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Vaccinated less likely to develop Long Covid

People who are vaccinated are less likely to develop Long Covid even if they catch the virus, a rapid review by the UK Health Security Agency reveals.

It looked at the available evidence to date from 15 studies around the world.

The findings suggest that while some who are jabbed catch Covid, vaccines reduce infection risk and illness, including symptoms like fatigue.

And unvaccinated people who catch Covid and get symptoms of Long Covid, do better if they then get vaccinated.

Vaccine effectiveness against most Long-Covid symptoms was highest in people aged 60 years and over

In people who already had Long Covid symptoms, it found that vaccines may improve rather than worsen Covid symptoms, either immediately or over several weeks

According to the UK Health Security Agency (UKHSA), around 2% of the UK population have reported symptoms of Long Covid, such as fatigue, shortness of breath and muscle or joint pain.

Symptoms like these can last for more than four weeks after the infection.

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Source: 15 February 2022

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Lassa fever: Patient who died in UK ‘was newborn baby’

A patient who died from Lassa fever last week was a newborn baby, according to reports.

The UK Health Security Agency (UKHSA) confirmed on Friday that an individual with the Ebola-like disease had died in Bedfordshire, and that two other people  were infected.

All three cases were linked to recent travel in West Africa.

The BBC said the fatality had been an infant at Luton and Dunstable Hospital, quoting an email sent to staff by Cambridge University Hospitals NHS Trust.

Hundreds of frontline workers at the hospital, as well as at Addenbrooke’s Hospital in Cambridge, were reportedly told to isolate after being identified as potential contacts.

Lassa fever is an acute viral infection endemic in parts of Africa, and the UKHSA has assured the public that the risk of further infections in the UK remains “very low”.

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Source: The Independent, 15 February 2022

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‘Don’t overwork staff’, says trust with just one 52-week waiter

Allowing staff enough rest has been ‘the key’ to elective recovery for an acute trust which has the lowest number of 52-week waiters in England, it has said.

Maidstone and Tunbridge Wells (MTW) Trust currently has just one patient who has waited 52 weeks or more on its lists, compared with a high of 976 at one point in April 2021.

MTW is one of a handful of trusts with very few long waiters. All are relatively small trusts – and are not regional centres for specialist/tertiary patients – but their 52-week-waiters also represent less than 1% of their total list.

MTW chief of service for the surgery division Greg Lawton told HSJ its success in tackling long waiters was down to “attention to detail” in tracking each patient, and not expecting staff to run too many extra sessions.

“Any problems patients are having getting through their pathways are identified early and addressed,” he said. "Treatment had been prioritised on the grounds of clinical need, he added, with cancer treatments still going ahead and cancer targets being met."

The trust, in the South East, has put on extra operating sessions to clear some of its backlog of patients but these had been limited in number, Dr Lawton said.

“What we have never done is try to run too many and I think that may be the key. If you try to do too much you will burn staff out,” he said. The trust had “been mindful that staff need a break,” he added. “Morale is very important.”

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Source: HSJ, 16 February 2022

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Concerns over 'enormous' backlog for NHS dentistry

Scotland's dental leaders say the backlog for patients getting NHS treatment is "enormous".

Official data shows people in more affluent areas of Scotland were much more likely to be seen by a dentist in the last two years compared to poorer communities.

Meanwhile, patients on long waiting lists are resorting to costly private treatment in order to be seen sooner.

The Scottish government said it was committed to tackling the pandemic-related backlog in routine dental care.

The shutdown of dental services in the early days of Covid, and then severe restrictions on working practices meant emergency care was prioritised in Scotland.

Denise Hesketh is one of thousands of Scots who couldn't see a dentist during the start of the pandemic.

The 58-year-old from Edinburgh has battled dental problems for years, but being unable to see a dentist during Covid meant her oral health has taken a turn for the worse.

She told BBC Scotland: "It was over a year before I was able to see a dentist and by then it just got too bad. Everything was unstable. It needn't have happened - it could have been repaired."

She now faces a bill of £20,000 for private care, with her NHS dentist unable to offer any help.

Some patients have raised fears that those who pay for private dental treatment are being prioritised.

BBC Scotland has seen an email to patients from one practice in Lanarkshire. It states "Due to NHS restrictions and waiting lists on routine care… there are other options for check-ups for adults and children to pay privately".

