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Half trust’s staff told CQC they had ‘no confidence’ in its leaders

More than half of a trust’s staff told the Care Quality Commission (CQC) they did not have confidence in its executive leadership, with just 16% saying they did, the regulator has reported.

The CQC surveyed staff as part of its inspection of East Kent Hospitals University Foundation Trust.

Eighty-four per cent either said they disagreed with the statement “I have confidence in the executive team”, or neither agreed nor disagreed. That leaves just 16% who said they did have confidence.

Some said they felt “traumatised”, “devalued” or “damaged” by a recent restructuring programme at the trust, which has been grappling major care quality and performance problems for several years.

The CQC also revealed in a report today that it issued a warning notice to the trust after inspections at its two main sites in July. They ordered immediate improvements in its emergency departments, medical care and children and young people’s services.

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Source: HSJ, 20 December 2023

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Eljamel patient Jules Rose says NHS Tayside tried to 'silence' her

A mother who endured a botched surgery at the hands of a disgraced neurosurgeon claims NHS Tayside tried to silence her against making complaints.

Professor Sam Eljamel removed Jules Rose's tear duct during a failed attempt to operate on a brain tumour - setting the 55-year-old on a path to becoming a prolific campaigner for patients' rights.

Ms Rose, however, has received sight of documents that show NHS Tayside writing to the then-health minister Humza Yousaf to say she had been "aggressive" and "vulgar" and they would no longer communicate with her.

In a letter in response, Mr Yousaf says he sees no evidence of any such conduct by the mother-of-two and tells the health board to enter into mediation with her.

Ms Rose said: "In the letter I have been given, Humza Yousaf writes back and say, 'She's quite right to feel aggrieved at the treatment she's received.

"'Therefore, I suggest that you continue liaising with Miss Rose and enter into mediation.'

"This was last November but I've only just had copies of the letters sent to me and when I saw them I thought, 'They've tried to shut me down, they're tried to silence me'."

The ongoing dispute with NHS Tayside is as a result of Ms Rose's long-running campaign for justice for patients - thought to be as many as 270 - harmed by Eljamel while he was in the health board's employ.

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Source: The Herald, 16 December 2023

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Patients’ experiences of disease should be taken more seriously, says study

Health experts say more attention should be given to patients’ experiences after research found multiple examples of their insights being undervalued.

A study led by the University of Cambridge and King’s College London found clinicians ranked patient self-assessments as the least important when making diagnostic decisions.

Ethnicity and gender were felt to influence diagnosis, particularly a perception that women were more likely to be told their symptoms were psychosomatic. Male clinicians were more likely to say that patients overplay symptoms.

The findings prompted calls for clinicians to move away from the “doctor knows best attitude” when caring for patients.

One patient shared the feeling of being disbelieved as “degrading and dehumanising”, and added: “I’ll tell them my symptoms and they’ll tell me that symptom is wrong, or I can’t feel pain there, or in that way.”

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Source: The Guardian, 18 December 2023

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GPs to offer more mental health support for mothers in England after giving birth

Mothers in England will be asked in detail if pregnancy or giving birth has affected their mental health as a result of new NHS guidance to GPs.

The move is part of a drive by NHS England to improve support for women suffering postnatal depression or other mental health problems linked to their pregnancy or childbirth.

Under the new guidance GPs will ask women more questions than before about how they are feeling when they attend their postnatal health check six to eight weeks after giving birth.

Family doctors will look for any sign that the woman may have a condition such as postnatal PTSD as a result of experiencing a traumatic birth or psychosis induced by bearing a child.

Anyone who the GP feels needs help with their mental wellbeing will be referred to specialist maternal mental health services, which have been expanded in recent years.

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Source: The Guardian, 18 December 2023

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NHS dentistry as we know it 'gone for good'

The traditional model of NHS dentistry is gone for good, experts are warning.

The Nuffield Trust think tank said the service had been cut back so much it was now at the most perilous position in its 75-year history in England.

