Could silk screws be strong enough to mend broken bones?

Weight for weight, when stretched, silk is as strong as steel. Scientists are now developing this idea and are creating screws, fashioned from silk, which are tough enough to cut through bone.

The basis for this technology is that screws and plates can hold fractured bones together, but if they start to corrode, then a second operation is required in order to remove them. The alternative, which is biodegradable materials, can trigger inflammation and are time-consuming to implant. In addition, in order to hold the screw in place it is necessary to drill a hole in the bone and create a helical ridge around the inside as the polymers are so soft.

Silk was dissolved in alcohol, poured into moulds shaped like implants and then baked. When tested on rats, the scientists found that the silk screws were hard enough to carve into bone and biodegrade naturally over time. Official trials should begin in the near future.

DNA project set to make the UK world research leader in genetics

A project aiming to revolutionise medicine by unlocking the secrets of DNA is underway in centres across England. Prime Minister David Cameron has said it “will see the UK lead the world in genetic research within years”.

The first genetic codes of people with cancer or rare diseases, out of a target of 100,000, have been sequenced. Experts believe it will lead to targeted therapies and could make chemotherapy outdated. Just one human genome contains more than three billion base pairs – the building blocks of DNA. This four-year project is run by Genomics England and will look at 100,000 genomes. Pilots have been set up at centres across England and the first genome was sequenced on 30 May. The project has now passed the 100 genome mark, with the aim of reaching 1,000 by the end of the year and 10,000 by the end of 2015.

The genome of a patient’s tumour will be examined for differences with the genetic code of their healthy tissue. People with rare diseases, usually children, will have their DNA compared with that of close relatives. University scientists and drug companies will be allowed to access the data for their research.

Tumours are caused by mutations in DNA which lead to abnormal cells growing unchecked. Previous research has shown how varied cancers can be – for example that breast cancer is not one disease but at least 10 – each with a different cause, life expectancy and requiring a different treatment. Genetics research has helped develop targeted drugs such as Herceptin, only given if a patient’s breast tumour has a certain mutation.

Sir John Chisholm, executive chair of Genomics England, said: “In Britain we were the discoverers of the structure of DNA, we were huge players in the human genome project and now the time has come for the next major step forward. One hundred thousand sequences is a very large step; it’s a huge commitment.”

Prof Jeremy Farrar, director of the Wellcome Trust, said: “I can see a future where genetics is going to come into every bit of medicine from cardiology to oncology to infectious diseases.”

David Cameron has announced a series of investments across government, industry and charities totalling £300m. He said: “I am determined to do all I can to support the health and scientific sector to unlock the power of DNA, turning an important scientific breakthrough into something that will help deliver better tests, better drugs and above all better care for patients.”

Ebola: the hunt for a vaccine

A British woman has been injected with a section of genetic material from the deadly Ebola virus, packaged inside a chimp cold virus. Trials are already underway in the US and more are planned in Africa, but this is the first UK study of the vaccine. Previously the vaccine has given monkeys long term protection, so it is hoped the same will occur with humans.

It was developed by scientists at the Swiss-Italian biotechnology company Okairos, which was purchased by Britain’s GlaxoSmithKline earlier this year. Chief executive Riccardo Cortese said scientists at the company had been working on the vaccine for six years. He told the BBC: “We made the vaccine and they did all the animal testing, which proved to be quite satisfactory, so it was decided even before the outbreak to proceed quickly to a safety-and-immunogenicity test in humans. This programme has been accelerated as a consequence of the outbreak.”

Alfredo Nicosia said it was not known how humans would respond to the jab, but based on similar vaccines, there was reason to be optimistic. The trial will determine if the vaccine is safe and if it triggers an adequate immune response.

Experts say there is no risk that the vaccine can cause someone to become infected with Ebola. On the basis of tests on a few hundred people, the vaccine may be rolled out to high risk groups. According to the World Health Organization, healthcare staff and other front-line workers would probably be the first to be offered the jab.

