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One in four NHS doctors tired to the point of impairment, survey finds

One in four doctors in the NHS are so tired that their ability to treat patients has become impaired, according to the first survey to reveal the impact of sleep deprivation on medics during the coronavirus pandemic.

Growing workloads, longer hours and widespread staff shortages are causing extreme tiredness among medics, leading to memory problems and difficulty concentrating, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, nurses, dentists and other healthcare workers.

The survey of more than 500 doctors across the UK, carried out within the past month and seen by the Guardian, uncovered almost 40 near misses as a direct result of exhaustion. In at least seven cases, patients actually sustained harm.

Despite encouraging signs the Omicron wave may be fading, doctors admitted the constant pressure of the past 22 months spent fighting coronavirus on the frontline was taking a toll on their technical skills and even their ability to make what should be straightforward medical decisions. Medics admitted for the first time sleep deprivation was causing real harm to patients in the NHS.

Almost six in 10 doctors (59%) reported their sleep patterns had worsened during the pandemic. More than a quarter (26%) of medics admitted being so tired that their ability to treat patients was “impaired”. Of these, one in six (18%) said a patient was harmed or a near miss occurred as a result.

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Source: The Guardian, 17 January 2022

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Mum tells of heartbreak at baby loss in Covid coma

A woman has spoken of her "devastation" after losing a baby delivered while she was in an induced coma with Covid.

Rachel, from Wolverhampton was admitted to hospital over the summer in the 19th week of pregnancy. She said uncertainty about whether pregnant women should have the Covid vaccine had put her off getting it.

Her condition deteriorated and she said she was so ill she did not realise at first son Jaxon was stillborn.

"I was heavily sedated a lot of the time and from what I'm told by my family, my chances weren't looking very good," the 38-year-old said. "They were trying to get the baby to survive to 28 weeks but unfortunately, at 24 weeks, my son was born stillborn."

Rachel, who said she had planned to have the vaccine after giving birth, is now urging others to get the jab, particularly women from minority backgrounds, for whom uptake is lower.

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Source: BBC News, 15 January 2022

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Increasing management spend does not improve hospital performance, research concludes

There is no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services, research has concluded.

Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19.

They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality. This was then compared to the number of managers each trust employed and the amount spent on management staff.

The researchers also attempted to measure the quality of management based on answers given to relevant questions in the annual NHS staff survey.

Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.”

They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.”

This leads the researchers to conclude: “Hospitals hiring more managers do not see an improvement in the quality of management leading to better performance, and increasing the numbers of managers does not appear to improve hospital performance through any other direct or indirect mechanism.”

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Source: HSJ, 17 January 2022

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Vulnerable woman starved to death in NHS hospital following ‘unacceptable’ failures

“Unacceptable” failures by a mental health hospital to manage the physical healthcare of a woman detained under the mental health act contributed to her starving to death, The Independent has learned.

A second inquest into the death of a 45-year-old woman, Jennifer Lewis, has found that the mental health hospital to which she was admitted “failed to manage her declining physical health” as she suffered from the effects of malnutrition.

Ms Lewis had a long-term diagnosis of schizophrenia. Her family described how she had lived a full life, completed a degree, and given lectures about living with mental illness. However, after undergoing bariatric surgery, against the wishes of her family, her mental state declined and she was admitted to the Bracton Centre, run by Oxleas, in 2014.

In an interview with The independent, her sister, Angela, described how, in the year before her death, Ms Lewis lost her hair, suffered from diarrhoea, and developed sores on her legs as she effectively “starved to death” from malnutrition.

Ms Lewis’s sister told The Independent that in the year leading up to her death, when the family warned doctors she was “starving to death”, their concerns were dismissed and they were told that the hospital “will not let it come to that”.

Mental health charity Rethink has called for improvements to physical healthcare for patients with severe mental illness, whose physical needs they say are “all too often ignored”, while experts at think tank the Centre for Mental Health have warned that patients with mental illness are dying too young as the system “still separates mental and physical health”.

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Source: The Independent, January 2022

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Dozens of deaths and stillbirths at maternity units cost hospital trust £103m in damages over decade

More than £100 million has been paid out in damages by one hospital trust over 10 years after its maternity units were accused of being responsible for dozens of deaths and stillbirths, Channel 4 News has revealed.

