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Public satisfaction with NHS drops to 25-year low

Public satisfaction with the NHS has dropped to its lowest level for 25 years after a sharp fall during the pandemic, a survey suggests.

The British Social Attitudes poll, seen as the gold standard measure of public opinion, found 36% of the 3,100 asked were satisfied in 2021.

That is a drop from 53% the year before - the largest fall in a single year.

Only once have satisfaction levels been lower since the poll started in 1983. That was in 1997, and shortly after that the Blair government started increasing the budget by record amounts.

The public said it was taking too long to get a GP appointment or hospital care, and there was not enough staff.

Satisfaction with GP care and hospital services were both at their lowest levels since the survey began.

Dan Wellings, senior fellow at the King's Fund, described them as "extraordinary".

He said the NHS initially saw a "halo" effect early on in the pandemic, with satisfaction rates being maintained as the NHS battled through the first wave. But he said it was clear that had now gone.

"People are often struggling to get the care they need. These issues have been exacerbated by the extraordinary events of the past two years, but have been many years in the making following a decade-long funding squeeze, and a workforce crisis that has been left unaddressed for far too long."

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Source: BBC News, 30 March 2022

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Lifestyle changes saving thousands from diabetes

Thousands of Britons have avoided being diagnosed with type 2 diabetes thanks to an NHS programme aimed at early intervention.

The Diabetes Prevention Programme identifies people at risk of developing the condition and gives them a nine-month plan to change their lifestyles.

Researchers at the University of Manchester found that the programme resulted in 18,000 fewer people in England being diagnosed with type 2 diabetes between 2018 and 2019 — a 7% reduction.

It focuses on eating and exercise habits and enables participants to join peer support groups and receive instruction from health coaches.

The programme also offers a digital service that helps participants monitor their progress using wearable technology and mobile phone apps.

Emma McManus, a research fellow at the university, said that diabetes was a “growing problem” for the country. The NHS spends about 10 per cent of its annual budget on treating it.

“However, if you change your lifestyle, the risk of developing type 2 diabetes reduces,” she said. “Our research has shown that the programme has been successful in reducing the number of new cases of diabetes.”

Emma Elvin, a senior clinical adviser at Diabetes UK, said: “This research adds to the evidence that many type 2 diabetes cases can be delayed or prevented with the right support and further highlights how the NHS diabetes prevention programme can be a real turning point for people at risk of type 2 diabetes.”

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Source: The Times, 28 March 2022

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NHSE pushes ‘private patient opportunities’ in leaked guidance

Official draft guidance has encouraged trusts to grow their ‘private patient opportunities’, despite facing huge backlogs of NHS work.

The NHS England document, leaked to HSJ, includes instructions to local leaders for the new financial year starting in April.

It said: “Trusts should continue to actively explore and develop opportunities to grow their external (non-NHS) income… Private patient services continue to be a significant source of material opportunity in the NHS.”

It adds that NHS England and NHS Improvement will work with trusts to “identify and scale-up NHS export opportunities and support development of private patient opportunities to generate revenue and provide benefits for NHS staff and local patients and services”.

It comes as the NHS faces huge backlogs of elective patients waiting for treatment. NHSE’s own plan to recover from Covid said the waiting list could rise to 14 million, up from the current 6 million.

Sally Gainsbury, senior policy analyst at the Nuffield Trust, said the guidance was “capitalising” on the surge in people paying for private treatment during the pandemic. 

Ms Gainsbury said: “It is a concern that with over 6 million patients on the NHS waiting list, NHS England is actively encouraging NHS trusts to expand their private patient activity."

“Scarce NHS capacity should be focused and prioritised on treating NHS patients and bringing these unacceptable waits down, not capitalising on the growth in the private treatment market on the back of this unprecedented backlog of care.”

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Source: HSJ, 29 March 2022

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Ex-trust executive to probe NHS manager’s death

An ambulance trust has appointed a former senior trust executive to lead an independent investigation into the circumstances surrounding the unexplained death of a staff member, HSJ  has learned.

East of England Ambulance Service Trust also shared the terms of reference for the investigation withHSJ, which follows the trust being forced to launch a similar probe in 2020 after three young staff members died in 11 days in December 2019.