Dr Benjamin Neuman, a virologist at the University of Reading, who is not involved in the vaccine trial said: “If all went well, a vaccine could be available as soon as January. But the immune system is a very complex thing, and it is hard to know whether it would work well enough to protect against Ebola. The real test of this vaccine will be when it gets into Africa and when a person who has had the vaccine comes into contact with Ebola.”

AML Healthcare at the Dentistry Show

AML Healthcare will be returning to the Annual premier dental exhibition showcase for 2015 due to be held at the NEC in Birmingham on the 17th and 18th of April. The Dentistry Show is a free-to-attend, two-day, action-packed event with a high quality and cutting edge education programme for those working in the dental profession, offering a wide choice of verifiable CPD opportunities.

AML Healthcare will be hosting a stand and will be delighted to meet with other delegates or exhibitors who are interested in our innovative Healthcare tax planning service.

Register your attendance at the event for free here.


Cigarette Packaging To Become Standardised

From 2016 every packet of cigarettes will look the same, with graphic photos accompanying health warnings and the only distinguishing features being the cigarette make and brand name.

This move has been welcomed by many across the health sector and saw 367 MPs vote in favour of standardised packaging with just 113 against it. The free vote also coincided with No Smoking Day (11 March 2015), the British Heart Foundation’s (BHF’s) key campaign to encourage one million smokers to attempt to quit.

The government first announced in 2011 it would be considering standardised packaging and ran a consultation in 2012. However, ministers then seemed to go off the plan which prompted accusations that it had been influenced by the tobacco industry. Afterwards another review of the public health benefits was ordered and it was concluded last year that it was very likely the change in packaging would lead to a modest but important reduction in the uptake and prevalence of smoking.

Currently more than 600 children aged 11 to 15 start to smoke every day. Which is more than 200,000 a year. The review said if that number could be cut even by 2%, 4,000 fewer would take up the habit.

Research has also shown that standardised packaging and darker colours (such as the proposed olive green) makes the packets less appealing and helps reinforce health messages.

British Lung Foundation chief executive Simon Gillespie, said: “This is a landmark victory that will go a long way to reducing smoking rates, improving the nation’s health and saving thousands of lives.”

Earlier this month the Irish Republic introduced a similar law and Australia has had plain packaging since 2012. At the other side of the world, the Australian Institute of Health and Welfare say smoking rates for people aged 14 and over fell from 15.1% to 12.8% between 2010 and 2013, and for people aged 18 and over the figures dropped from 15.9% to 13.3%. However, these statistics also support the continued long-term trend of declining smoking rates prevalent in most developed countries.

With this in mind, we now just have to wait for the House of Lords to see if they decide to give this legislation the final parliamentary stamp of approval.

The changing VAT landscape for Dentists

The changing VAT landscape for Dentists

The business aspects of dental practice have evolved a great deal in recent years, with numerous changes to dentists’ contracts, growing business requirements and patients’ expectations exerting an increasing influence on all aspects of the industry. This article highlights the VAT issues that accountants should be aware of when working with dentists.

Cosmetic dentistry

Cosmetic dentistry is on the rise in Britain with many private dental practices pursuing this lucrative side to their business, but there are some VAT considerations to be aware of. For example, where cosmetic services are performed as part of a supply of dental treatment (note that the British Dental Association has advised that it is rare for dental work to be carried out purely for cosmetic reasons), then there is a single supply of exempt healthcare. In contrast, where cosmetic dentistry is performed outside of any healthcare, it is standard rated.

However, the issue of whether a procedure is purely cosmetic or health related is contentious and open to interpretation. What we can be sure of is that the UK law provides for the supply of the following, by registered dentists and auxiliaries, to be exempt:

• Health services where the principal purpose is to protect, maintain or restore the health of the person concerned and;

• Dental prostheses.

All dental work is deemed to be medical care, but will not be exempt unless it can be demonstrated that the intention is to maintain or restore health. Therefore, the health professional needs to determine with an accountant’s or tax adviser’s support whether they consider that the requirements for exemption have been met.

