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Long delays to NHS care for children in England ‘creating forgotten generation’

Thousands of children’s lives are being blighted by shocking delays to NHS care of up to three years, according to a report that warns a “forgotten generation” will suffer long-term harm as a result.

The health service is struggling to cope with rapidly rising demand for increasingly complex and acute care needs among children and young people, the research by NHS Providers shows.

Health leaders say the crisis in England is so severe that there is now “deep concern” that lifelong, permanent harm is being caused by crippling delays to NHS care. Long waits for basic healthcare are derailing children’s development, educational attainment and mental health, they revealed.

One trust reported that waiting times for children’s autism assessments had risen from about 14 months before the Covid-19 pandemic to 38 months today. Children are also being forced to wait too long for essential speech and language therapy, hearing tests, medical treatment and surgery.

“Too many young lives are being blighted by delays to accessing vital NHS care,” said Sir Julian Hartley, the chief executive of NHS Providers. “We’re in danger of seeing a forgotten generation of young people.”

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Source: The Guardian, 15 July 2024

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'Staggering shortfall’ of NHS staff as record number of patients wait for tests

The waiting lists for diagnostic tests, including cancer scans, is at a record high in NHS England, with doctors warning of a “staggering shortfall” of clinical radiologists.

Figures published on Thursday reveal the diagnostic waiting list stands at 1,658,221 – twice what it was 10 years ago. Nearly 500,000 patients are waiting for CT scans and MRIs.

The figures show the scale of the task facing the new health secretary, Wes Streeting, who has ordered a review into the NHS. Labour pledged in its manifesto to double the number of scanners, but doctors warn there is an urgent need for more staff to operate them and read the resulting scans.

“The NHS is broken,” a spokesperson for the Department of Health and Social Care said in response to the figures. “Waiting lists are too high and patients have not been able to access the care they desperately need.

“The longer patients wait for tests and scans, the worse their outcomes will be. We’ve got to get patients diagnosed much earlier.”

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Source: The Guardian, 14 July 2024

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‘Likely’ supplier for ‘first of its kind’ EPR revealed

An integrated care board has named Oracle Health as the “likely” supplier of an electronic patient record that will be the first to be used across acute, mental and health services.

Mid and South Essex Integrated Care Board is planning to procure a single electronic patient record for both its sole acute, Mid and South Essex Foundation Trust and mental health and community service provider Essex Partnership University Trust. 

Details of the move were revealed in the integrated care system’s “joint forward plan” for 2024-2029 which was presented to the ICB’s July board.

Mid and South Essex Foundation Trust – which was formed by a merger of three trusts – currently uses seven different EPRs, while Essex Partnership University Trust has three. The new unified EPR is expected to go live in 2026-2027.

NHS England has encouraged ICSs to “converge” their EPR system for over two years. A number of acute trusts operating within the same system have already launched plans to share the same EPR. This includes Bath and North East Somerset, Swindon and Wiltshire and Norfolk and Waveney.

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Source: HSJ, 12 July 2024

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Hip and knee replacements on NHS four times longer than in Italy

Waiting times for hip and knee replacements are four times longer in England than Italy post-lockdown, analysis has revealed.

Patients in England are waiting an average of 128 days for hip replacements and 141 days for a new knee on the NHS, which are both up by around 50 per cent since before the pandemic.

It leaves England lagging behind other European countries, with waits that are four times longer than Italy, where hip replacements are completed in 33 days and knees within 30 days, according to analysis by the Nuffield Trust.

Sarah Reed, senior fellow at Nuffield Trust and author of the report, said countries around the world were “dealing with the effects of the Covid-19 pandemic, with many still struggling to bring down waiting times”.

“However, it’s striking that in England our pace of recovery has been much slower for major surgeries like hip and knee replacements, but for some minor procedures we appear to have improved more quickly than nearly everywhere else,” she said.

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Source: The Telegraph, 11 July 2024

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Girl died after missed opportunities, inquest finds

There were "missed opportunities" to treat a four-year-old girl who visited A&E and a GP in the 48 hours before her death, an inquest jury has concluded.

Makenna-Rose Thackray died on 20 December 2022 after stopping breathing and going into cardiac arrest.

She was taken to Wakefield's Pinderfields Hospital by ambulance two days earlier but went home after her family endured a fruitless six-hour wait for treatment. They visited a GP the following day and were sent home without antibiotics.

