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NHS leaders warn of service cuts as hospital energy bills soar

Hospital trusts in England face “eye-watering” rises in energy bills of £2m a month each due to the fuel price surge, with NHS leaders saying patients may face longer waiting times or even see their care “cut back” as a result.

NHS trusts are concerned they will have to make critical choices on staff levels and the services they provide in order to keep operating, with energy costs predicted to be as much as three times higher than a year ago.

The BMJ surveyed NHS trusts in England for details of their recent and predicted future energy bills and how they expected to operate this coming winter when taking into account the additional energy charges on the way. Most said they expected their energy bills to double at least.

Rory Deighton, senior acute lead at the NHS Confederation, which represents the whole healthcare system in England, Wales and Northern Ireland, said: “This isn’t an abstract problem, as the gap in funding from rising inflation will either have to be made up by fewer staff being employed, longer waiting times for care, or other areas of patient care being cut back."

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Source: The Guardian, 1 September 2022

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Covid: Pregnant women targeted with false vaccine claims

Covid vaccination advice in pregnancy has not changed, contrary to false social media posts, UK health agencies have clarified.

Inaccurate messages shared by thousands claimed that pregnant or breastfeeding women were now recommended not to take the vaccine.

In fact, the NHS says the vaccine is both safe and strongly recommended for this group.

The misleading claim came from a now out-of-date document from 2020. The document went viral after a Twitter user - whose account has since been suspended - shared a post stating incorrectly that the UK government had, "quietly remove[d] approval for use of Covid vax in pregnant and breastfeeding women".

She linked to a report from December 2020 which said, "reassurance of safe use of the vaccine in pregnant women cannot be provided at the present time", because of an absence of data and that, "women who are breastfeeding should also not be vaccinated".

This was true at the time, but since then data has been gathered finding no link between the vaccine and problems in pregnancy or birth. In fact, the Covid vaccine seems to reduce the risk of still-birth and pre-term delivery.

And unvaccinated pregnant women are more likely to need hospital treatment if they catch Covid, especially in the third trimester.

This evidence led to the recommendation being changed - so the statement found in this report no longer stands.

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Source: BBC News, 1 September 2022

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NHS doctors' paperwork piles up after cyber-attack

Doctors say it could take months to process mounting piles of medical paperwork caused by a continuing cyber-attack on an NHS supplier.

One out-of-hours GP says patient care is being badly affected as staff enter a fourth week of taking care notes with pen and paper.

The ransomware attack against software and services provider Advanced was first spotted on 4 August.

The company says it may take another 12 weeks to get some services back online.

Dr Fay Wilson, who manages an urgent-care centre in the West Midlands, says the main choke point for her team is with patient records.

She said it could affect patient care "because we can't send notifications to GP practices, except by methods that don't work because they require a lot of manual handling, and we haven't got the staff to actually do the manual handling".

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Source: BBC News, 31 August 2022

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Cold homes will cost children’s lives and cause long-term damage, warn experts

Cold homes will damage children’s lungs and brain development and lead to deaths as part of a “significant humanitarian crisis” this winter, health experts have warned.

Unless the next prime minister curbs soaring fuel bills, children face a wave of respiratory illness with long-term consequences, according to a review by Sir Michael Marmot, the director of University College London’s Institute of Health Equity, and Prof Ian Sinha, a respiratory consultant at Liverpool’s Alder Hey children’s hospital.

Sinha said he had “no doubt” that cold homes would cost children’s lives this winter, although they could not predict how many, with damage done to young lungs leading to chronic obstructive pulmonary disease (COPD), emphysema and bronchitis for others in adulthood.

Huge numbers of cash-strapped households are preparing to turn heating systems down or off when the energy price cap increases to £3,549 from 1 October, and the president of the British Paediatric Respiratory Society, also told the Guardian that child deaths were likely.

“There will be excess deaths among some children where families are forced into not being able to heat their homes,” said Dr Simon Langton-Hewer. “It will be dangerous, I’m afraid.”

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Source: The Guardian, 1 September 2022

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Patients fit for discharge stuck in hospital for up to nine months

Medically fit patients are waiting up to nine months to be discharged from some NHS hospitals as increasing numbers of working age people develop more complex conditions amid ongoing social care shortages, HSJ can reveal.

Trust data obtained by HSJ suggests patients at the hospitals which have struggled most with delayed discharges can face delays of many months after a decision has been made that they are fit to leave hospital.

