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NHS failed to act on brain surgeon who harmed patients

NHS Tayside has been criticised over its handling of disgraced brain surgeon Sam Eljamel in a new report.

The internal due diligence review criticised health board management for putting the doctor under indirect supervision in June 2013 rather than suspending him.

The surgeon harmed dozens of patients but was allowed to continue operating until he was suspended in late 2013.

Some of his patients were left with life-changing injuries.

He was employed as a surgeon by NHS Tayside for 18 years and later became the head of the neurosurgery department in Ninewells Hospital in Dundee.

NHS Tayside has apologised to former patients of Prof Eljamel and committed to assisting in the Scottish government's independent commission for patient concerns.

The health board claimed it became aware of concerns around the surgeon in June 2013, but an NHS whistleblower told the BBC the health board knew as early as 2009 that there were serious concerns.

He is now working as a surgeon in Libya.

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Source: BBC News, 1 September 2023

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Hospital waiting list deaths double in five years

More than 120,000 died waiting for NHS treatment, as backlog hits all-time high. 

The number of NHS patients dying while waiting for treatment has doubled in five years, new figures suggest.

More than 120,000 people died while on waiting lists last year, according to an analysis of health service data. The total is even higher than it was in lockdown, with health leaders saying the pandemic and NHS strikes have made clearing backlogs more difficult.

Matthew Taylor, the chief executive of the NHS Confederation, said: “These figures are a stark reminder about the potential repercussions of long waits for care. They are heartbreaking for the families who will have lost loved ones and deeply dismaying for NHS leaders, who continue to do all they can in extremely difficult circumstances."

“Covid will have had an impact on these figures – but we can’t get away from the fact that a decade of under-investment in the NHS has left it with not enough staff, beds and vital equipment, as well as a crumbling estate in urgent need of repair and investment.”

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Source: The Telegraph, 31 August 2023

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Brain fog after Covid linked to blood clots - study

Blood clots in the brain or the lungs might explain some common symptoms of "Long Covid", including brain fog and fatigue, a UK study suggests.

In the study, of 1,837 people admitted to hospital because of Covid, researchers say two blood proteins point to clots being one cause.

It is thought 16% of such patients have trouble thinking, concentrating or remembering for at least six months.

But the research team, from the universities of Oxford and Leicester, stress:

  • Their findings are relevant only to patients admitted to hospital.
  • They are "the first piece of the jigsaw" but further research is needed before they can propose or test any potential treatments.
  • They tracked cognitive problems at six and 12 months only and through tests and questionnaires, which may "lack sensitivity".

Identifying predictors and possible mechanisms was "a key step" in understanding post-Covid brain fog, study author Prof Paul Harrison, from the University of Oxford, said.

Leicester's professor of respiratory medicine, Chris Brightling, said: "It's a combination of someone's health before, the acute event itself and what happens afterwards that lead on to physical and mental health consequences."

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Source: BBC News, 31 August 2023

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Junior doctors and consultants to strike together

Junior doctors and consultants in England are to coincide strikes during the autumn in an escalation of the pay dispute with the government.

It will be the first time in this dispute they have walked together and comes after junior doctors voted in favour of continuing with strikes.

In the British Medical Association ballot 98% voted in favour, giving the union a fresh six-month mandate.

Junior doctors have already staged five walkouts this year.

They will strike on 20 to 22 September - the first day of which coincides with a walkout by consultants.

They will then walkout on 2 to 4 October, which is when consultants will also be striking.

When the two groups strike together cover will be provided to staff emergency services as well as a small amount of cover on the wards.

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Source: BBC News, 31 August 2023

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Chair who was ‘not always honest’ in old job gets NHSE’s ‘full support’

An integrated care board chair is keeping her job despite complaints being upheld against her in a previous role, it has emerged.

Danielle Oum left her position as Birmingham and Solihull Mental Health Foundation Trust chair last October.

It later emerged that an independent investigation carried out the month before her departure, the results of which were leaked to HSJ, had upheld several complaints against her and found she did not always act with “honesty, truthfulness and clarity”.

She was appointed to the ICB position in October 2021, four months before the complaints were made against her by an individual at the trust.

But NHS England now says it has reviewed the matter and concluded that it “continue[s] to offer Danielle our full support in her role as chair of Coventry and Warwickshire ICB”.

Following the independent investigation, which upheld 16 complaints against Ms Oum in total, NHSE carried out its own review of the issues.