A lawyer for Makenna-Rose's family said the evidence showed the girl's death was "entirely preventable".

On 18 December Makenna-Rose had been taken to children's A&E but the inquest heard the two nurses on shift that night dealt with almost 80 children, instead of the 30 to 40 which could have been safely treated.

Earlier in proceedings, one of the nurses on shift that night, Helen Parker, described the shift as "one of the worst" and when asked if they were under-staffed, replied: "Absolutely, yes."

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Source: BBC News, 11 July 2024

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Threefold ICS variation in GP phone access revealed

Patients trying to reach their GP are almost three times as likely to fail to get through in the worst-performing integrated care systems (ICS) than the best, according to analysis of new annual figures. 

The data is from NHS England’s annual GP patient survey, which has a large sample size, and is considered one of the best measures of GP access and experience.

In Birmingham and Solihull and Black Country, 7% of patients said their calls went unanswered — significantly lower than the best-performing systems at 2%, and the national average of 4%.

Some more urban and racially diverse areas tended to do worse on key GP access measures – such as Birmingham, the Black Country, large parts of London, Greater Manchester, and Bedfordshire, Luton and Milton Keynes – although more rural patches like Northamptonshire and parts of the South West also have big problems.

NHSE said in a statement: “NHS staff have worked incredibly hard to cope with increased demand for patient care, but this survey makes it clear there is much more to do to improve patient’s satisfaction and experience in accessing primary care services.”

It will work with the government to “tackle the issues that matter most to patients” including long-term conditions, continuity of care and patient access, it added. 

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Source: HSJ, 12 July 2024

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Paralysed woman inspires mammogram robot

A woman who is paralysed from the chest down is helping scientists in York develop a robot so people with mobility issues can receive breast screening.

Jane Hudson, 53, from Harrogate, was unable to get an accurate mammogram because she could not get into the right position for the X-ray machine. She was diagnosed with breast cancer a few months later.

Scientists at the University of York have now started working on a prototype robotic arm system which will support the patient's upper body weight.

Ms Hudson said: "I've faced many difficulties and challenges in the wheelchair and you do sometimes feel like you don't get listened to, so for something positive to come out of this is great."

Ms Hudson was invited for a mammogram at York Hospital because it was accessible but she was unable to position herself correctly in the machine for an X-ray to take place.

She said: "I did feel really humiliated. It takes a lot to upset me and I did feel very upset when I left the hospital that day because I just felt this is a regular screening for any woman and yet again a disability is stopping that from happening."

A few months later Jane was diagnosed with stage 3 breast cancer which had spread to her lymph nodes.

"That's when I started thinking if this had been picked up earlier maybe it wouldn't have spread," she said.

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Source: BBC News, 11 July 2024

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NHS patients raising safety concerns too often ‘fobbed off’, says commissioner

NHS patients raising safety concerns are too often “gaslighted”, “fobbed off” or dismissed as “difficult women”, according to England’s patient safety commissioner, who criticised health leaders for a “relentless focus” on finance and productivity.

Dr Henrietta Hughes said patients and loved ones sounding the alarm about substandard care should be an early indicator of danger or potential harm, but far too frequently they were completely ignored. NHS trusts focusing too much on budgets meant that “the culture becomes toxic, and we’re just on the road back to the Mid Staffs scandal”, she added.

Hughes was referring to the failures at Mid Staffordshire NHS foundation trust, where hundreds of patients were neglected, dismissed or ignored between 2005 and 2009. Some were left lying in their own urine, unable to eat, drink or take essential medication.

“The patient’s anecdote is the canary in the coalmine,” she said. “It’s the thing that tells us there’s something going wrong. But too often we hear about patients who have raised concerns being gaslighted, dismissed, and fobbed off.”

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Source: The Guardian, 10 July 2024

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Some smear test scientists investigated over screening

A small number of biomedical scientists are being investigated following fitness to practise concerns relating to cervical screening in the Southern Trust, BBC News NI understands.

In October 2023, it emerged smear tests of more than 17,000 women in the trust would be re-checked as part of a review dating back to 2008.

It is understood that some of the women affected have since referred the matter to the Health and Care Professions Council (HCPC) which investigates concerns about the practice of a professional on its register.

