NHS nurse who challenged trans doctor over female changing rooms cleared
'This follows a disciplinary hearing on June 25, which considered four gross misconduct allegations: two relating to patient care failures, one of 'misgendering' Dr Upton, and one relating to her encounter with Dr Upton in the workplace female-only changing room on Christmas Eve 2023.
'Sandie is relieved and delighted that this 18-month-long internal process has concluded and cleared her of all allegations.'
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The Independent
22 minutes ago
- The Independent
Shop-bought health tests not always fit for purpose, researchers warn
Off-the-shelf health tests for issues such as high cholesterol, vitamin deficiency, fertility and prostate problems may not be fit for purpose, researchers have warned. A team from the University of Birmingham examined tests that people can buy in UK supermarkets, pharmacies and shops and which they then use at home. They found the tests risked giving people the wrong result, could delay diagnosis, and most of them recommended follow-up with a doctor anyway, regardless of the result. The researchers called for much tighter regulation of the sector, adding the NHS may face additional demand after people self-test. They said: 'In the absence of guidance from healthcare professionals, individuals might use tests inappropriately or without a clear understanding of the implications of the results. 'False positive test results can lead to unnecessary anxiety, increased healthcare usage, and additional costs, whereas false negative test results may delay appropriate treatment or engagement with… screening programmes. 'Test errors can stem from inherent limitations in the accuracy of the test, as well as user-related issues such as sampling errors, incorrect processing, and difficulties in interpreting the results.' However, the team said that in the future, home tests could have great potential for patient care. The Medicines and Healthcare products Regulatory Agency (MHRA), which regulates medical products, said it would look at the findings. Professor Jon Deeks, from the University of Birmingham, said: 'A plethora of new health self-tests have emerged in recent years and are available to buy from many high street supermarkets and pharmacies in the UK. 'While these kits have been approved for sale, they are not subject to the same stringent regulations as pharmaceutical products. 'Our recent research raises concerns about the suitability, accuracy and usability of many of the self-testing products available that require users to sample, test and interpret results themselves. 'In some cases, it is unclear how accuracy claims are supported, and there is no requirement of manufacturers to share the evidence behind these claims.' Prof Deeks said the UK is looking at a 'new world' when it comes to self-testing, but there is more work to do to show claims made were robust. He said much of the literature contained with tests was 'not easy to understand', while some of the results could lead to a 'wrong diagnosis'. In one example, he said the self-tests for prostate-specific antigen (PSA) levels, a marker of prostate health, were fixed at a certain concentration level. However, 'if you're age 70 you need to have your PSA done at a very different level to when you're 20', he said. Self-testing is becoming increasingly popular, and the UK market for self-tests is expected to reach £660 million by 2030. Overall, 30 self-tests costing £1.89 to £39.99 were included in the study, published in the British Medical Journal (BMJ). The tests covered 19 different conditions, including vitamin deficiency, blood sugar levels, cholesterol, thyroid function, prostate health, HIV, menopause and bowel cancer. Researchers said only eight of the 30 tests provided information about who should or should not use the test, while four specified the presence of symptoms. External packaging on fewer than half of the tests (14) included any statement about their accuracy. Meanwhile, 90% of the tests recommended follow-up with a healthcare professional if test results were positive or abnormal, while 47% recommended this if test results was negative. Accuracy claims were made for 24 of the tests, including in pamphlets, and most (58%) claimed a performance of at least 98% accuracy, sensitivity or specificity. However, the researchers said evidence supporting accuracy claims were largely unavailable or did not provide sufficient information for people likely to purchase the tests. Prof Deeks said: 'Current regulations for the use of self-testing kits in a commercial setting are not adequately protecting consumers. 'Several of the self-test manufacturers refused to provide us with reports of their studies, which support their claims, stating that they were 'commercially confidential'. 'Legally, they do not need to share this information. However, for all matters of our health, it really is important that the evidence upon which health decisions are made is available and can be scrutinised.' Dr Clare Davenport, clinical associate professor at the University of Birmingham, said: 'The wide range of off-the-shelf tests now available to the public are not endorsed by the NHS and evidence for their benefit is lacking. 'This is in contrast to well-established self-tests, such as pregnancy tests. 'We are worried that consumers concerned about their health and tempted by the convenience of buying a test over the counter may be harmed if they use these tests in the wrong way.' Dr Davenport said the recommendation that people see a doctor anyway regardless of the result 'begs the question 'what's the point of doing the test in the first place?''