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Trust apologises for saying patient’s sexual assault ‘didn’t happen’

A hospital trust has apologised to a mental health patient who reported being sexually assaulted in its A&E department – after it emerged in a safety review that staff wrote ‘this has not happened’ and dismissed her claims of the attack.

The victim was admitted to West Suffolk Hospital’s emergency department following an overdose in January last year. While waiting in A&E for a mental health assessment from a specialist team employed by Norfolk and Suffolk Foundation Trust, she reported being sexually assaulted by a male patient who had also been admitted to A&E.

Yet a review into the incident, published several months later and shared with HSJ, reveals that after the victim reported the attack to a nurse, the staff member recorded “this has not happened”.

They stated that the male suspect in the cubicle next to her had not left his bed and was under constant observation. However, the patient safety review, drawn up after a serious incident probe was launched, adds that this statement was “incorrect, as the [male] patient was not under constant observation”.

“There were witnesses to this incident, and CCTV, and yet it was not escalated until I contacted the trust myself to complain,” the victim said. 

She added that she pursued the complaint, which resulted in a serious incident probe that took several months to conclude, “to prevent others from being failed” in the same way.

She said she was left “shocked, confused and furious” to discover staff had dismissed her assault and claimed the male suspect had not been admitted for an assessment on the day of the attack.

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Source: HSJ, 7 February 2022

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NHS England waiting times for cancer referral and treatment at record high

The numbers of cancer patients facing delays in seeing a specialist for the first time and starting their treatment have hit record highs in England, amid fears that overstretched NHS services can no longer provide prompt care.

The disclosure comes as a new row over how quickly hospitals can clear the record 6 million-strong NHS backlog has forced ministers to delay publication of the long-awaited plan to tackle it.

Half a million people in England with suspected cancer will have to wait longer than the supposed two-week maximum to see an oncologist this year, an analysis for the House of Commons library reveals.

The number of patients confirmed to have the disease who are unable to start treatment such as surgery or chemotherapy within the 31 or 62 days that hospitals try to guarantee is expected to exceed 75,000 for the first time.

Experts, who claim significant shortages in the NHS cancer workforce are to blame, fear delays in getting diagnosed and starting care could reduce a patient’s chances of survival. Cancer charities highlighted the “unimaginable distress and anxiety” they induce in patients.

“Cancer care is in crisis,” the shadow health secretary, Wes Streeting, said. “As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing.”

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Source: The Guardian, 6 February 2022

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New mothers left alone and in pain as maternity crisis worsens

Unable to move and with her newborn baby crying out of reach, Neya Joshi was left alone for hours on an understaffed maternity ward and had to beg for a glass of water.

“It was awful, I was so helpless and so desperate, and no one was interested in helping me. I have never felt fear like it,” she said.

The medical copywriter, 30, was diagnosed with post-traumatic stress disorder months after giving birth to her son Arjun at Croydon University Hospital in May 2020 and had therapy for a year to recover from the trauma.

She is one of thousands of mothers across the country experiencing poorer care because maternity units lack enough staff.

Data from 122 NHS trusts in England shows maternity units were forced to shut their doors to women in labour more than 323 times in 2020-21, with units shut for a total of 16,294 hours, the equivalent of 679 days. When this happens women are forced to go to an alternative hospital to give birth. Staffing shortages were given as a reason in more than two-fifths of the closures.

Joshi saw first hand the impact of a lack of midwives when she was admitted to hospital to be induced after her waters broke at the height of the pandemic. Visiting restrictions meant she was alone on a ward for 24 hours and, despite being told she was a high priority, there were no free beds.

“After they had started the induction I was told someone would come and check me within six hours but no one came and I was just left on my own for hours,” she said. Eventually, after concerns over her baby’s heart rate, she had an emergency caesarean section but her husband was then made to leave an hour later.

“I was taken to the postnatal ward and that’s where it all really went downhill,” she said. “It was awful. I was just lying there. I couldn’t move because I had the epidural and my baby was crying."

