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Sexual predator NHS doctors target vulnerable medical students during training, campaigners warn

Medical schools have been urged to protect students who face sexual assaults and “sinister” behaviour from senior doctors, who see them as easy targets, campaigners have warned.

Scores of students have come forward with stories of doctors, groping them and making inappropriate comments while they are being trained in hospitals, according to the campaign group Surviving in Scrubs. The group, which aims to address sexual harassment facing medics in the NHS, has raised new concerns over vulnerable students who it says are facing abuse while on training placements in hospitals, It is urging NHS and university leaders to protect vulnerable trainees.

Becky Cox, a GP and founder of Survivors in Scrubs, told The Independent: “When they’re out on placement qualified doctors will make inappropriate comments about their appearance and more sinister behaviours, there was a student who was sexually assaulted in the car on the way to the placement. The power dynamic is much greater for students. By and large, this is senior doctors perpetrating this. Medical students are right at the bottom of the food chain, and we feel they are specifically targeted and because the perpetrators know there is very little the students can do to challenge the behaviour, they’re unlikely to raise a concern.”

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Source: The Independent, 24 July 2024

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Pregnant women suffer racist and discriminatory abuse at NHS trust, says inquiry head

Expectant mothers at a scandal-hit NHS trust have experienced “discriminatory and racist behaviour” including staff mimicking their accents and refusing to provide interpreters, according to the head of an inquiry into its failings.

As part of the largest inquiry into a single service in the history of the NHS, Donna Ockenden’s team is conducting a review with more than 1,900 families who have experienced stillbirth, neonatal death, maternal death or babies diagnosed with brain damage at Nottingham University hospitals NHS trust (NUH).

Ockenden, a senior midwife, said she had concerns about reports of racist behaviour uncovered during her interviews with families and 744 staff members who have come forward to participate in the review.

“Both family and staff are reporting discriminatory and racist behaviour,” Ockenden told the Guardian. “Local women of Asian origin are reporting white women in the bed opposite being treated more kindly. They have had their accents mimicked, their facial movements mimicked, have been made fun of and seen staff laughing at them."

Ockenden said women were often not able to give informed consent to difficult procedures as they were told they “understood enough” when they asked for an interpreter. She added that she had found women from the most deprived backgrounds, of all races, were “certainly reporting to me very negative experiences of maternity services.”

Anthony May, the chief executive of NUH, said: “I want to apologise to these women and families for the shortcomings identified and pain caused. I also apologise to anyone who has experienced racism in our hospitals."

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Source: Guardian, 24 July 2024

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Faulty pathology system causes ‘significant’ issues for GPs

An ongoing fault with an acute trust’s new pathology system has left GPs with ‘significant’ workload issues and ‘anxiety’ for patient safety. 

At the start of this month, University Hospital Southampton (UHS) trust transferred to a new pathology IT system which resulted in issues with processing blood tests and communicating results. 

Wessex LMCs said the trust has shown a ‘distinct lack of understanding’ of general practice, which has caused ‘large issues’ and ‘an enormous associated workload’ for GPs.

GPs in the area told Pulse that there was immediately a ‘massive backlog’ from 1 July, as blood test requests were sent using the ‘old forms’ which the lab could not process quickly enough. 

However, one GP partner, who wished to remain anonymous, said there was ‘absolutely no communication with primary care’ to clarify that the old forms should not be used. 

As a result of this backlog, UHS introduced a ‘temporary measure’ which told GP practices they could only request ‘urgent blood tests’, meaning all routine blood tests were suspended.

This restriction was lifted last week, and UHS has since cleared the initial backlog, however GPs told Pulse that they are still not receiving blood test results, and those they do receive are often not in the correct format. 

Another Southampton GP partner, who preferred to remain anonymous, said that on top of the initial backlog – caused by slow processing of old forms – there has also been a ‘significant proportion of path results that aren’t coming into GP systems’. 

In one surgery, around 70% of bloods requested in one week had not yet received results. The GP partner said that "results are being processed at the hospital" but GPs "can’t see them" as a result of faults with the system.  She continued: "We are trying to make clinical decisions based on results and we’re not seeing them […] It’s causing a significant degree of anxiety and concern for patient safety."

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Source: Pulse, 23 July 2024

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Dementia diagnoses in England reach record high

Record numbers of people in England are being diagnosed with dementia, new figures have revealed.

The data from NHS England, which cover people of all ages, showed that 487,432 people were diagnosed with dementia in June this year. This was almost 5% more than the figure of 465,516 for the same time last year, and 0.65% more than the figure of 484,277 for May 2024.

