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NHS warns of 18,000 flu deaths since 2022 as it urges vaccination uptake

At least 18,000 deaths in England were associated with flu over the past two winters, figures have revealed, as health experts urge those eligible to take up a free vaccination on the NHS.

The figures from the UK Health Security Agency (UKHSA) cover the period from October to May in 2022-2023 and 2023-2024. Over the same timeframe UKHSA estimates a little more than 19,500 deaths were associated with Covid.

Steve Russell, the NHS national director for vaccinations and screening, said:

“Today’s data showing there were almost 20,000 deaths associated to flu over the past two winters is a shocking reminder that this is a seriously dangerous virus, and I urge those who are eligible to book their vaccine appointment as soon as they can as it is our best way of protecting those who are vulnerable as winter approaches.”

UKHSA said uptake of the flu vaccine fell last winter compared with the year before across all eligible groups, including the very young, elderly people and pregnant women. Among people aged six months to 65 years with one or more long-term health condition uptake declined from 49.1% in the winter of 2022-2023 to 41.4% in the winter of 2023-2024.

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Source: The Guardian, 30 September 2024

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Staff ‘rebuked’ for raising safety concerns despite patient deaths

Staff were ‘rebuked’ for raising safety concerns at a trust where the incorrect use of chemotherapy has been linked to patient deaths, HSJ has discovered.

In 2020, East and North Hertfordshire Trust identified higher-than-expected mortality rates among its ovarian cancer patients. An external review, obtained by HSJ, found chemotherapy may have contributed to the deaths of four patients in 2019 and 2020 whose comorbidities had not been adequately considered.

The serious incident investigation was undertaken by a team from specialist cancer trust The Christie. This identified issues including a “reluctance of staff to escalate safety concerns” and “poor consideration” of patient fitness levels in pre-treatment assessments.

The review said: “Many clinical decisions were driven from a senior individual member of the team, rather than a team-based decision-making model.”

“Some members of the MDT [multidisciplinary team] did not feel empowered to escalate issues around SACT [systemic anticancer therapy] assessments, with some staff stating that they felt that they were rebuked for escalating out-of-range blood test results.”

The review said decisions over treatment were not driven by protocol or multidisciplinary team input as part of general practice.

It added: “In the absence of a psychologically safe working environment, over time the above described behaviours became embedded in practice and were therefore less likely to be challenged.”

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Source: HSJ, 27 September 2024

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Radiographer-led pathway to improve NG tube safety launched

The Society of Radiographers is working alongside other organisations to launch a radiographer-led nasogastric (NG) tube position check pathway.

Aimed at reducing misplacement incidents and improving patient safety, the pathway has been developed with Royal College of Radiologists (RCR), the British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and the British Association of Parenteral and Enteral Nutrition (BAPEN).

Radiographers will be trained to evaluate and record NG tube placement via X-ray, increasing efficiency and providing a safe consistent structured process. 

Once trained, radiographers can perform these evaluations autonomously in real-time, reducing delays and providing a safe consistent structured clinical evaluation recorded on the Radiology Information System.

NHS sites are being encouraged to pilot this pathway, with support from both SoR and RCR. Trusts and boards need to obtain local governance approval and work with key stakeholders to integrate the pathway into existing clinical workflows.

Continuous learning will be supported through local audits, ensuring quality and safety are maintained. Radiologists play a key role in supporting radiographers and are essential for overseeing the implementation of the pathway.

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Source: The Society of Radiographers, 26 September 2024

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I won't back down on broken NHS claims - Streeting

Wes Streeting says he will not back down in his criticism of the NHS, after the BBC revealed there was growing unease in the service about the "broken" NHS messaging from government.

England's health secretary told the Labour Party conference that not acknowledging the problems in the NHS would result in "killing it with kindness".

His comments came after senior sources in the health service said they believe some of the claims have gone too far - and may result in patients being put off seeking help and causing lasting damage to staff morale.

In recent weeks, the government has claimed cancer is a "death sentence" because of NHS failings, while maternity services "shame" the nation.

