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More Diabetes undergoing a ‘paradigm shift’ as 5 types of the disease identified

A group of Scandinavian scientists have said diabetes can be separated into five different diseases, with specific treatments for each one possible.

The researchers from Sweden and Finland claim they have unearthed a far more complex picture of the disease and that we should give up the idea diabetes can be divided into just two types.

Leif Groop, professor of diabetes at Lund University and author of the study, claimed the results could herald a ‘paradigm shift’ in our understanding of the disease and said it could be the ‘first step towards personalised treatment’.

In the UK there are almost 3.7 million people living with diabetes, with a further 1 million estimated to be undiagnosed. Under current classifications, 90% of these have Type 2 diabetes.

The research, published in the Lancet, and which conducted a detailed analysis of 14,775 patients, argued the disease could be stratified into five distinct categories:

  • Severe autoimmune diabetes (SAID) – This is basically the same as Type 1 diabetes, where one’s immune system is unable to produce insulin and which effects people when they are young.
  • Severe insulin-deficient diabetes (SIDD) – Very similar to SAID, except their immune system was not to blame.
  • Severe insulin-resistant diabetes (SIRD) – For this class of patient, their pancreas was still producing insulin but their bodies were not responding to it. They were generally overweight.
  • Mild obesity-related diabetes (MOD) – This was mainly observed in people who were very overweight, although metabolically more health than those with SIRD.
  • And, mild age-related diabetes (MARD) – This form was linked to older age and tended to be milder and less harmful for patients.

Surprisingly, most specialists already acknowledged the shortcomings of type 1/type 2 split, said Dr Victoria Salem of Imperial College London.

Government scraps NHS pay cap

After seven years of wage austerity for nurses, the Government is to scrap the NHS pay cap.

Jeremy Hunt, the Secretary of State for Health, has just confirmed that the cap has been abandoned after months of intense pressure on the government to improve the pay of NHS staff. Mr Hunt, however, refused to say whether future pay awards will match or exceed inflation, which is now stands at around 3%.

Jon Skewes, from the Royal College of Midwives (RCM), said: ‘The RCM very much welcomes today’s announcement by the Secretary of State. However, this cannot be another empty promise by Jeremy Hunt. The time is now to concede NHS Unions’ pay claim on behalf of midwives and all NHS workers and fund it properly.’

Recently, a number of unions demanded that the government not only ‘scrap the cap’, but also award nurses and midwives an £800 pay claim to compensate them for years of declining wages in real terms.

Although the Health Secretary’s comments, made in the House of Commons to the shock of many MPs, are good news for the health sector, he also gave no commitment to increase NHS funding along side removing the cap. Last month when a similar pay cap for police and prison officers was lifted, there was not an accompanying increase in funding that meant that any increases in payment for staff would have to come out of the organisation’s own resources.

According to Mr Skewes: ‘The Government must commit to fully funding a real terms pay increase for Midwives and NHS staff. Anything less will fundamentally damage employment relations in the NHS and will add to the already rock-bottom NHS morale. It will further push midwives out of the profession at a time when we already have a shortage of midwives that is getting worse.’

Demands to ‘scrap the pay cap’ as inflation at four-year high

The Royal College of Midwives (RCM) has called for the pay cap on nurses’ wages to be lifted after it was revealed inflation has hit a four-year high and continues to outpace pay growth.Data from the Office for National Statistics (ONS) showed inflation running at 2.9% in May this year, as pay growth slowed to 1.7%.

Nurses’ pay rises have been capped at 1% for the past seven years, leading to several nursing groups considering or announcing protest action.

A years-long policy of capping pay rises for nursing staff at 1% annually was expected to continue until 2020, but the Conservative minister appeared to make concessions while speaking at NHS Confed17 in Liverpool on 15 June.

Mr Hunt told his audience of NHS senior managers he had a ‘great deal of sympathy’ with nurses, who he believed do ‘an absolutely brilliant job’. Following announcements from the NHS across the UK that the cap would continue, the Royal College of Nursing (RCN) decided in a ballot among its members to engage in a ‘summer of protest action’ in opposition.

‘I have had a very constructive letter from [RCN chief executive] Janet Davies. I will be meeting with her and will make sure the conversation is reflected back to the chancellor before we make that decision.

Primary care nurses ‘must make their voice heard

Primary care nurses (PCNs) who feel ignored or sidelined must make their voices heard over pay and staffing complaints, according to the chief executive of the Royal College of Nursing.

Speaking exclusively to Independent Nurse, Janet Davies urged PCNs to mobilise and form or join groups in order to have a presence in the disputes over nursing pay and staffing the RCN is set to engage in with the government over its ‘summer of protest’.

While PCN pay is usually set by the providers and trusts they work for individually, rather than decided by the government, their pay levels are usually kept in line with national policy – meaning the 1% cap in pay rises which has dominated discussions at the RCN Congress 2017 in Liverpool has a knock-on effect on primary care pay rates.

