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Dental checkups to become less frequent in England and Wales

The decades-old routine of visiting an NHS dentist for a six-month checkup is being scrapped across England and Wales for most adults as part of changes designed to address the dire lack of access to dental care for many people.

Wales has announced that most adults now only need to see their dentist once a year, which the government in Cardiff says will free up NHS dentists’ time and allow them to take on more than 100,000 extra patients annually.

The Labour-controlled Welsh government also hinted it wanted to recruit disillusioned dentists from England by offering chances to develop skills such as carrying out more complex surgery within their practices.

Its announcement came after the UK government wrote to NHS dentists last week saying that under the first changes to the dental contract in 16 years, healthy people will only need a checkup every two years. It said this complied with guidance from the National Institute for Health and Care Excellence (Nice), which says dental teams should see patients for a checkup based on their health risk, which can be once every two years instead of every six months.

Both governments claimed the moves would allow more people to find NHS care but dentists’ representatives in England and Wales described the changes as “tinkering” and “marginal tweaks”.

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Source: The Guardian, 27 July 2022

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Londoners several times more likely to get life-saving treatment

The NHS and the Treasury need to make a renewed commitment to increasing the number of patients who benefit from thrombectomy, the Stroke Association has said, as it revealed the service was dependent on just 106 doctors in England.

New analysis due to be published by the charity later this week – and shared with HSJ  – also found only a quarter of thrombectomy units are open 24 hours, seven days a week, with 42% only operating during office hours and Monday to Friday.

Despite an NHS long-term plan target of treating 10% of strokes with a thrombectomy by this year, only 2.8% were benefitting in December 2021 – a smaller proportion than in the US or some other Western European nations. It means nearly 6,000 people who could benefit from thrombectomy are missing out, the charity has calculated.

The Stroke Association’s report also highlighted large apparent regional variation in the share of stroke patients receiving the treatment — with London patients several times more likely to receive the treatment than elsewhere.

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Source: HSJ, 27 July 2022

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Pre-eclampsia: Test change for pregnant women could save lives

A change in pre-eclampsia testing for pregnant women could help save lives.

The potentially-fatal condition affects around 6% of women, often during the second half of pregnancy.

The National Institute for Clinical Excellence (NICE) had recommended a test that could only rule out the condition, but now recommends more accurate tests that can diagnose cases.

The Welsh government welcomed the new guidance, but said routine screening had not been recommended.

Jeanette Kusel, director for scientific advice at NICE, said: "These tests represent a step change in the management and treatment of pre eclampsia.

"New evidence presented to the committee shows that these tests can help successfully diagnose pre eclampsia, alongside clinical information for decision-making, rather than just rule it out.

"This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth"

Eleri Wyn Foxhall, 32, from Penygroes in Gwynedd had pre-eclampsia in 2020.

She welcomes the move, but called for women to be tested routinely.

She believes there is a general "lack of information" about pre-eclampsia, and wants more work to be done on early detection.

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Source: BBC News, 26 July 2022

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Likely cause of mystery child hepatitis outbreak found

UK experts believe they have identified the cause of the recent spate of mysterious liver problems affecting young children around the world.

Investigations suggest two common viruses made a comeback after pandemic lockdowns ended - and triggered the rare but very serious hepatitis cases.

More than 1,000 children - many under the age of five - in 35 countries are thought to have been affected. Some, including 12 in the UK, have needed a lifesaving liver transplant.

The two teams of researchers, from London and Glasgow, say infants exposed later than normal - because of Covid restrictions - missed out on some early immunity to an adenovirus, which normally causes colds and stomach upsets, and adeno-associated virus 2.

Noah, three, who lives in Chelmsford, Essex, needed an urgent liver transplant after becoming dangerously ill with hepatitis. His mother, Rebecca Cameron-McIntosh, says the experience has been devastating.

"He'd previously had nothing wrong with him," she says. "And for it to suddenly go so quickly. I think that's what kind of took us by surprise.

"We've just assumed it was one little problem that will get easily sorted out - but actually it just kept on snowballing."

Noah's recovery has been good - but he will need to take immunosuppressant drugs fo life, to stop his body rejecting the new liver he received.