The latest investigation is into the death of Nick Lee, 46, from Ovington in west Norfolk, who died on 3 December 2021. Mr Lee was an operations manager for the trust in the west Norfolk area and had worked for the trust for nearly 20 years. The cause of death is yet to be officially established.

Margaret Pratt has been appointed by the trust to lead the investigation. 

A trust statement issued to HSJ said: “The purpose of the investigation is to look at the events leading up to the death, review the circumstances of the death and consider whether there is anything that the trust can learn to contribute to improving the support provided to staff.”

The investigation follows a prolonged period of years in which the trust has been dogged by high-profile and deeply ingrained cultural and bullying problems.

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Source: HSJ, 29 March 2022

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Scotland’s A&Es facing ‘patient safety crisis’ as waiting times hit new high

The Royal College of Emergency Medicine (RCEM) estimated 36 Scots died as a direct result of avoidable delays in the week to 30 March.

It comes as the number of people in hospital with Covid reached another record high, the worst cancer waiting times were reported since records began in 2006, and the Royal College of Nursing issued a warning that patient care is under “serious threat” from record-high staffing shortages.

The RCEM said it would “welcome” a decision to extend the legal requirement to wear face coverings in Scotland to protect the NHS.

“Anything that can continue to reduce the spread and therefore try and relieve as much pressure as possible in the healthcare system would be welcomed,” said RCEM Vice President in Scotland Dr John Thomson.

Dr Thomson, an emergency medicine consultant at Aberdeen Royal Infirmary, said the government must understand the “unconscionable” harm coming to patients.

“We have clear evidence that prolonged weeks in an emergency department lead directly to patient deaths,” he said.

“Good evidence that, irrespective of what the medical problem is that they present with, that long wait alone is associated with death.

“We can measure that quite clearly. One in 72 patients who wait in an emergency department beyond eight hours will die as a direct result.

“In the last week alone we would estimate there were 36 avoidable deaths due to waits beyond eight hours. That's unconscionable.”

A&E’s in Scotland are facing the “biggest patient safety crisis for a generation”, he said.

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Source: The Scotsman, 29 March 2022

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Discharge policy reviewed as NHSE warns ‘capacity may decrease’

Two national reviews are taking place into hospital discharge policy, it has emerged, amid major changes to funding and legislation.

One review, led by the Department of Health and Social Care, is developing discharge policy for once the Health and Care Bill comes into force; and a second is reviewing the “clinical criteria to reside”.

Delayed discharge has been a major problem in the acute and emergency care system this winter, with the number of long-staying patients significantly up on previous years. It has been blamed for long patient waits for ambulances, to get into emergency departments, and to be admitted; and for interrupting elective care recovery. 

An NHSE letter confirmed that the government’s national “discharge taskforce” was developing “best practice in improving discharge processes and addressing barriers to timely discharge”, in preparation for the new system. 

It went on: “This includes improving hospital processes to support discharge; minimising delays in the transfer of care from an acute hospital on to follow-up care services; minimising long lengths of stay in rehabilitation at home or in bedded care and ensuring social care services are available at the right time for people with ongoing care requirements. Further resources and support will be shared as learning from these systems becomes clear.”

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Source: HSJ, 28 March 2022

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Matching drugs to DNA is 'new era of medicine'

We have the technology to start a new era in medicine by precisely matching drugs to people's genetic code, a major report says.

Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function. The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body.

The tests could be available on the NHS next year.

It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug.

She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating.

The skin damage started the next morning. Jane told the BBC: "I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I'd been on fire."

Jane's experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said "99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm."

"We need to move away from 'one drug and one dose fits all' to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines," said Prof Sir Munir Pirmohamed, from the University of Liverpool.

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Source: BBC News, 29 March 2022

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AI software predicting daily A&E admissions rolled out in 100 NHS hospitals

New artificial intelligence software being rolled-out in NHS hospitals will be able to predict daily A&E admissions weeks in advance.

The software, which launched in 100 hospitals across England on Monday, analyses data, including Covid infections rates, 111 calls and traffic to predict the number of patients that will seek emergency care.

It also takes into consideration public holidays, such as New Year’s Eve, when A&E is more likely to be busy.

The AI software is being rolled after trials showed an “impressive” ability to forecast admissions up to three weeks in advance.

