In medicine and biotechnology, the ability to evolve proteins with new or improved functions is crucial, but current methods are often slow and laborious. Now, Scripps Research scientists have developed a synthetic biology platform that accelerates evolution itself — enabling researchers to evolve proteins with useful, new properties thousands of times faster than nature. The system, named T7-ORACLE, was described in Science on August 7, 2025, and represents a breakthrough in how researchers can engineer therapeutic proteins for cancer, neurodegeneration and essentially any other disease area.
“This is like giving evolution a fast-forward button,” says co-senior author Pete Schultz, the President and CEO of Scripps Research, where he also holds the L.S. “Sam” Skaggs Presidential Chair. “You can now evolve proteins continuously and precisely inside cells without damaging the cell’s genome or requiring labor-intensive steps.”
Directed evolution is a laboratory process that involves introducing mutations and selecting variants with improved function over multiple cycles. It’s used to tailor proteins with desired properties, such as highly selective, high-affinity antibodies, enzymes with new specificities or catalytic properties, or to investigate the emergence of resistance mutations in drug targets. However, traditional methods often require repeated rounds of DNA manipulation and testing with each round taking a week or more. Systems for continuous evolution — where proteins evolve inside living cells without manual intervention — aim to streamline this process by enabling simultaneous mutation and selection with each round of cell division (roughly 20 minutes for bacteria). But existing approaches have been limited by technical complexity or modest mutation rates.
T7-ORACLE circumvents these bottlenecks by engineering E. coli bacteria — a standard model organism in molecular biology — to host a second, artificial DNA replication system derived from bacteriophage T7, a virus that infects bacteria and has been widely studied for its simple, efficient replication system. T7-ORACLE enables continuous hypermutation and accelerated evolution of biomacromolecules, and is designed to be broadly applicable to many protein targets and biological challenges. Conceptually, T7-ORACLE builds on and extends efforts on existing orthogonal replication systems — meaning they operate separately from the cell’s own machinery — such as OrthoRep in Saccharomyces cerevisiae (baker’s yeast) and EcORep in E. coli. In comparison to these systems, T7-ORACLE benefits from the combination of high mutagenesis, fast growth, high transformation efficiency, and the ease with which both the E. coli host and the circular replicon plasmid can be integrated into standard molecular biology workflows.
The T-7 ORACLE orthogonal system targets only plasmid DNA (small, circular pieces of genetic material), leaving the cell’s host genome untouched. By engineering T7 DNA polymerase (a viral enzyme that replicates DNA) to be error-prone, the researchers introduced mutations into target genes at a rate 100,000 times higher than normal without damaging the host cells.
“This system represents a major advance in continuous evolution,” says co-senior author Christian Diercks, an assistant professor of chemistry at Scripps Research. “Instead of one round of evolution per week, you get a round each time the cell divides — so it really accelerates the process.”
To demonstrate the power of T7-ORACLE, the research team inserted a common antibiotic resistance gene, TEM-1 β-lactamase, into the system and exposed the E. coli cells to escalating doses of various antibiotics. In less than a week, the system evolved versions of the enzyme that could resist antibiotic levels up to 5,000 times higher than the original. This proof-of-concept demonstrated not only T7-ORACLE’s speed and precision, but also its real-world relevance by replicating how resistance develops in response to antibiotics.

“The surprising part was how closely the mutations we saw matched real-world resistance mutations found in clinical settings,” notes Diercks. “In some cases, we saw new combinations that worked even better than those you would see in a clinic.”
But Diercks emphasizes that the study isn’t focused on antibiotic resistance per se.
“This isn’t a paper about TEM-1 β-lactamase,” he explains. “That gene was just a well-characterized benchmark to show how the system works. What matters is that we can now evolve virtually any protein, like cancer drug targets and therapeutic enzymes, in days instead of months.”
The broader potential of T7-ORACLE lies in its adaptability as a platform for protein engineering. Although the system is built into E. coli, the bacterium serves primarily as a vessel for continuous evolution. Scientists can insert genes from humans, viruses or other sources into plasmids, which are then introduced into E. coli cells. T7-ORACLE mutates these genes, generating variant proteins that can be screened or selected for improved function. Because E. coli is easy to grow and widely used in labs, it provides a convenient, scalable system for evolving virtually any protein of interest.
This could help scientists more rapidly evolve antibodies to target specific cancers, evolve more effective therapeutic enzymes, and design proteases that target proteins involved in cancer and neurodegenerative disease.
