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RCOG launches Race Equality Taskforce

The Royal College of Obstetricians and Gynaecologists ( (RCOG) has today launched a Race Equality Taskforce to better understand and tackle racial disparities in women’s healthcare and racism within the obstetric and gynaecology workforce.

Addressing health inequalities is a key priority area for RCOG President Dr Edward Morris, who is co-chairing the Taskforce alongside Dr Ranee Thakar, Vice President of the RCOG, and Dr Christine Ekechi, Consultant Obstetrician & Gynaecologist and RCOG Spokesperson for Racial Equality.

Statistics show, for example, that black women are five times more likely to die in pregnancy, childbirth or in the six-month postpartum period compared with White women and the risk for Asian women is twice as high.

During the pandemic, 55% of pregnant women admitted to hospital with coronavirus were from a Black, Asian or other minority ethnic background despite the fact 13% of the UK population identify themselves as BAME.

It is also clear that there is a significant gap in understanding the factors that result in a higher risk of morbidity and mortality for Black, Asian and other ethnic minority women in the UK.

The Taskforce will collaborate with groups across healthcare and government as well as individual women to address these concerning trends and will ensure that the work of the RCOG is reflective of its anti-racist agenda.

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Source: RCOG, 15 July 2020

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Shrewsbury Hospital: Care watchdog demands NHS action over ‘escalating’ harm at scandal-hit trust

A hospital trust at the centre of Britain’s largest ever maternity scandal has widespread failings across departments and is getting worse, the care regulator has warned as it calls for NHS bosses to take urgent action.

Ted Baker, chief inspector of hospitals, urged NHS England to intervene over the “worsening picture” at Shrewsbury and Telford Hospital Trust, which is already facing a criminal investigation.

There are as many as 1,500 cases being examined after mothers and babies died and were left with serious disabilities due to poor care going back decades in the trust’s maternity units.

Now, in a leaked letter seen by The Independent, Prof Baker has warned national health chiefs that issues are still present today across wards at the trust – with inspectors uncovering poor care in recent visits that led to “continued and unnecessary harm” for patients.

He raised the prospect that the Care Quality Commission (CQC) could recommend the trust be placed into special administration for safety reasons, which has only been done once in the history of the NHS – at the former Mid Staffordshire NHS Trust, where a public inquiry found hundreds of patients suffered avoidable harm and neglect because of widespread systemic poor care.

In a rarely seen intervention, Prof Baker’s letter to NHS England’s chief operating officer, Amanda Pritchard, warned there were “ongoing and escalating concerns regarding patient safety” and that poor care was becoming “normalised” at the trust, which serves half a million people with its two hospitals – the Royal Shrewsbury and Telford’s Princess Royal.

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Source: The Independent, 16 July 2020

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Oxford vaccine results ‘promising’ as initial data set for release in days

The initial data on a trial of the coronavirus vaccine being developed by Oxford University will be released in the coming week, The Lancet medical journal has announced amid reports its findings have been promising.

The development of a vaccine to fight against the virus has been touted as pivotal in returning the world to life as it was before the pandemic by protecting vulnerable people and building up immunity among populations.

Now Oxford University’s contribution - one of the world’s leading candidates for a viable vaccine – is understood to have made promising results in initial testing.

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Source: The Independent, 16 July 2020

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Scotland's children need post-COVID-19 mental health care, says report

Every child in Scotland will need additional mental health support as a consequence of measures taken to tackle the coronavirus crisis, according to the country’s children and young people’s commissioner.

Speaking exclusively to the Guardian as he publishes Scotland’s comprehensive assessment of the impact of the pandemic on children’s rights – the first such review undertaken anywhere in the world – Bruce Adamson said the pandemic had sent a “very negative” message about how decision-makers value young people’s voices.

He said Scotland has been viewed as a children’s rights champion but that efforts to involve young people in the dramatic changes being made to their education and support “went out the window as soon as lockdown came along”.