It said restoring services would probably need an unrealistic amount of money and called for radical reform, suggesting NHS support may need to be completely scaled back for some adults.

The Nuffield Trust said funding for NHS dentistry had suffered huge cuts in recent years. Some £3.1bn was spent in 2021-22 - a drop of £525m since 2014-15 once inflation is taken into account.

It said the number of treatments being done each year was now six million lower than it was before the pandemic.

The Nuffield Trust said tough policy choices needed to be made, suggesting one option could be to start charging adults for the full cost of treatment beyond emergency work and check-ups.

Shawn Charlwood, chairman of the British Dental Association's general dental practice committee, said the report "reads like the last rites for NHS dentistry" and that "patients and this profession deserve some honesty here".

He added: "The government say NHS dentistry should be accessible for all who need it.

"The plain facts are we're not seeing any evidence of the reforms or the resources to realise that ambition."

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Source: BBC News, 19 December 2023

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Coroner advises NHS England to warn prescribers about interaction of tramadol and warfarin

NHS England has been told it must take action to raise awareness about the potentially fatal interaction between tramadol and warfarin, following the death of a patient.

Graham Danbury, assistant coroner for Hertfordshire, issued a prevention of future deaths report on 1 December 2023, after Susan Gladstone, from Hertfordshire, died on 8 January 2021 from a bleed in the brain.

An inquest, which ended on 20 November 2023, concluded that Gladstone “died as a result of a generally unknown interaction between warfarin and tramadol, which caused exceptional thinning of her blood”. 

Gladstone was prescribed tramadol twice for lower back pain: on 20 December 2020 and 4 January 2021. According to the report, she had been taking the anticoagulation medication warfarin for “a number of years”.

The report continues: “There was nothing to warn the prescribing doctor of any possible interaction. I found on the balance of probabilities that an interaction between tramadol and warfarin had caused this dangerous, and in the event, fatal INR to develop.

“In my opinion, actions should be taken to prevent future deaths and I believe you, NHS England, have the power to take such action.”

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Source: Pharmaceutical Journal, 13 December 2023

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Sepsis breakthrough as blood test trial for killer condition underway

Scientists are hoping a new 45-minute blood test can quickly identify sepsis before it kills.

Sepsis is a life-threatening reaction to an infection. It occurs when the body overreacts and starts attacking its own tissues and organs.

The hard-to-diagnose condition kills nearly 50,000 Brits a year more than breast, prostate and bowel cancer combined - with severe cases taking just hours to prove fatal.

Dr Andrew Retter, an intensive care consultant at Guy’s and St Thomas’ NHS Foundation Trust, who is trialling the test told The Times: “If someone comes into A&E and they’re sick, we can spot that early and start treatment early.

“For every hour antibiotics are delayed, people’s mortality goes up by about 7 or 8 per cent if they’ve got sepsis.”

Melissa Mead’s one-year-old son William died after weeks of a lingering cough and concerns were dismissed by doctors and 111 operators.

The campaigner told The Times: “A test like this at the point of care in A&E, for example, could remove the uncertainty about sepsis, which presents differently in different people.

“This could give people a chance at life that my son never had.”

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Source: The Independent, 17 December 2023

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Community services need new national funding bid, says outgoing NHS England director

The national clinical director for older people has announced he is leaving NHS England and said a major government funding settlement will be needed to maintain progress and take community services to the ‘next stage’.

Adrian Hayter joined NHSE in 2019 as NCD for older people and integrated person centred care.

Dr Hayter, who is also a longstanding GP partner in Berkshire, said community services were now much more prominent at NHSE — and in its asks of the service – than they were four years ago. 

He said: “When I first came in, there wasn’t very much in planning guidance about what was happening in the community at all. Now that is different and we are expecting a range of initiatives in 2024.

“But the future is that all of these things are not individual programmes - they’re all part of a particular approach to how we manage and support people for as long as possible in their own homes.

“Urgent community response [where services are required to respond within two-hours to urgent needs, referred from a range of services] and virtual wards are a continuum of care.