From April 2010 to March 2021, £103,097,198 was paid out by the Mid & South Essex NHS Foundation Trust involving 176 obstetrics claims, according to NHS Resolution figures obtained by a freedom of information request.

Of those claims made against the trust, 36 related to mothers and children dying, 27 referred to stillbirths and 55 concerned babies born with brain damage or cerebral palsy.

Gabriela Pintilie died in Basildon University Hospital, which is run by the trust, in 2019 after losing six litres of blood giving birth, and a coroner said there were “serious failings” in her care.

Basildon University Hospital’s maternity unit was twice rated inadequate in 2020, following two separate inspections, with a report saying the service “did not always have enough staff to keep women safe”.

The report also criticised “longstanding poor staff culture” which had “created an ineffective team”.

In August 2020, the Care Quality Commission (CQC) issued a warning notice to the hospital as inspectors found six serious incidents occurred between March and April that year in which babies were born in a poor condition starved of oxygen and at risk of brain damage.

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Source: Channel 4 News, 14 January 2022

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Family of Cornwall girl, 6, misled over cause of death, coroner finds

A six-year-old girl thought to have died from sepsis was in fact suffering from a blood condition triggered by E coli infection, an inquest has found.

Coco Rose Bradford was taken to the Royal Cornwall hospital in the summer of 2017 suffering from stomach problems and later transferred to the Bristol Royal hospital for children, where she died.

The following year an independent review flagged up failings in her care in Cornwall and the Royal Cornwall hospitals trust apologised for how it had treated her.

Her family were left with the belief she had died of sepsis and could have been saved if she had been given antibiotics. But on Friday, coroner Andrew Cox, sitting in Truro, found that Coco died from multiple organ failure caused by haemolytic uraemic syndrome (HUS). The inquest heard there is no proven treatment for HUS.

Cox said Coco’s family had been misled over the sepsis diagnosis, which he said was deeply regrettable, adding: “As a matter of fact, I find Coco had overwhelming HUS, not overwhelming sepsis.”

During the inquest, the court heard Coco’s family felt staff at the Cornish hospital were “dismissive, rude and arrogant” and did not take her condition seriously.

Cox found that although staff had recognised the risk of HUS from the moment Coco was admitted, this was not clearly set out in a robust management plan. The coroner also said a lack of communication had made Coco “something of a hostage to fortune”.

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Source: The Guardian, 14 January 2022

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Sleep deprived doctors concerned about patient safety

Over a third of doctors say they feel sleep deprived on at least a weekly basis and over a quarter have been in a position where tiredness has impacted their ability to treat patients, a new survey by the Medical Defence Union (MDU) has found.

The UK's leading medical defence organisation carried out the survey among its doctor members. Of 532 respondents one in four doctors (26%) said tiredness had affected their ability to safely care for patients, including almost 40 near misses and seven cases in which a patient actually sustained harm. In addition, six in ten respondents said their sleep patterns had worsened slightly or significantly during the pandemic.

Dr Matthew Lee, MDU chief executive, said:

"Doctors and their healthcare colleagues are running on empty. Our members have come through a period of immense pressure caused by the pandemic and it is affecting all aspects of their life, including sleep patterns. Previous studies have shown that fatigue can increase the risk of medical error and affect doctors' health and wellbeing. In our survey, side effects doctors reported due to sleep deprivation included poor concentration (64%), decision making difficulties (40%), mood swings, (37%) and mental health problems (30%).

"Taking regular breaks is vital in the interests of doctors and their patients yet in our survey, three in ten doctors got no breaks at all during the working day despite many working long shifts. In addition, 21% didn't have anywhere to go such as a staff room, or quiet area, to take a break.

"Pressures on frontline healthcare workers are likely to get worse for doctors in the coming weeks. At a time of considerable staff absence in the NHS it is more important than ever that those staff who are fit to work are properly supported so they can care for patients safely."

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Source: MDU, 17 January 2022

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Red levels of staffing are the norm’: NHS workers on coping with Covid

The number of Covid patients in hospitals in England and Scotland has continued to rise this week, as NHS England reached a deal with private hospitals to free up beds amid the outbreak of Omicron cases.

