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50,000 people will die from pancreatic cancer by 2029 unless NHS gets major investment, charity warns

At least 50,000 people will die from pancreatic cancer over the next five years unless the government gives more funding to improve how quickly the condition is diagnosed and treated, a major charity has warned.

Pancreatic Cancer UK hit out at 50 years of “unacceptably slow progress” compared to other types of cancer as it warned that thousands of lives will be lost unless £35m of “urgent” investment is put towards improving survival rates of the disease.

The charity predicted that pancreatic cancer – described by experts as the “quickest-killing cancer” – is expected to kill more people each year than breast cancer by 2027, which would make it the fourth-biggest cause of cancer deaths in the UK.

The charity has also called for a commitment to treat everyone diagnosed with the cancer within 21 days, which it says would double the number of people getting treatment in time.

Figures show that, compared to the 52.5% survival rate across the 20 most common cancers in the UK, those with pancreatic cancer have just a 7% survival rate.

Around 10,500 people are diagnosed with the disease each year, with 9,558 deaths a year, according to Cancer Research UK, with more than half of people dying within three months of diagnosis.

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Source: The Independent, 12 March 2024

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Millions urged to get free NHS check for ‘silent killer’

Millions of people are being urged to get checks for a condition which has been described as the “silent killer”.

If left untreated, high blood pressure can lead to heart attacks, strokes, kidney disease and vascular dementia.

Up to 4.2 million people in England are thought to be living with high blood pressure without knowing it – around a third of all those with the condition.

Now, a new NHS Get Your Blood Pressure Checked campaign has been launched, backed by health charities, to warn people the condition often has no symptoms.

England’s chief medical officer, Professor Sir Chris Whitty, said: “High blood pressure usually has no symptoms but can lead to serious health consequences.

“The only way to know if you have high blood pressure is to get a simple, non-invasive blood pressure test.

“Even if you are diagnosed, the good news is that it’s usually easily treatable.

“Getting your blood pressure checked at a local pharmacy is free, quick and you don’t even need an appointment, so please go for a check today – it could save your life.”

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Source: The Independent, 11 March 2024

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Warning over use in UK of unregulated AI chatbots to create social care plans

Britain’s hard-pressed carers need all the help they can get. But that should not include using unregulated AI bots, according to researchers who say the AI revolution in social care needs a hard ethical edge.

A pilot study by academics at the University of Oxford found some care providers had been using generative AI chatbots such as ChatGPT and Bard to create care plans for people receiving care.

That presents a potential risk to patient confidentiality, according to Dr Caroline Green, an early career research fellow at the Institute for Ethics in AI at Oxford, who surveyed care organisations for the study.

“If you put any type of personal data into [a generative AI chatbot], that data is used to train the language model,” Green said. “That personal data could be generated and revealed to somebody else.”

She said carers might act on faulty or biased information and inadvertently cause harm, and an AI-generated care plan might be substandard.

But there were also potential benefits to AI, Green added. “It could help with this administrative heavy work and allow people to revisit care plans more often. At the moment, I wouldn’t encourage anyone to do that, but there are organisations working on creating apps and websites to do exactly that.”

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Source: The Guardian, 10 March 2024

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‘My GP suggested it’: Britons explain why they went private for surgery

Private hospitals are caring for a record number of patients paying through their own savings or private medical insurance, according to figures from the Private Healthcare Information Network. 

Helen, a semi-retired frontline worker in south-east England, spent nearly £50,000 of her retirement savings on major spinal surgery to get her life back after two years of debilitating pain.

Helen, 56, began experiencing extreme lower back pain and leg pain in September 2021, triggered by a dog colliding with her leg in the park. Though it was not caused by the trigger, she was diagnosed by the NHS with spondylosis in November 2021, and then a pars defect (a condition affecting the lower spine), and offered scans and physiotherapy. She said six months of physiotherapy, beginning in early 2022, resulted in no improvement, and she was offered pain management and a steroid epidural, which she said also did not help.

“I rarely ventured out in these two years … due to the extreme pain I was in when sitting, standing or walking. Life effectively stopped in 2021,” she said. Desperate, she booked a consultation in May 2023 with a neurosurgeon and was told she needed an operation.