Streeting told delegates in Liverpool: "I know the doctor's diagnosis can sometimes be hard to hear.

"But if you don't have an accurate diagnosis, you won't provide the correct prescription.

"And when you put protecting the reputation of the NHS above protecting patients, you're not helping the NHS, you're killing it with kindness.

"I won't back down. The NHS is broken, but it's not beaten, and together we will turn it around," Mr Streeting said.

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Source: BBC News, 25 September 2024

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NHS bosses reject calls for specialist ME care

NHS bosses have rejected pleas for specialist care for people with severe myalgic encephalomyelitis despite promises from a health minister to tackle the lack of provision.

The recent inquest into the death of Maeve Boothby-O’Neill, 27, whose case exposed failings in the treatment of patients with severe ME, led to a minister’s declaration she had fallen through the cracks.

Andrew Gwynne, the minister for public health and prevention, pledged in August to boost research, improve attitudes and “better the lives of people with this debilitating disease”.

However, The Times has been told that a national service for ME patients is not on the agenda despite acknowledgement that patients are not receiving the expert care they need.

Karen Hargrave, the co-founder of #ThereForME, said that the government had made encouraging commitments to improving the care for ME and long Covid patients. However she warned that there did not seem to be a sense of urgency, even though lives were at risk.

The government has committed to publishing its ME delivery plan, the long-delayed strategy to improve treatment and understanding of ME, but not until the late winter and then it will have to be implemented. “We need action now,” Hargrave said. “Patients are being failed, but healthcare workers are being failed just as badly. They need proper structures and clear guidance to provide people with ME-safe care and save lives when needed.”

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Source: The Times, 27 September 2024

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Politicians are failing to prepare for next pandemic, warns head of European health agency

Politicians throughout Europe are gambling on the next pandemic not happening for the next five years and as result are failing to invest in preparedness, warns a doctor in charge of protecting 500 million people in Europe from infectious diseases.

Pamela Rendi-Wagner, director of the European Centre for Disease Prevention and Control (ECDC), told the European Health Forum Gastein on 25 September, “Every politician now in parliament hopes [the next pandemic] will not be within the next five years of his or her period—that’s why they aren’t investing too much in preparedness."

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Source: BMJ, 26 September 2024

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Basic security measure would have prevented disastrous cyber attack

A major cyber attack which caused months of disruption across NHS services in south London would have been thwarted if the affected system had been protected by a basic IT security process, HSJ has learned.

Synnovis, which provides pathology services for more than 2 million people in the capital, was hit by a ransonware attack in June.

The attack locked staff working for the pathology provider to Guy’s and St Thomas’ and King’s College Hospital foundation trusts out of their systems for months. This resulted in widespread delays to care, including cancer treatment. Clinical teams in hospital had to revert to pen and paper, while GPs in the area were left “flying blind” without the ability to order tests.

Senior sources who worked on the response to the attack have now confirmed to HSJ that the system was not protected by multi-factor authentication (commonly known as “two-factor authentication”). MFA involves a user who has entered their password verifying their identity via another method, typically a call or text to their mobile.

After the attack, NHS England’s chief information security officer Phil Huggins wrote to all NHS providers saying two-factor authentication was now mandatory for all NHS systems and those used by their suppliers.

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Source: HSJ, 26 September 2024

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‘Aggressive’ ministers legitimising bullying in trusts, Letby inquiry told

Bullying, aggressive behaviour, and other forms of inappropriate pressure from ministers and the leaders of central bodies can significantly contribute to the development of an unhealthy workplace culture at local level, an expert witness has warned the inquiry into Lucy Letby’s crimes.

THIS Institute director Mary Dixon-Woods has been instructed by the Thirlwall inquiry to report on NHS cultural issues.

She said in evidence on Thursday: “The outer context more broadly, from ministerial level down, is highly impactful for culture and behaviour in NHS organisations.

“Pressures and behaviours (including bullying or aggressive behaviour) from those at the centre may be implicated in poor cultures at the level of NHS provider organisations.

“As well as being an unpleasant experience for those on the receiving end, they will tend to indicate that these are legitimate ways to behave that can be reproduced within organisations themselves.”

