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Why a year is 'long term' for vaccine safety

"We don't know the long-term side effects of Covid vaccines." That's a claim that's still common to see shared online.

But a year is actually considered relatively "long term" when it comes to vaccine safety.

This week marks the anniversary of the first delivery of Covid-19 vaccines under the Covax scheme - as well as being more than 14 months since the first dose was given.

And scientists explain that's enough time for all but the rarest side effects to have emerged.

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Source: BBC News, 25 February 2022

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NHS accused of ‘lack of urgency’ in addressing racial inequality of vaccine rollout

The NHS has been accused by a major charity of failing to address the emerging gap in Covid booster vaccine coverage for racialised communities.

Blood Cancer UK has told The Independent it has “serious concerns” over what it claims is a “shocking” lack of urgency from the NHS in addressing the gap in booster vaccine doses for immunocompromised people from black and minority ethnic communities.

The charity has said NHS England has failed to set out any “concrete” plans since it revealed 84% of immunocompromised people from a white British background had three vaccine doses by mid-December, compared to just 43% of immunocompromised people from a Pakistani background.

The news comes after the government announced people over 75 and immunocompromised children would be eligible to receive a fourth Covid vaccine by Spring.

According to an analysis published by Open Safely, a team of data scientists at Oxford University, of those who are part of the shielding population, as of the 22 February just 72% of Black people have had their booster does, and 73% of south Asian people. This compares to 89% of white people.

NHS England has highlighted a number of actions it is taking to address the situation such as using pop-up sites within communities and providing free transport.

Speaking with The Independent chief executive of Blood Cancer UK Gemma Peters, said: “We have serious concerns about how the poor roll-out of third doses for the immunocompromised has left people from some communities much less well-protected than people from a white British background. But while it is deeply troubling that a racial disparity in access to third vaccine doses has been allowed to develop, just as shocking has been NHS England’s apparent lack of urgency in addressing it."

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Source: The Independent, 25 February 2022

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Australia: New guidelines helping stem the tide of serious allergies in children

The rising rate at which Australian children are being admitted to hospital for serious food allergies has flattened since infant feeding guidelines were changed, new research shows.

The rate of hospitalisation for food anaphylaxis has increased in Australia in recent decades – but data suggests that changes to allergy prevention and infant feeding guidelines in 2008 and 2016 have helped to stem the rise in young children and teenagers.

In 2008, the Australasian Society of Clinical Immunology and Allergy guidelines were changed to recommend that allergenic solid foods should no longer be delayed, and in 2016 they were again updated to suggest such foods should be introduced in the first year of life.

Study co-author Prof Mimi Tang, an immunologist at the Murdoch Children’s Research Institute, said the greatest benefit of the updated guidelines was in children aged one to four.

Tang said there had been important changes to allergy prevention advice in the last 15 years. “Prior to 2008, all of the food allergy … prevention guidelines around the world were advising to delay the introduction of allergenic foods such as egg, milk and peanut until the ages of somewhere between two and four, depending on the food,” she said.

“The reason these recommendations were in place was based on theoretical concerns that the gut barrier was perhaps not as strong in young babies.”

But a growing body of evidence showed that delaying allergenic foods was associated with an increased risk of developing food allergies.

In the new study, published in the Journal of Allergy and Clinical Immunology, Tang and her colleagues noted an ongoing increase in anaphylaxis hospitalisation rates in teenagers aged 15 and older at the time the research was completed. People in this age group were born before the 2008 changes to the Australian guidelines.

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Source: The Guardian, 24 February 2022

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AI tutor outperforms human experts in training medical students to remove brain tumours

Medical students aided by an AI tutor outperformed peers taught remotely by human experts in a complicated surgical training procedure, new research reports.

The Neurosurgical Simulation and Artificial Intelligence Learning Centre in Montreal, Canada, randomly assigned 70 students feedback and assistance from either a sophisticated AI system, a remote expert human instructor, or neither, while they removed virtual brain tumours using a neurosurgical simulator.

The AI system, called the Virtual Operative Assistant (VOA), delivered personalised feedback to its students via a machine learning algorithm to teach them safe surgical techniques.

