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Trust ‘reviewing hundreds of patients’ after failings discovered

The suicide of a woman with severe mental illness has prompted a review into the care of hundreds of other patients, according to her family.

Frances Wellburn, 56, was under the care of Tees, Esk and Wear Valley Foundation Trust’s community mental health team in York, which before the coronavirus pandemic had categorised her as “medium risk”.

This meant she should have had regular contact from the service, but an internal serious incident report into her death, seen by HSJ, found no contact was made with her for three months.

In June 2020 she required admission to an inpatient unit for three weeks, but she deteriorated again after being discharged and took her own life in August.

Her family have said Ms Wellburn was making a “good recovery” from episodes of psychosis prior to the pandemic, but the lack of support in the spring of last year had contributed to a major deterioration in her condition.

According to sister, Rebecca Wellburn, the trust’s director of nursing Elizabeth Moody confirmed in a meeting with the family that a wider review had now been launched into the care of hundreds of patients under its York-based community services.

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Source: HSJ, 28 April 2021

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Trust ‘missed opportunities’ to prevent sex offender working as locum

A trust has admitted it ‘missed opportunities’ to identify that a locum doctor – who was arrested on hospital premises for two sexual offences — had already been cautioned for indecent exposure.

Salman Siddiqi admitted two offences – attempting to engage in sexual communication with a child and attempting to arrange or facilitate a meeting with a child for sexual offences – last month.

East Kent Hospitals University Foundation Trust, where he was working as a locum paediatric registrar at the time of the January offences, has now said there had been “missed opportunities” to identify his previous caution.

Chief medical officer Rebecca Martin told HSJ the trust had taken steps to ensure that these missed opportunities could not happen again. She said in a statement: “This includes standardising DBS checks for temporary workers booked through an agency and escalating all DBS and General Medical Council checks that feature conditions, cautions or warnings.”

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Source: HSJ, 23 February 2023

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Trust ‘led with integrity’ in face of maternity scandal, says CQC

A trust facing a police investigation into one of the NHS’s largest ever maternity scandals is no longer rated ‘inadequate’ by the Care Quality Commission in its well-led and maternity domains.

Nottingham University Hospitals Trust was rated “inadequate” for its leadership and maternity services during inspections in 2021 and 2022, following serious care failings exposed by staff and patients during this period. The Nottinghamshire police confirmed last week they were opening an investigation.

But the regulator noted improvements after its well-led and maternity inspections which took place in April and June.

The well-led rating has gone up from “inadequate” to “requires improvement” and maternity services at both hospitals have also gone up to “requirements improvement”.

Greg Rielly, CQC deputy director of operations in the Midlands, said: “During this inspection, we saw a team that consistently led with integrity who were open and honest in their approach.”

However, he stressed that while the culture across the trust was improving, some staff still didn’t feel able to raise concerns without fear of retribution.

“Leaders were aware of this and were working to create a workplace that is free from bullying, harassment, racism, and discrimination so we hope to see an improved picture soon,” he said.

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Source: HSJ, 13 September 2023

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Trust ‘could have avoided four never events’ if it had acted on alert

A trust which had four ‘never events’ where patients were connected to air rather than an oxygen supply could have avoided them if it had been more proactive when a national patient safety alert was sent out several years earlier, a report has found.

In one case, a baby being investigated for sepsis had oxygen saturation levels of just 75% before the mistake was realised. In another, a woman with COPD and pneumonia had oxygen saturation at 80% when she was connected to the air outlet.

Calderdale and Huddersfield Foundation Trust asked the Royal College of Physicians to carry out an invited review after the four never events at Calderdale Royal Hospital in 2018 and 2019. The earliest incident happened in February 2018 but was not identified until a retrospective audit nearly a year later.

The RCP’s report said that, had this been identified earlier, “steps could have been put in place to avoid such incidents from subsequently occurring”.

But it added: “All four never events could have been avoided if the trust had responded more proactively to the previous NHS Improvement patient safety alert about the dangers of erroneously connecting patients to air instead of oxygen and had subsequently restricted access to air outlets.”

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Source: HSJ, 2 November 2020

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Trust 'hiding serious harm and death' report

There was a fair bit of press coverage last week about an employment tribunal case against the Care Quality Commission – in which the regulator was found to have sacked an inspector for making a series of whistleblowing disclosures.

