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Inquiry after butt lift patients are hospitalised

A council is investigating after people ended up in hospital following Brazilian butt lift procedures.

Brentwood Borough Council in Essex wants to hear from anyone in the area who has had the non-surgical work done.

The procedure - also known as BBL or Liquid BBL - which uses a hyaluronic acid filler, is not illegal but is currently unregulated and can be fatal if not performed properly.

The council said "an individual and associated companies" in Brentwood had been banned from carrying out BBL procedures until any risks had been "controlled".

Environmental health officers were "investigating cases of hospitalisation due to members of the public undergoing a non-surgical aesthetic procedure, commonly known as a Brazilian Butt Lift, BBL or Liquid BBL in Brentwood," the council said.

It is working with other local authorities and industry experts after a flurry of cases raised concern, including reports of treatment being carried out in hotel rooms.

A spokesperson from Brentwood Borough Council said: "Individuals who have undergone these procedures have experienced excruciating pain, discomfort and infections, some of which have required medical interventions and hospitalisation."

They urged anyone experiencing symptoms to "seek medical assistance immediately".

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Source: BBC News, 4 July 2024

 
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Watchdog takes down ‘mummy makeover’ ads in crackdown against hundreds of cosmetic surgery clinics

The UK advertising watchdog has had to take down hundreds of adverts for cosmetic surgery clinics abroad and weight-loss jabs as dangerous ads target “mummy makeovers”, The Independent has been told.

The Advertising Standards Authourity is also taking down 100 unsafe or misleading adverts a day for prescription-only medicines, with the majority of action taken against promotions for Botox and weight-loss jabs.

The authority said it has been forced to take down hundreds of cosmetic surgery adverts since February this year, following a crackdown on clinics abroad attempting to attract UK patients.

Jessica Tye, investigations operations manager for ASA told The Independent: “They’re running adverts for cosmetic surgery abroad, mostly for clinics in Turkey, but not exclusively … Instagram and Facebook seem to be a big space for clinics to use, to attract people.”

She said the clinics were: “Using claims or images that would exploit people’s body insecurities, things like talking about mummy makeovers, which is like a package of surgery involving, breast surgery and liposuction.

“It’s a really serious operation, so it’s really important that ads for these clinics are not encouraging people to rush into a decision.”

Last week doctors at the British Medical Association annual general warned the NHS is being left to “pick up the pieces” as a result of complications linked to a rise in surgical tourism.

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Source: The Independent, 4 July 2024

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Departing chief spells out ongoing NMC challenges

Andrea Sutcliffe revealed in May that she would be resigning as chief executive and registrar of the Nursing and Midwifery Council (NMC) due to ill health.

Marking the end of her tenure at the NMC, Ms Sutcliffe spoke to Nursing Times about some of her key achievements while leading the organisation over the last five years, and the challenges that lie ahead for her successor and the important work that must be prioritised in the coming months.

Ms Sutcliffe’s departure comes at a tricky time for the regulator, which has come under fire for alleged failures in its regulatory processes and concerns about its internal culture.

A series of articles were published by The Independent last year, which raised serious concerns about the inner workings of the NMC, the way it treats staff and how it handles whistleblowing.

The newspaper reported that there was a “culture of fear” at the NMC that meant staff were afraid to speak out, while also claiming that there were issues of racial discrimination and sexism within the organisation.

Ms Sutcliffe said the articles raised “really serious concerns” about the internal workings of the NMC and stressed the necessity of the independent reviews to “thoroughly scrutinise” what has been going wrong.

“We’re trying to do things, but we’re clearly not doing enough and it’s not making the difference it needs to,” explained Ms Sutcliffe.

“Some people’s experience within the organisation is not acceptable, and we’ve got to get that right.”

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Source: Nursing Times, 28 June 2024

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More patients who died under neurologist's care to be reviewed

The health minister has announced that a further review of clinical records of 18 patients who died under the care of neurologist Michael Watt is to be carried out.

Mr Watt was at the centre of Northern Ireland's largest patient recall in 2018.

In 2022 a review of 44 patients' records found significant failures in their care and treatment under Mr Watt and poor communication with the families.

