Dementia is one of the most significant health crises of the 21st century

Guest Blog from Alzheimer’s Disease International

Every 3 seconds, someone in the world develops dementia. Today, more than 46 million people are living with the disease. This number is set to almost double every 20 years, making the dementia one of the most significant health crises of the 21st century.

Dementia is a collective name for degenerative brain syndromes which affect memory, thinking, behaviour and emotion. Although each person will experience dementia in their own way, after a period of time people living with dementia are unable to care for themselves and need help with all aspects of daily life.

Many people around the world are now living for longer. Over the past century, successes in improving standards of health and social care means the world population now has more older people than ever before.

As a result, much of the increase in dementia’s global prevalence will take place in low and middle income countries (LMICs). Today, over half of all people with dementia live in LMICs. By 2050, this will rise to 68%, so it is vital we are able to help these countries provide services and support.

In 2015, the global cost of dementia care is estimated at $818 billion. If global dementia care were a company, it would be the world’s largest by annual revenue exceeding Apple (US$ 742 billion) and Google (US$ 368 billion). In just three years’ time, dementia is set to become a trillion dollar disease.

Across the globe, there is a growing awareness about dementia, but stigma and misinformation remain significant barriers to making the world a better place for people living with the disease.

2 out of 3 people globally believe there is little or no understanding of dementia in their countries, so it’s essential we work together to educate ourselves and our communities to dispel lingering myths about dementia.


September is World Alzheimer’s Month™, an international campaign to raise awareness and challenge stigma. During September, Alzheimer associations around the world focus campaigns on advocacy and public awareness with a packed month of activities including information provision, Memory Walks and media appearances. Each year, more and more countries are participating in World Alzheimer’s Month events and in many areas, dementia awareness is growing.

ADI is the umbrella organisation of over 80 Alzheimer’s associations around the globe. It’s thanks to the hard work and dedication of these national Alzheimer associations that the impact of World Alzheimer’s Month is felt at both a national and global level.

World Alzheimer’s Month is a time for action, a global movement united by its call for change, but it is also a time to reflect on the impact of dementia, a disease that will affect more and more people as the years pass.

Dementia is a global issue that demands a global solution. By educating ourselves about dementia and campaigning for better health and social care provision we can help people living with dementia both now and in the future. By joining us this September and helping to spread the word you can help us make this a reality.

Find out how you can get involved and find events in your country by visiting and following Alzheimer’s Disease International on Twitter and Facebook.

Posted in Dementia, Elderly, Global Health, Health and Wellbeing, Patients | Tagged , , , , , , , , , | Leave a comment

Bad for your health: What can be done about Britain’s long hours’ culture?

Guest Blog from Working Families

Recent research by Working Families shows that parents are having to work longer than
their contracted hours on a regular basis¹, with fathers putting in the longest hours.  This is despite fathers wanting to play a greater part in their children’s lives², by for example dropping them off at school, and despite successive governments introducing more family friendly policies such as Shared Parental Leave (SPL) and the right to request flexible working for all, ensuring that parents and those without children have the same flexible working opportunities.

Other research by scientists at University College London, who conducted the largest study ever commissioned on the issue of stress and long hours culture, found that those who worked more than 55 hours a week have a 33% increased risk of stroke compared to those who work a 35-40 hour week, as well as a 13% risk of coronary heart disease³.

So a toxic combination of parents feeling stretched and stressed mixed with the physical demonstration of overwork is a clear demonstration that a long hours working culture is harming the nation’s health.

Screen Shot 2015-09-13 at 22.52.35So what can be done about it – what can we do as employees and employers to stop this madness? Fortunately, there are some employers who are leading the way in showing how flexible working can be made to work for both employees and employers.  Deloitte, the professional services company, has introduced their Time Out initiative, which allows employees to take an additional four week block of leave each year, helping employees to achieve a better balance between their careers and other commitments.  As Emma Codd, a Deloitte HR manager commented, “Our people say they love the policy”.

American Express, the banking and financial services company, has policies which encourage managers to initiate flexible working conversations with their employees, to ensure that they have the working hours which are right for their particular situation, including promoting home working along with providing technology to facilitate this.