However, many of the key details were either skirted over, or missed altogether, in the coverage.

The disclosures made by Shyam Kumar related not just to his role as a special adviser for the CQC, but also to his full-time employer, University Hospitals of Morecambe Bay FT, and to understand the case fully, they need to be separated out.

The important context (also skirted over) was that Dr Kumar had raised a series of legitimate concerns about another orthopaedic surgeon at UHMB, both internally within the trust, and externally with the CQC, in 2018.

This caused major tensions within UHMB, to the extent that Dr Kumar started to be targeted for criticism by a different surgeon, being labelled a ‘traitor’ to Indian doctors in a group email.

When challenged by Dr Kumar, the colleague complained to the CQC that Dr Kumar had sought to threaten and intimidate him, along with other accusations.

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Source: HSJ, 12 September 2022

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Trust 'failed to act' on cancer patient's X-rays

A man who died from lung cancer might have been saved if a hospital trust had not "failed to act" on two abnormal chest X-rays, an investigation found.

Growths identified in the patient's examinations were not followed up for three years and were then untreatable, the health ombudsman said.

North Cumbria University Hospitals NHS Trust also failed to correctly handle a complaint from the man's daughter.

The trust, which runs hospitals in Carlisle and Whitehaven, apologised.

The investigation was carried out by the Parliamentary and Health Service Ombudsman (PHSO), which deals with unresolved NHS England complaints.

The patient, referred to only as Mr C, was admitted twice to hospital with stroke-like symptoms in 2014 and 2015. On both occasions X-rays were carried out which found abnormal growths in his lungs, but no action was taken. In July 2017, Mr C was found to have advanced lung cancer and he died weeks later.

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Source: BBC News, 29 April 2021

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Truss move to cut management would ‘get in way’ of progress, says top CEO

Liz Truss’s desire to talk about cutting management in the NHS will get in the way of more important conversations about the future operating model of the health service, a respected system leader has said.

In an interview with HSJ, Rob Webster, chief executive of the West Yorkshire integrated care system, said NHS managers have been a “fundamental” part of the response to the pandemic and that they have a “good record of delivering” when backed by coherent plans.

His comments come after Ms Truss, who was confirmed as the new prime minister today, said during the Conservative Party leadership contest she was planning “fewer levels of management” in the NHS.

When asked about the comments made by Mrs Truss, as well as similar statements from health secretary Steve Barclay, Mr Webster said: “This is part of the reality of the NHS being a political issue, that you will get this sort of debate.

“And I think if you want to enter debate about the NHS being over-managed, you can look at any one of a number of independent publications that demonstrate that it’s not, from the Kings Fund, the Nuffield trust, and various others…"

Mr Webster said many patients in the NHS are still receiving good, safe and timely care, but at the same time many people are waiting too long to access services while staff have faced “incredible pressure” for an extended period.

“What we need to do is to work our way out of this,” he said. “And we can only do that with a coherent plan which is politically led nationally, politically owned locally, and led by people in the system collectively.”

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Source: HSJ, 6 September 2022

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True Global Solidarity: Spectacular World Patient Safety Day around the world

Dr Neelam Dhingra, Coordinator, Patient Safety and Risk Management, World Health Organization, reflects on World Patient Safety Day 2020.WPSD.png.da03fa56e160d143a1492a93e3ae8072.png

"Dear Colleagues

Congratulations. This is a moment of pride for all of us!

The WHO Patient Safety Flagship would like to express its deepest appreciation to members of the Global Patient Safety Network for an outstanding commemoration of the World Patient Safety Day 2020 around the world. The response to the call was phenomenal and we have already received great stories and truly inspiring reports from multiple countries, regions, partners and stakeholders showcasing a variety of activities. A number of global virtual events amplifying the messaging for the day. “Safe health workers, Safe patients” and “Speak up for Health worker safety!”. Moreover, hundreds, if not thousands, of iconic monuments, landmarks and health care facilities were lit up in colour orange from all over the world. We are working on a short summary and a full report illustrating all these amazing contributions. Most importantly, the day was a witness to expression of strong commitment and leadership of ministries of health for urgent and sustainable action, from countries across the world.