In a written statement to the assembly, Mike Nesbitt acknowledged "the exceptionally difficult circumstances which the families of deceased patients have experienced".

It is anticipated that this phase of the Neurology Deceased Patients Review (DPR) will be completed before the end of March 2025.

These reviews followed the 2018 recall of 2,500 outpatients who were in Dr Watt's care at the Belfast Health Trust.

About one in five patients had to have their diagnoses changed.

Mike Nesbitt said the work done to date as part of the Deceased Patients Review (DPR) has been "challenging and extensive".

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Source: BBC News, 3 July 2024

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Rise in Covid jab rates may protect children against asthma attacks, study finds

Higher Covid vaccination rates could help protect children against asthma attacks, according to research.

While previous studies show that vaccination helps prevent Covid 19 illness, the authors believe this is the first study to assess whether Covid inoculation is associated with reductions in children’s asthma symptoms, by preventing viral illness in children with asthma.

US researchers examined parent-reported asthma symptom prevalence in more than 150,000 children in the National Survey of Children’s Health between 2018-19 and 2020-21, broken down by US state.

The data was then compared with the proportion of people aged five years and older who were vaccinated in 2020-21, as well as age-adjusted Covid mortality rates and any face mask requirements in enclosed spaces.

With each increase of 10 percentage points in Covid vaccination coverage in US states, there was a 0.36 percentage point reduction in the rates of child asthma symptoms as reported by their parents, according to the study, published in Jama Network Open.

Dr Andy Whittamore, the clinical lead at Asthma + Lung UK, said: “Two million children in the UK live with asthma. Infections such as Covid-19 and flu can cause irritation and inflammation in the airways of people with asthma. This can lead to an increase in mucus and narrowing of the airways, which in turn can cause symptoms such as breathlessness, wheeze, tightness in the chest and coughing and potentially trigger an asthma attack.

“So it’s important for children with asthma to get any vaccinations they are eligible for, such as flu, to keep them safe. It’s also vital to make sure your child takes their preventer inhaler daily and always has their reliever inhaler with them.”

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Source: The Guardian, 3 July 2024

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Deaths review ordered after hospital infection outbreak

A hospital trust has ordered a review of potential death and harm caused by an outbreak of a serious healthcare-acquired infection, which is resistant to many antibiotics.

Frimley Health Foundation Trust has seen outbreaks of carbapenemase-producing enterobacterales (CPE) at both its Frimley Park and Wexham Park sites, starting in the middle of last year, it has emerged. In total, it identified 94 new CPE cases in 2023–24 compared with just 20 in total in 2022–23.

It is not clear what the outcomes were for patients infected with CPE, which is associated with a high mortality rate but often infects patients who are already seriously ill. The trust has commissioned a mortality and morbidity review but refused to answer any questions about it before publication.

CPE bacteria are resistant to many antibiotics, including carbapenems, which are broad-spectrum drugs used to treat serious infections. CPE infections pose a particular risk to vulnerable patients and can spread rapidly in hospitals. There has been increasing concern about them in the UK, with reporting requirements increasing and screening and testing of patients stepping up.

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Source: HSJ, 4 July 2024

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Endoscopic smoke poses ‘significant health risk’ to surgeons

Gastrointestinal procedures that generate high levels of smoke pose significant health risks to operating room personnel.

This is according to a recent study that suggests endoscopic smoke has the toxic equivalent of one cigarette per procedure over the course of a career.

Trent Walradt, a research fellow at Brigham and Women’s Hospital and lead author of the study, explained: "Surgeons in the operating room have regulations and guidelines to mitigate smoke exposure, but that does not exist for gastrointestinal endoscopy. When you’re using cautery, it generates a smoke plume. We wanted to know whether the smoke produced during some of our endoscopic procedures is dangerous."

The results were presented at Digestive Disease Week (DDW) 2024 in Washington, US.

Staff at risk included those attending certain smoke-producing endoscopic gastrointestinal procedures, including a procedure that uses electrical current to remove polyps.

Chris Thompson, director of endoscopy at Brigham and Women’s Hospital and principal investigator, said: "Over the course of a career, endoscopic smoke may pose significant health risks to personnel in the endoscopy suite. If you're doing four or five procedures a day, that’s five cigarettes a day. Over the course of a week, it’s like you're smoking a pack of cigarettes. That's not acceptable."