Helen asked whether it would be possible for the neurosurgeon, who also works within the NHS, to do it on the NHS rather than privately. A referral could be made, she was told – but the surgery was likely to involve a waiting time of 18 months to two years. “My husband and I discussed it, and he said: you’ve already had no life for the last two years, do you really want to wait another two?”

She had the spinal surgery in August 2023 and is now managing her pain with over-the-counter medication, rather than the stronger painkillers she was on before. It cost her a staggering £48,345.

The financial hit has been huge. “I was absolutely gutted to have to go private. This has knocked us both; we didn’t see us in our lives having to pay for something like this. We’ve managed our finances carefully and always saved where we can. But that lump sum [that we] can access when we retire … That lump sum has just gone now.”

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Source: The Guardian, 8 March 2024

 

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Bereaved families continue to wait for Essex mental health inquiry

Bereaved relatives have accused ministers of dragging their feet over an inquiry into the death of almost 2,000 patients across NHS mental health trusts in Essex.

The inquiry has still not started more than eight months after the announcement that it would be relaunched with beefed-up powers.

In June last year, the government gave in to pressure from families and the then chair of the inquiry, granting it legal powers to compel witnesses to give evidence. In December, the new terms of reference were sent to ministers, setting out what the inquiry will investigate.

But the terms of reference have yet to be approved by ministers, leaving relatives frustrated, with another “unnecessary” death reported a few weeks ago.

Melanie Leahy, whose son, Matthew, died at the Linden Centre in Chelmsford in 2012, said: “I know that this inquiry, the first of its kind nationally, if carried out in a timely and comprehensively investigative manner, it has the power to prevent more deaths, not just in Essex but all over the UK.

“Why am I and all the other bereaved families and injured individuals still waiting? Worse, why are we being met with such callous and terrifying indifference? Why are our legal team being ignored? We can only conclude that our government simply does not care. If the government continues to drag its feet in this way then they must be held to account for their failings. If there are more deaths during this interminable wait, this government needs to be held responsible.”

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Source: The Guardian, 12 March 2024

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Hospital declares critical incident as beds full

A large number of people in hospital beds waiting for onward care has forced an NHS trust to declare a critical incident to "protect patient safety".

Isle of Wight NHS Trust said on Monday demand for its emergency departments was outstripping the number of free beds, leading to delays.

People are being asked to collect their relatives as soon as they are ready to be discharged.

In a statement, interim chief operating officer Victoria Lauchlan said: "We currently have a high number of people in hospital beds who are waiting for onward care arrangements in the community.

"We are working as an island healthcare system to do everything we can to ensure we can help better support these people to be discharged home with a package of care or to care and nursing homes.

"At this time we are asking people to help by collecting their relatives or friends as soon as they are ready to leave and helping with any additional care and support at home."

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Source: BBC News, 12 March 2024

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USA: 10 urgent patient safety challenges in 2024

While employment for new clinicians was positive in the last year with 96% of new nurses finding work, the issue is transitioning those clinicians from education into bedside and hospital practice, which is the most pressing safety challenge of 2024, according to the ECRI's annual report on patient safety.

"[T]here is growing concern about the difficulty of transitioning new clinicians from education to practice — in the face of several factors exacerbated by the COVID-19 pandemic," an overview of the report states. "Without sufficient preparation, support, and training, new clinicians can experience loss of confidence, burnout, and reduced mindfulness around culture of safety. The combination of these factors may lead to preventable harm."

The ECRI publishes independent medical device evaluations, annually aggregates scientific literature and patient safety events, concerns reported to or investigated by the organization, and other data sources to create its top 10 report.

Each topic that landed in this year's top 10 "represents a failure in at least one of these areas; in fact, many overlap and their roots are found in multiple areas," the report notes. 

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Source: Becker Hospital Review, 11 March 2024

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Priory healthcare group fined £650,000 over death of patient

The Priory healthcare group has been fined more than £650,000 over the death of a 23-year-old patient who was hit by a train after absconding from a mental health hospital.