At WHO headquarters on 17 September 2020, a landmark Charter “Health worker Safety: A priority for patient safety”, was launched at a World Patient Safety Day Press Conference (https://twitter.com/who/status/1306496780649938944?s=24) by WHO Director General, Dr. Tedros Adhanom Ghebreyesus in the presence of International Labour Organization Director General, Dr Guy Ryder and Rt. Hon Mr Jeremy Hunt, Chair, Health and Social Care Select Committee, House of Commons of the UK, who played a key role in establishing World Patient Safety Day, an active campaigner on patient safety globally and also the Co-Chair of WHO Steering Committee on World Patient Safety Day.

WHO Member States and all relevant stakeholders are invited to support health worker safety by endorsing and signing up to the Charter.

Charter: Health worker safety: a priority for patient safety

https://bit.ly/2FNEzRu  

Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-to-the-charter---health-worker-safety

A Global Virtual Event “One world: Global solidarity for health worker safety and patient safety” was held showcasing rich participations from members of this very network, regions and countries. WHO Deputy Director General, Dr Zsuzsanna Jakab, and also the Co-Chair of WHO Steering Committee on World Patient Safety Day, in her closing remarks emphasised 'World Patient Safety Day 2020 should not be seen only as Day but a platform for change.  WHO will work with partners to advance the themes of the Day throughout the entire year'.

A number of advocacy, policy, technical products were launched at the event including:

1. World Patient Safety Day 2020-21 Goals. From this year onwards, WHO will launch theme-related goals with the aim of achieving tangible and measurable improvements at the point of health service delivery. Ministries of health and health care organizations are encouraged to incorporate these goals into ongoing service improvement programmes and drives. As a new set of goals will be proposed each year, implementation teams at health care facilities are advised to institutionalize patient safety improvements achieved, and to take on new goals as well as sustaining action on goals from the previous year. WHO is setting up an online platform where health care facilities and organizations can report progress and learn from each other. A certificate of appreciation will be provided to the registered facilities. The World Patient Safety Day goals 2020–2021 are aimed at improving health worker safety. Please sign up to the goals.

Goals https://www.who.int/publications/i/item/who-uhl-ihs-2020.8

Sign up: https://www.who.int/campaigns/world-patient-safety-day/sign-up-for-wpsd-2020-2021-goals

2. Patient safety incident reporting and learning systems: technical report and guidance: https://www.who.int/publications/i/item/9789240010338

3. WHO-ILO joint publication "Caring for those who care: National Programmes for Occupational Health for Health Workers" https://www.who.int/publications/i/item/caring-for-those-who-care

4. Protection of health and safety of health workers: Checklist for healthcare facilities https://www.who.int/publications/i/item/protection-of-health-and-safety-of-health-workers

5. An OpenWHO course on: Occupational health and safety for health workers in the context of COVID-19
https://openwho.org/courses/COVID-19-occupational-health-and-safety?tracking_user=79KWbMERvlyJs93otUBThL&tracking_type=news&tracking_id=5G2Mpe2LUQH0UI1yw8p8pV

World Patient Safety Day provides a torch bearing platform, which brings spotlight on global, national and local patient safety issues. This year the World Patient Safety Day brought a spotlight on health worker safety and its impact and interaction with patient safety.

This year’s WPSD came as a result of close collaboration between WHO and all stakeholders.  We strongly believe that the amazing sense of ownership was the key factor for success. For that, we thank you all.

Thanks and best regards,"

Dr Neelam Dhingra

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Troubled maternity wards still jeopardising patients, watchdog warns

Babies and mothers are at risk of injury and death because too many maternity units have not improved care despite a string of childbirth scandals, a Care Quality Commission (CQC) report has warned.

In a highly critical report published on Tuesday, the CQC voiced serious concern that lessons are not being learned and that many incidents involving patients’ safety are still not being recorded.

Some hospitals have been “too slow” to take the steps needed to make labour and birth safer, despite multiple inquiries, reports and recommendations to do so, it said.

The CQC also found other persistent weaknesses in maternity care, including tension and difficulties between obstetric doctors and midwives and poor oversight of risks to patients during an in-depth inspection of maternity care at nine hospitals in England. The NHS has been criticised for major maternity scandals involving poor care, which sometimes persisted for many years, at trusts such as Morecambe Bay, East Kent and Shrewsbury and Telford.

