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New discharge data reveals significant variation among trusts

The trusts with the most patients waiting at least a week after they are ‘ready’ to be discharged can be identified for the first time, following publication of new NHS England data.

The new collection shows how long patients are spending in hospital after being deemed fit for discharge, with around 3.7% of all patients in England waiting a week or longer in hospital following their “discharge ready” date — although about half trusts have so far failed to report accurate data. 

However, there is considerable variation across the country, with six trusts recording more than double the national average in terms of the proportion of patients declared medically fit for discharge being delayed by a week or more.

Sarah-Jane Marsh, NHSE’s national director for urgent and emergency care, told HSJ in February that NHSE would aim to set a “baseline” for the discharge-ready data.

HSJ understands NHSE will revisit the idea of a new target based on how long patients wait for discharge after they are “ready”, using the new collection, when more trusts are publishing data.

It is also planning to publish data based on responsible local authority in future, given councils’ major role coordinating social care support for some people awaiting discharge.

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Source: HSJ, 23 November 2023

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ICSs told to prepare ‘nuclear’ service cuts as NHSE plays ‘hardball’

Health systems are still struggling to meet their financial plans, despite hundreds of millions being raided from investment budgets to help balance the books.

Senior leaders in most regions said the cash falls short of their existing financial gaps.

Earlier this month, NHS England announced that £800m would be made available to integrated care systems (ICSs) to offset the additional cost of strikes. 

HSJ understands ICSs reported a combined deficit that was £1.5bn worse than planned in the six months to October, which implies a gap of several hundred million pounds unless systems can report substantial surpluses for the second half of the year.

HSJ spoke to senior sources in all seven regions, with more than half saying their systems would still fail to deliver breakeven, despite the funding transfers.

A source in the South East said their system’s share of the funding “won’t touch the sides”, adding that NHSE was playing “hardball”.

Another local source said they had identified a set of “nuclear options” to balance the books, but these would be “catastrophic for quality of care and/or nigh-on impossible to deliver”.

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Source: HSJ, 22 November 2023

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Bleach does not tackle fatal hospital superbug, UK researchers find

Liquid bleach does not kill off a hospital superbug that can cause fatal infections, researchers have found.

Clostridium difficile, also known as C diff, is a type of bacteria found in the human gut. While it can coexist alongside other bacteria without problem, a disruption to gut flora can allow C diff to flourish, leading to bowel problems including diarrhoea and colitis.

Severe infections can kill, with 1,910 people known to have died within 30 days of an infection in England during financial year 2021-2022.

Those at greater risk of C diff infections include people aged over 65, those who are in hospital, people with a weakened immune system and people taking antibiotics, with some individuals experiencing repeated infections.

According to government guidance, updated in 2019, chlorine-containing cleaning agents with at least 1,000 ppm available chlorine should be used as a disinfectant to tackle C diff.

But researchers say it is unlikely be sufficient, with their experiments suggesting that even at high concentrations, sodium hypochlorite – a common type of bleach – is no better than water at doing the job.

“With antimicrobial resistance increasing, people need to recognise that overuse of biocides can cause tolerance in certain microbes, and we’re seeing that definitely with chlorine and C diff,” said Dr Tina Joshi, co-author of the research, from the University of Plymouth.

While chlorine-based chemicals used to be effective at killing such bacteria, that no longer appears to be the case, she said.

“The UK doesn’t seem to have any written new gold standard for C diff disinfection. And I think that needs to change immediately,” she said.

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Source: The Guardian, 22 November 2023

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To engage the private sector in health, we must align goals and share risks

Engaging the private sector in delivering health care and goods requires a sound understanding of how to align resources with the strategic priorities of a health system. The WHO Regional Office for Europe and the European Observatory on Health Systems and Policies have released a new report for policy-makers that analyses governance evidence from the COVID-19 pandemic. 

“The question is not whether we should do it, but what we can do to do it well,” explained Dimitra Panteli, programme manager at the Observatory, who presented the policy brief during a WHO-hosted launch session at the European Public Health (EPH) Conference in Dublin.

Having played a key part in the COVID-19 pandemic, the private sector showed that it holds resources and expertise that can enhance the delivery of health goods and services and help achieve Universal Health Coverage. It also has a wider role in the maintenance of essential health services and in ensuring health system resilience. 

