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Unplanned ‘Ozempic babies’ may be harmed by weight-loss drugs

Women have been told to avoid using weight-loss drugs to help them get pregnant, as doctors report a rise in surprise “Ozempic babies”.

Some women struggling with infertility have unexpectedly become pregnant after being prescribed semaglutide, which is used to treat obesity and type 2 diabetes under the brand names Wegovy and Ozempic.

However, scientists have now issued a warning that the weight-loss injections may cause birth defects and should not be used by anyone hoping to become pregnant.

Professor Tricia Tan, from the department of metabolism, digestion and reproduction at Imperial College London, said: “Women need to know that these drugs should not be used during pregnancy. You can also see that most of the clinical trials have not included women who are intending to become pregnant. Animal studies did show that the animal babies born to animals who were given these medications had problems.”

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Source: The Times, 23 April 2024

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Asthma: Action needed on needless deaths, says charity

Urgent government action is needed to stop preventable asthma deaths, a leading charity has said.

More than 12,000 people in the UK have died from asthma attacks since 2014, according to Asthma and Lung UK.

It said the figures meant "shockingly little" had changed since a major report a decade ago which found two thirds of asthma deaths could have been avoided with better care.

People with asthma should get an annual condition review, a written action plan and inhaler technique checks.

But the charity said people with asthma were being "failed", with seven out of 10 not receiving basic care, partly because healthcare workers were over-stretched.

Asthma and Lung UK said 31% of asthmatics were "disengaged" with managing their condition, putting them at higher risk, according to its research.

Ministers in England and Wales said they were trying to improve services.

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Source: BBC News, 24 April 2024

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Stroke and heart attack patients wait more than a day for ambulances, new figures reveal

Patients needing urgent treatment for life-threatening illness such as strokes or heart attacks waited more than 24 hours for an ambulance response, new figures show.

New data shows the crisis facing NHS ambulance services resulted in every region missing vital NHS targets to respond to some of the most critically unwell patients last year.

Despite improvements compared to 2022, figures obtained by the Liberal Democrat party show ambulance services continued to struggle with response times to category two patients, which may include those who have suffered a stroke or heart attack and should receive a response within 18 minutes.

In two cases patients needing this level of response, in Warrington and Staffordshire, waited more than 25 hours for an ambulance.

Sir Julian Hartley, chief executive at NHS Providers, which represents all NHS trusts, called for “urgent” investment and warned that “rising demand, limited resources and vast staff shortages are piling pressure on an already-stretched service, further driving up ambulance waiting times.”

He said NHS hospital and ambulance leaders are working to reduce delays and responses at a time “when demand has never been higher.”

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Source: The Independent, 23 April 2024

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Ethnic minorities in England ‘need more GP visits’ before cancer diagnosis

Ethnic minorities and young people require more visits than other people to the GP before being diagnosed with cancer, according to new analysis.

On average, one in five people across England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation.

For young people aged between 16 and 24, about half needed at least three GP visits before being diagnosed, with 20% needing at least five visits. Despite this, young people were still more likely to be diagnosed at an early stage in their cancer.

Prof Kamila Hawthorne, the chair of the Royal College of GPs, said that identifying cancer symptoms in young people could be challenging as the risk for the group was generally much smaller.

Hawthorne said: “Ensuring patients receive timely and appropriate referrals for suspected cancers is a priority for GPs – and to this end, they are doing a good job, making more urgent referrals and ensuring more cancers are being diagnosed at an early stage than ever.

“Whilst GPs are highly trained to identify cancers, this remains challenging in primary care, not least and particularly with some cancers, because the symptoms are often vague and typical of other, more common conditions.”

Dr Liz Fisher, senior fellow at the Nuffield Trust, said: “Delays to a cancer diagnosis pose real risks for people and an early diagnosis plays a pivotal role in determining the treatments available to people and determining outcomes.

“The NHS has set an ambitious goal to dramatically increase early detection of cancer, but performance in this area has stubbornly stalled in recent years. Everyone’s experience of cancer diagnosis is different but the risks to delays aren’t felt equally, with younger people and those from minority ethnic groups requiring more visits to health professionals to secure a diagnosis.”