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Source: The Times, 6 February 2022

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Surgical mesh centres not working, warn MPs

Specialist centres to help women who have experienced complications following a pelvic mesh repair are "not working", MPs say.

A network of nine mesh centres was set up in the wake of a report about how three health treatments caused thousands of women avoidable harm.

However, a debate in Westminster Hall has heard that GPs are not always aware of the referral process. And some patients are experiencing long waits and living in "agony".

In 2020, the First Do No Harm report recommended specialist mesh centres should be set up to treat complications and carry out removals.

However, Alec Shelbrooke, co-chair of the surgical mesh all-party parliamentary group, has told MPs the centres are "not working".

"GPs are unaware of mesh complication centres and the referral process," he said

"Many patients are denied access and are offered physio and pain management instead, they pay thousands of pounds for private care and face extremely long delays for appointments.

"Many women end up seeing their implanting surgeons, who then dismiss them."

Sharing accounts of women's experiences, Mr Shelbrooke said one waited four years for a referral only to face more "gaslighting" and "suffering".

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Source: 4 February 2022

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Sorry, not sorry

Public figures accused of wrong-doing announce they are “sorry if” people have been offended, outraged, confused etc by their words or actions. The implication is that it is people’s reactions that have inspired the sorrow, not shame about the actions themselves – and often that those reactions are disproportionate to whatever perceived wrong has occurred.

Nearly as common is the “sorry but” tactic in which the public figure expresses sorrow, but adds some qualification that effectively absolves themselves of blame and, again, perhaps suggests the concern is disproportionate.

Sometimes, of course, the non-apology is just that - ‘I’ve done nothing to feel sorry about’. This is again, often followed by, ‘which is more than can be said for…’

It now appears as if the non-apology is being adopted by some NHS leaders.

In the space of seven days we have seen:

  • The Christie react to a report saying it had been “dismissive” of whistleblowers by – appropriately – dismissing the report as inaccurate and out of date.
  • The leadership of Walsall Healthcare Trust and Royal Wolverhampton Trust deploy the “sorry if” defence against accusations of “poor behaviour” by implying they needed to bang some heads together to drive improvement.
  • The chief executive of University Hospitals Birmingham express irritation about his referral to the General Medical Council, stating that he could “live with” the “admin error” which he said had sparked it.

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Source: HSJ, 4 February 2022

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Warnings over NHS mental health care issued in 14 young deaths in five years

Children with mental health problems are dying because of failings in NHS treatment, coroners across England have said in what psychiatrists and campaigners have called “deeply concerning” findings.

In the last five years coroners have issued reports to prevent future deaths in at least 14 cases in which under-18s have died while being treated by children’s and adolescent mental health services (CAMHS).

The most common issues that arise are delays in treatment and a lack of support in helping patients transition to adult services when they turn 18.

Coroners issue reports to prevent future deaths in extreme cases when it is decided that if changes are not made then another person could die.

Dr Elaine Lockhart, the chair of the Royal College of Psychiatrists’ faculty of child and adolescent psychiatry, said the findings were “deeply concerning” and every death was a tragedy.

She said there were too often lengthy delays and services were under strain as demand rises and the NHS faces workforce shortages.

“In child and adolescent mental health services in England, 15% of consultant psychiatrist posts are vacant,” Lockhart said, calling for more support, investment and planning to grow staff levels.

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Source: The Guardian, 3 February 2022

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Drug firms fined for fixing price of drug used by NHS cancer patients

Several drug companies have been fined £35 million for colluding to raise the cost of an anti-nausea drug used by cancer patients, taking the total fines stemming from a Times investigation to £400 million.

The price paid by the NHS for prochlorperazine 3mg dissolvable tablets rose by 700%, from £6.49 a packet to more than £51, between December 2013 and December 2017, costing the NHS an extra £5 million a year.