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Source: BBC News, 16 February 2022

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Majority of ‘last resort’ ambulance diverts reported by only two trusts

Two acute trusts account for almost two-thirds of emergency department ‘diverts’ reported over the last two months.

Between the start of December and the start of February, Worcestershire Acute Hospitals Trust and University Hospitals Sussex Foundation Trust implemented 122 temporary “diverts” between them – representing around 60% of the national total.

The measure is taken when a particular site, such as Worcestershire Royal or Royal Sussex County Hospital, comes under significant pressure and ambulances are temporarily directed to an alternative hospital, usually within the same trust.

NHS England guidance says diverts of emergency patients due to lack of physical or staff capacity to deal with attendances or admissions “should be an action of last resort” and that this “should only need to happen in exceptional circumstances, where internal measures have not succeeded in tackling the underlying problem”.

Helen Hughes, chief executive of Patient Safety Learning, said: “For ambulance services, the impact of A&E diverts is two-fold. It both increases the length of journeys that crews have to make once a divert is implemented, and increases the travel time required to get back to subsequent emergency calls."

“This has the potential to increase waiting times for patients, increasing the risk of avoidable harm, particularly for those who are seriously ill, frail or elderly.”

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Source: HSJ, 15 February 2022

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Waits for diagnosis and decision rise to over 38 weeks

Waiting times to diagnosis and decision rose by more than a week in December, reaching 38.6 weeks at month end. This matters because many urgent conditions are only detected when the patient reaches diagnosis, including nearly a quarter of all cancers, and such very long waits put those patients at risk.

Looking at the whole referral-to-treatment waiting list, which includes patients who have a diagnosis and decision, waiting times remained roughly steady at 43.4 weeks, compared with the standard of 18 weeks that is still required by legislation. Waiting times are a function of both the size and shape of the waiting list, and in December the former got worse and the latter improved.

There were 6,067,326 patients on the waiting list as December ended, which is the first time the official figures have topped six million. As many as 310,813 of them had waited over a year (strictly, 52 weeks), and 20,065 over two years (104 weeks). The NHS’s backlog recovery plan has committed that “By July 2022, no one will wait longer than two years for an elective treatment”.

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Source: HSJ, 10 February 2022

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USA: Alhambra Hospital nurses ratify a new contract with improvements for patient safety and nurse retention

Registered nurses at Alhambra Hospital Medical Center in Los Angeles, California, voted overwhelmingly in favor of ratifying a new three-year contract yesterday, winning protections to improve patient safety and nurse retention.. The collective bargaining agreement was the result of an almost six-month fight, which included an informational picket for patient safety and multiple other actions.

So Hee Park, an ICU nurse at Alhambra, said, “We are so thrilled that after months of negotiations, we have ratified an agreement that provides substantial measures to ensure nurses feel supported and can continue to provide optimal patient care, as well as numerous provisions that will improve recruitment and retention of experienced nurses.”

The contract includes several highlights that will help nurses create better outcomes for their patients, such as provisions for ensuring hospital compliance with existing registered nurse-to-patient safe staffing laws. The agreement also establishes a new Infectious Disease Task Force that will offer new protections against communicable diseases and guarantee levels of PPE supplies. The contract also expands workplace violence prevention plans for all hospital units, as well as stating that quality care be provided to all patients regardless of their immigration status.

Under the contract, nurses will also receive proper orientation when they’re floated to new hospital units, improving care for patients. And, rather than being sent home at management's whims, RNs will be able to remain at work to provide meal and break relief to other nurses, bolstering safe staffing. These measures will ensure nurses are prepared to provide patients with the highest and safest levels of care possible, resulting in improved nurse retention at Alhambra, which will benefit the entire community long term.

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Source: National Nurses United, 10 November 2022

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GPs each seeing 15% more patients, BMA says

The average number of patients each individual GP is responsible for has increased by 15%, or around 300 people, since 2015, the BMA has said.

This is due to the ‘slow but steady haemorrhaging’ of GPs over the last few years, which has led to pressures on services growing ‘even more acute’, it suggested.

The Association’s statement comes in response to the latest GP workforce data – published by NHS Digital (10 February) – which showed that 188 FTE GPs left between December 2020 and December 2021.

Dr Farah Jameel, chair of the BMA’s GP committee, said the figures are the direct result of an ‘over-stretched’ and ‘under-resourced’ NHS.