“We cannot have the illusion that we should not work with the private sector, especially as health services struggle to cope with backlogs caused by the pandemic,” pointed out Natasha Azzopardi Muscat, Director of Country Health Policies and Systems at WHO/Europe. 

This collaboration can however present challenges, for example around governance practices. Policy successes and failures during the pandemic provide lessons for countries on how to engage the private sector in their health systems effectively.

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Source: European Observatory on Health Systems and Policies, 20 November 2023

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Patient privacy fears as US spy tech firm Palantir wins £330m NHS contract

The NHS has sparked controversy by handing the US spy tech company Palantir a £330m contract to create a huge new data platform, leading to privacy concerns around patients’ medical details.

The move immediately prompted concerns about the security and privacy of patient medical records and the suitability of Palantir to be given access to and oversight of such sensitive material.

NHS England has given Palantir and four partners including Accenture a five-year contract to set up and operate the “federated data platform” (FDP).

The British Medical Association, which had previously voiced concern about the NHS’s alleged lack of scrutiny of bidders on “ethical” grounds, said Palantir’s winning bid was “deeply worrying”.

NHS England sought to allay such concerns. It stressed that none of the companies in the winning consortium would be able to access health and care data without its explicit consent; that it would retain control of all data within the platform; and that it would not include GP data.

It said the new software would be protected by the highest possible standards of security through the deployment of “privacy enhancing technology”.

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Source: The Guardian, 21 November 2023

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Concern after unqualified medics given senior Birmingham hospital roles

Medics who are not qualified doctors have been used in senior roles at Birmingham Children's Hospital.

Physician associates (PAs) have worked as the responsible clinician in the liver unit with a consultant on call.

The RCPCH said it had heard the concerns of its members and the need for a clearly defined physician associate roles and training pathways.

The doctors' union, the British Medical Association, called for a delay on recruitment of PAs until the group was properly regulated and supervised.

The trust running the hospital said the physician associates did not work in isolation and only did the role with the right level of experience.

Introduced in 2003, the PA role involved supporting doctors so they could deal with more complex patient needs.

Usually, physician associates have a science degree and do a two-year post-graduate qualification. They are not doctors and are not allowed to prescribe drugs.

The role is currently unregulated with the government planning legislation for regulations to be introduced before the end of 2024.

PAs have worked at Birmingham Children's Hospital for 10 years but the BBC saw rotas which show them on tier two - normally a rota for senior doctors called registrars.

PAs were not allowed to work unsupervised overnight and there were consultants on call at all times to offer advice, they said.

Dr Fiona Reynolds, the trust's chief medical officer, insisted the safety and quality of care offered to children, young people and families remained a priority for everyone at the trust and would not be compromised.

"Although small in number, [the PAs] skills and dedication to offering the best for our patients complements that of their colleagues in all fields - all of which are hugely valued by our trust," she added.

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Source: BBC News, 21 November 2023

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Letby inquiry to seek rapid change to NHS services and culture despite legal delays

The public inquiry into the Lucy Letby murders will seek changes to NHS services and culture next year despite the fact that formal hearings are likely to be delayed until the autumn.

Inquiry chair Lady Justice Thirlwall will issue an update message later today. In it she will stress the inquiry will “look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”.

HSJ understands Lady Thirlwall will look to agree on some changes, based on the inquiry’s evidence gathering and discussions with the sector before it begins oral hearings – which are unlikely to start for at least a year due to ongoing legal action.

Lady Thirlwall will say the legal constraints mean its early work will focus on the experience of families who were named in the cases already heard; and “on the effectiveness of NHS management, culture, governance structures and processes, as well as on the external scrutiny and professional regulation supposed to keep babies in hospital safe and well looked after”.

She said, “I want this to be a searching and active inquiry in the sense that it will look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”.

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Source: HSJ, 22 November 2023

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USA: Despite decades of promises, health research still overlooks women

Women are underrepresented in clinical trials, and even lab mice are predominantly male – and the effects show up in almost every aspect of human health

Women are twice as likely as men to die from heart attacks; when a nonsmoker dies of lung cancer, it’s twice as likely to be a woman as a man; and women suffer more than men from Alzheimer’s and autoimmune disease.

Yet research into these conditions, and many more, generally fails to examine women separately. It’s even less likely to look at disparities affecting women of color – why, for instance, Black women are nearly three times more likely to die in pregnancy than white women are.