Human instructors observed the students over a live feed and gave instructions based on their performance.

The students tutored by the AI system learned surgical skills 2.6 times faster and performed 36 per cent better than those advised by human experts, without experiencing the heightened stress the researchers had anticipated.

Using AI training models to tutor students could be an effective way to improve their skills and patient safety while reducing the burdens placed on human instructors, the study, published in the Journal of the American Medical Association, found.

“Artificially intelligent tutors like the VOA may become a valuable tool in the training of the next generation of neurosurgeons,” said Dr Rolando Del Maestro, the study’s senior author.

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Source: iNews, 22 February 2022

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Best NHS leaders should take on ‘biggest challenges’, says chief inspector

The NHS needs its best leaders to be prepared to take on “the biggest challenges” despite the risk of criticism, the Care Quality Commission’s chief inspector has said.

At its monthly meeting, the CQC board was discussing how three previously ‘inadequate’-rated trusts – United Hospitals Lincolnshire Trust, Isle of Wight Trust and The Queen Elizabeth’s Hospital Kings Lynn FT – have all recently moved out of ‘special measures’, following improved reports from inspectors.

In response, Professor Ted Baker said that at each of the trusts a “new approach to leadership had changed the culture”, and despite still being under “particular pressure” they were able to drive forward “major improvements”.

He was “grateful” for the three leaders at the trusts for taking on the leadership challenge. 

Professor Baker said: “One of my concerns is leaders are not attracted to these posts, as they feel they are posts where they can be easily criticised. The best NHS leaders need to take on the biggest challenges.”

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Source: HSJ, 23 February 2022

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Transgender teenager's death preventable, coroner says

The death of a "vulnerable" transgender teenager who struggled to get help was preventable, a coroner has said.

Daniel France, 17, was known to Cambridgeshire County Council and Cambridgeshire and Peterborough Foundation Trust (CPFT) when he took his own life on 3 April 2020.

The coroner said his death showed a "dangerous gap" between services.

When he died, Mr France was in the process of being transferred from children and adolescent mental health services (CAMHS) in Suffolk to adult services in Cambridgeshire.

The First Response Service, which provides help for people experiencing a mental health crisis, also assessed Mr France but he had been considered not in need of urgent intervention, the coroner's report said.

Cambridgeshire County Council had received two safeguarding referrals for Daniel, in October 2019 and January 2020, but had closed both.

"It was accepted that the decision to close both referrals was incorrect", Mr Barlow said in his report.

Mr Barlow wrote in his report, sent to both the council and CPFT: "My concern in this case is that a vulnerable young person can be known to the county council and [the] mental health trust and yet not receive the support they need pending substantive treatment."

He highlighted Daniel was "repeatedly assessed as not meeting the criteria for urgent intervention" but that waiting lists for phycological therapy could mean more than a year between asking for help and being given it.

"That gap between urgent and non-urgent services is potentially dangerous for a vulnerable young person, where there is a chronic risk of an impulsive act," Mr Barlow said.

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Source: BBC News, 25 February 2022

 

 
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Polycystic ovary syndrome: Mental health link 'not recognised'

The symptoms of polycystic ovary syndrome (PCOS) became so difficult for one woman, she did not want to live.

Angharad Medi Lewis from Carmarthenshire said "embarrassing" heavy periods and excess facial hair made her not want to leave home.

"I was having very heavy periods, I was in serious pain for a whole week every month, growing hair on my face, I was anxious, so worried about going out because of the heavy periods that it was actually embarrassing," she said.

According to Neuroendocrinology expert Prof Aled Rees, the condition and its link with mental health side effects "isn't appreciated enough".

"Patients often come to us at the clinic, and it's obvious from the symptoms they describe, that it's going to have an impact on their mental health."

He said there was a "gap" in the general conversation with PCOS patients.

"There needs to be greater emphasis for patients and doctors that any consultation they have includes a discussion about mental health because there is an effective treatment available".

The charity Fair Treatment for Women in Wales has called on the Welsh government to put women's physical and mental health at the top of the agenda.

Julie Richards, a consultant with the charity, said the mental health impacts of conditions like PCOS and endometriosis, are often forgotten.