She said: ‘Family doctors, exhausted and disenchanted, feel as though they have no choice but to leave a profession they love because of chronic pressures now made worse by the pandemic. Workload has dramatically increased, there are fewer staff in practices to meet patient needs.’

Insufficient staffing is particularly concerning as the backlog for care continues to grow, she suggested, with many GPs believing ‘the day job is just no longer safe, sustainable or possible anymore’.

The NHS and the Government must work to retain current staff as its ‘immediate priority’ and must urgently refocus on retention strategies as a key enabler for the NHS’ recovery.

She said: ‘The Government has repeatedly argued that the number of doctors is growing, but this isn’t the reality for general practice, and it begs the question: how many more have to go before something is finally done about it? Our NHS is the people who work in it, and without them, the entire system and provision of patient care is under threat.’

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Source: Management in Practice, 11 February 2022

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Surgery delays: Man feels forgotten after six-year wait

A County Tyrone man who has been waiting six years for a gall bladder operation has said he feels forgotten about by the health service.

John Doherty, 55, said he could not understand why he was unable to get updates on his operation.

BBC News NI can reveal almost 475,000 people are waiting for surgery or to see a consultant for the first time.

The Royal College of Surgeons wants patients to be told how long they will have to wait for treatment.

Mr Doherty said he felt anxious and depressed waiting for a telephone call from his local hospital and blamed the government for "letting him down".

"I feel forgotten about, they don't even get in touch with you, not even a letter to say it could happen three months down the line... they say they'll phone back but never do," he added.

"I feel neglected."

Mark Taylor, a consultant surgeon, people who had been languishing for years on lists deserved to know when to expect their surgery so they could attempt to get in shape for it.

He said about a one third of operations had to be cancelled daily as a result of people not being ready, either their blood pressure was too high, they were overweight or their diabetic control was not right.

"Pre-habilitation schemes can help to get patients ready for their operation as much as possible, a more personalised pre operation plan is required," he said.

Mr Taylor called on the government to have a proper conversation with the public about how hospitals might look in the future.

"This is not about closure, this is about the redesign and re-profiling of hospitals to get maximum gain," he said.

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Source: BBC News, 15 February 2022

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Call 999 over early heart attack symptoms, urges new NHS campaign

A life-saving campaign is being launched by the NHS to urge people to learn how to spot signs of a heart attack.

The survival rate for heart attack sufferers is seven in 10, rising to nine in 10 for those who have early hospital treatment.

The most common sign of a heart attack is chest pain, but other symptoms to look out for include chest, arm, jaw, neck, back and stomach pain, lightheadedness or dizziness, sweating, shortness of breath, nausea, vomiting, anxiety, coughing and wheezing.

The health service are encouraging anyone experiencing these indicators to call 999.

It comes after a poll found found that fewer than half of people knew to dial 999 if they or a loved one experienced the more vague signs of a heart attack.

Another priority of the campaign is to teach people how to differentiate between a heart attack and cardiac arrest.

According to the health service, there is often no warning and the person quickly loses consciousness when they suffer cardiac arrest.

Those experiencing a cardiac arrest will usually die within minutes if they do not receive treatment.

It also points out that a heart attack can lead to a cardiac arrest.

NHS medical director Professor Stephen Powis said: “Sadly, cardiovascular disease causes a quarter of all deaths across the country and we have identified this as the single biggest area where we can save lives over the next decade.

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Source: 13 February 2022

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Doctors call for action not words from NHS in response to racial inequality report

Health officials have “paid lip service” to racism in the NHS for years, leading black, Asian and minority ethnic doctors have warned as they called for “concrete” action to tackle inequalities exposed by a landmark review.

The damning study – the largest of its kind – had found “vast” and “widespread” inequity in every aspect of healthcare it reviewed, and warned that this was harming the health of minority ethnic patients in England.

In response, an NHS spokesperson said the health service was “already taking action” to improve the experiences of patients and access to services and was working “to drive forward” the recommendations made in the report.

However, Dr JS Bamrah, a consultant psychiatrist in Greater Manchester and national chairman of the British Association of Physicians of Indian Origin, said he was unsatisfied with the response.

“This 166-page review … is a terrible indictment of the current state of the NHS,” he told the Guardian. “As many of us have often said and reported, we don’t need any further reports. It’s action we need, as there are scores of patients who are not getting optimal treatment, and many are being neglected.