It’s been 30 years since the US Congress ordered the National Institutes of Health to make sure women were included equally in clinical trials. Despite some progress, research on women still lags, and there’s growing evidence that women and girls are paying the price.

“Research on women’s health has been underfunded for decades, and many conditions that mostly or only affect women, or affect women differently, have received little to no attention,” the first lady Jill Biden said in announcing a new White House initiative on women’s health research on 13 November.

“Because of these gaps, we know far too little about how to manage and treat conditions like endometriosis, and autoimmune diseases like rheumatoid arthritis. These gaps are even greater for communities that have historically been excluded from research – including women of color and women with disabilities.”

Not only do researchers fail to include enough women in clinical trials, they often don’t look for differences between how men and women respond to treatments.

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Source: The Guardian, 20 November 2023

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Culture of impunity for NHS staff accused of sexual violence, say campaigners

There is a culture of impunity around sexual violence by healthcare staff in the NHS, with known perpetrators going unchallenged, campaigners have warned.

A report by Surviving in Scrubs, a group of female doctors campaigning against misogyny in healthcare, said staff known to be perpetrators of sexual violence, who are most often senior male doctors, are tolerated or regarded as untouchable.

The study, which analysed 174 incidents of staff-on-staff sexism, sexual harassment and sexual assault anonymously self-reported to the group’s website, found those who had been abused – mainly junior female doctors – struggled to get their complaints addressed.

Some women said they faced threats of reprisals from those they were accusing. They reported feeling gaslit by colleagues who they said remained silent and, in some cases, colluded with the perpetrator.

One woman referred to a perpetrator as the “Jimmy Savile of the surgical community”, and was told by a senior female colleague that “he was known for this behaviour, that he’d got away with so much before and he was capable of ruining careers”.

Of the 209 incidents reported to Surviving in Scrubs since it launched last summer, just over 42% (89) were sexual harassment, a fifth (43) were sexual assaults, nearly 2% were rapes, and almost 37% (77) concerned sexist behaviour. Some incidents were recorded in more than one category.

Dr Becky Cox, the co-founder of Surviving in Scrubs, said a culture of sexism and sexual abuse had become normalised in the NHS.

“When you’re [a woman] coming into this profession, you see senior male consultants who are derogatory, use sexist language, and assault you. Male medical students see this behaviour and think that’s normal. Then they go up the ranks and continue to perpetrate the behaviour. It’s a never ending cycle.”

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Source: The Guardian, 21 November 2023

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Brazilian butt lift death prompts meeting between UK and Turkey officials

UK officials are to meet with counterparts in Turkey following the death of a British woman during so-called Brazilian butt lift surgery at a private hospital in the country’s capital Istanbul.

Melissa Kerr, 31, from Gorleston in Norfolk, travelled to the private Medicana Haznedar hospital for the buttock enlargement surgery in 2019.

She died at the hospital on the day of the surgery, which involves fat taken from elsewhere on the body being injected into the buttocks.

An inquest into her death, which took place place in Norwich earlier this year, heard that Kerr, who was self-conscious about her appearance, was given only “limited information regarding the risks and mortality rate” associated with the operation.

Jacqueline Lake, the senior coroner for Norfolk, wrote to the health secretary expressing concern about people travelling overseas for cosmetic surgery.

In a written response to Lake, health minister Maria Caulfield confirmed UK officials would be travelling to Turkey to meet with their counterparts.

“The intention is to discuss the regulatory framework, and the protections that are in place for UK nationals, and to identify concrete areas where the UK and Turkish authorities should work together to reduce the risks to patients in the future,” Caulfield says in the letter first reported by the BBC.

“Specifically, I have noted in your report the lack of standard pre-assessment questions provided to Ms Kerr in Türkiye.

“We remain aware countries providing healthcare tourism often conduct pre-assessment checks that may not match UK regulatory standards and we want to encourage all providers treating UK nationals to meet international best practices on pre-operative procedures whenever possible.

“Such transparency and standardisation are important to reduce potential risks to patients and improve patient care in the UK and overseas."

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Source: The Guardian, 21 November 2023

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'Poor' NHS interpreting services leading to misdiagnosis and deaths, says group

Calls are being made to improve NHS interpreting services, with staff resorting to online translation tools to deliver serious news to non-English speaking patients.