"We need specialist clinics in Wales, and when it comes to women's health generally, we're lagging behind in all areas," she said.

The Welsh government said women's wellbeing was a priority and it would publish plans on how to support women.

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Source: BBC News, 25 February 2022

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Breast cancer screening uptake at its lowest point in history

Breast cancer screening uptake fell to its lowest point ever during the pandemic, as the numbers of women seen dropped by more than one third.

Just 1.19 million women aged 45 and over were screened for breast cancer in 2020-21, while the numbers of women who actually took up their invitation for screening dropped to 61%.

Analysis by Breast Cancer Now, of the new NHS figures published on Thursday, found that uptake during the first year of the pandemic was the lowest it had been since records began.

The number of women who had cancer detected through screening decreased by almost 40 per cent, although rates when calculated per 1,000 women were up by 8.4%.

The news comes after NHS figures revealed that half of patients in October waited more than two weeks following an urgent breast cancer referral.

According to analysis from the Labour Party in January, breast cancer patients faced the longest waits when compared to all other cancer referrals.

Breast Cancer Now chief executive Baroness Delyth Morgan said: “Screening uptake has hit its lowest point in history, with less than 62% of women invited being screened, despite NHS staff working tirelessly, in the toughest of circumstances, to restart and continue breast screening services after they needed to be paused in March 2020.

“The human cost behind these figures is stark, with an estimated 8,870 women in the UK living with undetected breast cancer as a result of the pandemic – a significant number of which would have been detected at routine screening. Tragically, research suggests that up to an additional 680 women could die from breast cancer in the next decade due to impacts of the pandemic on screening.”

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Source: The Independent, 24 February 2022

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Ombudsman’s COVID report highlights ‘tragic individual cases’

A Covid report by the Local Government and Social Care Ombudsman has highlighted some ‘tragic individual cases’ over the past months.

The report analyses cases over the first 18 months of the pandemic which for the majority reveal that councils and care providers weathered the unprecedented pressures they were under fire.

However, the report also reveals the ‘serious impact on people’s lives’ when things go wrong.

Cases include a woman who died from COVID-19 at a care home with poor infection control procedures which was then compounded by staff trying to cover up the facts.

The Ombudsman’s report focuses on the lessons that can be learned from the complaints it has received about the pandemic and welcomes that, in many cases, councils and care providers are already using their experiences from the pandemic to consider how they can make improvements to services.

Michael King, Local Government and Social Care Ombudsman, said: “We have investigated some tragic individual cases over the past months. Each represents poor personal experiences where councils and care providers did not get things right.

“Our investigations have shown that, while the system did not collapse under the extreme pressures placed on it, Covid-19 has magnified stresses and weaknesses present before the pandemic affecting some councils and providers.

“We have always advocated how crucial good complaint handling is in any setting, so I am particularly saddened that, in some authorities, dealing with public concerns and complaints itself became a casualty of the crisis. At a time when listening to public problems was more important than ever, we saw some overstretched and under-resourced complaints teams struggle to cope.

“If evidence was needed, this report proves that managing complaints should be considered a frontline service.”

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Source: Care Home Professional, 24 February 2022

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Hundreds of TB outbreak contacts yet to be screened

Hundreds of people identified as contacts following a tuberculosis (TB) outbreak in a Carmarthenshire village are yet to attend a screening, health officials have said.

Public Health Wales (PHW) said 31 cases of active TB had been identified since the 2010 outbreak in Llwynhendy.

PHW urged the 485 people who have been identified as contacts, but not attended a screening, to act.

More than 2,600 people have attended screenings since June 2019.

TB is a bacterial infection, spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It is a serious condition, but can be cured with proper treatment.

PHW said since 2010, 303 people - or more than one in 10 of those who had been screened - had been diagnosed with latent TB, which is not infectious and does not affect a person's quality of life, but may develop into active TB at a later date.

Dr Brendan Mason, from Public Health Wales, said: "We understand that during the coronavirus pandemic people may have been reluctant to go to a hospital to have their screening done, but I can assure them that there are safety measures in place in order to prevent the spread of Covid-19.

"Now is the time to get tested.