The NHS believes it will help tackle the record waiting list and allow hospitals to more easily manage their patient and bed capacity, prepare for busier days and staff up when needed.

Nine trusts were given the software to use during the pandemic which notified them of expected spikes in cases, staff levels and numbers of beds and equipment necessary.

However, hospitals receiving the new equipment have also been warned uncertainties within the data mean the system should be used as a “starting point to consider an operational response, not as a definite signal for action.”

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Source: The Independent, 28 March 2022

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Doctor's bid to be removed from register rejected

A doctor's bid to be voluntarily removed from the medical register on health grounds has been rejected.

It means Dr Heather Steen, who is accused of failings following the death of Claire Roberts in 1996, will still face a fitness to practice tribunal.

The tribunal would have been halted if she had been removed from the register, as she would no longer have been a doctor.

Claire Roberts died at the Royal Belfast Hospital for Sick Children, where Dr Steen worked, in October 1996.

The nine-year-old's death was examined as part of the hyponatraemia inquiry.

Her father Alan said his family welcomed the decision to refuse the paediatrician's application.

He said the tribunal hearing was "in the public interest" and should proceed "to maintain public confidence in the medical profession, the regulatory process and to ensure that professional standards are upheld".

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Source: BBC News, 28 March 2022

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Government must allow at home early medical abortions, MPs warn

The government must stop treating women “like children” and permanently allow at home early medical abortions, MPs and health professionals have said.

Abortion rules changed after Covid hit the UK in March 2020, with the government allowing abortion pills to be sent via post to be taken at home after a phone consultation.

The new system - referred to as “telemedicine” - was due to run out on 25 March but the government declared a six-month extension for at home early medical abortions earlier in the month.

MPs are now set to vote on whether to make telemedicine abortion services permanent on Wednesday.

Clare Murphy, chief executive of the British Pregnancy Advisory Service (BPAS), told The Independent: “We welcome the vote. MPs have the opportunity to prevent the recriminalisation of women who use

Stella Creasy, a Labour MP and campaigner for abortion rights, is one of many MPs calling for telemedicine abortion services to be made permanent.

“Despite the best attempts to scare, telemedicine has been shown to be safe, secure and preferable for many patients for a variety of reasons - it’s time to trust women and ensure they can make the right choices for themselves when it comes to their own medical care”, she said.

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Source: The Independent, 29 March 2022

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£10m long Covid fund completely unspent after six months

Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton MSP today said the SNP/Green Government has “yet again let down long Covid sufferers” as it is revealed that not a single penny of the £10 million announced by ministers last September has been spent.

On 9 September 2021, the Scottish Government announced the £10 million Long Covid Support Fund. 

Now a parliamentary question from Alex Cole-Hamilton and a freedom of information request have confirmed that the money remains entirely unspent. 

Alex Cole-Hamilton commented: “The latest official statistics showed a record are a record 119,000 long Covid sufferers in Scotland. The SNP/Green Government has let down every single one of them by failing to spend any of the £10 million it announced last September.

“Time and again I have pressed Nicola Sturgeon for answers on the absence of long Covid clinics, pressed for automatic referrals and urged the rollout of in-home support for sufferers. Now we’ve learned that none of the money announced more than six months ago has been spent.

“Long Covid sufferers need new hope. Scottish Liberal Democrats are determined to see the rollout of proper care. 

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Source: Scottish Liberal Democrats, 27 March 2022

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Chief executive of prestigious hospital loses whistleblowing case

The chief executive of one of England’s most prestigious private hospitals has lost her employment tribunal claim that she was dismissed for whistle blowing over patient safety issues.

Aida Yousefi ran the Portland Hospital in central London from January 2017 until her dismissal in December 2019 on two counts of gross misconduct. She was also in charge of The Harley Street Clinic and a specialist cancer centre. 

Ms Yousefi’s argument that she was removed after raising concerns about the patient safety was rejected by central London employment tribunal in a judgment published last week.

The judge instead ruled that while other senior staff had raised patient safety concerns over cost-cutting, there was no evidence that Ms Yousefi had done so.

In their judgment the tribunal panel said: “In oral evidence the claimant further accepted that, as CQC-registered manager, if patient safety concerns were not being dealt with she should have raised it with CQC. She did not do so at any point during her employment.”

