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Avoid “unproven and unethical” polygenic risk scores in embryo selection, say genetics experts

Geneticists have warned the public against buying polygenic risk score analyses, which some private fertility clinics claim can help parents using in vitro fertilisation in selecting embryos that carry the least risk of future disease.

It appears that at least one child has been born after such a procedure, but the use of polygenic risk score analysis in this respect is severely limited. No evidence shows that these tests can predict the likelihood of an unborn child being liable to a specific disease in the future, representatives from the European Society of Human Genetics wrote in the European Journal of Human Genetics.

Polygenic risk score analysis is mainly offered by fertility clinics in the US, although the practice is also being promoted in the UK.

Patients need to be properly informed on the limitations of its use and a societal debate, focused on what should be considered acceptable with regard to the selection of individual traits, should take place before any further implementation of the technique in this population.

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Source: BMJ, 26 January 2022

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"I’m dying" – Son shares desperate 999 calls

Bina Patel, aged 56, died after struggling to breathe and waiting almost an hour for an ambulance.

Her son Akshay Patel has shared the six phone calls he made to North West Ambulance Service on the night of her death.

North West Ambulance say they "can never say sorry enough" for Bina's death.

"The amount of time it took for help to arrive is unacceptable and not how we want to care for our patients," a spokesperson said.

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Source: BBC News, 26 January 2022

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Period changes after Covid jabs are short-lived

Small changes to periods can follow a Covid vaccine but they quickly return to normal, a leading UK menstruation expert has said.

Dr Victoria Male, from Imperial College London, called studies from the US and Norway which tracked women's cycles "reassuring".

And she blamed misinformation for fuelling concerns over infertility. The Medicines and Healthcare products Regulatory Agency (MHRA) says there is no evidence Covid vaccines affect the ability to have children.

The MHRA has received more than 37,000 reports of unexpected vaginal bleeding, heavier and delayed periods after a Covid jab. It has always said there is no evidence of a link to the vaccine, because women's cycles vary naturally - but scientists called for more research.

Dr Male said: "Changes to the menstrual cycle do occur following vaccination - but they are small compared with natural variation and quickly reverse."

Women's concerns arose "from misinformation that Covid-19 vaccines cause female infertility", she said.

And more studies of pregnancy rates in couples trying to conceive were needed to make it clear they do not.

A Covid infection, however, "may reduce sperm count and quality" - and understanding more about that would mean patients could be given the right advice.

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Source: BBC News, 27 January 2022

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Staff will quit if not given ‘time to recover’, says NHSE director

An NHS England director and trust chief says he ‘fears [the NHS] will see increasing numbers of resignations’ unless more is done to ensure burnt-out staff are given sufficient leave to recover mentally and physically.

Matthew Winn, NHSE’s director of community health and Cambridgeshire Community Services Trust chief executive, set out his concerns in a paper for discussion at his trust’s board meeting today.

While the service is grappling to keep tabs on the number of staff it is losing because of compulsory vaccination plans, the issue of staff leaving because of burnout is harder to quantify, but a huge concern to NHS leaders. Nearly two years of tackling coronavirus has taken a huge emotional and physical toll on a large proportion of the workforce and burnout was a growing issue even before the pandemic.

Mr Winn’s paper says: “As the NHS starts to focus on recovering from the current covid pressures, it is vital that the national, regional and local planning must take into consideration that our staff need time to recover and that they cannot (for example) be expected to catch up on the waiting lists that have accrued, without time and resources to support them.

“In the absence of such an approach, I fear that we will see increasing numbers of resignations and the care we will be able to provide will be far short of the standards we set ourselves and that the public expects from us.”

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Source: HSJ, 26 January 2022

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Review reveals trust’s ‘deep-seated’ cultural and governance issues

One of the NHS’ most high-profile mental health trusts has ‘multiple’ corporate governance problems and ‘deep-seated’ cultural issues, according to an external review.

Tavistock and Portman NHS Foundation Trust, which provides mental health, educational and training services in London, commissioned an external firm to look into its leadership amid a period of intense public scrutiny in the latter half of 2021.

Among cultural issues identified at the trust, which reviewers described as “deep seated”, was a reluctance of staff to speak up about concerns.