“And the growth of virtual wards have helped extend what happens in the community all the way through to the acute level care.”

National long-term funding for several of the new services – badged in the 2019 long-term plan as “Aging Well” – is also now due to end, with integrated care boards instead asked to commission them locally.

Dr Hayter warned that, as well as moving those services closer together, there needed to be a future government spending review settlement aimed at growing community services, to meet the needs of the rapidly ageing population.

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Source: HSJ, 18 December 2023

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Autism diagnosis wait times hit 300 days

The average wait for an autism diagnosis in England has hit 300 days, according to new NHS data.

That is up 53% from 12 months prior and exceeds the NICE target of 91 days.

The National Autistic Society described such wait times as appalling, warning "autistic people shouldn't miss out on vital support because they haven't got a timely assessment."

A government spokesperson said it had made £4.2m available this year to improve services for autistic children.

Rose Matthews, 63, from County Durham, said receiving an autism diagnosis had been "lifesaving - and I don't say that flippantly".

Before receiving their diagnosis at the age of 59, Rose, who uses "they" and "them" as personal pronouns, said: "My life was unravelling.

"My career was unravelling."

They said their GP had "deeply misguided ideas about what being autistic meant" and brushed them aside.

Joey Nettleton-Burrows, policy and public affairs manager for the National Autistic Society (NAS), said: "We do see lot of misunderstanding from people, and it can include health and social care staff, but I wouldn't say it is common with GPs."

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Source: BBC News, 15 December 2023

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IT failures causing patient deaths, says NHS safety body

Urgent action is needed to address NHS computer failings which are causing harm to patients, the patient safety watchdog has told BBC News.

The watchdog has evidence of patient deaths due to IT system errors.

The government called the reports "concerning" and said it would work with NHS England to take necessary action to protect patients.

A recent investigation found thousands of hospital letters were unsent due to computer issues.

The Health Services Safety Investigations Body (HSSIB) says IT failures are among the most serious issues facing hospitals in England.

"We have seen evidence of patient deaths as a result of IT systems not working," said interim head, Dr Rosie Benneyworth.

Dr Benneyworth cited the example of a patient who was found unresponsive and then wrongly identified by healthcare staff as not wishing to be resuscitated.

Staff were unable to access information on the patient quickly through their IT system, which would have shown a mistake had been made, said the watchdog.

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Source: BBC News, 16 December 2023

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Lax oversight of semaglutide advertising could harm patients, warn critics

UK organisations responsible for protecting the public from advertisements of prescription-only drugs are putting patients at risk from the harms of weight loss drugs by not enforcing the law, critics have told The BMJ.

The UK’s Human Medicines Regulations 2012 prohibit the advertising of prescription drugs to the general public, and companies that break the rules can be sanctioned with fines, orders to issue a corrective statement, or prosecution.

Legal responsibility for regulating advertisements for medicines in the UK rests with the Medicines and Healthcare Products Regulatory Agency (MHRA) on behalf of health ministers. But there is also a system of self-regulation with a number of organisations operating their own codes of practice, including the Advertising Standards Authority.

But The BMJ has found that the MHRA has not issued a single sanction for prescription drugs in the past five years. And among 16 cases where the MHRA took action by requesting changes to advertisements for weight loss drugs from June 2022 to July 2023, all were triggered by external complaints, not internal mechanisms, and none resulted in sanctions.

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Source: The BMJ, 13 December 2023

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Hospitals ‘falling to bits’ as NHS in England faces record £12bn repair bill

The NHS in England has a record repair bill of almost £12bn, new figures show, with ministers needing to find more than £2bn for urgent maintenance to prevent catastrophic failure.

The annual report on the condition of the health service’s estate said on Thursday that the cost of improving rundown buildings and decrepit equipment was two and a half times larger than in 2011-2012, when it stood at £4.7bn.

The cost of the “high-risk” backlog – situations where the need to repair or replace facilities and equipment must be urgently addressed to prevent serious failure, significant injury or major disruption to clinical services – rose by almost a third to a record £2.4bn. This was £0.3bn in 2011-2012.