"It is really important that we screen all the contacts identified and make sure that anyone diagnosed with latent or active TB gets the monitoring or treatment that they need to prevent any further spread."

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Source: 24 February 2022

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Javid sets new target for trust digitisation

Electronic patient record (EPR) systems must be implemented in at least 90% of NHS trusts by the end of next year, the health secretary has announced at HSJ’s Digital Transformation Summit.

Speaking at the event with digital healthcare leaders in Birmingham, Mr Javid said an estimated one in five trusts are currently without EPR systems implemented. He said: “We have seen some brilliant progress {on digital transformation] but it’s not always been consistent across the board.”

He said: “We must see these disparities as just as unjust as disparities in access to education and employment.”

And added: “Electronic patient records are the essential prerequisite for a modern, digital NHS."

Mr Javid said 40% of social care providers were grappling with entirely paper based records, and he also wanted them to all adopt electronic records. 

He also outlined the intended future of the NHS App, and the government’s ambition for this to be used by 75 per cent of adults in England by March 2024. Currently it is just over half of all adults.

Mr Javid said he wanted the app to be the “future front door for interaction with the NHS”, and will be used by patients to directly communicate with their healthcare providers, to receive personalised health advice and to access test results.

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Source: HSJ, 24 February 2022

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London mum 'unable to walk more than 10 minutes' after vaginal mesh sliced into her organs

A London mum says she has been left in "agony" and only able to walk 10 minutes at a time after a transvaginal mesh implant perforated her organs. Anna Collyer, 53, had a transvaginal mesh fitted in 2015 at St. Helier hospital in Sutton.

The mesh is a net-like implant and aims to give permanent support to the weakened organs and to repair damaged tissue. The mesh implants are designed to be permanent, but last April, Anna started to experience severe pain when the mesh cut into her organs leaving her "unable to live any sort of life anymore," she said.

Even when doctors partially removed the mesh last June - her symptoms persisted. Anna, who lives in Morden, told MyLondon: "I could feel something sharp inside me. The pain relief tablets were not touching it. I was in agony.

"It's got to the stage now where 10 minutes is all I can walk, because the pain is excruciating. I have pain in pelvis, groin, hips, back and shooting pains in legs. The level is horrendous. I have to lie down all the time.

The vaginal mesh procedure was once common place in the UK, with more than 92,000 women receiving one between April 2007 and March 2015 in England alone. But the treatment was “paused” and The Independent Medicines and Medical Devices Safety Review was ordered by the then health secretary, Jeremy Hunt, in 2018 amid mounting safety concerns.

Women told the review team of “excruciating chronic pain feeling like razors inside their body" and felt dismissed when reporting complications including “unacceptable labelling of so many symptoms as ‘normal’ and attributable to ‘women’s problems’”, the report says.

The new review accuses medial professionals of displaying “an institutional and professional resistance” to changing practice. The report concluded that “those harmed are due not only an apology, but better care and support through specialist centres”.

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Source: MyLondon. 22 February 2022

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US maternal deaths rose in 2020, with Black mothers at far higher risk

Pregnancy-related deaths among US mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a new government report.

Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total, numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019.

Among Black people, there were 55 maternal deaths per 100,000 births, almost triple the rate for white people.

The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how Covid-19, which increases risks for severe illness in pregnancy, might have contributed.

The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have had an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health.

He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries.

Reasons for those disparities are not included in the data, but experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality healthcare and structural racism.

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Source: The Guardian, 23 February 2022

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New sickle cell treatment given to first patients in England

Sickle cell patients have begun receiving the first new treatment for the blood disorder in over 20 years.

The inherited condition can cause severe pain and organ failure, often requiring hospital admissions.

Crizanlizumab is given as a monthly infusion and is thought to cut visits to A&E by 40%. Loury Mooruth, 62, received the treatment at Birmingham City Hospital, having suffered repeated periods of intense pain for decades.

During a crisis, patients often need powerful opioid painkillers but Loury, like many others, has faced suspicion when at A&E.

"You know the protocol when you go in, which needles and so on. They think straight away you are a drug addict - they don't believe you," she says.

She has refused to go to hospital during a crisis for the past two years because of her negative experiences.

A report from MPs last year found "serious failings" in sickle cell care with some evidence of discrimination against patients.