Rebecca says: "There is something really heartbreaking about that because you go along following the rules, do what you are supposed to do to protect people that are vulnerable and then, in some horrible roundabout way, your own child has become more vulnerable because you did what you were supposed to do."

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Source: BBC News, 26 July 2022

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‘Arrogance and bullying’ persist from ‘less understanding’ regulators, say trusts

NHS England and the Care Quality Commission are becoming less understanding of the pressures on trusts, their leaders report, with one CEO complaining “the arrogance and bullying continues to get worse”. 

This is the finding of a new survey of trust chiefs, chairs and directors by NHS Providers, shared with HSJ and published in a new report on regulation today.

It found two-thirds of trust leaders felt NHSE had a good understanding of “the pressures that NHS providers are facing” — down from 74% cent in a similar NHSP regulation survey in 2019, and 75% in 2018.

NHSP found: “Leaders from the acute sector were much more likely to say regulators understood the pressure they were under than those from the mental health or community sectors.”

One combined acute/community CEO said: “Not only have the number of requests increased but now they are coming from multiple levels, [integrated care system], regional and national.”

Meanwhile, most respondents welcomed regulators’ proposed changes to their approach – for example, by the CQC to a “risk based” approach, and NHSE towards collaboration – but many indicated they did not feel these were being put into practice.

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Source: HSJ, 26 July 2022

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UK doctors ‘less likely’ to resuscitate the most seriously ill patients since Covid

Doctors are less likely to resuscitate the most seriously ill patients in the wake of the pandemic, a survey suggests.

Covid-19 may have changed doctors’ decision-making regarding end of life, making them more willing not to resuscitate very sick or frail patients and raising the threshold for referral to intensive care, according to the results of the research published in the Journal of Medical Ethics.

However, the pandemic has not changed their views on euthanasia and doctor-assisted dying, with about a third of respondents still strongly opposed to these policies, the survey responses reveal.

The Covid-19 pandemic transformed many aspects of clinical medicine, including end-of-life care, prompted by millions more patients than usual requiring it around the world, say the researchers.

In respect of DNACPR, the decision not to attempt to restart a patient’s heart when it or breathing stops, more than half the respondents were more willing to do this than they had been previously.

Asked about the contributory factors, the most frequently cited were: “likely futility of CPR” (88% pre-pandemic, 91% now); coexisting conditions (89% both pre-pandemic and now); and patient wishes (83.5% pre-pandemic, 80.5% now). Advance care plans and “quality of life” after resuscitation were also commonly cited.

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Source: The Guardian, 25 July 2022

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NHS has ‘broken’ its promise to the public over the ambulance service

The NHS has broken its “fundamental promise” to the public that life-saving emergency care will be available when they need it, a top NHS doctor has said, as ambulances continue to lose tens of thousands of hours waiting outside hospitals.

Katherine Henderson, the president of the Royal College of Emergency Medicine, said that what she described as the fundamental promise of the NHS to provide an ambulance in a real emergency has been “broken”.

Her comments come as the West Midlands Ambulance Service (WMAS) University NHS Trust predicted it would lose 48,000 ambulance hours waiting outside A&E departments in July. This would make it the worst month on record.

In papers published on Thursday, WMAS said the impact of handover delays means that patients are waiting longer than needed for an emergency response, including patients in category one, which includes those needing immediate life-saving care.

It added: “This means that patients who are immediately time-critical medical emergencies do not get the response they need and may suffer significant harm or death.”

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Source: The Independent, 26 July 2022

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Covid pandemic births: Mothers 'pitted against midwives'

Women have spoken to the BBC about the "nightmare" of giving birth during the restrictions imposed because of Covid.

The London Assembly was told a de facto maternity ward ban on partners meant new mums often got very little support.

Campaign group Pregnant Then Screwed said elective Caesareans spiked, as women tried to find a way to have their partner by their side.

Patient care also suffered as maternity units struggled with what a midwifery group said was a 40% staff absence.

A London Assembly health committee review of Covid pandemic pregnancy care has heard that more than three-quarters of the some 110,000 women who gave birth in the capital in 2020 were believed to have done so without their partner's support.

