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Almost half of doctors sexually harassed by patients, research finds

Almost half of doctors internationally have been sexually harassed by patients, new research has found, prompting calls for medics to be given panic alarms to help repel such behaviour.

Globally, 45% of doctors have suffered sexual harassment of different sorts from patients, according to a review covering seven countries published in the Internal Medicine Journal.

More than half (52.2%) of female doctors have experienced sexual harassment, which means they are much more likely to be affected than their male counterparts (34.4%), the academics found.

Doctors are subjected to many types of sexual harassment, including unwanted sexual attention and patients telling jokes of a sexual nature, asking them out on dates, touching them inappropriately and sending them romantic messages or letters.

Dr Kamau-Mitchell, one of the authors of the paper, said the high prevalence of sexual harassment by patients should impel hospitals, clinics and other healthcare providers to take firm action to safeguard doctors.

“I recommend that hospitals and clinics take these findings seriously, giving doctors who work in isolated wards, on night shifts or alone protection such as CCTV and panic alarms,” she said.

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Source: The Guardian, 9 September 2024

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Provider investigating ‘racism and bullying’ complaints

A community services provider has launched an investigation into its staff culture, following concerns including racism and bullying.

Sirona Care and Health, a major provider of NHS and council-funded community services in the south west, told HSJ: ”Our staff have stepped forward to tell our leadership about unacceptable behaviours – both experienced within Sirona’s staffing body and towards our colleagues from patients/service users.

“It is incumbent on all of us, led by our board and senior leadership, to listen and take decisive action towards the culture we want to build.”

Sirona is the main provider of community health services in Bristol, North Somerset, and South Gloucestershire, and one of the largest healthcare social enterprises.

Speaking at a recent staff question and answer session, interim chief executive Julie Sharma said the former chief executive and chair stepped away from their duties in May “to allow the organisation to carry out an investigation into a whole host of things”.

She said it would cover allegations of racism and bullying in the organisation, but that these allegations “are not directly related” to the former chief CEO or chair.

During the question and answer session, Ms Sharma said the organisation was committed to sharing a “lessons learned” review with staff once the investigation had concluded.

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Source: HSJ, 9 September 2024

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Man asks for anaesthetic review after wife's death

The family of a doctor who died after she was given too much anaesthetic during an operation want an urgent national review of how the drug is given to patients.

Rachel Gibson, 47, went into cardiac arrest following a hip replacement surgery at Spire Lea Hospital in Cambridge on 12 April 2022. She sustained irreversible brain damage and died at Addenbrooke’s Hospital three months later.

In a prevention of future deaths report to the Royal College of Anaesthetists (RCOA), Cambridgeshire coroner Philip Barlow said there was "inconsistency" with the way local anaesthetic was measured, increasing the risk of mistakes.

Dr Gibson's husband, Cliff, 49, said it was a "national problem" and "we need to put pressure on the college to make changes".

He previously worked in the pharmaceutical industry on a project on drug safety and medical labelling and said he knew "how strict they are with everything".

"So to see how little or no documentation is needed with the administration of a local anaesthetic in surgery with a drug known to be toxic and to cause cardiac arrest - I find the whole thing baffling," he said.

"We now know that there are major problems with basic record keeping, training, handover notes and communication."

Mr Barlow asked the RCOA to examine existing practices and see if improvements could be made, after it was revealed similar practices to those which occurred in Dr Gibson's operation were used nationally.

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Source: BBC News, 6 September 2024

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Australia: Fatal medication mistakes and surgery mix-ups among record number of ‘harm events’ in Victorian hospitals

Fatal medication errors killed 18 patients and four died or were seriously harmed after objects were left inside their bodies after surgery, a review into harmful events at Victorian hospitals in Australia has revealed.

The deaths are among 245 sentinel or “harm events” uncovered in the 12 months to the end of June 2023, according to a Safer Care Victoria report, up 2% on the previous year.