Matthew Caseby, a personal trainer, was able to leave Birmingham’s Priory hospital Woodbourne by scaling a wall after being “inappropriately unattended” for several minutes in September 2020, an inquest jury ruled in 2022.

The healthcare company pleaded guilty to a criminal safety failing linked to the death of a patient, breaching the 2008 Health and Social Care Act, at Birmingham magistrates court on Friday.

The London-based provider was charged after an investigation into the death of Caseby conducted by the Care Quality Commission.

Caseby’s father, Richard Caseby, who had been campaigning for a prosecution of the healthcare organisation, told the court the company attempted to “evade accountability for its gross failures”.

In a victim impact statement which he presented as part of the prosecution on Friday, he said: “I found it unbelievable that a private company commissioned by the NHS to care for its most vulnerable psychiatric patients in the greatest crisis of their lives could be so cruel and resort to such desperate tactics to hide the truth.”

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Source: The Guardian, 8 March 2024

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£35 million investment to boost maternity safety

Almost £35 million will be invested to improve maternity safety across England with the recruitment of additional midwives and the expansion of specialist training to thousands of extra healthcare workers.

The investment, which was announced as part of the Spring Budget 2024, will be provided over the next 3 years to ensure maternity services listen to and act on women’s experiences to improve care.  

The funding includes:

  • £9 million for the rollout of the reducing brain injury programme across maternity units in England, to provide healthcare workers with the tools and training to reduce avoidable brain injuries in childbirth
  • investment in training to ensure the NHS workforce has the skills needed to provide ever safer maternity care. An additional 6,000 clinical staff will be trained in neonatal resuscitation and we will almost double the number of clinical staff receiving specialist training in obstetric medicine in England
  • increasing the number of midwives by funding 160 new posts over 3 years to support the growth of the maternity and neonatal workforce 
  • funding to support the rollout of maternity and neonatal voice partnerships to improve how women’s experiences and views are listened to and acted on to improve care.

Health and Social Care Secretary Victoria Atkins said:

"I want every mother to feel safe when giving birth to their baby.

Improving maternity care is a key cornerstone of our Women’s Health Strategy and with this investment we are delivering on that priority - more midwives, specialist training in obstetric medicine and pushing to improve how women are listened to in our healthcare system.

£35 million is going directly to improving the safety and care in our maternity wards and will move us closer to our goal of making healthcare faster, simpler and fairer for all."

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Source: Gov.UK, 10 March 2024

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UK report reveals bias within medical tools and devices

Minority ethnic people, women and people from deprived communities are at risk of poorer healthcare because of biases within medical tools and devices, a report has revealed.

Among other findings, the Equity in Medical Devices: Independent Review has raised concerns over devices that use artificial intelligence (AI), as well as those that measure oxygen levels. The team behind the review said urgent action was needed.

Prof Frank Kee, the director of the centre for public health at Queen’s University Belfast and a co-author of the review, said: “We’d like an equity lens on the entire lifecycle of medical devices, from the initial testing, to recruitment of patients either in hospital or in the community, into the early phase studies and the implementation in the field after they are licensed,.”

The government-commissioned review was set up by Sajid Javid in 2022 when he was health secretary after concerns were raised over the accuracy of pulse oximeter readings in Black and minority ethnic people.

The widely used devices were thrown into the spotlight due to their importance in healthcare during the Covid pandemic, where low oxygen levels were an important sign of serious illness.

The report has confirmed concerns pulse oximeters overestimate the amount of oxygen in the blood of people with dark skin, noting that while there was no evidence of this affecting care in the NHS, harm has been found in the US with such biases leading to delayed diagnosis and treatment, as well as worse organ function and death, in Black patients.

The team members stress they are not calling for the devices to be avoided. Instead the review puts forward a number of measures to improve the use of pulse oximeters in people of different skin tones, including the need to look at changes in readings rather than single readings, while it also provides advice on how to develop and test new devices to ensure they work well for patients of all ethnicities.

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Source: The Guardian, 11 March 2024

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USA: Patient Safety Awareness Week

Patient Safety Awareness Week, an annual recognition event in the USA that occurs in March, is intended to encourage everyone to learn more about health care safety.

During this week, the Institute for Healthcare Improvement (IHI) seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce.