“What’s exciting is that it’s not limited to one disease or one kind of protein,” says Diercks. “Because the system is customizable, you can drop in any gene and evolve it toward whatever function you need.”
Moreover, T7-ORACLE works with standard E. coli cultures and widely used lab workflows, avoiding the complex protocols required by other continuous evolution systems.

“The main thing that sets this apart is how easy it is to implement,” adds Diercks. “There’s no specialized equipment or expertise required. If you already work with E. coli, you can probably use this system with minimal adjustments.”
T7-ORACLE reflects Schultz’s broader goal: to rebuild key biological processes — such as DNA replication, RNA transcription and protein translation — so they function independently of the host cell. This separation allows scientists to reprogram these processes without disrupting normal cellular activity. By decoupling fundamental processes from the genome, tools like T7-ORACLE help advance synthetic biology.
“In the future, we’re interested in using this system to evolve polymerases that can replicate entirely unnatural nucleic acids: synthetic molecules that resemble DNA and RNA but with novel chemical properties,” says Diercks. “That would open up possibilities in synthetic genomics that we’re just beginning to explore.”
Currently, the research team is focused on evolving human-derived enzymes for therapeutic use, and on tailoring proteases to recognize specific cancer-related protein sequences.
“The T7-ORACLE approach merges the best of both worlds,” says Schultz. “We can now combine rational protein design with continuous evolution to discover functional molecules more efficiently than ever.”
In addition to Diercks and Schultz, authors of the study, “An orthogonal T7 replisome for continuous hypermutation and accelerated evolution in E. coli,” are Philipp Sondermann, Cynthia Rong, Thomas G. Gillis, Yahui Ban, Celine Wang and David A. Dik of Scripps Research.
This work was supported by funding from the National Institutes of Health (grant RGM145323A).

Chronic diabetic wounds, including diabetic foot ulcers, are a significant burden for patients, as impaired blood vessel growth hinders the healing process. A recent breakthrough offers hope by combining small extracellular vesicles (sEVs) loaded with miR-221-3p and a GelMA hydrogel to target thrombospondin-1 (TSP-1), a protein that suppresses angiogenesis. This new bioactive wound dressing not only accelerates healing but also promotes blood vessel formation, offering a promising new approach to treating one of the most challenging complications of diabetes.
Diabetic wounds, particularly foot ulcers, are notorious for their slow and often incomplete healing due to reduced blood flow and endothelial cell dysfunction. One of the major contributors to this issue is thrombospondin-1 (TSP-1), which inhibits the growth of new blood vessels, a process crucial for tissue repair. Despite various existing treatments, the challenge of addressing this barrier to healing remains unmet. With the global rise in diabetes cases, new treatments targeting the underlying causes of delayed wound healing have become a critical area of research. In light of these ongoing challenges, this study explores a new approach to stimulate angiogenesis and speed up the healing process.
In a new study published in Burns & Trauma, a team of researchers from leading Chinese institutions has unveiled a novel therapeutic solution for diabetic wound healing. The study introduces an innovative wound dressing that combines miR-221OE-sEVs — engineered extracellular vesicles that target and reduce TSP-1 levels — with a GelMA hydrogel to create a sustained-release system. This cutting-edge approach has shown to significantly enhance wound healing and blood vessel formation in diabetic mice, offering hope for more effective treatments in the future.
In their study, the researchers discovered that high glucose conditions commonly found in diabetic wounds lead to increased levels of TSP-1 in endothelial cells, impairing their ability to proliferate and migrate — key processes for angiogenesis. By utilizing miR-221-3p, a microRNA that targets and downregulates TSP-1 expression, they restored endothelial cell function. The engineered miR-221OE-sEVs were encapsulated within a GelMA hydrogel, ensuring a controlled release at the wound site, mimicking the extracellular matrix. In animal trials, this composite dressing dramatically accelerated wound healing, with a notable increase in vascularization and a 90% wound closure rate within just 12 days, compared to slower healing in control groups.
Dr. Chuan’an Shen, a key researcher in the study, shared his excitement about the potential impact of this innovation: “Our results demonstrate the power of combining advanced tissue engineering with molecular biology. By targeting TSP-1 with miR-221OE-sEVs encapsulated in GelMA, we’ve not only improved endothelial cell function but also ensured a sustained and localized therapeutic effect. This breakthrough could revolutionize how we approach diabetic wound care, with the potential to improve patients’ quality of life significantly.”