Four people died or were seriously harmed due to a foreign object staying in their body after surgery, including surgical sponges or dressings which can lead to infections.

Swabs are counted during procedures and the report said most errors were due to staff changing over during surgery, when a procedure involved two stages or when a dressing was modified.

Surgery or invasive procedures were performed on the wrong side of a patient’s body three times while one person underwent the wrong procedure.

Eighteen patients died due to a medication error and eight needed life-saving intervention, with prescribing issues and wrong dosages most commonly to blame.

The total number of harmful events in the year to 2023 was the highest on record since Safer Care Victoria was established in 2017.

Its chief executive, Louise McKinlay, said it was important to learn from every single event so it was not repeated.

“We’re seeing a stabilisation in the number of sentinel events being reported to us – this demonstrates an improving culture of transparency on safety risk issues and a willingness to learn from patient harm,” she said.

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Source: The Guardian, 6 September 2024

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Darzi will highlight underinvestment in NHS managers

The imminent review of NHS performance by Lord Ara Darzi will highlight the need to invest more in NHS management and leadership, HSJ understands.

The former minister, eminent surgeon, and academic, was commissioned by the new government to carry out an independent review of NHS performance.

His report is due in the next fortnight and will seek to paint a hard-hitting picture of the severity and breadth of the service’s problems.

One trust CEO who had been briefed by the review team said it would “highlight low manager and leader numbers compared to other health services” – a message, they predicted, that the government “won’t want to hear”.

Another well-placed source said the review was likely to make clear that the NHS needed to invest more in good management, particularly in managers with the right skills and capabilities, and that it should not use reduced management costs as a barometer for success.

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Source: HSJ, 6 September 2024

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Target for cutting premature birthrate in England will not be met, minister says

The women’s health minister has admitted there is no chance the government will meet its target of reducing the premature birthrate to 6% in England by 2025.

Preterm birth, when a baby is born before 37 weeks of pregnancy, is the biggest cause of death among children under five in the UK. The previous government set a target in 2019 to reduce the preterm birthrate to 6% by 2025.

But giving evidence to parliament, Gillian Merron, the parliamentary under secretary of state for patient safety, women’s health and mental health, said “this ambition is not going to be met”. In 2022, 7.9% of babies born in England were premature and an estimated 53,000 babies are born prematurely every year in the UK.

In fact, officials told the Lords’ preterm birth inquiry that the rate of premature deliveries was increasing. Prof Donald Peebles, NHS England’s national clinical director for maternity, said the preterm birthrate for all gestations was going down, “not as fast as we would have wanted, but going down until about 2020”, but that since then had “clearly gone up”.

The NHS is likely to change the preterm birth target, it was also revealed. Lady Merron told the Lords that she wanted to look at whether the goals needed amending. “I understand that [the 6% target] has provided a focus, but a focus isn’t what we need, we need to actually achieve,” she said.

“There are, of course, circumstances in which preterm birth is the right thing to do, and it feels a bit of a blunt instrument for measurement,” she added. “So when we look at what our next ambition is, I will be very keen to make sure it’s a more sensitive ambition to reality.”

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Source: Guardian, 5 September 2024

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Doctor to take the stand at Covid-19 Inquiry to expose UK officials

Next week public hearings commence for Module 3 of the Covid-19 Inquiry, with a focus on the experience of healthcare during the pandemic. An eminent medic will take the stand on 12 September at the Covid-19 Inquiry to give testimony of how UK healthcare officials have systematically denied overwhelming scientific evidence that Covid-19 is airborne.

Dr Barry Jones chairs the COVID-19 Airborne Transmission Alliance (CATA) which is a Core Participant in the UK Covid-19 Inquiry. The Alliance includes professional associations representing 65,000 healthcare workers as well as individual experts. Since 2020, CATA’s membership have been seeking to persuade UK Health Officials to align national guidance to the scientific facts about how the disease is transmitted and how healthcare workers need to be protected from infection.

