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Trust warned by CQC over staff sleeping on duty

A mental health trust has received a warning from the Care Quality Commission over staff sleeping on duty and other serious concerns.

Essex Partnership University Foundation Trust was sent a “letter of intent”, which warns the CQC is considering taking urgent enforcement action, following an unannounced visit in November, according to a board report last week.

The trust is already subject to a high-profile inquiry into hundreds of patient deaths.

Natalie Hammond, executive nurse, said this would be “a fine tuning of our health roster which will be an early warning system that will determine and flag all staff members that may be at risk of working too much or their hours of working might perform a pattern that means they are at risk more of falling asleep on duty.”

She added: “We’ve done learning lessons and videos that link the importance of being fit and alert for work and how when you’re not, what mitigation and what steps you should undertake and what risk there is to patient safety.”

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Source: HSJ, 1 February 2023

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Boy dies of cancer after doctors dismissed mother’s warnings six times

A little boy whose headaches turned out to be a brain tumour died in his parent’s arms just four months after his diagnosis.

Rayhan Majid, aged four, died after doctors discovered an aggressive grade three medulloblastoma tumour touching his brainstem.

His mother Nadia, 45, took Rayhan to see four different GPs on six separate occasions after he started having bad headaches and being sick in October 2017.

No one thought anything was seriously wrong, but when his headaches didn’t clear up Nadia rushed him to A&E at the Queen Elizabeth University Hospital in Glasgow.

An MRI scan revealed a 3cm x 4cm mass in Rayhan’s brain.

Rayhan underwent surgery to remove as much of the tumour as possible and was told he would need six weeks of radiotherapy and four months of chemotherapy.

But before the treatment even started another MRI scan revealed the devastating news that the cancer has spread.

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Source: The Independent, 30 January 2023

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Elderly people waited nearly twice as long in A&E in England as in 2021

The amount of time people over 80 spend in A&E in England has almost doubled in a year, leaving them at increased risk of coming to harm and dying, emergency care doctors are warning.

An analysis by the Royal College of Emergency Medicine (RCEM) found that people of that age are spending 16 hours in A&E waiting for care or a bed, a huge rise on the nine hours seen in 2021.

The college, which represents the UK’s A&E doctors, warned that long waits, allied to overcrowding in hospitals and older people’s often fragile health, is putting them in danger.

Doctors specialising in emergency and elderly care warned that older people forced to spend a long time in A&E are more likely to suffer a fall, develop sepsis, get bed ulcers or become confused.

Dr Adrian Boyle, the RCEM’s president, said that it is also likely that some older people are dying as a result of the delays they are facing, combined with their often poor underlying health.

The risks older people face while waiting in sometimes chaotic A&E units are so great that they are likely to be disproportionately represented among the 500 people a week who the RCEM estimates are dying as a direct result of delays in accessing urgent medical help.

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Source: The Guardian, 31 January 2023

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Jess Hodgkinson: Lack of medication contributed to mother's death

A woman who died shortly after giving birth to her daughter did not receive the correct medication, a coroner has ruled.

Jess Hodgkinson, 26, from Chesterfield, died from a pulmonary embolism in 2021.

Assistant coroner Matthew Kewley said there was a "failure" to ensure Ms Hodgkinson received blood thinners right up until the birth.

Chesterfield Coroner's Court heard Ms Hodgkinson had a high risk pregnancy due to severe hypertension.

On 21 April 2021, a consultant in Chesterfield prescribed a prophylactic dose of tinzaparin due to an increased risk of clotting, the inquest heard.

During the inquest, the consultant said the intention was for Ms Hodgkinson to continue to receive a daily dose of anticoagulant medication up until birth.

Ms Hodgkinson was transferred to a hospital in Sheffield the next day, but there was a "failure to communicate" the medication plan, Mr Kewley said.

After being discharged, clinicians in Chesterfield "failed to identify" Ms Hodgkinson was no longer receiving the medication, the coroner said in his ruling.

On 13 May, Ms Hodgkinson attended Chesterfield Royal Hospital and a decision was made to carry out an emergency Caesarean section. The procedure was successful and Ms Hodgkinson's baby was born. But after delivery, Ms Hodgkinson went into cardiac arrest and later died.

In his concluding remarks, Mr Kewley said: "There was a failure to ensure that Jess received anticoagulant medication that a clinician had intended should be taken until birth. This failure made a more than minimal, negligible or trivial contribution to Jess' death".

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Source: BBC News, 31 January 2023

 

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Ian Paterson: Further 1,500 patients to be recalled

A further 1,500 patients of convicted breast surgeon Ian Paterson are to be recalled and their treatment investigated.