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Source: The Guardian, 24 April 2024

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Medical device companies pay millions to NHS while pushing products, says study

Medical device companies are paying millions of pounds to hospitals in the UK to fund staff places, as well as training and awareness campaigns, while pushing sales of their products, including implants, heart valves and diagnostic equipment, a new report reveals.

An analysis of disclosures by medical device companies found that between 2017 and 2019 they reported €425m (£367m at today’s rates) in payments to healthcare organisations in Europe, according to the study in the journal Health Policy and Technology.

The businesses reported paying more than €37m to hospitals and other healthcare bodies in the UK over the three-year period. The disclosures include payments to some of the biggest hospital trusts in England.

James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consultancy fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There is a huge number of payments that are not being disclosed. The descriptions for payments which are disclosed are very vague and it is not completely clear what they are for.”

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Source: The Guardian, 20 April 2024

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Block on data sharing contributed to death

A failure to share medical information between IT systems contributed to the death of a man in prison custody, a coroner has concluded.

In a newly published report on the death of Finlay Finlayson at HMP Lewes in 2019, the coroner highlighted “information sharing” problems and “permissions issues” between the prison IT system and that of the man’s GP surgery. 

Mr Finlayson died from blood clots in his lungs, having suffered from multiple long-term health conditions including cancer during his life. At the time of his death in 2019, health services at HMP Lewes were provided by Sussex Partnership Foundation Trust, though they are now provided by the Practice Plus Group.

According to the Prevention of Future Deaths report issued last month, coroner Laura Bradford heard evidence that Mr Finlayson’s care was affected by “confusion and uncertainty about his medical conditions caused by information sharing and permissions issues with SystmOne”.

It appears the GP practice had not enabled sharing of the data, which would have been required for it to be accessed in the prison.

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Source: HSJ, 22 April 2024

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How Covid is pushing up waiting lists for cancer treatment

New figures have quantified what the pandemic has meant for cancer waiting lists—and the impact is stark. 

Official data show that 15,971 cancer patients in the UK have had to wait more than 124 days, or four months, after diagnosis for their treatment to start since 2020 as the pandemic sends waiting lists soaring. The statistics show that the number of untreated patients has more than doubled since Covid began, with one patient waiting for more than two years, according to data released following a freedom of information request from the Liberal Democrats. This is despite an NHS target for patients to receive cancer treatments within two months of an urgent referral.

Last year, 6,334 patients waited more than 124 days, compared to 2,922 in 2022, the figures show. Data was received from 69 out of 137 acute health trusts in the UK, meaning the true number of people waiting long periods for treatment is likely to be much higher. Over 1,100 cancer patients last year were left waiting more than six months to receive treatment, triple the NHS target time.

Liberal Democrat Leader, Ed Davey, said: “Every single one of these figures is a tragedy. Long delays for treatment can have a devastating impact on cancer patients and their families, and in certain cases can even cost lives."

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Source: inews, 22 April 2024

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Hospital patients treated by women doctors are ‘less likely to die’

Hospital patients who are treated by women doctors are less likely to die and to be readmitted, a new study has found.

Research, by UCLA, discovered the health of female patients is more advantaged by treatment from women doctors than it is for men.

The study, published in the journal Annals of Internal Medicine, found the mortality rate for female patients was 8.15 per cent when treated by women physicians in comparison to 8.38 per cent when the doctor was male - which researchers deem a “clinically significant” difference.

Meanwhile, the mortality rate for male patients treated by female doctors was 10.15 per cent - less than the 10.23 per cent rate for male physicians. Researchers unearthed the same pattern for hospital readmission rates.

Professor Yusuke Tsugawa, one of the authors, said patient outcomes between male and female physicians would not be different if the professionals practiced medicine in the same way.

“What our findings indicate is that female and male physicians practice medicine differently, and these differences have a meaningful impact on patients’ health outcomes,” he said.