He will also challenge official assertions that healthcare workers did not need respiratory protective equipment when working close to infected patients or in poorly ventilated areas, except in an arbitrary set of situations. This position reveals the startling fact that since the outset of the pandemic, and despite all the evidence, health officials in the UK stubbornly continue to deny airborne transmission of the disease.

Proportionately, the UK reported a higher death rate of healthcare workers in the initial phase of the pandemic than almost anywhere in the world. In line with CATA’s evidence for Module 1, the Covid-19 Inquiry has already determined that the UK “prepared for the wrong pandemic” – one that is largely transmitted by droplets and touch.

As a result billions of pounds were wasted on inappropriate PPE. This ineffective PPE resulted in thousands of healthcare workers becoming infected in the workplace and transmitting Covid-19 to patients and co-workers. Not only were healthcare workers refused access to Respiratory Protective Equipment (RPE), but many were instructed to remove their own RPE, including those working in close quarters with infected patients and some staff were disciplined for asking for suitable RPE.

“The way in which healthcare workers were abandoned to their fates and their professional knowledge was disregarded has left a scar on the UK’s healthcare system,” says Kamini Gadhok, former CEO of the Royal College of Speech and Language Therapists and Vice Chair of CATA. “The mental health crisis in the NHS and staff shortages all have their roots in the disregard for life and expertise that professionals experienced through the pandemic.”

CATA’s ongoing concern has been that Health and Safety regulations and scientific principles were set aside through the pandemic in favour of Infection Protection and Control (IPC) guidance which did not even take account of advice from the Government’s own scientific experts.

Dr Barry Jones, Chair of CATA, is clear that “those responsible for the IPC guidance failed our healthcare workers, failed our patients and failed our communities.”

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Source: British Occupational Hygiene Society, 5 September 2024

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Doctor reveals ‘grim’ realities on NHS wards with staff giving ‘end-of-life’ care to patients on trollies

A doctor has described the harrowing reality of Britain’s A&E wards as she revealed staff were sometimes forced to give end-of-life care to patients in corridors on trollies.

Dr Rachel Clarke, a top palliative care doctor, shared the “grim” conditions found in NHS hospitals as she claimed “Dickensian” conditions are now the norm.

The former journalist who later retrained as a doctor recalled how she turned up for a morning shift to see a “broken” team and ten ambulances queuing outside the hospital with patients.

“You can’t really exaggerate how grim and crisis laden conditions are,” she told the former Downing Street director of communications Andy Coulson on his Crisis What Crisis? podcast.

“You know, we all see the news headlines. I walk into the A&E handover in the morning and I see a team who look absolutely broken from the night shift,

“There are ten ambulances queueing outside each with a patient, some of those patients are dying, they literally can’t even get into the hospital. There are patients in corridors on trollies.

“I might have to have an end of life conversation with a patient on a trolley in a corridor who doesn’t even have a curtain around them. It’s horrific, it’s sort of Dickensian. This is how broken the NHS is at the moment.”

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Source: The Independent, 5 September 2024

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Nearly one in three temporary Black and ethnic NHS workers suffer physical violence, internal report reveals

Almost one in three temporary Black and minority ethnic staff have suffered physical violence, according to a leaked NHS review revealing “shocking” levels of racism in the health service.

Tens of thousands of NHS workers on zero hour contracts, also called bank staff, have faced “unacceptable” levels of racism, the report found.

According to a survey of workers by NHS England, 28% of temporary Black and minority ethnic staff temporary experienced physical violence from patients, their relatives or the public. Compared to 23% of white temporary workers.

The report, seen by The Independent, also revealed Black temporary staff are almost six times more likely to be disciplined by NHS employers compared to their white counterparts.

Experts have called on NHS employers to act on the “shocking” findings and protect temporary workers, who are currently treated as “second class” employees.

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Source: The Independent, 6 September 2024

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Pupils 'set up to fail' by ADHD medication shortage

Some students starting new schools and colleges are being “set up to fail” due to an ongoing shortage of medication for ADHD, according to a charity chief.

