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Nicholson says competition is ‘harming efforts to improve patient care’, study finds most C Diff infections are ‘not hospital-spread’ and a grave warning about…the French horn

Private-sector style competition in the NHS is harming efforts to improve patient’s care, Sir David Nicholson has said.

The Independent reports that the outgoing NHS England chief executive has said hospitals are being held back from making changes that make ‘perfect sense from the point of view of patients’ because they do not meet new rules on competition between healthcare providers.

He said: ‘I’ve been somewhere [where] a trust has used competition law to protect themselves from having to stop doing cancer surgery, even though they don’t meet any of the guidelines [for the service].’

He continued: ‘Trusts have said to me they have organised, they have been through a consultation, they were centralising a particular service and have been stopped by competition law. And I’ve heard a federated group of general practices have been stopped from coming together because of the threat of competition law.’

‘All of these [proposed changes] make perfect sense from the point of view of quality for patients, yet that is what has happened.’

Most cases of C.difficile are not caused by the bug being spread around hospitals, the BBC reports.

University of Oxford researchers said ‘more and more deep cleaning ain’t going to do any good’ after an analysis of every C. diff infection in Oxfordshire for more than three years showed less than a fifth of cases had been spread between hospital patients.

Researchers said there was a growing awareness of animal and community sources of infection.

Over at the Guardian we find news of almost 700 GPs who earn more than £200,000 a year before tax. Of these, 160 have an income of over £250,000, figures from the Health and Social Care Information Centre show. However the number of big earners fell slightly compared to last year.

Research covered by the Daily Mirror found that GPs are failing to spot the early signs of leukemia, meaning an alarming 57% of those with acute leukaemia - the severest form of the disease - are being diagnosed in a hospital’s emergency department. And 30% of those with chronic leukaemia also only find out in A&E.

The Telegraph offers some pragmatic advice for those choosing which instrument to take up in the orchestra.

It seems the French horn, known for its soaring fanfares and powerful harmonics, can be bad for your hearing.

Scientists have found that those who play the distinctive, curved brass instrument experience some of the loudest noises within the orchestra and have the highest risk of hearing loss.

Up to a third of horn players suffer hearing problems in at least one of their ears, with younger musicians being most at risk. The triangle is always a safe bet.