Staffing concerns were raised by The Harley Street Centre chief nursing officer Claire Champion and others. However, the tribunal heard evidence that doing so could be frowned upon by senior management at HCA International.

The tribunal was shown an email from then vice president of financial operations at THSC and the Portland Enda O’Meara saying “Frankly – we are starting to piss some very senior people off in appearing that we can’t [make savings]. We can’t always cite patient safety. Because the response will always be other facilities are doing it”. 

Another email from Mr O’Meara said: “Please don’t cite ’patient safety’ unless you truly believe it to be the case. This term is particularly sensitive and nothing winds them up more”.

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Source: HSJ, 28 March 2022

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Stop charging migrant women for NHS maternity care, RCOG urges

The Royal College of Obstetricians and Gynaecologists (RCOG) has called for the immediate suspension of charging for NHS maternity care for migrant women because members say this government policy is harming the health of pregnant women and their babies.  It is the first time the health professionals’ body has issued a position statement on this issue.

The charity Maternity Action and the Royal College of Midwives have long expressed concern about the impact of NHS charging on this group of women. Charging forms a key plank of the Home Office’s hostile environment for migrants.

The government says the charging policy is in place to deter health tourism but medics treating migrant pregnant women say there is little evidence that previously free NHS maternity care for all attracted health tourists.

According to the 2019 MBRRACE-UK confidential inquiry into maternal deaths, three women were found to have died between 2015 and 2017 who may have been reluctant to access maternity care due to fears about charging and impact on their immigration status.

Dr Brenda Kelly, an NHS consultant obstetrician working in Oxford, treats many pregnant migrant women. She is calling for the barriers to them accessing maternity care to be removed urgently.

She described the case of one migrant woman who arrived in A&E shortly before delivering a stillborn baby. The woman had been fearful of coming forward for antenatal care although she was suffering from multiple, pregnancy-related health problems.

“I hope I never have to hear cries like that woman’s cries ever again,” said Kelly. “The way to safeguard these women is to build up trust. If they are landed with a bill of several thousand pounds they will disengage. They are not health tourists, they are desperate. The commitment to maternal health equity means ending charges for maternity care. The time for action is now.”

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Source: The Guardian, 27 March 2022

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USA: Former nurse found guilty in accidental injection death of 75-year-old patient

RaDonda Vaught, a former nurse criminally prosecuted for a fatal drug error in 2017, was convicted of gross neglect of an impaired adult and negligent homicide on Friday after a three-day trial in Nashville, Tenn., that gripped nurses across the country.

Vaught faces three to six years in prison for neglect and one to two years for negligent homicide as a defendant with no prior convictions, according to sentencing guidelines provided by the Nashville district attorney's office. Vaught is scheduled to be sentenced 13, and her sentences are likely to run concurrently, said the district attorney's spokesperson, Steve Hayslip.

Vaught was acquitted of reckless homicide. Criminally negligent homicide was a lesser charge included under reckless homicide.

Vaught's trial has been closely watched by nurses and medical professionals across the U.S., many of whom worry it could set a precedent of criminalising medical mistakes. Medical errors are generally handled by professional licensing boards or civil courts, and criminal prosecutions like Vaught's case are exceedingly rare.

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Source: OPB, 26 March 2022

See also: As a nurse in the US faces prison for a deadly error, her colleagues worry: Could I be next?

 

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Investigation begins into woman's childbirth death

An investigation has been launched after a woman died during childbirth at a hospital's maternity unit.

It was the third death of a mother in just over three years at Basildon University Hospital in Essex, in addition to a newborn baby's death.

The trust that runs the hospital said it could not comment on the case while it was under investigation.

Basildon University Hospital is part of Mid and South Essex NHS Foundation Trust, which also runs Southend and Broomfield hospitals.

The latest fatality follows the death of 36-year-old Gabriela Pintilie in February 2019. Ms Pintilie died after losing six litres of blood giving birth to her second child at the unit.

In separate incidents, a mother died and another woman had a stillborn baby at the unit in March 2019, while the trust was being inspected by the Care Quality Commission (CQC) following Ms Pintilie's death.

The unit at Basildon had its rating upgraded from "inadequate" to "requires improvement" in December by the CQC.

The hospital also apologised for the death of newborn Frederick Terry after he suffered a brain haemorrhage during a failed forceps delivery in November 2019.

