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Calls for action over unregulated care workers after NHS mental health abuse scandal exposed

Unregulated healthcare workers are a risk to the most vulnerable patients, a former victim’s commissioner has warned after The Independent and Sky News uncovered a “horrifying” sexual abuse scandal within NHS mental health services.

Dame Vera Baird called for a formal framework for healthcare assistants and support workers, who do not have a mandatory professional register like doctors and nurses and can “come in and go out from one hospital to another” without the same thorough checks.

Dame Vera told The Independent that the setup did not lead to a “very safe way of working” because healthcare assistants are “in an environment where they are responsible for vulnerable people”.

“If there has been abuse from mental health care assistants who are also agency staff who are coming in and going out from one hospital to another, that needs to be looked at,” she said.

“This is not a very safe way of working. Some kind of framework around agency staff seems to be very important [to have].”

She warned that sexual predators may go into mental health services and work in units where patients can be “highly sexualised”, prompting a “dreadful combination”.

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Source: The Independent, 30 January 2024

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Duty of candour a ‘tick box exercise’ for overworked leaders, says watchdog

Senior leaders are resorting to “ticking the duty of candour box” instead of developing a “just and learning” culture in their organisations because their bandwidth is full, the patient safety commissioner has said.

Speaking with HSJ as she begins the second year of her first term in the newly-established role, Henrietta Hughes said the bandwidth of senior leaders is “too full for them to make and maintain the necessary culture change”.

She warned the duty of candour — giving patients and families the right to receive open and transparent communication when care goes wrong — gets seen as a “bit of a tick box exercise, ‘doc tick’ as it’s described to me, which is a bit depressing really”.

A GP herself, she said individual doctors typically respond to concerns or they are handled by someone who knows the patient. Elsewhere, complaints are often addressed through a chief executive’s office, once all staff have provided written statements, she said.

She added: “[In general practice] it feels more compassionate and empathetic… I find it’s often quicker to have a conversation with the patient before it turns into a formal complaint and resolves it quickly.”

“What needs to change is that [NHS] trusts are currently held accountable to a very narrow set of criteria — financial and operational performance,” she said.

“This is how we will improve safety and experience, transparency, a just and learning culture, and improve morale.”

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Source: HSJ, 30 January 2024

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Northern Ireland: Dentists warn radical action needed to save dental services

Health service dentistry in Northern Ireland could be caught in a "death spiral" without radical action, more than 700 dentists have warned.

They say a combination of factors could make the service unsustainable.

These include a potential ban on dental amalgam metals used in fillings, budget pressures and a "financially unviable contractual framework".

The dentists have called on the Department of Health (DoH) "to show leadership and take action now".

A DoH spokesperson said the department "valued the important role" of dentists and was "aware of the ongoing pressures on dental practices".

In an open letter to Peter May, the top civil servant at the DoH, dentists from the British Dental Association (BDA) Northern Ireland warned that services were under "intolerable pressure".

The letter said: "Despite clear evidence and repeated warnings issued by the BDA about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities."

The dentists added that a move away from health service dentistry was "well and truly underway" and dentists would "be increasingly driven out of health service dentistry to keep their practices afloat".

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Source: BBC News, 30 January 2024

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Whistleblowers accuse NHS trust of avoidable baby deaths

Serious concerns about maternity services at an NHS trust have been revealed by BBC Panorama.

Midwives say a poor culture and staff shortages at Gloucestershire Hospitals NHS Trust have led to baby deaths that could have been avoided.

A newborn baby died after the trust failed to take action against two staff, the BBC has been told.

The trust says it is sorry for its failings and is determined to learn when things go wrong.

Concerns about two staff members, both midwives, had been raised by colleagues at the Cheltenham Birth Centre after another baby died 11 months earlier.

The birth centre allowed women with low-risk pregnancies the choice of giving birth there under the care of midwives - there were no emergency facilities in the centre.

In the event of complications, women should have been transferred to the Gloucestershire Royal Hospital, which is part of the same trust and about a 30-minute drive away.

But on both occasions, the two midwives did not get their patients transferred quickly enough.

The two midwives on duty for both deaths are now being investigated by their regulator, the Nursing and Midwifery Council.