Dementia diagnosis rates are currently the highest they have been since the start of the COVID-19 pandemic, according to NHS England. It acknowledged that the NHS has more to do to meet its ambition to diagnose 66.7% of the total number of people estimated to be living with some form of the disease.

However, dementia diagnosis rates have yet to return to prepandemic levels. The estimated dementia diagnosis rate fell by 5.4% between March 2020 and February 2023, from 67.4% to 62%.

Dr Jeremy Isaacs, national clinical director for dementia, NHS England said, "NHS staff have worked hard to recover services with the number of people with a diagnosis rising significantly over the last year, and now at a record level."

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Source: Medscape, 23 July 2024

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Hope for cancer patients as NHS tracking system could prevent treatment delays

Cancer patients could be spared the devastating consequences of their tissue samples being lost thanks to a new tracking system being tested in the NHS.

The loss of tissue samples can mean vulnerable patients are forced to redo biopsies, therefore delaying diagnosis and treatment. Lost samples cost the NHS an estimated £157m in claims every year.

However, losing samples could soon be a thing of the past in the NHS, as one of the UK’s largest health trusts tests a new tracking system its inventors hope will lead to a rollout in hospitals worldwide.

Leeds Teaching Hospitals NHS Trust, which deals with tens of thousands of cancer cases every year, will trial a real-time tracking system for cancer tissue samples.

The system is based on radio frequency identification (RFID) technology that is widely used in the retail and logistics industry to track assets and has been specially adapted to help improve treatment for people with serious and life-threatening conditions.

Dil Rathore, the trust’s biomedical scientist and pathology innovation lead said, "The stress and anxiety felt by patients awaiting a potential cancer diagnosis can be made much worse if they are told their sample has been lost. Unfortunately, this ‘never-event’ happens more often than is acceptable. That’s why we came up with a real-time system to track the precise location of each sample and its movement through our histopathology department. The interpretation of changes in tissue forms the foundation of successful cancer treatment.”

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Source: inews, 21 July 2024

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NHS finances so dire that whole service may collapse, says spending watchdog

The NHS’s finances are so dire that the whole health service may break unless it receives a massive cash injection, Whitehall’s spending watchdog has warned.

Years of underfunding have left the NHS in England so cash-strapped that it cannot treat patients quickly enough, and the rising tide of ill-health will make matters worse, the National Audit Office (NAO) said.

The NAO does not specify how much extra funding the health service needs to get it back on its feet and ensure trusts that provide care can balance their books. But a leading thinktank recently put that figure at £38bn more a year by the end of this parliament.

Its grim conclusions raise serious questions about whether Keir Starmer’s government can fulfil its ambitious pledges to rescue the NHS, and again meet key waiting time targets on surgery and A&E care, without spending significantly more money.

The NAO said: “When we consider how the health needs of the population look set to increase, we are concerned that the NHS may be working at the limits of a system which might break before it is again able to provide patients with care that meets standards for timeliness and accessibility. There is a wider question for policymakers to answer about the potential growing mismatch between demand for NHS services and the funding the NHS will receive. Either much future demand for healthcare must be avoided, or the NHS will need a great deal more funding, or service levels will continue to be unacceptable and may even deteriorate further.”

A Department of Health and Social Care spokesperson said, “Not only has this government inherited the worst economic circumstances since the second world war, but also an NHS in deficit. Getting the NHS back on its feet is our priority, but it will take time."

Read the National Audit Office report NHS financial management and sustainability 2024 on the hub

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Source: Guardian, 23 July 2024

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First-of-its-kind guidance aims to ensure safety and dignity of trans patients

A first-of-its-kind set of guidelines for the care of transgender people before and after general surgery has been created.

The guidelines recommend gender-inclusive language and consideration of whether a patient should be accommodated in a single room rather than on a ward.

The guidance, created independently of the NHS, is said to have been put together amid a “dearth of knowledge and confidence amongst anaesthetists when caring for transgender and gender-diverse patients”.

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Source: Independent, 24 July 2024

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Pregnant women suffer racist and discriminatory abuse at NHS trust, says inquiry head

Expectant mothers at a scandal-hit NHS trust have experienced “discriminatory and racist behaviour” including midwives mimicking their accents and refusing to provide interpreters, according to the head of an inquiry into its failings.

As part of the largest inquiry into a single service in the history of the NHS, Donna Ockenden is speaking with more than 1,900 families who have experienced stillbirth, neonatal death, maternal death or babies diagnosed with brain damage at Nottingham University hospitals NHS trust (NUH).