Joeli Brearley, director of Pregnant then Screwed, said elective Caesarean rates increased from 15% to 24%: "Women were requesting severe surgery simply so their partner could be there."

Suzanne Tyler, from the Royal College of Midwives, agreed that London hospitals were badly affected by staff shortages.

"At its worst, staffing was 40% down," she said. "The babies didn't stop coming during Covid but services did have to be rationalised."

Dr Tyler, who said the pandemic "ended up pitting midwives against women", criticised "confusing... contradictory" advice from the government and NHS England that "kept changing".

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Source: BBC News, 26 July 2022

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NHS England ‘hasn’t got long’ to develop ‘operating model’ for system working

NHS England and local leaders must urgently develop a coherent ‘operating model’ for the era of integrated care systems (ICS) or see the reforms fail, leading trust chief executives have told HSJ.

Despite ICSs formally launching on 1 July, the chiefs said there was still no clarity about how the service would be supported and held to account as the Health and Care Act reforms are rolled out and the stuttering Covid recovery continues.

The CEOs were speaking at a roundtable to mark the publication of HSJ's annual ranking of the NHS’s “top 50 trust chief executives”.

NHSE has been working on a new operating model since last year. It has confirmed it plans to keep its seven separate regional teams, and has recently indicated national programmes will be curbed as part of reductions to central staffing. 

Caroline Clarke, the chief executive of north London’s Royal Free group of trusts, said: “What’s unclear to me is, what the operating model is for [the] whole NHS? What is NHSE going to do… what’s expected of the regions and the ICSs… is the performance management line [for providers] going to go all the way through the ICS?”

Ms Clarke said she recognised “some kind of regional infrastructure” was needed and that the existing set-up made sense in widely recognised areas such as London and other “urban” conurbations. But she added: “Are [regions] just going to be aggregating features of the NHS, or are they actually going to have a kind of intent to them?”

Ms Clarke said she was “hung up” on getting an effective operating model because, without it, there was an increased chance NHSE staff would “get in the way and stop us making decisions”.

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Source: HSJ, 25 July 2022

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Five hospital wards run with one registered nurse each

Five wards at Scotland's largest hospital had to operate with one registered nurse on duty each.

Staff at the Queen Elizabeth University Hospital in Glasgow experienced the shortage on Monday night.

It is an example of the severe pressure affecting health services across the country, which has intensified due to the Covid-19 pandemic.

Greater Glasgow and Clyde health board said nurses were supported by a number of other staff.

Originally reported in the Daily Record, the shortage was described to staff in an email sent on Monday afternoon.

The email said nurse staffing levels across medicine were critical, despite attempts to seek support from bank or agency workers.

It said admin staff had been asked to stay on to offer support including answering phones and door buzzers for the rest of the week.

As well as staffing problems, the pandemic has caused more bed blocking in Scotland's hospitals and longer waits for both emergency and outpatient treatment.

Norman Provan, associate director at the Royal College of Nursing Scotland said the shortage had an impact on patient safety as well as staff wellbeing - concerns that had been raised with the health board and the Scottish government.

He added: "We're in this situation largely because of the failure of Scottish government to address the nursing workforce crisis, which has seen registered nurse vacancies reach a record high.

"Urgent action is needed to protect patient safety, address staff shortages and demonstrate that the nursing workforce is valued as a safety critical profession."

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Source: BBC News, 24 July 2022

 

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‘We are presiding over a failing NHS,’ say leading trust CEOs

A lack of accountability is causing the quality of NHS services to crumble, according to some of the most respected trust chief executives.

They said the problem arose from four factors: the lack of an operating model for how NHS England should oversee the service, confusion over what integrated care systems should be responsible for, the lack of clarity on which standards providers should be seeking to meet, and trust leaders not holding each other to account.

The views were expressed at a roundtable to mark the publication of HSJ’s annual ranking of the NHS’s “top 50 trust chief executives”.

The most strongly worded contribution came from Milton Keynes University Hospital Foundation Trust chief executive Joe Harrison.

He told the roundtable: “I’m really concerned about where we are at as an NHS. I think we’re in danger of all sitting around the campfire singing ‘kumbaya’ as the Titanic sinks.