Spire Healthcare, which runs private hospitals, said patients were being contacted after a trawl of IT systems.

Paterson was jailed for 20 years in 2017 for 17 counts of wounding people with intent.

The healthcare provider said it remained committed to tracking down all "outstanding patients".

The former surgeon subjected hundreds of patients to needless and damaging surgery over 14 years.

A 2020 independent inquiry ruled "a culture of avoidance and denial" left him free to perform botched operations in NHS and private hospitals in Birmingham and Solihull.

The inquiry recommended all 11,000 patients Paterson treated should be recalled for review.

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Source: BBC News, 1 February 2023

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‘The wait was agony’: Women with life-threatening breast cancer face weeks of delays

“I was worried it would grow and spread,” Charlotte Park, a breast cancer patient tells The Independent. “What happens if I hadn’t been that really pushy person? Sometimes I still go into a dark place and I think: I am so lucky to be here.”

The 50-year-old, from Richmond in Yorkshire, found a lump in her breast in June 2020 and went straight to see her GP who informed her she would have to wait two weeks to see a specialist. After a fortnight of waiting, she started to panic and rang the clinic who said they were still working through referrals from four to six weeks prior to her referral.

“I was getting frustrated and impatient by this point,” Ms Park recalls. “There was no leeway and they didn’t see if they could squeeze me in. I just felt frustrated. There was nothing I could do. It was all out of my hands. I was feeling teary.”

Ms Park is one of thousands of women with breast cancer in England facing delays of weeks or months to see a specialist or receive treatment. Data, shared exclusively with The Independent, shows delays were substantially worse for those with breast cancer than other forms of cancer.

In the end, Ms Park was forced to wait 25 days to see a specialist. The wait was “agony”, she said. It was difficult to definitively determine if the delays caused her cancer to grow, she noted.

Her comments come in the context of thousands of women with breast cancer being forced to wait longer than the NHS-recommended time of two months to get treatment, in a situation branded “perilous” by healthcare professionals. Exclusive data shows only seven in ten women in England received treatment for breast cancer two months after getting an urgent doctor’s referral between January and November 2022.

This amounts to just more than 16,500 women and is way below the NHS target for 85% of breast cancer patients diagnosed via an urgent GP referral to start their cancer treatment within two months of their GP visit.

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Source: The Independent. 31 January 2023

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Ambulance workers to strike on 10 February

Thousands of ambulance staff across five services in England - London, Yorkshire, the South West, North East and North West - will walk out on Friday 10 February, Unison says.

It means strikes over pay will now be happening across the NHS every day next week, apart from Wednesday.

Life-threatening 999 calls will be attended to but others may not be.

Downing Street says the continuing industrial action will concern the public.

The NHS's biggest day of industrial action is set to happen on 6 February, when many nurses and ambulance crews across England and Wales will be on strike.

Unison says the government must stop "pretending the strikes will simply go away" and act decisively to end the dispute by improving pay.

The union warned that unless the government had a "major rethink" over NHS pay, and got involved in "actual talks" with unions, it would announce strike dates running into March.

The government says the above-inflation pay rises requested are unaffordable.

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Source: BBC News, 31 January 2023

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Minister calls for staff evidence in deaths inquiry

A health minister has called for more staff to take part in an inquiry into deaths at a mental health trust.

An independent review into 1,500 deaths at the Essex Partnership University Trust (EPUT) over a 21-year period was launched in 2020.

It emerged earlier this month that 11 out of 14,000 staff members had come forward to give evidence to an independent inquiry.

The trust said it was encouraging staff to take part in the inquiry.

During a parliamentary debate, Health Minister Neil O'Brien said the trust was being given a "last chance" before the government intervened and instigated a statutory inquiry.

A statutory inquiry would allow staff to be compelled to give evidence.

In December, a further 500 deaths were made known to the review chair, Dr Geraldine Strathdee.

She said the inquiry could not continue without full legal powers.

Chelmsford MP Vicky Ford said she had been told by the chief executive of EPUT that staff were "very scared" to give evidence.

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Source: BBC News, 31 January 2023

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NHS set to publish hidden figures which expose true scale of A&E waiting times

The NHS will start publishing “hidden” figures on A&E waiting times following several leaks reported by The Independent.

After unveiling its emergency care plan on Monday, NHS England confirmed it would release internal data each month - currently only made public once a year - showing how many people are waiting for longer than 12 hours after arriving at an emergency department.

The Independent has published several leaks of this data, which shows that these waiting times can be up to five times higher than publicly available NHS figures. Official monthly figures only count the number of hours patients wait after a decision to admit them has been made, and so mask the true scale of the problem.