However, investment to reduce the backlog fell in the last year from £1.41bn to £1.38bn, a fraction of what is needed to restore the NHS estate back to acceptable levels of risk. The stark figures cover a time prior to the health service becoming embroiled in the crumbling concrete crisis which initially hit school buildings.

Sir Julian Hartley, the chief executive of NHS Providers, said that “too many NHS buildings are quite simply falling to bits”, and that we need “a step change in the government’s approach to planning and funding essential capital investment in the NHS”.

He said: “The eye-watering cost of trying to patch up creaking infrastructure and out-of-date facilities is mounting at an alarming rate.

“Mental health, hospital, community and ambulance services are crying out for much-needed funding for critical projects to overhaul ageing estates and to give patients and staff the safe, reliable conditions they need."

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Source: The Guardian, 14 December 2023

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Ambulance handover delays soar as winter bites

Ambulance handover delays rose last week with close to 13,000 crews waiting more than an hour to offload patients — marginally more than the comparable week last year.

Week of 27 November 2023 figures were missing data for several days from some trusts, NHSE said.

The number of hour-plus waits for ambulancs to pass patients to emergency departments was 12,797, according to new NHS England data. 

That appeared to be steeply up from about 8,000 in the past two weeks, although NHSE said last week’s was not directly comparable due to missing data.

It was just ahead of the 12,534 recorded for the week ending 11 December last year.

Last year the numbers rose to over 16,000 in the third week in December then peaked at 18,720 in the week running up to New Year, in what many said was the worst winter crisis for decades, amid a sharp, early wave of flu.

This year the numbers of long waits have risen earlier than last, and several ambulance trusts have reported coming under severe pressure in the last few days. NHS England has warned junior doctors strikes next week and in the new year may compound hospital flow problems.

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Source: HSJ, 15 December 2023

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Blackpool nurse and colleague jailed over drugging patients

An "evil" nurse who drugged patients on a stroke unit for an "easy shift" and a healthcare worker who conspired with her have been jailed.

Catherine Hudson, 54, was found guilty of giving unprescribed sedatives to two patients at Blackpool Victoria Hospital in 2017 and 2018.

She was also convicted of conspiring with Charlotte Wilmot, 48, to give a sedative to a third patient.

Hudson was jailed for seven years and two months. Wilmot was sentenced to three years.

Evidence during the trial highlighted the "dysfunctional" drugs regime on the stroke ward with free and easy access to controlled drugs and medication which led to "wholesale theft" by staff.

Prosecutors described it as a "culture of abuse" after police examined WhatsApp phone messages between the co-defendants and other members of staff.

The pair were investigated after a student nurse witnessed events while on a work placement on the stroke unit and told senior managers in November 2018, who called in police.

The whistleblowing nurse, who the prosecution had asked not to be named, told officers she had concerns over the use of insomnia medication Zopiclone, which can be life-threatening if given inappropriately.

She said Hudson had told her the patient had a Do Not Resuscitate Order in place "so she wouldn't be opened up if she died or... came to any harm".

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Source: BBC News, 14 December 2023

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Trust reviewing 100,000 patients put ‘on hold’

A trust is reviewing more than 100,000 patients on its outpatient lists, after concerns emerged that some had ‘been lost whilst on hold’ for follow-up appointments.

A report from Buckinghamshire Healthcare Trust, leaked to HSJ, found 116,575 patient records without a scheduled follow-up after an outpatient consultation, with more than half of those left inappropriately without action, some dating back a decade.

The review was triggered after staff spotted cases in which patients had been “lost whilst on hold”, the report said.

The trust this week told HSJ that, since the initial discovery in the summer of last year, it had been validating the lists and reduced the number of outstanding records to 47,778. It aims to complete the reviews in the next two months.

It told HSJ it had undertaken a harm review and found no “systemic harm”.