The Competition and Markets Authority (CMA) has ruled that several companies broke the law by fixing the market and agreeing not to produce a rival version of the drug, which is used to treat nausea and dizziness and can be prescribed to patients having chemotherapy.

Andrea Coscelli, chief executive of the CMA, said: “The size of the fines reflects the seriousness of this breach. These firms conspired to stifle competition in the supply of this important medication, so that the NHS — the main buyer of the drugs — lost the opportunity for increased choice and lower prices.”

He said the CMA would not “hesitate to take action like this against any businesses that collude at the expense of the NHS”.

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Source: The Times, 3 February 2022

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Deaf people diagnosed with cancer face 'big barriers'

Coleen McSorley, who has been deaf from birth, was left upset and struggling to understand the details of her cancer diagnosis. Now one care centre is hoping to offer more support to others facing a similar challenge.

Coleen was diagnosed with breast cancer in September 2020. At the time, Covid restrictions meant she was unable to bring an interpreter or her hearing parents to hospital appointments.

The 56-year-old said she was given wads of literature about her cancer - but like many people who have been deaf from birth, she struggles to read.

"English is my second language after British Sign Language," said the cleaner, from Stirling.

"At the hospital a big barrier was they were wearing too many masks. They were all talking at me but I didn't understand what they were saying, it was horrendous.

"I felt frustrated because I wanted them to pull down their masks so I could try to lip read a little bit, but they wouldn't and it was very confusing."

Coleen, who had stage three cancer, was treated with chemotherapy and had a mastectomy, found a local Maggie centre who supported her. Yvonne McIntosh, an oncology nurse and centre head at the Maggie's Forth Valley cancer care drop-in centre, says that even with an interpreter, a lot of information could be lost in translation.

"A lot of sense and meaning is lost and things can land differently so they don't come across with the same context," she said.

"When Coleen came to us she didn't know what the pills were that she was taking.

"She didn't understand about her treatment and didn't know how her medication worked for her."

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Source: BBC News, 4 February 2022

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‘Black market’ Botox scars women for life

Practitioners with no professional medical qualifications use social media to target women and girls, an investigation by undercover Times reporters has found.

The medicines regulator has begun an investigation after undercover Times reporters found beauticians offering to inject women with “black market” Botox, putting them at risk of being disfigured for life.

Practitioners with no professional medical qualifications used social media to target women and girls, suggesting the treatments were safe and would enhance their looks. Many used products that have not gone through safety checks in Britain. Reporters confirmed that at least three practitioners advertising facial injections on social media sites were using cheap versions of Botox that are not licensed in the UK.

Campaigners say they are receiving increasing reports of disfigurements such as permanent facial scarring and large sores caused by injections with unlicensed versions of Botox, often carried out in people’s homes and at beauty salons.

The Medicines and Healthcare products Regulatory Agency (MHRA) said it was reviewing the findings and would “take appropriate regulatory action where any non-compliance is identified”.

Sajid Javid, the health secretary, said the practices uncovered were “totally unacceptable” and officials were looking into whether legal changes were needed “to ensure no one is harmed”.

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Source: The Times, 2 February 2022

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People in England surviving cancer for longer, NHS reports

Growing numbers of adults and children in England are surviving for longer after being diagnosed with cancer, with increases in lifespan seen in almost all types of the disease.

Survival for one year and five years rose among adults diagnosed between 2015 and 2019 compared with those whose illness was identified between 2006 and 2010, NHS Digital reported.

Survival is highest in adults who have melanoma of the skin, one of the main forms of skin cancer. Nine out of 10 men now survive for five years, as do almost 95% of women.

However, survival remains stubbornly low for other forms of the disease, including pancreatic cancer and mesothelioma, which is mainly caused by prolonged exposure to asbestos. Just 6.3% of men and 7.8% of women who develop mesothelioma are still alive five years later.

NHS Digital found that “in England one-year non-standardised net survival has improved, with patients diagnosed between 2015 and 2019 having a higher one-year survival than patients diagnosed between 2006 and 2010.