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Source: BBC News, 27 March 2022

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Nurses’ well-being: ‘burnout’ too gentle a term for mental distress

Burnout is not a strong enough term to describe the severe mental distress nurses and other NHS staff are experiencing, says a doctor who has led efforts to improve care for health professionals.

Medical director of the NHS Practitioner Health service Dame Clare Gerada told MPs radical action was needed to improve the mental well-being of NHS staff.

She said nurses and other healthcare staff should be entitled to one hour of paid reflective time per month to be written into NHS employees’ contracts, alongside mentoring, careers advice and leadership training built in throughout people’s careers.

Dr Gerada was among senior clinicians who gave evidence this week to the Health and Social Care Committee, which is looking at issues around recruitment and retention of staff.

She told the committee the term ‘burnout’ simply did not cover the level of stress and mental anguish experienced by NHS workers. ‘Burnout is too gentle a term for the mental distress that is going on amongst our workforce,’ she said.

High suicide rates among nurses and doctors, high levels of bullying and staff being sacked because they have long-COVID are all signs the health service is failing to look after its employees, she said.

‘The symptoms we have got are the symptoms of an organisation that is unable to care for its workforce in the way that it should be caring,’ she said.

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Source: Nursing Standard, 25 March 2022

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Three hundred babies lost to a fixation on natural births

When Debbie Greenaway was told by doctors that she should try to deliver her twin babies naturally, she was nervous. 

But the doctor was adamant, she recalls. “He said: ‘We’ve got the lowest caesarean rates in the country and we are proud of it and we plan to keep it that way'."

For Greenaway, labour was seemingly endless. She was given repeated doses of syntocinon, a drug used to bring on contractions. By the second day, the midwife was worried for one of the babies, whom the couple had named John. “She was getting really concerned that they couldn’t find John’s heartbeat.”

Her husband remembers “the midwife shaking her head”. “She said a number of times that we should be having a caesarean.”

By the time doctors finally decided to perform an emergency C-section, it was too late. Starved of oxygen, baby John had suffered a catastrophic brain injury. When he was delivered at 3am, he had no pulse. Efforts to resuscitate him failed.

Their son’s death was part of what is now recognised as the largest maternity scandal in NHS history. 

The five-year investigation will reveal that the experiences of 1,500 families at Shrewsbury and Telford Hospital Trust between 2000 and 2019 were examined. At least 12 mothers died while giving birth, and some families lost more than one child in separate incidents, the report is expected to show.

The expert midwife Donna Ockenden and a team of more than 90 midwives and doctors will deliver a damning verdict on the Shrewsbury trust, its culture and leadership — and failure to learn from mistakes or listen to families.

At its heart is how a toxic obsession with “normal birth” — fuelled by targets and pressure from the NHS to reduce caesarean rates — became so pervasive that life-or-death decisions on the maternity ward became dangerously distorted for nearly two decades.

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Source:  The Times, 26 March 2022

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1,500 deaths to be investigated at scandal-hit mental health trust

More than 1,500 patient deaths are to be investigated in the largest-ever independent inquiry into “unacceptable” mental health care.

A probe into the deaths of patients who were cared for by NHS mental health services across Essex has revealed its investigation will cover deaths from 2000 to 2020.

All 1,500 people died while they were a patient on a mental health ward in Essex, or within three months of being discharged from one.

In 2001, following an investigation into 25 deaths, police criticised the trust for “clear and basic” failings but did not pursue a corporate manslaughter prosecution.

And in 2021, the Health and Safety Executive fined the trust £1.5m due to failures linked to the deaths of 11 patients. The regulator said the trust did not manage the risks of ligature points for a period of more than 10 years.

In January 2021, following pressures, former patient safety minister Nadine Dorries commissioned former NHS England mental health director Dr Geraldine Strathdee to chair an independent inquiry.

While it is not known yet how many of the 1,500 deaths were caused by neglect, Dr Strathdee said evidence had so far shown some “unacceptable” and “dispassionate” care.

Melanie Leahy, who has campaigned for change within Essex mental health services since her son died in 2012, has been leading the call for it to become a public inquiry on behalf of the families. Her son, Matthew Leahy, died as an inpatient at the Linden Centre, following multiple failings in his care.