The success of this engineered hydrogel in diabetic wound healing opens up several exciting possibilities. Beyond diabetic foot ulcers, the technology could be adapted for use in treating other chronic wounds, such as those caused by vascular diseases, or even in regenerating tissues like bone and cartilage. As further research and clinical trials progress, the promise of combining miRNA-based therapies with biocompatible hydrogels could become a cornerstone in regenerative medicine, offering patients more efficient and lasting wound healing solutions.
The study was supported by Beijing Natural Science Foundation (7244411) and Independent Innovation Science Fund of The Fourth Medical Center of the PLA General Hospital (2024-4ZX-MS-06, 2024-4ZX-MS-07, 2024-4ZX-MS-09).

Patients prescribed drugs to help them lose weight may experience a rebound in weight gain after halting their prescription, finds a meta-analysis published in BMC Medicine. The study, which analyses data for patients receiving weight loss drugs across 11 randomised trials, suggests that while the amount of weight regain varies depending on the specific drug, there is a broad trend in associated weight regain after the course of medication concluded.
Six anti-obesity medications (AOMs) have been approved by the US FDA for use in assisting with weight loss, including orlistat, phentermine-topiramate, and semaglutide. Glucagon-like peptide-1 (GLP-1) — a therapeutic developed to assist with diabetes — has also increasingly been prescribed to help patients lose weight. However, recent studies have suggested that patients prescribed AOMs may regain weight in the months after stopping taking these medications.
Xiaoling Cai, Linong Ji, and colleagues conducted a meta-analysis of 11 studies from around the world investigating weight change in patients after they stopped taking AOMs. Overall, the authors analysed data from 1,574 participants in treatment groups and 893 in control groups. Weight change was measured by changes in body weight and BMI after stopping medication. Of the 11 studies included in the meta-analysis: six focused on GLP-1 receptor agonists (RAs); one focused on GLP-1 and GLP dual Ras; one study focused on orlistat; two studies on phentermine-topiramate; and one study on naltexone-bupriopion.
The authors controlled for different contributing factors, including medication type, the presence of diabetes, and the presence or absence of lifestyle changes like diet or exercise. Their analysis found that AOMs were associated with significant weight loss while being used, followed by weight regain starting eight weeks after AOM discontinuation, with weight regain then continuing for an average of 20 weeks before plateauing. Weight regain varied with follow-up, with study participants experiencing significant periods of weight regain at eight, 12, and 20 weeks after AOM discontinuation. The amount of weight regained depended on several factors, including the type of medication taken by participants and the consistency of their lifestyle change. For example, participants who completed a 36-week treatment of tirzepatide, a commercially available GLP-1 RA, regained almost half the weight previously lost after switching to a placebo.
The authors note the meta-analysis did not include studies of lifestyle interventions and bariatric surgery, reducing the degree to which different weight loss approaches could be compared within the context of the study. They also note that weight regain has been reported with other weight loss methods, such as gastric bypass and vertical banded gastroplasty.

Scientists have discovered that jewel wasps can slow down their biological rate of aging.
A study of jewel wasps, known for their distinctive metallic colors, has shown that they can undergo a kind of natural ‘time-out’ as larvae before emerging into adulthood with this surprising advantage.
The groundbreaking study by scientists at the University of Leicester, has now been published in the journal, PNAS. It reveals that this pause in development within the wasp dramatically extends lifespan and decelerates the ticking of the so-called “epigenetic clock” that marks molecular aging.
Aging isn’t just about counting birthdays, it’s also a biological process that leaves molecular fingerprints on our DNA. One of the most accurate markers of this process is the epigenetic clock, which tracks chemical changes in DNA, known as methylation, that accumulate with age. But what happens if we alter the course of development itself?
To find out, a team at the University of Leicester including first author PhD student Erin Foley, Dr Christian Thomas, Professor Charalambos Kyriacou, and Professor Eamonn Mallon, from the department of Genetics, Genomics and Cancer Sciences, turned to Nasonia Vitripennis, also known as the jewel wasp.
This tiny insect is becoming a powerful model for aging research because, unlike many other invertebrates, it has a functioning DNA methylation system, just like humans, and a short lifespan that makes it ideal to study.
The researchers exposed jewel wasp mothers to cold and darkness, triggering a hibernation-like state in their babies called diapause. This natural “pause button” extended the offsprings’ adult lifespan by over a third. Even more remarkably, the wasps that had gone through diapause aged 29% more slowly at the molecular level than their counterparts. Their epigenetic clocks ticked more leisurely, offering the first direct evidence that the pace of biological aging can be developmentally tuned in an invertebrate.