There have been escalating concerns across the UK about children’s mental health after support structures were stripped away at the start of lockdown. Earlier this week, the Guardian revealed that five children with special educational needs have killed themselves in the space of five months in Kent, amidst warnings over the impact of school closures on pupils.

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Source: The Guardian, 16 July 2020

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Data show 5000 fewer hospital admissions for acute coronary syndrome during pandemic

Around 5000 fewer people were admitted to hospitals in England for acute coronary syndrome than expected from January to the end of May this year, an analysis has shown. The results, published in the Lancet, indicate that many patients have missed out on lifesaving treatments during the COVID-19 outbreak.

This decline started before the UK lockdown began on 23 March and “was qualitatively similar throughout the country, with only minor variations … in different demographic groups,” the authors wrote.

Among patients admitted to hospital with acute myocardial infarction there was a “sustained increase in the proportion ... receiving [a percutaneous coronary intervention (PCI) for acute myocardial infarction] on the day of admission and a continued reduction in the median length of stay,” they added.

“The reduced number of admissions … is likely to have resulted in increases in out-of-hospital deaths and long-term complications of myocardial infarction and missed opportunities to offer secondary prevention treatment for patients with coronary heart disease,” they concluded.

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Source: BMJ, 15 July 2020

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National roll-out of ‘call before you walk’ A&Es set for winter

Trials of new systems to prevent overcrowding in emergency departments ahead of a potential second wave of COVID-19 in the winter are taking place at hospitals in Portsmouth and Cornwall and are due to shortly be expanded to other areas, with Dorset and Newcastle likely sites, HSJ can reveal.

London is also experimenting with introducing the system, having pulled back from an earlier proposal to roll it out it rapidly, shortly after the COVID-19 peak.

In the trials, NHS 111 has acted as a “triage point” enabling patients not facing medical emergencies but needing urgent treatment to book access to primary care, urgent treatment centres or same-day emergency “hot clinics” staffed by specialists. 

Patients are discouraged from attending without an appointment, but they are able to do so; and sources said performance targets would continue to apply to them, although these were already subject to review pre-covid.

Both the Royal College of Emergency Medicine and NHSE are now hopeful a new triage system for emergency care can be in place by the winter.

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Source: 15 July 2020

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NHS staff taking 3.5 million sick days for mental health problems

The NHS is losing more than 3.5 million days of work because of staff sickness linked to mental health problems, it has emerged.

New data from NHS England shows the problem is getting worse with an increasing number of days and proportion of staff off sick for mental health reasons.

The data runs from March 2019 to February 2020, before the coronavirus crisis. It is feared the pandemic could lead to lasting mental health issues for some NHS workers.

Layla Moran, a Liberal Democrat MP who obtained the data through a parliamentary question, said: “These incredibly worrying figures show the mental health of NHS workers was already at a tipping point before the pandemic struck."

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Source: The Independent, 14 July 2020

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Coronavirus: Matt Hancock 'worried' about 'debilitating' long-term impact of COVID-19

Health Secretary Matt Hancock admits he is "worried" about the long-term impacts of coronavirus on those who have been infected.

Mr Hancock said a "significant minority" of people had suffered "quite debilitating" conditions after contracting COVID-19.

It comes after Sky News reported on how psychosis, insomnia, kidney disease, spinal infections, strokes, chronic tiredness and mobility issues are being identified in former coronavirus patients in northern Italy.

Asked about the long-term impact of the disease on patients, the health secretary told Sky News: "I am concerned there's increasing evidence a minority of people - but a significant minority - have long-term impacts and it can be quite debilitating. "So we've set up an NHS service to support those with long-term impacts of COVID-19 and, also, we've put almost £10m into research into these long-term effects."

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Source: Sky News, 15 July 2020

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The NHS’ approach to waiting list management needs urgent reform

Waiting lists for treatment in 2019 were at record levels, with the proportion of patients waiting less than 18 weeks for treatment at its lowest level in a decade.