HSJ obtained data from seven trusts which have consistently reported high numbers of delayed discharges through a freedom of information request.

At North Bristol Trust, one patient waited more than nine months to be discharged, while another waited around eight months.

David Maguire, a senior analyst at The King’s Fund think tank, said lengthy delayed discharges often involve patients with highly complex needs, elderly and frail patients, or people with mental health conditions or learning difficulties. But he said there is also a growing number of working age people with chronic and more complex conditions.

He added: “There has always been a large number of older people who will access health care and hospital services. But over the last few years we have seen a growing number of working age people requiring hospital care and social care services. That’s a growing part of the demand which will flow through into who needs discharge from hospital settings.

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Source: HSJ, 31 August 2022

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Staff shortages force most trusts to suspend NHSE maternity care model

More than two-thirds of trusts have been forced to suspend or pause a high-profile service improvement aimed at reducing neonatal and maternal deaths, because of widespread staffing shortages.

HSJ research revealed a majority of trusts have been unable to implement the continuity of carer maternity model, after they were told to look again at whether it could be safely implemented.

The model intends to give women “dedicated support” from the same midwifery team throughout their pregnancy, with a 2016 review saying it would reduce infant and maternal mortality rates and improve care more generally.

It is particularly aimed at improving care for patients from minority ethnic groups and those with other risk factors, and has been championed by Jacqueline Dunkley-Bent, NHS England’s chief midwifery officer. Key targets around the model were included in the 2019 NHS long-term plan.

However, there is consensus nationally that it can only be rolled out safely where there are adequate numbers of staff to do so – otherwise the risks outweigh the benefits.

Earlier this year, the final Ockenden report into maternity care failings at Shrewsbury and Telford Hospital Trust was critical of the model, and said it should be suspended until trusts have enough staff to meet “safe minimum requirements on all shifts”.

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Source: HSJ, 30 August 2022

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Hip fracture care too slow in some hospitals, study says

There are big differences in how well patients with hip fractures are cared for by hospitals in England and Wales, a Bristol University study says.

In some hospitals one in 10 people died within a month of surgery - more than three times worse than in the best.

Getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care. People should receive the same, high-quality care wherever they live, the researchers said.

"If you get it right for older people with hip fractures, you're probably getting it right for older people in general," says Professor Celia Gregson, who led the study of more than 170,700 patients in 172 hospitals between 2016 and 2019.

An NHS spokesperson said hip fracture care in the UK had "seen dramatic improvements in recent years".

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Source: BBC News (31 August 2022)

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AHSN Network Innovate Awards 2022 finalists announced

The finalists for The Innovate Awards 2022 have been revealed following a rigorous round of judging over the summer, and Patient Safety Learning is a finalist in the 'Enabling Safer Systems of Care Through Innovation' category.

In its inaugural year, The Innovate Awards saw a grand total of 194 entries from health and care teams across the country covering ten award categories. The ten eventual winners will also compete for ‘Innovation Champion of the Year’ to be announced on the evening of the award ceremony in September.

Commenting on the awards, Matthew Taylor, Chief Executive, NHS Confederation from NHS Confederation said: “Judges across all the award categories have remarked on how impressive and inspiring the work contained in these submissions has been. It has been a delight to see the wonderful efforts taking place in terms of innovation in the health and care sector and it is hugely important to recognise and celebrate this.”

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Source: AHSN Network (30 August 2022)

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App will let patients avoid long NHS waits

Patients will be able to use the NHS app to shop around for hospitals with the shortest waiting lists in a renewed drive to cut backlogs for routine care.

Health bosses agreed yesterday to give patients more choice over where they are treated by next April in an effort to use digital league tables to direct people towards hospitals with the shortest waits.

Steve Barclay, the health secretary, wants to give patients “real-time data” on their phones to decide whether to travel further to get quicker treatment for hip replacements, cataract removals and other non-urgent procedures.

A government source said: “We don’t need a big bureaucracy to funnel patients towards the hospital which NHS managers decide is best, when, armed with a right to choose and the right information on the app, patients will go where waiting times are lowest.”

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Source: The Times (31 August 2022)

 

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Almost 1.5m patients lose their GP as hundreds of practices close

Nearly 1.5 million patients have lost their GP in the last eight years after the closure of almost 500 practices, research has suggested.

Issues around recruitment were a factor in the closure of about two-fifths of the surgeries, while workloads and inadequate premises were also cited as triggers.