Meanwhile, Covid staff absences in England rose to their highest level since the introduction of the vaccine. The number of NHS workers in England off sick because of Covid was up by 41% in the week to 2 January, according to the latest figures.

Five health workers describe some of the challenges they are facing, including understaffing, waiting times and bed-blocking.

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Source: The Guardian, 14 January 2022

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No payments for unvaccinated staff, trusts told as NHS prepares for dismissals

NHS organisations have been told to prepare for redeploying or dismissing thousands of unvaccinated staff without an exit payment, and to raise the alarm about services which may be rendered unsafe.

NHS England today issued guidance on ‘phase two’ of the government’s “vaccination as a condition of deployment”, which requires all patient-facing staff to have had two covid vaccinations by 1 April. 

Tens of thousands of staff are believed to still be unvaccinated, and the cut off for having a first dose is 3 February.

The guidance said efforts should be made to adjust roles or redeploy staff, but added: “From 4 February 2022, staff who remain unvaccinated (excluding those who are exempt) should be invited to a formal meeting chaired by an appropriate manager, in which they are notified that a potential outcome of the meeting may be dismissal.”

It continued: “Whilst organisations are encouraged to explore deployment, the general principles which apply in a redundancy exercise are not applicable here, and it is important that managers are aware of this.”

Employers will “not be concerned with finding ‘suitable alternative employment’ and there will be no redundancy entitlements, including payments, whether statutory or contractual, triggered by this process”.

Trusts also do not have to “collectively consult” with staff being dismissed — as they would with a restructure — although this is “ultimately a decision for each organisation to take”.

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Source: HSJ, 14 January 2022

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NHSE tells staff: Consider legal action against patients who refuse to leave beds

NHS England has encouraged trusts to consider taking legal action against patients who refuse to leave hospital beds when step-down care is made available.

NHSE guidance sent to trusts late last year, seen by HSJ, advised clinicians that where people “with mental capacity” refuse to vacate a bed because they do not accept NHS-funded short-term care offers, the “local discharge choice policy” should be followed, which could involve legal action.

The guidance said the process “may include seeking an order for possession of the hospital bed” under civil law, and that “appropriate formal notification of the process must be given to the person and their representatives/carers”.

These legal powers were open to trusts prior to covid, but the memo from NHSE comes amid increasing pressure on trusts to improve discharge rates, as waits for emergency and elective care continue to soar.

Helen Hughes, chief executive of Patient Safety Learning, said: “Given the current pressures posed by covid, it is understandable that the NHS is seeking to ensure that the hospital discharge process is as swift and effective as possible.

“However, hospital discharges are complex processes and can potentially result in avoidable harm if patients are discharged before they are clinically ready. It only takes one element of this complex process failing to put a patient’s safety at risk.

“We would be particularly concerned if patients and their carers were put under pressure to accept potentially unsafe discharge options due to the threat of possible legal action by an NHS trust.”

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Source: HSJ, 14 January 2022

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Multiple sclerosis could be caused by the common ‘kissing disease’ virus, scientists say

The debilitating disease multiple sclerosis could be caused by the common virus behind "kissing disease", scientists claim.

A new study from Harvard University suggests the chronic disease could be from an infection of Epstein-Barr, a herpes virus that causes infectious mononucleosis.

Mono or glandular fever, as it’s otherwise known, is colloquially known as "the kissing disease" for being highly contagious through saliva.

While causing fatigue, fever, rash, and swollen glands, researchers propose that the Epstein-Barr virus could also establish a latent, lifelong infection that may be a leading cause of multiple sclerosis.

Affecting 2.8 million people, there is no known cure for the chronic inflammatory disease of the central nervous system.

“The hypothesis that EBV causes MS has been investigated by our group and others for several years, but this is the first study providing compelling evidence of causality,” the study’s senior author Alberto Ascherio, a professor of epidemiology and nutrition at Harvard Chan School, said in a press release.

“This is a big step because it suggests that most MS cases could be prevented by stopping EBV infection, and that targeting EBV could lead to the discovery of a cure for MS.”

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Source: The Independent, 13 January 2022

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NHSE orders health check blitz to stop mortality gap growing

NHS England is urging health systems to ramp up physical health checks for people with severe mental illnesses to address a widening life expectancy gap caused by covid, according to a letter seen by HSJ.