“This trend was seen for all cancers and both genders except for bladder cancer. The largest improvement was 1.6 percentage points on average per year for lung cancer in females.”

Greater survival after five years “was seen for all cancers and both genders except for bladder cancer and colon cancer,” the NHS’s statistical arm added. “The largest improvement was myeloma in females, [which was up] 1.4 percentage points on average per year.”

However, Anna Jewell, the chair of the Less Survivable Cancers Taskforce, warned that the chances of survival remained low for people with a number of some forms of the disease.

“Although overall cancer survival rates have generally increased in the past decades, we are not seeing the same improvements in prognosis for patients diagnosed with less survivable cancers, including those of the lung, liver, brain, oesophagus, pancreas and stomach.”

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Source: The Guardian, 4 February 2022

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Improving cancer care a huge challenge post-pandemic

Improving cancer care will be a huge challenge, ministers are being warned as they promise a new 10-year strategy for England.

Figures suggest there have been 34,000 fewer diagnoses since Covid hit - 50,000 if you include the whole UK. It risks an increasing number of late diagnoses which reduces the chances of survival, cancer charities said.

It comes as the government is promising to invest in new technologies and equipment to spot cancer quicker.

Health Secretary Sajid Javid said the new "war on cancer" strategy will be published later this year.

"It will take a far-reaching look at how we want cancer care to be in 2032. Looking at all stages from prevention, to diagnosis, treatment and vaccines," he said.

Mr Javid pointed out the NHS was already taking steps, including evaluating new blood tests to spot cancers early and opening a network of testing centres.

Lynda Thomas, of Macmillan Cancer Support, said given the impact of the pandemic people with cancer needed "support more than ever".

"We have been sounding the alarm for a long time," she added.

But she said while improving diagnosis and treatment was crucial, it was like "building sandcastles while the tide comes" without extra staff to tackle the backlogs and demand for care.

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Source: BBC News, 4 February 2022

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Substantial fall in diabetic health checks as GPs reprioritised during pandemic

The proportion of patients with type 2 diabetes who have had recommended health checks has fallen substantially, provisional data from 2021 suggests, as have the numbers hitting key disease control targets.

In response, primary care experts have called for GP practices to receive targeted investment to focus on the checks, which they had to deprioritise as the vaccination programme was introduced.

There are now 3.24 million people with a diagnosis of type 2 diabetes in England, the data across all GP practices shows.

National Diabetes Audit figures for England from January to September 2021 showed that:

  • 74% of patients had received a HbA1c check and 70% a blood pressure check compared with 93% and 95% respectively in 2019/20.
  • In the first nine months of last year, 61.9% of patients had an HbA1c under 58 mmol/mol, compared with around 66% in previous years.
  • The proportion of patients with blood pressure targets of under 140/80 was 66.5% in the latest figures compared with around 73-74% during 2015 to 2020.

Speaking with Pulse, Professor Partha Kar, NHS England national specialty advisor for diabetes said while this was not the final data, a drop off had been expected for a range of reasons outside GPs control.

‘What we have seen is that there was a massive drop off in wave one. Then around the middle of 2020 it started to pick up again but then it’s dropping off again so irrespective of data cleaning, I suspect you will see a massive drop off compared to where things have been over the last four or five years.

‘We need to be very clear its not because anyone was twiddling their thumbs, it’s because primary care was asked to do something else.

‘We can’t go back to primary care again for the vaccines because they are being taken away from the thing that they’re amazing at which is delivering long-term conditions at scale.’

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Source: Pulse, 2 February 2022

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‘We’ve broken the social contract between the NHS and its people’

‘We’ve broken the social contract between the NHS and its people’. That was the blunt conclusion of one senior NHS figure surveying the aftermath of the government’s U-turn on the mandatory vaccination of staff.

Most of the NHS’ leadership at national and local level were behind the policy of mandatory vaccination. They believed it was the right thing to do for patients, colleagues and the service.