The government, NHS leaders and patients have pressed the NHS in England to overhaul maternity safety to reduce the number of babies being left brain-damaged or dead and mothers injured or dead as a result of poor care during childbirth.

The watchdog also criticised hospitals for doing too little to seek the views from black, minority ethnic and poorer communities about how to improve their experience of giving birth. Black women are four times more likely to die in childbirth than white women, and Asian women twice as likely.

“We know that many maternity services are providing good care, but we remain concerned that there has not been enough learning from good and outstanding services,” said Ted Baker, the regulator’s chief inspector of hospitals.

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Source: The Guardian, 21 September 2021

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Troubled children’s service taken out of special measures

An independent children’s and adolescents’ mental health service has been taken out of special measures after cutting beds by two-thirds.

The Care Quality Commission has rated St Andrew’s Healthcare’s CAMHS unit in Northamptonshire “requires improvement” but removed it from special measures. Among improvements noticed were a major change in the service’s leadership and staff raising concerns openly and honestly.

The unit was rated “inadequate” and served with a section 31 notice following inspections in June and December last year. 

After its December inspection, the charity reduced the number of beds within its CAMHS offering from 90 to 30. Around the same time, St Andrew’s Healthcare chief executive Katie Fisher also revealed plans to shrink its services by half to address the serious quality issues.

Speaking to HSJ, St Andrew’s Healthcare chief executive, Kate Fisher, who was appointed in 2018, said: “this isn’t just words, we are absolutely walking the walk and seeing through the strategy we set ourselves.”

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Source: HSJ, 18 December 2020

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

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

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

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

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

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

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

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

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

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

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

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

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Source: BBC News, 3 October 2022

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Tribunal ‘astonished’ by trust’s handling of legitimate race discrimination concerns

A children’s nurse who raised legitimate concerns over racial discrimination at a major London trust was suspended and victimised by her managers for doing so, an employment tribunal has ruled.

Jeyran Panahian-Jand, who worked on a children’s ward at Whipps Cross Hospital, parts of Barts Health Trust, had raised concerns with her manager in 2019 that staff were divided on “racial lines”, with an “unfair allocation of work”, as well as bullying of two junior staff.

Her manager Heather Roberts, as well as other superiors, told Ms Panahian-Jand she should raise a formal complaint, without offering to look at the issues raised and keep the complaint informal, which the tribunal said they should have done under whistleblowing policies.

Ms Roberts later accused Ms Panahian-Jand, who identified as white, of continuing to talk about her allegations on the ward, and with the agreement of Ghislaine Stephenson, the associate director of nursing for children, Ms Panahian-Jand was suspended for the “disruption” and “upset” she was causing, the tribunal judgment said.

Ms Panahnian-Jand then lodged a formal complaint over race discrimination, as well as accusing two other bank nurses of making “racially abusive” remarks. A subsequent internal investigation supported three allegations of race discrimination made by Ms Panahian-Jand, while a separate probe into her own alleged misconduct found there was no case to answer.

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Source: HSJ, 23 February 2021

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Treatment disrupted as trust suffers major data loss

A major IT incident at an acute trust is disrupting treatment for eye patients after a significant data loss, it has emerged.

Sandwell and West Birmingham Hospitals Trust chief executive Richard Beeken revealed to his trust’s board that a data loss incident in December had “impacted on staff and patient care” after disrupting 20 systems across the organisation.

Recovery of the full data set for patients receiving treatment at the Birmingham and Midland Eye Centre is still under way, and some have had operations postponed.

Despite the incident, ophthalmologists are continuing to see the majority of patients, Mr Beeken said, telling HSJ: “[Numbers affected] are being kept to a minimum through the extraordinary efforts of the clinical team who are putting in extra hours to reassess each patient’s needs.”

Scanning continues in the majority of cases and the trust is pressing on with recovery work for all historic images and patient contact details, though leaders believe the chances of 100% data recovery are “still slim”.

No patient data was extracted during the incident and the information commissioner was made aware.

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Source: HSJ, 10 January 2022

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Treasury’s dead hand over NHS policy is the biggest patient safety threat

Patients are dying in the backs of ambulances or on trolleys in A&E while others languish in beds unable to be discharged due to the collapse in social care. Others waiting in pain are desperate to get a bed for much-needed surgery.

While there are many ingredients mixing together to create the current NHS crisis, a widespread shortage of nurses, doctors and other essential staff is one of the major contributory factors.