The investigation, by Pulse magazine, revealed for the first time the number of premises that have closed for good since 2013. Previously, research has identified the number of practices where GP partners have returned their contracts, or certain branches have closed or merged with others.

Prof Martin Marshall, the chairman of the Royal College of GPs, said: “The impact of a practice closing on its patients and neighbouring practices can be considerable. As such, a decision to close a practice will be one of the most difficult a GP partner can make. When the reason for closing a practice is workload pressures, and not being able to fill vacancies, then this needs to be addressed as a matter of urgency.”

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Source: The Telegraph (29 August 2022)

 

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The Valproate Families: The stories of the families affected by Sodium Valproate in Ireland

Major concerns are being raised about the Irish State’s failure to set up an inquiry into a drug that caused serious birth defects and developmental delays in at least 1,200 Irish babies.

Sodium valproate, a drug used to treat epilepsy and bipolar disorder, has been estimated to have caused major malformations in up to 341 Irish children between 1975 and 2015 after it was taken by their mothers during pregnancy.

The drug, which is sold in Ireland as Epilim, is also believed to have caused neuro-developmental delays in 1,250 children.

Many women were never warned of the risks that taking the drug during pregnancy would pose to their babies.

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Source: The Irish Independent

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U.S. life expectancy falls again in ‘historic’ setback

The average life expectancy of Americans fell precipitously in 2020 and 2021, the sharpest two-year decline in nearly 100 years and a stark reminder of the toll exacted on the nation by the continuing coronavirus pandemic.

In 2021, the average American could expect to live until the age of 76, federal health researchers reported on Wednesday. The figure represents a loss of almost three years since 2019, when Americans could expect to live, on average, nearly 79 years.

The reduction has been particularly steep among Native Americans and Alaska Natives, the National Center for Health Statistics (NCHS) reported. Average life expectancy in those groups was shortened by four years in 2020 alone.

“Even small declines in life expectancy of a tenth or two-tenths of a year mean that on a population level, a lot more people are dying prematurely than they really should be,” said Robert Anderson, chief of mortality statistics at the NCHS.

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Source: The New York Times (31 August 2022)

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NHS waiting lists hiding 10m patients in need of follow-up care

More than ten million patients are on “hidden” waiting lists for NHS care.

There are 6.7 million patients on the official NHS waiting list, which includes people who have been referred by GPs for hospital treatment such as cataract or hip and knee surgery.
However, data released by health service trusts under freedom of information laws suggests there are 10.3 million further patients who need follow-up care, illustrating the scale of the task facing the NHS.

Louise Ansari, national director at the patient group Healthwatch England, said: “Waiting a long time for treatment can put a huge strain on patients and their loved ones. But this can be so much worse when there is ‘radio silence’ from the NHS, leaving people uncertain if their referral has been accepted, unclear about how long they may have to wait and often feeling forgotten.”

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Source: The Times (30 August 2022)

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Patients waiting for surgery going to A&E because they 'can't cope'

Patients waiting for surgery are turning up at A&E because they “can't cope”, the head of the NHS Confederation has warned.

Matthew Taylor, chief executive of the body which represents all areas of the health service, said the NHS was in a "terrible situation" where it was facing "more demand than we can deal with".

Some 6.7 million people are waiting to start hospital treatment after being referred by their GP, latest official data show. Urgent and emergency care is also under significant pressure, with 12-hour A&E waits increasing by a third in July to reach 29,317 - the worst on record.

"We also know that people, many people, who are sick in the community waiting for operations, for example, and that's one of the reasons people end up in the emergency department because they get to the stage where they can't cope,” Mr Taylor said. "So the problem is that pressures in one part of the system drive pressure in others.”

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Source: The Telegraph (30 August 2022)

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Northern Ireland: Doctors considering quitting health service over pay, says BMA

A proposed pay settlement is making doctors consider leaving the health service, the British Medical Association (BMA) in Northern Ireland has said.

In a BMA survey of more than 1,000 doctors, 85% of respondents said the proposed uplift of 4.5% was too low.

The representative body said discontent was very high among junior doctors with 93% of them saying it was too low.

"When asked about their intentions as to the likelihood of them continuing to work in Northern Ireland, junior doctors said they were now more likely to leave because of the low pay award," said the BMA.

