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Social care: 'Jo's care will cost £1.5k a week - the system is broken'

It was only a year ago that Boris Johnson stood up in Parliament and said he was going to fix the long-term problems in social care. He announced a new tax - to raise about £12bn a year - would be spent on health and social care costs only. But the UK's new prime minister, Liz Truss, has already scrapped the plan. Families, carers and care providers have been left asking where the funding will now come from to fix a system, which they say is broken.

Dr Jo Wilson was a high-flying international executive before she was diagnosed with dementia two years ago, aged 66. Her husband, Bill, insists he's her husband, not her carer. But he now sees to Jo's every need. 

Bill has had to find fight and persistence to navigate the world of dementia care. "It took me two years to get a care package in place for Jo," he explains. "And I only got that because Jo had a collapse at home and was taken into hospital."

Even after it was confirmed Jo could have carers come to their home to help, Bill found the variety of staff, unreliable time keeping, and a lack of understanding of dementia, left him questioning whether it was worth it.

He's now permanently exhausted, and frustrated.

Professor Martin Green, chief executive of Care England, says without a complete restructure of the social care system "thousands, if not millions, will be left without support, and the NHS will be on its knees". It is a warning heeded by others.

A new poll by Ipsos Mori for BBC News, suggests more than 70% of those over 55 are not confident that social care services will provide care to those in need. More than half of responses cited staff shortages and limited public funding as their main concerns.

Care providers say it's these issues that are putting them under extreme pressure. "We know currently that three in five people with dementia do not get the support that they need once they have that diagnosis. And that leads to crisis in care", says Fiona Carragher, director of policy at the Alzheimer's Society."

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Source: BBC News, 7 October 2022

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UK power cut warning prompts fear for people using life-saving machines

Rolling power cuts enforced this winter if gas supplies run extremely low could endanger thousands of people who use life-saving machines at home, health leaders have warned.

They spoke out after National Grid warned on Thursday that households could experience a series of three-hour electricity outages this winter to manage extreme gas shortages, for example if Vladimir Putin shuts off supplies from Russia and cold weather sends demand soaring.

Such an event would mean consumers in different parts of the country being notified a day in advance of three-hour blocks of time during which their power would be cut off.

The prospect of rolling power outages caused alarm among some health groups, with particular concerns for the thousands of vulnerable patients who rely on electrical devices to keep themselves alive and healthy.

Laurie Cuthbert, a director of Kidney Care UK, a health charity, said thousands of adults and children depended on a constant source of power to provide life-saving dialysis at home.

Andy Fletcher, the chief executive of Together for Short Lives, which advocates for the UK’s 99,000 seriously ill children and their families, said: “For seriously ill children a three-hour blackout could deprive them of vital life-saving equipment such as ventilators, oxygen and temperature control. Families would be forced to decide whether to admit their child to hospital, which would be extremely disruptive and distressing.”

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Source: The Guardian, 6 October 2022

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Patients declining two dates could be struck from waiting lists

Patients face being removed from the NHS waiting list if they decline two dates offered to them for their treatment, new internal guidance seen by HSJ reveals.

The “interim operational guidance” from NHS England says if patients decline two proposed dates for treatment, they should be moved on to “active monitoring” and removed from the NHS’s main elective waiting list.

Waiting list consultant Rob Findlay said the guidance was an “abuse of national waiting times statistics”, and that “the menacing of patients [proposed in the strategies outlined in the guidance] is appalling”.

The Royal College of Surgeons of England told HSJ  it had not been consulted on the guidance, as it would have expected. The college said the guidance could be positive if used “sensibly” but it warned that “used poorly, it could see patients lost in the system, or banished to waiting list purgatory”.

NHSE elective recovery adviser Sir Jim Mackey told HSJ the guidance was to support trusts to manage “a small number of patients who… continue to decline treatment date offers [and] to fill appointment slots so patients get seen as soon as possible”.

He said there were long-waiting patients who have “refused offers of treatment alternative, sometimes multiple offers. This is absolutely their choice, but it does make access for other patients more difficult when slots are held for them”.