He added: "We’re in the early phases of this, but I think our findings are very important and, quite frankly, a little concerning and surprising."

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Source: Surgery, 25 June 2024

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What happens now baby killer Lucy Letby has been convicted again as public inquiry set to begin

The NHS will face scrutiny over alleged failures to listen to whistleblowers’ warnings about baby killer Lucy Letby after the nurse was convicted of another attempted murder.

Letby was convicted of trying to murder a “very premature” infant by dislodging her breathing tube in the early hours of 17 February 2016, following a retrial at Manchester Crown Court.

The 34 year-old’s latest conviction comes after she was found guilty of the murders of seven babies and the attempted murders of six others at the Countess of Chester Hospital’s neo-natal unit between June 2015 and June 2016, following her original trial last August.

The former nurse was given a rare whole-life order, making her one of Britain’s most prolific child serial killers. She is due to be sentenced for the further offence on Friday.

Detective superintendent Simon Blackwell, who is strategic lead for Operation Hummingbird, said: “The investigation, which is ongoing, focuses on the indictment period of the charges for Lucy Letby, from June 2015 to June 2016, and is considering areas including senior leadership and decision making to determine whether any criminality has taken place. The investigation is complex and sensitive and specific updates regarding progress will be issued at the appropriate time. At this stage we are not investigating any individuals in relation to gross negligence manslaughter.

“We recognise that this investigation has a significant impact on a number of different stakeholders including the families in this case and we want to reassure that we are committed to carrying out a thorough investigation. Since Letby’s original convictions in August 2023 it has been a very busy period for the investigation team. This has included a subsequent appeal, the re-trial for one count of attempted murder and the launch of the statutory public inquiry that Cheshire Constabulary is assisting with.”

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Source: The Independent, 2 July 2024

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Half of nursing students in England have considered quitting, survey finds

Almost half of nursing students in England have considered quitting before they graduate amid the worst workforce crisis in NHS history, according to the largest survey of its kind.

Applicant numbers have fallen significantly since the end of a grant to support nursing students in 2017. Now a report by the Royal College of Nursing (RCN), seen by the Guardian, suggests that as many as 46% of those enrolled – about 32,000 students – could walk away.

The cost of living was the top reason for students considering an early exit, with seven in 10 (70%) citing “financial difficulties” as a factor. Nursing students have to pay university fees of more than £9,000 a year.

“I wasted so much time and put my sweat, blood and tears into something that is burning me out before I start and isn’t even paying enough. It makes me sad for myself that this is the profession I chose.”

Nearly six in 10 respondents (58%) said witnessing low morale and burnout among qualified nurses had also prompted them to consider ditching their nursing degree.

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Source: The Guardian, 3 July 2024

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Doctors dismissed these women as hysterical. Now they're fighting back

There’s a memory, or more specifically a moment, that came to define Heidi Metcalf’s second birth.

It wasn’t saying goodbye to her husband and newborn before being wheeled into an operating theatre, or the heart attack she thought she was having as she lay there on the table.

It was when a male obstetrician “ripped the placenta” out of her body, without word or warning.

A nurse, Ms Metcalf knows the intervention - while immensely painful - was necessary. She couldn't push it out naturally, which was causing potentially fatal bleeding.

But she hadn’t “seen or met this man before”, and she can’t get past the fact that her consent, during one of the most traumatic experiences of her life, “meant so little”.

“It felt like a violation - I needed to feel involved in what was happening to my body, and not just like a bystander.”

Ms Metcalf is one of thousands of Australian women who have come forward to tell their stories, after the federal government assembled a team of experts to tackle what it calls “medical misogyny”.

So far, they have uncovered that a staggering two-thirds of females nationwide have encountered gender bias or discrimination in healthcare.

And many say it is taking place when they're at their most vulnerable, such as during intimate examinations, or like Ms Metcalf, while in labour. Others report having their pain dismissed or dangerously misdiagnosed.

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Source: The Guardian, 2 July 2024

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Virtual wards growth stalls in 2024

The expansion and use of virtual ward beds has stalled so far in 2024 after strong growth in the second half of last year, according to analysis of official figures.