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Source: The Independent, 22 April 2024

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Almost 600,000 in England awaiting gynaecological treatment, figures show

The government has been accused of “deprioritising women’s health” as analysis shows that almost 600,000 women in England are waiting for gynaecological treatment, an increase of a third over two years.

There are 33,000 women waiting more than a year for such treatment, an increase of 43%, according to Labour analysis of data from the House of Commons library.

It found that there is no region in England that meets the government’s target for cervical cancer screening of 80% coverage, with just over two-thirds of women (68.7%) having been screened in the past five and a half years.

Also, one in four women (26%) with suspected breast cancer waited more than a fortnight to see a specialist in the year to September 2023.

Under two-thirds (66.4%) of eligible women have been screened for breast cancer in the last three years, with just two English regions meeting the 70% coverage target.

The NHS target in England is that 92% of patients have a referral-to-treatment time of less than 18 weeks.

The figures come after the government pledged to end decades of gender-based health inequalities through a new women’s health strategy for England.

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Source: The Guardian, 22 April 2024

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‘Wholly unrealistic’ NHSE financial recovery policy risks ‘significant harm’ warns ICS

Leaders of an integrated care system in the Midlands have warned they cannot make the scale of staffing cuts required to balance the books without putting patients at risk.

Indicative analysis produced by Staffordshire and Stoke-on-Trent Integrated Care Board also found its provider trusts would have to cut 10 per cent of their workforce to break even.

This would equate to 2,300 posts across University Hospitals North Midlands, Midlands Partnership Foundation Trust and North Staffordshire Combined Healthcare, while the ICB would have to cancel a “very high proportion” of third-sector contracts.

The document says this “would bring our teams below safe staffing levels” and have a “profound effect on our ability to deliver safe services”.

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Source: HSJ, 23 April 2024

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Leaked NHS figures reveal 15,000 died in care of mental health trusts in one year

The shocking number of patients who are dying while under the care of stretched community mental health services can be revealed for the first time after a major NHS report was leaked to The Independent.

More than 15,000 people are estimated to have died in a single year while being cared for by community mental health teams – as trusts scramble for staff and funding while the demand for care is at an all-time high.

The figures, which relate to deaths between March 2022 and March 2023, can be revealed after a concerned insider handed the secret report to this publication. Health officials admitted the statistics had been collated for the first time last year in a bid to reduce deaths – but have not made them public.

The leaked report reveals that:

  • At least 137 women died between 2022 and 2023 while under the care of services for pregnant women at one unnamed trust.
  • Nearly one in 10 of the patients treated by a crisis service – designed to help those with the most severe mental health conditions – died while under that care.
  • One unnamed mental health trust recorded more than 500 deaths in that year-long period.

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Source: The Independent, 22 April 2024

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NHS England to review cutting compulsory training for doctors

The amount of time doctors have to spend doing compulsory training will be cut as part of an NHS drive to improve medics’ working lives, the Guardian can reveal.

Concern that doctors have too heavy a burden of mandatory training has prompted NHS England to commission a review, which it is expected to announce imminently.

It is aimed at reducing the need for doctors to undertake what for some can be up to as many as 33 sessions of training every year, depending on what stage of their career they are at. Each lasts between 30 minutes and several hours and together take about a day to complete.

NHS bosses have briefed medical groups and health service care providers on the plan, which they hope will address one of the many frustrations that some doctors – especially recently qualified doctors – have about working in the service, alongside pay, constant pressure and poor working environments.

Prof Sir Stephen Powis, NHS England’s national medical director, confirmed the review. “While statutory and mandatory training provides NHS staff with core knowledge and skills that support safe and effective working, we know that needing to repeat the same training courses every year isn’t the best use of a clinician’s time. So it’s right that we look to find ways to cut back on this, while still considering our legal obligations,” he said.

“Cutting red tape and ensuring this type of training is only carried out when necessary – for example, when junior doctors move between hospitals – will not only be better for our staff, who will spend less time worrying about training to adhere to legal requirements, but will also benefit patients by freeing up clinicians’ time for care and treatment."