Assessors said a recent employment tribunal, which ruled the trust’s treatment of a whistleblower had damaged her professional reputation and “prevented her from proper work on safeguarding”, had impacted the ability of staff to raise concerns.

They urged leaders to review their Freedom to Speak Up and whistleblowing procedures. 

And while reviewers commended board members for commissioning an external review of race equality, they said it had “yielded an outpouring of emotion” which suggested many staff from minority ethnic groups do not feel consistently supported, respected or valued.

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Source: HSJ, 25 January 2022

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NHSE calls on systems and maternity leads to vaccinate more pregnant women

An NHS England letter has warned of “significant variation” in the uptake of the COVID-19 vaccine amongst pregnant women, and called on systems to enable more “spontaneous” antenatal vaccination.

In the letter, sent to integrated care system vaccination programme leads, ICS maternity leads and other NHS clinical directors, NHS England said that while the rates of women who had received at least two doses of the vaccine before giving birth was on the rise, there was “significant variation in uptake between regions and systems and in every system, between women of different ethnicities, decile of deprivation in their local area, and age groups”.

The letter asks that covid vaccines are made available within antenatal clinics “to maximise uptake” and that partially vaccinated women “are offered vaccine confidence conversations and advised antenatally on the nearest available walk-in vaccinations”.

Vaccination programme and maternity service leads have also been told to make use of resources and funding available to drive uptake in at-risk groups.

It said: “Vaccination and maternity leads should discuss how this resource could be used to provide in-reach clinics within every maternity service, without creating additional burden on midwifery staff.”

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Source: HSJ, 26 January 2022

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Number of patients 'medically fit' to leave hospital increases

The number of patients in hospitals who are ‘medically fit’ to leave has increased in January, despite NHS England targets for trusts to dramatically reduce the numbers.

Internal data seen by HSJ suggests there were an average of 12,819 patients who no longer met the ‘criteria to reside’ in NHS hospitals in the week to January 23 – up from around 10,500 before the Christmas period.

Last month, NHS England told local systems to dramatically reduce their numbers of medically fit patients who remained in hospital, as they aimed to free up beds amid a surge in covid-19 admissions fuelled by the omicron wave. It told local leaders “a significant proportion of discharge delays are within the gift of hospitals to solve”.

The message was reiterated by NHSE’s regional teams at the start of January, with systems told to reduce their numbers of medically fit patients by between 30 and 50 per cent.

Yet the proportion of ‘medically fit’ for discharge patients occupying NHS general, acute or critical care beds has also been rising, from around 12% in December to around 14% in mid-January.

Delayed discharges are frequently cited as the main cause of long delays for patients being admitted through hospitals’ emergency departments, which have significantly worsened in recent months.

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Source: HSJ, 26 January 2022

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Nearly 50% of blood cancer patients insufficiently protected against Omicron after three jabs, study says

Nearly half of patients with blood cancer are insufficiently protected against the Omicron variant after three vaccine doses, according to a new study.

Experts from the Francis Crick Institute and the Royal Marsden NHS Foundation Trust said their research highlights the need for a fourth jab among these vulnerable people.

As part of the ongoing Capture study, scientists have been monitoring the antibody response of hundreds of patients with different types of cancer, after one, two and three vaccine doses.

Specifically, the researchers measured levels of neutralising antibodies which identify, attack and block the Omicron variant from infecting the body’s cells.

Patients with solid tumours appeared to generate antibody responses similar to people without cancer. But among patients with blood cancer who had three doses of a Covid-19 vaccine, only 56 per cent generated neutralising antibodies, according to the study, which has been published as a research letter in The Lancet.

This means that 44% of patients with blood cancer did not generate a sufficient antibody response.

The study supports the need for four jabs among these immunocompromised groups of people.

“We found that a third vaccine dose boosted the neutralising response against Omicron in patients with cancer, but the effect was blunted in patients with blood cancer compared to those with solid cancer,” the authors wrote.

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Source: The Independent, 25 January 2022

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Almost 100,000 could unknowingly have potentially deadly heart valve disease

Experts have estimated that almost 300,000 people in Britain could have a potentially deadly heart valve disease called aortic stenosis - including almost 100,000 who are unaware they have it.

The condition carries a high death rate if left untreated and occurs when the main valve which takes blood from the heart stiffens and narrows.