There have been problems with the supply of proper medication because of manufacturing issues and an increase in demand, although the Department of Health and Social Care (DHSC) says recent supply issues with most ADHD medicines are resolved.

The shortage caused panic among a number of students who were forced to ration their tablets in the run up to this year’s exam season.

Henry Shelford, chief executive of ADHD UK, said: “It’s been an unmitigated disaster. And now there’s been a new alert issued about shortages of medication. These kids are being set up to fail."

Alice, 16, from Surrey, previously said she was "terrified" of running out of medication during her exams as it would have left her unable to study.

Now, she is focusing on her first days at college, but does not want to be starting on new medication from a pharmacy.

"I could be getting a headache as a side effect, I could be feeling sick, I could be getting sleeplessness, or I could be really tired one day and that's all because I'm changing medication, which you're just not meant to do.

"But I have to do it to kind of keep up with the demand of my life, but also be able to sort out and prepare for sixth form."

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Source: BBC News, 5 September 2024

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

  • Was there an impact on your health (physical and mental)? 
  • Were you told the reason for it not being available? 
  • Was the issue resolved? If so, how long did it take?
  • If you are still impacted by medication supply issues, have you been told when you will be able to access them again?

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

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Men on sodium valproate told to use contraception

Men taking sodium valproate are being warned to use contraception while on the medicine, because of a "potential small increased risk" of autism and other neurodevelopmental problems for any children conceived.

They should continue to do so - and cannot donate sperm - until three months after they have stopped taking the drug.

Sodium valproate, prescribed under brand names including Epilim, Belvo, Convulex and Depakote, is an effective treatment for epilepsy and bipolar disorder.

The Medicines and Healthcare products Regulatory Agency (MHRA), which issued the warning, stressed patients must speak to their doctors before making any changes to their medicines.

The guidance follows a similar warning from the European Medicines Agency, after data from national registries in Norway, Denmark and Sweden suggested 5% of children born to men taking the drug were harmed.

That study did not prove sodium valproate was the cause, the MHRA said, or compare risks for children whose fathers were not on medication.

But it raised an "important safety issue that warrants action on a precautionary basis".

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Source: BBC News, 5 September 2024

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USA: New ‘structural’ patient safety measure for hospitals

Most US hospitals will soon be required to report whether they follow 25 best practices to ensure patient safety, to deflate preventable harms that swelled during the pandemic.

Unlike outcomes metrics like infections or falls, CMS’s new Patient Safety Structural Measure, which takes effect 1 October, assesses whether hospitals take a range of steps such as:

  • Addressing safety topics at governing board meetings.
  • Tracking safety disparities.
  • Maintaining a communication and resolution programme.

That holistic approach marks “a shift to leading indicators from lagging indicators,” Tejal Gandhi, M.D., M.P.H., chief safety and transformation officer for Press Ganey Associates, a consulting firm that works on patient safety and satisfaction issues, said via email. She added: “This is pushing organizations to have the foundational structures and processes in place that will drive the outcomes.”

For journalists and other members of the public, the measure promises to shed some light on hospital operations. The first scores will be reported in the fall of 2026.

“These best practices aren’t new, but patients don’t know which ones are and which ones are not in place in the hospitals we use,” Beth Daley Ullem, co-founder of the advocacy group Patients for Patient Safety US (PFPS US), said in a news release. She added that at this point, “CMS, the Joint Commission, and state licensing bodies do not know either.” 

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Source: Association of Health Care Journalists

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At 16 she was diagnosed with cancer, at 18 she died because the treatment she needed was too far away

It was Christmas jumper day at school, and then 16-year-old Emily Clark walked down the stairs to ask her mum Donna Dunn if she had shrunk her jeans. Emily complained they were tight.

Little did the family know it at the time, but it was the start of two years of heartbreak that would expose them to a great weakness in the Welsh healthcare system and would end with Emily's death at just 18 years old.