“It really isn’t good enough for NHS bosses to say that action is being taken and it’s even more disappointing to then not see any concrete proposals on dealing with glaring disparities despite all that we have learnt during the pandemic.”

Dr Rajesh Mohan, presidential lead for race and equality at the Royal College of Psychiatrists, said it was “time for warm words to end” as he urged NHS leaders to “do everything they can to ensure patients from ethnic minority backgrounds get the care they need”.

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Source: The Guardian, 15 February 2022

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Masks 'aggravated' fatal dosage miscommunication at Watford Hospital

Masks worn by doctors "aggravated" a miscommunication over the dose of an anti-epileptic drug that resulted in a man's death, a coroner has warned.

John Skinner died at Watford General Hospital in May 2020.

A coroner has written a Prevention of Future Deaths Report (PFDR) saying he feared the same could happen at other hospitals if action was not taken.

Assistant Coroner for Hertfordshire, Graham Danbury, said in the report: "As a result of failure in verbal communication between the doctors, aggravated as both were masked, a dose of 15mg/kg was heard as 50mg/kg and an overdose was administered."

Mr Danbury, writing to NHS England, said: "This is a readily foreseeable confusion which could apply in any hospital and could be avoided by use of clearer and less confusable means of communication and expression of number."

A spokesperson for West Hertfordshire Hospitals NHS Trust said: "A comprehensive action plan is in place to ensure that lessons are learned from this incident."

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Source: 15 February 2022

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US nurses to hold informational picket for patient safety at West Anaheim Medical Center

Registered nurses (RNs) at US Prime Healthcare’s West Anaheim Medical Center (WAMC) will hold an informational picket today to protest chronic short staffing and its impact on safe patient care.

Nurses say that the hospital should cancel elective surgeries because those beds and nurses are needed for other emergent patients. RNs in all medical departments are short-staffed, putting patient safety in jeopardy.

“Nurses are under incredible pressure to care for patients beyond the state’s mandated safe staffing ratios due to the staffing crisis in our hospital,” said John Olarte, RN at WAMC. “The employer should be making beds available by canceling elective surgeries for the foreseeable future. Save those beds for the patients who most need them and at the same time give the RNs a chance to truly care for these patients by not forcing nurses to take patients that don’t need to be in the hospital right now. The public needs to know that the hospital is not doing everything they can to help the nurses care for patients.”

“There is a staffing crisis because RNs are leaving,” said Sofia Rivera, RN in the emergency department at WAMC, “To attract and retain quality nurses — just staff the floors so the RNs do not have to pick up multiple extra shifts due to the revolving door of RNs in this hospital.”

Nurses say they want a strong contract so they can recruit and retain RNs and they want to establish a health and safety committee to ensure they have a voice on issues of nurse safety and patient care. They have been in contract negotiations since May 2021. Their contract expired in June 2021.

“We are getting slaughtered in the ER,” said Rasha Tran, RN. “Ambulances are just leaving their patients in the ER instead of waiting for an available bed because they are waiting too long. I don’t even know how we can sustain this demand to care for so many patients. It means less care for each patient. Continuing elective surgeries means that a regular bed is not available for a patient in the ER who is now is being held for hours or days before they are admitted. Even before this most recent Covid surge, nurses have been picking up extra 12-hour shifts to help our coworkers, often without a break for meals or rest periods.”

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Source: National Nurses United, 11 February 2022

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Delayed diagnoses and self-imposed lockdown: Australians living with cancer during Covid

Two years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks.

When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown.

“Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says.

In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks.

Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”.

“I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says.

Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year.

Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%.

“That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.”

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Source: The Guardian, 13 February 2022

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Heart-disease risk soars after COVID — even with a mild case

Even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis, a new study1 shows. Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease.

What’s more, the risk was elevated even for those who were under 65 years of age and lacked risk factors, such as obesity or diabetes.

“It doesn’t matter if you are young or old, it doesn’t matter if you smoked, or you didn’t,” says study co-author Ziyad Al-Aly at Washington University in St. Louis, Missouri, and the chief of research and development for the Veterans Affairs (VA) St. Louis Health Care System. “The risk was there.”

People who had recovered from COVID-19 showed stark increases in 20 cardiovascular problems over the year after infection. For example, they were 52% more likely to have had a stroke than the contemporary control group, meaning that, out of every 1,000 people studied, there were around 4 more people in the COVID-19 group than in the control group who experienced stroke.