Many people do not know they have the disease and only discover they do when it is too late for treatment.

An international team of scientists, including experts from the Universities of Glasgow and Southampton, set out to research the extent of the disease in the UK.

Their study, published in the journal Open Heart, estimated that in the UK in 2019 there were 291,448 men and women aged 55 and over with severe aortic stenosis.

Of these, an estimated 68 per cent would have symptoms. This means an estimated 92,389 people have the disease and do not know it.

The authors went on to estimate that more than 172,000 (59%) who have the disease will “die within five years without proactive management”.

They concluded that aortic stenosis is a “common condition” in the UK but warned that “without appropriate detection and intervention, survival prospects are likely to be poor”.

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Source: The Independent, 25 January 2022

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Long Covid: doctors find ‘antibody signature’ for patients most at risk

Doctors have discovered an “antibody signature” that can help identify patients most at risk of developing long Covid, a condition where debilitating symptoms of the disease can persist for many months.

Researchers at University hospital Zurich analysed blood from Covid patients and found that low levels of certain antibodies were more common in those who developed long Covid than in patients who swiftly recovered.

When combined with the patient’s age, details of their Covid symptoms and whether or not they had asthma, the antibody signature allowed doctors to predict whether people had a moderate, high or very high risk of developing long-term illness.

“Overall, we think that our findings and identification of an immunoglobulin signature will help early identification of patients that are at increased risk of developing long Covid, which in turn will facilitate research, understanding and ultimately targeted treatments for long Covid,” said Onur Boyman, a professor of immunology who led the research.

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Source: The Guardian, 25 January 2022

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Four-hour A&E standard is the ‘wrong target’, claims Javid

The four-hour standard for A&E waits is the ‘wrong target’, which ‘doesn’t work’ and leads to ‘perverse outcomes’, health and social care secretary Sajid Javid has said.

Mr Javid made the claim during an appearance before the Commons health and social care committee yesterday.

He also spoke about the requirement that NHS patient-facing staff must be vaccinated against covid and took the opportunity to restate his belief that radical action was needed to tackle “failing trusts”.

Mr Javid told the MPs: “Targets work if they are the right targets, and in the NHS I have already noticed there are targets which are the wrong targets and we’ve got to change them.

“The four-hour A&E target is the wrong target, it doesn’t work. It leads to really perverse outcomes.

“If you look at some NHS trusts, all of sudden when the individual in A&E has got to three hours and 55 minutes, guess what? They just admit it. That’s a poor outcome.

“There may have been a good reason to have that target in the past, but you’ve got to keep these targets constantly under review and that’s something I’m doing.”

The long-running clinical review of waiting time standards by NHS England had proposed replacing the four-hour target with a suite of other measures but the government has yet to formally respond.

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Source: HSJ, 26 January 2022

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Unvaccinated man denied heart transplant by Boston hospital

A US hospital has rejected a patient for a heart transplant at least in part because he is not vaccinated against COVID-19.

DJ Ferguson, 31, is in dire need of a new heart, but Brigham and Women's Hospital in Boston took him off their list, said his father, David.

He said the Covid vaccine goes against his son's "basic principles, he doesn't believe in it".

The hospital said it was following policy.

Brigham and Women's Hospital told the BBC in a statement: "Given the shortage of available organs, we do everything we can to ensure that a patient who receives a transplanted organ has the greatest chance of survival."

A spokesman said the hospital requires "the Covid-19 vaccine, and lifestyle behaviours for transplant candidates to create both the best chance for a successful operation and to optimise the patient's survival after transplantation, given that their immune system is drastically suppressed".

The hospital's carefully worded statement may suggest other factors lie beyond the patient's unvaccinated status for his ineligibility, but it refused to discuss specifics, citing patient privacy.

Dr Arthur Caplan, head of medical ethics at NYU Grossman School of Medicine, told CBS News that after any organ transplant a patient's immune system is all but shut down and even a common cold can prove fatal.

"The organs are scarce, we are not going to distribute them to someone who has a poor chance of living when others who are vaccinated have a better chance post-surgery of surviving," said Dr Caplan.