“It’s like the wasps who took a break early in life came back with extra time in the bank,” said Evolutionary Biology Professor Eamonn Mallon, senior author on the study.
“It shows that aging isn’t set in stone, it can be slowed by the environment, even before adulthood begins.”
While some animals can slow aging in dormant states, this study is the first to show that the benefits can persist after development resumes. What’s more, the molecular slowdown wasn’t just a random effect, it was linked to changes in key biological pathways that are conserved across species, including those involved in insulin and nutrient sensing. These same pathways are being targeted by anti-aging interventions in humans.
What makes this study novel and surprising is that it demonstrates a long-lasting, environmentally triggered slowdown of aging in a system that’s both simple and relevant to human biology. It offers compelling evidence that early life events can leave lasting marks not just on health, but on the pace of biological aging itself.
Professor Mallon added: “Understanding how and why aging happens is a major scientific challenge. This study opens up new avenues for research, not just into the biology of wasps, but into the broader question of whether we might one day design interventions to slow aging at its molecular roots. With its genetic tools, measurable aging markers, and clear link between development and lifespan, Nasonia vitripennis is now a rising star in aging research.
“In short, this tiny wasp may hold big answers to how we can press pause on aging.”
Funding for the study was provided by The Leverhulme Trust and The Biotechnology and Biological Sciences Research Council (BBSRC).

19 minutes agoShareSaveShareSaveBBCTom Parker was working alone three miles (4.8km) off the Devon coast when his fishing boat hit a wave and lurched to one side.”I was pulling one of the ropes and I slipped and fell,” he says. “I had this really, really bad pain in my ankle. So much so, I couldn’t get up off the floor.”He didn’t know it at the time, but Tom, 37, had broken his fibula and badly damaged his ankle ligaments.He somehow hauled in his fishing gear and made it to hospital to get patched up, but months after the accident his wound just wouldn’t heal properly.It was only after he turned up at an innovative clinic on the quayside in Brixham that he was put on strong antibiotics and told he needed a second operation.”Without that service, I would have probably ended up with my leg turning septic and I’m not too sure what would have happened after that,” he says.Under a 10-year plan, published last month, health officials said the NHS in England needed to undergo a radical shift, away from hospitals to community care, and away from treating sickness to preventing it in the first place.There are already small-scale examples of that approach in action across the country. So what can we learn from the Brixham model and how can the idea of targeted, local care be extended to treat millions more NHS patients?On a clear summer morning a spare room in the trawler agent’s offices in Brixham harbour is quickly being converted into a temporary health clinic.Blue screens are dragged across to split up the space: a makeshift reception at the front and then just enough room to cram in two GPs, a pharmacist, a physiotherapist, two nurses and someone organising prostate cancer tests.There’s a steady line of port workers coming in, from buyers in the fish market next door to crews from the trawlers in the harbour.”The skippers of the boats and the whole fishing community now know exactly where to find us,” says Dr James Gunning, the local NHS GP in charge of the clinic that day.”They’re a community that fits into health inequalities, where a population either can’t access, or struggles to access, normal NHS services.”Clinic staff start early in the morning, walking around the docks and coaxing workers off the boats with promises of free health screenings and physio.”Fishermen don’t have nine-to-five jobs, they don’t have lunchtime where they can just pop off their fishing boat and to the GP’s office, and so it’s really important that we take those services to them,” says Sandra Welch, chief executive of the Seafarers Hospital Society, which runs the initiative along with another charity, the Fishermen’s Mission.A pop-up Seafit clinic operates every three months in Brixham and at similar sites at ports across the UK, including Folkestone, Peterhead and Kirkeel in Northern Ireland.Some services have started to expand and now offer skin cancer checks, mobile dental services and access to mental health counselling.In its 10-year plan the NHS accepts that those who live in coastal and rural areas are more likely to experience worse health outcomes and to die younger. Seaside and coastal towns often have older populations with more complex health needs, while at the same time local NHS services can suffer from recruitment problems, leaving staffing gaps where they are needed most.An analysis of hospital statistics by the BBC suggests NHS trusts in England treating coastal communities tend to have higher than average wait times for both emergency care and appointments booked in advance, like surgery.The answer, according to NHS bosses and the Westminster government, is to shift as much treatment as possible out of those expensive hospitals.Under the 10-year plan a network of 300 neighbourhood health centres will be opened across England, starting in areas with the lowest healthy life expectancy. The sites, which should eventually be open 12 hours a day, six days a week, will be staffed by a mix of GPs, nurses, social