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Source: BBC News (31 August 2022)

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Flu could ‘bite’ as early as October, NHS leaders and scientists warn

Flu could “bite” months earlier than usual this year, NHS leaders and scientists have warned, leading to calls for millions to get their vaccination against the disease as soon as possible.

Around 20 million people in the UK, including all over-50s, will be offered a free jab this winter, as ministers fear the combination of a bad flu season, Covid and a cost of living crisis could lead to a spike in deaths.

Saffron Cordery, the interim chief executive of NHS Providers, which represents trusts in England, warned that this year flu had “come early and severely to parts of the southern hemisphere, and we’re going see it here potentially biting in October”.

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Source: The Independent (30 August 2022)

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Britain falls out of love with the NHS: poll reveals three in five now expect delays

People no longer believe the NHS will treat them quickly if they fall ill, according to new polling showing wide dissatisfaction about the state of the health service.

With hundreds of ambulances stacked outside overstretched A&E departments and patients languishing on record waiting lists, voters are far more likely to say the service has worsened than improved in the last year.

Fifty-eight per cent are not confident they would receive timely treatment from the NHS if they fell ill tomorrow, with 36 per cent not confident at all and 22 per cent just not confident. Meanwhile, 45 per cent believe the service they receive has worsened in the past 12 months. Just over half think it has become harder to get an appointment with their local doctor while 41 per cent think their local GP service has worsened.

Robert Ede, head of health and social care at the Policy Exchange think tank, said: “It is concerning to see that a majority of the public don’t believe they would receive timely treatment from the NHS if they became ill tomorrow. There is a risk that the perception of a service in crisis beds in and actually leads to a complete erosion in public confidence."

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Source: The Times (27 August 2022)

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Revealed: ‘disturbing’ race divide on cancer patients’ wait times in England

Black and Asian people in England have to wait longer for a cancer diagnosis than white people, with some forced to wait an extra six weeks, according to a “disturbing” analysis of NHS waiting times.

A damning review of the world’s largest primary care database by the University of Exeter and the Guardian discovered minority ethnic patients wait longer than white patients in six of seven cancers studied. Race and health leaders have called the results “deeply concerning” and “absolutely unacceptable”.

The analysis of 126,000 cancer cases over a decade found the median time between a white person first presenting symptoms to a GP and getting diagnosed is 55 days. For Asian people, it is 60 days (9% longer). For black people, it is 61 days (11% longer).

Michelle Mitchell, the chief executive of Cancer Research UK, which funded the research, said that while the differences are “unlikely to be the sole explanation for the inequalities in cancer survival”, at the very least “extended wait times may cause additional stress and anxiety for ethnic minority patients”.

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Source: The Guardian (28 August 2022)

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‘Vaccine fatigue’ could hit autumn Covid boosters

Britain faces a low uptake of the Covid booster jab this autumn amid “vaccine fatigue” and complacency about the virus, the new Pfizer boss has warned.

The booster campaign starts next week, with care home residents and the housebound the first to be invited. Over-75s and the clinically vulnerable will be able to book appointments from September 12, with a wider rollout for over-50s taking place in phases. Roughly 26 million in England will be eligible.

Susan Rienow, who was appointed UK managing director at Pfizer in February, said: “We have to remain vigilant. I recognise there may be some vaccine fatigue in the population. But making sure that people are boosting their immunity, so that we can prevent people from being hospitalised, is going to be really important.”

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Source: The Times (28 August 2022)

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Biden administration plans for new booster campaign soon after labor day

The Biden administration plans to offer the next generation of coronavirus booster shots to Americans 12 and older soon after Labor Day, a campaign that federal officials hope will reduce deaths from Covid-19 and protect against an expected winter surge.

Dr. Peter Marks, the top vaccine regulator for the Food and Drug Administration, said in an interview on Tuesday that while he could not discuss timing, his team was close to authorizing updated doses that would target the versions of the virus now circulating.

Even though those formulations have not been tested in humans, he said, the agency has “extremely good” data showing that the shots are safe and will be effective. “How confident am I?” he said. “I’m extremely confident.”

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Source: The New York Times (23 August 2022)

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Parts of England have one NHS dentist for thousands of people, data shows

Dental patients are still suffering from the fallout of the Covid-19 pandemic, as parts of England are left with only one NHS dentist for thousands of people.

In North Lincolnshire, there were just 54 NHS dentists – equivalent to one for every 3,199 people – at the end of March, NHS Digital figures show. This means every NHS dentist in the area would have to work nine-hour days every working day of the year without holidays for each resident to receive one annual checkup on the NHS.