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Source: BBC News, 26 January 2022

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Zoe Wilson inquest: Patient stayed on ward for 'low-risk patients'

A vulnerable woman judged to be at medium risk of self harm was on a mental-health ward that catered for low-risk patients, an inquest heard.

Zoe Wilson, 22, died on the Larch Ward at Bristol's Callington Road Hospital in June 2019 after being found unconscious in her room at 01.30 BST.

She had previously told staff that voices were telling her to kill herself, her inquest heard.

Healthcare assistant Sarah Sharma found her and immediately called for help. Addressing a jury inquest at Avon Coroners' Court, she said that "patients admitted to Larch should have all been low risk". 

This meant they would "preferably" have hourly observations by staff and be able to take their medication without any issues. Many were ready to be discharged and they were there because something was holding them up, normally housing, she said.

The experienced healthcare assistant said if the patient's risk increased they should be placed under "one to one" monitoring with a member of staff until they were moved to a more suitable unit.

The inquest heard earlier that Ms Wilson had been judged to be medium risk and was placed on 30-minute observations on 18 June.

Her risk level was re-assessed when she handed a belt to staff and informed them voices were telling her to kill herself.

Ms Sharma told the court that she was on her first overnight shift in two and a half weeks that night, and was informed in a handover that Ms Wilson was at risk of self-harming.

Having never met Ms Wilson - who had schizophrenia - she queried what kind of self-harm the patient was at risk of but said the nurse performing the handover told her he "didn't know".

Ms Sharma told the inquest she was unaware of the belt incident or that Ms Wilson had not been sleeping well and had requested medication to calm her down.

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Source: BBC News, 24 January 2022

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Face-to-face GP appointments in Scotland 'still feel like a treat'

Nightclubs have reopened, concerts have been given the go-ahead and football stadiums are welcoming fans - but there are still restrictions on face-to-face GP consultations.

Only a limited number of patients are being invited into surgeries, where there continue to be strict rules on physical distancing.

Edinburgh GP Dr Carey Lunan says she understands why the situation is confusing.

"The difference between a healthcare setting and, say, a restaurant or a football stadium, is that we have people coming into our building who are much more vulnerable and frail and don't have a choice in being unwell," she tells BBC Scotland.

"So we have to have higher levels of safety than a setting where people can choose to go, knowing that there may be a little bit of risk."

According to the British Medical Association's Dr Andrew Buist, the balance between telephone and in-person consultations should continue to adjust as we move out of the pandemic, guided by evidence.

But many patients will "very easily" have their needs met by phone appointments. So-called telephone triage - where patients are assessed over the phone before being invited into the building - has now become the norm.

"For a lot of patients it works really well if it's a simple problem and it means not having to take time off work or travel," says Dr Lunan.

"It works less well if English isn't their first language or they've not got the privacy at home to have a conversation about something that is a bit more sensitive, if it's a very complex issue or it's just not clear what the diagnosis is."

She adds: "We deal with things when someone comes in with problem A, but actually we end up having a conversation about problem B when they are in the room with us.

"It is much more challenging to do that kind of health care on the phone and I think we just need to be honest that there are limitations.

Dr Lunan says she hopes a return to more face-to-face appointments will come "in the not too distant future. I miss seeing patients if I'm honest," she says.

"When we get to the point where we are able to bring in more people we will welcome that because it feels like a treat at the moment."

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Source: BBC News, 25 January 2022

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Public urged to sign up for Covid drug trial

Over-50s and younger adults with underlying health conditions are being urged to participate in a study of life-saving treatments for COVID-19.

The study is open to those who test positive for Covid and had symptoms develop in the previous five days. Volunteers will be given pills to take at home.

The study will help decide how antiviral drugs will be used, Prof Sir Jonathan Van-Tam, the deputy chief medical officer for England, said.

Health Secretary Sajid Javid asked everyone eligible to "step forward" and "help us to learn more about medicines which could save thousands of lives".

Antivirals were "part of our approach as we learn to live with Covid, by preventing the most vulnerable from being hospitalised", he said.

The UK regulator has licensed both for treating Covid, with molnupiravir the first to be given the green light, in November. Both have completed clinical trials and shown promising results at reducing the risk of serious illness or death.

Launched in December, it already has 4,500 people signed up but needs 6,000 more as soon as possible.

