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Physician associates increase doctors’ workloads, survey finds

Working with physician and anaesthesia associates actually increases a doctor’s workload rather than freeing up time to focus on care of patients, a BMA survey finds.1

The association surveyed more than 18 000 UK doctors to inform its position on physician and anaesthesia associates. Some 55% (7397 of 13 344 who responded to this question) reported that their workload had risen since the employment of medical associate professionals, with only 21% (2799 of 13 344) reporting a decreased workload.

The House of Lords will shortly consider legislation to regulate physician associates under the General Medical Council rather than the Health and Care Professions Council.

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Source: BMJ, 2 February 2024

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‘I’ve been treated like the accused’: NHS nurse reveals 8 years of hell after raising sexual harassment claims

A nurse whistleblower has described her eight years of hell as she fights the NHS over its failure to properly investigate claims she was sexually harassed by a colleague.

Michelle Russell, who has 30 years of experience, first raised allegations of sexual harassment by a male nurse to managers at the mental health unit where she worked in London in 2015.

Years of battling her case saw the trust’s initial investigation condemned as “catastrophically flawed” while the nursing watchdog, the Nursing Midwifery Council, has apologised for taking so long to review her complaint and has referred itself to its own regulator over the matter.

With the case still unresolved, Ms Russell will see her career in the NHS end this week after she was not offered any further contract work.

Speaking to The Independent she said: “If I’m going to lose my job, I want other nurses to know that this is what happens when you raise a concern. I want the public to know this is what happens to us in the NHS when we are trying to protect the public.

“I have an unblemished career. They’re crying out for nurses. I’ve dedicated my life to the NHS. I haven’t done anything wrong.”

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Source: The Independent, 6 February 2024

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‘Get on with it’: patient champion demands epilepsy drug redress

Ministers must begin paying compensation to the families of children disabled by the epilepsy drug sodium valproate by next year, a report will say this week.

The report’s author, Dr Henrietta Hughes, England’s patient safety commissioner, says valproate is “a bigger scandal than thalidomide, in terms of the numbers of people affected”.

She will back calls for financial redress for the thousands of children left physically and mentally disabled. Every month, three babies are still being born who have been exposed to the drug.

Speaking before the report’s launch, Hughes, 54, a GP, said the state had failed pregnant women by not telling them about key information regarding the drug’s risks. “These families have already been betrayed, because they weren’t given the right information to be able to make decisions to keep themselves and their family safe,” she said.

“There are senior politicians of every stripe who have expressed their sincere sympathy and support for patients who have been harmed. I take the view that people who seek high office need to also accept the responsibility that comes with that high office.

“The time for redress is now. The government is responsible. I’ve been asked to give them options for redress and I’ve done that. They have the recommendations, they have the advice, they have everything they need. Get on with it.”

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Source: The Times, February 2024

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Rishi Sunak admits he has failed to cut NHS waiting lists

Rishi Sunak has admitted the government has failed on a pledge to cut NHS waiting lists in England.

The prime minister said the government had "not made enough progress" but that industrial action in the health service "has had an impact".

Mr Sunak made the comments in an interview with TalkTV.

Cutting NHS waiting lists is one of five priorities Mr Sunak set out in January 2023, along with measures on the economy and illegal immigration.

At the time he said "NHS waiting lists will fall and people will get the care they need more quickly" but did not set a timeframe for achieving that.

Asked if his government has failed to achieve that pledge, Mr Sunak said: "Yes, we have."

The prime minister continued: "What I would say to people is that we've invested record amounts in the NHS - more doctors, more nurses, more scanners.

"All these things mean the NHS is doing more than it ever has but industrial action has had an impact."

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Source: BBC News, 5 February 2024

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Trusts pressured to meet ‘political’ target by diverting staff to less sick patients

Hospitals are being pressured to shift their resources to treating patients with less serious conditions to meet a “politically motivated” target, according to multiple senior sources.