But they were also acutely aware of the reluctance of some staff to get the jab and that changing their minds would be tough – and in some cases unsuccessful. They were also prepared to deal with the consequences of the failure to convert the waverers.

They put their credibility and reputations on the line to give the vaccination push as much chance of success as possible. They found time to have and facilitate difficult conversations, even though those discussions were bound to impact on morale at a time of huge pressure.

…and then the government pulled the rug from under them.

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Source: HSJ, 2 February 2022

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Pfizer and BioNTech seek emergency use authorisation of the first coronavirus vaccine for children under 5 in the US

Pfizer and BioNTech said Tuesday that they were seeking emergency-use authorisation for the first coronavirus vaccine for children younger than 5 in the US and have begun submitting data on the safety and efficacy of the first two doses of a planned three-dose regimen.

The Food and Drug Administration asked the companies to apply for authorization of their vaccine, and in an email, FDA spokeswoman Stephanie Caccomo said the omicron surge had generated new data “impacting the potential benefit-risk profile of a vaccine for the youngest children.”

In December, Pfizer and BioNTech announced that the immune response generated by the vaccine in children between 2 and 4 years old was not sufficiently robust. But the companies said the vaccine had provoked a strong enough response in children 6 months to 2 years old. A third shot was added to the trial to increase the immune response.

An earlier vaccine trial in children 5 to 11 years old was also focused on showing that those children had adequate immune responses after vaccination. In addition, there were enough cases of illness in that study population to determine that the vaccine was 91% effective in preventing symptomatic illness.

The companies said Tuesday that the FDA requested they move forward with an application because of the “urgent public health need in this population,” noting that 1.6 million children under the age of 4 have tested positive for the coronavirus.

“The need for a safe and effective vaccine for our youngest children is significant, particularly given the rapid spread of the omicron variant, the notable rise in the number of hospitalizations in young children with severe disease, and the possibility that future variants could cause severe disease in those who are unvaccinated,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

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Source: The Washington Post, 1 February 2022

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An amputee's wife had to "carry him to the toilet" after her husband was sent home from hospital without a care plan

An amputee's wife having to "carry him to the toilet" after her husband was sent home from hospital without a care plan was just one of many findings in a report into vascular services at Betsi Cadwaladr University Health Board in north Wales.

The critical report by the Royal College of Surgeons England makes five urgent recommendations "to address patient safety risks".

Part one of the report, published last summer, made nine urgent recommendations and raised issues including too many patient transfers to the centralised hub, a lack of vascular beds and frequent delays in transfers.

The final part of the report, published on 3 February, focussed on the clinical records of 44 patients dating from 2014 - five years before centralisation - to July 2021, two years after the Ysbyty Glan Clwyd hub opened.

Assessors were "extremely concerned" about the case of a man where a decision was made to "amputate the foot rather than proceed to a below-the-knee amputation as the primary procedure".

The report adds: "The review team also noted that the patient had been discharged without a care plan and that the patient's wife was having to 'carry him to the toilet'."

It also highlights an "inappropriate" decision to offer a patient an "unnecessary and futile" amputation when "palliation and conservative therapy should have been considered instead".

Referring to that case, the report added that the risk from "major amputation was extremely high".

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Source: BBC News, 3 February 2022

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Health charities warn women with UTIs are “patronised” and “not believed” when seeking medical help as new research reveals “medical misogyny”

Research by Garmin finds 40% of young women say they have been accused of over-exaggerating symptoms of UTIs.     

While it’s clear that already strained services and a lack of funding contributed to the impact of the pandemic on the healthcare system, health inequality isn’t something that’s unique to Covid-19.

Instead, it’s often the result of commonly misunderstood, misrepresented and mistreated conditions that disproportionately affect women, such as polycystic ovary syndrome (PCOS), endometriosis and urinary tract infections (UTIs).