The number of virtual ward “beds” occupied by patients increased by 38% between July and December 2023. But from the end of 2023 to May 2024, it has increased by less than 1%.

The slowdown comes as ring-fenced national funding for virtual wards came to an end in March. The services – which involve the use of tech to care for patients in their own home when they would otherwise be in hospital – must now be drawn from wider urgent and emergency care funding. 

One integrated care board chief executive told HSJ  the national virtual wards programme had become “peripheral” to wider challenges facing the health system, whereas it had previously been treated as a high priority on its own.

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Source: HSJ, 3 July 2024

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Patients left in pain and to die alone amid NHS nurse shortages, survey finds

NHS patients are being left unseen in pain and in some cases to die alone because shifts do not have enough registered nurses, a survey shows.

The Royal College of Nursing said analysis of a survey it carried out showed that only a third of shifts had enough registered nurses on duty.

The union has also gathered testimonies from nurses who talk of always “rushing” and being asked to do more; working in “completely unsafe” levels of care; and having to make “heartbreaking” decisions on who does or doesn’t get seen.

Shortages mean individual nurses are often caring for dozens of patients at a time, the RCN said. It has called for limits on the maximum number of patients for whom a single nurse can be responsible.

Nicola Ranger, the RCN’s acting general secretary and chief executive, said the survey showed that patients were being failed.

“In every health and care setting, nursing staff are fighting a losing battle to keep patients safe,” she said. “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs.

“It is dangerous to patients and demoralising for nursing staff.”

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Source: The Guardian, 1 July 2024

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UK nursing regulator’s new chief resigns after four days following racism row

The UK nursing regulator’s new interim chief executive has stepped down just four days into the job after facing widespread staff backlash over her links to a high-profile race discrimination case.

Multiple staff working at the Nursing and Midwifery Council (NMC) raised concerns to its directors over the appointment of interim CEO Dawn Broderick, who was head of HR at another trust when it was found to have discriminated against a Black employee.

The Independent can now reveal Ms Broderick resigned from the NMC on Monday evening.

It is the latest in a succession of controversies to hit the nursing regulator, following reports uncovered by The Independent last year. These include allegations from whistleblowers that racism within the NMC was allowing complaints against nurses to go unchecked.

Staff have come forward to The Independent, warning they do not have confidence the NMC’s board will take the issue of racism seriously.

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Source: The Independent, 2 July 2024

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If a female doctor gets treated like this, is there hope for any women?

The agonising pains came midway through Dr Rageshri Dhairyawan’s third cycle of IVF, ten years ago. “I felt as if a heavy metal shovel was scraping away at the lining of my abdomen,” she recalls. 
“It was like nothing I’d ever felt before,” she says. Her fear was ovarian torsion — “when the ovaries become so big from all the follicle stimulation that they twist on their stalk, which is excruciating and needs to be repaired surgically because the ovary becomes starved of oxygen.”

Her husband rushed her to A&E where she was given morphine, then admitted to a gynaecology ward. As a scan revealed no ovarian torsion, “It was thought the hormones had flared up my endometriosis.” 

Dhairyawan was in so much pain she couldn’t move, and yet she recalls being treated as though she was an attention-seeker “trying to get strong opioids through dishonest means” and “as a nuisance for pressing my buzzer”. It was as if, she says, “I didn’t have something they thought was very serious so why was I still there? I just remember not wanting to feel like more of a nuisance because I knew what being a nuisance on a ward can look like — I’d been a doctor for ten years.”

Dhairyawan’s husband demanded pain relief for her. She left hospital shaken. “It massively changed me,” she says. “The experience of not being listened to as a patient, not being taken seriously — it really shocked me. Because I thought, I’m a senior doctor, I know exactly how the NHS works, I know my medical condition, I now what to ask for. And I still can’t speak up and advocate for myself.”

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Source: The Times, 2 July 2024

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‘Ludicrous’ expectation pushes trusts to plan savings of up to 9%

NHS trusts are signing up to deliver efficiency savings of up to 9% of costs, HSJ  has found.