The pressure appears to be coming through NHS England’s regional teams, with local sources saying they are being told to focus energies on patients in their emergency departments who do not need to be admitted to a ward.

These cases are typically faster to deal with, and therefore shifting resources to this cohort could significantly improve performance against the four-hour target.

However, experts in emergency care repeatedly warn that admitted patients are the most likely to suffer long waits and harm.

The NHS has been tasked with lifting performance against the four-hour target to 76% in 2023-24, but has failed to meet that in any month this year. Performance in December was 69%.

Some trust leaders told HSJ they would ignore the instructions, saying they would continue to focus resources on reducing the longest waits.

One chief executive in the north of England said: “It’s a complete nonsense and just politically motivated. We’re getting a very clear message to hit 76 per cent which is hugely problematic because it will drive non patient focussed behaviour. We have said ‘no, we are focussing on long waiters and ambulance delays’… in other words doing the right thing for patients.”

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Source: HSJ, 5 February 2024

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Under fives betrayed as health declines

Worsening health among the under fives in the UK needs to be urgently addressed, experts say.

The Academy of Medical Sciences highlights what it says are "major health issues" like infant deaths, obesity and tooth decay.

It says society is betraying children and the problems are limiting their future and damaging economic prosperity.

The report says:

  • The UK is 30th out of 49 rich countries for infant mortality.
  • One in five children falls short of the expected level of development aged two.
  • One in five is overweight or obese by five.
  • Vaccination targets are being missed for diseases such as measles.
  • One in four is affected by tooth decay by five.
  • One in five women struggles with their mental health during or just after pregnancy.
  • Air pollution is linked to worsening asthma.
  • Rising demand for child mental health services.

The report calls for a cross-government vision to be developed to tackle the problems and investment in the child health workforce, including health visitors.

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Source: BBC News, 5 February 2024

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‘They thought they were doing good but it made people worse’: why mental health apps are under scrutiny

“What if I told you one of the strongest choices you could make was the choice to ask for help?” says a young, twentysomething woman in a red sweater, before recommending that viewers seek out counselling. This advert, promoted on Instagram and other social media platforms, is just one of many campaigns created by the California-based company BetterHelp, which offers to connect users with online therapists.

The need for sophisticated digital alternatives to conventional face-to-face therapy has been well established in recent years. If we go by the latest data for NHS talking therapy services, 1.76 million people were referred for treatment in 2022-23, while 1.22 million actually started working with a therapist in person.

While companies like BetterHelp are hoping to address some of the barriers that prevent people from seeking therapy, such as a dearth of trained practitioners in their area, or finding a therapist they can relate to, there is a concerning side to many of these platforms. Namely, what happens to the considerable amounts of deeply sensitive data they gather in the process? Moves are now under way in the UK to look at regulating these apps, and awareness of potential harm is growing.

Last year, the UK’s regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (Nice), began a three-year project, funded by the charity Wellcome, to explore how best to regulate digital mental health tools in the UK, as well as working with international partners to help drive consensus in digital mental health regulations globally.

Holly Coole, senior manager for digital mental health at the MHRA, explains that while data privacy is important, the main focus of the project is to achieve a consensus on the minimum standards for safety for these tools. “We are more focused on the efficacy and safety of these products because that’s our role as a regulator, to make sure that patient safety is at the forefront of any device that is classed as a medical device,” she says.

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Source: The Guardian, 4 February 2024

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Misogyny and racial bias routinely putting patients at risk, warns NHS England safety chief

Deeply ingrained medical misogyny and racial biases are routinely putting people in need of treatment at risk, the government’s patient safety commissioner in England has warned.

Dr Henrietta Hughes was appointed in 2022 in response to a series of scandals in women’s health. She outlined a “huge landscape” of biases in need of levelling, citing examples ranging from neonatal assessment tools and pulse oximeters that work less well for darker skin tones to heart valves, mesh implants and replacement hip joints that were not designed with female patients in mind.