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Source: BBC News, 29 January 2024

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Physician associates accused of illegally prescribing drugs and missing diagnoses

Physician associates have attempted to illegally prescribe drugs at dozens of NHS trusts and missed life-threatening diagnoses, a dossier claims. 

Doctors working across the country claim patients’ lives have been put at risk by physician associates (PAs) who they say have failed to respond appropriately to medical emergencies – alleging more than 70 instances of patient harm and “near misses”.

The Telegraph has seen responses from more than 600 doctors to a survey on PAs run by Doctors’ Association UK (DAUK), a campaign group.

The data suggest that at over half of England’s hospital trusts, doctors are being replaced by PAs on the rota, despite associates only completing a two-year postgraduate course and having no legal right to prescribe.

A spokesperson from the Department of Health said their role “is to support doctors, not replace them”.

The Telegraph has interviewed more than a dozen surveyed doctors, as well as other clinicians worried about patient safety.

At Dudley Group NHS Trust, one junior doctor said a PA had missed an “obvious heart attack” on an ECG, having “just signed it as if it was normal”.

A clinician in primary care alleged PAs repeatedly misdiagnosed a patient’s metastatic cancer as muscle ache – despite blood results that were “tantamount” to a cancer diagnosis.

They said: “The patient could have been saved eight months of pain; their life could have been prolonged.”

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Source: The Telegraph, 27 January 2024

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Cancer patient went year without check-up, inquest told

A prostate cancer patient went a year without a check-up because his referral to a consultant was lost.

An inquest into the death of Thomas Ithell also heard that when the error was spotted it was not recorded because staff at Wrexham Maelor Hospital were too busy.

The 77-year-old from Wrexham died in November 2022 after being admitted to hospital with shortness of breath.

Assistant Coroner for North Wales East and Central, Kate Robertson, has submitted a Prevention of Future Deaths report to the health board in relation to Mr Ithell's case.

As well as concerns over the lack of an investigation, she also questioned how the patient's follow-up appointment was missed.

"There have been no assurances as to what, if any, changes and learning have been identified other than a tracking system for PSA monitoring," she wrote, referring to a type of blood test that helps diagnose prostate cancer.

She was also concerned to learn that the hospital's Datix system - used for reporting incidents such as Mr Ithell's - had been described as "not user-friendly".

Time constraints also sometimes prevented staff from completing these reports, thereby failing to trigger subsequent investigations by the board, the assistant coroner added.

"I remain incredibly concerned that where matters are not raised in accordance with internal health board processes that assurances given to me in previous Prevention of Future Deaths reports cannot be supported," Ms Robertson added.

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Source: BBC News, 27 January 2024

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Mental health patients ‘raped and sexually assaulted’ as NHS abuse scandal revealed

Tens of thousands of sexual assaults and incidents have been reported in NHS-run mental health hospitals as a “national scandal” of sexual abuse of patients on psychiatric wards can be revealed.

Almost 20,000 reports of sexual incidents in the last five years have been made in more than half of NHS mental health trusts, according to exclusive data uncovered in a joint investigation and podcast by The Independent and Sky News.

The shocking findings, triggered by one woman’s dramatic story of escape following a sexual assault in hospital revealed in a podcast, Patient 11, show NHS trusts are failing to report the majority of incidents to the police and are not meeting vital standards designed to protect the UK’s most vulnerable patients from sexual harm.

Throughout the 18-month investigation, multiple patients and their families spoke to The Independent about their stories of sexual assault and abuse while locked in mental health units.

Dr Lade Smith, president of the Royal College of Psychiatrists, called the findings “horrendous”, while shadow health secretary Wes Streeting said it was a “wake-up call” for the government.

Dr Smith told The Independent: “There is no place for sexual violence in society, which has a profound and long-lasting negative impact on people’s lives. Today’s horrendous findings show that there is still much to do to make sure that patients and staff in mental health trusts are protected from sexual harms at all times.

“It is deeply troubling to see that so many incidents in mental health settings go unreported.”