Stella McLoughlin from Newry, who is one of the 17,500 women affected by the re-check, said the review process has left her feeling “very afraid, fragile, and angry”.

Following news that other women in her position have referred the matter to the HCPC, she said there needs to be an investigation.

"I don't know why they're calling it a review because to me this is a scandal. This has affected so many women," she said.

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Source: BBC News, 11 July 2024

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Wes Streeting to ‘write prescription’ for NHS after independent investigation

An independent investigation will be held into the performance of the NHS, the health secretary has announced.

Writing in the Sun, Wes Streeting said the investigation would be aimed at “diagnosing the problem” so the government could “write the prescription”.

Streeting said: “It’s clear to anyone who works in or uses the NHS that it is broken. Unlike the last government, we are not looking for excuses. I am certainly not going to blame NHS staff, who bust a gut for their patients.

“This government is going to be honest about the challenges facing us, and serious about solving them.”

Streeting said the investigation would be led by the former health minister Lord Ara Darzi, who he has asked to “tell hard truths”.

Streeting said: “Honesty is the best policy, and this report will provide patients, staff and myself with a full and frank assessment of the state of the NHS, warts and all.

“The NHS has been wrecked. This investigation will be the survey, before we draw up plans to rebuild it anew, so it can be there for all of us when we need it, once again.”

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Source: The Guardian, 11 July 2024

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Eye doctors say private cataract operations have hurt the NHS

The vast majority of eye doctors believe increased outsourcing of cataract operations to private clinics in England in recent years has negatively affected their NHS departments, research has found.

Almost three-quarters of ophthalmologists surveyed said that outsourcing of cataracts to the private sector had a negative impact on their NHS eye care departments, with 54% flagging a large negative impact and 16% a small one.

The survey of 200 eye doctors by the Centre for Health and the Public Interest (CHPI), shared with the Guardian, came after Wes Streeting, the new health secretary, pledged to divert billions of pounds from hospitals to GPs to “fix the front door to the NHS” and met junior doctors on Tuesday to try to end a long-running pay dispute.

Nearly 60% of the ophthalmologists polled said outsourcing had a negative impact on NHS staffing, 62% said the same for staff training, and 46% said it harmed the ability of public eye care departments to treat patients with more complex conditions. Issues raised about staffing included the loss of consultants, nurses and optometrists to the private sector.

While eye care budgets have increased by only 15% at 43 NHS trusts over the past five years, ophthalmology spending has gone up by 52%, partly due to a surge in the number of cataract operations, research from the CHPI showed. Hundreds of thousands more NHS patients a year are having cataracts removed in England in a boom driven by private clinics but funded by taxpayers.

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Source: The Guardian, 10 July 2024

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Transfusion never events just ‘tip of iceberg’ at troubled trust

Fourteen never events recorded at University Hospitals Birmingham Foundation Trust’s transfusion service were the “tip of an iceberg”, an external review has concluded.

The Royal College of Physicians (RCP) investigation, obtained by HSJ, reveals the service saw more than 150 additional “adverse events” recorded in just three months.

The review of the service’s activities between 2019 and early 2023 also concluded there had been “inaction” at senior management level on addressing the problems and that there was a lack of understanding among senior leaders about the significance of the risks posed by the service. 

The RCP report said it was unlikely the reviewed never events “comprised the totality” of transfusion errors by the service and concluded that they were in fact just the “tip of an iceberg” of the errors made by the service.

These included seven incidents of the wrong blood being stored in tubes and a patient “with childbearing potential” incorrectly transfused in accident and emergency with group O RhD positive blood. This risks the patient’s antibodies attacking a future unborn baby if the foetus is RhD positive. 

ABO-incompatible blood transfusions have a potential for significant morbidity and mortality and are “wholly preventable”, according to NHS Blood and Transplant.

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Source: HSJ, 10 July 2024

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Ambulance handover delays still harming tens of thousands each month

Tens of thousands of patients are still suffering harm from delays in ambulance handovers to emergency departments despite a concerted effort to tackle the problem, figures seen by HSJ indicate.

The data shows more hours have been lost to handover delays lasting more than 15 minutes in most of the first five months of 2024 compared to the same period in 2023. In May, more hours were lost than in May 2022 and May 2023. 

The Association of Ambulance Chief Executives told HSJ the problem remained severe and the government needed to act to improve it.