Many in the NHS reacted with disbelief on Tuesday after 280 MPs voted with the government to reject a bid to force through better workforce planning for the NHS.

Former health secretary Jeremy Hunt had pulled together a coalition of health organisations and charities who backed his proposal which demanded ministers draw up and publish workforce plans every two years.

Mr Hunt’s amendment fell victim to the fear of the cost of actually training enough doctors and nurses to work in the NHS.

The Treasury’s dead hand over NHS policy has and continues to be one of the biggest patient safety threats in the UK.

As Mr Hunt told MPs, the costs are borne not only from huge bills for locum doctors and nurses who earn incredible pay working alongside exhausted full-time staff, but also in the safety failures caused by staff shortages.

Exhausted nurses will make mistakes. One nurse cannot safely look after a ward of 16 elderly patients. A doctor can only see one patient at a time in A&E.

Speaking to MPs, Mr Hunt pleaded with the Commons to offer some hope to the NHS workforce.

He said NHS staff were “exhausted” but also “daunted” by the challenges they were seeing. He added: “All they ask is one simple request, that they can be confident we are training enough of them for the future.”

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Source: The Independent, 23 November 2021

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Treasury ‘the barrier’ as full hospitals desperate to discharge patients to social care

The government is being pressed to urgently pay care homes to take on thousands of patients from hospitals, many of which are on course to be overwhelmed by COVID-19 patients.

Hospitals, particularly in London and the surrounding areas, are seeing very high and rapidly growing numbers of covid-19 admissions, and are running out of options to free up beds. Multiple senior NHS leaders said they need to discharge more patients to care homes, but that this had become increasingly difficult.

Beds in many care homes are lying empty, but many care providers are refusing to accept residents where there is a risk of introducing covid-19 and fear of repeating the disaster of the spring in the sector.

Part of the problem is some care providers which would otherwise become covid-designated homes say they are not insured for the risk of doing so.

HSJ understands national officials in the NHS and government are now considering options to try to alleviate the problem, amid urgent requests from local NHS leaders, including paying for the additional insurance cost. However, sources said the Treasury had not yet been willing to foot the bill.

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Source: HSJ, 7 January 2021

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Transgender women may be banned from women's NHS wards

Transgender people may be banned from single-sex hospital wards under plans to restore "common sense" in the NHS, the health secretary says.

Speaking at the Conservative party conference, Steve Barclay announced a consultation on strengthening the protections in place for women.

NHS guidance issued in 2021 said trans people may be placed on wards according to the gender they identify as. 

The change would stop that with trans people given their own rooms and areas. But doctors have questioned whether there are the facilities available to achieve that.

And the move would have to meet the legal threshold set by the Equality Act, which allows trans people to be excluded from single-sex spaces if there is a proportionate means of achieving a legitimate aim, such as privacy or safety.

Mr Barclay said he wanted to make sure the "dignity, safety and privacy" of all patients was respected, while the rights of women are protected.

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Source: BBC News, 3 October 2023

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Transgender teenager's death preventable, coroner says

The death of a "vulnerable" transgender teenager who struggled to get help was preventable, a coroner has said.

Daniel France, 17, was known to Cambridgeshire County Council and Cambridgeshire and Peterborough Foundation Trust (CPFT) when he took his own life on 3 April 2020.

The coroner said his death showed a "dangerous gap" between services.

When he died, Mr France was in the process of being transferred from children and adolescent mental health services (CAMHS) in Suffolk to adult services in Cambridgeshire.

The First Response Service, which provides help for people experiencing a mental health crisis, also assessed Mr France but he had been considered not in need of urgent intervention, the coroner's report said.

Cambridgeshire County Council had received two safeguarding referrals for Daniel, in October 2019 and January 2020, but had closed both.

"It was accepted that the decision to close both referrals was incorrect", Mr Barlow said in his report.

Mr Barlow wrote in his report, sent to both the council and CPFT: "My concern in this case is that a vulnerable young person can be known to the county council and [the] mental health trust and yet not receive the support they need pending substantive treatment."

He highlighted Daniel was "repeatedly assessed as not meeting the criteria for urgent intervention" but that waiting lists for phycological therapy could mean more than a year between asking for help and being given it.