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Source: The Independent, 29 January 2024

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‘Disingenuous’ wait times on NHS App will be half those patients have to face

Next week’s launch of the ‘Wayfinder’ waiting time information service on the NHS App will give patients “disingenuous” and “misleading” information about how long they can expect to wait for care, senior figures close to the project have warned.

Briefing documents seen by HSJ show the figure displayed to patients will be a mean average of wait times taken from the Waiting List Minimum Data Set and the My Planned Care site.

However, it was originally intended that the metric displayed would be the time waited by 92% of relevant patients. This is more commonly known as the “9 out of 10” measure.

Mean waits are likely to be about “half the typical waiting time” measured under the 9 out of 10 metric, according to the waiting list experts consulted by HSJ.

Ahead of The Wayfinder service’s launch on Tuesday, NHS trusts and integrated care boards have been sent comprehensive information on how to publicise it, including a “lines to take” briefing in case of media inquiries. This mentions the use of an “average” time but does not provider any justification for this approach.

HSJ’s source said the mean average metric was “the worst one to choose” as it would be providing patients with “disingenuous” information that will leave them disappointed. They added that the 92nd percentile metric would be a “far more realistic” measure “for a greater number of people”.

They concluded that “using an average” would create false expectations “because in reality nobody will be seen in the amount of time it is saying on the app.”

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Source: HSJ, 26 January 2024

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NHS trust ‘abandoned’ budding paramedic who took her own life

Rebecca McLellan, a trainee paramedic, pursuing the job she had dreamed of as a child, took her own life at the age of 24.

Amid the devastation felt by her loved ones, serious questions have now emerged about the standard of care she received at Norfolk and Suffolk NHS Foundation Trust (NSFT).

In notes recorded before her death last November, McLellan said that Norfolk and Suffolk NHS Foundation Trust (NSFT) had “abandoned” her in a time of need. An internal investigation has now been launched by the mental health trust, which has been dogged by safety concerns for more than a decade.

Relatives of McLellan, who lived in Ipswich, Suffolk, and was being treated for bipolar disorder, are among hundreds of bereaved families who believe their loved ones were failed under the care of the trust. Her mother, Natalie McLellan, 48, said it was clear that some of her daughter’s feelings of helplessness in her final months were “shaped by their inadequacy”.

“She was somebody that had it all,” said Natalie. “She had a supportive family, she had a nice flat, she had a nice car, she was doing exactly what she wanted to do in life. She had a voice, she was able to speak and advocate for herself as a medical professional. If she can’t get help, what the hell hope is there for anybody else?

Recent months have seen calls for a public inquiry and criminal investigation into NSFT after bosses last year admitted to losing count of the number of patients that had died on its books. Campaigners describe the mismanagement of mortality figures as “the biggest deaths crisis in the history of the NHS”.

The Times has spoken to trust staff, bereaved relatives and MPs who say that despite repeated promises of improved care the trust’s overstretched services remain unsafe and require urgent reform.

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Source: The Times, 26 January 2024

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Crumbling hospitals cause over 100 care disruptions a week, NHS figures show

Hospitals in England are being hit with disruptions to patients’ care more than 100 times every week because of fires, leaks and problems created by outdated buildings, NHS figures reveal.

There have been 27,545 “clinical service incidents” over the past five years – an average of 106 a week – data compiled by the House of Commons library shows.

They are incidents the NHS says were “caused by estates and infrastructure failure related to critical infrastructure risk” and are linked to the service’s massive backlog of maintenance, the bill for which has soared to £11.6bn. All the incidents led to “clinical services being delayed, cancelled or otherwise interfered with” for at least five patients for a minimum of 30 minutes.

That means the 27,545 incidents between 2018-19 and 2022-23 disrupted the care of at least 137,725 patients, according to an analysis of NHS data by the Commons library commissioned by Ed Davey, the leader of the Liberal Democrats.

“These findings are shocking but sadly not surprising, given the dilapidated, and in some cases dangerous, state of so many NHS facilities,” said Saffron Cordery, the deputy chief executive of NHS Providers, which represents health service trusts.

The “unacceptable impact on patients” should spur ministers into increasing the NHS’s capital budget so trusts can urgently overhaul their estates, she said.