The move comes after health secretary Steve Barclay said the NHS would, from April, publish this “real” number in a bid for “greater transparency.”

Writing in The Telegraph, he said: “Too much of the debate about A&E and ambulance services is based on anecdotal evidence. I want NHS managers and the wider public to have access to the same facts from the front line, starting with publishing the number of 12-hour waits from the time of arrival in A&E from April.”

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Source: The Independent, 31 January 2023

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System’s trusts failing to tackle ‘completely unjust’ health inequalities

All three acute trusts in an integrated care system are failing to meet national requirements to tackle health inequalities after being overwhelmed by emergency and elective care pressures.

A report by Devon Integrated Care Board found progress on addressing variation in poor health outcomes had “slipped due to capacity issues.” Both Royal Devon University Healthcare Foundation Trust and Torbay and South Devon FT were rated “red” for a lack of headway.

All trusts were told by NHSE in 2021 to undertake a range of actions as part of work to reduce health inequalities during 2022-23.

These included publishing analyses of waiting times disaggregated by ethnicity and deprivation, using the waiting list data to identify disparities between different patient groups, and measuring access, experience and outcomes for patients from a deprived community or an ethnic minority background.

Sarah Sweeney, interim chief executive of National Voices, which represents health and care charities and patients, said she was “really concerned to see that some ICSs are not making as much progress on reducing health inequalities as expected and hoped”.

“These inequalities are completely unjust and preventable,” she said. 

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Source: HSJ, 30 January 2023

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Cancer: Urgent action needed amid NHS pressures, warns charity

The Covid-19 pandemic cannot continue being blamed for poor cancer care, a charity boss has said.

Judi Rhys, of Tenovus Cancer Care, said urgent action was needed to save lives when more people than ever are living with cancer in Wales.

It comes as the Wales Cancer Network publishes a three-year plan to improve cancer outcomes and patient experience.

But the group's clinical director warned the immediate priority would be maintaining current services.

Prof Tom Crosby, clinical director for Wales Cancer Network, which was tasked by Wales' health minister to draw up the improvement plan, said the biggest pinch point at the moment was access to diagnostics.

"We're absolutely trying to shorten overall times for patients coming into the system being diagnosed and then being treated," he said.

On average in November, people suspected of having cancer had to wait 17 days for a first appointment and 23 days for a first test.

It was an average 31 days from point of suspicion to being told if they had cancer or not and an average 24 days from point of diagnosis to treatment starting.

"We hope that this year we will develop the first regional diagnostic centre and that is likely to be in south-east Wales," Prof Crosby said.

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Source: BBC News, 31 January 2023

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UK dementia care agency’s half-hour home visits ‘lasted as little as three minutes’

A dementia home care agency spent as little as three and a half minutes on taxpayer-funded care visits and filed records claiming far more care was given, according to evidence seen by the Guardian.

The hasty care was exposed by Susan Beswick’s family, who called it “totally inadequate”. They say they had been told visits to 78-year-old Beswick, who has Alzheimer’s disease, were supposed to last 30 or 45 minutes.

Across nine visits this month, care workers formally logged close to six hours of care. But security cameras suggest they were in the house for under one hour 20 minutes – less than nine minutes a visit on average.

On one evening visit, footage showed two carers entering, asking if Beswick had eaten and checking her incontinence pad, before leaving three minutes and 15 seconds later. But they appeared to log on a care tracking app that they had been with her for one hour and 16 minutes.

Beswick, who for years was a care worker herself, “deserves so much better”, said her daughter-in-law Karen Beswick.

“It’s upsetting us the way mum is being cared for here,” she said. “They come in and check her [incontinence] pad and go. They are supposed to be encouraging her to drink. They don’t really talk to mum a lot. It’s not good at all. I will start crying. We are all trying to get the best for mum.”

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Source: The Guardian, 30 January 2023

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Wards at Royal London Hospital mothballed amid concerns over fire safety

Six wards in a busy London Hospital, added at a cost of £24 billion during the pandemic, are lying empty because the builders did not install sprinklers. 

With the NHS in crisis, the Royal London Hospital in east London, has had to mothball the space, which is large enough to take 155 intensive care beds, while officials work out what to do with it. They have no patients in it since last May.

Source: The Sunday Times, 29 January 2023

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Switch to cheaper drugs leaves Parkinson’s patients suffering ‘devastating effects’

Parkinson’s patients are suffering from “devastating effects” as GPs have started to switch to cheaper drugs which have different release rates into the body.

Parkinson’s UK put out a warning when a 65-year-old man who had been successfully managing the condition for 17 years suddenly needed help eating and getting dressed.