New research from fitness company Garmin, published by The Independent, found that 40% of young women say they have been accused of over-exaggerating symptoms of UTIs or being “overdramatic” about their wellbeing when seeing a doctor. 45% also said they’ve had their UTI symptoms written off as “part of being a woman”.

According to the Chronic Urinary Tract Infection Campaign (CUTIC), 50% of all women will suffer at least one UTI episode in their lifetime, one third of these by the age of 24. 

“Statistics show that UTI is the most common infection seen by GPs,” says CUTIC. “In fact, doctors are so familiar with UTIs that they are frequently dismissed as merely a woman’s problem, rooted in the ‘flawed female anatomy’.

“With little training in UTI management, GPs and urologists rely heavily on discredited laboratory tests which miss up to 60% of infections."

“The medical training for UTI diagnosis is inadequate and most doctors are not aware of the complexity of this illness. They are trained to accept the test results and look no further,” CUTIC suggests.

“It is clear from the recent government probe into menopause that women’s health has not been an area of priority. Conditions which primarily affect women are underfunded and under researched – this includes UTIs. Women are frequently patronised and not believed when they describe symptoms relating to UTIs, peri-menopause, menopause and vaginal atrophy. Medical training fails to include proper diagnosis and effective treatment for such conditions. Change is needed now.”

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Source: The Stylist, 2 February 2022

Have you attempted to access treatment for a urinary tract infection (UTI), or recurrent UTIs? We'd love you to share your experiences with us? Share your experience on the hub.

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NHS Nightingale hubs cost £11m to build ... only to treat seven patients

The Nightingale surge hubs cost more than £10.6 million to set up but have admitted roughly seven patients, it has emerged.

Eight temporary sites were built at hospitals across the country during the height of the omicron wave, with the capacity to house about 100 patients each. However, it has now been revealed that the hubs cost £10,672,088 to build and only one has admitted a handful of patients.

Announcing the hubs in December, NHS England said they would be used if “the record number of Covid-19 infections leads to a surge in admissions and outstrips existing capacity”.

However, as of Jan 30, there were 1,285 daily admissions, an eight per cent decrease on the previous week.

The chief executive of the William Harvey Hospital, in Ashford, Kent – the location of one of the eight omicron hubs – has expressed concerns that the structure “may adversely impact” other services and never be used.

The cost of the hubs was revealed in response to a written question submitted by Damian Green, the Conservative MP Mr Green said that the temporary sites were an “insurance policy” and added “it looks like they won’t be needed”. He called on ministers to assess if they could be repurposed to help clear the backlog of patients waiting for treatment.

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Source: The Telegraph, 2 February 2022

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Thousands of children are falling through the cracks in youth addiction services

Thousands of children are falling through the cracks in youth addiction services owing to Covid, staff shortages and funding cuts, psychiatrists have said, as figures suggest the number able to get help has fallen to the lowest on record.

Analysis of data from the National Drug Treatment Monitoring System (NDTMS) found that 11,013 under-18s were in treatment for drug and alcohol dependency in England in 2020-21, which was 3,278 fewer (23% less) than in 2019-20. It was the sharpest annual fall since records began, and means 13,481 fewer children were being treated than at a peak in 2008-09.

The vast majority of children in treatment (89%, or 9,832) had a problem with cannabis and 41% (4,459) had a problem with alcohol. About 12% (1,333) were struggling with ecstasy use and 9% (976) reported a problem with powder cocaine.

The Royal College of Psychiatrists, which analysed the data, said the pandemic, together with “drastic” historical funding cuts, was preventing young people from accessing the drug and alcohol treatment they need, potentially condemning them to a life of addiction.

Dr Emily Finch, the vice-chair of the addictions faculty at the Royal College of Psychiatrists, said: “Children and their families up and down the country are having their lives blighted by drug and alcohol use due to drastic cuts, workforce shortages and the impact of the pandemic.