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Source: The Guardian, 26 January 2024

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Valdo Calocane ‘fell off radar’ of mental health services

Campaigners have said that more lives would be lost unless mental health services were reformed. Figures show 120 people each year are killed by people with mental illnesses.

Julian Hendy, whose father was killed by a psychotic man with a long history of mental ill health 17 years ago, said health professionals must be “more assertive” and work better with other agencies such as the police.

Valdo Calocane, who was sentenced on Thursday to an indefinite hospital order after being convicted of manslaughter of three people in Nottingham, had fallen off the radar of mental health services, which allowed him to avoid taking his medicine.

Hendy accused Nottinghamshire Healthcare NHS Foundation Trust, which was responsible for Calocane’s care, of “washing their hands” of him.

He said: “It’s not responsible and it’s not safe. It doesn’t look after people properly … That hasn’t helped him at all, or protected his rights at all, because he has now committed this terrible offence.”

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Source: The Times, 26 January 2024

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Diabetes patients struggling without 'wonder drug'

Diabetes patients have told the BBC they are struggling without what they have called a "wonder drug".

Experts estimate about 400,000 people with Type 2 diabetes could have been affected by a national supply shortage caused by rising demand.

The new generation of medicines - GLP-1 receptor agonists - mimic a hormone that not only controls blood sugar levels but also suppresses appetite.

The government said it was trying to help resolve the supply chain issues.

NHS England has issued a National Patient Safety Alert for the drugs.

The NHS alerts require action to be taken by healthcare providers to reduce the risk of death or disability.

The diabetes medicines in short supply are Ozempic, Trulicity, Victoza, Byetta, and Bydureon. They work via injections instead of tablets.

The group of medicines has been used by the NHS for diabetes for around a decade but in recent years there has been a growth in private clinics prescribing the same drugs for weight loss for people who do not have diabetes, pushing up demand.

Novo Nordisk, which manufactures Ozempic and Victoza, told the BBC it was experiencing shortages of its medicines for people in the UK with Type 2 diabetes due to "unprecedented levels of demand".

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Source: BBC News, 26 January 2024

Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.

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Claims patients are dying in queuing ambulances

Paramedics are "watching their patients die in the back of ambulances because they can't get them into A&E", according to the health union, Unison.

It was commenting on data showing 2,750 hours were lost by ambulance crews waiting to hand over patients at Hull Royal Infirmary in October 2023.

One crew was stuck outside A&E for 10 hours and 27 minutes.

Hull University Teaching Hospitals said it was "confident" a new urgent treatment centre on the hospital site would "improve overall waiting times" and lost ambulance hours had "reduced notably" this month.

The figures, obtained by the BBC through a freedom of information request, showed on 9 October 2023 ambulance crews lost 144 hours and 18 minutes, the equivalent to one crew being out of action for six full days and nights.

Megan Ollerhead, Unison's ambulance lead in Yorkshire, said paramedics were "literally watching their patients die in the back of these ambulances because they can't get into A and E."

"I talk to a lot of the people who receive the 999 calls in the control rooms and they're just listening to people begging for ambulances and they know there are none to send."

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Source: BBC News, 26 January 2024

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EU plan for medicine stockpile could worsen UK’s record shortages

The EU is to stockpile key medicines that will worsen the record drug shortages in the UK, with experts warning that the country could be left “behind in the queue”.

The EU is seeking to safeguard its supplies by switching to a system in which its 27 members work together to secure reliable supplies of 200 commonly used medications, such as antibiotics, painkillers and vaccines.

But the bloc’s move to insulate itself from growing drug shortages threatens to exacerbate the increasing scarcity of medicines facing the NHS, posing serious problems for doctors.

“Europe is securing access to key drugs and vaccines as a single region, with huge influence and buying power. As a result of Brexit the UK is now isolated from this system, so our drug supplies could be at risk in the future,” said Dr Andrew Hill, an expert on the pharmaceutical trade.

Britain is experiencing a record level of drug shortages, with more than 100 – including treatments for cancer, type 2 diabetes and motor neurone disease – scarce or impossible to obtain.

Mark Dayan, the Brexit programme lead at the Nuffield Trust health thinktank, said the EU’s decision to act as a buying cartel could seriously disadvantage Britain.