Concerns have been raised over several years about the extent of overdue and unreviewed patients on follow-up lists, and the potential for them to deteriorate and come to harm. There are no national figures monitoring the patients, many of whom have long-term health needs.

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Source: HSJ, 15 December 2023

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‘Long flu’: study finds flu patients at higher risk of longer-term illness

People who have been hospitalised with flu are at an increased risk of longer-term health problems, similar to those with long Covid, data suggests.

While the symptoms associated with such “long flu” appear to be more focused on the lungs than ongoing Covid symptoms, in both cases the risk of death and disability was greater in the months after infection than in the first 30 days.

“It is very clear that long flu is worse than the flu, and Long Covid is worse than Covid,” said Dr Ziyad Al-Aly, a clinical epidemiologist at Washington University in St Louis, Missouri, who led the research.

He was motivated to study the phenomenon after observing the scale of long-term illness experienced by people who have recovered from Covid.

“Five years ago, it wouldn’t have occurred to me to examine the possibility of a ‘long flu.’ But one of the major lessons we learned from this pandemic is that a virus we all initially thought could only cause acute disease is leaving millions of people with long Covid, he said. “We wondered whether this could be happening with other things. Could this be happening with the flu, for example?”

The research, published in the Lancet Infectious Diseases, found that while Covid patients faced a greater risk of death or hospital readmission in the following 18 months, both infections carried a significant risk of ongoing disability and disease.

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Source: The Guardian, 14 December 2023

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Hundreds more middle-aged adults dying a month since Covid pandemic

Hundreds more middle-aged adults have been dying each month since the end of the pandemic, as obesity and NHS backlogs drive a surge in excess deaths.

New analysis of official statistics has revealed that there were an extra 28,000 deaths in the UK during the first six months of 2023, compared with levels in the previous five years.

The biggest rise in unexpected deaths has been among adults aged 50 to 64, who are increasingly dying prematurely from preventable conditions including heart disease and diabetes.

The Covid inquiry is now being urged to shift its focus from “tactical decisions made by politicians” and to examine the lasting disruption that has kept deaths persistently high since the virus peaked.

Experts believe that difficulties in accessing GPs since lockdown and record NHS waiting lists mean that middle-aged patients are missing out on life-saving preventative treatment such as blood pressure medication. Unhealthy lifestyles, obesity and widening health inequalities are also contributing to a rise in avoidable deaths.

Professor Yvonne Doyle, who led Public Health England during the pandemic, warned that the official Covid inquiry risks “missing the point” by focusing on the drama and WhatsApps of Westminster politicians. In an article for The Times, Doyle, who gave evidence to the inquiry six weeks ago, says that the tens of thousands of excess deaths since Covid “represent an underlying pandemic of ill health” that should be addressed.

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Source: The Times, 13 December 2023

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Hospital violence ‘going through the roof’, says CEO

A London acute trust is planning to provide staff working in frailty units with body cameras and those in antenatal clinics with additional security, as violence and aggression against them goes ‘through the roof’.

Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals Trust in north east London, described the measures the trust is planning to take in response to growing staff concerns about their safety.

Speaking at a King’s Fund event about making NHS careers more attractive, Mr Trainer said: “We need to understand the impact of violence and aggression against the workforce and that’s going through the roof just now.

“Our ultrasound technicians have now asked for help as their antenatal scans are becoming so fraught. We are about to introduce body cameras in our frailty wards to help with the increase in violence and aggression against staff there.”

Mr Trainer – who joined BHRUT in 2021 from Oxleas Foundation Trust – said a long-running problem with violence and aggression in emergency departments was spreading to other departments.

Mr Trainer stressed the main problem, particularly in frailty units, was not patients’ own behaviour, but that of family and friends visiting them.

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Source: HSJ, 13 December 2023

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Only half of trusts’ staff were trained ahead of troubled IT go-live

Only half of staff across two acute trusts were fully trained in the use of a new electronic patient record before its introduction, which led to disruption and patient harm, HSJ has revealed.