Emily had a type of blood cancer that most patients survive yet she did not as she became too ill to travel to England for the treatment she needed. Consultant haematologist Dr Ceri Bygrave said that care for patients like her was compromised on a daily basis because of "the crumbling NHS infrastructure that exists in Wales that lags a long way behind other centres in England."

Emily did have treatment in Cardiff but more specialist treatment was needed. This was only available in Bristol but as a result of the complications she became too unwell to travel, yet remained well enough for the treatment.

Emily sadly died at the age of 18 in March 2016. Following her death, Donna and the rest of Emily's family have been so passionate about raising awareness of the symptoms of blood cancer, and also highlighting the need for improvement in treatments.

Blood Cancer UK has launched an action plan which recommends improvements inthe workforce, early diagnosis initiatives, reducing barriers to accessing care and increasing access to treatments.

Speaking specifically on the challenges faced in Wales, Dr Ceri Bygrave, who sat on the Blood Cancer UK Taskforce, said: “The haematology workforce are overstretched and understaffed, with critical staff shortages and increasingly complex treatments leaving people delivering NHS blood cancer care under major pressure. This is a particular challenge in Wales where by 2032, 74% of permanent haematology consultants will reach the age of 60 with a shortfall in trainees to replace them.

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Source: Wales Online, 5 September 2024

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Long delays in NHS care causing serious damage to children’s health across UK

Children across the UK are suffering serious damage to their health – including chronic pain, asthma flare-ups, weight loss and developmental problems – because of long delays for NHS care.

Some under-18s are finding it so hard to obtain prompt treatment for their diabetes or epilepsy that they are forced to turn to A&E for care because their health has deteriorated so badly.

Children’s doctors said the findings were “shocking” and warned that some children would endure “lifelong consequences” as a result of delays that could sometimes last several years.

The details have emerged in a dossier of evidence the Royal College of Paediatrics and Child Health (RCPCH) has collated illustrating the harm that treatment unavailability causes.

One paediatrician specialising in neurodevelopmental problems said children who joined the list had to wait six years for their first appointment because the service was unable to meet demand. Another said the average waiting time for an initial consultation was three years and five months.

The anxiety and challenges caused by the delays can be so difficult for children and families to deal with that some parents have even split up as a result of that pressure, because they have reached “breaking point”, the college said. In addition, some families are being forced to pay for private care, in order to circumvent NHS waiting lists.

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Source: The Guardian, 5 August 2024

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Hospital Inquiry hears health boss tried to stop whistleblower

The boss of Scotland's biggest health board tried to persuade a top doctor not to blow the whistle about patient safety concerns, a public inquiry has heard.

Dr Penelope Redding, a former clinical director at NHS Greater Glasgow and Clyde (GGC), claimed the board's chief executive Jane Grant "urged me not to do it".

Dr Redding was one of a number senior doctors who raised infection control concerns at the Queen Elizabeth University Hospital (QEUH) in Glasgow.

In a submission to the Scottish Hospitals Inquiry, Dr Redding claimed there was a "profound culture of fear and bullying" at the board which put more people off speaking out.

The inquiry is investigating the construction of the £870m QEUH campus in Glasgow, which includes the Royal Hospital for Children.

It was set up after a number of patient deaths including that of 10-year-old cancer patient Milly Main.

Dr Redding worked as an infection control doctor until 2008. She was involved in the preliminary planning for the QEUH, which opened in 2015, and was a whistleblower before she stepped down as a consultant microbiologist in 2018.

In evidence to the hearing, the retired doctor criticised "a culture of not putting things in writing, in emails, not putting things in minutes, an atmosphere of intimidation and bullying" within the NHS. She said she only felt comfortable speaking out as she was approaching retirement.

A spokesperson for NHS GGC said: "The current Scottish Hospitals Inquiry hearings have yet to hear from various key staff. A number of staff being mentioned during these hearings will also provide evidence and will endeavour to support the Inquiry to fully establish the facts."

Read more about the Scottish Hospitals Inquiry on the hub.