Cancer waiting times were the worst on record, with 73% of trusts not meeting the 62-day cancer target. Waiting for diagnostic tests was at the highest level since 2008: 4.2% of patients were waiting over six weeks against a target of less than 1%.

On 17 March 2020, NHS England and NHS Improvement asked trusts to postpone all non-urgent elective operations to free up as much inpatient and critical care capacity as possible. At this point, there were 4.43 million people on waiting lists for consultant-led elective treatment.

It is imperative that we open a national debate on what the NHS can deliver in a resource-constrained environment. To translate into action, this must involve patients, clinicians, system and regional leaders, the public and politicians. Such a debate is long overdue: current methods for prioritising elective care, such as referral to treatment or the 62-day cancer standard, are no longer fit for purpose.

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Source: HSJ, 14 July 2020

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Coronavirus: People told to phone ahead before going to A&E in Wales

People with non-life threatening illnesses will be told to call before going to Wales' biggest A&E department. Patients will be assessed remotely and given a time slot for the University Hospital of Wales in Cardiff if needed.

Hospital bosses feel returning to over-crowded waiting rooms would provide an "unacceptable" risk to patients due to coronavirus.

The system is set to start at the end of July, but will not apply to people with serious illnesses or injuries.

Details are still being discussed by Cardiff and Vale health board, but patients with less serious illnesses or injuries will be told to phone ahead, most likely on the 24-hour number used to contact the local GP out-of-hours service. They will be assessed by a doctor or a nurse and, depending on the severity of the condition, will either be given a time window to go to A&E or be directed to other services.

This system was introduced in Denmark several years ago.

"This is all about being safe and ensuring that emergency medicine and emergency care is safe and not about putting barriers in place to those more vulnerable people," says the department's lead-doctor Dr Katja Empson.

"What we really think is that by using this system, we'll be able to focus our attention on those vulnerable groups when they do present."

If successful, the system could become a long-term answer to reducing pressures on emergency medicine, she added.

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Source: BBC News, 14 July 2020

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‘No one ever tried to contact me’: Former police chief’s anger over ‘do not resuscitate’ order for his sister

Across the country there have been reports of “do not resuscitate” (DNR) orders being imposed on patients with no consultation, as is their legal right, or after a few minutes on the phone as part of a blanket process.

Laurence Carr, a former detective chief superintendent for Merseyside Police, is still angry over the actions of doctors at Warrington Hospital who imposed an unlawful “do not resuscitate” order on his sister, Maria, aged 64.

She has mental health problems and lacks the capacity to be consulted or make decisions and has been living in a care home for 20 years. As her main relative, Mr Carr found out about the notice on her records only when she was discharged to a different hospital a week later.

Maria had been admitted for a urinary tract infection at the end of March. Although she has diabetes and an infection on her leg her condition was not life threatening.

Mr Carr said: “My sister has no capacity to effectively be consulted due to her mental illness and would not understand if they did try to explain, so I was furious that I had not been consulted."

He later learnt that the reason given by the hospital for imposing the DNR was "multiple comorbitidies".

In a statement, Warrington and Halton Teaching Hospitals Foundation Trust said it was fully aware of the law, which was reflected in its policies and regular training.

It said: “We did not follow our own policy in this case and have the requisite discussions with the family. The template form which was completed in this case indicates that discussion with the family was ‘awaiting’. Regretfully due to human error this did not occur."

Mr Carr and his sister are not alone. National charity Turning Point said it had learnt of 19 inappropriate DNARs from families, while Learning Disability England said almost one-fifth of its members had reported DNARs placed in people’s medical records without consultation during March and April.

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Source: The Independent, 14 July 2020

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Coroner orders closer working between five trusts after prisoner’s death

Five NHS trusts in the South West have been ordered to make immediate improvements after the death of a 20-year-old prisoner who needed healthcare.