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Source: The Guardian, 22 April 2024

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Surgeon at NHS hospital promoted despite allegedly assaulting staff

Managers at a hospital where police are investigating dozens of deaths promoted a consultant surgeon months after they allegedly assaulted junior doctors during surgery, the Guardian can reveal.

Two female registrars at the University Hospitals Sussex NHS trust in Brighton sent written statements to the trust’s chief medical officer in March 2022 detailing how they were allegedly assaulted by the surgeon in separate incidents as they helped to operate on patients, leaked documents reveal.

The incidents were not reported to the police and are not part of a separate Sussex police investigation into allegations of medical negligence and cover-up at the trust’s surgery and neurosurgery departments, involving at least 40 deaths and more than 60 incidents of patient harm.

The consultant surgeon was alleged to have slapped one of the registrars across her face with the back of a hand. The other registrar claimed she was slapped on the hand and had surgical instruments snatched from her by the same person.

The trust said its investigation found the surgeon’s actions were inappropriate but did not constitute assault and were taken in the interest of patient safety. The surgeon apologised to the registrars.

The investigation concluded that, in the first incident, the registrar’s visor was blocking the consultant’s field of vision during surgery, causing them to instinctively push the visor away. In the second incident, it concluded that an instrument was taken from the registrar’s hand during a procedure for patient safety purposes.

After these events, other registrars threatened to refuse to go into theatre with the consultant and pointed to other alleged examples of their bullying, sources claim. They had expected the consultant to be disciplined, given time off work and supported in changing their behaviour, the sources added. Instead, within a year of the complaints, the consultant was given a leadership role in the surgery department, despite the trust’s stated policy of zero tolerance for violence and aggression.

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Source: The Guardian, 22 April 2024

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Letby to seek permission for conviction appeal

Lucy Letby is to apply for permission to appeal against her convictions for the murder and attempted murder of babies in her care.

A panel of three judges at the Court of Appeal in London is due to consider the former nurse’s case later.

The 34-year-old was handed 14 whole life terms last year.

She was found guilty of murdering seven babies and attempting to murder a further six at the Countess of Chester Hospital between 2015 and 2016.

Second stage

Shortly after her trial ended in August, Letby applied for leave to appeal against her convictions.

She lost the first stage of the process, in which a single judge reviewed her arguments as a paper exercise.

Letby, originally of Hereford, now has the right to a second stage, which involves renewing her application before a panel of judges at a hearing at the Court of Appeal.

Separately to the appeal, Letby is due to be re-tried on one charge of attempted murder, which the jury at her trial was unable to decide on.

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Source: BBC News, 2 April 2024

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‘I had to do an 80-mile trip’: the stress caused by UK drug shortages

Patients have described the effect on their health and wellbeing of the “new normal” of drug shortages in the UK, which has led to three-month delays and 80-mile round trips to acquire medication.

Simon Bell, a 43-year-old data analyst from Tyne and Wear, has cystic fibrosis and requires medication that allows him to digest food. “For people with cystic fibrosis, the part of our pancreas which releases enzymes and allows us to digest food doesn’t work, so we have to take these tablets, which does the job of what’s missing from our pancreas,” he says.

Since the outbreak of the coronavirus pandemic, Bell says he has been experiencing shortages of Creon 25000, the drug he takes, and once was unable to get his medication for more than three months.

Bell decided he had no choice but to stockpile the medication when he could get it, as the effects of going without the drug are much graver than taking a lower dose.

“I went three months without getting any, so after that I started just to build up stock by not taking my full amount of medication every month, so now I always keep three months’ supply. Doctors would never advise this but I feel like I have no choice,” Bell says.

The situation has prompted concerns for Bell that his other medications will begin experiencing shortages, which could make him seriously ill. “Kaftrio is an expensive drug that if we stop taking would make us really seriously ill,” he says. “If I couldn’t get hold of that medication that would have serious implications in terms of health, long-term health and my ability to work. It could be quite devastating.”