AACE managing director Anna Parry said it had consistently warned about the ongoing risk of handover delays.

She said: “This is why one of our key requests of the new government has been that they proactively support the ambulance sector’s aim to ensure patients universally receive high-quality, timely care and no longer experience unacceptable delays in response or handover of care, for example, at hospital emergency departments.

“This problem is not intractable. We have demonstrated that in areas where there is a strong leadership focus and true system-wide support, handovers can be managed effectively, despite the significant pressures and constraints our health and social care system is under. However, it remains vital that we see more demonstrations of excellent leadership to get to that point across the country.”

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Source: HSJ, 10 July 2024

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Wes Streeting pledges billions to GPs in order to ‘fix front door’ of NHS

Ministers will divert billions of pounds from hospitals to GPs to “fix the front door to the NHS”, Wes Streeting has promised as he said millions of patients will be able to see the same family doctor at every appointment.

The health secretary made his first major policy announcement as he prepared to begin vital talks with junior doctors on Tuesday, aimed at finally ending the strikes that have crippled the health service since 2022.

Less than 10% of the £165bn NHS budget in England is spent on primary care, and that share has been falling, despite record high demand at GP surgeries. In a significant policy shift, Streeting on Monday said he would reverse that trend and boost the proportion of the budget for primary care so patients could access help sooner.

More than 5 million patients a month in England are waiting longer than a fortnight for a GP appointment after the previous government promised everyone would be able to get one within 14 days.

After visiting Abbey Medical Centre, a GP surgery in St John’s Wood, London, Streeting said: “Patients are finding it harder than ever to see a GP. Patients can’t get through the front door of the NHS, so they aren’t getting the timely care they need.

“That’s no surprise, when GPs and primary care have been receiving a smaller proportion of NHS resources. I’m committed to reversing that.”

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Source: The Guardian, 8 July 2024

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NHS urged to prioritise cancer care basics over tech and AI ‘magic bullets’

The NHS must concentrate on the basics of cancer treatment rather than the “magic bullets” of novel technologies and artificial intelligence, or risk the health of thousands of patients, experts have warned.

In a paper published in the journal Lancet Oncology, nine leading cancer doctors and academics say the NHS is at a tipping point in cancer care with survival rates lagging behind many other developed countries.

The NHS has not met its target for 85% of cancer patients to start treatment within two months since December 2015. International research shows that every four weeks of delay in treatment increases the risk of death by up to 10%. It means hundreds of thousands of people have to wait months to start essential cancer treatment, and only 67% begin treatment within 62 days.

The paper highlights 10 pressure points that are contributing to entrenched cancer survival inequalities, diagnosis and treatment delays, and inappropriate care.

In a sharply worded warning, the cancer experts say “novel solutions” such as new diagnostic tests have been wrongly hyped as “magic bullets” for the cancer crisis, but “none address the fundamental issues of cancer as a systems problem”.

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Source: The Guardian, 8 July 2024

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Fall after fall - care home accused of neglect

The daughter of an elderly care home resident who suffered 32 falls in only 11 months said she had sent social services "a begging email" to warn her mother "was going to die" unless urgent improvements were made.

"She suffered neglect in every way - it was devastating to see," said Kylie Gobin, whose mother Winifred Tubb lived at St Luke's in Runcorn, Cheshire.

Mrs Gobin spoke to the BBC as part of an in-depth investigation which found nearly one in five care homes across England were rated as either "requiring improvement" or "inadequate".

A spokesman for Halton Borough Council, which operates St Luke's, said it had "fully investigated" the complaints and "some lessons have been learnt".

BBC England's data journalism team analysed Care Quality Commission (CQC) statistics and found the regulator now regards more than 2,500 care homes across England as "requiring improvement".

The number of "inadequate" homes stands at 194 across England, but this figure is down on both 2022 and 2023.

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Source: BBC News, 9 July 2024

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‘Dysfunctional’ culture at UK nursing regulator is safety threat, review warns

A “dysfunctional” culture at the UK nursing regulator is threatening public safety, according to a damning report that found the Nursing and Midwifery Council (NMC) took seven years to strike off a nurse who had been accused of rape and sexual assault.

Staff at the regulator broke down in tears “as they recounted their frustrations over safeguarding decisions that put the public at risk”, according to the authors of an independent review of the regulator.