“We are presiding over a failing NHS. There’s no question about it. And if we carry on like this, people have every right to say, ‘what on earth are we spending £150bn on?’”

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Source: HSJ, 25 July 2022

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Trust declares its cancer waiting list ‘unmanageable’

One of the NHS’s biggest hospital trusts has declared its cancer waiting list is now at an ‘unmanageable size’.

Mid and South Essex Foundation Trust leaders set out the stark judgement in a  paper for its July board meeting, held last week.

The report said: “The 62-day [referral to treatment backlog as of 3 July] has increased for the second consecutive week to 1,055.

“[The cancer patient tracking list] is getting bigger and has reached an unmanageable size. Referral rates have plateaued from March 2021 [but] treatment rates have not increased in line with PTL growth.

“This points to a noisy PTL, where the hospital is extremely busy managing patients who do not have cancer.”

The paper also said NHS England had recognised the trust’s 62-day cancer target needed to be delivered “in more realistic and achievable stages”.

It highlighted particular concerns around a “serious” demand and capacity problem in its dermatology department which contributed to almost half of its 62-day backlog. The trust had 445 62-day RTT cancer breaches in dermatology alone in May, the latest data reported.

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Source: HSJ, 22 July 2022

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Maternity failings account for the majority of the NHS’s £13bn spend on negligence

Maternity failings continue to account for the majority of billions of pounds spent by the NHS on clinical negligence claims, as an NHS body warns of the “devastating” consequences of poor care.

Two-thirds of the £13bn spent by the NHS in 2021-21 in respect of negligence claims was related to maternity care, according to new data.

A report released by NHS Resolution said it was “a stark reminder that although the NHS remains one of the safest healthcare systems in the world within which to give birth, avoidable errors within maternity can have devastating consequences for the child, mother and wider family, as well as the NHS staff involved.”

According to the figures, 1,243 maternity-related negligence claims were reported to the NHS in 2021-22, up from 1,571 in the previous year.

The data also shows that 200 claims relating to cerebral palsy or brain damage were received in 2021-22 – a decrease from the previous year, in which there were 250.

The organisation said that the growth in obstetrics claims over the past three years was due to trusts reporting cases of cerebral palsy and brain damage earlier through its early notification scheme, which was launched in 2017.

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Source: The Independent, 24 July 2022

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NHS in England facing worst staffing crisis in history, MPs warn

The large number of unfilled NHS job vacancies is posing a serious risk to patient safety, a report by MPs says.

It found England is now short of 12,000 hospital doctors and more than 50,000 nurses and midwives, calling this the worst workforce crisis in NHS history.

It said a reluctance to decisively plug the staffing gap could threaten plans to tackle the Covid treatment backlog.

The government said the workforce is growing and NHS England is drawing up long-term plans to recruit more staff.

Former Health Secretary Jeremy Hunt, who chairs the Commons health and social care select committee that produced the report, said tackling the shortage must be a "top priority" for the new prime minister when they take over in September.

"Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long-term plan by the government to tackle it," he said.

It said conditions were "regrettably worse" in social care, with 95% of care providers struggling to hire staff and 75% finding it difficult to retain existing workers.

"Without the creation of meaningful professional development structures, and better contracts with improved pay and training, social care will remain a career of limited attraction, even when it is desperately needed," the report said.

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Source: BBC News, 25 July 2022

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What is monkeypox and how worried should we be?

The monkeypox outbreak has been declared a global health emergency by the World Health Organization.

According to the UK Health Security Agency, early symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes and chills, as well as other features such as exhaustion.

Monkeypox does not spread easily between humans, and requires close contact. According to the US Centers for Disease Control and Prevention, it is thought that human-to-human transmission primarily occurs through large respiratory droplets.

Globally, there have so far been 16,016 monkeypox cases – 4,132 of which were in the past week, according to WHO data. It is now in 75 countries and territories and there have been five deaths.

The European region has the highest number of total cases, at 11,865, and the highest increase in the past seven days, with 2,705.

The west African strain of monkeypox is generally a mild infection for most people, but it is important those infected and their contacts are identified. The virus is more of a concern among vulnerable people such as those with weakened immune systems or who are pregnant.