“There is a real risk that measures in such a large neighbour, which is now a separate market due to Brexit, will leave the UK behind in the queue when shortages strike,” Dayan said.

It also has an initiative for member states to transfer stocks of medicine to cover shortages in others. These measures could shut UK purchasers out in certain scenarios.

“This would risk worsening shortages from a starting point where they are already exceptionally severe for the UK and other countries, with a mounting impact in terms of costs and wasted time for the NHS, and in terms of patients struggling to get what their doctors have said they need.”

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Source: The Guardian, 25 January 2024

Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.

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NHSE announces £16m procurement of teams to support EPR delivery

NHS England said it had opened a tender worth £16 million to support provider organisations as they seek to improve their digital maturity and get electronic patient records in place by the end of March 2026. 

NHSE said its frontline digitisation programme is working with NHS secondary care trusts providing acute specialist, community, mental health and ambulance services to help them reach a minimum level of digital capability as defined by the Digital Capabilities Framework. 

To fulfil this ambition, NHSE is seeking a partner to create an experienced, multi-skilled, rapid response intervention service, also known as a Tiger Teams service, capable of supporting EPR delivery across England.

This service will be an expansion to an existing comprehensive support offer available to providers, designed to support the national demand for resource, expertise, and information necessary to successfully rollout EPRs. 

NHSE said: “Often during EPR delivery, there is a requirement for either a planned, or unplanned, specific, time-bound skill set, capable of providing a set of deliverables, problem rectification or other specialist intervention for an element of the EPR Programme.

“Trusts are finding it increasingly challenging to obtain good quality, skilled short-term resources, both from the recruitment and contingent labour market.” 

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Source: Digital Health, 22 January 2024

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Bullying 'normal occurrence' at Newcastle NHS trust, say CQC

A "significant deterioration" in leadership at an NHS trust probably had a "knock-on effect" on its standard of services, a watchdog has found.

Inspectors found staff felt encouraged to "turn a blind eye" to bullying in hospitals run by the Newcastle Hospitals NHS Foundation Trust.

The Care Quality Commission (CQC) downgraded the trust's overall rating to "requires improvement".

The trust said it "fully accepts" the report and that recommendations were being worked on "as a matter of urgency".

Ann Ford, CQC's director of operations in the north, said: "We found a significant deterioration in how well the trust was being led.

"Our experience tells us that when a trust isn't well led, this has a knock-on effect on the standard of services being provided to people.

"Some staff told us that bullying was a normal occurrence, and they were encouraged to 'turn a blind eye' and not report this behaviour.

"This is completely unacceptable."

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Source: BBC News, 25 January 2024

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New inquiry: NHS Leadership, performance and patient safety

The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS.

Inquiry: NHS leadership, performance and patient safety

MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.

The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues.

An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry.

Health and Social Care Committee Chair Steve Brine MP said:

“The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety.

Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made.

We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers.

Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.”

Terms of Reference

  • The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals.  
  • Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words.  
  • How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this?
  • What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety?
  • What progress has been made to date on recommendations from the 2022 Messenger Review?
  • How effectively have leadership recommendations from previous reviews of patient safety crises been implemented?
  • How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety?
  • How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved?
  • How could investigations into whistleblowing complaints be improved?
  • How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule?
  • What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear?

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Source: UK Parliament, 25 January 2024

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Virtual ward costs twice that of inpatient care, study finds

Researchers have found the costs of treating patients in a 40-bed virtual ward were double that of traditional inpatient care.

The study’s authors said the findings should raise concerns over a flagship NHS England policy, which has driven the establishment of 10,000 virtual ward beds.

Virtual wards, sometimes described as “hospital at home”, are cited as a safe way to reduce pressure on hospitals, by reducing length of stay and enabling quicker recovery.

The study at Wrightington Wigan and Leigh Teaching Hospitals, in Greater Manchester, found a clear reduction in length of stay but also found higher rates of readmission.

The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £1,077, compared to £536 in a general inpatient hospital bed. 