The review team highlighted a “toxic culture” at the NMC, with one former employee describing their section of the organisation as a “hotbed of bullying, racism and toxic behaviour”.

The report also shone a spotlight on suicides by nurses caught up in long drawn-out fitness to practise investigations, highlighting how some nurses had been under investigation for nearly 10 years.

The authors commented on the NMC’s backlog of 6,000 cases, which meant some nurses were forced to wait four or five years for their investigation to be completed, even though some cases were “baseless complaints where no further action is required”.

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Source: The Guardian, 9 July 2024

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Lucy Letby sentenced to 15th whole life term

Former nurse Lucy Letby has been sentenced to another whole life term for trying to kill a premature baby girl.

The 34-year-old is already in jail for murdering seven babies and attempting to murder six others at the Countess of Chester Hospital between June 2015 and June 2016.

On Tuesday, she was found guilty of trying to murder another girl, known as Baby K, following a retrial.

Letby had refused to go up to the dock to be sentenced to 14 whole life terms last August, but was in the dock earlier to be handed her 15th.

Her original murder trial jury acquitted her of two counts of attempted murder, and there were six further charges on which jurors could not decide, including that concerning Baby K.

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Source: BBC News, 5 July 2024

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Fix NHS gaps or face more attacks - ex cyber chief

A leading cybersecurity expert has warned that the NHS remains vulnerable to further cyber-attacks unless it updates its computer systems.

This stark assessment comes in the wake of a major ransomware attack that has severely disrupted healthcare services across London.

Prof Ciaran Martin, the founding CEO of the UK's National Cyber Security Centre (NCSC), told the BBC: "I was horrified, but not completely surprised. Ransomware attacks on healthcare are a major global problem."

NHS England said it was increasing its cybersecurity resilience and had invested £338m in the past seven years addressing this issue.

But Prof Martin's warnings suggest more urgent action may be needed.

He highlighted three critical issues facing NHS cybersecurity: outdated IT systems, the need to identify vulnerable points, and the importance of basic security practices.

He warned: "In parts of the NHS estate, it's quite clear that some of the IT is out of date."

He stressed the importance of identifying "single points of failure" in the system and implementing better backups.

Prof Martin also emphasised that improving basic security measures could significantly hinder attackers, stating: "Those little things make the point of entry quite a lot harder for the thugs to get in."

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Source: BBC News, 8 July 2024

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Much of NHS in England ‘does not take obesity seriously enough’

Much of the NHS does not take obesity seriously enough, despite it being an unfolding health disaster that costs the UK £98bn a year, says a report.

Only five of England’s 42 integrated care boards (ICBs) – regional groupings of NHS trusts which coordinate care over wide areas – have made tackling obesity or sticking to a healthy weight one of their top priorities, according to the Future Health thinktank.

Its analysis found that the other 37 ICBs did not identify obesity as a key issue in their forward plans, which set out what they see as the most pressing issues over the next five years.

“Too many parts of the NHS are giving obesity too little priority,” said Richard Sloggett, the report’s author, a former special adviser at the Department of Health and Social Care.

“Given what a huge and worsening problem obesity is – for individuals, the NHS, society at large and also its impact on the economy – I was concerned to see that so few NHS bodies regarded tackling it as one of their key priorities,” he added.

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Source: The Guardian, 7 July 2024

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Public safety endangered by ‘toxic’ nursing regulator as staff ‘gaslighted’ after raising alarm

A damning report into the UK’s nursing and midwifery regulator will find the body is endangering the public due to its toxic culture and failing to address widespread racism within its ranks, The Independent can reveal.

An explosive review into allegations that the Nursing and Midwifery Council (NMC) has a “deep-seated toxic culture” is set to be published next week and concerns over public safety will be one of many shocking revelations it will deliver, The Independent understands.

Staff who have given evidence to the report and also spoken to The Independent, have reported being “gaslighted” and intimidated or bullied when trying to report concerns about public safety to leaders.

The review, carried out by Nazir Afzal, a former chief crown prosecutor, and Rise Associates, was commissioned following reports by The Independent revealing whistleblower allegations that racism and sexism within the NMC are leading to complaints against nurses going “unchecked”.

The review covers responses from around 1,000 staff and former staff, who were asked about the organisation’s culture in a survey, and hundreds of staff interviews.