The risk of heart failure increased by 72%, or around 12 more people in the COVID-19 group per 1,000 studied. Hospitalization increased the likelihood of future cardiovascular complications, but even people who avoided hospitalization were at higher risk for many conditions.

“I am actually surprised by these findings that cardiovascular complications of COVID can last so long,” Hossein Ardehali, a cardiologist at Northwestern University in Chicago, Illinois, wrote in an e-mail to Nature. Because severe disease increased the risk of complications much more than mild disease, Ardehali wrote, “it is important that those who are not vaccinated get their vaccine immediately”.

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Source: Nature, 10 February 2022

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Vulnerable women are being failed by maternity services, report finds

Current models of maternity care in the UK are failing to reach pregnant women living in adverse social circumstances, research commissioned by the Royal College of Obstetricians and Gynaecologists has found.

Georgina Jones, one of the report’s authors and professor of health psychology at Leeds Beckett University, told The BMJ, “Women are often living in a tangled web of complex inequalities that is beyond their control, and this impacts on the care they receive and the outcomes of that care . . .We’ve really been letting down these women in the way that our maternity and reproductive health services are currently delivered, and strategies and care pathways need to be identified and put in place to remedy this.”

A number of recommendations have been made in the paper including:

  • Understanding it is the vulnerable, minoritised and disadvantaged women in society that have an increased risk of maternal death. These women are often living in an entangled web of complex inequalities that is beyond their control, which impacts on the care they receive and the outcomes of that care.
  • Strategies and care pathways need to be identified and put in place to improve their situation. These women have been let down in the way that our maternity and reproductive health services are currently delivered.
  • We need to find a better way of recording social determinant data. The current way of doing this is inadequate and not fit for purpose, and it doesn’t provide us with enough information to really understand how the complex circumstances of the woman impacts on her maternal outcomes.
  • The research shows current models of care are still failing pregnant women who have lived in adverse social circumstances prior to, during and after pregnancy. Maternal outcomes are particularly poor for socially disadvantaged women affected by pre-existing physical or mental health problems; those who misuse substances; those who have a lower level of education; those who are overweight, undernourished or poorly sheltered; and those who are at increased risk due to the threat of abusive and unsupportive partners, families and peers.

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Source: BMJ, 10 February 2022

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Radical action needed to tackle racial health inequality in NHS, says damning report

Radical action is needed urgently to tackle “overwhelming” minority ethnic health inequalities in the NHS, leading experts have said, after a damning study found the “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients.

Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have “negatively impacted” the health of black, Asian and minority ethnic people in England for years, according to the review, commissioned by the NHS Race and Health Observatory, which reveals the true scale of health inequalities faced by ethnic minorities for the first time.

“Ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death,” says the review, the largest of its kind. Yet despite “clear”, “convincing” and “persistent” evidence that ethnic minorities are being failed, and repeated pledges of action, no “significant change” has yet been made in the NHS, it adds.

From mental health to maternity care, the sweeping review led by the University of Manchester paints a devastating picture of a healthcare system still failing minority ethnic patients despite concerns previously raised about the harm being caused.

“By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system,” said Habib Naqvi, the director of the NHS Race and Health Observatory, an independent body established by the NHS in 2020 to investigate health inequalities in England.

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Source: The Guardian, 13 February 2022

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Staff on prolonged leave with long covid could be dismissed, says NHSE

Staff on prolonged sick leave due to long covid could be dismissed if ‘redeployment is not an option’ and they are unable to fulfil their contract, new NHS England guidance says.

The advice was set out in guidance published this month and follows the government’s temporary, non-contractual guidance that was issued in response to the coronavirus pandemic during its first waves.

The government’s advice aimed to provide a temporary enhancement of covid sick pay and meant that staff who were absent with covid would remain on full pay, therefore, did not feel pressured to return.

However, NHSE’s guidance warned that “while this provision is still available, it is possible that it may change”.

The move has been seen as an inevitable step as the guidance was brought in as an emergency measure, while some employers may have been holding off dismissing staff with long covid or covid-related absences due to guidelines in place.

NHSE’s new Guidelines for supporting our NHS people affected by long covid said: “According to [the] guidance, periods of covid-19 sick pay would not be counted towards a colleague’s normal sickness entitlements.

“However, if a colleague is approaching long-term sickness (for a period of 12 months or more), the employing organisation would be expected to complete a review at 12 months to understand the ongoing need and potential challenges with a return to work.