RCN members voted by a large majority to mobilise into industrial action in protest to the cap and the college announced it will be devising a programme of protest activity for the summer. A mandate for a formal strike has yet to be established.

Ms Davies said: ‘While we can’t act exactly like a trade union we will be advising primary care nurses individually, guiding them through our actions over the pay cap and getting it reversed by the government.

‘We understand PCNs might feel like they don’t have a voice in the RCN but to that I would say join us. Become a member, join a primary care group of nurses, put motions forward for meetings and Congress. If you feel you don’t have a voice, mobilise and get one. You are always welcome in the RCN.’

According to Ms Davies, the RCN cannot carry out activities in the same way as a trade union but would still be confronting primary care providers on their pay rates as they will the government, though specific approaches would be figured out on a local level tailored to each provider.

Revalidation process has nearly 95% completion rate in second quarter

November 2016

Nearly 95% of nurses due to revalidate between July and September have completed the process, according to data from the Nursing and Midwifery Council (NMC).

A total of 75,513 nurses and midwives successfully renewed their registration during this period. A total of 80,668 were due to revalidate.

The number of nurses and midwives who did not revalidate is in line with rates from previous years, at approximately 5%.

‘While the first three months of revalidation were a success we knew the second quarter would be more challenging, with September seeing more than three times as many nurses and midwives going through the process compared with other months,’ said Jackie Smith, NMC chief executive and registrar.

Around 1065 revalidated through the exceptional circumstances procedure, which allows nurses and midwives who were unable to meet the standard requirements, due to maternity leave or long-term illness, to finish their portfolios.

‘Figures for this period are extremely positive and it is clear that nurses, midwives and employers continue to embrace the process,’ added Ms Smith.

Of those that allowed their registration to lapse, 1685 nurses elected to not undergo the process, along with 96 midwives. A further 2497 did not report to the NMC that they were going to allow their registration to lapse.

‘While the first six months of revalidation have been extremely successful, we know that over the course of the next two and a half years, hundreds of thousands more nurses and midwives will be going through it for the first time,’ said Emma Broadbent, the NMC’s director of registration and revalidation.

The total number of nurses and midwives who have revalidated is now over 110,000.

Hear Jackie Smith’s revalidation update at the Association for Prescribers Annual Conference 23rd November 2016 a few places still available!

More Mental health nurses think service is inadequate

Oct 2016

Around 70% of mental health nurses think that the NHS is not capable of treating the growing number of people referred to them, a study by the guardian on behalf of the Royal College for Nursing (RCN) has found.

The survey found that children’s services are particularly stretched. Half of all mental health nurses working with young people say Child and Adolescent Mental Health Services (CAMHS) are inadequate. A further 20% thought they are extremely inadequate. Just 13% believe they are good or very good, while the rest say they are adequate.

‘Without treatment, problems are very likely to escalate and children are more likely to self-harm or become suicidal, to be violent and aggressive, or to drop out of school, which can ruin their prospects for the future,’ said Sarah Brennan, chief executive of YoungMinds. ‘Delays can also have a disastrous effect on families, with parents forced to leave their jobs to look after their children.’

Pharmacy Management is Bringing The Popular Academy Series to You This

September 2016


This autumn, our focus is on Managing Change in the NHS of 2016 and beyond.   This is a free training course, for all pharmacy professionals and nurse prescribers where we will address the best way to deal with change.

Attached is a copy of the training course agenda and a flier which gives details of all the locations across where we will be holding the course.

Visit our website to register your free NHS place: and then follow the links via our events page to the closest workshop for you

To allow as many Pharmacy Professionals and Prescribers as possible to benefit from this great opportunity, we would be grateful if you could share the details of this free, one-day training event with your contacts in yours and other surrounding areas.

If you have any questions relating to this or future Pharmacy Management events, we will be happy to hear from you.


Pharmacy Management National Forum Workshop Website Goes Live

September 2016IMPORTANT ANNOUNCEMENT – The Pharmacy Management National Forum Workshop website goes live…
The Pharmacy Management National Workshop goes live with details of Satellite sessions and registration.
This year’s event is being produced in partnership with the South London Academic Health Sciences Network ( and promises to be a very high quality event.

If you have any queries or require further assistance, please do not hesitate to contact Katie Fraser (Senior Executive Assistant) at or on 01747 829501.


Guidance for the Prescribing of Specials

August 2016

The Royal Pharmaceutical Society has published this professional guidance for the specials. This is an update of the resource first published in 2011 by the National Prescribing Centre. In 2011 the National Prescribing Centre became part of the National Institute of Health and Care Excellence (NICE). The Royal Pharmaceutical Society is updating the guidance in agreement with NICE and the intention is that the RPS will maintain the guidance in the future.—prescribing-specials.pdf