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Source: HSJ, 6 October 2022

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We must challenge 'doctor knows best' attitude, bereaved mother says

Merope Mills, an editor at the Guardian, has questioned doctors' attitudes after her 13-year-old daughter Martha's preventable death in hospital.

Martha had sustained a rare pancreatic trauma after falling off a bike on a family holiday, and spent weeks in a specialist unit where she developed sepsis.

An inquest concluded that her death was preventable, and the hospital apologised.

Ms Mills said her daughter would be alive today if doctors had not kept information from the parents about her condition, because they would have demanded a second opinion.

She added that doctors' attitudes "reeked of misogyny", citing a moment when her "anxiety" was used as an argument to not send critical care to Martha.

In a statement, Prof Clive Kay, chief executive of King’s College Hospital NHS Foundation Trust said he was "deeply sorry that we failed Martha when she needed us most".

"Our focus now is on ensuring the specific learnings from her case are used to improve the care our teams provide - and that is what we are committed to doing."

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Source: BBC News, 6 October 2022

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Four of UK’s top countries for nurse recruitment on WHO ‘red list’

Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used.

Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022.

All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers.

Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer.

But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees.

Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”.

“It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said.

“This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce.

“They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.”

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Source: Nursing Times, 4 October 2022

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WHO alert over India-made cough syrups after deaths in The Gambia

A global alert has been issued over four cough syrups after the World Health Organization (WHO) warned they could be linked to the deaths of 66 children in The Gambia.

The syrups have been "potentially linked with acute kidney injuries and 66 deaths among children", it said.

The products were manufactured by an Indian company, Maiden Pharmaceuticals, which had failed to provide guarantees about their safety, the WHO added.

The WHO identified the medicines as Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup.

The four products had been identified in The Gambia, but "may have been distributed, through informal markets, to other countries or regions", the WHO added, in the alert published on its website.

It warned that their use may result in serious injury or death, especially among children.

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Source: BBC News, 6 October 2022

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‘Sack poor NHS managers’, says new government adviser

An MP who has just become a ministerial assistant in the Department of Health and Social Care has called for ‘underperforming’ NHS managers to be ‘sacked’, claiming some executives in the health service earn up to £500,000 per year.

James Sunderland, who was made a Department of Health and Social Care parliamentary private secretary just days ago, told a Conservative party conference fringe event that money spent on executives should be reinvested into the coal face.

Mr Sunderland, MP for Bracknell since 2019, also said the NHS is “better funded now than at any time in its history”.

He said: “The solution is not more money, it’s better managers. We need to get to grips with the senior management of the NHS. People not performing need to be sacked.

“We need to reinvest money spent on executives and management into the coalface. It’s about efficiency in how we do business.”

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Source: HSJ, 3 October 2022

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Coroner warns of lack of change since man's death

A coroner has raised concerns about a mental heath trust where staff falsified records made on the night a man died.

Eliot Harris, 48, died in the Northgate Hospital in Great Yarmouth, run by the Norfolk and Suffolk Foundation Trust (NSFT), in April 2020.

Norfolk coroner Jacqueline Lake said that, two years on, staff were still not recording observations properly.

The 48-year-old, who had schizophrenia, had been sectioned under the Mental Health Act after he became agitated at his care home and refused to take medication. He was taken to Northgate Hospital and, after a period in a seclusion room, was transferred to a private room on the ward.

Mr Harris was discovered unresponsive in bed during the early hours of 10 April and pronounced dead half an hour later.

In a Prevention of Future Deaths Report (PFDR), Ms Lake said: "Quality audits undertaken following Eliot Harris's death, show that observations are still not being carried out and recorded in accordance with NSFT's most recent policy - more than two years following Eliot's death."

She said that on the night Mr Harris died there was no nurse in charge and instead of being allocated specific tasks, staff were told to "muck in", causing confusion about job responsibilities.

These issues were not resolved at the time of the inquest, she said, with no evidence provided about whether specific tasks were allocated on the night shift.

Not all staff had been trained in recording observations, there was a lack of evidence about procedures for entering a patient's room over concerns for their welfare, and there was "still some way to go to make sure care plans are completed", Ms Lake said.