The Queen Elizabeth Hospital King’s Lynn has a cost improvement programme of nearly £30m in 2024-25, equivalent to 9% of spending, which is three times higher than the amount it delivered last year.

Trusts and commissioners were last month issued with new financial targets as NHS England attempted to bring down a £3bn forecast deficit for local organisations.

A spokeswoman told HSJ the trust had already identified three-quarters of the £30m, and said “we believe that there are further efficiencies in our system, which would see us go further than the 3.1% achieved last year.”

She added: “All cost-saving initiatives go through a robust process to make sure that they will not impact patient safety or clinical care provided by the trust.”

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Source: HSJ, 1 July 2024

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I thought I was seeing a GP – but I was misdiagnosed by a physician associate

'PAs' -  who have just two years training - are being used to treat NHS patients, but doctors are concerned about patient safety, reports Sarah Graham.

PAs, or physician associates, are a relatively new type of health professional, first introduced in the UK in 2003 and increasingly used across the NHS to provide care to patients, including at GP surgeries. They undergo two years of postgraduate training (compared with the ten years of medical training needed to become a GP).

There are now more than 3,000 PAs working in the NHS. The Government has said it wants to increase the number to 10,000 by 2037, but the scheme has become controversial following a series of reports of patients being misdiagnosed, some with fatal consequences.

As far as Dave Hay knew, he was seeing a GP. It was 2022 and he’d started having bouts of dizziness, brain fog and fatigue. “It was having an impact on my work and everyday life, so I called my local surgery to make an appointment. I saw someone who wasn’t my usual doctor, but she introduced herself as Dr Smith,” says Hay, 57, a scientist from Yorkshire. “I explained my symptoms. She didn’t do any kind of examination – didn’t check my ears or my vision – and just said, ‘look, I don’t think there’s anything seriously wrong with you, but come back if your symptoms get worse’,” he says.

Two weeks later Dave, now 57, a scientist from Yorkshire, felt worse. 

It was only later, during a chance conversation with the practice nurse, that Dave learned he hadn’t been seeing a GP at all. “I was at a routine appointment and explained what had happened,” Dave says. “The nurse asked who I’d seen and said, ‘that’s not a doctor, that’s a PA’. I had no idea what a PA was.” 

When Dave arranged an appointment with one of the named GPs, she diagnosed depression and anxiety, because of issues at work and a recent family bereavement. “She looked at my medical history and asked some much more targeted questions, pieced it all together, and recommended talking therapy and antidepressants,” Dave explains, who is now well.

However, he does feel that he was misled and waited longer for the right treatment because the PA did not explain her actual role, which they are supposed to do. 

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Source: iNews, 1 Jul7 2024

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Wider use of physician associates will increase inequality, say UK doctors

Doctors are warning the UK medical regulator that wider use of physician associates in the NHS may risk patient safety and lead to greater inequalities in care in deprived areas that struggle to recruit GPs.

The government’s plan to recruit 10,000 physician associates – healthcare professionals supervised by doctors – has angered many clinicians who consider the roles ill-defined and a potential threat to patient safety.

The General Medical Council (GMC) is to regulate physician and anaesthesia associates, who also work under doctors’ supervision, from December.

The doctors’ union, the British Medical Association, last week announced it was seeking a judicial review of the GMC over the “dangerous blurring of lines” between doctors and medical associate professions. It argues physician and anaesthesia associates need regulating, but not by the GMC.

Other professional membership organisations want clarification of associates’ roles. The Royal College of General Practitioners (RCGP) told the GMC that regulation is a “significant step forward”, but the scope of practice needs to be urgently developed.

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The Guardian, 30 June 2024

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Jury concludes Sunny Parker-Propst was unlawfully killed and neglect contributed to the death Elena Ali

A jury has returned conclusions of unlawful killing, contributed to by neglect, and accidental death, contributed to by neglect, in respect of two premature babies poisoned with sodium nitrite in error 12 days apart at Chelsea and Westminster Hospital in 2020.

The ten-day inquest reached a conclusion of accidental death contributed to by neglect for Elena Ali and unlawful killing contributed to by neglect for Sunny Parker-Propst.

The inquest heard how Elena and Sunny were both given sodium nitrite instead of sodium bicarbonate while under the care of Chelsea and Westminster Hospital NHS Foundation Trust.  