“This raises concerns [over] the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management. This evidence should be taken into consideration by [the] NHS in planning the next large deployment of virtual wards within the UK…

“Virtual wards must be cost effective if they are to replace traditional inpatient care, the costs must be comparable or lower than the costs of hospital stay to be economically sustainable in the medium to long terms.”

To break even, the paper said the virtual ward would need to double its throughput, but warned this would risk lowering the standard of care.

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Source: HSJ, 25 January 2024

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Covid-19: Doctors instruct law firm in bid for compensation after developing Long Covid

A group of doctors with Long Covid are preparing to launch a class action for compensation after contracting SARS-CoV-2 at work.

The campaign and advocacy group Long Covid Doctors for Action (LCD4A) has engaged the law firm Bond Turner to bring claims for any physical injuries and financial losses sustained by frontline workers who were not properly protected at work.

On 25 January Bond Turner, which specialises in negligence cases, complex litigation, and group actions, launched a call to action inviting doctors and other healthcare workers in England and Wales to make contact if they believe that they contracted covid-19 as a result of occupational exposure.1

Sara Stanger, the firm’s director and head of clinical negligence and serious injury claims, said that the ultimate aim was to achieve “legal accountability and justice for those injured.”

She told The BMJ, “I’ve spoken to hundreds of doctors with long covid, and many of them have had their lives derailed. Some have lost their jobs and their homes; they are in financial ruin. Their illnesses have had far reaching consequences in all areas of their lives.”

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Source: BMJ, 25 January 2024

Nurses, midwives, and any other healthcare workers who are suffering with Long Covid and which they believe they contracted through their work and who wish to join the action should visit the Bond Turner website here: https://www.bondturner.com/services/covid-group-claim/. Although this action has been initiated by doctors in the first instance, it is not limited to doctors.

Further reading on the hub:

 

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NHSE drive on follow-ups only delivers marginal reduction

NHS England’s drive to encourage patient-initiated appointments is only having a marginal impact on reducing overall outpatient follow-ups, a major study suggests.

NHS England currently has a target to have 5% of outpatients on patient-initiated follow-up pathways, and hopes this can be increased substantially in future years.

The headline finding in a study by the Nuffield Trust think tank, which analysed almost 60 million cases, was that for every 5% on PIFU pathways, this roughly corresponded to 2% fewer outpatient follow-up attendances overall.

It suggests PIFU implementation would need to be dramatically expanded to get anywhere close to a 25% reduction in total follow-up activity, which NHSE had previously targeted by March 2023. As previously reported, there has been little to no reduction so far.

Chris Sherlaw-Johnson, senior fellow at the Nuffield Trust, said: “As few patients are currently on PIFU pathways at present, it’s not going to have that noticeable impact on the overall number of follow ups.”

He also stressed it was not clear whether the reduction was caused by the genuine elimination of unnecessary follow-ups or if patients were not returning for care despite needing it.

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Source: HSJ, 25 January 2024

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ICB maternity plan risks increasing deaths, senior medics claim

The medical leaders of the maternity unit of a flagship hospital threatened with closure have written to their chief executive saying the downgrade would not be safe, HSJ has learned.

Nineteen obstetric and gynaecological staff, including the clinical director, wrote to the chair and CEO of the Royal Free London Foundation Trust this week saying the proposals to shutter services at the trust’s main site in Hampstead would increase the risk of harm to mothers.

Their letter said: “Whilst we accept, and support, the need to review provision of maternity and neonatal services across [north central London], aiming for care excellence and best outcomes, we have significant concerns about the current proposals.”

The letter said the Royal Free was the only unit in NCL to offer a “range of supporting specialist services for complex maternity care”, including rheumatology and neurology and is the “only hospital in NCL to provide both 24-hour interventional radiology and on-site acute vascular surgery and urology support”.

The medics’ letter said co-morbidities from cardiac, renal, haematological and neurological conditions had driven an increase in maternal mortality over the past decade and that RFH’s services were well-equipped to manage these complex cases.

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Source: HSJ, 24 January 2024

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Scotland: Mother wrongly downgraded to low risk

Doctors "failed to realise" that a first-time mother's pregnancy had become "much higher risk" because crucial warning signs were not properly highlighted in her medical records, an inquiry has heard.