Hughes said: “I don’t see this as blaming individual healthcare professionals – doctors and nurses – for getting it wrong. It’s pervasive in the systems we have – the training, the experience, the resources.

“Anatomy books are very narrow in their focus. Even the resuscitation models are of pale males – we don’t have female resuscitation models, we don’t have them in darker skin tones. This is deeply ingrained in the way that we assess and listen to patients.”

She described the realisation that pulse oximeters, used to measure blood oxygen levels, work less well for darker skin tones as a “real shock to the system” when the problem was highlighted during the pandemic. More recently, the NHS Race and Health Observatory highlighted concerns about neonatal assessments.

Bilirubinometers, widely used to assess jaundice in newborn babies, are less reliable for darker skin tones and some guidelines for the assessment of cyanosis (caused by a shortage of blood oxygen) refer to “pink”, “blue” or “pale” skin, without reference to skin changes in minority ethnic babies. The Apgar score, a quick test given to newborns that was rolled out in the 1950s, traditionally includes checking whether a baby is “pink all over”.

“Even the names of those conditions – jaundice and cyanosis – suggest a colour. The Apgar score includes P for pink all over,” said Hughes. “There are systemic biases in that if you have a darker skin tone those conditions may not be so apparent.”

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Source: The Guardian, 4 February 2024

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‘Horrifying’ failure to provide safety warnings for high-risk medicine

Concerns have been raised that patients may not be receiving “vital” safety information after HSJ discovered a high-risk medication was frequently not being dispensed as originally packaged. 

In 2018, the Medicines and Healthcare Products Regulatory Agency asked pharmacies to dispense valproate-containing medications in their original pack where possible, to ensure packages include safety warnings. 

It also asked manufacturers to produce smaller pack sizes and add pictorial warnings, while pharmacists were additionally asked to add stickered warnings to the outer box of any valproate-containing medication not dispensed in its original packaging.

Yet, data obtained via freedom of information requests to the NHS Business Services Authority revealed that while the proportion and number of valproate-containing items dispensed as split packs – as opposed to whole packs – had decreased over the last five years, split packs still accounted for more than half of items dispensed in 2022-23. 

Emma Murphy, of campaign group In-Fact, said the figures on split pack dispensing were “quite horrifying” and showed “the system is not working”.

She added: “Attitudes have got to change – prescribers, GPs etc need to be proactive and warn women of the risks because this isn’t just a side effect, this is harming real babies. As a mum of five affected children, the consequences of valproate in pregnancy on that baby is devastating.”

Alison Fuller, of Epilepsy Action, said the high proportion of split packs being dispensed made it “clear why the change in guidance introduced in October 2023 was necessary”, adding: “The manufacturer’s original full pack always contains all the relevant information, which is why it’s the best option for patient awareness.”

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Source: HSJ, 

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Parents of sudden-death children 'let down by NHS'

The NHS is failing some parents whose children die unexpectedly, a leading paediatrician has told BBC Panorama.

About 50 children's deaths in the UK every year are termed as "sudden unexplained death in childhood" (SUDC). Little is known about what causes them.

Gavin and Jodie's two-year-old son Addy died unexpectedly in November 2022.

BBC Panorama followed the parents over nine months as they searched for answers to why their son died - and whether it could have been prevented.

Even after a forensic post-mortem examination, no-one could work out why the little boy went to sleep and never woke up, so his death was categorised as SUDC.

When a child dies unexpectedly, a review is held to gather information about what happened. The NHS is required to assign a key worker to help bereaved parents to navigate this process, and provide emotional support. The role of key worker can be taken by a range of practitioners and is often a specialist nurse.

However, even though it is a mandatory requirement, a survey carried out by the Association of Child Death Review Professionals (ACDP) found that more than half of NHS areas in England do not have a specialist nurse to visit parents after an unexpected death.

"It makes me really angry," says paediatrician Dr Joanna Garstang, the chair of the ACDP, who runs one of the few teams in England that support parents.

"Bereaved families after the sudden death of a child are the most vulnerable people. And if we don't put in early support… we're setting these parents up for a lifetime of misery."