The National Register of Public Service Interpreters said "poorly managed" language services are "leading to abuse, misdiagnosis and in the worst cases, deaths of patients".

The BBC's File on 4 programme has found interpreting problems were a contributing factor in at least 80 babies dying or suffering serious brain injuries in England between 2018 and 2022.

NHS England says it is conducting a review to identify if and how it can support improvements in the commissioning and delivery of services.

Rana Abdelkarim and her husband Modar Mohammednour arrived in England after fleeing conflict in Sudan, both speaking little English.

It was supposed to be a fresh start but they soon suffered a devastating experience after Ms Abdelkarim was called to attend a maternity unit for what she thought was a check-up.

In fact, she was going to be induced, something Mr Mohammednour said he was completely unaware of.

"I heard this 'induce', but I don't know what it means. I don't understand exactly," he said.

His wife suffered a catastrophic bleed which doctors were unable to stem and she died after giving birth to her daughter at Gloucestershire Royal Hospital in March 2021.

He said better interpreting services would have helped him and his wife understand what was happening.

"It would have helped me and her to take the right decision for how she's going to deliver the baby and she can know what is going to happen to her," he added.

The Healthcare Safety Investigation Branch (HSIB) found there were delays in calling for specialist help, there was no effective communication with Ms Abdelkarim, and the incident had traumatised staff.

Gloucestershire Royal Hospitals NHS Foundation Trust has apologised and said it had acted on the coroner's recommendations to ensure lessons have been learned to prevent similar tragedies.

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Source: BBC News, 21 November 2023

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Two-year waits for community mental health services revealed for the first time

HSJ analysis of the NHS England data also found that 19,000 adults with a serious mental illness are waiting for longer than 18 months for a second contact with community mental health services. This is seen as a more meaningful metric for adults than the first contact.

In total, almost 240,000 children and young people were waiting for treatment from community mental health services in August 2023, as well as more than 192,000 adults.

The data revealed the median, or typical, waiting time for children and young people from referral to first contact was 178 days. The median wait time for adults from referral to “second contact” was 120 days.

The NHS long-term plan set out proposals for a four-week waiting time standard for children and adults to access community mental health services. This approach was piloted and a consultation published, but the new standards are yet to be implemented.

Sean Duggan, chief executive of the mental health network at the NHS Confederation, said leaders would be concerned – although “not surprised” – that patients were waiting so long for community services.

He added: “We need access and waiting times standards for all mental health services, to help us improve national data and to direct and allocate resources effectively.”

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Global partners cheer progress towards eliminating cervical cancer and underline challenges

World leaders, cervical cancer survivors, advocates, partners, and civil society came together last week to mark the third Cervical Cancer Elimination Day of Action. The Initiative, which marked the first time Member States adopted a resolution to eliminate a noncommunicable disease, has continued to gain momentum, and this year's commemoration promises to be a beacon of hope, progress, and renewed commitment from nations around the world.

“In the last three years, we have witnessed significant progress, but women in poorer countries and poor and marginalized women in richer countries still suffer disproportionately from cervical cancer,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “With enhanced strategies to increase access to vaccination, screening and treatment, strong political and financial commitment from countries, and increased support from partners, we can realize our vision for eliminating cervical cancer.”

Australia is on target to be among the first countries in the world to eliminate cervical cancer, which the country anticipates to achieve in the next 10 years. 

In Norway, researchers have recently reported finding no cases of cervical cancer caused by the human papillomavirus (HPV) in 25-year-olds, the first cohort of women who were offered the vaccine as children through the national vaccination programme.

Indonesia announced this week a declaration committing to reach the 90-70-90 targets for cervical cancer elimination through the national cervical cancer elimination plan (2023 to 2030).

In the United Kingdom, England’s National Health Service (NHS) pledged this week to eliminate cervical cancer by 2040.

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Source: WHO, 17 November 2023

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Toxic doctors put patients at risk, says NHS watchdog

Patient safety is being put at risk by the “toxic” behaviour of doctors in the NHS, the health ombudsman has said.

Rob Behrens, who investigates complaints about the NHS in England, warned that the hierarchical and high-handed attitude of clinicians was undermining the quality of care in some hospitals.

He called for medical training to be redesigned to encourage a more empathetic and collaborative approach from doctors.