At the employee end of the spectrum, there are high profile standard bearers for flexible working such as Thomasina Myers, co-founder of the Mexican food chain Wahaca, who works 3-4 days a week, and Nicola Mendelsohn of Karmarama, the TV company which makes the popular TV drama Last Tango in Halifax.  But there are also less well known flexible working role models, in organisations as diverse as financial institutions and government agencies.  Simon, who works part-time for a government agency in Scotland, says that working three days a week means he has to be super-efficient, but because he works reduced hours, he doesn’t get stressed.  And Lee, a mother of two working for an investment bank, is ambitiously keen to keep climbing the corporate ladder and feels able to do so in her working environment despite working flexibly.

Working Families, the leading work life balance organisation, campaigns for better work life balance, and is running National Work Life Week from 21-15 September 2015, which aims to highlight the difficulties faced by employees as they struggle with finding the balance that’s right for them.

Screen Shot 2015-09-06 at 23.45.09And during that week, a day has been designated as Go Home on Time Day, on Wednesday 23 September, a day when workers are encouraged to leave work on time rather than stay late, and demonstrating that productive work can and should be achieved within working hours, and that the free time spent out of office hours benefits the employee’s health and wellbeing and ultimately the employer, whose workers are healthier and more productive.

So it doesn’t have to be this way and on a positive note, more and more companies are recognising that they will not achieve higher levels of productivity by promoting long hours’ culture, in fact, quite the opposite.

To find out more about Working Families’ National Work Life Week, visit and for Go Home on Time Day UK visit

¹Modern Families Index, 2015
²Modern Families Index, 2015
Posted in Children, Employment, Health and Wellbeing, Wellbeing, Work | Tagged , , , , , , , , | 1 Comment

The biggest cancer you’ve never heard of

Guest Blog by Chris West, Head of Media & Public Affairs at Bloodwise

Being given the news you have cancer is one of the most devastating things you can hear.  People who have gone through it talk about the shock, about not knowing if they’ll live beyond it, and wondering how to go about telling their family.

Now imagine that in addition to all that, you have the added confusion and fear of being told you have a cancer you’ve never heard of.  You don’t know anything about this kind of cancer, or know anyone who’s ever had it.  You don’t understand what the disease is, what the treatment options are, or where to go for information and support.

This is too often the experience of patients who are diagnosed with a blood cancer.  It’s a complex disease area comprising of 137 individual diseases, some of which affect thousands of people, others only a handful.  Combined, blood cancer is the fifth most common cancer in the UK, accounting for 38,000 new cases and 14,000 deaths each year, yet many people have never heard of it, let alone the charities that exist to help.

To address this, our charity is taking two big steps this month.

Firstly, we’re changing our name.  As the charity has grown over recent years, we’ve started to do more and more for patients.  The name Leukaemia & Lymphoma Research obviously covered our world leading research, but didn’t include our growing patient support services, our campaigning and advocacy work or our fundraising.  In addition, our vision is to beat all blood cancers, not just lekaemia and lymphoma.  Our name was no longer representing who we are or what we do, and starting to hold us back.

The name Bloodwise embraces all blood cancers.  It’s simple, short, and crucially, easy to remember, particularly important to someone who’s life has just been turned upside down by news of a diagnosis.

Screen Shot 2015-09-06 at 23.35.02
The second big step we’re taking is to embark on the UK’s biggest blood cancer awareness raising campaign this month, to coincide with Blood Cancer Awareness Month.

Early this year, we published the results of our research into what patients need.  We asked 2,000 people affected by blood cancer what patients and their families needed most.  They came up with many areas of need from right across the patient pathway, including diagnosis, treatment, and care once treatment had ended.

One major issue of need they raised was low public awareness.  Low awareness added significantly to feelings of worry, confusion and isolation for patients.  Being diagnosed with a cancer you’ve never heard of, one that contains many long and complicated words can often make patients feel like there’s nowhere they can turn to for support – low awareness of the disease equals low awareness of charities that can help.  In addition, patients felt that increasing awareness of blood cancer would be a starting point in addressing all the other areas of need they identified.

Screen Shot 2015-09-09 at 11.07.403,000 billboards will be going up across Britain this month for the “137 campaign”, raising awareness of blood cancer and the diseases it includes.  We hope this will help to raise awareness of one of the biggest cancers in the UK – and starting to demystify blood cancer can only help to support and reassure patients and their families.

Screen Shot 2015-09-06 at 23.41.17

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Do you ‘Know your Numbers’?