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Source: BBC News, 5 February 2024

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The NHS is failing our children, says top children’s doctor

Children are being forgotten by the government as they face “disgraceful” waiting times for NHS treatment, Britain’s top paediatric doctor has warned.

Dr Camilla Kingdon said children are being failed because their care is not being treated as a priority, despite considerable progress having been made in reducing waiting times for adults.

In her final interview as president of the Royal College of Paediatrics and Child Health, she also issued a stark warning over the impact of poverty on young people’s health, lamenting the rise in the number of children being treated for severe lung disease due to damp and poor ventilation in inadequate housing.

Many parents cannot afford to be at their dying or sick child’s bedside because of financial pressures – an issue that has grown significantly worse in the past five years, she said.

She told The Independent: “Children simply need to be made a priority. We cannot afford to be ignoring this problem.”

The latest NHS figures show that the backlog for children’s hospital care has risen again, increasing from 387,000 in August to 412,000 in January, despite the adult waiting list having fallen since October.

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Source: The Independent, 31 March 2024

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Irish medical negligence legal costs among highest in world, report says

Legal costs in Irish medical negligence cases are among the highest in the world, according to a report that says the slow pace of legal actions here is damaging patients and doctors’ mental wellbeing.

The average cost of a legal claim for medical negligence in Ireland is almost three times higher than in the UK, and cases take over 50 per cent longer to resolve, the industry report says.

Patients and doctors in Ireland are dragged through what can be a brutal process, for longer than necessary, with patients having to wait longer to receive compensation, the report by the Medical Protection Society (MPS) asserts.

In the report, the society, which provides indemnity cover for 16,000 doctors and other healthcare professionals in Ireland, compared the length and cost of legal actions here with other jurisdictions in which it operates.

A medical negligence claim in Ireland takes 1,462 days on average (four years), 14% longer than in South Africa and 56% longer than in Hong Kong, the UK or Singapore, it found.

Two hundred doctors in Ireland were interviewed for the report: 88% said they were worried about the length of time the litigation process was taking and 91% were worried about their mental wellbeing while it was ongoing. Some said they needed professional help, experienced suicidal thoughts, or quit medicine as a result of the claim.

“It was horrendous. I had to leave medicine after it,” says one doctor involved in a claim who is quoted in the report. “I developed severe anxiety during the course of the claim and PTSD. I lost my career in medicine and I am devastated about that. I knew I could never go through the same again.”

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Source: The Irish Times, 31 January 2024

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NHSE director admits ‘huge cost’ to cutting ambulance delays

Reductions in the number of long ambulance delays have come at a “huge cost” as hospitals are having to take in more emergency patients than they have space for, NHS England’s urgent care director has said.

Sarah-Jane Marsh told NHS England’s board meeting on Thursday that emergency departments and hospital wards are now taking more “risk” by taking extra patients in a bid to get ambulances back on the road quicker.

This year, many fewer hours have been lost to ambulance delays, although the total number of delays of more than 60 minutes is approaching the same as last winter. Emergency department waits in November and December were better than last year, although still much worse than pre-covid and a long way below targets. 

But Ms Marsh said the improvement was a result of hospitals agreeing to take more patients into EDs and acute wards, even when they did not have space or staff to properly care for them.

She said: “It’s come at a huge cost. Some of the things we have achieved are because we have moved pressures around in the system.

“We have moved risk out of people’s houses and from the back of ambulances, and in some cases we’ve moved that into emergency departments [and] wards, that have had to take the pressure of taking additional patients.

“Next year one of our learnings is that we need to have a really big focus on what is happening inside our hospitals [so] we decongest some very crowded areas.”

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Source: HSJ, 1 February 2024

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Maternity delays spark thousands of safety alerts each year

Maternity departments are raising thousands of safety reports every year about delayed inductions of labour, HSJ can reveal.

Induction of labour may be used when women are overdue, because their waters have broken, or for other medical reasons to speed up the birth, such as poor growth of the baby.