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Source: BBC News, 6 October 2022

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How 175 British children were infected with HIV

At least 175 children with the blood disorder haemophilia were infected with HIV in the 1980s, according to documents from the national archives seen by BBC News. Some of the families affected are giving evidence at a public inquiry into what has been called the worst treatment disaster in the history of the NHS.

It was almost 36 years ago - in late October 1986 - but Linda will never forget the day she was told her son had been infected.

She had been called into a consulting room in Birmingham Children's Hospital, with 16-year-old Michael.

As a toddler, he had been diagnosed with haemophilia, a genetic disorder that stopped his blood clotting properly.

Linda assumed the meeting was to discuss moving his care to the main Queen Elizabeth Hospital in the city.

"It was so routine that my husband stayed in the car outside," she says.

"Then, all of a sudden, the doctor said, 'Of course, Michael is HIV positive,' and he came out with it like he was talking about the weather outside. My stomach just fell."

Between 1970 and 1991, 1,250 people with blood disorders were infected with HIV in the UK after taking Factor VIII - a new treatment that replaced the clotting protein missing from their blood.

About half of those infected with HIV died of an Aids-related illness before life-saving antiretroviral drugs became available.

Almost three decades later, Linda is giving evidence to the long-running public inquiry into the treatment disaster.

She will appear alongside other parents, in a special session about the experiences of families whose children were infected in the 1970s and 80s.

"I felt as though I needed to do it because I want to help get to the bottom of it," she says. "We all want to know why it was allowed to happen and to keep on happening as well."

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Source: BBC News, 6 October 2022

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Nurses to vote on strikes in Royal College of Nursing’s first ever UK-wide ballot

Nurses will start voting on Thursday on whether to strike over pay amid warnings that record numbers are leaving the profession.

Around 300,000 members of the Royal College of Nursing (RCN) are being asked if they want to mount a campaign of industrial action in the union’s first UK-wide ballot.

The RCN said new analysis by London Economics to coincide with the ballot launch showed that pay for nurses has declined at twice the rate of the private sector in the last decade.

It is the first time in its 106-year history that the RCN has balloted members across the UK on strike action and it is urging them to vote in favour. 

RCN general secretary Pat Cullen said in a message to those being balloted: “This is a once-in-a-generation chance to improve your pay and combat the staff shortages that put patients at risk.

“Governments have repeatedly neglected the NHS and the value of nursing. We can change this if together we say ‘enough is enough’.

“Record numbers are feeling no alternative but to quit and patients pay a heavy price. We are doing this for them too."

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Source: The Independent, 6 October 2022

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Vulnerable patients injured by 'inadequate' service

A troubled trust’s inpatient wards for people with a learning disability or autism have been rated “inadequate”, with staff criticised for resorting to restraint too readily which sometimes injured patients.

Care Quality Commission inspectors visited Lanchester Road Hospital in Durham and Bankfields Court in Middlesborough, run by Tees, Esk and Wear Valleys Foundation Trust, in May and June.

They found most people were being nursed in long-term segregation and some patients had very limited interaction with staff.

Among the CQC’s main criticisms was of high levels of restrictive practice used by staff, including seclusion, restraint and rapid tranquilisation.

Inspectors said incidents were not always recorded and staff did not learn from them to reduce levels of restrictions in place. They also warned staff were not always able to understand how to protect people from poor care and abuse.

Karen Knapton, CQC’s head of hospital inspection, said: “Three people had been injured during restraints, and 32 incidents of injury had been reported for healthcare assistants, some requiring treatment.

“This is unacceptable and measures must be put in place to keep patients and staff safe.”

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Source: HSJ, 5 October 2022

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Cancer patients in England and Wales facing ‘unacceptable’ wait for support

The physical and mental health of tens of thousands of cancer patients in England and Wales is deteriorating because they are having to wait months for financial support from the government, a charity has warned.

Macmillan Cancer Support said many are waiting as long as five months to receive their personal independence payment (PIP), which is paid to people with long-term physical and mental health conditions or disability, and who have difficulty doing certain everyday tasks or getting around.