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Source: The Guardian, 23 July 2022

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World first in hologram patients

Medical students are using hologram patients to hone their skills with life-like training scenarios. The project at Addenbrooke’s Hospital in Cambridge is the first in the world to use the mixed reality technology in this way.

Students wear Microsoft HoloLens headsets that let them interact with the patient while still being able to see each other. Lecturers are able to alter the patient’s response, make observations and add complications to the scenario. It enables realistic and immersive safe-to-fail training which can be delivered remotely as well as in person.

The first module, covering respiratory conditions and emergencies, has already been launched and more are planned around cardiology and neurology.

The HoloScenarios system is being developed by Cambridge University Hospitals NHS Foundation Trust, in partnership with the University of Cambridge and US-based tech firm GigXR.

Consultant anaesthetist Dr Arun Gupta, who is leading the project in Cambridge, said: “Mixed reality is increasingly recognised as a useful method of simulator training. As institutions scale procurement, the demand for platforms that offer utility and ease of mixed reality learning management is rapidly expanding"

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Source: CIEHF, 21 July 2022

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Pfizer fined £63m after overcharging NHS for phenytoin sodium epilepsy drug

Pfizer has been fined £63 million after overcharging the NHS for a life-saving epilepsy drug which rose in price by 2,600%.

The drug company was fined by the Competition and Markets Authority (CMA) for its involvement in a secret deal to hike the price of phenytoin sodium capsules, which cost the NHS tens of millions of pounds.

Pfizer and a small British company, Flynn Pharma, were able to circumvent NHS price controls by de-branding the drug in 2012 and relaunching it under its generic name. The price then rose from £2.83 to £67.50 per pack, pushing up the cost from £2 million a year to £50 million.

Internal emails obtained by the CMA showed that Pfizer officials raised concerns about the proposed scheme, with one manager writing: “The top line looks great, however, this would increase the price of phenytoin capsules to the NHS drastically and, to be frank, doesn’t feel right.”

Andrea Coscelli, the outgoing chief executive of the CMA, said phenytoin was an “essential drug relied on daily by thousands of people throughout the UK to prevent life-threatening epileptic seizures”.

He said the two companies had “illegally exploited their dominant positions to charge the NHS excessive prices and make more money for themselves — meaning patients and taxpayers lost out”.

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Source: The Times, 21 July 2022

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Over 285,000 medicines and medical devices seized UK-wide in global action

Medicines and medical devices valued at over £850,000, totalling more than 285,000 items, have been seized by officers from the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) as part of a global operation to tackle the illegal sale of medical products, with UK seizures estimated to be worth around 9% of the global total.

In the UK, 48 social media accounts unlawfully offering to supply medicines were also shut down. Officers from the MHRA Criminal Enforcement Unit searched five premises in the West Midlands and London, with two suspects arrested.

During the global week of action coordinated by Interpol, which ran from 23-30 June, this year’s ‘Operation Pangea’ saw countries across the world joining forces to seize non-compliant medical products. The operation also involved the arrests of several suspected organised criminals.

In the UK, anti-depressants, erectile dysfunction tablets, painkillers, anabolic steroids and slimming pills were among the medicines seized.

Andy Morling, Deputy Director (Criminal Enforcement) at the MHRA, said: "Criminals illegally trading in medicines and medical devices are not only breaking the law but they also have no regard for your health. Unlicensed medicines and non-compliant medical devices pose serious risk to public health as both their safety and efficacy can be compromised."

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Source: MHRA, 20 July 2022

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Study finds Covid-19 infection raises risk of diabetes and heart disease diagnoses in following weeks

Patients who contract Covid-19 are at increased risk of being diagnosed with cardiovascular disorders and diabetes in the three months following infection, although the risk then declines back to baseline levels, a large UK study has found.

Researchers from King’s College London say patients recovering from Covid-19 should be advised to consider measures to reduce diabetes risk including adopting a healthy diet and taking exercise.

The GP medical records from more than 428,650 Covid-19 patients were matched with the same number of controls and followed up to January 2022. All patients with pre-existing diabetes or cardiovascular disease were excluded from the study, published in the open access journal PLOS Medicine.