Delaying induction therefore may increase risks for both mothers and babies and the National Institute for Health and Care Excellence says trusts should raise a “red flag event” if it is delayed for more than two hours after admission.

Information collected by HSJ from 50 trusts show 4,945 red flags related to delays in induction of labour in 2022-23. HSJ also found 3,109 reports in 2021-22 and 1,807 in 2020-21 across 47 trusts. 

Meanwhile, there were 1,997 Datix reports mentioning induction of labour in 2022-23 across 59 trusts able to give HSJ figures, in response to Freedom of Information Act requests, compared with 1,690 in 2021-22 and 1,368 in 2020-21. 

The Care Quality Commission has also raised concerns in inspections that incidents which should have been treated as “red flags” have not always been reported as such. The watchdog has also raised concerns about a lack of board-level oversight of maternity safety incidents and a need for clearer guidance for staff on reporting processes. 

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Source: HSJ, 2 April 2024

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Anger at daughter’s sepsis death fuels my campaign

Jason Watkins, a British actor, has urged A&E units to look again at procedures surrounding infants as he has channels his anger at his young daughter’s death from sepsis into trying to “improve the system”.

The actor said that his fury at the death of Maude aged two on New Year’s Day 2011 led him to smash up his shower.

“It wasn’t anger at any individual, it was anger at fate. Why should we deserve this?” he told Andy Coulson’s Crisis What Crisis? podcast.

“You feel really vulnerable and there’s a sort of rage against that. And there are all these different ways of resolving and wrestling out of this horrible dark pit that you’re in."

He now campaigns for the UK Sepsis Trust.

“I was never angry at any individual,” he said. “My anger was fuelled into trying to work out better ways of dealing with sepsis, or even more than that, the way that we look at infants in A&E. Because you know, it’s a funding issue, it’s an organisational issue. It’s another conversation.

“Because I had identified that there wasn’t an individual at fault in the hospital, it has to be the system. So we’ve got to improve it. My anger is fuelled into that. There’s no bitterness. Nobody made a technical mistake, it’s just nobody really thought of the possibilities of what could be happening.

“For me the whole of looking at infants arriving at A&E needs to be looked at again. Because if I say that Maude died twelve years ago, and that the ombudsman report about sepsis a couple of months ago said that nothing had changed about sepsis, now, that was like a body-blow, that makes me feel sick even thinking about it now, because we’ve worked so hard over that time.”

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Source: The Times, 1 February 2024

 

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Cancer deaths in UK set to rise by more than 50% by 2050, experts warn

Deaths from cancer in the UK are set to rise by more than 50% in the next 26 years, stark new estimates suggest.

Experts from the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO) have found there were 454,954 new cases of cancer in the UK in 2022 and warned this is expected to rise to 624,582 by 2050.

In 2022, 181,807 people died in Britain from cancer, but researchers warned this is expected to rise to 279,004 by 2050 – a 53% increase.

The estimates suggest the rising rates of cancer will be driven by the UK’s growing and ageing population. However, researchers have also called for new policies to tackle levels of smoking, unhealthy diets, obesity and alcohol to help lower the expected surge in cases.

The study examined cancer data from 115 different countries and estimated global cases would rise by 77 per cent, from 20 million in 2022 to 35 million in 2050.

The organisations estimate that cancer deaths around the world will almost double from 9.7 million to 18.5 million in that time.

Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, said the new estimates “show the increased burden that cancer will have in the years to come”.

“UK governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has in part widened health inequalities,” she added.

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Source: The Independent, 1 February 2024

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Online GP access leaves patients lost, says report

Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says.

Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups.

This included people with English as a second language and those less confident with technology.

Online services include booking appointments, requesting repeat prescriptions and viewing test results.

Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about."

One Epsom and Ewell resident was asked by their surgery to book a blood test online.

They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back.

"I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me."

Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services.

She said: "People feel they're being pushed online, and that spans a range of different demographics.