In a letter circulated to integrated care system leads, chairs, mental health and community trust executives on Wednesday, national commissioners warn the impact of the pandemic may widen current gaps in life expectancy for people with SMI and learning disabilities even further, without “decisive and proactive action”.

The letter, circulated by national mental health director Claire Murdoch, learning disability and autism director Tom Cahill and inequalities director Bola Owolabi, quotes NHS data suggesting people with SMI are five-and-a-half times more likely to die prematurely and those with learning disabilities three times more likely to die from an avoidable cause of death.

It says: ”The health inequalities faced by people living with SMI and people with a learning disability are stark… The impacts of the pandemic will widen this gap further unless we take decisive and proactive action to address inequalities… These checks are a key lever to address the reduced life expectancy for both groups.”

It calls on primary care teams, already delivering thousands of covid vaccinations as part of the booster programme, to prioritise annual physical health checks alongside the rollout, “even as we continue with a level 4 national incident” caused by the omicron variant.

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Source: HSJ, 14 January 2022

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Record 6m people waiting for routine hospital treatment in England

Just under 6 million people in England are now waiting for hospital treatment – a record high – as latest performance figures show how the NHS was struggling even before the Omicron Covid variant emerged.

A total of 5,995,156 patients were on the waiting list for an operation in November, of whom more than 2 million had already waited longer than the maximum standard of 18 weeks for routine treatment.

Figures published by the NHS underlined its growing inability to provide timely care. They also showed that more than 300,000 people have been waiting more than a year for surgery and that performance against the crucial four-hour A&E target is the worst ever.

The figures led to warnings from the Health Foundation thinktank that the NHS was “being stretched to its limits” and from the Liberal Democrat health spokesperson Daisy Cooper that “patients are being catastrophically let down by this government’s woeful neglect of the NHS”.

“With the NHS now in the thick of one of the most uniquely challenging periods in its history, unacceptably long waits for hospital care are becoming increasingly commonplace,” said Siva Anandaciva, the chief analyst at the King’s Fund.

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Source: The Guardian, 13 January 2022

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Covid in pregnancy linked to birth-related complications

A new study has linked COVID-19 to complications during pregnancy.

Scottish researchers found that women who catch the virus near the end of pregnancy were more vulnerable to birth-related complications. They are more likely to suffer them than women who catch Covid in early pregnancy or not at all.

The researchers say getting vaccinated is crucial to protect pregnant women and their babies from life-threatening complications.

The latest findings come from the Covid in Pregnancy Study (Cops), which carried out research across Scotland to learn about the incidence and outcomes of Covid-19 infection and vaccination in pregnancy. It is one of the first national studies of pregnancy and Covid.

They found that preterm births, stillbirths and newborn deaths were more common among women who had the virus 28 days, or less, before their delivery date. The majority of complications occurred in unvaccinated women.

The results, which have been published in Nature Medicine, come after recent data showed 98% of pregnant women admitted to UK intensive care units with coronavirus symptoms were unvaccinated.

Researchers are now calling for measures to increase vaccine uptake in pregnant women.

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Source: BBC News, 13 January 2022

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Maternity service safety threatened by staff vacancies and mandatory vaccination, warns trust

A trust has warned it could be forced to restrict maternity services due to a high midwife vacancy rate, and large numbers unvaccinated among the current staff.

The government has mandated that all patient-facing NHS staff must have had two covid vaccination doses from 1 April — meaning they will need to have received their first dose by 3 February. If not, they can be redeployed to non patient-facing roles, or face dismissal.

Barking, Havering and Redbridge University Hospitals Trust’s board heard on Tuesday that the current numbers pose a “significant operational problem” amid efforts to encourage more staff to get both covid jabs before the government’s deadline.

The board meeting was told that, of the trust’s 7,550 staff, approximately 1,300 workers – or 17.4% – do not have a vaccination recorded against them, with the areas of greatest concern being women’s and children’s health, geriatric services, the emergency departments and some clinical support services.

At the board meeting, BHRUHT chief executive Matthew Trainer said: “The vacancy rate, plus the unvaccinated rate, would put us in quite a serious position.