NHSE said its review involved a “rigorous fact-finding process” and it was grateful to those who raised “freedom to speak up” concerns.

It said in a statement: “A thorough review has taken place at regional and national level, and the committee responsible for adjudicating these issues has delivered what we believe is a fair decision."

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Source: HSJ, 31 August 2023

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‘National tragedy’: figures show large rise in people dying while on NHS waiting list

More than 120,000 people in England died last year while on the NHS waiting list for hospital treatment, figures obtained by Labour appear to show.

That would be a record high number of such deaths, and is double the 60,000 patients who died in 2017/18.

For example, the Royal Free hospital in London said it had had 3,615 such deaths, while there were 2,888 at the Morecambe Bay trust in Cumbria and 2,039 at Leeds teaching hospitals trust.

Hospital bosses said the deaths highlighted the dangers of patients having to endure long waits for care and reflected a “decade of underinvestment” that had left the NHS with too few staff and beds.

Healthwatch England, a patient advocacy group that scrutinises NHS performance, said the number of people dying while waiting for care was “a national tragedy”.

Louise Ansari, the chief executive, said: “We know that delays to care have significant impacts on people’s lives, putting many in danger.”

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Source: The Guardian, 31 August 2023

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NHS urges breast cancer patients from minority backgrounds to participate in trials

An NHS body is encouraging women with breast cancer from minority backgrounds to take part in more clinical trials, after research found they are under-represented in studies that can offer life-saving treatment.

The pilot project, supported by the NHS Race and Health Observatory, is intended to improve representation in breast cancer clinical trials partly through culturally sensitive communications to people from racially diverse backgrounds.

Research from the UK Health Security Agency suggests young black women are more likely to have aggressive breast cancer tumours, experience poorer care and have higher mortality rates, but are significantly under-represented in clinical research.

Their lack of inclusion in trials could be partly down to distrust of the research process and a lack of knowledge, according to research by the UK’s National Institute for Health Research.

The project, which works in conjunction with Macmillan Cancer Support and the pharmaceutical company Roche, will run for a year and look at developing new ways for people with breast cancer to access clinical trials. It will develop action plans to improve representation and provide enhanced support for patients.

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Source: The Guardian, 31 August 2023

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Lucy Letby: Inquiry given powers to compel witnesses to give evidence

The inquiry into how nurse Lucy Letby was able to murder seven babies will now have greater powers to compel witnesses to give evidence.

In a significant move, ministers upgraded the independent inquiry after criticism from families of the victims that it did not go far enough.

The inquiry, ordered after Letby was found guilty this month, was not initially given full statutory powers.

Health Secretary Steve Barclay said he had listened to the families.

He said he had decided a statutory inquiry led by a judge was the best way forward and "respects the wishes" of the families.

Mr Barclay said the key advantage was the power of compulsion.

"My priority is to ensure the families get the answers they deserve and people are held to account where they need to be," he added.

He said an announcement about who would chair the inquiry would be made in the coming days - ministers have already said it will be a judge.

Richard Scorer, a lawyer who is representing two of the families, welcomed the government's announcement.

"It is essential that the chair has the powers to compel witnesses to give evidence under oath, and to force disclosure of documents. Without these powers, the inquiry would have been ineffectual and our clients would have been deprived of the answers they need and deserve," he said.

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Source: BBC News, 30 August 2023

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CEO to take joint leadership of neighbouring trust

The leadership of a specialist trust in Liverpool is set to be taken over by the chief executive of the city’s main acute provider.

A message to staff seen by HSJ said James Sumner, who leads Liverpool University Hospitals Foundation Trust, will also become interim CEO of Liverpool Women’s FT at the end of the year when Kathryn Thomson steps down.  Ms Thomson announced her retirement in May.

There have been long-standing ambitions to move Liverpool Women’s standalone hospital to the new Royal Liverpool Hospital site in the city centre, run by LUHFT, with a possible merger of the organisations.

The relocation remains the ambition, although the trusts are focusing on service integration in the short term.

The message to staff, sent this afternoon by chair Robert Clarke, said: “We have been clear for some time about our preferred future direction of travel for the trust, namely a closer collaboration with the large acute provider of services in the city as we believe this will support the long term clinical and financial sustainability of services for the benefit of women, babies and others who access our services.