"It's really important for practices to identify the needs of their patients and how they can best meet those."

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Source: BBC News, 2 February 2024

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USA: Best hospitals by specialty national rankings

In 2023-2024, the US News Best Hospitals ranked hospitals in the USA in 15 adult specialties as well as recognised hospitals by state, metro and regional areas for their work in 21 more widely performed procedures and conditions.

Of the nearly 5,000 hospitals analyzed and 30,000 physicians surveyed, only 164 hospitals ranked in at least one of the specialties.

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Source: US News

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EU pushes for higher uptake of two key cancer-preventing vaccines

The European Commission is recommending measures EU countries should adopt to increase the uptake of two vaccines that prevent viral infections that can cause cancer, it said on Wednesday.

The two vaccines are against the human papillomaviruses (HPV) that can cause many cancers, including cervical cancer, and against hepatitis B (HBV), which can lead to liver cancer.

As part of Europe's Beating Cancer Plan, the European Union wants member countries to reach HPV vaccination of 90% for girls by 2030 and significantly increase the rate for boys.

"Many Member States are well below 50% HPV vaccination coverage for girls with limited data available for boys and young adults, and there is a significant lack of data on HBV vaccination rate," the Commission statement said, adding it was as low as 1% in some countries.

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Source: Medscape UK, 31 January 2024

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Next government should declare NHS a national emergency, experts warn

The NHS is in such a dire state the next government should declare it a national emergency, experts are warning, as it emerged that record numbers of patients are being denied timely cancer treatment.

It is facing an “existential threat” because of years of underinvestment, serious staff shortages and the demands of the ageing population, according to a group of leading doctors and NHS leaders.

Whoever wins power after the general election will have to “relaunch” the health service and ask the public to do what they can to help save it and preserve its founding principles, they say.

The call, by a commission of experts assembled by the BMJ medical journal, comes as new figures show that since 2020 more than 200,000 people in England have not received potentially life-saving surgery, chemotherapy or radiotherapy within the NHS’s supposed maximum 62-day wait. Professor Pat Price, a leading NHS oncologist who helped analyse NHS cancer care data, said that the UK was facing “the deepest cancer crisis” of her 30-year career treating cancer patients. 

The acute concern about the NHS’s ability to cope with the rising tide of illness deepened last night when A&E doctors claimed that a government plan launched a year ago to relieve the strain on overcrowded emergency departments had made no difference. A&E remains in “permacrisis” while care in units is “as unsafe, or more unsafe, than at this time last year”, despite Rishi Sunak hailing his “ambitious and credible plan to fix it”.

Although 5,000 more hospital beds have been created, the “half-baked” plan has “made little real difference to the experience of patients and the working conditions of health care professionals”, said Dr Ian Higginson, the vice-president of the Royal College of Emergency Medicine.

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Source: Guardian, 31 January 2024

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Patients at risk of suicide and harm over unsafe hospital discharges

Mental health services are failing to keep patients safe from suicide and harm after leaving hospital, the Parliamentary and Health Service Ombudsman (PHSO) has warned.

It also identified failings around planning and communication when patients are discharged, and has urged the Government to strengthen the Mental Health Act.

The warning comes after the Department for Health and Social Care was forced to announce a Care Quality Commission (CQC) rapid review into mental health services in Nottingham following the killings of students Grace O’Malley-Kumar and Barnaby Webber, both 19, and school caretaker Ian Coates, 65, in June last year, by Valdo Calocane.

Knifeman Calocane had paranoid schizophrenia and had been a regular patient of Highbury Hospital with mental health problems. In a report last week, The Independent revealed separate investigations into Highbury Hospital which have led to the suspension of more than 30 staff over allegations of falsifying records and harming patients.

The latest report by the Parliamentary and Health Service Ombudsman (PHSO), following a report in 2018, looked at more than 100 complaints between 2020 and 2023 where it had identified failings in mental health care. 