Pointing to failings in the treatment of sepsis and the problems in maternity services, Behrens said he was “shocked on a daily basis” by what he saw as ombudsman. Too often, “organisational reputation has been put above patient safety”, he told The Times Health Commission.

The ombudsman warned of a “Balkanisation” of health professionals, with rivalries between doctors and nurses or midwives and obstetricians harming patient care. “For all the brilliance of clinicians quite often they’re not very good at working together,” he said. “Time and again, the handover from one clinician to another, from one shift to another, or the inability to raise the issue at a senior level has been a key factor in what has gone wrong.”

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Source: The Times, 18 November 2023

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Patients ‘neglected and confused’ after leaving hospital, says NHS watchdog

Patients are being left feeling “confused and neglected” by not being told who to contact about their future care when they are discharged from hospital, an NHS watchdog has said.

Research by Healthwatch England has found that 51% of people are not being given details when they leave of which services they can turn to for help and advice while they are recovering.

The NHS was risking patients having to be readmitted as medical emergencies and hospital beds becoming even more scarce by failing to adhere to its own guidelines on discharge, it said.

“While our findings show some positive examples, it’s alarming that guidance on safe discharge from the hospital is routinely not being followed,” said Louise Ansari, the patient champion’s chief executive. Healthwatch asked 583 people and their carers how their discharge had gone.

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Source: The Guardian, 19 November 2023

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Autistic patient trapped in hospital ward for four months due to system failures

Two young people facing mental health crises were left on paediatric wards for months while different agencies across a health system struggled to find appropriate placements. 

The patients – who were both autistic and had learning disabilities, with special educational needs – were admitted to Maidstone and Tunbridge Wells Trust (MTW) last year after attending emergency departments more than 10 times within a two-month period.

They were left on a paediatric ward – one of the patients for four months – as this was the “only available place of safety as opposed to the optimum setting to meet their needs,” according to Kent and Medway Integrated Care Board’s “learning review” of children and young people with complex needs, which the two cases prompted. 

The review, which HSJ obtained under a Freedom of Information request, revealed several problems with joint working, despite a multidisciplinary team meeting regularly to discuss the young patients’ needs.

Since the review, a new escalation process has been introduced, urgent mental health risk assessments in the community have been enhanced and a three-month pilot of a self-harm service has been implemented at Tunbridge Wells Hospital, part of MTW.

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Source: HSJ, 17 November 2023

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BMA calls for immediate pause on recruitment of physician associates

The BMA has called for an immediate halt to the recruitment of Medical Associate Professionals (MAPs) in the UK including Physician Associates (PAs) and Anaesthetic Associates (AAs).

Doctors from across the UK who make up the BMA’s UK Council have passed a Motion which calls for the moratorium on the grounds of patient safety. They want the pause to last until the government and NHS put guarantees in place to make sure that MAPs are properly regulated and supervised. The move follows a number of recent cases in which patients have not always known they were being treated by a physician associate and tragically have come to harm.

Professor Phil Banfield, BMA chair of council, said:

“Doctors across the UK are getting more and more worried about the relentless expansion of the medical associate professions, brought into sharp focus by terrible cases of patients suffering serious harm after getting the wrong care from MAPs. Now is the time for the Government to listen before it is too late. We are clear: until there is clarity and material assurances about the role of MAPs, they should not be recruited in the NHS.  

“We have always been clear that MAPs can play an important part in NHS teams, and doctors will continue to value, respect and support individual staff they work with. But MAPs roles and responsibilities are not clearly defined. We are seeing increased instances of MAPs encroaching on the role of doctors; they are not doctors, do not have a medical degree and do not have the extensive training and depth of knowledge that doctors do. As doctors, we are worried that patients and public do not understand what this could mean in respect of the level of experience and expertise in care they receive.

“The General Medical Council is the exclusive regulator of doctors in the UK. Adding staff who are not doctors and do not have a medical degree to the GMC register brings into question the competence and qualification of the whole medical profession. The Government may view this as a price worth paying for a shortcut to solving the workforce crisis they have presided over. We know otherwise. GMC regulation of MAPs will only add to the confusion and uncertainty that patients face.

“Ministers may hope that by using secondary legislation, which may not even require the vote of MPs, they can avoid raising the alarm. But patients want doctors to remain doctors, regulated by a dedicated body, and they have a right to have confidence in the expert medical care they receive. There must be no doubt that when a patient goes to see a doctor, they are going to see a doctor. This blurring of roles and the confusion caused to patients must stop now.”