Lewis Francis was arrested in Wells, Somerset, in 2017 after stabbing his mother while “acutely psychotic” and taken into custody. Although his condition mandated a transfer to a medium secure mental health hospital, there was “no mechanism” in place to move Mr Francis and he was taken to prison, where he died by suicide two days later, according to a coroner.

Contributory factors to his death included “insufficient collaboration, communication and ownership between and within organisations… together with insufficient knowledge of… the Mental Health Act,” according to Nicholas Rheinberg, the assistant coroner for Exeter and Greater Devon.

In a Prevention of Future Deaths report, Mr Rheinberg said a memorandum of understanding was in place for the transfer of “mentally ill prisoners direct from police custody” in the West Midlands, and he called on the South West Provider Collaborative to agree a similar deal with “relevant organisations and agencies”.

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Source: HSJ, 14 July 2020

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Trust failed to complete 21 instructions from safety review

Only two out of 23 recommendations from a royal college review into a trust’s troubled maternity services can be shown to be fully implemented, a new investigation has revealed.

A learning and review committee, set up by East Kent Hospitals University Foundation Trust, found that 11 more of the recommendations from a 2016 review by the Royal College of Obstetricians and Gynaecologists (RCOG) were “partially” implemented.

But it said there was either no evidence the remaining 10 had been delivered, or there was evidence they were not implemented.

The original RCOG review looked at a number of cases where babies had died as well as broader issues within the maternity service at the trust.

The committee was set up after an inquest into the death of Harry Richford, who died a week after his birth in 2017 at the trust’s Queen Elizabeth, the Queen Mother, Hospital in Thanet. Many of the issues which came to light at his inquest echoed those from the RCOG report.

Committee chair Des Holden, medical director of Kent Surrey Sussex Academic Health Science Network, highlighted the difficulties in tracking evidence and action plans during a time when the trust had significant changes in leadership. But he said the committee felt cases where evidence could not be found or the standard of evidence gave concern, the recommendations could not be said to be met.

Derek Richford, Harry’s grandfather, said on behalf of the family: “We are saddened and shocked to find that over four years after the RCOG found fundamental systemic failings and made 23 recommendations, only two have been completed. It is not good enough for them to now say ‘leadership has changed’. The main board must take responsibility and be held to account.”

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Source: HSJ, 13 July 2020

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NHS data reveals 'huge variation' in COVID-19 death rates across England

A wide disparity in coronavirus mortality rates has emerged in English hospitals, with data seen by the Guardian showing that one hospital trust in south-west England had a death rate from the disease of 80% while in one London trust it was just 12.5%.

The figures, which NHS England has compiled but never published, show the age-standardised mortality rates that all of the country’s 135 acute hospital trusts have recorded during the pandemic. Doctors regard age as the single biggest predictor or risk factor for dying from COVID-19.

They cover the period from the start of the coronavirus crisis in March, through its peak in late March and April, up until 15 May, by which time 42,850 (85%) of the 50,219 deaths so far in all settings had occurred in England and Wales.

It is the first such data to emerge about how many people have lived or died in each trust after being treated there because they had been left critically ill by the disease. They are based on patients who were treated in an intensive care or high-dependency unit or on a ward.

Senior doctors said the dramatic gap in death rates of 67.5 percentage points between the trusts with the highest and lowest rates was notable and may mean that some hospitals needed to learn lessons from others.

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Source: Guardian, 14 June 2020

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COVID-19: Many trusts have not done risk assessments for ethnic minority staff

Some NHS trusts in England are yet to complete /cOVID-19 risk assessments for their staff from ethnic minority groups more than two months after the NHS first told them to do so, an investigation by The BMJ has found.

On 29 April NHS England’s chief executive, Simon Stevens, wrote to all NHS leaders telling them to carry out risk assessments and make “appropriate arrangements” to protect ethnic minority staff, amid growing evidence that they were at greater risk of contracting and dying from COVID-19.