care workers, pharmacists, mental health specialists and other medics.The big idea, as with the Brixham fishermen’s clinic, is to better tailor health services to local communities, and offer people more checks and tests to stop them falling sick in the first place.Much of this might feel very familiar.Similar ambitions were set out by ministers in 2019, 2015 and even by the Blair government back in the early 2000s.”Despite being the right aim, none of those truly delivered,” says Luisa Pettigrew, a GP and senior policy fellow at the Health Foundation think tank.”Moving money out of hospitals and into community services is hard to do. You need the upfront investment and the results might not be visible for five or 10 years, in some cases longer.”Healthcare unions have also questioned how the new centres will be staffed, saying doctors “must not be moved around like pieces on a chess board or made to work even harder”.The medics working in Brixham though are convinced their local, preventative approach can benefit not just the fishing community but the wider health service. “We’ve managed to find new diabetic patients who otherwise may have gone on to develop more serious disease,” says Dr Gunning. “We’ve picked out others with cardiovascular disease, and those with high blood pressure. So we would certainly hope we can prevent more costly illness from developing.”Rob Caunter, who finally retired from the fish market this year, is just finishing his radium treatment for prostate cancer. The 66-year-old, who has a family history of the disease, was diagnosed after staff at the clinic convinced him to take a blood test.”I was gobsmacked really because I didn’t think there was anything wrong with me,” he says. “If I never went for the checks, I don’t think I would be here today. So it was a real godsend for them to come down to the quay.”

Trials of a daily obesity pill have shown it can help patients lose around 12% of their body weight over 72 weeks. The manufacturer, Eli Lilly, says the drug, which is not yet licensed, could be available next year.The daily pill, called orforglipron, works by suppressing appetite and making you feel more full.Preliminary results of a major trial show those on the highest dose lost an average of 12 kilos (nearly two stone) over 16 months but about one in 10 stopped taking the pills due to side effects, including nausea and vomiting.In addition to weight loss, participants also benefited from reductions in cholesterol, blood fats and blood pressure.Dr Kenneth Custer of Eli Lilly said the company was planning to submit the drug for licensing before the end of the year and preparing for a “global launch to address this urgent pubic health need”.So where might this weight loss pill fit in to the blockbuster multi-billion pound market dominated by injectable drugs like Mounjaro, Wegovy and Ozempic?The pill is much less effective than injectables.The 12% weight loss achieved by those taking orforglipron compares to 22% weight loss for patients on Mounjaro, given by weekly injection. Both drugs are made by Eli Lilly. Despite being less effective, there is likely to be a significant market for weight loss pills, as a needle-free means of cutting obesity levels.Obesity experts hope the oral drug will be far cheaper than current injectables which would make it available to many more patients.The full results of the trial will be presented next month at the European Association for the Study of Diabetes annual meeting and published in a peer-reviewed journal.Rival manufacturer, Novo Nordisk, also has an oral version of its injectable drug Wegovy which it has already submitted for approval in the US.In trials, patients on the highest dose of the Novo Nordisk daily pill lost around 15% of their bodyweight after 64 weeks.

A University of Queensland-led study has found Australian skinks have evolved molecular armor to stop snake venom from shutting down their muscles.
Professor Bryan Fry from UQ’s School of the Environment said revealing exactly how skinks dodge death could inform biomedical approaches to treating snakebite in people.
“What we saw in skinks was evolution at its most ingenious,” Professor Fry said.
“Australian skinks have evolved tiny changes in a critical muscle receptor, called the nicotinic acetylcholine receptor.
“This receptor is normally the target of neurotoxins which bind to it and block nerve-muscle communication causing rapid paralysis and death.
“But in a stunning example of a natural counterpunch, we found that on 25 occasions skinks independently developed mutations at that binding site to block venom from attaching.
“It’s a testament to the massive evolutionary pressure than venomous snakes exerted after their arrival and spread across the Australian continent, when they would have feasted on the defenseless lizards of the day.

“Incredibly, the same mutations evolved in other animals like mongooses which feed on cobras.
“We confirmed with our functional testing that Australia’s Major Skink (Bellatorias frerei) has evolved exactly the same resistance mutation that gives the honey badger it’s famous resistance to cobra venom.
“To see this same type of resistance evolve in a lizard and a mammal is quite remarkable – evolution keeps hitting the same molecular bullseye.”
The muscle receptor mutations in the skinks included a mechanism to add sugar molecules to physically block toxins and the substitution of a protein building block (amino acid arginine at position 187).
The laboratory work validating the mutations was carried out at UQ’s Adaptive Biotoxicology Laboratory by Dr Uthpala Chandrasekara who said it was incredible to witness.