This happened after his branded medication Sinemet was changed to a cheaper form of the drug.

Barrie Smith - who comes from Birmingham - was left in pain, developed slow speech and experienced an uncontrolled tremor when his normal Sinemet medication was switched to a more generic form of medication last year without consultation. He called the effects “devastating”.

Dr Rowan Wathes, Associate Director of the Parkinson’s Excellence Network at Parkinson’s UK, said: “Changes to brands or manufacturers can trigger a significant deterioration of symptoms. It is vitally important for prescribers to specify the Parkinson’s medication brand or generic manufacturer on prescriptions for people with Parkinson’s. ”

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Source: The Independent, 30 January 2023

You may also be interested in the following blogs written by Parkinson's UK for the hub:

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Trusts ‘coping better with strikes’ and on track to eliminate 78-week waits, says NHSE director

Trusts are getting better at coping with industrial action and are still on track to hit the national target of eliminating the backlog of 78-week waiters, an NHS England director has told staff.

Paul Doyle, NHS England’s programme director for elective recovery, said: “We continue to make really good progress [on elective recovery]… we are very much in the end game now of meeting the 78-week ambition for the end of March.”

There have been concerns about the impact of recent strike action on eliminating the 78-week backlog, but Mr Doyle praised managers’ handling of the strikes and said administrative staff were doing an “incredible job”.

He added: “Most organisations affected have got better and better as time has gone on about making sure that there are as few cancellations as possible and that cancellations are rebooked quickly or that clinical time is put to good use such as doing virtual outpatient appointments or doing validation of waiting list.”

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Source: HSJ, 30 January 2023

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Testing artificial hip and knee joints 'will save the NHS £200 million a year'... and reduce unnecessary pain for patients in future

Artificial hip and knee joints that have to be removed after failing early are to be examined routinely to save the NHS £200million a year – and reduce unnecessary pain for patients in future.

Less than 1 in 100 removed implants are examined to see why they failed, so surgeons don’t learn what went wrong or pick up on potential scandals.

Consultant orthopaedic surgeon Raghavendra Sidaginamale, of North Tees and Hartlepool NHS Trust, said: "Most removed implants are put in the bin. A wealth of information goes down the drain."

Now the NHS is setting up an Implants Analysis Service, enabling hospitals to send them off to be analysed for signs of unusual wear or chemical degradation.

Each year, 15,000 hip and knee replacements are replaced. If this happens within ten years, they are deemed to have failed early. Jason Wilson, of the IAS, said they are ‘like a black box flight recorder in a plane’, adding: "They hold a wealth of information we can learn from."

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Source: Daily Mail, 29 January 2023

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Hospital doctor accused of sexual assaults on patients

The National Crime Agency and Interpol has been drafted in by detectives investigating a junior doctor accused of multiple sexual assaults on children and adults in A&E departments. 

Last year, Staffordshire police began an investigation into a 35-year-old medic's work at two hospitals, the Royal Stoke University Hospital in Staffordshire and the Russells Hall Hospital in Dudley, West Midlands.

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Source: Sunday Times

Shared by Shaun Lintern Tweet, 29 January 2023

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‘Hospitals at home’ plan to save NHS

More than half a million patients a year will be treated in “hospitals at home” in an attempt to relieve pressure on A&E departments.

Under the plans, elderly and frail patients who fall will be treated by video link, with ministers saying that a fifth of emergency admissions could be avoided with the right care.

Health officials said the “virtual wards” would be backed up by £14 billion in extra spending on health and care services over the next two years, as the NHS tackles record backlogs, with seven million people on waiting lists.

Rishi Sunak said the Urgent & Emergency Care Recovery Plan showed that the NHS was one of his “top priorities”.

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Source: The Telegraph, 29 January 2023

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Medicines blackout threatens ICS prevention target

The government’s target for England to become smoke-free by 2030 – which integrated care systems are expected to pursue – is being undermined by the unavailability of two smoking cessation medicines.

The objective, set by government in 2019, is being taken forward by many ICSs, as they seek to prevent premature illness and death, and narrow health inequalities, with smoking rates normally higher in more deprived populations.

However HSJ analysis of drug shortages revealed that the two cessation medicines are both currently unavailable for an extended period.

Champix (varenicline) has been unavailable since October 2021, a situation exacerbated by the absence of Zyban (bupropion), since December 2022.

Both drugs were withdrawn because of concerns about the presence of nitrosamines, which may increase risk of cancer if people are exposed to them above acceptable levels, and will be subject to further tests and regulatory checks if they are to return.