Dr Shivan Pancham, a consultant haematologist at Birmingham City Hospital, told the BBC: "Our patients often find the experience in emergency departments challenging with a lack of understanding of the severity of pain.

"It is hoped with these new therapies if we reduce the likelihood of attending emergency departments, ultimately this will be much better for the patients."

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Source: BBC News, 24 February 2022

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NHS faces ticking ‘time bomb’ of 8m cancelled or delayed operations due to anaesthetist shortage

The NHS is facing a “time bomb” and will be forced to cancel or delay around 8 million operations each year by 2040, due to a lack of consultant anaesthetists across the services.

The Royal College of Anaesthetists (RCOA) said the current shortage of at least 1,400 staff across the UK means millions operations will not be able to take place.

The college has warned its speciality is facing a “perfect storm” of limited training places, poor retention and an ageing workforce with 39 per cent nearing retirement age.

The analysis found as demand for surgeries continue the need for anaesthetists is due to increase by 3.85 per year, meaning the NHS will need around 25,000 doctors in these posts by 2040.

Dr Fiona Donald, president of the RCOA said: “The NHS is facing an anaesthetic workforce time bomb. We already have profound workforce shortages that are preventing huge numbers of operations from taking place – and unless urgent action is taken, the problem is going to worsen.

“We would welcome government funding for additional anaesthetic training posts. One hundred additional posts per year would start to plug the gap and help get the UK back on a sound footing to be able to address the waiting list backlog. Without this investment, we foresee impacts to patient care and a further impact on the mental health of our current workforce – they need to be able to prioritise their own health and that of their families alongside the focus they already place on the health of patients and the public.”

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Source: The Independent, 22 February 2022

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Mothers who helped uncover the biggest NHS maternity scandal

Next month, a report will be published into one of the biggest scandals in the history of the NHS, the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust. The BBC's Michael Buchanan who helped uncover the problems examines why so many failures were allowed to happen for so long.

Kayleigh Griffiths' baby, Pippa, died at 31 hours old. The cause of death, the couple were later told, was an infection - Group B Strep. The Shrewsbury and Telford Hospital NHS Trust told the family they would carry out an investigation. But after several weeks of silence, Kayleigh contacted the trust to be told it was an internal investigation and the couple's input wouldn't be required. Kayleigh, an NHS auditor at a different trust, feared the truth was being hidden from her. That's when she decided to send the email to Rhiannon Davies, whose baby, Kate, also died at the Shrewsbury and Telford Hospital NHS Trust

As the bond between the mothers deepened, their conversations morphed into something else. Armed with little more than a gnawing suspicion, they started to scour the internet, coroner's records and death notices to see if any other families had received poor maternity care at the Shropshire trust.

They collated 23 cases dating back to 2000 - including stillbirths, neonatal deaths, maternal deaths and babies born with brain injuries. Appalled by what they had found, they wrote to the then health secretary Jeremy Hunt in December 2016, asking him to order an investigation. He agreed and in May 2017, senior midwife Donna Ockenden was appointed to lead the review.

One of the themes the inquiry has already noted, in an interim report published in December 2020, is that in many cases the trust failed to investigate after something went wrong, or simply carried out its own inquiry. Panorama has discovered the trust even developed its own investigation system, what they called a High Risk Case Review.

It was outside any national framework that has been used to help learn lessons from incidents and doesn't appear to be a system that's used in any other NHS organisation. Another consequence of the unorthodox system was that fewer incidents were reported to NHS regulators, limiting the opportunity to learn lessons.

One of the earliest cases on the original list of 23 compiled by the two couples was the death of Kathryn Leigh in 2000. Panorama has investigated the case and discovered that a theme identified almost two decades ago was to come up repeatedly in subsequent incidents.

The publication of the final report by Donna Ockenden next month will be a watershed moment in the history of the NHS - the revelation of multiple instances of maternity failures in a rural corner of England. Pippa Griffiths and Kate Stanton-Davies lived fewer than 40 hours between them, but their legacy, in terms of improved maternity care, could last decades.

