with King’s Health Partners including an interest in how to support UK health professionals in providing service to developing countries through working alongside (and at the request of) overseas colleagues.  Going forward, we aspire to build on our shared commitment to increasing the understanding, education and awareness of UK health sector students, as well as staff, in global health issues and the needs of developing countries.”

Andy Leather, Director of the King’s International Development Unit, King’s College Hospital NHS Foundation Trust, added; “King’s College Hospital have had a long standing relationship with THET and I am excited that this extended partnership as King’s Health Partners will not only further strengthen the capacity building and educational work in Somaliland but will also catalyse research partnerships with institutions there.”

• To view the presentations from the event, visit our Presentations page
• To listen to podcasts from the event and to view King’s THET Somaliland Partnership video, visit our Audio & Visual page

Prof Beverley Hunt, Clinical Lead in Blood Sciences, won the £2,500 award in the ‘Diagnostics/Laboratory’ category.  She has developed a test to diagnose antiphospholipid antibodies that can cause blood clots in the arteries and veins and miscarriage in pregnancy. This is based on a finding her team made that blood from patients shows resistance to heparin in the test tube. 

Professor Beverly Hunt explains: “I am delighted that our work has been recognised by NHS Innovations London.  Being able to better detect antiphospholipid antibodies is crucial to the better management of patients.  We hope our work will result in a new diagnostic test that is simple to perform, reliable and cost effective, and will impact on patients with antiphospholipid syndrome, and be transferable across the whole of the UK to increase the quality of patient care.”

Dr Mohammad Ibrahim, Consultant and Lead Immunologist at King’s, was victorious in the Pharmaceuticals/Drug Delivery category, which NHS judges admitted was ‘extremely hard fought’. Dr Ibrahim has developed a new method which uses genetic engineering to combine proteins in order to create a novel therapy. It is hoped the idea could form the basis of a new immunological treatment and/or technology platform for protein drug delivery.

Dr Ibrahim said: “I am honoured our efforts at King’s have been recognised by NHS Innovations London. I hope that our innovation will accelerate development of better drugs to treat chronic inflammatory diseases.”

Professor Frank Walsh, Director of research and development at King’s Health Partners said: “I am very pleased that my colleagues have received these prestigious awards.  Innovation and translation in research is at the heart of King’s Health Partners and these two awards demonstrate real advances.  Patients will benefit immediately by having a more accurate diagnosis from Professor Hunt’s work and access to innovative new treatment trials in Dr Ibrahim’s work.”

The collaboration, made up of around 30 organisations, forms the South London Health Innovation Education Cluster (HIEC) - one of the new government funded networks aimed at delivering high quality patient care through better trained clinicians and faster translation and adoption of research and innovation.

South London HIEC brings together members of south London’s two major healthcare networks - King’s Health Partners Academic Health Sciences Centre and the South West London Academic Health and Social Care Network. This includes all south London’s primary care and mental health trusts, 17 NHS hospitals, the London Ambulance Service and the local Health Protection Unit, as well as six universities, further education providers and social care teams.

Members of the HIEC will work together to improve patient care and local health services by more rapidly delivering the benefits of research and innovation directly to patients, for example through the early adoption of new technologies and introduction of improved processes. Early work will include a review of current education and training aimed at health professionals across south London and is expected to lead to the introduction of new programmes, as well as enhancements to existing training courses.

The South London HIEC has identified four areas to focus on initially: mental health; infection prevention and control; diabetes, and stroke.

The new HIEC will be jointly led by King’s Health Partners Academic Health Sciences Centre and the South West London Academic Health and Social Care Network.

Commenting on the successful bid, Professor Anne Greenough, Lead of the South London HIEC and Director of Education and Training for King’s Health Partners said: “We are delighted that our bid was successful, as we believe it will bring many benefits for our local population, as well as for patients from further afield. Our successful bid is testament to the comprehensive range of world class expertise that exists across south London in education, health and social care.”

Director of South West London Academic Health and Social Care Network, Laurence Benson, adds: “South London is home to around three million people and includes some of the most affluent, as well as some of the most deprived, neighbourhoods in the country. This diversity brings unique challenges to the local services who are committed to meeting the needs of the population they serve. But we’re lucky to have the commitment of first class researchers, working alongside exceptional doctors and nurses, to devise and deliver new solutions - the HIEC’s job is to put these solutions into practice and deliver real benefits to local people.”

The Department of Health announced successful HIEC applications following a rigorous selection process, including a formal interview by the National Award Panel chaired by St Alan Langlands.