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Source: HSJ, 27 September 2024

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ADHD: ‘We’re sharing and rationing meds to get by’

A year ago, life for many people in the UK with attention deficit hyperactivity disorder (ADHD) became unpredictable and disorientating as their medications suddenly became scarce. They were told the shortages would be over within months - but people with the condition tell the BBC it is still a problem.

Spending two hours on hold to her pharmacy or GP each day has become the norm for Lorelei Mathias, 44, who has struggled to get a consistent supply of her prescription ADHD drugs since the shortages began last September.

The Brighton-based author and comedian, who created the web series Life in ADHD, says she has gone "against advice" and started rationing, hoarding and sharing pills with friends on similar prescriptions to make sure they all have enough.

"I have many friends who are also really struggling and splitting pills or shutting down from work as they can't function without it," she says.

When the UK government issued a patient safety alert, external warning last September about a shortage of many ADHD medications, it said it expected the disruption to end by December 2023.

Dr Ulrich Müller-Sedgwick, a consultant psychiatrist for adult neurodevelopmental pathways at the Royal College of Psychiatrists, says production and manufacturing issues are a factor.

He says: "There’s only a limited number of factories where these medicines are actually produced. They're stimulants, so there’s also quite a high security standard in these factories and they’re not easy operations to run."

The Department of Health and Social Care (DHSC) says most supply issues have been resolved and it is working with manufacturers on the remaining problems.

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Source BBC News, 27 September 2024

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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 and insights on the hub here. You'll need to register with the hub first, its free and easy to do. 

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‘Scenes from hell’: Hospitals ran out of body bags and were close to collapse in pandemic, Covid inquiry told

Politicians chose not to equip the UK with enough intensive care units before the pandemic, the government’s chief medical officer has said, as a senior NHS doctor described scenes “from hell” on hospital wards.

NHS hospitals were dealing with the equivalent of daily “terrorist attacks” during the pandemic with wards so overwhelmed they ran out of body bags, former national clinical NHS advisor Professor Kevin Fong told the Covid-19 inquiry.

In a tearful account of the pandemic during Thursday’s hearing, he recalled seeing hospital wards with sick patients “raining from the sky”, with staff so overworked they were forced to wear nappies rather than go to the toilet.

The harrowing depiction of the pandemic came before Professor Sir Chris Whitty, chief medical officer for the government, admitted the number of intensive care unit (ICU) beds in the UK was too low compared to provision in other countries.

He said: “Taking ICU, in particular, the UK has a very low ICU capacity compared to most of our peer nations in high-income countries. Now that’s a choice, that’s a political choice. It’s a system configuration choice, but it is a choice. Therefore you have less reserve when a major emergency happens, even if it’s short of something of the scale of Covid.”

He talked about how systems could not be “scaled up” without trained workers, adding that beds and space can be purchased but that the limit to any system is having trained people.

Prof Whitty admitted the government made no plans for the mental health impact of the pandemic and said officials “didn’t get it across well enough” that people should continue to go to hospitals for serious illnesses other than Covid.

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Source: The Independent, 27 September 2024

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Pharmacy closures in England threaten plan to use them instead of GPs for some care

High street pharmacies are closing at such an alarming rate that it threatens the drive to use them instead of GPs to care for millions of people, the NHS’s patient champion warns today.

A total of 436 community pharmacies in England shut permanently last year and there were also 13,863 temporary closures, which stopped patients from obtaining health advice and medication.

What appears to be a growing trend of permanent closures is hitting rural areas, those with larger numbers of older people and deprived communities hardest, according to Healthwatch England.

Its findings, which were based on figures supplied by NHS bodies, prompted fears that closures are leaving some parts of England as “pharmacy deserts” where patients struggle to access care.

“Staff shortages, the key driver of permanent and temporary closures, call into doubt the potential of Pharmacy First, meaning people can’t get the advice, care and medications they need and when they need them”, said Louise Ansari, Healthwatch’s chief executive.