According to the analysis, diabetes mellitus diagnoses were increased by 81% in acute covid-19 and remained elevated by 27% from 4 to 12 weeks after infection.

Lead study author Emma Rezel-Potts said, “While it is in the first four weeks that covid-19 patients are most at risk of these outcomes, the risk of diabetes mellitus remains increased for at least 12 weeks. Clinical and public health interventions focusing on reducing diabetes risk among those recovering from covid-19 over the longer term may be beneficial.”

The researchers said that people without pre-existing cardiovascular disease or diabetes who become infected with covid-19 do not appear to have a long term increase in incidence of these conditions.

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Source: BMJ, 22 July 2022

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Children’s health waiting lists rising double the rate of adults, top doctor warns

Care waiting lists for children are rising at double the rate of the adult backlog, a top doctor has warned.

The waiting list for children’s care, including surgeries, hit 360,000 in May, the latest NHS data shows, and the Royal College of Paediatrics and Child Health (RCPCH) warned it is set to get worse amid worsening summer pressures.

In an exclusive interview with The Independent, Dr Camilla Kingdon, president of RCPCH, said children’s services hadn’t been adequately prioritised since taking a hit during the pandemic, which was compounded by an “extremely busy summer”.

She said children’s services now faced a “perfect storm” as they struggled to meet demand due to the increased pressure of viruses not previously seen at high levels during summer, and staff being off sick with Covid.

Dr Kingdon said: “I don’t think it’s a surprise at all, that the waiting lists are rising. I think the truth is that the rate of rise of the waiting list for children is more than double the rate of rise for adults.”

An NHS spokesperson said: “It is right that hospitals have been prioritising patients with the most urgent clinical need. The number of people waiting the longest – which includes many children – has dropped by more than 80 per cent since January.”

But Dr Kingdon warned the official waiting list data, published by NHS England, was a “gross underestimation” of the actual number of children waiting for care overall.

She said: “We’re not even collecting the data adequately to be able to truly understand the extent of the problem.”

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Source: The Independent, 21 July 2022

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NHSE tries to put £2.3bn cap on agency staff spend

NHS England is introducing a new ceiling on the amount spent within each integrated care system on agency staff — cutting it by at least 10% in each area in one year — as part of a drive to find further savings across the health service.

Integrated Care Services (ICSs) have been told to cut spending on temporary staff by providers in their area by at least 10%, or £257m, on 2021-22 levels, taking expenditure down to a total of £2.3bn nationally. A letter to finance directors sent today, seen by HSJ says: “This will mean that some systems will need to go beyond their current financial plans to reduce agency expenditure.”

The move is part of a wider efficiency crackdown from NHS England, with further national control measures to be introduced over the next 18 months. HSJ understands that the renewed drive will focus on five other areas in addition to agency spend: medicines, pathway redesign, corporate services, procurement and specialised commissioning.

The extra savings ask comes on top of ICSs already committing to £5.5bn in efficiencies over 2022-23, which Nuffield Trust CEO Nigel Edwards said was “not a credible savings target”.

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Source: HSJ, 20 July 2022

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NHS waits force patients to pay for private ops

Long NHS waiting times appear to be pushing people into paying thousands of pounds for private treatment.

There were 69,000 self-funded treatments in the UK in the final three months of last year - a 39% rise on the same period before the pandemic.

Experts said it was a sign of how desperate people had become.

The BBC has seen evidence of people taking out loans and resorting to crowdfunding to pay for private treatment.

The figures from the Private Healthcare Information Network (PHIN) do not include those who have private insurance - instead they are the people paying the full cost of treatment themselves, leaving them liable for huge bills.

Patient groups warned there was a risk of a two-tier system being created, with the poorest losing out because they were the least likely to be able to afford to pay for treatment.

Patient watchdog Healthwatch England said waits for treatment were one of the most common concerns flagged by patients, and warned the situation risked "widening health inequalities".

Chief executive Louise Ansari said for most people going private "simply isn't an option", especially with the cost-of-living crisis.

"People on the lowest incomes are the most likely to wait the longest for NHS treatment. This leads to a worse impact on their physical health, mental health and ability to work and care for loved ones."