You can sign up at the study website now or your GP may contact you to ask you to participate if you test positive for Covid.

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Source: BBC News, 25 January 2022

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I travelled to the US and paid £19,000 to have mesh implant removed

Anne Monie is one of hundreds of Scottish women to have suffered painful, life-changing side effects from mesh implants.

She was fit and healthy when she went to her doctor with anterior prolapse and mild stress incontinence in 2010. But an operation to fit transvaginal mesh left her in agony.

With nowhere to turn for help in Scotland, the 69-year-old spent £19,000 travelling to the US to get her implant removed.

Anne spoke to BBC Scotland as the Scottish Parliament looks set to pass a bill which would see her and others reimbursed for the cost of private surgery.

That may bring financial concerns to an end - but she is by no means cured. And she worries about other women still trying to go through the mesh-removal process.

Anne was offered a simple "gold standard" transvaginal mesh procedure when she first sought medical help 12 years ago.

But after the operation to fit it, she began to suffer from a range of problems and was left in chronic pain.

After years of frustration, she paid to go to Missouri to have mesh removal surgery with world-renowned expert Dr Dionysios Veronikis.

"It's a massive amount of money to be paying out, especially when you're retired. But then, what price do you put on health?"

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Source: The Guardian, 25 January 2022

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NHS England plans dental ‘treatment blitz’ to tackle appointments backlog

Hundreds of thousands of dental patients in England are to be offered weekend and evening appointments under NHS plans to tackle the backlog exacerbated by the pandemic.

More than 350,000 extra dental appointments are to be made available in February and March, NHS England said, with a new £50m funding pot aimed at fuelling a dentistry “treatment blitz”.

However, senior dentistry sources said the cash was a “drop in the ocean”, with tens of millions of NHS appointments cancelled as a result of Covid-19 and the resulting backlog set to take years to clear.

Some also expressed doubts about whether there would be enough staff to offer the additional appointments, since hundreds of dentists have quit the profession in the last year amid warnings that NHS dentistry is increasingly “hanging by a thread”.

Millions of patients have struggled to access dental care since 2019. Some have spent weeks or months in pain as a result, and others believed they had no option but to conduct “DIY dentistry” while waiting for treatment, or felt coerced into “going private”.

Under the new plans to tackle the backlog, NHS England said dentists involved in the scheme would “be paid more than a third on top of their normal sessional fee” for delivering care outside their core hours.

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Source: The Guardian, 25 January 2022

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Long Covid: nearly 2m days lost in NHS staff absences in England

NHS trusts in England lost nearly 2m days in staff absences due to long Covid in the first 18 months of the pandemic, according to figures that reveal the hidden burden of ongoing illness in the health service.

MPs on the all-party parliamentary group (APPG) on coronavirus estimate that more than 1.82m days were lost to healthcare workers with long Covid from March 2020 to September 2021 across England’s 219 NHS trusts.

The estimate is based on data obtained under the Freedom of Information Act from 70 NHS trusts and does not include the impact of the highly transmissible Omicron variant that has fulled record-breaking waves of infection in the UK and globally since it was first detected in November.

Layla Moran, the Liberal Democrat MP who chairs the APPG, said the government had paid “almost no attention to long Covid and the severe impact it was having on vital public services” and called for immediate support for those affected.

“Thousands of frontline workers are now living with an often debilitating condition after being exposed to the virus while protecting this country,” she said. “They cannot now be abandoned.”

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Source: The Guardian, 24 January 2022

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Unvaccinated seniors 49 times more likely to be hospitalised than those with boosters – CDC

New data from the US Centers for Disease Control and Prevention (CDC) has revealed that unvaccinated adults infected with Covid-19 who are 65 and older are 49 times more likely to need hospitalisation compared to those who have received booster doses.

The CDC also found that in December, unvaccinated adults in that same age group experienced a rate of Covid-related hospitalisation 17 times higher than those who are fully vaccinated.

For unvaccinated adults between 50 and 64, they are 44 times more likely to require hospitalisation compared with those who are immunised.

In that same age group, unvaccinated adults were also 17 times more likely to experience Covid-related hospitalisation.

According to the CDC, adults who are 65 and older and have received both doses of either the Pfizer or Moderna vaccine showed a 94% reduced risk of Covid-related hospitalisations.