A 2018 parliamentary health service ombudsman report on his death, and that of another young man called Richard Wade, identified “systemic” failings on behalf of the trust. These included the failure to manage his risk level, to look after his physical health and to take action when he reported being raped in the unit.

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Source: The Independent, 28 March 2022

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Online retailers stop sales of some blood oxygen monitors after investigation

Amazon, eBay and Wish have stopped stocking some monitors that let people keep track of their blood oxygen levels after an investigation found they were not fit to be sold.

The online marketplaces removed a number of pulse oxygen testing devices known as oximeters from sale after being alerted to flaws identified by the consumer organisation Which?

Pulse oximeters have boomed in popularity as a result of Covid, with millions of people keeping one at home so they can quickly assess if their blood oxygen level has fallen worryingly low – a condition known as “silent hypoxia” – which is a common side-effect of the disease.

Some of the devices were not legally fit to be sold in the UK, did not carry the CE quality Kitemark or wrongly claimed that they had been approved by the NHS.

The Department of Health and Social Care (DHSC) said it would look into the unauthorised use of the health service’s iconic blue and white branding on the devices. It made clear that “the NHS does not approve or endorse any medical devices, including oximeters”.

“The department strictly controls the NHS identity and takes unauthorised use or adaptation of the NHS logo and the letters ‘NHS’ very seriously”, a DHSC spokesperson said.

Which? said that 11 of the cheap pulse oximeters it bought from those websites failed to comply with UK and European Union law when it examined them closely.

“It is very concerning that our investigation found these medical devices for sale without the required safety markings or brazenly claiming to be approved by the NHS, and the biggest online marketplaces were not picking up on these red flags”, said Natalie Hitchens, the consumer group’s head of home products and services.

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Source: The Guardian, 26 March 2022

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Whistleblower reveals 'culture of fear' stopped hospital staff exposing baby deaths

A whistleblower who worked at a hospital trust where hundreds of babies died or were left brain-damaged says there was "a climate of fear" among staff who tried to report concerns.

Bernie Bentick was a consultant obstetrician at the Shrewsbury and Telford NHS Trust for almost 30 years.

"In Shrewsbury and Telford there was a climate of fear where staff felt unable to speak up because of risk of victimisation," Mr Bentick said.

"Clearly, when a baby or a mother dies, it's extremely traumatic for everybody concerned.

"Sadly, the mechanisms for trying to prevent recurrence weren't sufficient for a number of factors.

"Resources and the institutionalised bullying and blame culture was a large part of that."

More than 1,800 cases of potentially avoidable harm have been reviewed by the inquiry. Most occurred between 2000 and 2019.

Mr Bentick worked at the Trust until 2020. He said from 2009 onwards, he was raising concerns with managers.

"I believe there were significant issues which promoted risk because of principally understaffing and the culture," he said.

He also accuses hospital bosses of prioritising activity - the number of patients seen and procedures performed - over patient safety.

"I believe that the senior management were mostly concerned with activity rather than safety - and until safety is on a par with clinical activity, I don’t see how the situation is going to be resolved," he said.

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Source: Sky News, 27 March 2022

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Government asks NHS to ‘cut core funding’ by £500m

NHS England must find hundreds of millions of pounds in last-minute savings to pay for ongoing covid staff tests, it has been revealed

NHSE chief financial officer Julian Kelly told a meeting of NHS England’s board: “We have been asked to see if we can cut core NHS funding - at the moment that is probably to the tune of £500m.” Mr Kelly said achieving this would likely involve “slowing down” some transformation programmes and ambitions in the Long Term Plan.

He added that rising inflation could add an extra £1bn in financial pressure, telling the board “we’re going to have to look at what that means for our ability to deliver NHS goals in the round.”

It was reported in February that Health Secretary Sajid Javid and Chancellor Rishi Sunak were at loggerheads over whether the Department of Health and Social Care (DHSC) should receive additional funding for covid testing on top of the health service’s spending envelope. The row is said to have led to a delay in plans to scrap all remaining virus-related restrictions.

The DHSC reduced its ask for extra cash down from £5bn to an eventual £1.8bn but even this lower sum was rejected by the Treasury, according to reports. This means continuing staff testing will have to paid for out of the existing NHS budget.

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Source: HSJ, 24 March 2022

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Welsh Ambulance: Paramedics say job is soul destroying

"Absolutely soul destroying" is how one paramedic describes his job.

