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NHS to target same elective activity next year

Health systems will be asked to deliver the same amount of elective activity next year as they were tasked with completing in 2023-24, HSJ understands.

Local leaders have been issued with varying interim targets for 2024-25 that produce an average national threshold of 7% more activity than pre-covid levels, on a value-weighted basis.

It means the target for the current year has effectively been rolled over into next, suggesting the elective recovery is a year behind schedule.

Even if systems hit their thresholds next year, they will still fall well short of the central target set out in the elective recovery plan in 2022.

Recent weeks have seen other elective ambitions ditched or watered down, including the prime minister’s headline pledge to bring the overall waiting list down. It is likely a result of the government accepting it cannot push more elective activity due to ongoing strikes and overspending.

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Source: HSJ, 27 February 2024

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'Overwhelming' response to birth trauma inquiry

An inquiry into birth trauma has received more than 1,300 submissions from families.

It is estimated that 30,000 women a year in the UK have suffered negative experiences during the delivery of their babies, while 1 in 20 develop post-traumatic stress disorder.

The investigation is a cross-party initiative, led by MPs Theo Clarke and Rosie Duffield, in collaboration with the Birth Trauma Association.

Ms Clarke the Conservative MP for Stafford, triggered the first ever parliamentary debate on the issue in October.

In an emotional exchange in the House of Commons, she described her own experience following her daughter's birth at the Royal Stoke University Hospital in 2022.

She bled heavily after suffering a tear and had to undergo two-hour surgery without general anaesthetic, due to an earlier epidural.

The Birth Trauma Association, which is administering the inquiry, invited the public to submit written accounts of their own experiences.

Dr Kim Thomas, from the association, said she had received an "overwhelming" number of personal accounts. Some cases date back as far as the 1960s.

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Source: BBC News, 25 February 2024

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Wales Covid families want answers as inquiry arrives

Accountability is top of the wishlist from the Covid inquiry as it comes to Wales, say bereaved families and those charged with protecting vulnerable people.

Over the next three weeks the focus will largely be on the decisions made by the Welsh government during the pandemic.

From the timings of lockdowns to the rationale of doing things differently to the UK government, the hearings will scrutinise actions taken in Wales.

For many, it will be a chance to hear the justifications for policies that they say left them feeling unsupported and alone.

Ann Richards did not get to say a final goodbye to her husband Eirwyn before he died from hospital-acquired Covid in January 2021.

Ann still wonders if non-urgent healthcare had been fully up and running, could Eirwyn have been discharged sooner, or perhaps even avoided a hospital admission altogether?

Additional rules put in place to reduce the spread of the virus meant there were delays in getting a purpose-built wheelchair – delaying his discharge from hospital.

"I understand there had to be rules in place," said Ann. "But it's the wellbeing of the patients I think they lost a lot of."

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Source: BBC News, 26 February 2024

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UK trails other countries on waiting times for cancer treatment, study finds

Cancer patients in the UK wait up to seven weeks longer to begin radiotherapy or chemotherapy than people in comparable countries, research has revealed.

The stark findings are yet more damning evidence of the extent to which the UK lags behind other nations, as experts warn that people’s chances of survival are being affected by long waits for treatment.

In the first research of its kind, experts at University College London analysed data from more than 780,000 cancer patients diagnosed between 2012 and 2017 in four comparable countries: Australia, Canada, Norway and the UK. Eight cancer types were included: oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer.

The two studies, published in the Lancet Oncology, were the first to examine treatment differences for eight cancer types in countries across three continents. UK patients experienced the longest waits for treatment, the research found.

The average time to start chemotherapy was 48 days in England, 57 in Northern Ireland, 58 in Wales and 65 in Scotland. The shortest time was 39 days in Norway.

In radiotherapy, the UK fared even worse. It took 53 days on average for treatment to begin in Northern Ireland, 63 in England, 79 in Scotland and 81 in Wales.

Cancer Research UK, which part-funded the two studies, said delays to begin treatment were partly a result of the UK government’s lack of long-term planning on cancer in recent years. Countries with robust cancer strategies backed by funding had seen better improvements in survival rates, it said.