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Source: BBC News, 4 September 2024

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Women in the north die two years sooner than those in the south

Women from northern England die two years younger on average than those in the south, a new report has revealed.

Analysis of life expectancy data shows that a baby girl in the North East statistical region can expect to live until she is 81.2 years old, and in the North West the figure is 81.3, according to the report by Health Equity North.

The South West has the highest female life expectancy, 83.9 years, closely followed by the South East at 83.8, and London at 83.6.

The findings show women in the north also have higher rates of chronic and long-term illnesses.

Hannah Davies, executive director at Health Equity North, said: “Our report provides damning evidence of how women in the north are being failed across the whole span of their lives.

“Over the last ten years, women in the north have been falling behind their counterparts in the rest of the country, both in terms of the wider determinants of health and, consequently, inequalities in their health. There is a lot of work that needs to be done to turn the tide on the years of damage detailed in this report.

“But the situation for women’s health in the north can be changed for the better through evidence-based policy interventions.”

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Source: The Times, 3 September 2024

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‘I’m an NHS whistleblower. Patients are dying needlessly’

The number of deaths and patients seriously harmed due to alleged clinical negligence at a scandal-hit trust is “just the tip of the iceberg”, an NHS whistleblower has claimed.

Several hundred more cases are likely to come under Operation Bamber, a formal investigation into multiple deaths and injuries at the Royal Sussex County Hospital between 2015 and 2021, according to sources close to the inquiry.

The operation was initially launched in June 2023 after two consultant surgeons who reported concerns over surgical standards were dismissed by the University Hospital Sussex NHS trust (UHS), which runs the hospital. Police then expanded the operation to investigate 105 cases of alleged medical negligence but, insiders have said they expect that number to reach “many hundreds” the longer the inquiry goes on.

Michael Swinn, a Surrey-based consultant urological surgeon who blew the whistle on bad practice at his own trust, said he has been approached by senior clinical staff across the country, including Brighton, since publishing a book about his own experience. Some have blown the whistle on poor practice already, others are considering it and seeking advice.

Mr Swinn, 58, told inews: “The reports about Brighton say the police are looking at around 100 cases. I’m told it is many, many more. Potentially several hundred."

Sussex Police said it is continuing to investigate allegations of medical negligence relating to neurosurgery and general surgery at the Royal Sussex.

A spokesperson for the force said: “A number of cases from within the specified NHS departments and during the specified time period have been assessed and are forming part of the ongoing investigation… Sussex Police is committed to conducting a thorough and transparent investigation. Due to the complex nature of the enquiries, this is likely to take some time to complete.”

Among the cases forming part of the investigation is the death of Lewis Chilcott, 23, who suffered a fatal arterial haemorrhage after an alleged error in his tracheostomy led to infection. A review by the Royal College of Surgeons found that it was likely that the low position of the inserted tube caused the fatal damage.

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Source: inews, 2 September 2024

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Woman with cancer warns of rare breast implant risk

A woman who developed a rare type of cancer linked to her breast implants has warned that others with similar implants could be "walking around like timebombs".

Susan Axelby, 68, was recently paid £57,000 by Allergan Limited after she fell ill with breast-implant associated anaplastic large-cell lymphoma (BIA-ALCL).

It is thought to be one of the first payouts of this kind linked to Allergan breast implants in the UK.

She had her breasts removed to avoid the risk of inherited breast cancer - but went on to develop cancer after the implants.

Regulators have received at least 106 reports of BIA-ALCL relating to surgery in the UK, involving six manufacturers.

The Medicines and Healthcare products Regulatory Agency (MHRA) is currently collecting data on women who are affected.

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Source: BBC News, 4 September 2024

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Hospital reconfigurations ‘negatively impacting’ patients, warn government advisers

Clinical service reconfigurations are mostly driven by the “poor condition of [the] NHS estate” and a lack of staff rather than a desire to “improve clinical outcomes”, advisers to the Department of Health and Social Care have said.