Patient Safety Awareness Week serves as a dedicated time and platform for growing awareness about patient safety and recognising the work already being done.

IHI works with partners around the world to improve the safety of health care for patients, caregivers, and the health care workforce.

Learn more about IHI's work to advance patient and workforce safety.

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Thousands of A&E patients wait longer than a day for treatment

More than 7,300 people waited longer than 24 hours for emergency treatment in Scottish hospitals last year, with the longest wait more than 122 hours.

Public Health Scotland statistics obtained by Scottish Labour through freedom of information (FoI) revealed that 7,367 patients were in an emergency department for more than 24 hours before being discharged, admitted or transferred in 2023.

The longest wait in A&E last year occurred at NHS Ayrshire and Arran’s University Hospital Crosshouse, where a patient waited more than 122 hours, or the equivalent of five days. Waits of more than 88 hours were recorded in NHS Borders, and 72 hours in NHS Lanarkshire.

Dame Jackie Baillie, Scottish Labour’s health spokeswoman, has demanded action from Neil Gray, the health secretary.

“Scotland’s A&E departments are in the grip of a deadly crisis, with lives being put on the line day in and day out,” she said. “That some people have waited days — even a working week — to be seen is dangerous and disgraceful.

“Hard-pressed A&E staff are working tirelessly to look after patients, but SNP mismanagement has created a perfect storm in our hospitals. Neil Gray has inherited an NHS in deadly disarray from his colleagues.

“It’s time for action to be taken now to bolster A&E departments by tackling delayed discharges and investing in primary care to avoid putting further pressure on hospital services.”

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Source: The Times, 11 March 2024

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NHS scandal exposed as elderly patients ‘treated like animals’ on overwhelmed hospital wards

Distressed elderly patients are being “treated like animals” and left begging for care as NHS staff struggle to cope with overwhelmed wards and an ever-increasing ageing population, an investigation by The Independent has revealed.

Scores of families have come forward to share harrowing allegations of neglect as one top doctor warns that elderly people are receiving care “well below the standards they should expect” – including long waits in waiting rooms and “degrading” corridor care.

In one shocking case, a 96-year-old patient admitted to the hospital with a urinary tract infection (UTI) was allegedly left semi-naked and delirious in his hospital bed – before choking on vomit after being sedated without his family’s permission, his daughter told The Independent. Another patient, 99, was traumatised after being left in a bed next to the body of a dead woman.

The investigation was sparked by the horrific story of 73 year old Martin Wild who was left so desperate for pain medication he was forced to call 999 from his hospital bed.

It comes as analysis by the Independent shows the government was warned three times last year by coroners over the increasing risk to elderly patients’ lives amid fears they are not being “effectively safeguarded”.

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Source: The Independent, 11 March 2024

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Ombudsman warns over-stretched doctors could put cancer patients at risk

England’s NHS Ombudsman has warned that cancer patients could be put at risk because of over-stretched and exhausted health staff working in a system at breaking point and delays in diagnosis and treatment.

The Parliamentary and Health Service Ombudsman (PHSO) revealed that between April 2020 and December 2023, his Office carried out 1,019 investigations related to cancer. Of those 185 were upheld or partly upheld.

Issues with diagnosis and treatment were the most common cancer-related issues investigated by PHSO. These issues included treatment delays, misdiagnosis, failure to identify cancer, the mismanagement of conditions, and pain management.

Complaints about cancer care also included concerns about poor communication, complaint handling, referrals, and end-of-life care.

Most investigations were about lung cancer, followed by breast cancer and colorectal cancer.

The Ombudsman recently closed an investigation around the death of Sandra Eastwood whose cancer was not diagnosed for almost a year after scans were not read correctly. The delay meant she missed out on the chance of treatment which has a 95% survival rate.

In 2021, PHSO published a report about recurrent failings in the way X-rays and scans are reported on and followed up across the NHS service.

Mr Behrens said, “What happened to Mrs Eastwood was unacceptable and her family’s grief will no doubt have been compounded by knowing that mistakes were made in her care.

“Her case also shows, in the most tragic of ways, that while some progress has been made on my recommendations to improve imaging services, it is not enough and more must be done.

