With public trust in healthcare organizations dropping, clinical laboratories worldwide must work doubly hard to provide competent, secure services to their patients
Is the UK’s National Health Service hurting people? About 10% of NHS patients said yes in a recent survey conducted by the London School of Hygiene and Tropical Medicine (LSHTM) and the University of Oxford. And those findings are a public stain on the physicians and clinical laboratories in an already strained healthcare system.
Of the 10,000 people interviewed, nearly 1,000 “reported they had experienced harm caused by the NHS in the previous three years. Of those, 6.2% cited their treatment or care and 3.5% blamed the harm on a lack of access to NHS services,” according to an LSHTM news release.
While the definition of “hurt” within the confines of the survey wasn’t specified, what is clear is that public trust in the UK’s healthcare system is decreasing. Fallout from the survey may affect the public’s trust in clinical labs that are facing unfavorable feedback from slow test result delivery times or rare instances of incorrect results.
“I’ve been studying patient safety and working in and with the NHS, including as a GP, for many years. It’s a complex challenge to pinpoint the cause of the problem and solve it,” said study author Helen Hogan, PhD, MBBS, a general practitioner and associate professor in the department of Health Services Research and Policy at LSHTM, in the news release.
“These findings indicate that healthcare harm affects a considerable number of the general public. It shows that there is still some way to go to improve safety across the NHS,” said study author Helen Hogan, PhD, MBBS, general practitioner and associate professor in the department of Health Services Research and Policy at LSHTM, in a news release. (Photo copyright: London School of Hygiene and Tropical Medicine.)
Of the 9.7% that reported NHS harm, 6.2% claimed it was from the actual treatment or care given and 3.5% from the access to care. Severity ranged from 37.6% reporting moderate impact to 44.8% reporting severe impact, and the majority claimed the impact occurred at hospitals, the authors wrote in BMJ Quality and Safety.
Women led the respondents in reports of harm, and more severe harm or higher rates of harm were reported from those in disadvantaged groups or lower social grades and those with disabilities or long-term illness, according to the researchers.
Though 60% got professional support for their troubles, including 11.6% contacting the NHS’ Patient Advice and Liaison Service (PALS), only 17% made a formal complaint. A small percentage, 2.5%, sought financial compensation, the survey showed.
Poor Patient Service Experience
Further, the patients reported poor results when they sought relief from the harm. Some (44.4%) desired treatment or care to help with the harm, while others (34.8%) wanted an explanation for the harm. Two-thirds said their incidents were not dealt with well and only half reported a positive PALS experience, the survey noted.
“Those harmed by healthcare are looking for a compassionate and caring response from services. What they really want is to be listened to, to have their harm acknowledged, and get an explanation,” noted Michele Peters, PhD, fellow survey author and associate professor at Oxford Population Health, University of Oxford, in the LSHTM news release.
Loss in Confidence
To make matters worse for the UK’s publicly run healthcare system, an unrelated patient satisfaction survey published contemporaneously found that NHS satisfaction hit record lows. According to The Guardian, the annual patient survey found a 24% decrease in satisfaction among adults in Britain in how NHS is run (now at a mere 21%). Dissatisfaction rose from 52% to 59% in the past year.
General practice, accident and emergency, and dental care were the areas of biggest disappointment, the study revealed.
“It is by far the most dramatic loss of confidence in how the NHS runs that we have seen in 40 years of this survey,” said Mark Dayan, a policy analyst at the Nuffield Trust who was engaged by The King’s Fund to analyze the survey data.
“There is a need to better understand the patient perspective following harm and for further consideration of what a person-centered approach to resolution and recovery might look like,” the researchers noted in BMJ Quality and Safety.
These types of findings can contribute to public mistrust of healthcare organizations worldwide, including clinical laboratories and pathology groups. It’s worth watching how the NHS resolves these issues.
UK study shows how LDTs may one day enable physicians to identify patients genetically predisposed to chronic disease and prescribe lifestyle changes before medical treatment becomes necessary
Could genetic predisposition lead to clinical laboratory-developed tests (LDTs) that enable physicians to assess patients’ risk for specific diseases years ahead of onset of symptoms? Could these LDTs inform treatment/lifestyle changes to help reduce the chance of contracting the disease?
A UK study into the genetics of one million people with high blood pressure reveals such tests could one day exist.
They also confirmed 274 loci (gene locations) and replicated 92 loci for the first time.
“This is the most major advance in blood pressure genetics to date. We now know that there are over 1,000 genetic signals which influence our blood pressure. This provides us with many new insights into how our bodies regulate blood pressure and has revealed several new opportunities for future drug development,” said Mark Caulfield, MD,
The researchers believe “this means almost a third of the estimated heritability for blood pressure is now explained,” the news release noted.
Clinical Laboratories May Eventually Get a Genetic Test Panel for Hypertension
Of course, more research is needed. But the study suggests a genetic test panel for hypertension may be in the future for anatomic pathologists and medical laboratories. Physicians might one day be able to determine their patients’ risks for high blood pressure years in advance and advise treatment and lifestyle changes to avert medical problems.
By involving more than one million people, the study also demonstrates how ever-growing pools of data will be used in research to develop new diagnostic assays.
The video above summarizes research led by Queen Mary University of London and Imperial College London, which found over 500 new gene regions that influence people’s blood pressure, in the largest global genetic study of blood pressure to date. Click here to view the video. (Photo and caption copyright: Queen Mary University of London.)
Genetics Influence Blood Pressure More Than Previously Thought
In addition to identifying hundreds of new genetic regions influencing blood pressure, the researchers compared people with the highest genetic risk of high blood pressure to those in the low risk group. Based on this comparison, the researchers determined that all genetic variants were associated with:
“having around a 13 mm Hg higher blood pressure;
“having 3.34 times the odds for increased risk of hypertension; and,
“1.52 times the odds for increased risk of poor cardiovascular outcomes.”
“We identify 535 novel blood pressure loci that not only offer new biological insights into blood pressure regulation, but also highlight shared genetic architecture between blood pressure and lifestyle exposures. Our findings identify new biological pathways for blood pressure regulation with potential for improved cardiovascular disease prevention in the future,” the researchers wrote in Nature Genetics.
Other Findings Link Known Genes and Drugs to Hypertension
The UK researchers also revealed the Apolipoprotein E (ApoE) gene’s relation to hypertension. This gene has been associated with both Alzheimer’s and coronary artery diseases, noted LabRoots. The study also found that Canagliflozin, a drug used in type 2 diabetes treatment, could be repurposed to also address hypertension.
“Identifying genetic signals will increasingly help us to split patients into groups based on their risk of disease,” Paul Elliott, PhD, Professor, Imperial College London Faculty of Medicine, School of Public Health, and co-lead author, stated in the news release. “By identifying those patients who have the greatest underlying risk, we may be able to help them to change lifestyle factors which make them more likely to develop disease, as well as enabling doctors to provide them with targeted treatments earlier.”
Working to Advance Precision Medicine
The study shares new and important information about how genetics may influence blood pressure. By acquiring data from more than one million people, the UK researchers also may be setting a new expectation for research about diagnostic tests that could become part of the test menu at clinical laboratories throughout the world. The work could help physicians and patients understand risk of high blood pressure and how precision medicine and lifestyle changes can possibly work to prevent heart attacks and strokes among people worldwide.