Source: BMA, 16 November 2023

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NHSE tells GPs they’re ‘breaching contract’ by denying record access

NHS England has taken the unusual move of warning multiple GP practices they are breaching their contract by refusing to give people automatic access to future entries in their record.

Under the current national GP contract, practices were ordered to give people on their list automatic access to prospective (future) medical records, via the NHS App, by 31 October. 

However, the British Medical Association GP committee has urged GPs to instead adopt an “opt in” model, saying it is concerned that giving automatic access could endanger some people.

The BMA gave practices a template letter to use to tell their integrated care boards they cannot move ahead with automatic access “due to several risks that cannot be sufficiently mitigated”.

NHS England’s own template letter for ICBs to use in response, seen by HSJ, states: “Based on your letter we interpret that the required changes were not implemented by 31 October 2023, thereby putting you in breach of your contractual obligations. We would therefore like to discuss with you your plan, including the timeline to become compliant.”

It is an unusual warning from NHSE which could potentially apply to hundreds or thousands of practices.

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Source: HSJ, 16 November 2023

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NHS failing to prioritise those in most need, says departing ICB chief

The NHS should better track patients with the greatest clinical need so they can move to the front of the queue for treatment, a former government waiting list tsar has said.

Anthony “Mac” McKeever told HSJ the health service could improve how it works through its elective backlog by using a system introduced during the covid pandemic to prioritise the most pressing cases.

He said a “large chunk” of cases were still not given a code to say how long they are considered to be able to wait for surgery, which is at the heart of this process.

Mr McKeever retired as Mid and South Essex Integrated Care Board  chief executive this month following nearly five decades in the health service, including as a trust leader. 

Although Mr McKeever said he only knew the regional situation for the East of England, he would be “very surprised” if the national picture was any different. Waiting list expert Rob Findlay agreed this was a reasonable assumption.

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Source: HSJ, 17 November 2023

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Nursing watchdog to miss target to cut soaring complaints backlog

The nursing watchdog will miss its target to tackle a 5,500-case backlog of complaints as referrals hit a record high.

The Nursing and Midwifery Council NMC has admitted it won’t hit its pledge to cut the number of unresolved complaints against nurses and midwives to 4,000 by March 2024.

The news comes as it faces questions over the way it handles complaints after The Independent revealed a number of serious allegations, including poor investigations that have led to fears of rouge nursing going unchecked. The newspaper exposes have prompted two independent reviews.

Details of the first two reviews have been revealed for the first time and will look at:

  • The NMC’s response to whistleblower concerns, including whether they were treated fairly and whether it acted fairly and reasonably.
  • Any evidence of cultural issues which may have impacted the NMC’s response to whistleblowing.
  • Whether concerns raised are substantiated and indicate a decision-making process by the NMC which is insufficient in protecting the public.
  • Evidence of shortcomings in guidance and training.

The senior whistleblower whose evidence prompted the review said: “The NMC has refused to change its approach to the investigations into my whistleblowing concerns to allow me to share and explain my evidence without fear of reprisal. I don’t think it is possible to draw safe conclusions about either how I have been treated or the impact of our culture on case work from reviewing only 13 of our current 5,500 open cases, and 6 closed cases and a selection of my emails.”

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Source: The Independent, 16 November 2023

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Forcing medical staff to work during strikes could harm care, NHS Providers says

Forcing some medical staff to work through industrial action under new anti-strike laws could end up harming patient care, hospital trust leaders have said, as ministers claimed their new measures would keep public services running over Christmas.

NHS Providers, which represents hospital, mental health and ambulance trusts, said there was a significant risk it would damage relationships between staff and employers that are already very challenged, in a way that could affect patients.

In a submission to the consultation on minimum service levels in hospitals, it said: “Our key concern is that rather than strengthening services as intended, the legislation proposed would worsen relationships between employers and staff, and between trusts and local union representatives to the longer-term detriment of patient care.”

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Source: The Guardian, 17 November 2023

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Therapy could be offered to women suffering menopause symptoms

Women experiencing hot flushes, night sweats, depression and sleep problems could be offered therapy to help reduce their menopause symptoms, under new guidelines.

But menopause champions warned that those suffering with symptoms could have long waits for mental health support and stressed that the new draft guidance to GPs from the National Institute for Health and Care Excellence (NICE) must not distract from “ongoing challenges” of getting HRT.