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Source: The Guardian, 27 February 2024

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NHSE looks to scrap ‘follow ups’ target

NHS England is looking to ditch a key elective target that aimed to deliver large reductions in follow-up appointments, HSJ has learned.

Senior sources privately admit progress has not been made against the target to cut the volume of the most common type of outpatient follow-up by 25 per cent target.

This is supported by publicly available data. While this only gives a partial picture, the data suggests the volumes have actually increased compared to pre-covid levels.

The volume-based target is widely viewed as unrealistic and senior figures told HSJ it had also “masked” some genuine progress trusts have made in reforming outpatient services and reducing less productive appointments.

Sources familiar with discussions said having a volume-based target to reduce a subset of patients while trying to increase overall activity volumes had been logistically complex.

NHSE is instead pushing for a new “ratio-based” target which sources said would be a better measure to reduce the least productive types of outpatient follow-ups and be a fairer measure of progress.

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Source: HSJ, 26 February 2024

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'Daily life is a struggle without my ADHD medicine'

"Taking medication meant my brain was quiet for the first time; it was amazing, I cried because I was so happy," Jass Thethi, whose life was transformed after an ADHD diagnosis just over a year ago, told a BBC North West investigation.

But the 34-year-old's joy was short-lived because, like more than 150,000 others who live with the condition and are reliant on medication, Jass has been affected by a UK-wide medicine shortage that started in September.

Jass, who lives in Levenshulme, Greater Manchester, said: "When the medication shortage started I had to go back to white knuckling everyday life… I had to take the decision to change things and I had to quit the job I was doing."

The charity ADHD UK said it had recorded a "significant decline" in the availability of medicines, with only 11% having their normal prescription in January, a drop from 52% in September.

The Department of Health and Social Care (DHSC) said increased global demand and manufacturing issues were behind the shortages.

Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, said Jass's experience was not unique and many patients' lives had been "completely destabilised".

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Source: BBC News, 27 February 2024

Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? 

To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our Community post.

We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. 

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Over 30 sepsis deaths linked to ‘systemic’ failings, investigation reveals

Major progress made in sepsis care during the previous decade has been significantly reversed amid repeated failures in recognising and treating the condition.

HSJ has identified 31 deaths in the last five years where coroners have warned of systemic problems with diagnosing and treating sepsis, including nine cases relating to children. Many of the deaths were deemed avoidable.

Meanwhile, investigations suggest a majority of acute trusts are failing to record their treatment rates for sepsis, which is deemed a crucial aspect of driving improvements.

Repeated shortcomings raised by coroners, including 10 separate cases in 2023, include delays or failures to administer antibiotics, not following protocols for identifying sepsis, and inaccurate, missed or skipped observations.

Health ombudsman Rob Behrens, who issued a report on sepsis failures last year, said the same mistakes were “clearly being repeated time and time again”.

He added: “What is chilling to me is that these [coroners’ reports] fit in almost exactly with the issues we raised in our sepsis report… and even the 2013 sepsis report issued by my predecessor, including unnecessary delays, wrong diagnosis, and failure to provide adequate plans for sepsis.”

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Source: HSJ, 27 February 2024

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They bite, they hit, they spit: patients assault staff at Nottingham hospital

“I’ve seen patients take swings at doctors because they’re not happy with the time it’s taken or the doctor’s diagnosis. I’ve seen fire extinguishers set off and thrown at people, computers lifted and thrown across the emergency department and people run out of cubicles and punch other patients – people they don’t know – for no reason.”

Roger Webb, a security supervisor at the Queen’s Medical Centre hospital in Nottingham, is recalling some of the more unsavoury incidents he has witnessed in the course of his work.

“I’ve been struck in the groin, had scratches all over my arms where people have dug their nails in. I’ve been bitten and I’ve been spat at while trying to deal with situations. The spitting is the most depressing of those, though, because it’s so contemptuous and so horrible. And legally it’s assault.”