“Addiction is a treatable health condition. Intervening early will mean many kids won’t go on to have an addiction in their adulthood, keeping them out of the criminal justice system and helping them to live full lives. It’s now time for the government to act on their promise and deliver the multimillion-pound investment into drug services.”

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Source: The Guardian, 3 February 2022

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“Injured people will suffer twice” – furious reaction to clinical negligence fixed costs

Those harmed by the NHS will “have to pay again by losing access to justice” as a result of government plans to introduce fixed costs, campaigners have claimed.

The Department of Health & Social Care has published long-awaited proposals for fixed recoverable costs for fast-track cases, and significantly chose to set the fees at levels recommended by defendant representatives, rather than higher ones proposed by the claimant side.

Peter Walsh, chief executive of Action against Medical Accidents (AvMA), noted that the government consulted on similar proposals in 2017 and received a thumbs down from the majority of respondents.

He said: “It is shocking that the government is still pushing to bring in these illogical and potentially unfair proposals rather than looking at the root causes of high costs and addressing them…

“The government seems to have ignored the fact that the likely effect of these proposals would be that many people whose lives have been devastated by perfectly avoidable, negligent treatment will not be able to challenge denials or get access to justice.

“In effect, the very people that the NHS has harmed through lapses in patient safety will have to pay again by losing access to justice. If lawyers are unable to claim for time they spend overcoming denials of liability, injured people will not be able to get legal representation.”

Mr Walsh argued that the best way to save the NHS money was to improve patient safety to prevent these incidents in the first place, “and when mistakes do happen investigate them properly and make early, fair and appropriate offers of compensation without costly litigation”.

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Source: Legal Futures, 1 February 2022

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Long waits at Scotland's A&E 'putting patients at serious risk'

Long waits at accident and emergency (A&E) departments in Scotland continue to put patient safety at “serious risk”, the Royal College of Emergency Medicine has warned.

New figures from Public Health Scotland show 78 per cent of patients visiting A&E in the week to January 23 were seen and admitted, transferred or discharged within four hours.

This is an increase on the previous week, but still below the Scottish Government target of 95%

It comes as the number of planned operations across NHS Scotland dropped 13% from November to December, to 17,835.

Dr John Thomson, vice-president of the Royal College of Emergency Medicine in Scotland, said the college was concerned poor A&E performance times are becoming the “status quo”.

“With fewer attendances performance has plateaued, but be in no doubt that the health service and its staff in Scotland remain under unprecedented pressure and increasing burnout,” he said.

Dr Thomson added: “The impact of this continued poor performance is distress and moral injury to staff and serious discomfort and risk to the safety of patients.

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Source: The Scotsman, 2 February 2022

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Electronic decision support ‘to be the norm for all clinicians’ under NHSE plan

Electronic systems and clinical decision support software must become “the norm” for all NHS clinicians, under plans being drawn up by NHS England’s new transformation directorate, HSJ has revealed.

The massive increase in clinicians’ use of technology forms a major part of the draft plans, seen by HSJ, with the new directorate set to launch ambitious targets for the health service.

Other targets include every integrated care system creating virtual wards which are the equivalent size of a district general hospital — around 500 beds each — and installing electronic patient records at every NHS trust.

The proposals are led by former US healthcare chief Tim Ferris, NHSE’s new transformation director, who was appointed last year.

According to the plans, NHSE’s ambition is to increase the “safe and effective use” of computer assisted processes and clinical decision support so it becomes the “expected norm for all clinicians”.

NHS leaders have welcomed the use of virtual wards to improve home care and reduce hospital occupancy, but clinicians have warned of safety issues within virtual wards, with some prominent doctors calling for a careful implementation of the policy.

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Source: HSJ, 2 February 2022

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Dr Ted Baker announced as the new Chair of HSSIB

Dr Ted Baker has been formally appointed as the new chair of the Health Services Safety Investigations Body (HSSIB).

The Secretary of State for Health and Social Care, Rt Hon Steve Barclay MP, made the announcement today (1 December 2022).