A NICE evidence review found that cognitive behavioural therapy (CBT) can help make night-time sweats less severe and frequent and should be considered “alongside or as an alternative to HRT”.

The guidance is not mandatory but GPs will be expected to take the new guidance “fully into account”, said Nice.

Caroline Nokes, chair of the Commons’ women and equalities committee, welcomed the new guidance saying there was no “one size fits all” to help women going through the menopause, but said it must not be used to fob off women, some of whom were still facing drug shortages.

A major HRT drug shortage last year resulted in 22 restrictions being put in place, pushing some women to turn to the hidden market or meet up with other women to buy, swap or share medicines.

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Source: The Guardian, 17 November 2023

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Loughborough University to deliver course to NHS professionals in a bid to improve patient safety

Loughborough University is collaborating with NHS England to deliver learning to hundreds of healthcare professionals in a bid to improve patient safety.

Human factors and ergonomics experts in the School of Design and Creative Arts will deliver Levels 3 and 4 of the NHS Patient Safety Syllabus and Curriculum after winning a competitive tender process.

Under the leadership of Dr Mike Fray, supported by Professor Sue Hignett and Professor Thomas Jun, the Loughborough University team will craft and deliver educational content to 820 patient safety specialists across various NHS Trusts in England from 2023 to 2024.

In 2021, the NHS Patient Safety Syllabus was created by drawing upon best practice from a number of safety-critical industries. It has as a core aim of changing how staff think about improving patient safety. The key to this is switching the focus to proactive prevention of safety incidents, and away from the current largely retrospective analyses.

Dr Fray believes Loughborough University’s world-leading reputation in the delivery of human factors and ergonomics education will help the NHS achieve its goals.

Dr Fray said: “No healthcare worker goes to work thinking they will do harm, but the systems, processes and complexity of the work can lead to errors, omissions, or reductions in quality of care.  “With this new course we will be able to support patient safety specialists in each Trust to lead safety improvement work and provide safety science expertise to their organisations so that patients across the NHS can benefit.”

Aidan Fowler, National Director of Patient Safety said: ‘’Training and education is at the centre of the NHS Patient Safety Strategy so that we can empower people with the latest skills and knowledge in patient safety science.

“The launch of this training for our patient safety specialists is the latest development in this work, using the syllabus created with the Academy of Medical Royal Colleges and adding to the training already available to all staff in the NHS.”

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Source: Loughborough University, 15 November 2023

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Private firms harming NHS patients by failing to deliver medicines, Lords report warns

Private healthcare companies are harming NHS patients in their own homes by failing to deliver vital medicines, and then escaping censure amid an alarming lack of oversight by ministers and regulators, members of the House of Lords have warned.

More than 500,000 patients and their families rely on private companies paid by the NHS to deliver essential medical supplies, drugs and healthcare to their homes. The homecare medicines services sector is estimated to be worth billions of pounds.

A report by the Lords public services committee says patients are being harmed due to “real and serious problems” with the services provided by for-profit companies. The absence of a single person or organisation with overall control or oversight of the sector means poor performance is going unchecked, it says.

“There are serious problems with the way services are provided,” the Lords report says. “Some patients are experiencing delays, receiving the wrong medicine or not being taught how to administer their medicine. [This] can have serious impacts on patients’ health, sometimes requiring hospital care. This leaves NHS staff either firefighting the problems caused by problems in homecare medicines services, or working on the assumption that those services will fail.”

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Source: The Guardian, 16 November 2023

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More women to get contraceptive pill from chemists in England

Almost half a million women will be able to get the contraceptive pill from pharmacies in England, from next month, without the need for a GP appointment.

Treatments for urinary infections and other common conditions will also be on offer under the Pharmacy First scheme.

NHS England said it was a safe and common-sense way of making NHS services easier for patients to use.

New Health and Social Care Secretary Victoria Atkins said the changes meant "more options for women when making a choice about their preferred contraception" and would free up GP appointments.

From February, pharmacists who successfully apply to join the scheme will be able to offer advice and treatment, including antibiotics, for seven common conditions:

  • sinusitis
  • sore throat
  • earache
  • infected insect bites
  • impetigo
  • shingles
  • urinary tract infection in women.

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Source: BBC News, 16 November 2023

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