Connect with us

Primary Care

Flu: why this year’s outbreak is one of the worst



The UK is being hit with one of the worst flu seasons in recent decades. A total of 664 hospital admissions and 85 confirmed deaths have been reported since the beginning of winter 2017.

The British media have blamed “Aussie flu” for the outbreak. The truth is, there is not just one flu strain we should be worried about, and “Aussie flu” is a bit of a misnomer.


First, a bit about flu strains. There isn’t really a flu virus. Flu virus is a name we give a group of four closely related viruses: influenza A, influenza B, influenza C and influenza D. While humans can’t catch influenza D (that’s for pigs and cows), we can be infected with influenza A, B and C. Public health officials, however, are less worried about influenza C as it isn’t a major cause of illness. But influenza A and B are a real worry.

Influenza A has been found in – and causes disease in – lots of animals, including birds, bats, dogs, pigs and penguins. One of the major worries is pandemic influenza, where a new virus jumps from animals and spreads across the world easily because we haven’t had a chance to build up immunity to that new type.

Influenzas A and B can be subdivided even further by the proteins they carry on their surface – hemagglutinin (H) and neuraminidase (N). These proteins help the virus identify the right cells to infect.

For influenza A there are 18 Hs and 11 Ns identified so far. Hence we get names such as H1N1 for swine flu or H5N1 for bird flu. Contrast this with the fact that there are really only two lineages of influenza B, named after cities in Japan and Australia: Yamagata and Victoria, respectively.

The Hs and Ns are continuously evolving in response to our immune systems, which recognise and make antibodies to stop the virus taking hold. A vaccine usually supplies the H and N proteins without the potentially dangerous virus. Scientists also continuously track the H and N of circulating influenza viruses and adjust the vaccine to match what’s out there. This is the basis for flu vaccination and why you have to get a new vaccine jab every year.


Enter ‘Aussie flu’

“Aussie flu” refers to one kind of influenza A virus strain, the H3N2 strain.

The southern hemisphere, including Australia, just experienced one of its worst influenza seasons in recent history and this is the virus that has reached British shores. But we don’t actually know where the virus originated from. All we can say is, it probably wasn’t from Australia.

One place it is more likely to have come from is the sub-tropical regions that do not have winter seasons. These regions do not suffer from the same large flu epidemics that temperate countries like the UK and Australia have (we don’t know why, but some scientists have suggested it’s to do with temperature or humidity), but have continuous lower-level circulation of flu that allows influenza viruses to persist between winters.

What’s worrying about this season is the experience Australia had last flu season. Australia was hit particularly hard by influenza virus H3N2. H3N2 is a typical seasonal flu strain – like H1N1 – but it tends to be more difficult to control.

There are three red flags this flu season, and they are that H3N2 viruses typically causes more hospitalisations and deaths in older people, there are difficulties in producing effective H3N2 vaccines (explained below), and there’s more than just H3N2 to consider, especially in the UK this year.

Although good against the other strains, this season the vaccine is about 20% protective against H3N2 viruses (not great, but better than nothing) as the virus changed unavoidably during production. This is due to a quirk of how flu vaccines are produced. They are grown in chicken eggs, and then inactivated before being used in vaccines.

Flu viruses mutate quickly and they mutate to adapt to their environment. Of course, a chicken egg is a different environment to a human body, so the end result may be a virus that’s not best suited to a flu vaccine. This appears to have been what happened with the latest H3N2 vaccine.

Seasonal flu epidemics are usually caused by a mixed bag of viruses. This year, the mix is so far mainly shared between H3N2 and influenza B.

What’s worse is that this increase in proportion of influenza B makes it more difficult to protect from because the most popular vaccine in the UK is a “trivalent” that protects against three flu viruses (H1N1, H3N2 and one of the two kinds of influenza B). This year, though, the other type of influenza B (Yamagata) is more common meaning that those with the trivalent vaccine will be protected less, although they would likely get some cross-influenza B protection.