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Source: BBC News, 23 February 2022

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NHS to treat 25,000 hospital patients at home in ‘virtual wards’

The NHS plans to treat up to 25,000 hospital patients at home in “virtual wards” to help clear the backlog caused by the pandemic, the “living with Covid” plan has revealed.

Patients will be offered acute clinical care at home, including remote monitoring and treatment, as an alternative to hospital stays.

Consultants or GPs will review patients daily via digital platforms and phone calls. In some cases, patients will be provided with a wearable device to continuously monitor and report their vital signs.

The NHS has set a national target of 40 to 50 virtual beds per 100,000 population, which equates to about 25,000 beds across England, according to the “living with Covid” plan published this week.

The document said: “The use of ‘virtual wards’ and ‘hospital at home’ models of care have ensured that patients can be safely cared for in their own homes and that additional bed capacity can be freed up in hospitals.” 

Commenting on the initial rollout of virtual wards, Dr Tim Cooksley, the president of the Society for Acute Medicine, warned a “hasty” rollout could risk patient safety.

He said: “Virtual wards do have the potential to be a model of the future. However, it is essential they are appropriately planned, resourced and staffed so they simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic. Incorrect implementation could risk patient safety and significantly impact clinician and patient confidence.”

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Source: The Telegraph, 22 February 2022

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Mysterious conditions are afflicting Americans after Covid. It could signal a looming cardiac crisis

Five months after being infected with the coronavirus, Nicole Murphy’s pulse rate is going berserk. Normally in the 70s, which is ideal, it has been jumping to 160, 170 and sometimes 210 beats per minute even when she is at rest — putting her at risk of a heart attack, heart failure or stroke.

No one seems to be able to pinpoint why. She’s only 44, never had heart issues, and when a cardiologist near her hometown of Wellsville, Ohio, USA, ran all of the standard tests, “he literally threw up his hands when he saw the results,” she recalled. Her blood pressure was perfect, there were no signs of clogged arteries, and her heart was expanding and contracting well.

Murphy’s boomeranging heart rate is one of a number of mysterious conditions afflicting Americans weeks or months after coronavirus infections that suggest the potential of a looming cardiac crisis.

A pivotal study that looked at health records of more than 153,000 U.S. veterans published this month in Nature Medicine found that their risk of cardiovascular disease of all types increased substantially in the year following infection, even when they had mild cases. The population studied was mostly White and male, but the patterns held even when the researchers analyzed women and people of color separately. When experts factor in the heart damage probably suffered by people who put off medical care, more sedentary lifestyles and eating changes, not to mention the stress of the pandemic, they estimate there may be millions of new onset cardiac cases related to the virus, plus a worsening of disease for many already affected.

“We are expecting a tidal wave of cardiovascular events in the coming years from direct and indirect causes of covid,” said Donald M. Lloyd-Jones, president of the American Heart Association.

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Source: Washington Post, 21 February 2022

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NHS not ‘human’ enough to get greater role in social care, says government review

The NHS should not be given greater control of social care because it is ‘hierarchical, centralised and not person-centred’, according to a government-commissioned review which is repeatedly scathing about the health service.

The review was ordered by then health and social care secretary Matt Hancock in June 2020. Cross-bench peer, writer and former Number 10 adviser Baroness Camilla Cavendish was asked “to make recommendations for social care reform and integration with health in the wake of the Covid-19 pandemic, which could fit alongside the funding reforms planned by the department in the context of the NHS long-term plan.”

In her final report, Baroness Cavendish wrote that “one answer” to the problems facing the sector “would be to let the NHS take over social care. On paper, this would join up the care continuum.”

However, she rejected the idea because of the NHS’ “hierarchical” and “centralised” nature. Baroness Cavendish also suggested the NHS’ role should be limited because it is “still struggling to join up primary and secondary care”.

In contrast to the NHS, she claimed: “Social care is more innovative, more responsive and human.”

She added: “The culture of the NHS is still largely one of ‘doing to’ patients, and the NHS has much to learn from social care about how to be responsive and human facing.”

Referencing “recent attempts to import the successful [Buurtzorg] model of self-managing teams into the NHS”, the cross-bench peer said these “have foundered, because the NHS culture cannot seem to cope with giving staff the autonomy required”.