It adds: “Consideration of dismissal due to the colleague being unable to fulfil their contract should only be considered if redeployment is not an option.”

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Source: HSJ, 11 February 2022

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NHS hospital doctor arrested on suspicion of sexual assault

Two NHS hospital trusts are working with police after a doctor was arrested on suspicion of sexual assault.

Staffordshire Police has launched a major incident review of the doctor's work at hospitals in Dudley, West Midlands, and Stoke-on-Trent, The Sunday Times reported.

The force said the 34-year-old man from the West Midlands was arrested in December and released on bail.

It is reviewing an investigation into the same suspect it undertook in 2018.

The doctor was suspended from seeing patients at the Royal Stoke University Hospital in Staffordshire when the parents of a vulnerable female raised concerns about his examination of her, the Sunday Times reported.

The case was referred to police in 2018 who said there was "insufficient evidence to take further action" at the time.

The Staffordshire force has now reported itself to the Independent Office for Police Conduct.

University Hospitals of North Midlands NHS Trust, which runs the Royal Stoke, said it was working with police and had set up a helpline for any patient and guardian who may have concerns.

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Source: BBC News, 13 February 2022

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Doctors repeatedly told a woman stress was causing her symptoms. Then they pulled out a volleyball-size tumor.

Again and again, Hannah Catton told doctors something was wrong with her body. Again and again, she said, the doctors dismissed her concerns.

They didn’t listen in late 2018 when she told them about her frequent urinary tract infections. They didn’t listen months later when she returned to tell them she was having irregular periods. And they didn’t listen when she complained of bloating, constipation, diarrhea and extreme pain.

Catton was telling them her body was in rebellion. Almost a dozen physicians told her otherwise: She was young and healthy, so it was probably nothing — just a little too much stress. One told her she was overweight and losing a few pounds might ease her symptoms.

Almost three years passed after Catton’s symptoms first emerged, during which she saw about 10 doctors. Then, in October, she collapsed in pain and took herself to the emergency room. From one of her ovaries, surgeons pulled a cancerous blob weighing roughly 4½ pounds and stretching nearly eight inches — about the size of a volleyball.

After her years-long crusade to be heard, Catton, now 24, wants other women and doctors to learn from her experience. Women should learn the warning signs of ovarian cancer and forcefully advocate for themselves, she said, while doctors need to become better versed in recognizing the symptoms. More importantly, Catton said, physicians need to listen to patients instead of dismissing them.

Catton knew early on that something was wrong, that it wasn’t just stress. Despite that, she acquiesced to the doctors because she didn’t “want to be a patient that wastes time.”

She’s not alone, clinical psychologist Bella Grossman told Northwell Health’s Katz Institute for Women’s Health in the article “Gaslighting in women’s health: No, it’s not just in your head.” Men tend to be more persistent with their doctors when they have concerns about their health, Grossman said.

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Source: Washington Post, 9 February 2022

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7,469 research nurses and midwives across the UK and Ireland, new census reveals

There are at least 7,469 research nurses and midwives across the UK and Ireland working within all areas of healthcare, reveals a landmark new census initiated by a group of NIHR 70@70 Senior Nurse & Midwife Research Leaders.

The census, incorporating responses from research nurses and midwives across all four UK nations and the Republic of Ireland, reveals nurses and midwives are working at every level in healthcare from Bands 5 – 9 in the UK, and from staff nurse to Directors of Nursing or Midwifery in the Republic of Ireland. This suggests there are opportunities to join the profession at every level, with continued potential for career progression. Clinical research nurses and midwives are a specialist workforce, with knowledge, skills and expertise in both clinical practice and research delivery.

The census shows that:

  • 33.7% reported working in joint posts, for example as a clinical research nurse for part of their role as well as a clinical nurse specialist;
  • 72% are working within a single disease/area specialism; 
  • 28% reported covering multiple disease areas. 

NIHR Director of Nursing & Midwifery Professor Ruth Endacott said: “This census reveals the true breadth and depth of our research nursing and midwifery community. We know there are scores of people working incredibly hard day and night helping to bring us new treatments and medicine alongside their healthcare colleagues but we now have a much clearer idea of the size of the workforce. Research nurses and midwives are making a difference to the health of people across the UK and Ireland."