Pharmacy First is the government’s drive to reduce the strain on overworked GPs through pharmacists treating what it hopes will be millions of patients a year for seven minor ailments such as a sore throat, earache, infected insect bite or sinusitis.

“It’s clear that rising levels of closures are risking leaving some areas of the country as pharmacy deserts, with people having to travel much further to get access to vital services”, said Paul Rees, the chief executive of the National Pharmacy Association.

“Community pharmacies act as the front door to the NHS. If people lose access to them it will force more patients into the eight o’clock scramble at their GP surgery, putting pressure on the rest of our NHS system.”

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Source: The Guardian, 26 September 2024

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Streeting backs role for physician associates in NHS despite RCGP vote

Physician associates (PAs) have a role to play in the NHS, but doctors' concerns about how they are working must be taken seriously, the health and social care secretary Wes Streeting has said.

Mr Streeting's comments come after the Royal College of General Practitioners (RCGP) voted last week to oppose any role for PAs in general practice in a move that marked a change in position for the college.

Responding to a question from GPonline about his views on the college's decision at Labour’s annual conference in Liverpool on 23 September, Mr Streeting said: 'I think physician associates do have a role to play in a modern NHS and there are physician associates every day in our country providing great care and making a great contribution, not just to patients but to their colleagues.'

He added: "Where I think we have a challenge is that legitimate concerns that have been expressed by doctors, both about [doctors being substituted for PAs] and patient safety, have been ignored by the previous government and in the process [doctors] have felt gaslit. 

"That has fuelled quite a toxic debate particularly online that has led to a lot of physician associates feeling quite demoralised and doctors feeling unheard."

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Source: GP Online, 24 September 2024

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HIT teams to be sent into trusts to improve efficiency

The government will send in teams of clinical experts to 20 trusts to improve theatre productivity, the health and social care secretary has announced.

High-intensity theatre (HIT) lists have been used by Guys and St Thomas’  Foundation Trust to significantly increase the number of operations carried out each day.

An article in the journal Nature last year explained: ”This increase is achieved by meticulous planning and parallel processing of patient care on the day of surgery, aiming to minimise or eliminate turnaround time, minimise non-operative time and maximise operating time.” 

Mr Streeting said the trusts would receive visits from the HIT teams but said they would be “in areas with the highest numbers of people off work sick.”

The support will be led by the national Getting It Right First Time team and extend beyond HIT to include other measures such as reducing missed appointments, which are higher in deprived areas, and identifying local capacity in the private sector, NHSE said.

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Source: HSJ, 25 September 2024

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Six NHS schemes that could help fix the health service

The government in England is planning the biggest reimagining of the NHS in its history.

It follows a damning report by surgeon and independent peer Lord Darzi, which warned the health service was in a “critical condition”.

The prime minister has said the new 10-year plan will be based on three concepts: greater use of digital technology, more emphasis on community care, and preventing ill health in the first place.

Across the NHS there are already pockets of innovation - and these localised schemes could help the wider NHS in years to come, including:

  1. Tests and scans in shopping centres.
  2. Virtual wards.
  3. Surgery hubs - with patient video diaries.
  4. Rapid discharge teams.
  5. Lung cancer screening trucks.
  6. Prescribing dance and arts.

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Source: BBC News, 22 September 2024

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NHSE chief: Federated data platform will ‘not be spectacular’

An NHS England chief has admitted the controversial ‘federated data platform’ will ‘not be that spectacular’ despite national leaders previously talking it up as ‘critical for the future of the NHS.’

NHSE chief data and analytics officer Ming Tang said the new data platform, which is being rolled out to trusts across the country, will help staff manage logistical tasks but said the system is “not pretty”.

NHSE wants trusts to adopt the FDP to bring together operational data currently stored in separate systems into “one safe and secure environment.” However, politicians and campaigners have raised concerns about privacy and data protection, particularly over the involvement of US firm Palantir, which is leading the consortium to deliver the FDP.

Speaking at the Health Excellence Through Technology conference on Tuesday (24 September), Ms Tang said “the most important thing… is that we deliver products that work for people, not the products that we want to push.