Like staff across the NHS, those at the QMC have seen a rise in abusive, threatening and intimidatory behaviour by patients and their relatives in recent years. In 2021-22, Nottingham University hospitals (NUH), the NHS trust that runs the QMC and its sister City hospital, recorded 1,237 incidents of aggression, violence and harassment. But it had many more – 1,806 – during the following year, 2022-23.

Last year brought another increase. In the six months between April to September alone, NUH recorded another 1,167 incidents, leaving 2023-24 likely to be the worst ever on record.

Staff have been hit, spat at, threatened, verbally abused and racially abused during this roll call of unpleasant incidents. Racially aggravated harassment has increased notably.

Some of the incidents have led to perpetrators being charged and convicted. Worryingly, in a growing number of cases, the patient has been responsible for several incidents while receiving one single episode of care.

Care delays are the main trigger for abuse at the QMC. But such incidents also arise when staff are treating drunks, rival gangs, people who are high on drugs and those with mental health problems.

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Source: The Guardian, 25 February 2024

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Mums call for Strep B screening to save babies

Mothers of babies who died or suffered brain damage from a Group B Strep (GBS) infection say routine screening is needed.

Oliver Plumb, from the charity Group B Strep Support, said it was a "small number of babies" exposed to the bacteria that developed a serious and potentially fatal infection.

He said around 800 babies a year developed the infection - which is about two babies a day - and about one a week will die, while another a week will be left with a lifelong disability.

"It's a heart-breaking start to life for families and that often the first they hear of Group B Strep is when their baby is sick or in intensive care".

The charity has called for GBS to be a notifiable disease to make it a legal responsibility for infections to be reported. It added that current figures could be "missing around one fifth of the infections".

There was a "postcode lottery" in terms of how many families will hear about GBS, he said. The charity also backed calls for screening.

"In the UK we don't sadly have a routine testing programme, that's at odds with much of the rest of the high-income world. "

A DHSC spokesperson said a public consultation on the notifiable diseases list was carried out last year.

"DHSC and UKHSA are considering the responses and confirmation of any changes will be published in due course," they said.

Several reasons for not recommending routine screening have been given by the committee, including that results can change in the last few weeks of labour, and that GBS does not cause infection in every baby.

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Source: BBC News, 26 February 2024

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UK eating disorder charity says calls from people with Arfid have risen sevenfold

The number of people in the UK who have avoidant restrictive food intake disorder (Arfid), in which those afflicted avoid many foods, has risen sevenfold in five years, figures show.

The eating disorders charity Beat received 295 calls about Arfid in 2018 – comprising 2% of its 20,535 inquiries that year. However, it received 2,054 calls last year, which accounted for one in 10 of its 20,535 requests for help. Many were from children and young people or their parents.

Andrew Radford, Beat’s chief executive, said: “It’s extremely worrying that there has been such a dramatic increase in those seeking support for Arfid, particularly as specialist care isn’t always readily available.”

Patchy provision of NHS help meant many people were experiencing long delays before accessing support, he added.

Eight in 10 eating disorder service providers did not state on their website whether or not they offered Arfid care, research by Beat found.

“All too often we hear from people who have been unable to get treatment close to home or have faced waits of months or even years to get the help they need,” Radford said.

Arfid is much less well-known than anorexia or bulimia. It is “an eating disorder that rarely gets the attention it deserves”. The sharp increase in cases should prompt NHS chiefs to end the postcode lottery in care for Arfid and ensure that every region of England had a team of staff fully trained to treat it, he added.

“Unlike other eating disorders such as anorexia or bulimia, Arfid isn’t driven by feelings around [someone’s] weight or shape,” Radford said. “Instead, it might be due to having sensory issues around the texture or taste of certain foods, fear about eating due to distressing experiences with food, for example choking, or lack of interest in eating.”

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Source: The Guardian, 26 February 2024

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Newly installed EPR contributed to A&E death, warns coroner

A newly installed electronic patient record contributed to the “preventable” death of a 31-year-old woman in an emergency department, a trust has been warned.