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Source: National Institute for Health Research, 9 February 2022

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Soaring trolley waits spark warnings A&E pressures getting ‘worse and worse’

The number of 12-hour waits in accident and emergency departments rose by 27% in one month to reach record levels in January amid warnings overcrowding is harming an increasing number of patients.

Official monthly performance data prompted the Royal College of Emergency Medicine’s president to warn that the problems facing emergency departments were getting “worse and worse”, while pointing out the real number of 12-hour A&E breaches is likely higher than official data records. 

The figures also revealed the waiting list had hit a new high of 6.1 million, while the number of two-year breaches also rose a record level.

Trusts recorded 16,558 patients last month waited 12 hours or more in an emergency department from decision to admit to being discharged or admitted. This was up from 12,986 in December.

RCEM president Katherine Henderson warned on Twitter: “This is [decision to admit] plus 12 – a concept which must be retired as a performance metric. We should have 0-12 hour data. You cannot fix a problem if you [are] unwilling to face up to what it actually is. We estimate reality is 20 x more. This is getting worse and worse.”

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Source: HSJ, 10 February 2022

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CDC proposes new guidelines in the US for treating pain, including opioid use

The federal government on Thursday proposed new guidelines for prescribing opioid painkillers that remove its previous recommended ceilings on doses for chronic pain patients and instead encourage doctors to use their best judgment.

But the overall thrust of the recommendations was that doctors should first turn to “nonopioid therapies” for both chronic and acute pain, including prescription medications like gabapentin and over-the-counter ones like ibuprofen, as well as physical therapy, massage and acupuncture.

Though still in draft form, the 12 recommendations, issued by the Centers for Disease Control and Prevention (CDC), are the first comprehensive revisions of the agency’s opioid prescribing guidelines since 2016. They walk a fine line between embracing the need for doctors to prescribe opioids to alleviate some cases of severe pain while guarding against exposing patients to the well-documented perils of opioids.

“We are welcoming comments from patients who are living with pain every day and from their caregivers and providers,” said Christopher Jones, a co-author of the draft and acting director of the National Center for Injury Prevention and Control, the arm of the CDC that released the new guidelines.

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Source: The New York Times, 10 February 2022

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Organ donation: Change to Northern Ireland law passes final hurdle

Campaigners have welcomed the "life-saving" legislation to bring opt-out organ donation to Northern Ireland.

The legislation, which will align Northern Ireland with the rest of the UK, passed its final stage in the assembly on Tuesday. It means people will automatically become donors unless they specifically state otherwise.

Máirtín MacGabhann, whose son Dáithí is waiting on a heart transplant, said it was "phenomenal".

The bill is to be known as 'Dáithí's Law' after the five-year-old whose family have campaigned for the law change.

Mr MacGabhann said it was an emotional day for them.

He told BBC NI's Evening Extra programme: "The most important thing, regardless of the name, is that it's passed its final stage and that life-saving legislation will go through."

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Source: BBC News, 9 February 2022

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Record levels of self-harm found at Derbyshire women’s prison

Inmates held in a women’s prison are making 1,000 calls a month to Samaritans amid record levels of self-harm, increased violence and low safety levels usually only seen in men’s facilities, a damning report has found.

Nearly a third of women held at Foston Hall in Derbyshire, which holds 272 residents, told inspectors they felt unsafe, while the use of force in the prison has doubled over nearly three years and is the highest on the women’s prison’s estate.

The women’s prison and youth offender institute is the first to be given a score of “poor” – the lowest – for the safety of female prisoners, since HM Inspectorate of Prisons developed its current framework more than a decade ago.

Charlie Taylor, HM chief inspector of prisons, said the rating of “poor” for safety levels was a “rare and unexpected finding” in a women’s prison.

Recorded levels of self-harm were also the highest in the women’s estate and two prisoners had taken their own lives since the last official inspection in February 2019, he said.

“As an indicator of the level of distress, women were making 1,000 calls a month to Samaritans. The prison had no strategy to reduce self-harm or improve the care for those in crisis,” Taylor said.

The response to women in crisis was too reactive, uncaring and often punitive, Taylor observed. “This, taken with other safety metrics and observation, meant it was no surprise that in our survey nearly a third of women told us they felt unsafe,” he said.

The report also found that the majority of women who harmed themselves did not have enough support or activity and faced daily frustration in getting the help they needed. 

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Source: The Guardian, 9 February 2022

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