“At the minute, for example, the Queen’s Birth Centre [at Queen’s Hospital in Romford, east London], I don’t think, has been open since I got here. I couldn’t see any circumstances in which it would reopen if we lost another chunk of midwives, for the foreseeable future certainly, in terms of vaccination.

“I think it would leave us in a position where we’d have to look at constraining services and focusing in on core [services], establishment being focused on the labour ward, looking at complex births and making sure we’re doing everything we possibly can to manage it as safely as possible.”

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Source: HSJ, 12 January 2022

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Trust launches investigation after staff member’s death

East of England Ambulance Service Trust has launched an ‘independent investigation into the circumstances’ surrounding the death of a staff member, its chief executive told a board meeting today.

Nick Lee, 46, from Ovington in west Norfolk, died on 3 December. The cause of death is yet to be officially established. He was a leading operations manager for west Norfolk, and hospital ambulance liaison officer at Queen Elizabeth Hospital King’s Lynn Foundation Trust and had worked for the ambulance trust for nearly 20 years.

This is not the first time the trust, which has faced significant cultural problems in recent years, has been required to investigate the circumstances surrounding the deaths of members of their workforce.

The trust launched an investigation into the “underlying factors associated with” the sudden deaths of three of its employees in November 2019, HSJ exclusively revealed in January 2020.

A whistleblower alleged in 2019 that staff at the ambulance provider were at risk of suicide because of its “completely toxic culture”. A month after the allegations were reported in October, three young staff members died suddenly in 11 days.

The deaths happened while the trust was transitioning to a new staff welfare provider. The staff who died were ambulance dispatcher Luke Wright, aged 24, and paramedics Christopher Gill, from Welwyn Garden City, and Richard Grimes, from Luton.

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Source: HSJ, 13 January 2022

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Paramedics jailed for stealing medication from dying patients

Two paramedics have been sentenced to five years in prison for stealing medication from terminally ill patients.

Ruth Lambert, 33, and Jessica Silvester, 29, of the South East Coast Ambulance Service (Secamb), preyed specifically on people receiving end-of-life care packages, Kent Police said in a statement.

The pair, who live together at Gap Road in Margate, accessed addresses of patients in the east Kent area through their work and posed as nurses to gain access to patients’ homes to steal morphine and other painkillers.

They worked in tandem, one researching the addresses and sending details to the other who would visit and steal the medication, police said, with victims being targeted in Thanet, Canterbury, Whitstable, Faversham and Herne Bay.

Evidence gathered from the pair’s mobile phones showed they had also conspired to steal from Secamb by taking medication from ambulances when on duty.

Detective sergeant Jay Robinson, from Kent Police, described the offences as “an astonishing abuse of position”.

“Many of their victims have since passed away and will never know that justice has been done,” he said. “Our investigation was carried out, knowing we had to represent those victims and do the very best for them.”

Dr Fionna Moore, medical director for Secamb, added that Lambert and Silvester’s behaviour was a “clear and targeted abuse of their position and does not reflect the commitment and integrity of our staff”.

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Source: The Independent, 12 January 2022

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USA: COVID-hospitalisation numbers are as bad as they look

Many supposedly “incidental” infections aren’t really incidental, and cannot be dismissed, writes Ed Yong.

More Americans are now hospitalised with COVID-19 than at any previous point in the pandemic. The current count—147,062—has doubled since Christmas, and is set to rise even more steeply, all while Omicron takes record numbers of healthcare workers off the front lines with breakthrough infections. For hospitals, the math of this surge is simple: Fewer staff and more patients mean worse care. Around the United States, people with all kinds of medical emergencies are now waiting hours, if not days, for help.

Some reporters and pundits have claimed that this picture is overly pessimistic because the hospitalisation numbers include people who are simply hospitalised with COVID, rather than for COVID—“incidental” patients who just happen to test positive while being treated for something else. In some places, the proportion of such cases seems high. UC San Francisco recently said a third of its COVID patients “are admitted for other reasons,” while the Jackson Health System in Florida put that proportion at half. In New York State, COVID “was not included as one of the reasons for admission” for 43% of the hospitalised people who have tested positive.