“Getting very sick means that older adults with Covid-19 might need hospitalization, intensive care, or a ventilator to help them breathe, or they might even die. The risk increases for people in their 50s and increases in 60s, 70s, and 80s. People 85 and older are the most likely to get very sick,” the CDC said on its website.

“Get vaccinated as soon as possible,” the agency added.

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Source: The Guardian, 21 January 2022

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The evidence which shows poorer and ethnic minority patients wait longer for NHS care

The significantly longer waiting times suffered by patients from minority ethnic groups and in more deprived areas for a range of elective procedures have been laid bare in NHS analysis shared with HSJ.

The problem of waiting time disparities between different patient groups has been highlighted by health leaders for several years.

But the NHS chief who oversaw this new work quantifies the issue for a local NHS trust, provides a template for others to follow, and has led to an improvement in waiting times disparities in response.

The analysis of elective waiting lists by Calderdale and Huddersfield Foundation Trust found that in October last year patients from a minority ethnic background were waiting three weeks longer on average than white patients for a “priority two” operation – which must be done within a month.

It also found patients from the most deprived communities were waiting 2.5 weeks longer than those from the least deprived areas.

However, Owen Williams, who led the trust when the analysis was carried out, said the analysis, which began early last year, contributed to these disparities being cut significantly over the course of 2021.

In May last year the trust’s patients from the most deprived areas were waiting 8.5 weeks longer on average for priority two operations than those from more affluent areas, while patients from minority ethnic groups were waiting 7.8 weeks longer than white patients.

Mr Williams said NHS trusts boards must be proactive in undertaking similar analysis to reduce health inequalities.

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Source: The Guardian, 24 January 2022

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Endometriosis care in Scotland not meeting 'base level'

Clinical care for sufferers of endometriosis is not meeting "base level", according to new research seen by BBC Scotland.

The debilitating condition affects 100,000 women in Scotland and is more common than diabetes, yet it takes eight and a half years to be diagnosed.

Almost half of those with endometriosis are in pain most days.

The study, commissioned as part of the Scottish government's Women's Health Plan, found that services were lacking.

The charity Endometriosis UK said the condition costs the UK economy £8.2bn each year in treatment, healthcare costs and loss of work.

It carried out the study and has recommended four main areas for improvement:

  • Implementing National Institute for Health and Care Excellence guidelines and quality standards on endometriosis care across Scotland - the research found that this base level of care "is not currently being met".
  • Building relationships between healthcare services through managed clinical networks to allow for smoother referrals.
  • Increasing education in primary and secondary care levels - including GPs and non-specialist gynaecologists.
  • Investment in a public health campaign and improved menstrual education in schools.

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Source: BBC News, 23 January 2022

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Infected blood scandal: ex-pupils and relatives sue Hampshire school

A group of survivors and relatives of people who died in the infected blood scandal are suing a school where they contracted hepatitis and HIV after being given experimental treatment without informed consent.

A proposed group action lodged by Collins Solicitors in the high court on Friday alleges that Treloar College, a boarding school in Hampshire that specialised in teaching haemophiliacs, failed in its duty of care to these pupils in the 1970s and 80s.

The claim could result in a payout running into millions of pounds, and is based on new testimony given by former staff at the school to the ongoing infected blood inquiry.

Gary Webster, 56, a former pupil who was infected with hepatitis C and HIV after being treated with contaminated blood at the school in the early 80s and gave evidence to the inquiry last year, is the lead claimant of the 22 survivors in the group.

Speaking to the Guardian, he said: “We were lab rats or guinea pigs. We always thought that we may have been experimented on for research purposes, but we had no proof until the evidence given in the inquiry.”

Last year in testimony to the inquiry, the former headteacher of Treloars, Alec Macpherson, confirmed that doctors at the school were “experimenting with the use of factor VIII”, an imported pooled plasma that was later discovered to be contaminated with HIV and hepatitis.

He said he and other teaching staff did not question doctors about the trials. He told the inquiry: “We didn’t have any authority or reason to interfere. You can’t – doctors are god, aren’t they?”

Macpherson said he consented to the treatment because he trusted the doctors, and he could not recall if parents were informed and consulted.