However, The BMJ asked England’s 140 acute care trusts for details of risk assessments they had carried out and what subsequent actions they had put in place. Seventy trusts responded. Of these, 27 (39%) said that assessments were yet to be completed for all ethnic minority staff, and 43 (61%) indicated that assessments had been completed. But the other 70 trusts were unable to provide a response within the 20 day deadline, citing “unprecedented challenges” posed by the COVID-19 pandemic, so it is not known what stage they are at in risk assessing staff.

Commenting on The BMJ’s findings, Chaand Nagpaul, the BMA’s chair of council, said, “Clearly, we know that a significant number of doctors have not been risk assessed. It is a shame that it has taken so long, because the risk assessments and mitigations would have been most useful and impactful during the peak of the virus.”

Doctors’ leaders have suggested that systemic race inequalities in the workplace may have exacerbated delays in risk assessing staff. Nagpaul said, “The BMA survey found that doctors from a BAME [black, Asian, and minority ethnic] background felt under more pressure to see patients without adequate protection. So it does beg the question of whether there’s also been this added factor of BAME healthcare staff feeling unable to demand their right to being assessed and protected."

“This is something the NHS needs to tackle. This is an issue that predates covid. It’s vital that we have an NHS where anyone is able to voice their concerns. No one should have to suffer or have fear in silence.”

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Source: The BMJ, 10 July 2020

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Man plans to sue NHS after cancer surgery delayed due to coronavirus

A former senior NHS official plans to sue the organisation after he had to pay a private hospital £20,000 for potentially life-saving cancer surgery because NHS care was suspended due to COVID-19.

Rob McMahon, 68, decided to seek private treatment after Worcestershire Acute Hospitals NHS trust told him that he would have to wait much longer than usual for a biopsy. He was diagnosed with prostate cancer after an MRI scan on 19 March, four days before the lockdown began.

McMahon was due to see a consultant urologist on 27 March but that was changed to a telephone consultation and then did not take place for almost two weeks.

“At that appointment, the consultant said: ‘Don’t worry, these things are slow-growing. You’ll have a biopsy but not for two or three months.’ I thought, ‘that’s a long time’, so decided to see another consultant privately for a second opinion.”

A PET-CT scan confirmed that he had a large tumour on both lobes of the prostate and a biopsy showed the cancer was at risk of breaking out of the prostate capsule and spreading into his body. He then paid to undergo a radical prostatectomy at a private Spire hospital.

“This is care that I should have had on the NHS, not something that I should have had to pay for myself. I had an aggressive cancer. I needed urgent treatment – there was no time to waste,”, he said. “With the pandemic, he added, “it was almost like a veil came down over the NHS. He worked for the NHS for 17 years as a manager in hospitals in London, Birmingham and Redditch, Worcestershire, and was the chief executive of an NHS primary care trust in Leicester.”

Mary Smith of Novum Law, McMahon’s solicitors, said: “Unfortunately, Rob’s story is one of many we are hearing about from cancer patients who have been seriously affected by the disruption to oncology services as a result of COVID-19."

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Source: The Guardian, 11 July 2020

 

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Coronavirus sufferers still have weird symptoms 100 days after surviving bug

Coronavirus patients have continued to suffer from fatigue, breathlessness and forgetfulness more than 100 days after contracting the bug. Many COVID-19 survivors have found that they are not back to normal months after they tested positive.

Louise Nicholls, from Litherland in Liverpool, is one of those people who found themselves suffering from curious symptoms long after she should have been back to normal.

She was told she had coronavirus by her doctor on 1 April having gone in search of medical help after suffering from a number of respiratory symptoms. "I was trying to do my workouts and I was getting really short of breath," Louise said.

"I couldn't put my finger on what was going on but it got worse every day. My chest started getting tighter and my lungs were burning. I didn't have a cough or a fever but I had shortness of breath and I was waking up with night sweats."