But the “with COVID” hospitalisation numbers are more complicated than they first seem. Many people on that side of the ledger are still in the hospital because of the coronavirus, which has both caused and exacerbated chronic conditions. And more important, these nuances don’t alter the real, urgent, and enormous crisis unfolding in American hospitals. Whether patients are admitted with or for COVID, they’re still being admitted in record volumes that hospitals are struggling to care for. “The truth is, we’re still in the emergency phase of the pandemic, and everyone who is downplaying that should probably take a tour of a hospital before they do,” says Jeremy Faust, an emergency physician at Brigham and Women’s Hospital, in Massachusetts.

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Source: The Atlantic, 12 January 2022

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Staffing at UK care homes 30% less than needed, survey finds

Care homes are missing a third of the staff they need and more than one in four have closed their doors to new admissions in a deepening labour crisis that is “putting safety and dignity at risk”.

With thousands of care workers off sick with Covid on top of a rising number of vacancies, the situation in social care has become “grim, difficult and relentless”, according to the National Care Forum (NCF), which ran a survey of its not-for-profit care-home members.

Omicron absences are running at 14% on top of an 18% vacancy rate – a sharp increase on estimates before the pandemic – as beleaguered care workers quit jobs, often for better paying roles in retail or warehouses. The picture is even worse for domiciliary care, with two-thirds of providers forced to decline families’ new requests for help because they are short of carers.

The executive director of the NCF, Vic Rayner, said the worsening situation showed the government’s approach to tackling the problem of staff shortages by giving social care “crumbs from the table” was negligent.

We “have been highlighting the growing shortages in the workforce and the knock-on impact on those who remain working in the sector and those who use care and support services for many months”, she said. “How many times does this message need to be repeated for it to be heard?”

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Source: The Guardian, 13 January 2022

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Ill health in ‘left behind’ areas costs England £30bn a year, says report

Endemic ill-health in England’s “left behind” neighbourhoods costs the country almost £30bn a year because people are often too ill to work and die earlier, a report claims.

The cost of lost productivity results directly from those very deprived areas having much worse health than the rest of the country, according to parliamentarians and academics.

Experts from the Northern Health Science Alliance (NHSA) have calculated that the economy would grow by that amount if health in those areas was improved to such an extent that local people began to enjoy the same health as those in better-off places.

The report, by the NHSA and all-party parliamentary group for left behind neighbourhoods (LBNs), highlights the scale of the challenge Boris Johnson faces in meeting his pledge to level up England’s poorest and richest areas.

“The health of people living in left behind neighbourhoods is considerably worse than the health of people living in the rest of the country,” said Dr Luke Munford, the report’s lead author and a lecturer in health economics at the University of Manchester. “This is true across all measures of health.”

The report shows rates of obesity, lung conditions, high blood pressure, mental health problems and other diseases are much higher than the national average in the 225 LBNs. This means people there have less “healthy life expectancy” and also shorter lives and thus are less productive over their lifespan than those elsewhere.

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Source: The Guardian, 13 January 2022

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Nurse who saw woman, 22, self-harm and told colleague, 'leave her, she'll faint before she dies'

A nurse who was struck off for refusing to admit a woman to a mental health unit before she killed herself said 'leave her, she will faint before she dies' before he kicked her out of the facility.

Paddy McKee allegedly made the comment as Sally Mays, 22 - who had mental health issues - tried to strangle herself when she was refused admission.

Ms Mays killed herself at home in Hull in July 2014 after being refused a place at Miranda House in Hull by McKee and another nurse.

Despite her being a suicide risk, they would not give her a place at the hospital after a 14-minute assessment.

Her parents Angela and Andy have fought for several years for improvements to be made and lessons to be learnt from her death.

McKee was this month struck off following a Fitness to Practice hearing conducted by the Nursing and Midwifery Council. The report by the NMC was this week published and condemned McKee, saying 'he treated her in a way that lacked basic kindness and compassion'.

The NMC found his actions to refuse Ms Mays' admission had contributed to her death.

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Source: Mail Online, 12 January 2022

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Liver-branding transplant surgeon struck off medical register

A surgeon who burned his initials on to the livers of two patients during transplant surgery has been struck off the medical register.

Simon Bramhall, 57, admitted using an argon beam – used to stop livers bleeding during operations and to highlight an area to be worked on – to sign “SB” into his patients’ organs in 2013 while working at Birmingham’s Queen Elizabeth hospital.