Health leaders said the “unacceptable” situation had now become critical, with thousands of cancer patients increasingly desperate for help.

Research for the charity found that among people with cancer who receive PIP, more than one in four (29%) have reported a deterioration in physical or mental health while they wait to receive it. This rises to almost half (46%) among those who wait more than 11 weeks to receive their first payment.

Macmillan is launching a “Pay PIP Now” campaign, saying it is hearing from patients going into debt, skipping meals and cancelling medical appointments due to travel costs, all because of delays to PIP. It wants ministers to cut the average wait times for PIP from 18 weeks at the moment to 12.

Research suggests most people with cancer suffer a financial impact from their diagnosis, including from being unable to work while having treatment, increased heating bills to stay warm and the cost of attending appointments.

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Source: The Guardian, 6 October 2022

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Radar that checks people living with Parkinson’s in their own home

A miniature radar system that tracks a person as they walk around their home could be used to measure the effectiveness of treatments for Parkinson’s.

The disease, which affects about 145,000 people in the UK, is linked to the death of nerve cells in the brain that help to control movement.

With no quick diagnostic test available at present, doctors must usually review a patient’s medical history and look for symptoms that often develop only very slowly, such as muscle stiffness and tremors.

The device, about the size of a wi-fi router, is designed to give a more precise picture of how the severity of symptoms changes, both over the long term and hourly.

It sits in one room and emits radio signals that bounce off the body of a patient. Using artificial intelligence it is able to recognise and lock on to one individual. Over several months it will notice if their walking speed is becoming slower in a way that indicates that the disease is becoming worse. During a single day it can also recognise periods where a person’s strides quicken, which means that it could be used to monitor the effectiveness of new and existing drugs, even where the effects last a relatively short time.

“This really gives us the possibility to objectively measure how your mobility responds to your medication. Previously, this was nearly impossible to do because this medication effect could only be measured by having the patient keep a journal,” said Yingcheng Liu, a graduate student at the Massachusetts Institute of Technology (MIT) who is part of the team behind the device. 

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Source: The Times, 22 September 2022

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Residents 'not safe' at four-inquest care home

A care home that will close after admitting "shortcomings in care" and failures in leadership has been labelled "not safe" by inspectors.

The Elms in Whittlesey, Cambridgeshire will shut later this month, and the Care Quality Commission (CQC) has found the service to be inadequate.

In May, the BBC first reported the concerns of relatives about The Elms after their loved ones died in 2019, weeks after a meeting in which worries were raised about "poor care".

Inquests into the deaths of the residents - George Lowlett, Margaret Canham and David Poole - remain ongoing. HC-One also apologised to the family of Joyce Parrott, who died in April 2020.

Inspectors found "people were not safe and were at risk of avoidable harm" and described multiple occasions when people had "not received their medicines as prescribed".

Other findings included:

  • Staff had not referred all potential safeguarding events to the local authority
  • A failure to "establish systems to ensure people were effectively safeguarded from abuse"
  • The provider had failed to learn when things went wrong
  • "Widespread and significant shortfalls" in leadership
  • No reliable record of the staff that had worked at the home and a reliance upon agency staff, which "resulted in people not receiving consistent care"

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Source: BBC News, 5 October 2022

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AI eye checks can predict heart disease risk in less than minute, finds study

An artificial intelligence (AI) tool that scans eyes can accurately predict a person’s risk of heart disease in less than a minute, researchers say.

The breakthrough could enable ophthalmologists and other health workers to carry out cardiovascular screening on the high street using a camera – without the need for blood tests or blood pressure checks – according to the world’s largest study of its kind.

Researchers found AI-enabled imaging of the retina’s veins and arteries can specify the risk of cardiovascular disease, cardiovascular death and stroke.

They say the results could open the door to a highly effective, non-invasive test becoming available for people at medium to high risk of heart disease that does not have to be done in a clinic.

“This AI tool could let someone know in 60 seconds or less their level of risk,” the lead author of the study, Prof Alicja Rudnicka, told the Guardian. If someone learned their risk was higher than expected, they could be prescribed statins or offered another intervention, she said.