Ockenden, a senior midwife, said she had concerns about reports of racist behaviour uncovered during her interviews with families and 744 staff members who have come forward to participate in the review.

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Source: The Guardian, 24 July 2024

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Weight-loss drug approved for heart problems in UK

Weight-loss treatment Wegovy has been approved by the UK's medicines regulator, for reducing the risk of serious heart problems in overweight and obese people.

Wegovy contains the drug semaglutide, which is already prescribed on the NHS to help some people with a body-mass index (BMI) above 26 lose weight.

And it now becomes the first anti-obesity drug to be used to control heart attacks and strokes in people with established heart problems and a similar BMI.

A trial of 17,600 people suggested weekly semaglutide injections for up to five years reduced major cardiovascular events by 20%.

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Source: BBC News, 23 July 2024

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Exclusive: Lack of surgery capacity adding to risk for babies and mothers

A lack of surgery capacity at dozens of maternity units is adding to risk of serious harm to mothers and newborn babies, HSJ has found.

An investigation established that at least 33 units nationally have no second dedicated obstetric theatre for emergency Caesarean sections and found evidence this was delaying operations beyond the safe period in some cases.

HSJ also found multiple examples of safety incidents linked to C-sections delayed due to a lack of quick access to staffed theatres and regulatory concerns.

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Source: HSJ, 24 July 2024

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GP industrial action may hit all services, ICBs and trusts warned

Integrated care boards and trusts should develop plans to deal with potential “whole system” impact of GP “collective action” from next week, NHS England has warned.  

In a letter to ICB and trust leaders this evening, NHSE asked systems to make a “best estimate” of the knock-on effects across urgent and emergency care, electives and discharge, and community and mental health.

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Source: HSJ, 22 July 2024

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Dementia diagnoses in England hit a record high, NHS data reveals

The number of people in England being diagnosed with dementia is at a record high as the NHS begins to recover from a post-pandemic dip, according to figures.

The latest data shows a record 487,432 people had a diagnosis in June – up from 77,112 in the same month last year.

While diagnosis rates are at their highest since the start of the pandemic at 65 per cent, the health service said it still has more to do to meet its ambition of diagnosing 66.7 per cent of the total number of people estimates suggest are living with a form of the disease.

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Source: Independent, 22 July 2024

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Woman died after begging GP for help - inquest

A young woman died months after begging her GP for help with her chronic fatigue syndrome, an inquest heard.

Maeve Boothby-O’Neill, 27, had written to her doctor asking for help with feeding as she was hungry.

Ms Boothby-O’Neill had been diagnosed with myalgic encephalomyelitis (ME). She died at home in Exeter, Devon, in October 2021.

The inquest, which is scheduled to last two weeks, continues.

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Source: BBC News, 22 July 2024

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Babies died after hospital neglect - inquest jury

Two premature babies died within weeks of each other after neglect by a hospital, an inquest jury has found.

Westminster Coroners’ Court heard Elena Ali and Sunny Parker-Propst were both given sodium nitrite instead of sodium bicarbonate in 2020 while under the care of staff at Chelsea and Westminster Hospital.

On Monday they returned verdicts of unlawful killing contributed to by neglect for baby Sunny, and accidental death contributed to by neglect for baby Elena.

Lesley Watts, chief executive of Chelsea and Westminster Hospital NHS Foundation Trust, said: “We apologise unreservedly for the failings in care provided to Elena and Sunny."

Ms Watts added: “We took immediate action to put measures in place to prevent such tragic incidents from happening again.”

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Source: BBC News, 22 July 2024

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AI could solve ‘disgraceful’ structural problems, says minister

Artificial intelligence could be used to figure out the causes of “disgraceful” structural problems like the higher rates of maternal mortality for black women, a minister told a conference yesterday.

Health minister Karin Smyth said AI could be used not only for clinical and administrative functions but also to “diagnose” issues. She also said the way government funded AI adoption needed to change.

Ms Smyth, a former NHS manager, was giving her first speech as a minister at a Health Foundation conference on AI. The conference also heard from leading tech experts who said the UK was “exceptionally well placed for a global leadership role in health and AI”.

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Source: HSJ 

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One in five patients don’t know the difference between doctors and physician associates, watchdog warns

Almost a quarter of people do not know the difference between a physician associate and a doctor, according to a new poll.

While 52 per cent of people can differentiate between the two roles, some 23 per cent said they did not know the difference, the survey conducted for Healthwatch England has revealed.

The organisation, which represents the interests of patients across England, has called for more clarity around the role of physician associates (PAs).