On Tuesday, a review by the Medical Practitioners Tribunal Service (MPTS) concluded Bramhall’s actions were “borne out of a degree of professional arrogance” and that they “undermined” public trust in the medical profession.

Bramhall, of Tarrington, Herefordshire, was first suspended from his post as a consultant surgeon in 2013 after another surgeon spotted the initials during follow-up surgery on one of his patients. A photograph of the 4cm-high branding was taken on a mobile phone.

During his sentencing hearing in 2018, Bramhall was told one of the victims suffered serious psychological harm as a result of the branding. The surgeon later told police he branded the organs to relieve operating theatre tensions following difficult and long transplant operations.

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Source: The Guardian, 11 January 2022

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Stepping Hill Hospital praised for A&E improvements

A hospital rated inadequate by inspectors two years ago has been praised for making improvements.

The Care Quality Commission (CQC) has welcomed changes in urgent and emergency care at Stepping Hill Hospital in Stockport, Greater Manchester.

The trust said the report was a "testament" to its staff's hard work.

The CQC's unannounced inspection in November was carried out to check improvements had been made since a previous visit in August 2020.

Among the concerns highlighted previously were patients left at high risk of harm during periods of heavy demand, staff shortages and staff who were "not competent for their roles".

The new report said inspectors found urgent and emergency care had improved from inadequate to good overall and for being safe and well-led.

"It has gone from requires improvement to good for being effective and caring. Responsive has gone from inadequate to requires improvement," the report said.

Karen Knapton, CQC's head of hospital inspections, said: "We acknowledge the efforts of the emergency care team at Stepping Hill Hospital. We found staff provided good care and treated people with compassion and kindness."

"They gave patients, their families and carers help, emotional support and advice when they needed it. Also, the service has been tailored to meet individual needs, including those living with dementia or a learning disability. "

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Source: BBC News, 12 January 2022

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‘Low priority’ community cases to be deferred as staff redeployed

NHS England has told local systems to defer ‘low priority’ cases across 11 community services, because of the pressures created by the omicron wave. 

NHSE has issued guidance for the prioritisation of the community health workforce “given the increasing pressures on the health system due to the omicron wave of COVID-19 this winter and the need to provide booster jabs as quickly as possible”.

It is hoped the guidance will encourage the redeployment of community staff to help reduce the strain on acute services.

Staff working in musculoskeletal services are being asked to deprioritise some low priority rehabilitation work, with patients enabled to self-manage at home.

It adds: “Where possible, provide capacity to support other community resources focused on rehabilitation and recovery for those discharged from acute care and those whose functioning is deteriorating at home, and/or the administration of vaccines.”

A host of other services have been advised to continue, but with “prioritised” waiting lists and a deferral of provision considered for “low priority cases” to “free up workforce capacity”, including children’s therapy interventions, children’s community paediatric services and audiology services for older adults.

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Source: HSJ, 11 January 2022

 

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Rise in non-Covid virus that can leave children struggling to breathe

Parents are being warned to look out for signs of a non-Covid virus that is “rife” in the UK amid a surge in reports of children struggling to breathe.

The British Lung Foundation (BLF) said Respiratory Syncytial Virus (RSV) is staging a comeback this winter after lockdown last year meant there were fewer infections than would normally occur.

It is concerned that this year children will have “much lower immunity” at a time when the NHS is already under extreme pressure.

“In the last few weeks, we have noticed a surge in calls from parents who are worried about their child’s breathing,” said Caroline Fredericks, a respiratory nurse who supports the BLF’s helpline. “Most of these parents have never heard of RSV which is worrying.”

RSV is common in babies and children. Almost all will have had it by the time they are two. It may cause a cough or cold but for some it can lead to bronchiolitis, an inflammatory infection of the lower airways which can make it hard to breathe.

The early symptoms of bronchiolitis are similar to those of a common cold but can develop over a few days into a high temperature, a dry and persistent cough, difficulty feeding, and wheezing. While many cases clear up in two to three weeks, some children will end up being hospitalised.

“There are steps parents can take to make their child more comfortable at home if their RSV develops into bronchiolitis, such as keeping their fluid intake up, helping them to breathe more easily by holding them upright when feeding and giving them paracetamol or ibuprofen suitable for infants,” said Fredericks.

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Source: The Guardian, 12 January 2022

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