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Source: The Guardian, 23 January 2022

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Severe shortage of nurses in UK children’s intensive care units

Britain’s sickest children are being treated in intensive care units that are struggling with severe shortages of the specialist nurses needed to look after them, a report says.

The shortages in the UK’s 30 paediatric intensive care units (PICUs) are so severe that healthcare assistants are covering the work of nurses in an attempt to ensure that staffing levels are maintained.

Only one of the PICUs – at the James Cook University hospital in Middlesbrough – was found to have enough nurses to guarantee the standards of care expected. About 15,000 children and young people a year, often with life-threatening conditions, are cared for in PICUs.

Clinical standards that prevail in PICUs require them to ensure that seven nurses are on duty for each bed in a 24-hour cycle. However, the report by the Paediatric Intensive Care Audit Network (PICANet), a group of experts from Leicester and Leeds universities, found that 29 of the 30 had too few nurses to do that, and that all 30 had vacancies, sometimes large numbers of them.

“Parents will find this extremely alarming”, said Patricia Marquis, the Royal College of Nursing’s England director. “Most people wouldn’t believe that only one paediatric intensive care unit across the whole UK has enough staff to function properly, but this is the reality of the workforce crisis. Key roles in specialist nursing teams are lying vacant for years.”

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Source: The Guardian, 23 January 2022

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HeartWare gadget was a ticking time bomb for our daughter

At the age of 36, Nola Borcherds could hardly walk ten steps without gasping for breath. A viral infection years earlier had weakened her heart and left her with a constant wheezy chest.

Her heart was failing and she needed a new one. No transplant was available, but the next best thing was an implant called HeartWare. Unlike pacemakers, which send an electrical pulse to keep it beating regularly, the device would attach to Nola’s heart and keep her alive by taking over its function, continuously pumping blood around the body.

Brochures promised the gadget could be life changing. It was smaller, safer and more effective than others, and designed to last up to ten years, raising her chance of a transplant.

When Nola’s pump was implanted in December 2018 it made a tremendous difference.  “Two to three months after she had it fitted, she could virtually run up the stairs,” her mother, Jenny Kiddie said.

But on 21 May 2021, two and a half years after the device went in, it stopped working. Doctors at Harefield Hospital in Hillingdon, west London, were carrying out maintenance when it failed to turn back on, cutting the supply of blood to her brain.

“The hospital called and said, ‘Nola’s become very unwell. How quickly can you get here?’” her mother said. “By the time we arrived, she was already in the morgue.”

What her family believe Nola did not know, and what the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), failed to react to, was that HeartWare pumps had already been linked to hundreds of deaths globally. 

As early as 2011 some doctors switched to alternatives. Yet the UK regulator allowed them to stay on the market — and they continued to be implanted on the NHS until last year. Some patients are still living with the pieces of equipment, because surgery to remove them is so risky.

Families, medical experts and lawyers want to know why the MHRA failed to take firm action despite repeated warnings about the devices, which they believe could have contributed to patients dying. By Nola’s death last year, the health regulator had passed on at least 16 safety alerts to doctors warning of problems identified by the manufacturer. 

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Source: The Sunday Times, 23 January 2022

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Women report waiting longer for operations and appointments in pandemic

Women are being forced to wait longer for operations and healthcare appointments in the wake of the pandemic, according to a new report.

Research carried out by the Care Quality Commission, England’s regulator of health and social care, found 53% of women experienced longer waiting times for appointments or healthcare procedures during the Covid crisis.

The report also found 3 in 10 women experienced appointment cancellations.

More women report grappling with these issues than men – with some 44% of men saying they have experienced longer waiting times for appointments or procedures.

Helena Mckeown, a GP who previously specialised in women’s health at the British Medical Association (BMA), told The Independent she is not surprised by the findings.

"Our world is full of sexism and we know of other examples of sexism and biases in healthcare. Some of them are racial biases. To stop unconscious biases, they need to be recognised and addressed.

Ms Mckeown, one of the directors of the Menopause Expert Group, a non-profit which provides education about menopause, said female patients are treated differently to men.

She added: “We need to make sure we are not taking women saying they are in pain differently to men saying they are in pain. It is really important that we address this problem of women waiting longer for operations and appointments.”

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Source: The Independent, 22 January 2022

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