“I’ve always said [FDP is] not pretty, it’s not that spectacular. But what we’re really doing is helping people do their workflow, helping nurses on the ward so they don’t have to have bits of paper in their pockets, [helping] multidisciplinary teams so they’re not running around chasing emails.

“So, [it’s] taking away some of those logistical activities so they can focus on the frontline and on the patients.”

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Source: HSJ, 26 September 2024

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GPs refused to give prostate cancer tests to one in four black men in UK, survey finds

One in four black men in the UK have been refused a prostate cancer test by their GP despite having twice the risk of developing the disease than the overall adult male population, a report has found.

A PSA test measures the level of the protein prostate-specific antigen in the blood, and may be able to detect prostate cancer in its early stages.

But according to a survey conducted by Prostate Cancer Research of 2,000 black men in the UK, almost a quarter (24%) attempting to get tested in the past year reported being obstructed by a GP.

The survey also found a quarter (25%) believed discrimination prevented them from being tested for prostate cancer, while just under a half (47%) thought they would receive the same level of care from the NHS as their white counterparts.

Oliver Kemp, the chief executive of Prostate Cancer Research, said: “These black and white figures are shocking, and an important call to action. It shouldn’t be the community alone who has to fix this – just as we have seen members of the community come together around our Real Talk campaign, we are calling on government, the NHS, and other partners to come together and work with us to close this health gap.

“It is vital we raise awareness not only among the community, but also among healthcare professionals and policymakers. We are calling on GPs to be mindful of black men’s greater risk when considering PSA testing, and on government to introduce screening for men in high risk groups – our data shows that 82% of black men would be willing to take part in such a programme, if it were rolled out. It is staggering to think of how many lives could be saved.”

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Source: The Guardian, 26 September 2024

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Arrests after woman dies following Brazilian butt lift procedure

Two people have been arrested on suspicion of manslaughter following the death of a woman believed to have undergone a non-surgical Brazilian butt lift (BBL).

Alice Webb, 33, died after being taken to Gloucestershire Royal Hospital in the early hours of Tuesday after falling unwell.

Gloucestershire Police said it had been called by the ambulance service at 11:35 BST on Monday and an investigation, led by the major crime team, was ongoing.

The two arrested people have been released on police bail.

Save Face, a national register of accredited practitioners who offer non-surgical cosmetic treatments, said this was the "first case of a death caused by a non-surgical BBL in the UK".

While non-surgical BBLs are not illegal in the UK, last year Wolverhampton City Council barred a company from carrying out the procedure after identifying risks associated with their processes, including blood clots, sepsis, and the potential for the death of body tissues.

Save Face’s director Ashton Collins said the organisation had supported 500 women who had suffered complications from the procedure.

Ms Collins said: “Liquid BBL procedures are a crisis waiting to happen. They are advertised on social media as ‘risk-free’, ‘cheaper’ alternatives to the surgical counterpart and that could not be further from the truth.”

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Source: BBC News, 25 September 2024

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Covid inquiry rejects clinicians’ anonymity plea

The chair of the Covid inquiry has refused an application from the UK Health Security Agency to keep the identities of two junior clinicians secret.

Lawyers for UKHSA applied for an order preventing publication of their names, on the grounds they could be subject to abuse and harassment on social media and in person.

Both individuals attended Infection Prevention and Control (IPC) Cell meetings to discuss the guidance on masks and personal protective equipment (PPE) during the pandemic.

Baroness Hallett ruled their names could be published in minutes of those meetings, as any risk was outweighed by the public interest in reporting on the group's work.

From February 2020 until it was disbanded in 2022, guidance on the use of PPE in healthcare settings was drawn up by the IPC Cell, a group of clinicians and officials from the NHS, government and public-health bodies such as Public Health England, which then Health Secretary Matt Hancock replaced with UKHSA in 2021.

Critics have said the IPC Cell was too slow to strengthen its recommendations on PPE after it became clear Covid could be spread by tiny airborne particles.