. Sue Davies, Which? head of consumer rights and food policy, said: ' Consumers should be careful with self-tests – they can be expensive, tricky to interpret and don't always come with an expert consultation to help you understand your results. 'It's also likely you'll need to follow up with your GP, so we'd always recommend involving them from the start if you have any particular health concerns. 'Most tests you'll need will be available for free on the NHS and your GP will also be able to speak to you about how you're feeling and spot any symptoms that might not show up on a test.' While clinical trials and medicines must go through the MHRA, self-test devices are subject to checks by notified bodies. A spokesman for Suresign, which provides three of the self-tests studied, said: 'We find this blanket condemnation of a small range of home tests available to be unreasonable and unprofessional, since they admit they are content with many of those examined. 'This is not a clinical approach to a highly scientific subject. 'They also did not confirm that the clinical studies related to our tests were supplied to them, as confirmed to us by the BMJ. 'Our detailed responses to their questions were not fully reflected in their article. 'They have implicitly criticised the professionalism of notified bodies appointed by the MHRA, when we find them to be very exacting in their audits. 'We are content our tests give the public access to healthcare screening not easily available with the NHS at the present time.' Joseph Burt, MHRA head of diagnostics and general medical devices, said it would review the evidence and 'consider all allegations about device deficiencies'. He added: 'We have strengthened post-market surveillance powers to monitor and act on concerns. 'These require manufacturers to actively monitor their products and report significant incidents to us, including for CE-marked self-tests. 'We're overhauling the medical device regulations to further strengthen standards for safety, usability and clinical performance and we're exploring new transparency measures such as requiring published summaries of clinical evidence. 'In the meantime, we strongly encourage anyone using a self-test to check for a CE or UKCA mark, read the instructions carefully, and seek medical advice if they're unsure about their result.'
The Independent
22 minutes ago
- The Independent
Scientists say you don't need 10,000 steps a day. Here's how many to do instead
A new study suggests that hitting 7,000 steps a day could be sufficient to ward off a range of serious illnesses, offering a more attainable target than the widely publicised 10,000-step goal. While many find the latter difficult to achieve, new research indicates "sizeable" health benefits are still possible with fewer daily steps. Academics from the University of Sydney in Australia led the study, examining data from dozens of global studies, including those in the UK, involving tens of thousands of adults. Their findings revealed that individuals consistently walking 7,000 steps daily appeared to gain significant protection against various diseases. This included a 25 per cent lower risk of heart disease, a 14 per cent reduced risk of type 2 diabetes, a 38 per cent decrease in dementia, and a 22 per cent reduction in depression. Experts noted that even modest step counts of 4,000 steps a day could yield benefits over very low activity levels. However, they also clarified that "10,000 steps per day will still be better than 7,000 steps," with the higher count leading to even more comprehensive health advantages. The researchers also found that when people walked 7,000 daily steps, compared to walking 2,000 steps, they were 47 per cent less likely to die during the follow-up periods of the studies analysed. And while the number of steps walked did not sway whether or not a person got cancer, people who walked more steps were significantly less likely to die from cancer – with 37 per cent lower odds of cancer death compared to people who walked fewer steps. 'Although 10,000 steps per day can still be a viable target for those who are more active, 7,000 steps per day is associated with clinically meaningful improvements in health outcomes and might be a more realistic and achievable target for some,' the authors wrote in the journal Lancet Public Health. They added: 'Even modest daily step counts were associated with health benefits. '7,000 steps per day was associated with sizeable risk reductions across most outcomes, compared with the reference of 2,000 steps per day.' Commenting on the study, Dr Daniel Bailey, Reader – Sedentary Behaviour and Health, Brunel University of London, said: 'The finding that doing 5000-7000 steps per day is an important addition to the literature which helps to debunk the myth that 10,000 steps per day should be the target for optimal health. 'This study suggested that 5000-7000 steps per day can significantly reduce the risk of many health outcomes, but that does not mean you cannot get benefits if you don't meet this target. 'The study also found that health risks were reduced with each 1000 extra steps per day, up to a maximum of 12,000 steps per day. So just adding more steps from your starting point can have important benefits for health.' Dr Andrew Scott, senior Lecturer in clinical exercise physiology at the University of Portsmouth, added: 'In most cases, the 10,000 steps per day will still be better than 7,000 steps, just by decreasing margins of health benefit return. 'More important than the exact number of steps, it demonstrates that overall, more is always better and people should not focus too much on the numbers, particularly on days where activity is limited. 'The steps per day is useful when people's exercise is weight-bearing, however cycling, swimming and rowing are not well-represented by the steps per day model.'