The neonatal nurse coordinator gave evidence at the inquest where she accepted that she knew of the policy to check vials thoroughly by picking them up and looking at them at eye level, but she did not follow the policy. She accepted these are fundamental steps to take and that if she had taken the vial in her hand and looked at eye level, she would have been able to see sodium nitrite.  

Evidence was also heard from the hospital’s chief pharmacist, who the coroner said had admitted there had been a “complete and total” failure in self-checking within the pharmacy, which resulted in a box of sodium nitrite being issued instead of sodium bicarbonate. Internal investigations in the pharmacy failed to identify who had issued the wrong drug.  

Both families still do not know how a drug, that would never be needed in the neo natal intensive care unit, was checked out of the pharmacy and delivered to and stocked in the NICU cupboard under the heading sodium bicarbonate. 

It was heard how, had proper practice been applied, nurses would have noticed they were administering nitrite. Vials should have been checked properly and procedures should have been followed with timings recorded correctly and multiple nurses overseeing the process, with checks being restarted if anything was not done properly. When the potential drug error was recognised, the clinical staff should have been informed straight away. It was highlighted how the checks were basic and safety should come first, irrespective of the pressure the nurses were facing and if done properly, they would have realised it was nitrite and the deaths would not have occurred.

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Source: Leigh Day, 22 July 2024

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'We desperately need safety-critical nurse-to-patient ratios enshrined in law'

The latest release of data from the Royal College of Nursing's Last Shift Survey shows the urgent need for investment in the nursing workforce and safety-critical nurse-to-patient ratios enshrined in law. New analysis finds more than 11,000 members reveals just a third of shifts had enough registered nurses.   

Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The RCN are now calling for safety-critical limits on the maximum number of patients a single nurse can be responsible for.   

Our survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. 

Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely.   

RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said: “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff.   

“When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on.   

“We desperately need urgent investment in the nursing workforce but also to see safety-critical nurse-to-patient ratios enshrined in law. That is how we improve care and stop patients coming to harm.”  

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Source: RCN, 1 July 2024

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Hacked UK trove includes data on newborns, cancer patients...

Hackers behind a London hospital attack recently published records that include personal information about pregnant women, newborns, cancer patients, people suffering from schizophrenia and thousands of others across the UK and Ireland, revealing the breach was far more widespread than authorities have previously indicated.

An analysis of the data trove by Bloomberg News found that it contains tens of thousands of medical records on patients from more than 400 public and private hospitals and clinics. Among the records are some 40,000 highly sensitive documents sent by doctors requesting biopsies and blood tests for individual patients in all regions of the UK and some hospitals in Ireland.

A breach of the kind faced by Synnovis was inevitable, according to Saif Abed, a former NHS doctor and expert in cybersecurity and public health. “The NHS has some of best patient safety and cybersecurity standards in the world,” Abed said. “They are just immensely poorly enforced.”

Abed said that there was a lack of mandatory cybersecurity audits on any contractors providing services to the NHS, which meant those contractors could have substandard cybersecurity practices that could in turn leave the NHS vulnerable.

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Source: Bloomberg UK, 26 June 2024

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Many overseas doctors feel ill-prepared to join NHS, survey finds

Many doctors from overseas are left feeling lost, anxious and not ready to care for patients after joining the NHS because they are not properly looked after, research has found.

Many international medical graduates (IMGs) feel the NHS does not help them prepare for life as a doctor in the UK and the practicalities of moving to a new country, according to a survey.

Almost six in 10 (58%) of those questioned thought their induction was inadequate, and almost half (48%) felt anxious about starting to perform clinical duties in the UK.

The Medical Protection Society (MPS), which surveyed 737 IMGs working in England, said the results showed that too many foreign-trained doctors were “still being let down” professionally and personally by the NHS.

One doctor said: “I was very anxious and worried as working clinically without induction and [a] very brief period of shadowing … I was just lost.”

Another said: “I asked several times about induction, to be told that I will just learn on the job and ‘it will be fine’.”