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Source: The Guardian, 18 April 2024

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Infected blood scandal: Children were used as 'guinea pigs' in clinical trials

The true scale of the number of medical trials using infected blood products on children in the 1970s and 80s has been revealed by documents seen by BBC News.

They reveal a secret world of unsafe clinical testing involving children in the UK, as doctors placed research goals ahead of patients' needs.

They continued for more than 15 years, involved hundreds of people, and infected most with hepatitis C and HIV.

The trials involved children with blood clotting disorders, when families had often not consented to them taking part. The majority of the children who enrolled are now dead.

Documents also show that doctors in haemophilia centres across the country used blood products, even though they were widely known as likely to be contaminated.

Luke O'Shea-Phillips, 42, has mild haemophilia - a blood clotting disorder that means he bruises and bleeds more easily than most.

He caught the potentially lethal viral infection hepatitis C while being treated at the Middlesex Hospital, in central London, which was administered because of a small cut to his mouth, aged three, in 1985.

Documents seen by the BBC suggest he was deliberately given the blood product - which his doctor knew might have been infected - so he could be enrolled in a clinical trial.

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Source: BBC News, 18 April 2024

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Trusts and NHSE ‘neglecting whistleblower training’

Trusts and NHS England are failing to prioritise training for senior leaders on listening to whistleblowers — despite repeated findings of serious concerns going unheard — the National Guardian’s Office has said.

The Guardian’s Office — set up by the government to ensure whistleblowers and other staff raising concerns are properly listened to — made the claim in its written evidence to an inquiry into NHS leadership, performance, and patient safety.

The Commons health and social care committee is considering regulation of NHS leaders and managers, among other issues, including progress made on the 2022 report for ministers by General Sir Gordon Messenger. 

The NGO’s evidence, published on Wednesday, said: “In our opinion, there has been little progress on recommendations from the Messenger Review to date…

“The NGO has developed, in collaboration with [NHSE], three e-learning modules (Speak Up, Listen Up, Follow Up) which are freely available for anyone who works in healthcare. We have recommended to the sector that these modules should be a minimum standard for all staff and be made mandatory.

“Although accessible to all, many organisations have not adopted them, and NHS England has not prioritised these across the system.”

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Source: HSJ, 18 April 2024

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Private health insurance market grows by £385m in a year amid NHS crisis

Britain’s health cover market has grown by £385m in a year as the NHS crisis prompted more people to seek out private medical treatment and demand for dental insurance increased, according to a report.

The total health cover market, including medical and dental insurance and cash plans, grew 6.1% to £6.7bn in 2022, the latest year for which figures are available, according to the health data provider LaingBuisson.

About 4.2 million people were subscribed to medical cover schemes. Including dependants on the policies, 7.3 million people were covered – the highest number since 2008.

The NHS waiting list in England continued to lengthen, to a peak of nearly 7.8m last September. In February, it was still 7.5m and half of the patients had been waiting for 18 weeks or longer.

Private medical insurance, the largest part of the health cover market, grew by 6% year on year in 2022 to £5.3bn, more than triple the average annual growth rate of 1.8% between 2008 and 2019. After a decade of decline until 2018, more people signed up, particularly in the aftermath of the Covid-19 pandemic which led to a backlog of major procedures such as hip and knee replacements.

Tim Read, author of the report, said: “Demand began to increase in 2018, as the NHS waiting list began to rise out of control. A new Labour government is likely to aim to tackle it but will have limited fiscal headroom to make substantial progress.

“With people still struggling to access NHS services and the waiting list remaining stubbornly high, there is little likelihood that demand for health insurance is going to fall any time soon.”

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Source: The Guardian, 18 April 2024

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Scandal of care home sex predators free to target the vulnerable

Predatory staff who target vulnerable adults in care homes are free to move jobs unchallenged, The Independent can reveal, as almost 10,000 incidents of sexual abuse have been recorded in the last three years.

The fact that abusers can move from home to home emerged in an independent review sparked by complaints made three decades ago by the family of a man with learning disabilities.