Across England, 24,272 dentists treated some NHS patients in the year to 31 March – up 2.3% from the previous year, broadly in keeping with the general population increase in the same period, but lower than pre-pandemic figures for the three previous years.

The chair of the British Dental Association, Eddie Crouch, said the service was “on its last legs” and the figures underlined the need for radical and urgent change. “The government will be fooling itself and millions of patients if it attempts to put a gloss on these figures,” said Crouch. “NHS dentistry is light years away from where it needs to be. Unless ministers step up and deliver much-needed reform and decent funding, this will remain the new normal.”

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Source: The Guardian (25 August 2022)

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Boy, 17, found dead after seeking mental health help ‘had not seen GP in person’

A coroner has expressed concern at the difficulty of getting face-to-face appointments with GPs and other health professionals after a 17-year-old boy suffering from mental health problems was found dead.

Sean Mark, who described himself as an “anxious paranoid mess”, was desperate for help but felt “palmed off” when he asked for assistance, an inquest heard. He was found dead in his bedroom four months after a phone consultation with a GP and before he had spoken to anyone in person about his concerns.

The area coroner, Rosamund Rhodes-Kemp, recorded a verdict of death by misadventure, saying she could not be sure Sean had intended to kill himself.

Dr Robin Harlow, clinical director of the Willow Group, where Sean Mark was a patient, said it had increased the number of face-to-face meetings. When told that Sean felt palmed off, he said: “I would want him to be seen face to face at the second time, if not the first time. We have seen a lot more face-to-face appointments since then.”

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Source: The Guardian (23 August 2022)

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Leaked report shows ‘long-standing’ bullying and discrimination within national agency

Internal documents show significant evidence of bullying and discrimination within NHS Blood and Transplant (NHSBT) which dates back at least eight years, when the organisation was led by the current chief executive of the Care Quality Commission.

HSJ has seen a report which detailed major tensions and dysfunction at NHSBT’s Colindale site in north London in 2016, four years before another report found similar problems.

Given the damning findings of the second report, in 2020 – which found a “toxic environment”, multiple accounts of bullying, and “systemic racism” at the same site – it raises questions around the actions taken by NHSBT’s former leaders, including current CQC boss Ian Trenholm, to address the issues raised in the 2016 report.

The 2016 report was commissioned by the manufacturing directorate and concluded the hospital services department at the Colindale site was “dysfunctional” after a highly contentious reorganisation of some services and teams.

It noted “a series of bullying and harassment incidents” were being reported, but which staff felt were not investigated appropriately, and claims of “discriminatory practice” by managers.

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Source: HSJ, 26 August 2022

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Dr Ted Baker named as preferred candidate for Chair of HSSIB

Dr Ted Baker has been named as the government’s preferred candidate for chair of the Health Services Safety Investigations Body (HSSIB).

Steve Barclay, the Secretary of State for Health and Social Care, has today (26 August 2022) invited the Health and Social Care Committee to hold a pre-appointment scrutiny hearing with Dr Baker.

Ted Baker was Chief Inspector of Hospitals at the Care Quality Commission between 2017 and 2022. He trained as a paediatric cardiologist. He was in clinical practice for 35 years and has held a range of clinical and academic leadership roles including medical director at Guy’s and St Thomas’ NHS Foundation Trust.

He was selected following an open public appointment process.

Following the select committee hearing, the committee will set out its views on the candidate’s suitability for the role. The Secretary of State will then consider the committee’s report before making a final decision on the appointment.

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Source: HSIB, 26 August 2022

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Private mental health unit scrutiny recommended by Norfolk committee

A report into the care of three women at a former mental health unit has recommended greater monitoring and scrutiny of private provision.

The Norfolk Safeguarding Adults Board (NSAB) review focused on care given to women known as L, M and N, who lived at Milestones Hospital near Norwich.

The women, in their 20s, were found to have visited accident and emergency 53 times, mostly due to self-harm. The unit shut down last year and the company that run it has been dissolved.

Heather Roach, chair of NSAB, said: "When vulnerable patients are placed in hospitals like Milestones, it's vital that our whole system works together to keep them safe. This review has shown that there are gaps in the monitoring of private provision, particularly when patients are placed in Norfolk from out of our county."

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Source: BBC News (25 August 2022)

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