The Covid-19 Airborne Transmission Alliance (CATA), a group made up of healthcare organisations and individuals which campaigned for stronger guidance, has called it a “shadowy” organisation with “unclear” accountability structures.

UKHSA said the “heated and aggressive” public discourse around the subject meant there was a “high likelihood” junior members of staff could face online abuse if they were named in minutes published by the inquiry.

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Source: BBC News, 26 September 2024

Related reading on the hub:

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Inquiry chair praises courage of victims' families

The chair of an inquiry into more than 2,000 mental health-related deaths in Essex has praised the "courage and candour" of victims’ families.

The Lampard Inquiry is investigating the deaths of people in the care of mental health services in Essex between 2000 and 2023.

The inquiry, which has been sitting for the last three weeks, has now adjourned until November.

Baroness Lampard said that statements from bereaved families “had made a lasting impression” on her.

More than 40 people have given commemorative statements so far, telling the inquiry about their loved ones and what kind of people they were before they died.

Addressing the inquiry on its final day before an adjournment, Baroness Lampard said the opening statements had been “thought-provoking”.

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Source: BBC News, 25 September 2024

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New York declares ‘imminent threat’ after first death from eastern equine encephalitis in decade

New York officials announced an “imminent threat” to public health this week after a resident died from the state’s first case of mosquito-borne eastern equine encephalitis, or EEE, in nearly a decade.

The deceased individual was a resident of Ulster County, two hours north of New York City. The case, the state’s first human case since 2015, was confirmed earlier this month.

“We’ve been informed this patient has passed away from EEE, we extend our sympathies and our hearts go out to their family,” New York Governor Kathy Hochul said.

Eastern equine encephalitis is a rare but severe viral disease, spread by infectious mosquitoes. Approximately 30 percent of those who contract EEE die from the disease, and survivors are often left with neurologic problems. There are no vaccines or medications to treat or prevent it.

State Health Commissioner Dr James McDonald issued the declaration to unlock state resources and help support response to the virus, including continued efforts to spray for mosquitoes through the end of November.

Governor Hochul activated multiple agencies to expand access to insect repellent at New York parks and campgrounds, and to increase public awareness of the threat by placing signs at potentially vulnerable sites.

“Keeping New Yorkers safe is my top priority,” Hochul said.

Read full story

Source: The Independent, 24 September 2024

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Mother wins decade-long battle for more than £10m over botched operation on child at NHS hospital

A mother has won a 12-year battle for compensation against an NHS hospital after successfully claiming her child suffered brain damage as a result of a botched surgery.

The toddler, now a teenager, was left wheelchair-bound as a result of the operation in Alder Hey Children’s Hospital in 2012, with lawyers claiming the child was starved of oxygen.

A settlement has now been reached between the NHS Litigation Authority, which handles claims against the NHS for negligent care, and the family.

The trust that manages the Liverpool-based hospital has also apologised for the “failings in care”.

The mother said: “Ever since that day, my child has had to go to countless appointments, see countless therapists and doctors and specialists, and will do for the rest of their life. I am traumatised and exhausted, and I am on the defence all the time.

“I can’t cut any of them any slack after what happened 12 years ago. Twelve years is such a painfully long time.”

She also hit out at the process of claiming compensation through medical negligence claims.

She added: “It takes years and this length of time is not good enough. Parents commit suicide, marriages break down, they’re often too frightened to have more children. All because of how long it takes to get justice for your child, and how hard that is to achieve.” 

Read full story

Source: The Independent, 25 September 2024

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Women dying ‘unnecessarily’ of heart disease, say experts

Thousands of women are dying from heart disease worldwide because of the misconception that it is a “man’s disease”, doctors and scientists say.

Cardiovascular disease (CVD) was the “number one killer” of women but, despite significant progress in its medical management, many were dying “unnecessarily” because they were underdiagnosed, undertreated and under-represented in clinical trials, the experts said.

A consensus statement drawn up by 33 leading health figures affiliated with the British Cardiovascular Society aimed to address unmet needs, ensuring parity of care and improving the health outcomes of women with CVD in the UK and worldwide.