Dr Baker is a retired consultant paediatric cardiologist, and most recently was Chief Inspector of Hospitals at the Care Quality Commission (CQC) between 2017 and 2022.

Dr Baker says: “I am delighted to be joining such a ground-breaking organisation. I have been impressed by the quality of the work coming from the HSIB and I am excited to be joining the organisation at such an important time in its history."

Source: HSIB, 1 December 2022

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NHS 'riddled with racism' against ethnic minority doctors

The NHS is "riddled with racism", the chair of the British Medical Association's council has told the BBC.

Dr Chaand Nagpaul has spoken out in response to a survey by the BMA, shared exclusively with BBC News.

At least 75% of ethnic minority doctors experienced racism more than once in the last two years, while 17.4% said they regularly faced racism at work, the survey said.

NHS England said it takes a "zero-tolerance approach" to racism.

Racism affects patients as well as doctors' wellbeing, by stopping talented people from progressing fairly and affecting doctors' mental health, Dr Nagpaul warned.

"This is about a moral right for anyone who works for the NHS to be treated fairly," he said.

Around 40% of the NHS's 123,000 doctors are from minority backgrounds, compared to about 13.8% of the general population. But despite this diversity, doctors told the BBC that there was a toxic "us versus them" culture in NHS trusts across the UK.

They said they had faced bogus or disproportionate complaints from colleagues, racist comments from superiors, and even physical assault in the workplace. Some said they had tried to lodge complaints which were then ignored or dismissed without investigation.

One consultant, from a black African background, told the BMA that after reporting previous incidents "no action was taken... I feel uncomfortable and anxious of reprisals".

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Source: BBC News, 2 February 2022

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Hormone replacement therapy could be made available over the counter

Hormone replacement therapy (HRT) could be made available to buy over the counter.

Health watchdogs are proposing a re-classification of the medication so women would be able to buy it in pharmacies without a prescription, it’s claimed.

HRT is mainly used to treat menopause symptoms but it is not yet known which version of the medication will be a part of the proposal, the Daily Telegraph reports.

Symptoms can include hot flushes, reduced sex drive and mood swings and usually pass after a few years.

More than one million women a year are believed to suffer each year but treatment is currently only available after consultation with a GP or a specialist.

A spokesperson for the Department of Health and Social Care said: "We understand that for some women menopause symptoms can have a significant impact on their quality of life, and we are committed to improving the care and support they receive.

"That’s why we’re developing the first ever government-led Women’s Health Strategy, informed by women’s lived experience. Menopause, including improving access to Hormone Replacement Therapy, will be a priority under the Strategy."

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Source: The Independent, 2 February 2022

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Trust CEO ‘behaved poorly’ and chair was ‘complicit’, NHS England review concludes

An NHS England review into the behaviour of high-profile senior leaders who took over a Midlands trust has concluded that the interim CEO “behaved poorly and inappropriately” while its chair was “complicit with” and failed to address problems.

NHS England had commissioned an independent probe into allegations about the behaviour of new executives, who had recently been appointed to the board of Walsall Healthcare Trust.

David Loughton and Professor Steve Field, who hold the same roles at the Royal Wolverhampton Trust, were brought in as interim chief executive and chair respectively in spring 2021.

Walsall has faced care quality concerns for some years and it was hoped the pair from neighbouring Wolverhampton would bring improvements. 

Dr McLean wrote in her review: “Leadership changes can, understandably, represent a period of anxiety for those affected but this can be minimised if changes are made in line with appropriate values and processes. 

“Whilst I conclude that the joint chair and interim CEO were motivated to act in the best interests of patients, I was saddened by much of what I heard.

”In the narratives I heard, there was a consistent lack of compassion or respect for people.”

She concluded: “The interim CEO, while motivated by the safety and care of patients, has behaved poorly and inappropriately … the joint chair has been complicit with and failed to address this behaviour.”

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Source: HSJ, 2 February 2022

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