“Liverpool Women’s has secured agreement with NHS Cheshire & Merseyside on our ambition to move to a shared CEO model…This is a positive step in providing ongoing stability for Liverpool Women’s.”

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Source: HSJ, 30 August 2023

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A public defibrillator may be a mile away in deprived areas

In the most deprived areas of England and Scotland, the nearest 24/7 accessible defibrillator is on average a round trip of 1.8 km away—over a mile—according to a pioneering study supported by the British Heart Foundation (BHF).

The researchers, led by Dr Chris Wilkinson, senior lecturer in cardiology at Hull York Medical School, used data from national defibrillator network The Circuit to calculate the median road distance to a defibrillator with unrestricted public access across Great Britain's 1.7 million postcodes.

Among the 78,425 defibrillator locations included, the median distance from the centre of a postcode to a 24/7 public access defibrillator was 726.1 metres – 0.45 miles. In England and Scotland, the more deprived an area was, the farther its average distance from a 24/7-accessible defibrillator – on average 99 metres more in England, and 317 metres farther in Scotland for people living in the most compared with the least deprived areas. There was no link between defibrillator location and deprivation in Wales.

The researchers said they hoped the findings, presented at the European Society of Cardiology (ESC) Congress in Amsterdam and published in the journal Heart, would lead to more equal access to defibrillators. They noted that there were over 30,000 out-of-hospital cardiac arrests (OHCA) annually in the UK; in England nearly 30% happened at weekends, and 40% between 6pm and 6am. 

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Read research study: Automated external defibrillator location and socioeconomic deprivation in Great Britain (28 August 2023)

Source: Medscape, 29 August 2023

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NHS 'to employ half of public sector by 2026'

The NHS workforce plan will cost £50 billion and result in the health service employing half the public sector by the 2030s, analysis concludes today.

Jeremy Hunt, the chancellor, has in effect “stolen more than a decade’s worth of budgets” from his successors by setting out plans to hire almost a million extra NHS staff without a clear way to pay for them, the Institute for Fiscal Studies (IFS) says.

Hunt has been urged to use his autumn statement to start setting out whether tax rises, borrowing or cuts elsewhere will be used to fund the “massive spending commitment”.

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Source: The Times, 30 August 2023

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Targeted screening of diabetic patients ‘could double heart condition diagnoses’

Targeted screening of patients with type 2 diabetes could more than double new diagnoses of heart conditions, a study suggests.

When applied at a larger scale, such an approach could translate into tens of thousands of new diagnoses, researchers believe.

Conditions such as coronary artery disease, atrial fibrillation and heart failure affect millions of people worldwide, causing a large number of deaths and increasing healthcare costs.

Treatments are available that can prevent stroke or acute heart failure, but systematic screening is not currently common practice.

Those living with conditions such as type 2 diabetes or chronic obstructive pulmonary disease (COPD) – a group of lung conditions that cause breathing difficulties – are at high risk of such conditions.

A team of researchers led by Dr Amy Groenewegen, from the University Medical Centre Utrecht in the Netherlands, has developed a three-step screening process to detect conditions in high-risk people at an early stage.

Study author Dr Groenewegen said: “An easy-to-implement strategy more than doubled the number of new diagnoses of heart failure, atrial fibrillation and coronary artery disease in high-risk patients.”

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Source: Independent, 29 August 2023

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Flu jab IT system to be ‘switched off’ weeks before vaccine programme starts

All tech support for flu and covid vaccinations will be switched off on Thursday after NHS England decided against extending its contract with its supplier in favour of developing an in-house system, according to HSJ.

NHSE last week told suppliers System C and Graphnet it would not extend the contract for the National Immunisation Management Service – just one week before the contract ends.

NIMS, provided by the two British firms in partnership with NHS South Central and West Commissioning Support Unit, has been used for the last three years to manage the vaccination programme.

Its functionalities include a single data store holding vaccination records for more than 60 million people, a call and recall service that can identify and contact groups of eligible individuals according to age and clinical priority, and reporting and analysing of vaccination activity in “near real time”.

NHSE informed System C it would not extend the contract last Thursday – five working days before it was due to expire, according to a message from System C to customers, seen by HSJ.

In its message, System C said: “This means that all functionality, including the NIMS application programming interface links to third party booking systems, all outgoing feeds and extracts, NIMS dashboards and the point of vaccination data capture application will stop working after 31 August.”

There is currently “significant usage” of the system by GPs and trusts, which means NIMS users “may need to take action to deal with the retirement of the system” – the message stated.