Speaking from a health conference in Copenhagen, Rudnicka, a professor of statistical epidemiology at St George’s, University of London, added: “It could end up improving cardiovascular health and save lives.”

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Source: The Guardian, 4 October 2022

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Emergency care in ‘dire’ situation as performance plummets over weekend

Several ambulance trusts have moved to the highest level of alert in the wake of severe pressure on emergency services in recent days.

Internal data seen by HSJ suggests ambulance response times have deteriorated dramatically, while the average time for call handlers to answer 999 calls has increased to almost two minutes in some areas.

Staff across the country have been sounding the alarm over the pressures, with one senior source saying the situation was “really dire” again, after a period in which pressures had eased in August and September.

The internal data showed ambulance trusts in the South West, East of England, London and the West Midlands had all declared the highest level of alert, known as REAP 4. More are expected to follow.

The average response time for category 2 calls in the South West – including suspected heart attacks and strokes – was 1 hour 24 minutes, with 10% of these calls responded to in more than 3 hours 11 minutes. The target is 18 minutes.

Emergency departments have also faced severe pressure. An emergency care consultant in Plymouth tweeted that patients were facing 70-hour waits to be admitted to wards, with some waiting 18 hours to be handed over by ambulance staff. Fionna Lowe added: “I have taken to asking families to feed their relatives. It has never been this bad.”

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Source: HSJ, 4 October 2022


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Covid inquiry ‘marginalising’ bereaved on first day of hearing

Bereaved families fear their experiences will be “diluted” in the UK Covid-19 Inquiry after it was confirmed their evidence would be submitted to a third-party company.

Instead of the usual “pen portraits” heard in the inquiry, families will submit their evidence to a private research company as part of a parallel listening exercise that will analyse the responses and feed back the findings to the inquiry chaired by Baroness Heather Hallett.

Matt Fowler, co-founder of the Covid-19 Bereaved Families for Justice campaign, said while families believe the start of the inquiry is a step in the right direction after campaigning for two years, they fear being excluded from the inquiry because of the listening exercise.

“All bereaved families want from the inquiry is the same outcome that anyone should, for lessons to be learnt from our loss that can stop the monumental scale of death that took place from happening again,” Matt said following the preliminary hearing. “As Baroness Hallett herself has acknowledged, for that to happen the experiences of the bereaved must be learnt from, so why is she leaving us out in the cold instead of working with us?”

A&E doctor Saleyah Ahsan, from east London, worked in intensive care units during the pandemic. She said she remembers holding hands with people and telling them they needed to be incubated as they desperately called their families – some died in intensive care.

“It is very important that stories jump off the page and are real because they are real,” 

She added: “If we really want to make sure we get this right there is only this inquiry, it has to be right. I am a medic, I see the numbers are rising, it’s autumn. Thankfully we’ve got a booster but hospitals are getting busy – I’m worried.”

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Source: The Independent, 4 October 2022

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Hospital merger confusion blamed for cancer deaths

A ‘leading’ cancer service has reported a series of safety incidents which contributed to patients being severely harmed or dying, HSJ  has reported.

An internal report at Liverpool University Hospitals Foundation Trust suggests the incidents within the pancreatic cancer specialty were partly linked to patient pathways being ill-defined following the merger of its two major hospitals.

The report lists seven incidents involving severe harm or death, and five involving moderate harm. It is not clear how many of the patients died.

The trust was formed in 2019 through the merger of the Royal Liverpool and Aintree acute sites, with the consolidation of clinical services an integral part of the plans. However, there were no formal plans to change the configuration of pancreatic cancer services, which already operated under a “hub and spoke” model.

In one finding relevant to all 12 incidents, the report said: “Patient ownership and clinician accountability (local vs specialist) have not been defined following the merger of the legacy trusts and subsequent service reconfigurations.

“This has contributed to system failures in the provision of timely quality care, particularly in patients with time-critical clinical uncertainty.”

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Source: HSJ, 5 October 2022

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Woman died from sepsis 'as doctors argued for hours over which ward to treat her on'

Tina Hughes, 59, died from sepsis after doctors allegedly delayed treating the condition for 12 hours while they argued over which ward to treat her on.