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Source: The Guardian, 28 June 2024

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Midwives call women in labour ‘Asian princesses’ amid ‘hostile’ environment fears

The NHS Race and Health Observatory has raised fundamental concerns about racism towards maternity patients after several cases have come to light in recent months, including midwives branding patients as “Asian princesses”.

The watchdog’s intervention follows regulators identifying patterns of racist and discriminatory behaviour at the maternity departments of two large hospital trusts and a smaller general hospital in the last six months.

The observatory’s CEO Habib Naqvi told HSJ  he was “deeply concerned” by the seriousness of the issues raised.

He added that “discriminatory behaviours and ways of working… [can] lead to hostile and unsupportive learning environments… impact patient care and safety, and also seriously undermine the NHS’s goal of attracting and retaining its workforce”.

Examples given included the term “Asian princess” being used by midwives in reference to brown-skinned women requesting pain relief during labour.

The students also described a “disregard” from some midwives towards black and brown-skinned women, particularly where English was not their first language. 

It was also reported when Asian women verbalised their pain during labour, some midwives responded with “Oh, they are all like this”, while additional derogatory comments were made towards asylum seekers, that “they are playing the system”, the NHSE team’s report said.

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Source: HSJ, 28 June 2024

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NHS England’s plans to replace traditional GP referrals

An NHS England document has confirmed that that it wants to ‘optimise’ GP referrals to secondary care via an enhanced model of advice and guidance.

GP leaders recently raised concerns that NHS England had encouraged Integrated Care Boards (ICBs) to adopt the ‘advice and refer’ model, effectively replacing traditional GP referrals and adding barriers for patients in accessing secondary care. 

At the time, NHS England did not address concerns about this specific model, but Pulse has now seen a ‘framework’ document which encouraged local commissioners to ‘strengthen’ specialist advice services in order to ‘optimise’ referrals. 

The guidance suggested the use of the ‘advice and refer’ model, which means all referrals or advice requests from GPs ‘come in through one route’ and directly bookable appointments are ‘discouraged or removed’.

Under this service, all referrals are then ‘triaged’, allowing hospitals to reject referrals and send them back to GPs with advice. 

This mechanism removes the option for GPs to send standard referrals, whereas the usual model of advice and guidance (A&G) allows GPs to seek advice if they wish, but maintains the direct referral route.

NHS England emphasised its commitment to empowering regions to ‘develop diverse models’ of specialist advice in line with their local needs.

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Source: Pulse, 26 June 2024

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Pfizer in the crosshairs again

Kansas is the latest US state to file a lawsuit against Pfizer, accusing the pharmaceutical giant of misleading the public about the safety and effectiveness of its Covid-19 vaccine.

Kansas Attorney General Kris Kobach claims that Pfizer knew about the risks associated with its vaccine, “including myocarditis and pericarditis, failed pregnancies, and deaths” but failed to disclose this information to the public.

The 179-page lawsuit also alleges that Pfizer made ‘false and misleading’ statements regarding the vaccine's ability to prevent viral transmission, its waning effectiveness and its ability to protect against new variants of the virus.

“To keep the public from learning the truth, Pfizer worked to censor speech on social media that questioned Pfizer’s claims about its Covid-19 vaccine,” alleges the lawsuit.

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Source: Maryanne Demasi, 23 June 2024

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Corridor care ‘must not be the norm’, NHSE warns trusts

NHS England has warned trusts corridor care “must not be considered the norm”, adding that the failings exposed by a recent undercover documentary were “not acceptable”.

In a letter to boards after a Dispatches documentary filmed at Royal Shrewsbury Hospital aired on Monday, NHSE’s chief operating officer, chief nursing officer, national medical director and director of urgent and emergency care warned trusts they must ensure basic standards of care.

The note, seen by HSJ, described footage filmed at RSH’s emergency department as “stark”, adding that it highlighted the service some patients receive is “not acceptable”.

The documentary captured many instances of patients being treated in corridors, and the letter said corridor care or that delivered outside a normal cubicle environment “must not be considered the norm”.

NHSE added: “It should only be in periods of escalation and with board-level oversight at trust and system level… where it is deemed a necessity… it must be provided in the safest and most effective manner possible, for the shortest period of time… with patient dignity and respect being maintained throughout.”

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Source: HSJ, 27 June 2024

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

 

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