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Source: Independent

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Suspended surgeon harmed hundreds of women

A surgeon has been suspended on the same day a hospital review concluded harm had been caused in hundreds of cases.

A tribunal ruled that Tony Dixon, who used artificial mesh to treat prolapsed bowels at Southmead Hospital, in Bristol, and the Spire Hospital, still posed a risk.

The Medical Practitioners Tribunal Service's hearing concluded on Thursday that a six-month suspension was "appropriate".

Spire Healthcare has now released its review of Mr Dixon, and found 259 cases where harm had been caused. Health bosses have "apologised sincerely".

The majority of harm was in three main areas: the failure to adequately investigate patients prior to offering the procedure; the failure to adequately offer alternative treatments; and poor consent with risks and benefits of the procedure not adequately discussed.

The tribunal found Mr Dixon’s fitness to practise is impaired and his suspension would allow him time to "to develop further insight and remediate his misconduct".

The General Medical Council brought the case against Mr Dixon, who denies all the allegations and maintains that the procedures were carried out in good faith.

His suspension will start immediately.

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Source: BBC News, 18 July 2024

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IT outages hit thousands of services

Thousands of GP practices — and some other localised services — are without their IT systems today, due to global outages also affecting banking, media and aviation.

All EMIS GP IT systems, which are used by more than half of the 8,000-odd GP practices in England, were down. It was leaving many practices unable to book appointments or consult with patients first thing on Friday morning.

This will quickly lead to a backlog of appointments and likely pressure on other urgent care.

Patient-facing digital services linked to EMIS also appeared to be down, such as records access via the NHS app.

The National Pharmacy Association said some community pharmacy services were down — such as “accessing of prescriptions from GPs and medicine deliveries” were disrupted. It’s unclear if that is also caused by EMIS, or other systems.

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Source: HSJ, 19 July 2024

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More than 5,000 early career nursing staff quit profession in one year

A fifth of the nursing and midwifery professionals who left the register in the last year did so within 10 years of joining, figures show.

Nursing leaders described the statistic as “deeply alarming” and called on ministers to “grasp the nettle and make nursing an attractive career”.

The latest Nursing and Midwifery Council (NMC) annual report on its register of nurses, midwives and nursing associates in the UK shows 27,168 staff left the profession between April 2023 and March 2024, a slight decrease on the previous 12 months.

However, 20.3% of the total - or 5,508 - did so within the first 10 years. This is compared to 18.8% in 2020/2021 and “reflects a rise over the last three years”, according to the report.

Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing (RCN), said: “It is deeply alarming that over 5,000 young, early-career nursing staff chose to quit the profession last year, most vowing never to return.

“When the vacancy rate is high and care standards often poor due to staffing levels, the NHS cannot afford to lose a single individual.

“New ministers have to grasp the nettle and make nursing an attractive career.”

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Source: The Independent, 19 July 2024

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Patient care in hospital corridors is 'now normal'

BBC reporters are at Queens hospital in Romford, east London, and, like many across the capital it is busy. Really busy.

When filming, 17 patients from their A&E were being treated on beds in corridors.

Growing numbers of attendances have meant that what was once an emergency measure has now become the norm.

Ruth Green is the director of nursing for the emergency department and says corridor care has become "customary practice"

When the BBC last filmed the corridor treatments here back in January 2023, the department was seeing 1,400 patients arrive each month by ambulance. Now that number has risen to 2,100.

The number of ambulances arriving every day has gone up in a year too, from around 90 per day to around 120.

Ruth Green, the director of nursing for the emergency department said: "Unfortunately it is now customary practice to have patients treated on our corridors pretty much all of the time, not every day now it’s the summer, but still far too often."

They have had to install new plugs in the corridors so they can operate the hospital beds, new nurse call buttons and a new sink.

One patient in a bed in the corridor is Louis Vella.

He spent 18 hours in A&E after coming in with chest pains and was eventually transferred to a corridor to wait for a bed on a ward.

He said: "It’s not ideal, no, but they are working as best they can with what they’ve got and what else can one ask for?"

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Source: BBC News, 19 July 2024

Related reading on the hub:

A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift

Reflections on a clinical shift: "After 20 years of nursing, this is one of the worst shifts I have ever completed"

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Review finds 418 ‘unnatural, unexpected deaths’ linked to troubled trust

A troubled mental health trust’s internal mortality review has concluded 418 of an estimated 12,503 patient deaths over a four-and-a-half year period were “unexpected and unnatural”.

Norfolk and Suffolk Foundation Trust’s leaders said the findings showed there had been a “much, much smaller” number of avoidable deaths than had been implied by previous reviews and reported by the media in the past.