Guest Blog by Katharine Jenner, Chief Executive at Blood Pressure UK

High blood pressure is the UK’s biggest silent killer with 16 million people in the country suffering from the condition.

Worryingly though, as it is symptomless, only half of these people are aware they have the condition which means they are putting themselves at high risk of having a stroke or a heart attack as it is responsible for 60% of strokes and 40% of heart attacks. High blood pressure is also a risk factor for kidney disease and dementia.

That’s why UK charity Blood Pressure UK has it’s annual flagship awareness campaign, Know your Numbers! Week – the nation’s largest annual blood pressure testing and awareness event. It encourages adults across the UK to know their blood pressure numbers and take the necessary action to reach and maintain a healthy blood pressure.  Last year it provided free checks, information and advice for around 250,000 adults across the UK on simple steps to keep blood pressure under control.

Anne Zak_Heart Centre 2013 (C) Gary SchwartzThis year’s campaign takes place from 14-20 September and the charity is encouraging people to or check themselves at home, in a pharmacy or GP surgery or visit one of the hundreds of Pressure Stations across the UK to get their blood pressure checked. Knowing Your Numbers is quick, free, painless and could save your life – giving you one less thing to worry about.

What is high blood pressure?

You probably have high blood pressure (hypertension) if your blood pressure readings are consistently 140 over 90, or higher, over a number of weeks. You may also have the condition if just one of the numbers is higher than it should be over a number of weeks.

If you have high blood pressure, this higher pressure puts extra strain on your heart and blood vessels. Over time, this extra strain increases your risk of a heart attack or stroke but by lowering blood pressure you reduce the likelihood of this happening.

However even at lower levels you could still be at risk.  Any intervention that would lower blood pressure in the general population, even by small amounts, is likely to be of immense benefit in preventing both strokes and heart attacks.

What are the signs and symptoms of high blood pressure?

High blood pressure usually has no signs or symptoms, so the only way to know if you have high blood pressure is to have yours measured. However, a single high reading does not necessarily mean you have high blood pressure. Many things can affect your blood pressure through the day, so your doctor will take a number of blood pressure readings to see that it stays high over time.

Occasionally people with very high blood pressure say they experience headaches, but it is best to visit your GP if you are concerned about symptoms.

What causes high blood pressure?

For most people, there may be no single cause for their high blood pressure. We do not know exactly what causes high blood pressure but we do know that your lifestyle can affect your risk of developing it. You are at a higher risk if:

– you eat too much salt
– you don’t eat enough fruit and vegetables
– you are not active enough
– you are overweight; or
-you drink too much alcohol.

Lower your blood pressure

Your diet, exercise levels and weight have a real effect on your blood pressure. If you have high blood pressure, you can start lowering it today by eating more healthily and being more active.

Your bloodBPtest pressure readings are what you eat. A healthy, balanced diet will keep you full of energy, and less salt (throw away the salt shaker!) and more potassium from fruit and veg will lower your blood pressure.  To help lower blood pressure, adults should eat at least 5 different portions of fruit and vegetables per day. A portion is 80 grams, or roughly the size of your fist.

No need to cut out alcohol completely if you enjoy a nice glass of red at the end of the day – recent research has shown that drinking a small glass of wine or half a pint of beer a day could in fact lower the risk of heart failure – although the researchers warn that any more than that increased the risk of death over all.

We recommend you follow NHS guidance until more is known: Men should not regularly drink more than 3-4 units of alcohol a day, and women should not regularly drink more than 2-3 units a day.

Being more active and taking regular exercise lowers blood pressure by keeping your heart and arteries in good condition. There is now strong evidence that even a small amount of physical activity each day could have substantial health benefits for people who are physically inactive – a 20 minute brisk walk each day would take an individual from the ‘inactive’ to ‘moderately inactive’ group, and reduce their risk of premature death by between 16 to 30 per cent.

Being the right weight lowers blood pressure because your heart doesn’t have to work so hard and will help to reduce your blood pressure and heart strain.

If you have high blood pressure, you need to take action to bring it down.  Currently there is no cure for high blood pressure, this means that if you start taking medicines, you will probably need to keep taking them for life.  However, the more you can lower your blood pressure without medicines, the less blood pressure medicine you will need.