Associate agreements

It is common for one dentist, or a number of dentists in partnership, to own the whole practice. The practice owner (often termed the principal) may then make all the facilities available to other dentists (or the associates). Each associate is likely to be self-employed and will, in fact, be a separate business for VAT purposes. The associate dentist is not, as many mistakenly believe, acting as an agent or sub-contractor for the principal doctor or dentist.

Under this arrangement, there will be supplies of goods and services by the practice owner to the dentist. Such supplies may consist of the use of a fully equipped surgery, the supply of materials and consumables necessary in the provision of treatment, laboratory services, accountancy services and the use of chair-side/reception staff. The practice owner may also provide guidance to the associates on specific medical or dental services. In return, the associate will pay the practice owner a retainer fee for the use of the services offered.

Over the years, the VAT liability in relation to this exchange has become somewhat problematic. Following protracted discussions with the Commissioners, it has been agreed that: “When there is more than one dentist within a practice there may be payments between the dentists in respect of shared facilities, equipment, prostheses and staff. Such charges are exempt, provided that they relate to services or facilities that are predominantly medical in nature and are necessary to allow the recipient to perform dentistry.” Despite this lenient treatment, some major limitations within the associate agreement arrangements remain. For example, supplies performed by a dentist who has ceased to practise are not covered by the exemption.


For more information about AML Healthcare, please contact:

T: 0845 527 0050 – E:

Hunt Imposes More Restrictions on Locum Doctors and Nurses in England

It was confirmed yesterday (14 October 2015) that a new cap will be imposed on the amount that recruitment companies can charge per shift for all NHS staff in England, including doctors and non-clinical personnel.

The hourly price cap will be introduced from 23 November, reducing over time until April 2016. From then NHS trusts will not be able to pay more than 55% more to agencies than it costs to pay a member of NHS staff for a shift, with the difference allowing for lack of paid holiday, sick pay and pensions.

These changes will be implemented alongside strict new rules already introduced earlier this year, which include banning the use of agencies that are not approved and a requirement to obtain specific permission for any expensive consultancy contracts over £50,000.

Figures suggest that the NHS paid a record £3.3 billion on agency doctors and nurses in the last financial year, more than the cost of all that year’s 22 million A&E admissions combined and spending on temporary workers rose by £800million during the same period.

Health Secretary, Jeremy Hunt, said the new cap will result in savings of £1billion over the next three years. However, set parameters for pricing of agency staff already exists within the NHS framework agreement and critics fear that these further restrictions will do little to resolve the huge financial deficits that trusts are facing due to spiralling patient demand and reducing budgets. Too many posts have been cut and too few students are coming up the ranks to fill the void. Arguably, without agency staff pitching in, the NHS and its patient care could suffer.

More detail on exactly how these new caps will be reconciled with NHS trusts’ legal responsibility regarding safe staffing levels is yet to be confirmed. Those against the restrictions are also concerned that the changes are due to come into force towards the end of the year, a time when health workers are overstretched and demand for agency staff is likely to be at its greatest.

Nine in 10 Hospitals are Missing Their Targets

Latest figures show that the vast majority of hospitals are struggling to recruit enough nurses. Throughout August this year 92% of the 225 acute hospital trusts in England did not manage to run wards with their planned number of nurses during the day. This is compared with data from January when 85% of hospitals missed their nurse staffing targets.

In addition figures also showed 81% of hospitals failed to have enough registered nurses working at night during august and some 79% of hospitals missed their target for registered nurse staffing across both day and night. As a result, many hospitals have had to rely heavily on overseas recruitment as well as agency staff just to provide safe staffing levels.

A spokesman from the Health Service Journal said that 50,000 nurses were currently in training to help alleviate the issue and the government has announced plans to remove the cap on how many can go into training, which it says should help boost numbers.
Royal College of Nursing chief executive Janet Davies said “We went through a period of time where we were trying to save money. We cut posts, we didn’t train enough nurses and we’re still feeling the effect of that.”