Clive Treacey was allegedly groomed and sexually abused at the age of 23 in a private care home in Cheshire and then moved to Staffordshire where his abuser was able to access him again, it was claimed. Both Mr Treacey and his alleged abuser have since died.

His story was first reported by The Independent in 2021 and the review into his care – carried out by the most senior safeguarding expert in England Professor Michael Preston-Shoot and seen exclusively by this publication – showed huge failures in dealing with concerns raised by his family.

It warned that vulnerable adults across the country could still be at risk of harm with no national guidance for officials on how to respond to allegations of abuse of adults by care home staff in positions of trust.

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Source: The Independent, 18 April 2024

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Met investigates 'stem-cell autism cure' claim

The Met Police has launched an investigation over concerns about stem-cell injections being offered to children as a cure for autism.

The Royal Borough of Greenwich told BBC London it was aware of concerns surrounding "experimental procedures" on autistic children.

The Met said it was investigating "a reported fraud relating to the provision of medical services".

The National Autistic Society said there was no "cure" for autism.

Greenwich Council said it issued a warning to schools and nurseries in the borough after it became aware of concerns.

A spokesperson said the authority had recently been made aware of concerns that "an individual claiming to be a doctor plans to visit the UK to offer dangerous, experimental procedures on children with autism".

"We understand that this person is proposing the transfer of bone marrow and spinal fluid to the brain by injection," the spokesperson said.

"This unlicensed procedure poses a significant threat to life and there is no evidence of any benefits.

"The safety and welfare of our children and young people is of the utmost importance."

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Source: BBC News, 17 April 2024

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Experts warn GPs on prescribing antipsychotic drugs for dementia

Doctors are being urged to reduce prescribing of antipsychotic drugs to dementia patients after the largest study of its kind found they were linked to more harmful side-effects than previously thought.

The powerful medications are widely prescribed for behavioural and psychological symptoms of dementia such as apathy, depression, aggression, anxiety, irritability, delirium and psychosis. Tens of thousands of dementia patients in England are prescribed them every year.

Safety concerns have previously been raised about the drugs, with warnings to medics based on increased risks for stroke and death, but evidence of other dangers was less conclusive.

New research suggests there are a considerably wider range of harms associated with their use than previously acknowledged in regulatory alerts, underscoring the need for increased caution in the early stages of treatment.

Antipsychotic use in dementia patients was associated with elevated risks of a wide range of serious adverse outcomes, including stroke, blood clots, heart attack, heart failure, fracture, pneumonia and acute kidney injury, the study’s authors reported. 

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Source: The Guardian, 18 April 2024

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NHSE intervenes over ‘fear and bullying’ in surgery department

Nearly a dozen junior doctors have been relocated from a London hospital’s general surgery department by NHS England, after concerns about a culture of fear, poor support, and reports of bullying. 

NHSE has withdrawn 11 surgical foundation year trainees from Barnet Hospital, in north London, after a review uncovered concerns regarding staff behaviour and safety.

The General Medical Council has opened a case into the hospital’s department, which is run by the Royal Free London Foundation Trust, and the trainees have been placed elsewhere in the trust.

Colin Melville, the GMC’s medical director and director of education and standards, told HSJ: “Doctors in training in the department reported a culture of fear, worry, and feeling unsupported and unable to raise concerns in the appropriate manner.

“There are also concerns over their supervision, bullying, and undermining behaviours in the department, as well as doctors’ physical and mental wellbeing.

“Because of the [trust’s] failure to meet the high standards we require, we stand firmly with NHSE workforce, training, and education London’s decision to relocate the 11 trainees, [to] where they can work and learn in a supportive environment.

“This action is necessary not only to ensure their safety, but to protect the public as well.”

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Source: HSJ, 18 April 2024

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Seven more avoidable sepsis deaths spark coroner warnings

Preventable deaths of seven people from sepsis – including four children – have prompted coroners to flag major concerns about NHS services’ management of the condition.

Since the start of March, six English coroners have sent formal warnings to trusts, NHS England and the government warning of systemic failures to spot sepsis and delays in administering antibiotic treatments.