"That gap between urgent and non-urgent services is potentially dangerous for a vulnerable young person, where there is a chronic risk of an impulsive act," Mr Barlow said.

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Source: BBC News, 25 February 2022

 

 
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Transgender people lose NHS waiting times High Court case

A group of transgender people have lost their legal case against NHS England over waiting times to get seen by a gender specialist.

The two trans adults and two trans children had tried to get the wait times - more than four years in one of their cases - deemed illegal. But a High Court judge ruled on Monday the waiting times are lawful.

The Good Law Project - which helped to bring the legal action - said it would seek permission to appeal.

The four people brought the legal action against NHS England (NHSE) over the waiting time to get a first appointment with a gender dysphoria specialist.

The claimants argued that NHS England was failing to meet a duty to ensure 92% of patients referred for non-urgent care start treatment within 18 weeks.

They said the waiting times were discriminatory, arguing the delays faced by trans people were longer than for other types of NHS treatment.

But the judge dismissed the claim on several grounds.

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Source: BBC News, 16 January 2023

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Transformative learning programme to improve workplace wellbeing and cut business costs

Organisations across the UK and beyond are set to benefit from a unique NHS- academic partnership which sees a focus on staff safety and morale – and delivers significant cost savings.

Together Northumbria University and Mersey Care NHS Foundation Trust are pioneering professional development courses on Restorative Just Culture. This approach at the Liverpool-based Trust has seen reduced dismissals and suspensions, leading to substantial business savings, and has generated great interest across the health sector.

Starting in 2016 Mersey Care has worked to deliver a Restorative Just Culture. And despite increasing its workforce by 135%, the Trust has since seen an 85% reduction in disciplinary investigations and a 95% reduction in suspensions – helping them drive down costs significantly. During the same period, it has also seen improved staff engagement and safety culture scores as measured by the NHS national staff survey.

Mersey Care’s Executive Director of Workforce Amanda Oates says: “Mersey Care started on our journey towards a Restorative Just and Learning Culture after conversations with our staff about the barriers staff faced delivering the best care that they could possibly give."

“The feedback was overwhelmingly about the fear of blame if something didn't go as expected. This was preventing staff from telling us what wasn’t working. More importantly, it was preventing the opportunity for learning from those things to prevent them from happening again. As a Board, we had the conversation - are we looking at problems the wrong way?”

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Source: FE News, 27 October 2020

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Trans woman’s death ‘preventable with right support’, mother says

The family of a young trans woman who is believed to have taken her own life have said she was “failed by those tasked with her care”, as the coroner investigating her death described services for transgender people as “underfunded and insufficiently resourced”.

Alice Litman had been waiting to receive gender-affirming healthcare for more than three years when she died in Brighton at the age of 20 in May 2022.

Ahead of an inquest which began in Hove on Monday, her mother, Dr Caroline Litman, described Alice’s death as “preventable with access to the right support”.

Adjourning the inquest on Wednesday to give a narrative conclusion in two weeks’ time, the coroner Sarah Clarke told the court: “It seems to me that all of these services are underfunded and insufficiently resourced for the level of need that the society we live in now presents".

Describing the trans healthcare system as “not fit for purpose”, Alice's family, who are being supported by the Good Law Project, added: “We are grateful that the coroner has agreed that the conditions of Alice’s death warrant a report to prevent future deaths.”

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Source: The Guardian, 20 September 2023

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Trans boy takes NHS to court over delays to gender identity treatment

A transgender boy is taking NHS England to court over delays in accessing gender identity treatment.

The 14-year-old, who was referred to the UK’s only youth gender identity clinic in October 2019, has been told he may have to wait at least another year to be seen.

He said he was experiencing “fear and terror” while he waits for treatment.

Young people are currently facing “extensive waits” to see a therapist, with the average delay being 18 months or more, according to the Good Law Project, which is representing the boy.

The not-for-profit organisation said the health service was legally required to ensure patients referred to gender identity development services (GIDS) are seen within 18 weeks.

Gender clinics for adults across the country have reported similar delays, with the Devon Partnership NHS Trust reporting “lengthy waiting times” while the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust said patients were facing delays “in excess of 32 months” for an initial appointment and 62 months from referral to treatment.

Trusts have blamed a surge in demand as well as reduced capacity, including staffing problems.