Emily Harkleroad died at University Hospital of North Durham in December 2022 following “failures to provide [her] with appropriate and timely treatment” for a pulmonary embolism, a coroner has said.

The inquest into her death heard emergency clinicians had raised concerns about a newly installed electronic patient record, provided by Oracle Cerner, which they said did not have an escalation function which could clearly and quickly identify the most critical patients.

The inquest heard the new EPR, installed in October 2022, did not have a “RAG rating” system in which information on patient acuity “was easily identifiable by looking at a single page on a display screen” – as was the case with the previous IT system.

The software instead relied on symbols next to patients’ names which indicate their level of acuity when clicked on, but did “not [provide] a clear indication at first glance” of their level of acuity.

Rebecca Sutton, assistant coroner for County Durham and Darlington, said that “errors and delays” meant Ms Harkleroad did not receive the anticoagulant treatment that she needed and “which would, on a balance of probabilities, have prevented her death”.

“It is my view that, especially in times of extreme pressure on the emergency department, a quick and clear way of identifying the most critically ill patients is an important tool that could prevent future deaths.”

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Source: HSJ, 23 February 2024

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Lying in agony in urine-soaked sheets: the horrific reality of patient life on an NHS ward

Left in agonising pain, with staff ignoring his cries for help, Martin Wild called 999 from his hospital bed, desperate for someone to get him the medication he needed.

This was just the beginning of the 73-year-old’s “nightmare” experience at the hands of Salford Royal Hospital.

Over nearly five months, the former car salesman says he was subjected to prolonged periods of neglect, including being left to lie in urine-soaked sheets, pleading for medication.

He lost so much weight that, according to his wife, he became skin and bone. One staff member involved in his care said they’d never seen a hospital patient neglected to such a serious degree.

Mr Wild told The Independent that his time at Salford Royal Hospital has shattered his belief in the NHS and that he believes it is not fit for purpose.

“It was a nightmare in that ward. I didn’t feel like there was much caring going on,” he said.

“I used to lie there at night; I could hear people shouting and screaming for help. It was like being in the third world.”

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Source: The Independent, 24 February 2024

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Physician associate law may confuse patients, says BMA

The House of Lords is being urged to throw out plans for non-doctor associate roles to be licensed by the same body as doctors.

Under a planned new law, physician associates (PAs) will be regulated by the General Medical Council (GMC).

The British Medical Association (BMA) believes this could lead to patients confusing the different roles, which it says could have "tragic consequences".

There are about 3,200 PAs working in GP surgeries and hospitals in England, with 10,000 more planned in the next decade or so.

They were introduced to help doctors with their work - examining and diagnosing patients and discussing treatments with them - although PAs are currently unregulated.

Unlike doctors, they do not have to hold a medical degree, but they usually have a degree in a life science and have to undertake a two-year training course.

The BMA, the union representing doctors in the UK, believes that regulation by the GMC could lead to a "blurring of the lines" between PAs and doctors.

In an open letter to the House of Lords ahead of a debate on Monday, the BMA's chairman Prof Phil Banfield said: "PAs are not doctors. They do not hold a medical degree and are not medically trained, despite misleading statements made by some.

"We know that patients are already confused about telling the difference between PAs and doctors, and this legislation will make this problem worse.

"Keeping the GMC as the regulator exclusively of doctors would mean we retain the clear distinction between doctors and PAs."

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Source: BBC News, 25 February 2024

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Seeing same GP ‘improves patient health and cuts workload of doctors’

Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind.

Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet.

They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found.

Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors.

People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions.

Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up.

The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.”

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Source: The Guardian, 23 February 2024

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Black children suffer ‘more complications’ after appendicitis surgery

Black children in the UK are four times more likely to experience complications after appendicitis surgery than their white counterparts, a study has found.

The study, funded by the Association of Paediatric Anaesthetists of Great Britain and Ireland, looked at 2,799 children from 80 hospitals across the UK aged under 16 who had surgery for suspected appendicitis between November 2019 and January 2022.

Of these, 185 children (7%) developed postoperative complications within 30 days of the surgery. Three-quarters of these complications were related to the wound, while a quarter were respiratory, urinary or catheter-related or of unknown origin.