“Government must act now to prioritise this issue and protect more patients from harm.”

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Source: Parliamentary Health and Health Service Ombudsman, 9 March 2024

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Blind people in England at risk from ‘shocking’ social care delays, finds report

The lives of thousands of blind and partially sighted people are being put at risk by delays in vital care that they have a legal right to after being assessed as visually impaired, according to a report.

More than a quarter of English councils are leaving people who have just been diagnosed as blind waiting more than a year for vision rehabilitation assessments and potentially life-saving support, the report by the RNIB revealed.

It cited the example of one person who died while waiting for council help. The Guardian can reveal that the case involved a woman from Church Stretton in Shropshire who had been waiting 18 months for an assessment when she tripped on a pothole and died later from head injuries. She had been trying to teach herself how to use a white cane, without any support or training, despite getting a certificate of visual impairment.

Councils are obliged to provide such help for those coping with a recent visual impairment under the 2014 Care Act. The support involves helping people cope practically and mentally with visual impairment at a critical time after a diagnosis.

The social care ombudsman recommends that councils should provide these services within 28 days of someone receiving a certificate of visual impairment.

But the RNIB report, which is based on freedom of information requests to councils in England, found that 86% were missing this 28-day deadline. The report, Out of sight – The hidden scandal of vision rehabilitation warned that the delays uncovered in the figures were dangerous.

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Source: The Guardian, 10 March 2024

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East London fertility clinic has licence suspended after losing embryos

A fertility clinic in London has had its licence to operate suspended because of “significant concerns” about the unit, the regulator has said.

The Homerton Fertility Centre has been ordered by the Human Fertilisation and Embryology Authority (HFEA) to halt any new procedures while investigations continue.

The clinic in east London said there had been three separate incidents highlighting errors in some freezing processes. This resulted in the “tragic loss of a small number of embryos” that either did not survive or became “undetectable”, which means an embryo stored in frozen liquid solution in a container cannot be found during subsequent thawing.

The clinic has informed the patients affected and apologised for any distress caused.

Homerton Healthcare NHS foundation trust said it began an investigation in late 2023 and immediately made regulators fully aware of it. The HFEA is now conducting its own investigation alongside the trust.

In a statement, the clinic said that while the investigators had not been able to find any direct cause of the errors, it had made changes in the unit to prevent the recurrence of such incidents.

All staff now work in pairs to ensure all clinical activities are checked by two healthcare professionals, competencies of staff within the unit have been rechecked, and security at the unit has been increased.

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Source: The Guardian, 8 March 2024

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Patients exposed to excess radiation by out-of-date radiology device

Patients are being exposed to radiation doses at the “upper limit of safe” because a hospital is relying on a radiology machine three years after its “end of life” with a substandard second-hand part.

The risk was revealed in board papers from Medway Foundation Trust, in Kent, among several other serious problems linked to outdated equipment.

Recent board papers said the machine was necessary for maintaining the trust’s interventional radiology service which includes being on-call 24/7.

It said: “Owing to the age of the machine we are experiencing a growing number of faults and breakdowns and due to its age no new parts are available.

“At present a second hand tube has been installed to replace the existing faulty equipment.”

But the papers went on to say the second-hand part has a defect “causing serious issues with the imaging [which] has the potential to increase imaging acquisitions required which will increase patient radiation dose and lengthen the procedure time”. 

A business case for a new machine described current radiation doses as “within the upper limit of safe”.

The trust indicated “mitigations” are in place, including additional reviews of patients who use it.

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Source: HSJ, 11 March 2024

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Patients facing uphill struggle to see GPs

Patients in parts of England are facing an uphill struggle to see a GP, experts say, after an analysis showed wide regional variation in doctor numbers.

The Nuffield Trust think tank found Kent and Medway had the fewest GPs per person, followed by Bedfordshire, Luton and Milton Keynes.

It comes as ministers have struggled to hit the pledge to boost the GP workforce by 6,000 this Parliament.

But the government said it had plans in place to tackle shortages.