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Source: HSJ, 30 August 2023

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Close to 1m NHS appointments lost to strikes

The number of appointments and treatments postponed by strike action in the NHS in England is nearing one million.

The 48-hour walkout by consultants in England last week saw more than 45,000 appointments being cancelled.

It brings the total number of postponed hospital appointments since industrial action began in the NHS in December to 885,000.

Once mental health and community bookings are included, it tops 944,000.

The true total is likely to be even higher, as services have stopped scheduling appointments on strike days and these will not be included in the figures released by NHS England.

Alongside consultants, junior doctors, nurses, physios, ambulance workers and radiographers have also walked out at various stages.

NHS national medical director Professor Sir Stephen Powis said: "Industrial action continues to have a huge impact on the NHS, and on the lives of patients and their families. This strike took place into a bank holiday weekend, when NHS activity is generally lighter, but many services have for some time avoided scheduling any planned appointments for strike days in order to prioritise emergencies. This means the true impact of this action will be even higher, and as we move into September, the extraordinary cumulative effect of more than nine months of disruption poses a huge challenge for the health service, as staff work tirelessly to tackle the backlog."

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Source: BBC News, 29 August 2023

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Nurses caring ‘for too many patients’ as vacancy rates rise again

Around one in ten NHS nursing jobs remain unfilled leaving already stretched service struggling to cope.

The number of unfilled NHS nursing jobs in England has risen again after falling slightly earlier this year.

Between March and June of this year, the number of vacant nursing positions across the NHS in England increased by 3,243 taking the total to a staggering 43,339.

With the number of applications to study nursing also falling by a massive 13,380 in just two years, experts admit they are concerned about how the NHS is going to cope.

In real terms, the figures mean around one in ten NHS nursing jobs remain unfilled.

The Royal College of Nursing (RCN) has warned the high vacancy rate will leave the health service “underprepared” for winter.

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Source: Nursing Notes, 25 August 2023

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University Hospitals Birmingham: Whistleblowers fear no change at 'toxic' NHS trust

Whistleblowers who first revealed a toxic environment at one of England's largest NHS trusts say they do not believe crucial changes will be made.

In a letter, they said families who suffered due to management failings at University Hospitals Birmingham (UHB) "have every reason to feel let down".

Investigations have been examining UHB after staff told the BBC a climate of fear put patients at risk.

The letter was written by three doctors to the Labour MP For Birmingham Edgbaston, Preet Gill, who is heading a cross-party reference group on the trust.

In their letter, the consultants raise concerns about the appointment from within the trust of new chief executive Jonathan Brotherton and feel the management team remains largely unchanged.

"More than six months have elapsed since we spoke to you of the need to repay the debt owed to those UHB staff, patients and their families who have suffered as a result of the board's serious failings," they wrote.

"They now have every reason to feel let down."

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Source: BBC News, 29 August 2023

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USA: Why are so many kids losing Medicaid coverage?

At the end of the COVID pandemic, more than half (54%) of US children were covered by Medicaid or CHIP; the vast majority by Medicaid. So, the lifting of the pandemic-related Medicaid continuous enrolment protection this spring is a really big deal, putting low-income children at risk of losing access to health care and/or exposing their families to medical debt.

In fact, researchers at federal Office of the Assistant Secretary for Planning and Evaluation (ASPE) projected that just shy of three-quarters of children losing Medicaid would be disenrolled despite remaining eligible. Children are most at risk of losing coverage during the unwinding despite being eligible and the likelihood that the child uninsured rate will go up if states do not take care in the process.

Over half a million children have lost Medicaid already in 21 states where there is data. And that large number doesn’t include Texas, a state that disenrolled more than 500,000 people on June 1st, and where state agency employees recently blew the whistle on systems errors that caused inappropriate terminations.

The Biden Administration must take swift and definitive action to pause all terminations in states with systemic problems. Governors who see large numbers of children losing coverage must pause the process. Coverage must be reinstated for those who lose coverage inappropriately. The time for action to protect children is now.

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Source: McCourt School of Public Policy at Georgetown University, 23 August 2023

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‘Cost of living crisis’ contributing to stillbirths, research finds

The cost of living squeeze is a significant factor in some stillbirths, according to case reviews carried out in one of England’s most deprived areas.