The study found that black children had a four times greater risk of experiencing complications after the operation, and that this risk was independent of the child’s socioeconomic status and health history.

Appendicitis is one of the most common paediatric surgical emergency with 10,000 performed every year. The authors said that this was the first study to look at the demographic differences of postoperative complication rates in regards to appendicitis.

The researchers said they could not draw firm conclusions regarding why black children had worse outcomes after this type of emergency surgery, and that this apparent health inequality “requires urgent further investigation and development of interventions aimed at resolution”.

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Source: The Guardian, 22 February 2024

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Scotland's NHS cannot meet growing demand, warns watchdog

Scotland's NHS is unable to meet the growing demand for health services, a spending watchdog has warned.

A review by Audit Scotland said the increased pressure on the NHS was now having a direct impact on patient safety and experience.

The watchdog also claimed there was no "overall vision" for the future of the health service.

The annual report on the state of Scotland's health service highlighted that the NHS was facing soaring costs, patients were waiting longer to be seen and there were not enough staff.

Stephen Boyle, Auditor General for Scotland, said this had "added to the financial pressures on the NHS and, without reform, its longer-term affordability".

He added: "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services.

"To deliver effective reform the Scottish government needs to lead on the development of a clear national strategy for health and social care.

"It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS."

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Source: BBC News, 22 February 2024

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Baby loss certificates introduced in England

Bereaved parents who lose a baby before 24 weeks of pregnancy in England can now receive a certificate in recognition of their loss.

Ministers say they have listened to bereaved parents who have gone through the painful experience of miscarriage.

Campaigners said they were "thrilled" that millions of families would finally get the formal acknowledgement that their baby existed.

All parents who have experienced baby loss since September 2018 can apply.

They should visit the gov.uk website - applicants must be at least 16 years old, have been living in England at the time of the loss and be one of the baby's parents or surrogate.

In Wales, there are plans to deliver a similar scheme. 

Babies who are born dead after 24 completed weeks of pregnancy are called stillbirths, and their deaths are officially registered. But this does not happen for babies who die before that stage.

Pregnancy loss or miscarriage before 24 weeks is the most common complication of pregnancy, experienced by an estimated one in five women in the UK.

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Source: BBC News, 21 February 2024

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Long Covid ‘brain fog’ may be due to leaky blood-brain barrier, study finds

From forgetfulness to difficulties concentrating, many people who have Long Covid experience “brain fog”. Now researchers say the symptom could be down to the blood-brain barrier becoming leaky.

The barrier controls which substances or materials enter and exit the brain. “It’s all about regulating a balance of material in blood compared to brain,” said Prof Matthew Campbell, co-author of the research at Trinity College Dublin.

“If that is off balance then it can drive changes in neural function and if this happens in brain regions that allow for memory consolidation/storage then it can wreak havoc.”

Writing in the journal Nature Neuroscience, Campbell and colleagues report how they analysed serum and plasma samples from 76 patients who were hospitalised with Covid in March or April 2020, as well 25 people before the pandemic.

Among other findings, the team discovered that samples from the 14 Covid patients who self-reported brain fog contained higher levels of a protein called S100β than those from Covid patients without this symptom, or people who had not had Covid.

This protein is produced by cells within the brain, and is not normally found in the blood, suggesting these patients had a breakdown of the blood-brain barrier.

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Source: The Guardian, 22 February 2024

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Health secretary urges patients to report ‘horrific’ sexual abuse allegations

Health secretary Victoria Atkins has said mental health patients and staff must report the “horrific” sexual abuse allegations uncovered by The Independent to the police.

Ms Atkins said victims would have her full support if they reported their claims to the police.

Her intervention comes following a joint investigation by The Independent and Sky News, which revealed almost 20,000 reports of sexual harassment and abuse on NHS mental health wards in England.

The allegations uncovered include patients claiming to have been raped by staff and other patients while being treated on mental health wards.

In response to the initial investigation, Ms Atkins said a review launched last year into mental health services would now also look into sexual assault within the sector.