But the review’s findings were swiftly dismissed by campaigners, who said they had “no confidence” in the new figures, accused the trust of “corporate gaslighting” and renewed calls for a statutory public inquiry.

The review was initiated after a similar exercise by Grant Thornton last June concluded it was not possible to work out how many avoidable deaths there had been because of the trust’s poor data.

A month later, BBC Newsnight reported evidence it had watered down criticism in the Grant Thorton report, with allegations of “weak” and “inadequate” governance in earlier versions of the report removed from the final version. The trust and auditor said the changes were due to “fact checking”.

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Source: HSJ, 18 July 2024

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‘I developed ovarian cancer after my symptoms were dismissed as menopause’

A woman has said her ovarian cancer diagnosis was delayed after her symptoms were wrongly dismissed as menopause or irritable bowel syndrome (IBS) – accusing her doctor of misogyny and medically gaslighting her.

Sbba Siddique, a 55-year-old business owner, told The Independent that “unconscious bias and cultural incompetence” were also to blame for her delayed diagnosis.

Ms Siddique, who lives in Berkshire, said she began to feel unwell around October 2021 but did not get diagnosed with late-stage ovarian cancer until March the following year.

“I was feeling really tired all the time. I had no energy. I was piling on weight that wasn’t there previously despite not changing my eating habits. I was needing to wee more,” the mother of three recalled.

“I was going back and forth with my GP trying to get an appointment. I couldn’t get a face-to-face – every consultation was on the phone or via online forms. That was part of the problem of the misdiagnosis.”

Her GP was “very dismissive” of her symptoms and attributed them to IBS or the menopause, she added.

“At the end of the day, I’m not the expert, the GP is – I believed him,” she said.

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Source: The Independent, 14 July 2024

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Hancock and Hunt failed to prepare UK for pandemic, Covid inquiry finds

The former health secretaries Jeremy Hunt and Matt Hancock have been criticised for their failure to better prepare the UK for the pandemic, in a damning first report from the Covid inquiry that calls for an overhaul in how the government prepares for civil emergencies.

Hunt, who was the health secretary from 2012-18, and Hancock, who took over until 2021, were named by the chair to the inquiry, Heather Hallett, for failing to rectify flaws in contingency planning before the pandemic, which claimed more than 230,000 lives in the UK.

The government had focused largely on the threat of an influenza outbreak despite the fact that coronaviruses in Asia and the Middle East in the preceding years meant “another coronavirus outbreak at a pandemic scale was foreseeable”. Lady Hallett said that to overlook that was “a fundamental error”.

“It was not a black swan event,” Hallett said in a 240-page report. It concluded: “The processes, planning and policy of the civil contingency structures within the UK government and devolved administrations and civil services failed their citizens. Ministers and officials were guilty of ‘groupthink’ that led to a false consensus that the UK was well prepared for a pandemic. Never again can a disease be allowed to lead to so many deaths and so much suffering.”

In what families bereaved by Covid welcomed as a “hard-hitting, clear-sighted and damning analysis of how and why the UK found itself to be fatally underprepared”, Hallett said “preparedness and resilience for a whole-system emergency must be treated in much the same way as we treat a threat from a hostile state”.

The arrival of another pandemic – “potentially one that is even more transmissible and lethal” – was a question of when, not if, she said, and “unless we are better prepared” it would bring “immense suffering and huge financial cost and the most vulnerable in society will suffer most”.

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Source: Guardian, 18 July 2024

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NHS and social care ‘tripping over each other’ on staffing

The NHS should help social care recruit and retain nurses, including with better pay and conditions, particularly for new service models where care staff take on more health tasks.

This is among the recommendations in the first workforce plan for adult social care, published by Skills for Care today, which also warns government must not delay promised improvements in staff pay, standards and conditions, while it waits to decide on funding reform.

The report also recommends a pay uplift for care staff which it estimates would cost between about £2bn and £6bn a year – but it suggests there would be a significant net benefit overall due to reducing turnover costs and increasing care capacity.

The report says integrated care systems should develop joint “one workforce” plans, “align terms and conditions, training and wellbeing support”, and “create the pipeline for registered nurses and nursing associates” to go into care roles.

Nursing turnover in care providers is very high and it is thought nurses often leave for NHS jobs with better pay and conditions. However, nursing staff are increasingly needed to supervise “delegated healthcare tasks” for care users with rising acuity. It is an approach government, and many systems, want to grow as part of integrated teams, such as testing and monitoring in “virtual wards”.

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Source: HSJ, 18 July 2024

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