The review was undertaken in Bradford last year, and concluded: ”the current financial crisis is impacting on the ability of some women to attend essential antenatal appointments”. Missing these appointments was a factor in a range of maternity safety events, including stillbirths, it said. 

The researchers are now calling for new national funding to help ensure expectant parents do not miss important appointments because they cannot afford to attend.

The research findings include:

  • ‘Did not attend’ rates increased due to lack of funds for transport to antenatal appointments;
  • “Lack of credit on phones prevented communication between women and maternity services, for example, making [them] unable to rearrange scans or appointments”;
  • Wide spread incidence of “digital poverty, [for example] a lady with type 1 [diabetes] was unable to monitor her glycaemic control over night due to only having one phone charger in the house”; and
  • “Families with babies on a neonatal unit going without food in order to finance transport to and from the unit.”

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Source: HSJ, 25 August 2023

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Global COVID-19 data gap grows as countries stop reporting to WHO

Fewer than 20 countries worldwide still report COVID-19 hospitalisation and ICU data to the World Health Organization (WHO), leaving the UN health body blind to the impact and evolution of the virus in most of the world, agency leaders have said.

The decline in data reporting is a major setback for the WHO’s efforts to track the pandemic. Without reliable data, the WHO cannot accurately assess the burden of disease, identify new variants, or target its resources where they are most needed.

“We don’t have good visibility of the impact of COVID-19 around the world,” said Dr. Maria Van Kerkhove, who leads the WHO’s COVID-19 task force. “It is really important that surveillance continues, and this is on the shoulders of governments right now.”

“While we are certainly not in the same situation that we were in a year ago or two years ago, SARS-Cov-2 circulates in all countries right now,” said Van Kerkhove. “It is still causing a large number of infections, hospitalisations, admissions to the ICU and deaths.”

The current set of dominant COVID-19 variants can still cause the “full spectrum” of disease, from asymptomatic infections to severe disease and death, Kerkhove said.

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Source: Health Policy Watch, 25 August 2023

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Norfolk and Suffolk NHS trust deaths report 'watered down to spare bosses'

A critical report into how a mental health trust mismanaged its mortality figures was edited to remove criticism of its leadership, the BBC has found.

In June, auditors Grant Thornton revealed how the Norfolk and Suffolk NHS Foundation Trust (NSFT) had lost track of patient deaths.

But earlier drafts included language around governance failures that were missing in the final version.

NSFT and Grant Thornton said the changes were due to fact-checking.

A number of drafts of the report were produced, with the first dated 23 February this year.

The first version described "poor governance" in the way deaths data was managed, with governance also being called "weak" and "inadequate".

But many of these critical words were missing from the report released to the public, with "governance" also being replaced with "controls", according to leaked documents.

After losing her son Tim in 2014, Caroline Aldridge has been highlighting what she and others claimed had been the trust's undercounting of deaths.

"I think people need to know what was removed and what was changed, because I suspect that the first report is a lot nearer to the truth," she said.

Ms Aldridge added: "It takes all responsibility from governance, removing the words 'inadequate', 'poor', 'weak' governance, removing significant pieces of information that's not factual accuracy.

"We cannot have people watering it [the report] down when it's about deaths."

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Source: BBC News, 29 August 2023

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NHSE calls urgent meeting over powers to strike off managers

Amanda Pritchard has said it is time to ‘look again’ at whether NHS England should be given formal powers to disbar managers for ‘serious misconduct’.

In an email to regional leaders and some national bodies yesterday, seen by HSJ, the chief executive officer of NHS England said the murder trial of neonatal nurse Lucy Letby has brought the issue of professional regulation for managers back into focus. She has planned an urgent meeting next week to discuss the options.

Ms Pritchard said she wanted the meeting to explore; the feasibility of NHSE being given the powers and resources to act as a regulator; who this could apply to and how it could operate; and how a dedicated regulatory body for NHS leaders might fulfil the role.

She stressed any new powers would need to be determined by the government, but said the NHS “should contribute proactively and fully, and with an open mind, to this decision-making process”.

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Source: HSJ, 25 August 2023

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Chilling warning that scandals across NHS will be covered up as staff say whistleblowers are ignored

More than half of NHS staff believe bosses would ignore whistleblowers amid fresh concerns hospitals could be covering up potential scandals following the Lucy Letby case.

New national figures seen by the The Independent reveal that in the majority of hospitals, most doctors and nurses do not believe their concerns would be acted upon if they were raised with senior managers.