Speaking on Sky News, she said: “These are horrific allegations that should not and must not happen in our care. Very, very vulnerable people have to stay in mental health inpatient facilities, and they do so because they need care, support, and treatment.

“Some of the behaviours that have come to light are criminal offences, and so I would encourage anyone who feels able to – and I appreciate it is a difficult step – to go to the police and please report them, because they are crimes and we must drive them out.”

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Source: The Independent, 21 February 2024

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Doctors tore down posters offering Martha’s Rule-style rights, teenager’s mother claims

Doctors tore down posters offering patients a secondary care review if they were worried about their condition in hospital, the mother of a teenager who died of sepsis claimed.

Merope Mills, who has campaigned for a similar policy called “Martha’s Rule” named after her 13-year-old daughter, claimed a small minority of “bad actors” in hospitals risked slowing down the initiative.

It comes as NHS England announced 100 hospitals with critical care units will be invited to sign up for the policy, which will be rolled out from April this year.

Martha died from sepsis in 2021 after staff at King’s College Hospital failed to move her to intensive care despite her family warning them her condition had deteriorated.

“When something similar to Martha’s Rule was introduced to Royal Berkshire Hospital, doctors actually pulled down the posters advertising the service to patients because they hated the idea of giving patients this kind of power,” Mrs Mills told the Today Programme.

“A small minority of bad actors whose arrogance, complacency or pride stops them listening and doing the right thing and that is what we are trying to challenge with Martha’s Rule. There are pockets of damaging cultures in hospitals around the country. Sometimes it is not a whole hospital, sometimes it is just a ward in a hospital, sometimes it is just a particular individual on a ward in a hospital.”

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Source: The Independent, 21 February 2024

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The mothers fighting a scandal bigger than thalidomide: ‘We were told the medication was safe’

In 2009, Emma Murphy took a phone call from her sister that changed her life. “At first, I couldn’t make out what she was saying; she was crying so much,” Murphy says. “All I could hear was ‘Epilim’.” This was a brand name for sodium valproate, the medication Murphy had been taking since she was 12 to manage her epilepsy.

Her sister explained that a woman, Janet Williams, on the local news had claimed that taking the drug during her pregnancies had harmed her children. She was appealing for other women who might have experienced this to come forward.

Murphy found the news segment that evening and watched it. “I was just stunned,” she says. “Watching that, I knew. I knew there and then that my children had been affected.”

At that point, Murphy was a mother to five children, all under six, and married to Joe, a taxi driver in Manchester. “My kids are fabulous, all of them, but I’d known for years that something was wrong,” she says. “They weren’t meeting milestones. There was delayed speech, slowness to crawl, not walking. There was a lot of drooling – that was really apparent. They were poorly, with constant infections. I was always at the doctors with one of them."

A call between Murphy and Janet Williams was the start of an incredible partnership. It led to the report published this month by England’s patient safety commissioner, Dr Henrietta Hughes, which recommended a compensation scheme for families of children harmed by valproate taken in pregnancy. Hughes has suggested initial payments of £100,000 and described the damage caused by the drug as “a bigger scandal than thalidomide”. It is estimated that 20,000 British children have been exposed to the drug while in the womb.

Williams and Murphy have campaigned relentlessly to reach this point. It is by no means the endpoint – even now, an estimated three babies are born each month having been exposed to the drug. Together, the women formed In-Fact (the Independent Fetal Anti Convulsant Trust) to find and support families like theirs. They were instrumental in the creation of an all-party parliamentary group to raise awareness in government. 

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Source: The Guardian, 22 February 2024

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'Catastrophic' consequences after oxygen error

A patient in north Wales suffered "catastrophic" consequences when staff didn't connect their oxygen supply correctly.

The Betsi Cadwaladr health board, which was caring for the patient at the time, is investigating and says it was one of a small number of recent similar incidents.

But it refused to say whether the patient died, or to explain what the “catastrophic” consequences were.

It says it is working to improve staff training to avoid similar incidents happening again.