However, Dr Billy Palmer, of the Nuffield Trust, said: "Solely boosting the number of staff nationally in the NHS is not enough alone - the next government should set a clear aim of reducing the uneven distribution of key staffing groups and shortfalls to tackle unfairness in access for patients."

The think-tank report found while the government had met its target to increase the number of nurses by 50,000 this Parliament, the rises had not been felt evenly, with some specialist nurse posts, such as health visitors and learning-disability nurses, seeing numbers shrink.

Dr Palmer said minimum numbers of GPs may have to be set for local areas - and better incentives to attract them to those with the fewest.

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Source: BBC News, 8 March 2024

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More than a quarter of ambulance staff ‘sexually harassed by public’

More than 58,000 NHS staff reported sexual assaults and harassment from patients, their relatives and other members of the public in 2023 in the health service’s annual survey.

For the first time ever, the NHS staff survey for England asked workers if they had been the target of unwanted sexual behaviour, which includes inappropriate or offensive sexualised comments, touching and assault.

Of the 675,140 NHS staff who responded, more than 84,000 reported sexual assaults and harassment by the public and other staff last year.

About 1 in 12 (58,534) said they had experienced at least one incident of unwanted sexual behaviour from patients, patients’ relatives and other members of the public in 2023.

Almost 26,000 staff (3.8%) also reported unwanted sexual behaviour from colleagues.

Rates were highest among ambulance workers, with more than 27% reporting sexual harassment from the public and just over 9% from colleagues.

The survey also found record numbers of health workers experienced discrimination, including racism, sexism, homophobia and ableism, from patients and colleagues last year.

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Source: The Guardian, 7 March 2024

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Coroners' death reports reveal rise in NHS warnings

Coroners in England and Wales sent 109 warnings to health bodies and the government in 2023 highlighting long NHS waits, staff shortages or a lack of NHS resources, the BBC has found.

The number of cases identified that were linked to NHS pressures was the highest in the past six years.

Prevention of future death reports (PFDs) are sent when a coroner thinks action is needed to protect lives.

About 35,000 inquests take place in England and Wales each year. In a fraction of those - about 450 - the coroner writes a PFD, or Regulation 28, report.

The BBC analysed 2,600 PFDs - and supporting documentation - sent between 2018 and 2023.

The proportion of the total number of PFD reports that referenced an NHS resource issue rose to one in five in 2023, from one in nine in the two years before Covid.

Of the 540 reports written last year, 109 were found that highlighted a long wait for NHS treatment, a shortage of medical staff or a lack of NHS resources such as beds or scanners.

Of these, 26 involved mental illness or suicide, and 31 involved ambulances and emergency services.

The government says it "responds to, and learns from, every report".

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Source: BBC News, 8 March 2024

 

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‘First of its kind’ guidance sees BMA set out PA ‘scope of practice’

Physician associates should never see ‘undifferentiated’ patients in a GP setting, the BMA has declared in new ‘first of its kind’ guidance.

Today, the union has published a national scope of practice laying out how physician associates (PAs) and anaesthesia associates (AA) should work safely in GP practices and secondary care. 

According to the BMA, the guidance is different from what it describes as the current ‘piecemeal or fragmented approach’ whereby individual organisations set their own guidelines for how PAs should be supervised.

In general practice, the guidance said a GP ‘should first triage’ all patients and ‘decide which ones a PA can see’, suggesting annual health checks as an appropriate contact. 

The union is also clear that PAs ‘must not make independent management decisions for patients’ and must be clear in all their communications that ‘they are not doctors’. 

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Source: Pulse, 7 March 2024

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Researchers study brain activity of surgeons for signs of cognitive overload

It is a high-stakes scenario for any surgeon: a 65-year-old male patient with a high BMI and a heart condition is undergoing emergency surgery for a perforated appendix.

An internal bleed has been detected, an anaesthetics monitor is malfunctioning and various bleepers are sounding – before an urgent call comes in about an ectopic pregnancy on another ward.

This kind of drama routinely plays out in operating theatres, but in this case trainee surgeon Mary Goble is being put through her paces by a team of researchers at Imperial College London who are studying what goes on inside the brains of surgeons as they perform life-or-death procedures.