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Source: HSJ, 23 February 2022

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'Bullying, unsafe practices and dysfunctional culture': Consultant speaks out on Shropshire maternity scandal

A former consultant gynaecologist has told how he raised concerns over bullying, unsafe practices and a "dysfunctional culture" ahead of a report into a maternity scandal.

Bernie Bentick, who worked at Shrewsbury and Telford Hospitals Trust (Sath) for almost 30 years, has spoken publicly about maternity care at the trust for the first time.

Sath is at the centre of the largest inquiry in the history of the NHS into maternity care, which is expected to report next month. An official investigation is examining the care that 1,862 families received.

Mr Bentick says he told senior management several times about a deteriorating culture at Sath.

“I was increasingly concerned about the level of bullying, of dysfunctional culture, of the imposition of changes in clinical practice that many clinicians felt was unsafe," Mr Bentick told BBC's Panorama.

"If the resources had been made available to employ adequate numbers, to provide safe levels of care in accordance with national guidelines, then the situation may have been profoundly different.”

Mr Bentick went on to say that though some “cursory” investigations were launched into his complaints, he believed the trust responded in a way that tried to “preserve the reputation of the organisation.”

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Source: Shropshire Star, 23 February 2022

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Seven-week gap advised for elective surgery after Omicron

Despite a backlog of routine operations, NHS hospitals are being advised to delay elective surgical procedures by at least seven weeks if a patient has just had Omicron.

UK experts say it is a precaution since the first couple of months following infection is a riskier period, linked to poorer post-operative recovery.

In some circumstances the surgery may be urgent enough to go ahead, however. Patients should ideally have had all of their Covid vaccines too.

The advice has been issued by surgery and anaesthesia experts, including two Royal Colleges representing those professions.

The experts who drew up the recommendations say the desire to tackle waiting lists and backlogs must be balanced with delivering the safest care possible.

The latest expert guidance on routine operations recommends:

  • Elective surgery should not take place within 10 days of a confirmed Covid infection, mainly because the patient may be infectious which is a risk to staff and other patients.
  • Operations that happen in the six-week period after an infection - even an asymptomatic one - carry a higher risk of serious complications for the patient, experience suggests.

Dr Mike Nathanson, president of the Association of Anaesthetists, said: "The frustration felt by patients is immense and we - the healthcare professionals - want to do our jobs and provide these services when it is safe to do so and with the risks clear to all involved."

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Source: BBC News, 23 February 2022

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CQC should not ‘sit in an ivory tower’ when rating ICSs, says preferred chair

The Care Quality Commission (CQC) should not ‘sit in an ivory tower and dream up what it thinks good looks like’ when it starts rating integrated care systems, the proposed new chair for the regulator has told MPs.

Ian Dilks, the government’s preferred candidate to become the CQC’s new chair, was questioned by the health and social care committee on Tuesday. During the session the committee chair’s Jeremy Hunt asked how Mr Dilks would make the rating of systems “a success”.

Mr Hunt said: “We became the first healthcare system in the world to ‘Ofsted rate’ our hospitals. Under your leadership, assuming you take up this role, we will become the first healthcare system in the world to do the same for entire geographical regions of health systems.”

Mr Dilks responded: “I don’t think it is up to the CQC to sit in an ivory tower and dream up what it thinks good looks like.”

“It will not be in anybody’s interest if the CQC comes up with a whole bunch of ratings and ICSs say, ‘well I don’t know how you got there’.” He added: “I think involving all parties in the development process so that what emerges has a high degree of acceptance.”

He was also asked at the session about what he had learnt about improving patient safety while working at NHS Resolution.

Mr Dilks said: “I do not think the system is good at learning… it needs some help and encouragement to firstly really understand what’s gone wrong when you have an outcome that isn’t the correct one, and secondly how do you encourage and support the system to do better the next time around.”

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Source: HSJ, 23 February 2022

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NHS to tackle 'unfair' maternity outcomes

A taskforce has been set up to tackle disparities in maternity care experienced by women belonging to ethnic minorities and those living in deprived areas.

Black women are 40% more likely to miscarry than white, studies suggest. Maternal death rates are also higher among black and Asian women.