The implementation of Oracle Cerner’s EPR at Royal Surrey Foundation Trust and Ashford and St Peter’s Hospitals FT was carried out, despite the trusts not having achieved their target of 80% of staff having completed the necessary training, newly disclosed documents show.

HSJ has also seen an internal report by the Royal Surrey’s informatics team which warned of risks to patient safety and data problems, unless preparations improved in the three months leading up to go-live. 

The two acute trusts implemented the EPR in May last year under a programme called Surrey Safe Care, but there have been multiple problems ever since – including some of the issues that the internal report warned of.  

The trusts acknowledged the process had been “challenging” but said they had trained a higher proportion of the staff who were working in the two weeks after go-live, with Royal Surrey describing the findings of the internal informatics report as an “inaccurate representation” of readiness.

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Source: HSJ, 13 December 2023

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Raychel Ferguson: Coroner rules death caused by 'inappropriate infusion'

A fresh inquest into the death of Raychel Ferguson has found she died of a cerebral oedema, or swelling in the brain, due to hyponatraemia.

He said the "inappropriate infusion of hypertonic saline fluid" was the most significant factor.

The nine-year-old died at the Royal Victoria Hospital for Sick Children in June 2001.

Coroner Joe McCrisken said her death was due to a series of human errors and not systemic failure.

He outlined three causes of the hyponatraemia but said he was satisfied the "inappropriate infusion of hypertonic saline fluid... played the most significant part".

The new inquest into Raychel's death was first opened in January 2022 after being ordered by the attorney general but was postponed in October when new evidence came to light.

Raychel was one of five children whose deaths over the course of eight years at the same hospital prompted a public inquiry.

In 2018 the Hyponatraemia Inquiry - which examined the deaths of five children in Northern Ireland hospitals, including Raychel - found her death was avoidable.

The 14-year-long inquiry was heavily critical of the "self-regulating and unmonitored" health service. In his report in 2018, Mr Justice O'Hara found there was a "reluctance among clinicians to openly acknowledge failings" in Raychel's death.

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Source: BBC News, 11 December 2023

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Autistic man facing abuse in mental health hospital must be given home ‘urgently’, NHS and council told

The NHS and a local council have been told to urgently find a home for a 28-year-old autistic man who is facing psychological and physical abuse within a mental health hospital, after an independent review of his care.

Nicholas Thornton has autism and learning disabilities and is currently being held in the Rochford mental health unit, in Essex, after a decade of being locked away in places not able to care for him adequately.

Now an independent safeguarding review into his care provided at the Essex hospital has ordered the local authority and NHS to find him a home in the community because his relationship with hospital staff has become so bad he is facing psychological and physical harm.

He is one of the 2,045 people with learning disabilities and autism trapped within inpatient units across England.

Mr Thornton has been in the unit, run by the Essex Partnership University NHS Foundation Trust (EPUT), since May this year. He is not under a mental health section, nor does he need mental health treatment, but he is unable to leave because the local authority has not agreed on a place into which he can be discharged.

EPUT is currently facing a public inquiry probing the deaths of 2,000 patients following multiple reviews since 2016 from coroners, the police and health ombudsman criticising the care within the hospital.

A safeguarding report into Mr Thornton’s situation, seen by The Independent and Channel Four News, revealed staff working in the Rochford hospital told investigators they cannot adequately care for Mr Thornton themselves as they are not trained in supporting patients with autism.

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Source: The Independent, 13 December 2023

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Revealed: Trusts paying the highest negligence premiums

The trusts paying the highest premiums for clinical negligence as a proportion of their income have been revealed through HSJ analysis of internal data.

Several acute trusts in and around London are now spending more than 4% of their income on premium costs to insure themselves against clinical negligence, according to internal NHS data.

One expert suggested trusts with higher proportions of ethnic minority patients often have high rates of negligence claims against them, partly due to the complexity of medical presentation, but also communication problems.

Lisa Jordan, head of medical negligence at law firm Irwin Mitchell, said trusts that act as tertiary referral centres tend to admit the most complex cases, which are more likely to lead to claims.