Matthew Evison, a lung cancer and tobacco dependency specialist at Manchester University Foundation Trust, said Champix was clinicians’ “most powerful weapon” against smoking. He said the treatment gap would make the target harder because “smoking prevalence declines will be slower without varenicline”.

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Source: HSJ, 30 January 2023

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A mysterious Adderall shortage reveals how America fails ADHD patients

Erik, a 26-year-old Seattle grocery clerk, who also has attention-deficit hyperactivity disorder (ADHD), has been unable to get his medications filled for months now – and he’s worried he’ll lose the first full-time job he’s ever had.

For people like Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD.

In recent months, patients have reported problems filling nearly every type of ADHD medication. What’s stranger is that no one seems to know why. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown?

Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation.

The situation has left patients in turmoil.

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Source: The Guardian, 30 January 2023

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NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn

The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures.

Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK.

In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”.

Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone.

NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay.

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Source: The Guardian, 29 January 2023

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Thousands of NHS staff with long Covid risk losing their pay

Thousands of NHS staff across the UK are facing pay cuts because of a change in Covid sickness policy.

Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with Long Covid.

Unions are accusing the government of failing to support health staff who worked during the coronavirus pandemic.

The government says the Covid-19 public inquiry will examine these issues when it begins taking evidence in May.

Changes to special sick pay rules introduced during the pandemic mean that some NHS staff unable to work due to Long Covid may soon no longer receive full pay.

Enhanced provision ended last year. Many had a six-month transition, so expect their wages to go down soon.

Some face losing their jobs.

Professor David Strain is the chair of the Board of Science at the British Medical Association (BMA) and says this makes him "genuinely angry".

He explains: "We've got a group of people that have put themselves forward to look after the population, they've been left with an illness and they're not being supported.

"They're just in a no man's land."

He believes that health workers with long Covid should be allowed to focus on their recovery without money worries.

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Source: BBC News, 30 January 2023

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Toxic slimming pill drug DNP to be declared poison

A highly toxic chemical compound sold illegally in diet pills is to be reclassified as a poison, a government minister has said.

Pills containing DNP, or 2,4-dinitrophenol, were responsible for the deaths of 32 young vulnerable adults, said campaigner Doug Shipsey.

His daughter Bethany, from Worcester, died in 2017 after taking tablets containing the chemical.

The deaths were down to a "collective failure of the UK government", he said.

DNP is highly toxic and not intended for human consumption. An industrial chemical, it is sold illegally in diet pills as a fat-burning substance.

Experts say buying drugs online is risky as medicines may be fake, out of date or extremely harmful.

Mr Shipsey said he had targeted the minister following the death of another young man who had taken the drug sold as a slimming aid.

Prior to this, following the inquests of dozens of young people who had suddenly and unexpectedly died from DNP toxicity, the government had "ignored numerous coroners reports" to prevent future deaths, he said.

"So, at last after 32 deaths and almost six years of campaigning, the Home Office (HO) finally accept responsibility to control DNP under the Poisons ACT 1972," he added.

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Source: BBC News, 28 January 2023

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NHSE launches new intervention regime for worst A&E performers

NHS England has revealed a new intervention regime, as it seeks to deliver on its new urgent and emergency care recovery plan.

Systems will be placed in three “tiers of intervention”, with those systems deemed “off-target on delivery” being given “tier three intensive support” from NHSE, which will include on-the-ground planning, analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”.

The approach follows that which has been taken over the past year for elective and cancer care recovery. 

The urgent care plan, published by NHSE and the Department of Health and Social Care today, says: “NHS England will identify and share good practice so that all can learn from the best. For those systems that are struggling, we will offer support to ensure that they have the best opportunities to drive improvement locally.”

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Source: HSJ, 30 January 2023

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NHS plan: £1bn for hospital beds and ambulance fleet

Thousands of extra hospital beds and hundreds of ambulances will be rolled out in England this year in a bid to tackle the long emergency care delays.

The 5,000 new beds will boost capacity by 5%, while the ambulance fleet will increase by 10% with 800 new vehicles.

Details of the £1bn investment will be set out later in a joint government and NHS England two-year blueprint.

Questions have also been raised about how the extra resources will be staffed - 1 in 10 posts in the NHS is vacant.

The government believes the measures, which will be introduced from April, will help the NHS to start getting closer to its waiting time targets.

It has set goals that by March 2024:

  • 76% of A&E patients will be dealt with in four hours. Currently fewer than 70% are. The official target is 95%
  • An average response time of 30 minutes for emergency calls such as heart attacks and strokes. In December patients waited over 90. The official target is 18.

Prime Minister Rishi Sunak said cutting NHS waiting times was one of his five main priorities.

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Source: BBC News, 30 January 2023

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