It comes after The Independent revealed that NHS bosses accused of ignoring complaints about Letby were the very same people later appointed to act on whistleblower concerns at the hospital where she murdered seven babies and tried to kill six more.

Several doctors who worked alongside her during the killing spree say they attempted to raise the alarm with hospital managers – only to have their pleas ignored. They believe the lack of action by bosses resulted in more babies being killed, stating managers who failed to act were “grossly negligent” and “facilitated a mass murderer”.

In nearly three-quarters of general hospitals – such as the Countess of Chester where Letby worked – fewer than half of staff believed their trust would act on a concern, according to results from the latest NHS staff survey.

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Source: The Independent, 27 August 2023

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‘Insecure’ junior medics ‘crying every day’ in ‘chaotic’ department

Delays in patient care and a lack of consultant support have left junior medics fearing for their mental health, an NHS England investigation has discovered.

Junior doctors described haematology services delivered from University Hospitals Birmingham’s Heartlands Hospital as “chaotic”.

Their concerns are raised in a report by NHS England Workforce, Training and Education (formerly Health Education England). UHB’s haematology service has been under scrutiny since 2021, when HSJ revealed whistleblower concerns over patient safety, including a series of blood transfusion’ never’ events.

The WTE team visited UHB in April. As a result, the haematology service is now subject to the General Medical Council’s enhanced monitoring regime. This means intensive support is given to trainees and the trust to improve medical training. UHB’s obstetrics and gynaecology department is also under enhanced monitoring.

The WTE report warns that consultants working across multiple sites left trainee medics at Heartlands without sufficient support and supervision. Most conversations with consultants were via telephone, leaving juniors feeling “unsupported and insecure”. 

The report stated: “Trainees described the workload … as chaotic and some reported the stress … was affecting their mental health… Some reported they do not feel valued, and the panel heard examples of people crying every day. Most described their roles as 100 per cent service provision… [they] reported very limited learning opportunities overall.”

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Source: HSJ, 24 August 2023

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Early death risk grows with just three ‘slightly unhealthy mid-life traits’

Just three “slightly unhealthy traits” in mid-life increase the risk of early death by a third, research suggests.

The study found people carrying extra weight in their 40s and 50s who also had slightly raised blood pressure, cholesterol or blood sugar levels were also 35 per cent more likely to have a heart attack or stroke over the next three decades.

Researchers warned that middle-aged people with this “cluster of slightly unhealthy traits” – known as metabolic syndrome – typically had a heart attack or stroke two years earlier on average than healthier people the same age.

Dr Lena Lönnberg, of Västmanland County Hospital, Sweden, who was lead researcher for the study, said: “Many people in their 40s and 50s have a bit of fat around the middle and marginally elevated blood pressure, cholesterol or glucose but feel generally well, are unaware of the risks and do not seek medical advice. “In fact, most people live with slightly raised levels for many years before having symptoms that lead them to seek healthcare.”

She warned that because the individual “unhealthy traits” did not usually make people feel unwell, most people were unaware of the risks combined with excess weight.

An estimated one in four UK adults has metabolic syndrome, with rising obesity levels one of the main drivers.

On their own, diabetes, high blood pressure, and obesity can damage the blood vessels. 

But even if patients only have mild versions of each condition, experts warn having the three together can be particularly dangerous.

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Source: The Telegraph, 25 August 2023

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Sepsis: Perforated bowel Barry mum told to drink tea

A mum suffered a perforated bowel and sepsis after being told she was anxious and should take constipation medication and drink peppermint tea.

Farrah Moseley-Brown was in "agonising pain" after having her second son, Clay, but the hospital sent her home.

Because of the delay in treating her, Ms Moseley-Brown, 28, of Barry, Vale of Glamorgan, now has a stoma.

Cardiff and Vale health board admitted failures in her care and gave its "sincere apologies".

Since the error, Ms Moseley-Brown has turned to TikTok to inform people about the dangers of sepsis and has had 15 million views one one video alone.

She was booked into University Hospital Wales, Cardiff, for a Caesarean on 7 May 2020. After Clay was born, Ms Moseley-Brown lost about two-and-a-half pints of blood and needed further surgery to stem the bleeding.

"I felt really unwell and I said this to the nurses and the staff at the hospital which they didn't listen to. They kept saying it was after-pain but it was just agonising," Ms Moseley-Brown said.

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Source: BBC News, 25 August 2023

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