He is not alone.

Over the past few months, BBC Wales has been contacted by employees from the Welsh Ambulance Service who paint a dire picture of a service under immense pressure.

Ambulance waiting times have climbed and climbed throughout the pandemic. The impact that has on patients is well known - but what about those on the other side?

Mark, who did not want to disclose his real name or show his face for fear that he would lose his job, described the stress of his shifts with a radio strapped to his chest, hearing "red calls waiting, red calls waiting".

"That is the potential of somebody's life waiting in the balance - and you can't get there. It's absolutely soul-destroying. We wouldn't treat animals this way, why are we treating humans?", he said.

Mark said the job has always come with pressure and anxiety.

But over the course of the pandemic that has intensified and he has "never known as many people looking for other jobs as they are at the moment".

The stress has become so bad that he is now on antidepressants.

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Source: BBC News, 25 March 2022

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Persistent cough may be tuberculosis not Covid, doctor warns

The UK's top public health doctor says anyone with a persistent cough and fever should not dismiss it as Covid - and should consider other infectious illnesses like tuberculosis (TB).

Dr Jenny Harries' warning comes as provisional data shows there were 4,430 cases recorded in England in 2021, despite sharp declines in recent years.

Charities are calling for more funding to tackle the disease around the world. They say the pandemic and conflicts have set back progress worldwide.

In 2020, global deaths because of tuberculosis ranked second to Covid for any infectious disease.

The charity Stop TB Partnership warns the war in Ukraine could have "devastating impacts on health services", including the country's strong national TB treatment programme.

The charity is urging all countries to put facilities in place urgently so refugees can be given the care they need.

In the UK a requirement for Ukrainians to take a TB test before arrival has been waived for those who are coming to the country on the family scheme visa. Refugees arriving on the scheme will get medical care and testing via GPs.

Meanwhile Dr Jenny Harries, chief executive of the UK Health Security Agency, said delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected cases in England.

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Source: BBC News, 24 March 2022

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Covid-19: Public inquiry must include effects on children, say experts

The government’s upcoming Covid-19 public inquiry must include the effect of the pandemic on children and young people, a group of leading doctors and scientists have said.

The draft terms of reference for the inquiry were published on 15 March but made no specific mention of children or young people other than a single reference to “restrictions on attendance at places of education."

“There is no doubt that school closures and broader lockdowns harmed children,” said the letter to the Times signed by 50 people including Russell Viner, former president of the Royal College of Paediatrics and Child Health, and Andrew James, president of the Royal College of Psychiatrists. “Educational losses have been most marked in children from deprived families and in vulnerable children.”

They pointed out that mental health problems increased from being experienced by one in nine children and young people before the pandemic to one in six during 2020 and 2021. Childhood obesity rates last year were at least 20% above previous years.

One of the signatories to the letter, education committee chair Robert Halfon, has also written directly to the inquiry chair Heather Hallet.3 “The closure of schools and the restrictions placed on education settings has been nothing short of a national disaster for children and young people, not only in terms of their educational attainment but also with regards to their mental health and wellbeing, their life chances, and their safety,” he wrote.

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Source: BMJ, 24 March 2022

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Pregnant women to be offered NHS test to detect pre-eclampsia

Pregnant women with suspected pre-eclampsia will now be offered a test on the NHS to detect the condition.

Pre-eclampsia affects some women, usually during the second half of pregnancy or soon after their baby is born.

It can lead to serious complications if it is not picked up during maternity appointments, with early signs including high blood pressure and protein in the urine.

In some cases, women can develop a severe headache, vision problems such as blurring or flashing, pain just below the ribs, swelling and vomiting.

Tests have been available to help rule out the condition but midwives will now use tests designed to pick up a positive diagnosis.

In new draft guidance, the National Institute for Health and Care Excellence (NICE) said midwives could use one of four blood tests to help diagnose suspected preterm pre-eclampsia.

Jeanette Kusel, the acting director for medtech and digital at NICE, said: “These tests represent a step-change in the management and treatment of pre-eclampsia. New evidence presented to the committee shows that these tests can help successfully diagnose pre-eclampsia, alongside clinical information for decision-making, rather than just rule it out.

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

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Source: The Guardian, 25 March 2022

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