KJ BP test_Heart Centre 2013 (C) Gary SchwartzThere is a wide range of high blood pressure medicines, you can take more than one type of medicine because they each lower your blood pressure in different ways.

The good new is that if detected, high blood pressure can be successfully managed and returned to a healthy level which is why it is so important for every adult to know their blood pressure numbers and get themselves checked.

Did you know that in the time it takes to boil a kettle, you could have taken a home blood pressure reading? For more information and to find your nearest station please visit

Posted in Alcohol, Patients, Preventative healthcare, Public Health, Self-care, Stroke | Tagged , , , , , , , , , | Leave a comment

Arrogant , regressive and out of context: GP magazine rubbishes Personal Health Budgets

The GP magazine Pulse are running  a story today on Personal Health Budgets stating that the NHS allows patients to splash cash on holidays, summer houses and Wii Fits’.

Out of context this sounds scandalous, but, it is out of context.

The background to this is that the Government offered the right to have a personal health budget – which provide patients with their own budget to spend on care they feel would benefit them – to any patient on NHS Continuing Healthcare nationally from 2014, and it was rolled out to any patient with a long-term condition in April 2015. People assessed as requiring Continuing Healthcare (CHC) usually have complex clinical needs requiring life-long care.

The GP magazine Pulse undertook FOI requests and heard back from 33 Clinical Commissioning Groups on what PHB monies have been spent on.

Whilst all NHS spending should be undertaken wisely and open to scrutiny, to smear people who have received a PHB like this is shameful. 2020health produced a balanced report in 2013 Personal Health Budgets: a revolution in personalisation highlighting the benefits and concerns around PHBs. We spoke to NHS PHB leads who implored cynics to examine expenditure of state money by the outcome (remember those?!) not by the thing bought. Results have shown that from the 2009-2012 personal health budget trial there was a majority view (70%) among users that the PHB had increased their sense of what could be achieved in terms of outcomes and lifestyle.

PHBs allow people to

  • identify what is important to them in their health and wellbeing
  • consider what will be of the most help
  • take more control and responsibility for their health
  • make efficiencies and savings in their care costs

Pulse seems to have run successive biased articles against personal health budgets, which in our opinion reflects some GPs unwillingness to allow patients to make decisions about their care and let go of their treasured professional status.

We know that medical treatments have limited efficacy and all have side effects. Evidence shows that at most, 60% of people comply with their prescribed medication, and experts claim that 90% of drugs only work in 30-50% of people[1] (hence the drive for pharmacogenetics). Pills are not enough. The growth in Social Prescribing surely also mirrors the PHB ethos that people often need non-medical treatment to meet their health and wellbeing needs.

To ridicule patients through their choice of treatment is arrogant and regressive; some GPs have been superb at encouraging patients to take control and seen the benefits to both their health and in reduced expenditure.

Examples of ‘alternative’ PHB use in context are:

  • people suffering from depression paid for leisure activities to reduce social isolation
  • some patients with diabetes improved wellbeing by using the money for a Wii fit or personal trainer
  • a patient with cancer bought a wig of their choice
  • an iRobot vacuum cleaner was bought by a disabled person
  • archery lessons for muscle training for an MS Sufferer
  • air-conditioning or de-humidifying equipment – to help with breathing difficulties
  • singing lessons, as an alternative to respiratory therapy – for a COPD patient

However the statistics show that the vast majority of funds (80-90%) are spent on carers, PAs and nurses. Our 2013 report showed how essential and effective it is when the NHS involves patients in the planning of their own care. Only the patient themselves know why improving their health matters to them – which is why we need to start thinking of ourselves as PARTICIPATIENTS. It is absurd that patients are still not being treated as an essential partner in their health – and some professionals need to stop being so paternalistic. The PHB encourages a dialogue between GPs and patients where each share their expertise, motivation and a shared plan is shaped together.

PHBs treat a person as a whole – allowing them to consider their social, mental and physical needs through one budget. PHBs are finally a way of making integration and whole person care a reality for people.

We are not the only ones who think this. In 2012 the Royal College of Psychiatrists said:

“PHBs are important tools for recovery. They

give greater control to individuals and allow

them to go beyond statutory services…the very

approach embeds the three core components of

recovery: hope, control and opportunity.”