The Independent understands the review has found evidence supporting the whistleblowers’ accusations.

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Source: The Independent, 7 July 2024

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Trust ‘forced out’ senior doctor who raised safety concerns

A prestigious teaching hospital constructively dismissed the head of its transplant unit after he raised safety concerns about Great Ormond Street Hospital, a tribunal heard.

An employment judge ruled Professor Nizam Mamode had been constructively dismissed by Guy’s and St Thomas’ Foundation Trust, who employed him as their clinical lead for adult and peadiatric transplants.

GSTT suspended Professor Mamode from practising in June 2020 and removed him from his leadership role, saying his behaviour had caused relationships with colleagues to break down.

Professor Mamode told the tribunal these complaints had been made after “collusion” with GOSH after he had raised safety concerns with that trust’s medical director Sanjiv Sharma.

He claimed another consultant at GOSH, where Professor Mamode held an honorary post, had put a patient at risk. These concerns prompted a review of the renal transplant service between January and March 2020. HSJ asked GOSH for the result of this review and the trust said “no immediate safety concerns were found”.

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Source: HSJ, 8 July 2024

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Biggest ever fall in maternal smoking after NHS prevention scheme expanded

Last year saw the biggest ever fall in the proportion of mothers smoking during pregnancy, which campaigners have attributed to expansion of a “stop smoking” programme in maternity services. 

Newly published figures for this key public health indicator show the figure dropped by more than a percentage point from 2022-23 to 2023-24, for the first time since 2007-8. The absolute fall in mothers recorded as smoking at the time of delivery was about 6,300.

Anti-smoking charities said it ”follows sustained investment to provide better quit support” and “shows what can be done with proper investment in evidence-based support”.

Much of the new intervention work is done by midwives, and Royal College of Midwives professional policy advisor Clare Livingstone said the drop was “a testament to the dedication and hard work of our maternity services” which had “integrat[ed] smoking cessation support into routine care”.

NHS England’s director for prevention and long-term conditions Matthew Fagg said the reduction was “fantastic” and added: ”With almost all NHS maternity services now offering support to help expectant mums quit smoking… this will protect the health of mums and babies and will help reduce inequalities in outcomes.”

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Source: HSJ, 4 July 2024

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Popular weight-loss jabs Ozempic and Wegovy linked to rare condition that can cause blindness

Popular weight-loss jabs have been linked to an eye condition that can cause blindness.

People with diabetes prescribed semaglutide (brand names Wegovy and Ozempic) were more than four times more likely to be diagnosed with a condition called non-arteritic anterior ischemic optic neuropathy (NAION), according to a new study.

Meanwhile, people who were overweight or obese prescribed the drugs were more than seven times as likely to develop the condition as those on other weight-loss medicines.

NAION, which is uncommon, occurs from a lack of sufficient blood flow to the optic nerve. People typically suffer sudden vision loss in one eye, without any pain, and patients often notice the issue on waking up.

There are no current treatments for NAION and vision often does not improve.

The new study, published in JAMA Ophthalmology, was led by Joseph Rizzo, a professor of ophthalmology at Harvard Medical School in the US.

He said: “The use of these drugs has exploded throughout industrialised countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk.

“It is important to appreciate, however, that the increased risk relates to a disorder that is relatively uncommon.”

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Source: The Independent, 5 July 2024

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Maternity staff faced racism from colleagues

Maternity staff at an NHS trust faced racism from their own colleagues, a Care Quality Commission (CQC) report said. The problem was identified at both the Luton and Dunstable (L&D) and Bedford hospitals during an inspection.

Some ethnic minority overseas staff told the CQC discrimination had become "normalised".

The regulator was alerted to concerns around the safety, culture, and management of the service by whistleblowers.

On the first day of the inspection, last November, the Luton and Dunstable Hospital's maternity unit was at full capacity and the trust had to divert new arrivals.

Low staffing levels also meant women and babies were not always kept safe.

The trust was issued with a warning to improve and maternity services at both hospitals have now both been rated as 'inadequate'.

At the L&D some staff told the inspectors they did not feel able to report instances of racism. 

Management acknowledged some parts of the unit had a "challenging culture". There were concerns racist incidents being reported to the trust would not be investigated in line with the trust’s values.

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Source: BBC News, 5 July 2024

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