One vaccine to rule them all

Influenza is incredibly diverse. And this diversity can have devastating consequences for human and animal health. Although our ability to track flu, predict the viruses making up the next season and produce safe and effective vaccines is improving, we are always playing catch up. Efforts to produce a universal flu vaccine are, however, being pursued by scientists across the world. The idea would be that a single vaccine given a few times during your life would protect you from any flu virus, irrespective of H, N, A or B.

The ConversationBut, until then, you can defend yourself and your loved ones from the flu this year by getting your vaccine, practising good personal hygiene, such as handwashing, and avoiding crowded spaces if you are experiencing flu-like symptoms.

Connor Bamford, Virologist, University of Glasgow and Julien Amat, PhD Candidate, University of Glasgow. This article was originally published on The Conversation. Read the original article.
Continue Reading


Cancer patient forced to sleep in “consultation room” because of bed shortage



The recovering cancer patient was forced to sleep in a hospital “consultation room” due to a bed shortage.

Martyn Wells, 49, was placed in the cramped windowless room at Birmingham’s Queen Elizabeth Hospital last Wednesday – just hours after having a total gastrectomy, an operation which removes the stomach.


The IT Director and father of four has been battling cancer since he was diagnosed with stage four malignant melanoma earlier this year.

Mr Wells tweeted a picture of his cupboard to Health and Social Care Secretary Jeremy Hunt but is still yet to get a reply.

Image: Martyn Wells

In a statement on social media, Mr Wells Said; “Cupboard. I woke up in a cupboard. So I lie here typing this, surrounded by cannulas, stoma bags and other accessories.

“A team of ninja nurses burst into my room in the small hours, told me gently I was being moved and wheeled me into another dark haven. 


“Waking this morning I find my new location is a cupboard. Are things SO bad in our great health service that they have to move stage IV cancer patients into a cupboard? Whatever happened to patient dignity?
I’ve been told to use the staff toilet and have no access to any washing facilities. The staff toilet is 50 metres up the main corridor; handy when you’re on an overnight drip feed and have been given laxatives.

“I’m going home. There’s no reason for me to be here now; half my staples were removed yesterday and I’m pretty sure I have all the tools I need in my new room to remove the rest. I can run my own food pump, have received dietician advice and my blood results are trending back to normal so I’m getting discharged. It’s going to be a long and careful convalescence but I’m sure it’s now the best place for me.
I’m trying hard not to moan as I am genuinely grateful just to be alive but I’ll be glad to get home as there is something very wrong with the bed management in our hospitals.”

A spokesman for the University Hospitals Birmingham NHS Foundation said: “We are sorry Mr Wells is unhappy with his situation.

“The trust has a standard operating procedure for capacity escalation and a full capacity protocol which are strictly followed to ensure the safe care of all of our patients.

“When a ward reaches maximum capacity a patient who is clinically fit for discharge may be moved into a consultation room to allow another patient with clinical needs to be transferred onto the appropriate ward.

“The consultation rooms such as the one occupied by Mr Wells are fully equipped clinical areas and are used to support capacity management across the hospital.

“The dignity and safe care of all of our patients remains our priority.”

Mr Wells is set to walk the length of the River Severn in ten days in September to raise money for Macmillan Cancer Support. His fundraising page can be found here.

Continue Reading


Why Work In A Care Home?



It is well documented that the UK is on the brink of a Social Care crisis. There is a lack of healthcare workers and nurses wanting to work in residential settings, with people seeming to favour the acute hospital environment.


Sharon Allen, chief executive of Skills for Care, the employer-led workforce development body for adult social care in England, agrees that recruitment and retention is “the number one issue for the sector”.

There are 60,000 vacancies in adult social care on any one day.

Contrary to the popular belief that this type of job is not rewarding and job satisfaction is low, I would like to talk about why I loved working in a care home.

Why I Loved Working in a Care Home

I worked as a Carer, a Registered Nurse and Home Manager in a busy nursing and residential home for many years. The main reason I loved working in a care home was that the residents became our extended family. 