The Independent
22 minutes ago
- The Independent
High street self-tests for bowel cancer and menopause may be unfit for purpose, researchers warn
High street self-tests for vitamin deficiencies, menopause and bowel cancer may not be fit for purpose, researchers have warned. There are many products available to UK customers without the need for a doctor's appointment. But concerns have been raised about the quality, appropriateness and safety of these kits, with doctors warning they could be 'dangerous' and cause 'false reassurance'. The researchers called for much tighter regulation of the sector, warning the NHS may face additional demand after people self-test. The market for self-tests is booming and is expected to reach a projected revenue of £660m by 2030 in the UK. To put these readily available health checks to the test, researchers at the University of Birmingham reviewed 30 self-tests bought from local supermarkets, pharmacies and health and wellbeing shops. The findings published in the BMJ on Wednesday show that most self-tests lack essential information about who should use them, how to interpret the results, and what actions to take next. Researchers looked at tests that covered 19 conditions including vitamin D deficiency, blood sugar, thyroid function, prostate health, HIV, menopause and bowel cancer. However, out of the 30 tests, less than half made any statement about accuracy, and only eight had information on the box about who should or should not use the test. Just seven of the at-home tests told users what to do after getting their results. Just 16 tests explicitly stated they were for screening, diagnosis, or monitoring, while nine did not indicate the symptoms or risk factors for their use. However, nearly all tests (27 out of 30) recommended follow-up with a healthcare professional if results were positive or abnormal, and 14 regardless of the result. Around half (14) claimed an accuracy of 98 per cent, but study authors highlighted that the evidence to back these claims was either not publicly available or was of low quality, which they said raised ethical concerns. Researchers also said 18 of the tests were 'high risk' due to the quality of the testing equipment, sampling process, or instructions and interpretation of the results. The authors acknowledge that the study sample was restricted to the Birmingham area and that their assessments were limited by the lack of access and poor reporting of documentation provided by manufacturers. However, they say this is a robust, reliable evaluation of self-tests available to the UK public. Kristien Boelaert, professor of endocrinology at the University of Birmingham and a consultant endocrinologist, said: 'I actually think it's dangerous. I would like there to be central UK-wide regulation... that prevents these things from coming on the market. I think the biggest potential harm is a false reassurance that, if it's not positive, everything is fine.' Joseph Burt, head of diagnostics and general medical devices at the Medicines and Healthcare products Regulatory Agency (MHRA), said it would review the evidence and 'consider all allegations about device deficiencies'. He added: 'We have strengthened post-market surveillance powers to monitor and act on concerns. These require manufacturers to actively monitor their products and report significant incidents to us, including for CE-marked self-tests. 'We're overhauling the medical device regulations to further strengthen standards for safety, usability and clinical performance, and we're exploring new transparency measures such as requiring published summaries of clinical evidence. 'In the meantime, we strongly encourage anyone using a self-test to check for a CE or UKCA mark, read the instructions carefully, and seek medical advice if they're unsure about their result.' Bernie Croal, president of the Royal College of Pathologists, warned of the knock-on effects for the NHS: 'There are significant risks to patients when poor quality tests are carried out inappropriately, with both false reassurance and unnecessary consequences for the NHS to repeat tests or take additional action.' Since the initial sample in 2023, researchers have continued to track the booming self-test market. A repeat search of the same geographical area in December 2024 identified 63 tests, twice as many as the previous year. 'There is an urgent need for coherent guidance and improved regulation to protect both individuals and healthcare systems from misuse and misinformation,' researchers concluded. Irwin Armstrong, founder and CEO of CIGA Healthcare and Suresign, which provides three of the numerous self-tests studied, criticised the BMJ study. He said: 'We find this blanket condemnation of a small range of home tests available to be unreasonable and unprofessional, since they admit they are content with many of those examined. This is not a clinical approach to a highly scientific subject. 'They also did not confirm that the clinical studies related to our tests were supplied to them, as confirmed to us by the BMJ. Our detailed responses to their questions were not fully reflected in their article. 'They have implicitly criticised the professionalism of notified bodies appointed by the MHRA, when we find them to be very exacting in their audits. We are content [that] our tests give the public access to healthcare screening not easily available with the NHS at the present time.' Mr Armstrong added: 'Suresign tests are intended to be used as screening tests and not for taking medical decisions. They are not intended to replace tests carried out by professionals. Currently, it is difficult to get an appointment with a GP and therefore, these tests provide information to enable users to actively seek a medical opinion if necessary.'