The Independent Reconfiguration Panel, which advises ministers on large-scale changes to clinical services, today published its evidence to the Darzi review of NHS performance.

IRP chair Sir Norman Williams said the panel had “seen a shift to centralisation within the NHS justified as a clinical necessity and a means of resolving staffing issues, even when it presents a risk to access for patients and may negatively impact the patient experience, often with regards to travel, transport, and ambulance conveyance times.”

The former Royal College of Surgeons president said the NHS had got better at involving patients and use “clinical senates”, but warned: “In recent times, the IRP has observed that rather than service change being driven by an ambition to improve clinical outcomes, the trend has often been for reconfigurations to emerge from operational necessity such as a lack of NHS staffing to sustain services, as well as the poor condition of NHS estates, an issue particularly seen with community hospitals.”

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Source: HSJ, 3 September 2024

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NHS faces ‘tipping point’ in England where most appointments will not be with GPs

The NHS in England is heading towards a “tipping point” after which GPs will no longer provide the majority of appointments because their numbers are falling so fast.

That is the conclusion of an extensive piece of new research that also shows one in five surgeries has shut and the number of patients each family doctor looks after has soared over the last decade.

It is unrealistic to expect the diminishing number of GPs working full-time to continue providing about half of all consultations, as they do now, according to the study, which has been published in the journal BMJ Open.

“Falling GP numbers delivering the same number of appointments per 1,000 patients seems unsustainable,” warn the researchers from University College London and the London School of Hygiene & Tropical Medicine (LSHTM). “Therefore there is likely to be a tipping point in the near future where the majority of appointments in English general practice are no longer delivered by GPs.”

Patients seeing a GP less often would damage the quality and continuity – defined as regular contact with the same doctor – of the care they receive, they added.

“Maintaining relational continuity of care will be harder to achieve if there is a shortage of GP appointments, and if patients need to see different clinicians for different problems this will likely have implications for quality of care,” say the team, led by Dr Luisa Pettigrew, a GP and research fellow at LSHTM.

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Source: The Guardian, 4 September 2024

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Trust hired ‘untrained strike-breakers who put patients at risk’, union claims

A trust has been accused of putting patients at risk by bringing in “untrained strike-breakers” from hundreds of miles away and paying for their hotel accommodation to ‘disrupt’ a week-long walkout by facilities management staff.

East Suffolk and North Essex Foundation Trust brought in staff last week from as far away as Manchester, Newcastle and Hull on night shift rates of up to £27 an hour during industrial action by soft facilities management staff, Unison alleged.

The trust acknowledged workers from “external partner organisations” were brought in, but it said the staff were either already trained or had “undergone training to make sure [they] were able to provide essential cover for patients”.

The union cited alleged examples of what it claimed was the trust’s “cavalier attitude” to patient safety in a media statement. They included:

  • External staff used to cover portering roles were “given just a two-hour induction for blood and oxygen monitoring duties. Regular training usually takes weeks”;
  • Staff said “they saw serious breaches of infection control procedures, including mixing clinical waste with regular rubbish and leaving it piled up in corridors”; and
  • Strikers finding milk and food left out past its use-by date rather than properly disposed of, which “poses a risk to patient safety” when they returned to work.

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Source: HSJ, 3 September 2024

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Coroner issues anaesthetic warning after death

A coroner has raised concerns about how local anaesthetic is administered after a woman was given too much during an operation and later died.

Rachel Gibson, 47, went into cardiac arrest following hip replacement surgery at Spire Lea Hospital in Cambridge on 12 April 2022.

She sustained irreversible brain damage and died at Addenbrooke’s Hospital three months later.

In a prevention of future deaths report to the Royal College of Anaesthetists (RCOA), coroner Philip Barlow said there was "inconsistency" with the way local anaesthetic was measured, increasing the risk of mistakes.

He said: "The evidence was that the drug was sometimes specified in millilitres and sometimes in milligrams.

"This is of particular concern when the intention is for the drug to be diluted."