Ms Hughes was rushed to A&E after developing symptoms of the life-threatening illness on September 8 last year. Despite paramedics flagging to staff they suspected sepsis, it was not mentioned on her initial assessment at Sandwell General Hospital, in West Bromwich.

A second assessment six hours later also failed to mention sepsis while medics disagreed over whether to treat her on a surgical ward or a high dependency unit.

The grandmother-of-five was eventually transferred to the acute medical unit at 3am the next morning where sepsis was finally diagnosed, but she continued to deteriorate and was admitted to intensive care four hours later and put on a ventilator.

She died the following morning.

A serious incident investigation report by Sandwell and West Birmingham Hospitals NHS Trust has since found there was "a delay in explicit recognition of sepsis".

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Source: The Telegraph, 4 October 2022

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Teen held in hospital for months due to lack of secure children’s home place

A young teenager with complex needs in local authority care has been deprived of their liberty and held in hospital for several months because no secure placement could be found anywhere in England, a family court has heard.

General hospitals are not registered to provide secure accommodation for children in this situation, and do not have the specialist staff required to provide the care and therapeutic input needed.

High court judges have repeatedly raised concerns that children in urgent need of secure accommodation are waiting months to find a place, to the detriment of their mental health.

England has an acute shortage of secure therapeutic placements for children with severe emotional and psychological needs. Government figures published in March show there are just 132 spaces in secure homes for children with urgent and complex needs.

On any given day, about 50 children – twice as many as in the previous 12 months – were seeking a placement. About 30 children – an increase of a third on the previous 12-month period – end up placed hundreds of miles from home in Scotland due to the lack of available secure units in England.

A Department for Education spokesperson said: “All children and young people deserve to grow up in stable, loving homes, and local authorities have a statutory duty to ensure that there are enough places for their looked-after children.

“We are supporting local authorities through providing £259m to maintain capacity and expand provision in secure and open children’s homes.

“This will provide high quality, safe homes for some of our most vulnerable children. It will mean children can live closer to their families, schools, and health services, in settings that meet their needs.”

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Source: The Guardian, 4 October 2022

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Failing NHS hospitals to be boosted by Cobra-style meetings

Underperforming hospitals face special measures before what ministers warn will be one of the worst winters in the history of the NHS.

Thérèse Coffey, the health secretary, told a fringe event at the Conservative Party conference that there was too much “variation in what patients experience” as her department plans to impose closer control on failing hospitals.

Robert Jenrick, the NHS minister, said that the government “shouldn’t be tolerant of those parts of the NHS which are underperforming” and had demanded quicker improvement from more than a dozen hospitals.

He acknowledged that NHS staff were overstretched in the aftermath of the pandemic, saying that he wanted to “put boosterism to one side” and accept that the shortage of doctors and nurses was the biggest problem facing the health service.

However, he also questioned why some hospitals were doing so poorly when other nearby hospitals with similar problems were seeing much shorter waits.

“A very striking dynamic is the variability that we see within the NHS and I think this is where we as Conservatives have a message, which is that we shouldn’t be tolerant of those parts of the NHS which are underperforming.”

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Source: The Times, 4 October 2022

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Lung cancer tests urged for ex-smokers over 55

Lung cancer screening should be offered to over-55s who have smoked, government advisers have said.

New guidance from the UK National Screening Committee has called for a mass introduction of checks for all present and former smokers between the ages of 55 and 74. While the NHS offers routine screening for other types of cancer, including breast, bowel and cervical, there is no lung cancer screening programme.

Lung cancer is the UK’s deadliest form and every year 48,000 people are diagnosed, with 35,000 deaths. The death rate is so high because it is often spotted when symptoms develop and it is too late for treatment. Only 5% of those diagnosed with lung cancer at the latest stage survive for five years, but when picked up early more than half survive.

Officials have recommended targeted screening to cut death rates. It involves a CT scan which takes a detailed picture of the lungs to look for abnormalities.

The National Screening Committee said that targeting all of those who have smoked would reduce deaths because 70% of lung cancer cases are caused by smoking.