The teenager involved in the case said in a statement: “The length of the NHS waiting list means the treatments which are essential for my well being are not available to me."

“By the time I get to the top of the list it will be too late, and in the meantime I suffer the fear and terror that gender dysphoria causes, every day.”

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Source: The Independent, 23 November 2020

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Trainee nurses to join coronavirus fight

Third year undergraduate trainee nurses will be invited into clinical practice to support the coronavirus effort, while routine care quality inspections are “going to need to be suspended”, the Chief Executive of NHS England has said.

Speaking at the Chief Nursing Officer’s summit event in Birmingham this morning, Sir Simon Stevens told delegates NHSE was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”.

It is understood they would be paid, and follows government moves to pass emergency legislation to relax rules around working in healthcare. 

Asked about Care Quality Commission inspections during the outbreak, Sir Simon said: “There will be a small number of cases where it would be sensible to continue for safety related reasons… but the bulk of their routine inspection programmes is clearly going to need to be suspended and many of the staff who are working as inspectors need to come back and help with clinical practice.” 

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Source: HSJ, 11 March 2020

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Trainee doctors in ‘meltdown’ at major hospital maternity department

Regulators have raised serious concerns over trainee doctors within the maternity department at one of the largest trusts in the country.

The NHS’ training regulator said it had concerns over the treatment of trainee doctors within the obstetric and gynaecology department at University Hospitals Birmingham Foundation Trust, while some medics report being in ‘meltdown’.

Reviewers raised an incident where a consultant had refused to respond to an obstetric emergency in A&E which had been requested by a junior doctor.

“The panel unanimously agreed that Consultant presence was required without delay,” the report added.

The latest review follows concerns in November 2020 and June 2021 when patient safety issues were also identified.

It warned there was a “real risk” trainees would soon become “hesitant and reluctant” to call for consultant support when need.

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Source: The Independent, 5 June 2022

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Trainee doctors 'scared to come to work'

Some trainee doctors and consultants at one Welsh health board are "scared to come to work", a report has found.

A report by the Royal College of Physicians (RCP) described "frightening experiences" staff faced at Aneurin Bevan University Health Board. Chronic understaffing and excessive workloads at the Grange hospital in Cwmbran were causing "very serious patient safety concerns", it added.

The Health Board said it had taken the findings of the report very seriously.

The report, obtained by BBC Wales, said that some trainee doctors and consultants were worried about working in case they lost their licence to practise. It also said the problems had caused some consultants to feel demoralised and on the brink of leaving.

One trainee told the authors of the report: "On one overnight shift, I treated a four-year-old with seizures. The ambulance took six hours. Colleagues treated an 18-month-old with burns. Lots of kids come in with respiratory distress. Paediatric cases are not uncommon. We've treated stabbing victims. Colleagues delivered a baby earlier in the minor injuries unit. These things shouldn't happen at all."

Another trainee said: "There's so much patient movement with [this] model. I recently sent someone from Nevill Hall to the Grange to get a scan, then to the [Royal] Gwent to get a follow-up procedure, then back to Nevill Hall.

"That's three bed moves, three ambulance crews and three medical people dealing with the same patient. It's extremely inefficient."

And another added: "I worry about the safety of the patients coming into this hospital."

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Source: BBC News, 

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Toxic workplaces pushing GPs out of UK practice

GPs are leaving UK practice over workplace incidents rather than due to falling ‘out of love’ with the profession, the General Medical Council (GMC) has warned.

Speaking to the NHS Providers conference (16 November), chief executive Charlie Massey said that many specialty and associate specialist (SAS) and locally employed (LE) doctors feel their careers are being ‘curtailed’ and that they ‘can’t tolerate the environments’ in which they work.

He cited new GMC research into doctors’ migration which identified poor workplace conditions and ‘negative experiences with colleagues’ as a ‘far more impactful’ as a trigger compared to poor experiences with patients.

According to the research, bullying at work, lack of respect from line managers and experiences of favouritism ‘provided the nudge for them to consider making a change and migrating abroad’.

Mr Massey said: "This is a senseless waste of talent, not least because these issues are preventable. With a focus on compassionate, supportive cultures, they can be put right. This will not only improve doctors’ wellbeing, but also their productivity. Happier workers are better workers, and they deliver better results."

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Source: Healthcare Leader, 16 November 2022

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