On Tuesday, Wales' health minister Eluned Morgan said the health board still had "a lot to do," before it could be taken out of special measures.

A report to the committee said: “Further patient safety incidents have occurred in the health board related to the preparation and administration of oxygen using portable cylinders.

“On review, the cylinder had not been prepared correctly, resulting in no flow of oxygen to the patient.

“One incident had a catastrophic outcome and is under investigation.”

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Source: BBC News, 20 February 2024

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Medicine shortages ‘around double what they were a year ago’

Medicine shortages have increased and are “around double what they were a year ago”, it has been claimed.

Speaking to the Health and Social Care Committee on Monday, Mark Samuels, chief executive of the British Generic Manufacturers Association (BGMA), said they have been highlighting the medicine shortage risk to ministers since July 2021 and the BGMA is “very concerned about it”.

He said: “We’ve been monitoring it for several years now, and as you saw in the written evidence, shortages have increased.

“They’re around double what they were a year ago. We have them at 101 shortages in February this year.”

We've just been hearing devastating stories from people about the emotional toll it's sort of taking on them not being able to access vital medications.

The shortage of certain medications “continues to be challenging”, Dr Rick Greville, director of distribution and supply at the Association of the British Pharmaceutical Industry (ABPI), told the committee.

But when asked if the shortage is getting better or worse, he said it is “difficult to know as to whether it is increasing significantly, but certainly it’s a long-standing issue”.

Meanwhile, there is “serious concern” about the potential harm to people with diabetes due to a shortage of medication, the committee was told.

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Source: Evening Standard, 20 February 2024

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More women investigated for illegal terminations, says abortion provider

An unprecedented number of women are being investigated by police on suspicion of illegally ending a pregnancy, the BBC has been told.

Abortion provider MSI says it knows of up to 60 criminal inquiries in England and Wales since 2018, compared with almost zero before.

Some investigations followed natural pregnancy loss, File on 4 found.

Pregnancy loss is investigated only if credible evidence suggests a crime, the National Police Chiefs' Council says.

File on 4 has spoken to women who say that they have been "traumatised" and left feeling "suicidal" following criminal investigations lasting years.

Speaking for the first time, one woman described how she had been placed under investigation after giving birth prematurely, despite maintaining that she had never attempted an abortion.

Dr Jonathan Lord, medical director at MSI, which is one of the UK's main abortion providers, believes the "unprecedented" number of women now falling under investigation may be linked to the police's increased awareness of the availability of the "pills by post" scheme - introduced in England and Wales during the Covid-19 lockdown. Scotland also introduced a similar programme.

These "telemedicine" schemes, which allow pregnancies up to 10 weeks to be terminated at home, remain in effect. Campaigners are concerned that it is possible for women to knowingly or unknowingly use the pills after this point.

MSI's Dr Lord says criminal investigations and prosecutions further "traumatise" women after abortions, and that women deserve "compassion" rather than "punishment".

"These women are often vulnerable and in desperate situations - they need help, not investigation and punishment," he says.

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Source: BBC News, 20 February 2024

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Codeine linctus to be reclassified to a prescription-only medicine because of risk of abuse and addiction

Codeine linctus, an oral solution or syrup licensed to treat dry cough in adults, is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced.

Codeine linctus is an opioid medicine which has previously been available to buy in pharmacies under the supervision of a pharmacist but will now only be available on prescription following an assessment by a healthcare professional.

Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’.

The decision to reclassify the medicine has been made following a consultation with independent experts, healthcare professionals and patients. 992 responses were received.

The consultation was launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant.

Dr Alison Cave, MHRA Chief Safety Officer, said: "Patient safety is our top priority. Codeine linctus is an effective medicine for long term dry cough, but as it is an opioid, its misuse and abuse can have major health consequences."

Alternative non-prescription cough medicines are available for short-term coughs to sooth an irritated throat, including honey and lemon mixtures and cough suppressants.

Patients are urged to speak to a pharmacist for advice and not to buy codeine linctus from an unregistered website as it could be dangerous.

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Source: MHRA, 20 February 2024

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