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Source: The Times, 30 September 2022

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Tribunal told of 'failure' over girl's blood tests

If doctors had tested a nine-year-old girl's blood sooner they may have changed the treatment she received before her death, an expert witness has confirmed to a medical tribunal.

The hearing was told this was a "significant failure" in the care of Claire Roberts.

Claire died at the Royal Belfast Hospital for Sick Children in 1996. In 2018 a public inquiry concluded she died from an overdose of fluids and medication caused by negligent care. At the time, her parents were told a viral infection had spread from her stomach to her brain.

The General Medical Council (GMC) said one of the doctors involved in Claire's care, Dr Heather Steen, acted dishonestly in trying to conceal the circumstances of her death.

Dr Steen denied allegations that she acted dishonestly and engaged in a cover-up.

The Medical Practitioners Tribunal Service (MPTS) heard from a defence expert witness on Monday who said doctors not checking the sodium levels in Claire's blood earlier was a "significant failure" in her care.

Dr Nicholas Mann told the tribunal he would have ordered more blood tests on Claire on the morning after she was admitted to hospital but he said he did not know if this would have prevented her death.

"There should have been more attention to her fluids and electrolytes on the day after admission. Whether that would have altered the final outcome I don't know but certainly it would have been sensible to do that," he said.

The tribunal also heard that Claire's death was not referred to a coroner, despite this being something all of the doctors caring for her would have had a duty to do.

It was also told that a letter sent to Claire's parents from the hospital in 2005 contained inaccuracies.

During questioning of Dr Mann, a barrister for the GMC highlighted the involvement of Dr Steen in compiling the letter which was signed by another doctor. Tom Forster KC said it was the GMC's case that Claire's family were given incorrect information about potential causes of her death despite these not being definitively diagnosed.

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Source: BBC News, 3 October 2022

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Record number of NHS staff hand in resignation

The latest NHS workforce figures have shown that a record number of staff voluntarily resigned from their jobs during the first quarter of this financial year.

According to the data, almost 35,000 NHS workers resigned voluntarily, which was up from 28,105 during the same period in 2021, and 19,380 in 2020. It is also higher than in any equivalent first quarter over the last 10 years.

The most common reason for leaving during quarter one of 2021-22 was ‘work-life balance’, with almost 7,000 NHS workers citing this as their reason for leaving their jobs.

Close to 2,000 NHS workers also left in the same period in search of a ‘better reward package’, with almost 1,000 reporting ‘incompatible working relationships’. In it unclear from the NHS digital data whether they left the NHS altogether.

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Source: HSJ, 3 October 2022

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Hundreds of thousands more women than men prescribed powerful anti-anxiety drugs ‘harder to come off than heroin’

Hundreds of thousands more women than men have been prescribed powerful anti-anxiety drugs which experts warn are harder to come off than heroin, The Independent can reveal.

New information obtained under freedom of information (FOI) laws shows women in England were 59% more likely to be prescribed benzodiazepines – better known by the brand names of Valium, Xanax and Temazapam – than men between January 2017 and December 2021.

Benzodiazepines are commonly prescribed for anxiety and insomnia, with the drug’s withdrawal symptoms including depression, acute anxiety, insomnia, vivid nightmares, headaches, vomiting, shakes, cramps and, in the worst cases, seizures which can cause death.

Many countries explicitly state benzodiazepines should not be taken for more than four weeks, while research has found benzodiazepines can cause memory loss and Alzheimer’s.

In September 2020, the US Food and Drug Administration announced its “black box warning” must be placed on all benzodiazepines to inform patients withdrawal from the drugs can be life-threatening.

Stephen Buckley, head of information at Mind, a leading UK mental health charity, told The Independent it was difficult to “know the exact reasons behind why women are more likely to be prescribed benzodiazepines than men” but said the FOI “findings support others which show gender discrepancies in prescribing have been occurring for a long time”.

“Previous research in some parts of the world has found that male prescribers were more likely to prescribe benzodiazepines to female patients than male patients. Research into the reasons behind gender differences in prescribing psychiatric medication is important.”

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Source: The Independent, 3 October 2022

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