“We used synthetic peptides and receptor models to mimic what happens when venom enters an animal at the molecular level and the data was crystal clear, some of the modified receptors simply didn’t respond at all,” said Dr Chandrasekara.

“It’s fascinating to think that one tiny change in a protein can mean the difference between life and death when facing a highly venomous predator.”
The findings could one day inform the development of novel antivenoms or therapeutic agents to counter neurotoxic venoms.
“Understanding how nature neutralizes venom can offer clues for biomedical innovation,” Dr Chandrasekara said.
“The more we learn about how venom resistance works in nature, the more tools we have for the design of novel antivenoms.”
The project included collaborations with museums across Australia.
The research has been published in International Journal of Molecular Sciences.

21 minutes agoShareSaveChloe HaywardShareSaveAmyAs a child, Amy was often violently attacked. At 15, she was threatened with a knife. Now diagnosed with complex PTSD, she’s spent over a decade isolated at home with her mum, desperately seeking help. She has seen a psychiatrist only once.”I was self harming and felt suicidal and didn’t want to be alive anymore,” says Amy, who’s stuck on the long waiting list for NHS mental health treatment.She has bounced up and down the list for years despite being known by crisis teams at her local hospital and GP surgery.Amy is one of thousands of patients across England caught in the backlog of mental health care.Exclusive analysis for the BBC by charity Rethink Mental Illness reveals a stark – and widening – inequality between mental and physical healthcare. There are 12 times more patients waiting longer than 18 months for treatment compared to those with physical conditions.Despite four emergency ambulance callouts this year, Amy remains on an indefinite waiting list for severe mental health treatment – with no timeline and no clear path out of crisis.”I just get told to wait and that services are struggling,” she says. “Sometimes I feel really angry and like screaming and cry all day because I can’t move on with my life.”Amy finally got onto a college course last year but was asked to leave after a crisis.”I feel like I’m going round and round in circles and end up in the same situation every single day,” she says. Amy’s mum no longer works, in order to care for her.Their story reflects the harsh reality behind the statistics: lives unravelling while help remains out of reach.Mental health gap wideningSDI Productions/Getty ImagesWhile the physical health waiting list in England is declining rapidly, the mental health backlog is not coming down rapidly and remains stubbornly high – leaving vulnerable people like Amy stuck and unsupported.”This is an urgent wake-up call,” says Brian Dow, deputy chief executive of Rethink Mental Illness. “Long delays worsen outcomes. It becomes more expensive to treat them. They end up in secondary care, which is more complex – and they fall further from work and become more reliant on benefits.”The analysis uses data from NHS England’s monthly statistics. It includes only adults with severe mental illness that have waited more than 78 weeks.To be included on the waiting list numbers they have to have been referred by community mental health services for further treatment or assessment. Those waiting for talking therapy for mild anxiety or depression are not included in these statistics.A list of organisations in the UK offering support and information with some of the issues in this story is available at BBC Action Line.For the month of May there were 14,586 patients waiting longer than 18 months (78 weeks) for mental health treatment compared to 1,237 people waiting for a physical health operation or appointment.Dr Becks Fisher of the Nuffield Trust health think tank said the government had made progress on a pledge to recruit 8,500 more mental health workers but added that access for people referred to mental health services “had not been as prominent” in recent planning and guidance as reducing physical health waits.She said that the share of health spending going towards mental health was set to fall in the financial year ending in April.In effect that means departmental funding had been favouring physical health services.”Mental health problems disproportionately affect young people,” adds Mr Dow. “It makes huge health sense and huge economic sense to prioritise mental health access.”What ‘good’ care looks likeA new mental health hub in East London is offering a radically different approach – described as an example of what “good” mental health care could look like.Open for walk-in patients without appointments, it provides early intervention in a well-staffed, welcoming space. The effects are already visible – Dr Sheraz Ahmad, a consultant psychiatrist at the centre, says waiting lists have already fallen markedly.The hub has three consultant psychiatrists and a number of mental health specialists that can offer around-the-clock care. The team here is stable.”We want to have conversations early on,” explains Dr Ahmad. “Once we understand the problem, we can point people in the right direction – avoiding that vicious circle.”Here, it’s not just treatment. It’s the continuity of care that helps most. “Having access to the same clinicians that know your story everyday makes a huge difference. It builds trust,” he says.”I come every day and play pool,” says Moyna, who is living with schizophrenia.”Sometimes I watch TV, listen to music – and feel better.”He credits the hub with helping him avoid relapse, and reducing his need for hospital care. He doesn’t need an appointment any more to