Among other things, it called for dedicated women’s heart champions and heart hubs to prevent the “needless death toll” from an essentially preventable disease.

Conventional risk factors, such as high blood pressure and high cholesterol, were often not treated as promptly or as appropriately as they were in men, despite accounting for about half of all preventable cardiovascular disease deaths, the statement said.

Women also faced particular cultural, societal, and financial issues, which magnified their heart disease risks.

Healthcare professionals and the public mistakenly believed that women’s risk of CVD was lower than men’s, the statement said. “Myths and unconscious biases within clinical practices and societal perceptions further obscure the reality that heart disease does not discriminate by sex,” it said.

All too often women’s voices went unheard and their heart symptoms were not taken seriously enough, it added.

Read full story

Source: The Guardian, 24 September 2024

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The 22 areas testing radical changes to GP operating model

HSJ can reveal the 22 primary care networks taking part in an unprecedented national programme designing a new “GP operating model” set to influence the national GP contract.

The groups, spread across seven integrated care boards, will trial new “operating models” for GP provision, under an initiative announced by the ICBs and NHS England in May.

If successful, the project will influence future national care models for GP and “neighbourhood” services, and probably shape the core national GP contract, HSJ understands. They will also look to use their evidence to prove the case for more primary care investment.

The sites will initially test five types of “interventions”, with specific actions to be agreed by the PCNs and ICBs in coming months. 

  1. Optimising key aspects from the Primary Care Access and Recovery Plan
  2. Implementing digital methods for risk stratification and repetitive process automation tools to reduce administrative burden;
  3. Enhancing population health management, such as identifying patient searches for case or medication reviews;
  4. Defining and measuring the impact of multidisciplinary teams for complex cohorts; and
  5. Funding to increase clinical capacity as outlined in the long-term workforce plan.

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Source: HSJ, 25 September 2024

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Safety alert over 25 serious incidents linked to common drug

Maternity services have been issued with a national patient safety alert over inappropriate use of a common labour-inducing drug following a review of 25 serious incidents.

NHS England’s national patient safety team, backed by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives and the Royal College of Anaesthetists, has issued an official alert instructing all providers to stop pre-preparing oxytocin infusions at ward level, in all clinical areas.

Trusts must complete this and three other actions by 31 March 2025. Oxytocin is one of the most commonly used drugs in labour and childbirth and can be administered to initiate contractions. In a much higher dose, it can treat postpartum haemorrhage, severe bleeding after birth. 

The inadvertent administration of a postnatal dose of oxytocin before a baby is born can lead to significant harm to mother and baby.

Safety reports into deaths and harm in maternity services, including the Ockenden reports into Shrewsbury and Telford Hospitals Trust and the seminal case which prompted the East Kent inquiry, that of Harry Richford, mention inappropriate use of oxytocin.

Read full story (paywalled)

Source: HSJ, 24 September 2024

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‘Drug-resistant typhoid is the final warning sign’: disease spreads in Pakistan as antibiotics fail

From his sickbed, eight-year-old Ukasha could see his siblings play with a ball in the courtyard. His head hurt and his body felt too heavy to move. Ukasha had typhoid fever – an illness he should have recovered from in days. It had been a month.

At its worst, typhoid can kill. Ukasha’s family were anxious, even moving his bed outside to give him fresh air and sunlight.

Children across the village – on the outskirts of Peshawar, northern Pakistan – had been falling ill.

Typhoid, also known as enteric fever, is an infection caused by contaminated food or water. If left untreated, it kills one in five. But the cure is a simple course of antibiotics. Most people, if they get the drugs promptly, should start recovering within a few days.

But the antibiotics used to cure typhoid are now failing. The bacteria, Salmonella typhi, have developed resistance to the antibiotics meant to kill them. It’s a pattern repeated across the world; the problem of resistant infections is global and borderless.

“Typhoid was once treatable with a set of pills and now ends up with patients in hospital,” says Jehan Zeb Khan, a clinical pharmacist at Hayatabad Medical Complex, a hospital in Peshawar.

Read full story

Source: The Guardian, 24 September 2024

 

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