Louise said her symptoms were dismissed as anxiety by those around her at first, but when her symptoms got worse she phoned the doctor who said it sounded like coronavirus.

Louise said: "My doctor said it sounds like covid. She said 'you're young and fit, you'll be over it in a few weeks' and sent me on my way."

Louise's breathing continued to get worse and she was given a steroid inhaler, which she is still taking today. Although Louise feels much better than she did at one time, she is still struggling with her breathing today and is continuing to use her inhaler.

She said: "I feel much better than I was but I can't push myself too much... My chest feels tight if I don't take my inhaler every day."

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Source: Mirror, 12 July 2020

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Warning of serious brain disorders in people with mild coronavirus symptoms

Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned.

Neurologists are on Wednesday publishing details of more than 40 UK COVID-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom.

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication.

“We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust.

“What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added.

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Source: The Guardian, 8 July 2020

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Non-invasive ventilation deaths fell for first time in 2019, audit finds

Inpatient mortality among people receiving non-invasive ventilation (NIV) has decreased for the first time since 2010, falling from 34% in 2013 to 26% in 2019, figures released by the British Thoracic Society show.

The annual National Adult Non-Invasive Ventilation audit, which began in 2010, reported “substantial improvements in processes of care and patient outcomes” in 2019 when compared with previous years.

“Some improvement in overall mortality may be attributed to improved patient selection,” it said. “Mortality outcomes were lower for each diagnostic category, and most notably for patients with COPD [chronic obstructive pulmonary disease] and obesity-related respiratory failure.”

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Source: BMJ, 10 July 2020

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Government delay could see people miss out on vaccines

Pharmacies are warning people are at risk of not getting the flu jab unless an urgent decision is made over the winter vaccination programme.

The Company Chemists’ Association, which represents large pharmacy groups, told HSJ the government and NHS England need to “urgently” clarify how many people it wants vaccinated for flu this year, as well as making changes to regulations.

An expanded and successful winter vaccine programme is seen as key to avoiding potentially catastrophic demand for hospital beds, with flu demand coinciding with covid-19 surges.

Malcolm Harrison, chief executive, said: “We need decisions made now. We have an ongoing dialogue with NHS England but they seem to be waiting on secretary of state’s decision on which groups need vaccinating. That is something [the health secretary, Matt Hancock] needs to make a decision about very, very soon.”

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Source: HSJ, 10 July 2020

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Coronavirus: Dementia patients 'deteriorating' without family visits

Relatives of care home residents with dementia should be treated as key workers, leading charities say.

In a letter to the health secretary, they write that the care given by family members is "essential" to residents' mental and physical health.

They argue the current limits on visitors have had "damaging consequences" and they want visits to resume safely, with relatives given the same access to care homes and coronavirus testing as staff.

Signed by the bosses of leading charities including Dementia UK and the Alzheimer's Society, the letter calls on the government to "urgently" address what it calls the "hidden catastrophe" happening in care homes.

The charities say that this "enforced separation" has caused a "deterioration" in residents' mental and physical health, particularly for those living with dementia - who make up more than 70% of the population of care homes.

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Source: BBC News, 9 July 2020

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If we only ever sanctify the NHS, its harrowing failures will NEVER be cured, says Ian Birrell

Daniel Mason was born half a century ago without hands, with missing toes, a malformed mouth and impaired vision.

From an early age, he and his family had to deal with people asking about his disabilities. The impact on his life has been considerable.

Daniel’s mother Daphne long suspected the cause of his problems was a powerful hormone tablet called Primodos that was given to women to determine whether they were pregnant. But when she raised her concerns with doctors, they were dismissed.

Now, at last, Daphne has been vindicated with official confirmation this week that her fears were right, in the landmark review by Baroness Cumberlege into three separate health scandals that has exposed a litany of shameful failings by the NHS, regulatory authorities and private hospitals.