get support and care in times of crisis, and it is all within his neighbourhood.The facility is the first of its kind, with short-stay beds. It is only one of six planned by NHS England from Birmingham to Sheffield, York to Cumbria.The hubs, which are tricky to set up and so are unlikely to be able to be scaled up drastically, unite the voluntary sector and the NHS.Costs are limited with psychiatrists and infrastructure being the main outlays. Most other staff are volunteers and the east London venue has been provided by a charity.Despite growing calls for more low-cost, high-impact hubs like these, access to this kind of care remains a distant hope for thousands like Amy.Shifting care from hospitals to the communityHealth Minister Stephen Kinnock acknowledges the reality of mental health care in England: “For far too long people have been let down by the mental health system and that has led to big backlogs.”He says the government has a plan to tackle the problems.”We’re seeing more people present with challenges, and the way to deal with that is shifting support from hospitals into the community,” he says.In mental health care, “it’s all about prevention” adds Mr Kinnock. That’s how he thinks the government can help reduce waiting lists. The gap between mental and physical health waits has grown since Labour came into government.Last month, when Amy’s mum was discharged after a short hospital stay, she was given a consultant appointment for her physical condition – an undiagnosed heart problem – just a few weeks later. By contrast, Amy continues to wait.”We don’t know how we’re going to get out of this situation,” she says. “I want to get a job and go to college and things like that. But we’re both just stuck living this life.”

18 minutes agoShareSavePhilippa RoxbyHealth reporterShareSaveGetty ImagesThe government has announced plans to crack down on dodgy cosmetic practitioners who it says are exploiting people and causing harm.Under the new proposals, only qualified health professionals will be able to carry out risky non-surgical Brazilian butt lifts (BBLs) and clinics will need to meet strict rules to obtain licences to offer fillers and Botox.Under-18s will also be protected from potentially dangerous beauty trends on social media with age restrictions on certain procedures.The industry has welcomed the plans, although the government says it now needs to consult further to figure out exactly how this will work in practice.There has been concern over the lack of rules in parts of the non-surgical cosmetic industry for some years.Many procedures, such as liquid BBLs, are marketed as non-surgical but are invasive and carry serious risks, experts say.Non-surgical BBLs are one of the most high-risk procedures which involve filler being injected into the buttocks to make them bigger, more rounded or lifted. Women have told the BBC of dangerous complications, pain and permanent scarring after treatment by rogue operators. In September 2024, Alice Webb is believed to have become the first person to die in the UK after receiving this unregulated procedure.The government says it will bring in regulations for the most dangerous procedures first – such as breast fillers and BBLs – which means only some qualified health professionals will be able to perform them.Rules on who can offer lower-risk treatments such as lip fillers, Botox and facial dermal fillers will also change. A licensing scheme run by local authorities will require practitioners to meet strict safety, training and insurance standards before they can operate.However, it could still be several years before any of these measures comes into force. The plans will be subject to public consultation and must go through Parliament before they are introduced.’Wild west’Health Minister Karin Smyth said the industry had been plagued by “a Wild West” of “cosmetic cowboys causing serious, catastrophic damage”.She said the government was taking action to protect people, support honest practitioners and root out the unqualified, dangerous ones, while also reducing the costs to the NHS of fixing botched procedures.”This isn’t about stopping anyone from getting treatments. It’s about preventing rogue operators from exploiting people at the expense of their safety.” A public consultation in 2023 demonstrated widespread support for tighter regulation across the industry.Ashton Collins, director of Save Face, a register of approved clinics and practitioners, said she had seen first hand “the devastating impact these procedures can have on the lives of victims and their families”.”I am delighted that the government has recognised the significant and potentially fatal risks posed by highly dangerous procedures like liquid BBLs, and has made it a priority to implement restrictions to protect public safety.”There are thought to be around 16,000 businesses involved in non-surgical cosmetic procedures, which have seen a huge boom in popularity in recent years.The Joint Council for Cosmetic Practitioners (JCCP) said ensuring all cosmetic practitioners were regulated and licensed, appropriately insured and worked from safe premises had become “imperative”.”These proposals have our full support and we welcome the opportunity to engage in further consultation,” says JCCP executive chair Prof David Sines. Health officials are currently investigating 38 cases of poisoning following suspected fake Botox injections.The public is reminded to make sure they only use registered and qualified practitioners and use products licensed for use in England.The Scottish government recently set out measures to improve the safety and standards of the non-surgical cosmetic procedures industry, following a consultation.