Nicola McCormick was obese and had experienced repeated episodes of bleeding and reduced foetal movement, but was wrongly downgraded from a high to low risk patient weeks before she went into labour.

Her daughter, Ellie McCormick, had to be resuscitated after being born "floppy" with "no signs of life" at Wishaw General hospital on March 4 2019 following an emergency caesarean.

She had suffered severe brain damage and multi-organ failure due to oxygen deprivation, and was just five hours old when her life support was switched off.

A fatal accident inquiry (FAI) at Glasgow Sheriff Court was told that Ms McCormick, who was 20 and lived with her parents in Uddingston, should have been booked for an induction of labour "no later" than her due date of 26 February.

Had this occurred, she would have been in hospital for the duration of the birth with Ellie's foetal heartbeat "continuously" monitored.

In the event, Ms McCormick had been in labour for more than nine hours by the time she was admitted to hospital at 8.29pm on 4 March.

A midwife raised the alarm after detecting a dangerously low foetal heartbeat, and Ms McCormick was rushed into theatre for an emergency C-section.

Dr Rhona Hughes, a retired consultant obstetrician who gave evidence as an expert witness, told the FAI that Ellie might have survived had there been different guidelines in place in relation to the dangers of bleeding late in pregnancy, or had her medical history been more obvious in computer records.

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Source: The Herald, 24 January 2024

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Department of Education updates National Framework for Children’s Social Care

The Department of Education has recently provided an update to the national framework for Children’s Social Care. The key point to be aware of is the increased focus on sharing responsibility and strengthening multi-agency working to safeguard children.

This change is likely to impact a wide variety of stakeholders involved in children’s care, including NHS Trusts, ICBs, education partners, local authorities, voluntary, charitable and community sectors and the police. 

The focus continues to be on a child-centred approach with the intention of keeping children within the care of their families wherever possible; this collaborative working may include working with parents, carers or other family but the wishes and feelings of the child alongside what is in the child’s best interests remain paramount. Joined up working is to be viewed as the norm.

For health professionals, you will be expected to have lead roles for children with health needs, such as children who are identified as having special educational needs or disabilities. 

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Source: Bevan Brittan, 23 January 2024

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US midwife fined $300k for faking vaccine records for 1,500 children after giving them ‘homeopathic pellets’

A midwife in New York who reportedly gave 1,500 children homeopathic pellets rather than the vaccinations required by the state has been fined $300,000 by the state's health department.

The midwife was identified as Jeanette Breen, who operates the Long Island-based Baldwin Midwifery.

Ms Breen reportedly gave the pellets as an alternative to required vaccinations and then proceeded to falsify the children's immunisation records, according to the New York Department of Health.

The midwife reportedly began giving the pellets during the Covid-19 pandemic, specifically during the 2019-2020 school year. The majority of the affected children live in Long Island, according to the Associated Press.

The health department said that the false records have since been voided, and that the families will have to ensure their students are up-to-date with their shots before they can return to school.

“Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health,” State Health Commissioner James McDonald said in a statement.

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Source: The Independent, 24 January 2024

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UK records highest annual cardiovascular deaths since 2008

The rate at which people are dying early from heart and circulatory diseases has risen to its highest level in more than a decade, figures show.

Data analysed by the British Heart Foundation (BHF) shows a reverse of previous falling trends when it comes to people dying from heart problems before the age of 75 in England.

Since 2020, the premature death rate for cardiovascular disease has risen year-on-year, with the latest figures for 2022 showing it reached 80 per 100,000 people in England in 2022 – the highest rate since 2011 when it was 83.

This is the first time there has been a clear reversal in the trend for almost 60 years.

Between 2012 and 2019 progress slowed and, from 2020, premature death rates began to clearly rise, the data reveals.

Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist, said: “We’re in the grip of the worst heart care crisis in living memory.

“Every part of the system providing heart care is damaged, from prevention, diagnosis, treatment, and recovery; to crucial research that could give us faster and better treatments.

“This is happening at a time when more people are getting sicker and need the NHS more than ever.

“I find it tragic that we’ve lost hard-won progress to reduce early death from cardiovascular disease.”

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Source: Medscape, 22 January 2024

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