It comes after an HSJ investigation in February uncovered more than 30 avoidable deaths from sepsis, and undertook analysis of internal figures revealing repeated failures by NHS trusts to provide prompt treatment.

Coroner warnings since March include:

Two notices were sent this week by Nottingham assistant coroner Elizabeth Didcock to Sherwood Forest Hospitals Foundation Trust, raising concerns over its ability to provide safe paediatric care following the deaths of 10-week-old Tommy Gillman and five-year-old Meha Carneiro from sepsis;

A warning from earlier in April criticising University Hospitals Birmingham FT for its failure to treat 56-year-old Tracey Farndon’s sepsis and low blood pressure.

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Source: HSJ, 17 April 2024

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Patients face “new normal” of medicines shortages as UK hampered by supply issues and impact of EU exit

Global supply problems have caused a “shock rise” in shortages of life-saving drugs like antibiotics and epilepsy medication, new research reveals. These shortages come at a cost to the patient and the taxpayer, and are happening despite the NHS spending hundreds of extra millions trying to mitigate the problem. The UK risks being left in the cold when it comes to co-ordinated EU attempts to tackle them. 

That’s according to a new report by the Nuffield Trust think tank and a group of academics, funded by the Health Foundation, which examined key indicators on drug shortages in the UK in the context of global problems with supply chains and the availability of key ingredients. It finds that the past two years have seen constantly elevated medicines shortages, in a "new normal" of frequent disruption to crucial products.  

Key findings on drugs shortages include: 

  • Price concessions (where the government gives extra funding because there are no drugs left at the NHS price) have risen sharply in recent months: prior to 2016 there were rarely more than 20 per month but in late 2022 they peaked at 199 and have remained high ever since.  
  • The excess cost for medicines in months when they were subject to price concessions was £220m across the year to September 2023.
  • There are now over double the number of notifications by drugs companies warning of impending shortages than there were three years ago: in 2023 there were 1,634 such alerts issued, compared to 648 in 2020 (a spike in 2021 was caused by concerns over supply fears in Northern Ireland following Brexit).   
  • The UK has been slower to approve drugs than the EU for new drugs that are authorised centrally. Of drugs authorised in the year to December 2023, 56 drugs authorised in Europe were approved later in the UK and eight have not been approved. Four were approved faster.

The report shows that the EU Exit has not caused the recent spike in medicine shortages, but it is likely to significantly weaken the UK’s ability to respond to them by splitting it from European supply chains, authorisations and collective efforts to respond to shortages. In particular, the research highlights the risks posed to the UK from being left out of key initiatives like the Critical Medicines Alliance and Voluntary Solidarity Mechanism, led by EU member states to work together to insulate themselves from the impact of medicines shortages.  

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Source: The Nuffield Trust, 18 April 2024

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NHS hospitals heavily reliant on locum doctors charging up to £850 per shift are 'undoubtedly' risking patient safety, study warns

Hospitals which rely heavily on locum doctors are 'undoubtedly' risking patient safety, a study of NHS practice found.

While temporary staff are a 'vital resource' to plug workforce gaps, issues such as unfamiliarity with protocols and procedures mean they 'pose significant patient safety challenges' for the NHS, experts say.

The report warned many were left feeling isolated and stigmatised by resident staff, creating a 'hostile environment'.

This has led to a 'defensive' culture over mistakes, hindering improvements to care, according to researchers.

Calling for greater monitoring by inspectors, NHS leaders must rethink how these professionals are supported and used, the authors said.

Writing in a linked editorial, Professor Richard Lilford, of the Institute of Applied Health Research at the University of Birmingham, said the findings suggested 'the life of the locum is a difficult and lonely one, opening up many pathways to unsafe practice.'

Likening it to airline pilots, he suggested staff would benefit from standardised practices – such as how the medicine cabinet is stocked – to minimise mistakes.

Agencies providing staff should be given routine feedback by employers and locum staff, to enhance patient safety, he said.

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Source: MailOnline, 16 April 2024

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