Royal College of Obstetricians and Gynaecologists head Dr Edward Morris told BBC News implicit racial bias was affecting some women's care.

Patient Safety and Primary Care Minister Maria Caulfield said: "For too long disparities have persisted which mean women living in deprived areas or from ethnic minority backgrounds are less likely to get the care they need and, worse, lose their child.

"We must do better to understand and address the causes of this.

"The Maternity Disparities Taskforce will help level-up maternity care across the country, bringing together a wide range of experts to deliver real and ambitious change so we can improve care for all women - and I will be monitoring progress closely."

Chief midwifery officer Prof Jacqueline Dunkley-Bent, who will co-chair the taskforce, said: "The NHS's ambition is to be the safest place in the world to be pregnant, give birth and transition into parenthood - all women who use our maternity services should receive the best care possible."

The taskforce will meet every two months and focus on:

  • improving personalised care and support plans
  • addressing how wider societal issues affect maternal health
  • improving education and awareness of health when trying to conceive, such as taking supplements and maintaining a healthy weight
  • increasing access to maternity care for all women and developing targeted support for those from the most vulnerable groups
  • empowering women to make evidence-based decisions about their care.

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Source: BBC News, 23 February 2022

Source: BBC News, 

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NHS cuts to cover Covid costs may hit patient care, Labour warns

Patient care may suffer as a result of cuts to the NHS budget to fund the continuing costs of Covid, NHS leaders and Labour have said, after Sajid Javid refused to say where the axe would fall.

The Department of Health and Social Care (DHSC)  is trying to make savings from its budget to fund free lateral flow tests for elderly people, Covid surveillance studies and genomic sequencing, after the Treasury refused its request for £5bn in extra funding.

Although the government announced an end to most free mass testing and contract tracing on Monday, remaining Covid measures are expected to cost more than £1bn.

The Treasury and the DHSC refused to say exactly how much cash would be needed or which services would have to be cut back, prompting fears that the NHS could have to find savings at a time of a huge waiting list backlog.

It is understood that DHSC officials are working on identifying savings in the department’s £178.5bn budget for 2022-23, to fund the measures agreed on Monday, including maintaining a “baseline” testing capability that can be scaled up if necessary.

They have ruled out hitting Javid’s plan for tackling waiting lists, but a government source would not rule out any other areas being affected, saying a “significant amount of money” would have to be found by “reprioritising”.

Saffron Cordery, the deputy chief executive of NHS Providers, warned the government against abandoning its commitment to give the NHS “whatever it needs” to tackle Covid and called for transparency about “where the impact of these extra costs will fall”.

“Trust leaders are understandably anxious over reports that the ongoing and significant costs of living with Covid will be met by ‘reprioritising’ the NHS’s existing budget,” she said. “There is a very real risk of trade-offs affecting the quality of patient care – something no one wants to see.”

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Source: The Guardian, 23 February 2022

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Covid-19: Mexico City gave ivermectin kits to people with covid in “unethical” experiment

The government of Mexico City handed out nearly 200 000 “ivermectin based kits” last year to people who had tested positive for Covid-19, without telling them they were subjects in an experiment on the drug’s effectiveness.

The results of that experiment were then written up by public officials in an article placed on popular US preprint server SocArXiv. It became one of site’s most viewed articles, claiming that ivermectin had reduced hospital admissions by 52-76%.

But those officials have been under fire at home since SocArXiv withdrew the paper earlier this month, calling it “either very poor quality or else deliberately false and misleading.”

Opposition deputies in Mexico City’s Congress demanded hearings and said they would bring legal action against the paper’s lead author, José Merino, head of the city’s Digital Agency for Public Innovation.

Explaining the decision to withdraw the article—the first to be taken down by SocArXiv—the site’s steering committee wrote that it had responded “to a community groundswell beseeching us to act” in order “to prevent the paper from causing additional harm.”

The committee wrote, “The paper is spreading misinformation, promoting an unproved medical treatment in the midst of a global pandemic. The paper is part of, and justification for, a government programme that unethically dispenses (or did dispense) unproven medication apparently without proper consent or appropriate ethical protections.”

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Source: BMJ, 22 February 2022

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