The final proof goes to Northampton, one of the in-depth (pilot) sites specialising in mental health, collated the following list of measurable health outcomes in April 2012. These are outcomes that their MH patients with PHBs were at the time either making progress towards or achieving:

  • An increase in their independence and their confidence, they feel much more in control
  • An increase in social interaction and social activities of many different types
  • Improvement in mood, reduction of stress/anxiety and a change in behaviour, which has enabled increased contact with family, children and friends
  • Being able to give much more support to others
  • An increased understanding of their condition/ disease and how and why it is impacting on their life
  • Improvements in general physical health including losing weight, learning to swim, attending a gym regularly
  • A reduction or ceasing of self-harming
  • Studying for new qualifications, gaining or returning to employment both paid and unpaid/voluntary work; development of a back to work plan
  • Reduction of, or stopping, medication
  • Managing crisis/exacerbation of condition/ disease, recognising triggers and managing symptoms, keeping safe
  • Reduction in the need for and use of acute and primary care services



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Obesity and Sugar – Successive governments have failed to act despite the warnings

The Scientific Advisory Committee on Nutrition (SACN) report out on Friday 17th makes recommendations on sugar and fibre consumption.  Inevitably the recommendations on sugar got the most attention, with a call for us to reduce our intake by half.

2020health’s top messages:

  • Our 2014 report Careless Eating Costs Lives’ top message is that there is no sobesitythumbnailingle solution and unless a comprehensive strategy is put in place, levels of obesity will still rise.
  • Of crucial importance is prevention and early intervention. A holistic strategy is urgently needed for children and should be a top priority.
  • The evidence tells us that once an adult is obese, the vast majority remain obese. 0.5% of men will return to normal weight; and just under 1% of women [1]. The best evidenced treatment for obesity is bariatric surgery.

Our take – clinical and political

  1. Whilst updated research is necessary, this is unhelpful if it leads to piecemeal ‘solutions’ to a complex and multi-faceted problem.
  2. We are mystified as to why taxpayer’s money was used to produce another report telling us that sugar causes tooth decay and that people who eat too much sugar put on weight.
  3. The recommendations on fibre intake will be difficult for anyone to consume. The example given is: 30g of fibre a day could be achieved, for example by consuming ALL of the following in a day: five portions of fruit and vegetables, two slices of wholemeal bread, a portion of high fibre breakfast cereal, a baked potato and a portion of whole wheat pasta.
  4. Successive governments have failed to act despite the warnings. This is the biggest    public health failure of our time.

Julia Manning, CEO of 2020health said: This report tells us what we already know, and it isn’t the obesity strategy that we desperately need. There is no single solution to obesity and whilst many people do eat too much sugar, this advice needs to be part of a cross-cutting hard-hitting obesity strategy. We have called for a cross-departmental obesity task-force, and for all policy to be considered in the light of what it will mean for the public’s health. We still haven’t got the action we require to tackle this enormous problem.

[1] reporting from the American Journal of Public Health

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NHS Costs and charging: Publicity, shame and complexity

Commenting on today’s press about Jeremy Hunt has created waves with his new plan to state the cost of medicines on the label and with his comment last night (July 2nd) on Question Time that he is not opposed to charging patients for missed NHS appointments. The story is covered here.

2020Health’s top messagesChaging the culture 2010

  • Our short paper ‘Responsibility in healthcare: changing the culture’ (2010) recommended publicising the cost of medicines, devices and A&E attendance
  • We all need reminding to use NHS resources wisely – advertising the costs of treatment or missed treatment would help inform us
  • Flat fines for missing NHS appointments would hit those with the most complicated lives

Our take – clinical and political

2020health does not want to see anyone deterred from seeking medical advice when they feel they need it; flat fines for missed appointments may have this unintended consequence.

We value things more when we know what they are worth – especially the Brits who are more interested in value for money that European counterparts

All Political Parties should support schemes to reduce waste in the NHS

Some in the press have called this idea ‘shaming’ – feeling shame is important – shame means we feel we have done wrong and are more likely to redress a situation and try better next time.


Julia Manning, CEO of 2020health said: “We would not want to see a child who has just left care, or someone who is homeless, being told they can’t’ rebook an appointment until they have paid a fine. However we agree that we value things more when we know what they are worth and we recommended five years ago that we start publicising the cost of medicines on the packet. We think this will lead to a reduction in waste.”

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