She added: “Trusts in areas with higher proportions of ethnic minority groups, also often have higher rates. That is in part about the complexity of medical presentation, and also communication problems.”

Helen Hughes, chief executive of Patient Safety Learning, said: “Scarce funds that could be spent proactively improving the quality of care are being spent on the costs of error and harm.”

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Source: HSJ, 13 December 2023

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Public confused over physician associates working in NHS, research finds

Many people are deeply confused about the growing number of “physician associates” in the NHS and wrongly assume they are doctors, research suggests.

Around 4,000 physician associates work in the NHS in England. Ministers and health chiefs plan to increase the figure to 10,000 to help plug widespread gaps in the NHS workforce.

However, there is widespread confusion among the public about their role and relationship with fully trained medics, according to a survey commissioned by the British Medical Association (BMA).

A quarter of the representative sample of 2,009 people erroneously believed that a physician associate was a doctor, while a fifth made the same mistake about “physician assistants”.

Many respondents thought that a physician associate was more senior than a junior doctor, even though only the latter have a medical degree.

The expansion of physician associates has prompted a backlash by grassroots medics. They fear patients will be misled into thinking they have seen a doctor despite physician associates not having the same skills and training.

The government has moved to try to quell criticism of physician associates by legislating to ensure they are regulated by the General Medical Council (GMC).

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Source: The Guardian, 13 December 2023

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Culture progress sees NHS Highland escalation eased

NHS Highland will no longer receive extra government support in leadership, governance or culture, following improvements after the Sturrock review.

The board was initially escalated to Stage 3 of NHS performance escalation framework in 2018 following concerns of a culture of workforce bullying and harassment.

An independent report by John Sturrock QC, commissioned by the Scottish government, confirmed “fear, intimidation and inappropriate behaviour” and called for wide-ranging changes.

The Healing Process was created in response, with an independent review panel established to speak to victims of bullying and come up with recommendations for the health board to make improvements.

A total of 272 current and former NHS Highland and local health and social care partnership staff provided testimony between 2019 and March this year, with more than £2.8m paid out to those affected by bullying.

Concerns were raised by some of the first people to go through the healing process that the system was “broken” and many victims could end up “bitterly disappointed”.

The board has also established systems and processes to allow colleagues to speak up in the wake of the Sturrock Review, including an independent Guardian Service and staff training in Courageous Conversations.

NHS Highland was handed oversight of its own escalation and de-escalation, rather than a Scottish government-led oversight group, in November 2021.

Following a letter of assurance from the board chair earlier this year, the Chief Executive of NHS Scotland, Caroline Lamb, agreed to the de-escalation in September.

Independent progress tracking shows the board has delivered significantly against many actions laid out by the review but the board concluded in its final June update that ‘culture change is not yet embedded at all levels of our organisation’.

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Source: Health and Care Scotland, 2023

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GPs don’t have time for NHSE ‘modernisation’ work, say ICBs

GP practices with the most outdated technology and processes do not have enough staff or funding to take part in NHS England’s performance recovery programme, integrated care boards are warning.

In new recovery plans which they were required to publish by NHSE, multiple ICBs have said that stretched capacity means hardly any practices have signed up to the “general practice improvement programme”, which is meant to help them implement the national primary care access recovery plan.

The ICBs pointed out that the programme is time consuming, and practices which take part are not always given funding to pay for staff time.

HSJ has reviewed the primary care recovery plans which all ICBs were required to bring to their board meetings in October and November, to explain how they were implementing the national plan published by NHSE in the spring.

NHSE’s plan sought to improve ease and speed of access through spreading “modern” methods and processes; as well as measures to save clinicians’ time, improving same-day access, and delivering more appointments.

But HSJ’s  review of the ICB plans found several warning that their uptake of the improvement plan was off track, especially for “intermediate” and “intensive” support, which require substantial time for the practices, and are likely to be required by those most in need of help.

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Source: HSJ, 12 December 2023

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