Lucy Schonegevel, director of policy and practice at the charity Rethink Mental Illness, said: “Someone being discharged from a mental health service, potentially into unsafe housing, financial insecurity or distanced from family and friends, is likely to face the prospect with anxiety and a sense of dread rather than positivity. Mistakes or oversights during this process can have devastating consequences. This report puts a welcome spotlight on how services can improve the support they offer people going through the transition back into the community, by improving communication and the ways in which different teams work together to provide essential care.”

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Read PHSO report Discharge from mental health care: making it safe and patient-centred (PHSO, 1 February 2024)

Source: Independent (1 February 2024)

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‘Insufficient curiosity’ of trust’s leaders enabled abuse

A major review into a mental health unit abuse scandal has found a catalogue of failings, including repeated missed opportunities to act on concerns, and a board “disconnected” from the realities faced by patients and staff.

The independent review into failings at Greater Manchester Mental Health Foundation Trust was published today, commissioned after BBC Panorama revealed a “toxic culture of humiliation, verbal abuse and bullying” at Edenfield Centre in Prestwich in September 2022.

The trust’s then chair, Rupert Nichols, resigned in November 2022, and CEO Neil Thwaite stepped down in spring last year.

Review chair Professor Oliver Shanley, a former mental health trust CEO and chief nurse, describes in his report how the trust’s culture and leaders’ “insufficient curiosity” contributed to the “invisibility” of the deterioration in care quality. He says its board was focused on “expansion, reputation and meeting operational targets”.

Read full story (paywalled)

Read the report of the Independent Review into Greater Manchester Mental Health NHS Foundation Trust

Source: HSJ, 31 January 2024

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Pharmacists to prescribe drugs for minor illnesses

Treatments for seven conditions such as sore throats and earaches are now available directly from pharmacists, without the need to visit a doctor.

The Pharmacy First scheme will allow most chemists in England to issue prescriptions to patients without appointments or referrals.

NHS England says it will free up around 10 million GP appointments a year.

Pharmacy groups welcome the move but there is concern about funding and recent chemist closures.

Pharmacists can carry out confidential consultations and advise whether any treatment, including antibiotics, are needed for the list of seven minor ailments.

Patients needing more specialist or follow-up care will be referred onwards.

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Source: BBC News, 31 January 2024

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People severely ill with suspected sepsis should be given antibiotics, Nice says

People who are severely ill with suspected sepsis should promptly be given life-saving access to antibiotics to prevent unnecessary deaths, according to updated guidance from the National Institute for Health and Care Excellence (NICE.) The guidelines state that the national early warning score should be used to assess people with suspected sepsis aged 16 and over, who are not and have not recently been pregnant, and are in an acute hospital setting or ambulance.

The updated guidance also recommends that doctors are more considerate as to who is given antibiotics, in order to reduce the risk of antibiotic resistance in people being prescribed them for less severe cases of sepsis.

With the update, NICE says that more people will be categorised at a lower risk level where a sepsis diagnosis should be confirmed before being given antibiotics.

Prof Jonathan Benger, Nice’s chief medical officer, said: “This useful and usable guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics.

“We know that sepsis can be difficult to diagnose so it is vital there is clear guidance on the updated [national early warning score] so it can be used to identify illness, ensure people receive the right treatment in the right clinical setting and save lives."

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Source: The Guardian, 31 January 2024

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NHS adds digital prescriptions to app after successful trial

New digital prescriptions mean NHS App users in England can now collect medication from a pharmacy without having to visit a GP or health centre.

The usual paper slip given by doctors has been replaced by an in-app barcode, which can be scanned at any pharmacy.

Users can already request repeat prescriptions on the app - and every digital order fulfilled will save the GP three minutes, NHS Digital says.

It comes after a trial last year, involving more than a million users.

Patients can use the app to check what medicines they have been prescribed, and when.

Anyone who has a nominated pharmacy can continue to collect medication without a paper prescription or barcode, as the details are sent to their pharmacy electronically.

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Source: BBC News, 30 January 2024

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