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Source: BBC News, 21 July 2022

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Gloucestershire maternity service failures 'putting women and babies at risk'

A shortage of maternity staff is putting women and babies at risk in Gloucestershire, inspectors have said.

The county's maternity services have been downgraded by two levels, from good to inadequate, by the Care Quality Commission (CQC).

Its report highlighted staff shortages, missed training, exhaustion among workers and concerns over equipment.

Gloucestershire Hospitals NHS Foundation Trust issued an apology and said improvements have been made.

CQC inspectors visited maternity wards, birth units and community midwives in Gloucester, Cheltenham and Stroud in April after receiving concerns about the "culture, safety and quality of services".

They found the service did not have enough midwifery staff with the "right qualifications, skills, training and experience to keep women safe from avoidable harm or to provide the right treatment all the time".

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Source: BBC News, 22 July 2022

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London NHS trust cancels operations as IT system fails in heatwave

One of the NHS’s biggest hospital trusts is facing major problems after its IT system failed because of the extreme temperatures earlier this week.

Guy’s and St Thomas’ trust (GSTT) in London has had to cancel operations, postpone appointments and divert seriously ill patients to other hospitals in the capital as a result of its IT meltdown.

The situation means that doctors cannot see patients’ medical notes remotely and are having to write down the results of all examinations by hand. They are also unable to remotely access the results of diagnostic tests such as X-rays and CT and MRI scans and are instead having to call the imaging department, which is overloading the department’s telephone lines.

GSTT has declared the problem a “critical site incident”. It has apologised to patients and asked them to bring letters or other paperwork about their condition with them to their appointment to help overcome doctors’ loss of access to their medical history.

One doctor at GSTT, speaking on condition of anonymity, said: “This is having a major effect. We are back to using paper and can’t see any existing electronic notes. We are needing to triage basic tests like blood tests and scans. There’s no access to results apart from over the phone, and of course the whole hospital is trying to use that line.

“Frankly, it’s a big patient safety issue and we haven’t been told how long it will take to fix. We are on divert for major specialist services such as cardiac, vascular and ECMO.”

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Source: The Guardian, 21 July 2022

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Catheter pilot scheme sees infections fall by 100%

A pilot scheme to reduce infections following catheter insertions has shown a 100% fall within a hospital trust.

NHS Supply Chain is now encouraging acute trusts in England to take advantage of the scheme which has shown to not only reduce infection rates but shorten patient length of stay and save clinicians’ time.

Catheter associated urinary tract infections (CAUTIs) are not uncommon and can cause patients significant pain, discomfort, confusion and anxiety for family and friends. They further impact healthcare with increased antibiotic use, prolonged hospital stays, increased clinical activity and risk of complaints and litigation. 

University Hospitals of North Midlands NHS Trust had audited its urethral catheterisation practice, and the way catheterised patients w19 July ere cared for in clinical areas. The audit highlighted a wide variation in care delivery leading to inconsistent outcomes for patients and staff.

After reviewing the available options, the University Hospitals of North Midlands NHS Trust decided to pilot the BARD® Tray which contains all the essential items to catheterise or re-catheterise a patient in one pack and includes the catheter with a pre-connected urine drainage bag. This unique ‘closed system’ prevents ingress of bacteria and helps avoid catheter related infection. 

NHS Supply Chain: Rehabilitation, Disabled Services, Women’s Health and Associated Consumables worked alongside supplier Beckton Dickinson to provide the tray products required by the trust.

During the three-month pilot, catheter related infection rates fell by 100% at the trust which coincided with a reduction in complaints and a reduced length of hospital stay for patients. Clinicians reported that the pack was intuitive and saved around five minutes per catheterisation, which during the pilot process meant saving 83 hours from 1,000 catheterisation procedures.

While the BARD® Tray was more expensive than the individual components that were currently purchased, the pilot study demonstrated the clinical and financial value that was delivered by the tray being implemented across an organisation. The overall cost of components is slightly cheaper, but due to reduced catheterisations, consumables spend fell by 24%.

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Source: NHS Supply Chain, 19 July 2022

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