Goble looks cool and collected as she laparoscopically excises the silicon appendix, while fending off a barrage of distractions. But her brain activity, monitored through a cap covered in optical probes, may tell a different story.

The researchers, led by Daniel Leff, a senior researcher and consultant breast surgeon at Imperial College healthcare NHS Trust, are working to detect telltale signs of cognitive overload based on brain activity. In future, they say, this could help flag warning signs during surgery.

“The operating theatre can be a very chaotic environment and, as a surgeon, you have to keep your head and stay calm when everyone is losing theirs,” said Leff. “As the cognitive load increases, it has major implications for patient safety. There’s no tool we can use to know that surgeon is coping with the cognitive demands of that environment. What happens when the surgeon is maxed out?”

In the future, Leff envisages a system that could read out brain activity in real-time in the operating theatre and trigger an intervention if a surgeon is at risk of overload.

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Source: 2 March 2024

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USA: My emergency patients wait hours — or days — for a hospital bed


It has been well-documented that Covid-19 took a devastating toll on emergency departments nationwide, revealing and exploiting the fragility of our acute-care system. Less has been written, however, about the side effects of hospitals’ attempts to recover from that era — one of the most serious of which is the proliferation of boarding.

As hospitals scramble to regain their footing (and their profit margins), the financial incentive structure that undergirds US medicine has gone into overdrive. Inpatient beds that might previously have been reserved for patients who require essential care but generate very little money for the hospital, are increasingly allocated for patients undergoing more lucrative procedures.

The consequences of this systemic failure cannot be overstated. Four hours is supposed to be the maximum time spent boarding in an emergency department, but recent data shows that hospitals in the US are failing to meet that goal when occupancy is high (which it routinely is).

"On any given shift, hallways in the emergency department are lined with patients on stretchers. Boarding leads to a cascade of harms — including ambulances diverted to hospitals far from patients’ homes, patients charged for beds they haven’t yet occupied and overwhelmed emergency medicine personnel leaving the field because of burnout," says Hashem Zikry, an emergency medicine physician and a scholar in the National Clinician Scholars Program at UCLA.

Many narratives around boarding focus on the patients themselves, shaming some for inappropriately using the emergency department. Proposed solutions include pushing patients to urgent-care centers or modifying “patient flow.” But the issues with boarding cannot be addressed with such minor tweaks.

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Source: The Washington Post, 28 February 2024

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Health services for eating disorders overrun

Health services for Londoners with eating disorders are struggling to cope with demand, a new report warns.

Data from London's mental health trusts shows adult referrals have increased by 56% - from 3,000 to nearly 8,000 - in the last six years

Child and adolescent referrals increased by 158%, from 1,400 to 4,000, in the same time period.

The report has been compiled by the London Assembly's health committee.

It has made 12 recommendations to London Mayor Sadiq Khan and City Hall officers, which include assessing other physical and mental health indicators as well as just patients' bodyweight as per their BMI.

One consultant clinical psychologist told the committee that "almost all of the eating disorder services in London do not have the staffing levels available to safely provide the care required".

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Source: BBC News, 7 March 2024

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NHS England leaders welcome £6bn budget boost but say much more is needed

NHS leaders have welcomed the £6bn budget boost Jeremy Hunt handed the beleaguered service to help it meet rising demand, tackle the care backlog and overhaul its antiquated IT system.

The chancellor gave the NHS in England an extra £2.5bn to cover its day-to-day running costs in 2024/25, after the Institute for Fiscal Studies had warned that it was set to receive less funding next year than this.

Julian Hartley, the chief executive of hospital body NHS Providers, said the money would offer “much needed – but temporary – respite” and “some breathing space” from the service’s acute financial difficulties, which have been exacerbated by inflation and the costs incurred by long-running strikes by NHS staff.

However, there was little to stabilise England’s creaking adult social care system, and Hunt’s budget delivered an ongoing squeeze on resources, said the Association of Directors of Adult Social Services (ADASS).

“Millions of adults and carers will be disappointed,” said Anna Hemmings, joint chief executive of ADASS. “Directors can’t invest enough in early support for people close to home, which prevents them needing hospital or residential care at a greater cost.”

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Source: The Guardian, 6 March 2024

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