In the case of Dr Gibson, an inquest found the intention was for a 2% solution of Ropivacaine to be diluted with normal saline before it was infiltrated.

Evidence suggested it was not done and an excessive amount of the drug was administered by mistake.

Mr Barlow said evidence suggested this type of practice was common nationally.

He added: "The hospital [Spire] has now introduced a system for labelling and countersigning the drug that was given during the operation.

"However, the evidence at the inquest was that, on a national basis, there is wide variation in the way local anaesthetic is prescribed, checked and administered in this type of procedure; and that it is common to use similar practice to that which occurred during this operation".

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Source: BBC News, 3 September 2024

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NHS trust apology after baby given wrong breast milk

A hospital trust has apologised to the parents of a baby who was given another mother's breast milk after being born prematurely.

Melissa and Callum say they were "let down repeatedly" during their son Milo's treatment at Leicester Royal Infirmary (LRI) and Leicester General Hospital (LGH).

Milo, who was born at 26 weeks in March, was fed stored breast milk from a woman who was not his mother on three occasions.

University Hospitals of Leicester NHS Trust (UHL), which runs the hospitals where Milo was treated, apologised to his parents and said changes had been made to its processes.

Melissa said: "I thought, what if he's got an infection from it? Because there's so many unknowns with other people's bodily fluids." 

The milk was fed to Milo through a syringe, from a bottle which had two labels on it - one for Melissa, and one identifying it as the milk of another mother on the ward. The hospital later found that the milk was not Melissa's.

Melissa said that she faced strange answers to questions she asked during ward rounds about Milo's future treatment.

She said: "I was told by a consultant that we were going to be moved to LGH because 'the junior members of her team were afraid to approach me because I ask too many questions'.

"This wasn't the first time in our weeks there I was called angry, unapproachable and scary."

UHL later told Melissa it was sorry its staff "did not have the skills" to support her fully.

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Source: BBC News, 2 September 2024

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NHSE and ICBs to highlight ‘resource gaps’ in wake of stabbings

NHS England is asking systems to highlight “gaps” in resources for intensive community mental healthcare in public in the wake of the Valdo Calocane stabbings.

In a letter last week, NHSE’s mental health directors said integrated care boards must ask provider trusts for evidence to include in new reviews of their assertive and intensive community services. It said the findings and “action plans” must be presented and discussed publicly at ICB board meetings “to support transparency”. 

The letter from national director Claire Murdoch and clinical director Adrian James said the reviews must “set out potential longer-term actions, which may have resource implications”, and should “include these potential resource gaps in your review”.

It goes on: “NHS England will collate national trends and use it to inform future policy and understanding of resource requirements in this area, as well as communicate the outcomes to the Care Quality Commission and Department of Health and Social Care.”

The letter – following on from NHSE’s initial request in July – focuses on “intensive and assertive community treatment for people with severe mental health problems”, in the wake of Mr Calocane’s three killings in Nottingham last June, which have led to several local and national reviews.

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Source: HSJ, 3 September 2024

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NHS doctors face bullying and reprisal for speaking out

Fewer than a fifth of doctors are satisfied with their organisation’s response to whistleblowing, a survey by BMA Scotland suggests.

The poll found some doctors fear being bullied by managers as well as being blacklisted or marginalised if they speak out.

BMA Scotland carried out an online survey with 436 responses.

Just over half (51%) of doctors surveyed had experience of whistleblowing, with patient safety the most common reason for doing so.

Only 17% said they were satisfied with their organisation’s response to whistleblowing.

Some said they were aware of repercussions from whistleblowing – with 56% saying this took the form of bullying and 39% saying doctors’ mental states were questioned.

One doctor responded to the survey saying their health board had made up false complaints, referred them to the medical regulator and blacklisted them in response to raising concerns.

Another said complainants had been “interrogated while in tears”.

Meanwhile another doctor from an ethnic minority background said international graduates were rarely taken seriously.

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Source: Medscape, 30 August 2024

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