This damning report shows again the danger of placing a public service on a pedestal, with politicians happy to spout platitudes but scared to tackle systemic problems or confront the medical establishment.

But how many more of these inquiries must be held? How many more disturbing reports and reviews must be written?

How many more times must we listen to ministerial apologies to betrayed patients? How much more must we hear of ‘lessons being learned’ when clearly they are largely ignored?

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Source: Mail Online, 9 July 2020

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NHS patients in England face longest waits on record for surgery and cancer care

Far fewer people are having surgery or cancer treatment because COVID-19 has disrupted NHS services so dramatically, and those who do are facing the longest waits on record.

NHS figures reveal huge falls in the number of patients who have been going into hospital for a range of vital care in England since the pandemic began in March, prompting fears that their health will have worsened because diseases and conditions went untreated.

Patients have been unable to access a wide range of normal care since non-COVID-19 services were suspended in hospitals in March so the NHS could focus on treating the disease. Many patients were also afraid to go into hospital in case they became infected, which contributed to a fall in treatment volumes.

Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The dramatic falls in people visiting A&E, urgent referrals for suspected cancer and routine hospital procedures during lockdown are all growing evidence that more people are going without the care they need for serious health conditions."

“Early diagnosis and prompt treatment of cancer is crucial to saving lives, and delays in referrals and treatment during the pandemic are likely to mean more people are diagnosed later when their illness is further advanced and harder to treat.”

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Source: Guardian, 9 July 2020

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MHRA's response to the Cumberlege report

The Medicines and Healthcare products Regulatory Agency (MHRA) has published its response to the Independent Medicines and Medical Devices Safety Review.

In its response, the MHRA said: “Today’s publication of the Independent Medicines and Medical Devices Safety Review is of profound importance for the MHRA, since the safety of the public is our first priority."

"We therefore take this report and its findings extremely seriously. Throughout the Review’s work we have listened intently to the many distressing experiences of women and their families. We will now carefully study the findings and recommendations of the Report.

We recognise that patient safety must be continually protected and that many of the major changes recommended by the Review cannot wait. We are therefore making changes without delay to ensure that we listen to patients and involve them in every aspect of our work.

We are already taking steps to strengthen our collaboration with all bodies in the healthcare system and will strive to ensure that, working with these other bodies, the safety changes we advise are embedded without delay in clinical practice.

We wholeheartedly commit to demonstrating to those patients and families who have shared their experiences during the Review, and anyone else who has suffered, that we have learned from them and are changing and improving because of what they have told us. We are determined to put patients and the public at the heart of everything we do."

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Source: GOV.UK, 8 July 2020

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Winter warning as 35,000 respiratory diagnoses delayed due to pandemic

Patients with respiratory disease have been overlooked during the COVID-19 pandemic, with the NHS storing up problems for the winter months, a group of experts including the Royal College of General Practitioners (RCGP) has warned.

Analysis by the 34-member Taskforce for Lung Health showed that referrals for lung conditions fell by 70% in April, with two-in-five (39%) of CCGs seeing no appointment bookings for respiratory conditions for the whole of May.

On average, the group calculated a weekly average of 3,399 lung patients missing out on urgent and routine referrals during the COVID-19 lockdown, amounting to a total of at least 34,780 people, based on NHS England data.

This was blamed in part on a general reduction in routine procedures during the pandemic, which will have affected all disease areas, but also the limitations on clinicians including GPs to carry out spirometry due to the risk of COVID-19 infection spread.

But the taskforce - which includes the RCGP and the Primary Care Respiratory Society, as well as the Royal College of Physicians and Asthma UK - is now calling on NHS England to urgently restore services to pre-pandemic levels to tackle the backlog of lung patients requiring support. It said that failure to do so risked causing the premature death of patients who require urgent diagnosis as well as overwhelming the NHS during the winter season, when respiratory symptoms worsen.

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Source: Pulse, 9 July 2020

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