44 minutes agoShareSaveKatie McEvinneyBBC DisclosureShareSaveBBCExtra-strong nicotine products designed to appeal to children – including some which have ripped off the logos of popular sweet brands – are being openly sold in shops, BBC Scotland has found.A Disclosure reporter, filming undercover, bought nicotine pouches which mimic the name and branding of the well-known ‘Millions’ sweets in a shop in the east end of Glasgow.The shop worker who sold the pouches claimed they contained 100mg of nicotine, which would make them about 10 times the strength of a cigarette.Tests later showed a lower level of 17mg, which would still be defined as extra strong by most legitimate manufacturers.Trading Standards said they were concerned about products with a “worrying child appeal” as well as flavours and “eye-catching packaging” that mimicked sweets.However, there is no law restricting the age of sale for nicotine pouches, so any child can legally enter a shop and buy the addictive products.No strength restrictionsThe pouches are small, pillow-like sachets that contain nicotine – a chemical found in tobacco which acts as a stimulant.There are no restrictions on the strength of the nicotine in the pouches.They are placed under the top lip, against the gum and deliver a nicotine hit which can be stronger than cigarettes or vapes. The pouches are significantly less harmful than cigarettes, and because chemicals do not enter the lungs, they may carry fewer risks than vapes.Some people use them as a way to quit smoking, though they are not recommended by the NHS.Kate Pike, from the Chartered Institute of Trading Standards, said it was “outrageous” that products were mimicking popular sweet brands in a bid to target children.For the BBC Disclosure documentary Nicotine Pouches: What’s the Problem?, a reporter was secretly filmed buying a tub of orange-flavoured Millions pouches for £7.50.The shop worker who sold the product told her: “They’re special.”The product did not have all of the required hazard warnings, nor did it have traceable manufacturer details.The design on the tub featured photos of the Millions sweets, made by Scottish confectionery manufacturer Golden Casket Ltd.They told the BBC they had no connection to nicotine pouches and were “appalled” their branding was being used in this way.Another brand called ‘Candys’, with pictures of Gummy Bears, was also for sale.The makers of the Candys brand did not respond.Ms Pike told the BBC: “Millions sweets are clearly a product for children and there is no reason to link them with nicotine pouches unless you want to attract children.”If this was alcohol, there would be an outcry. A child coming across that would think it’s for them and nicotine is a highly addictive substance.”Retailers should be more responsible for what they are offering in their communities.”Prof Crawford Moodie, of the University of Stirling, has been researching the marketing of tobacco and nicotine products for years.He said: “It makes you question what these companies are trying to do. I mean, clearly, they don’t have consent to do that.”But the fact that companies are putting these on the market and retailers are quite happy to sell them shows that we are not in a good place with respect to controlling the nicotine pouch market and protecting young people in particular.”There’s very little in the packaging to tell you that they’re not sweets and the potential for abuse and detrimental effects for young people are clearly there.”When contacted by the BBC, the retailer said it had now taken the Millions product off its shelves.The Disclosure programme spoke to young people who said they had used pouches.Alex started taking them two years ago when he was 15 in school and became addicted. He said he had never tried smoking or vaping before.It was the packaging, how the different flavours were advertised and seeing his friends take the pouches, that made him want to try them himself.He said: “I think it was just something different.”It went from one a day to three a day to – at my highest – I was using probably 15 a day.”If I didn’t take them, I’d just get withdrawals and just feel demotivated and like I didn’t want to do anything until I took another one.”Nicotine pouches are currently unregulated and can be sold legally to under-18s.The Tobacco and Vapes Bill is going through the House of Lords but there are calls for government to speed up the legislation to shut down loopholes.The bill will ban the sale of nicotine pouches to under-18s and will restrict things like where they can be positioned in shops as well as limiting flavours, strengths, packaging and how they are advertised.”We are receiving widespread reports from across the UK that these nicotine pouches are being sold to children,” said Ms Pike, Trading Standards’ lead officer for tobacco and vaping.”Parents are getting in touch assuming we can take action and are shocked when we tell them we can’t. “At the moment it’s perfectly legal and there’s nothing we can do.”The BBC contacted several of the biggest manufacturers of nicotine pouches and all of them supported forthcoming legislation.British American Tobacco said its pouches “should never be used by those under-age”, manufacturer Phillip Morris said nicotine pouches had proved “hugely successful” for adults to quit cigarettes, and Japan Tobacco International said “minors should never use or access nicotine-containing products”.