Some of our residents had lived in the home for years and with that, we were able to get to know people really well. Some residents did not have loved ones or even visitors, and as staff we filled that role.

I enjoyed coming to work to see familiar faces and had a genuine bond with our residents; working in a hospital with a fast turnover of patients makes it difficult to get to know people as well.


Furthermore, I used to enjoy building a relationship with the families of our residents too.

I understand how hard it is for them to leave their loved ones in our care. Knowing that family members trusted us to look after them made us feel valued and appreciated. 

Special Occasions with our Residents

Working in a care home is very sociable. We are effectively working in people’s homes and it is important to ensure that we maintain a homely feel that is less formal than that of acute environments.

Care home staff are able to share special occasions such as Birthdays and Christmas with their residents and make these events meaningful.

I can recall many Christmas mornings when we would sit with the residents in the day room and open presents together in the same way that families sit together and open gifts.

We cared for one lady who had lived with us for many years who did not have any family. Several of the staff members used to buy her a gift so that she had presents to open on Christmas morning.

I can recall many trips and events I was involved in at the Care Home. Some of the favourites being a trip to the Zoo, going to Blackpool Illuminations and the Christmas Church services.

Critical Clinical Skills Required

Older people often have a range of medical conditions. Working in a care home means that staff need to have excellent clinical skills to be able to look after people with frequently complex care needs. 

Many older people do not want to go into hospital and want to stay in the care home for their treatment. This dispels the myth that care home nurses lose their clinical skills. I believe that they need them more than ever.

Finally, working in a care home means that sadly sometimes we have to say goodbye to our residents. Having looked after somebody whether for a short time or a long time makes it hard for staff when a resident passes away. When someone is dying, I consider it a privilege to be able to sit and hold their hand and support them and their loved ones through such a difficult time in their lives.

For all of these reasons, I found working in a care home to be the most rewarding role I have had.

It can be tough. There are many pressures facing social care, but if you can go to work and make a difference to your resident’s lives there is nothing more rewarding than that.

Written by Claire Bailey, Registered Nurse and Clinical Operations Manager at AutumnCare.

Continue Reading

Primary Care

Pioneering price match scheme frees up millions for frontline care



Doctors have freed up millions of pounds to fund frontline care by banding together to create a pioneering ‘price match’ scheme.

The scheme will drive down the cost of simple items such as anti-embolism stockings and surgical gloves.


The clinician-led scheme in Sheffield saw staff and patients work closely across seven hospitals to agree on the best product and commit to bulk buy jointly to save money.

The hospitals had been using a variety of brands and paying different prices for the same products which all did the same job.

Evaluation of the products takes place to ensure there is no difference in the standard of care for patients as a result of a switch to the most cost effective product and robust opportunities for staff to make any concerns heard are in place.

By committing to buy a larger quantity of product thanks to the collaboration, 11 products were changed leading to savings of £2 million, including a saving of £400 thousand alone by switching to one type of examination glove.

Professor Des Breen, clinical lead for the South Yorkshire Integrated Care System, said: “It was just a no-brainer to keep using products we knew were the same quality as others we could buy for less purely because each department procures them individually.


“We knew we had to take advantage of buying for all the hospitals at the same time; it was a lot of work but well worth it when we think of all the extra services we can use that money to provide for patients.”

A scoring system was used on all of the products to make sure that they met the high standard needed for use by the NHS and the product which met all of these and was deemed the best value for money was chosen.

Further opportunities to use the process to make savings on other products are being scoped out and other areas across the country are considering using South Yorkshire’s approach.

Michael Macdonnell, director of system transformation at NHS England, said: “The South Yorkshire programme demonstrates how neighbouring hospitals can team up to improve clinical quality and reduce waste, working together as integrated systems. It also shows what can be achieved when clinicians take charge.

“But perhaps most impressive is that the team has already saved £2m which can now be reinvested into better patient care.”

Continue Reading