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Organ harvesting: Trafficked for his kidney and now forced into hiding

Daniel was about to get the fright of his life.

He was sitting in a consulting room at the Royal Free hospital in London, speaking to doctors with his limited English.

The 21-year-old street trader from Lagos, Nigeria, had come to the UK days earlier for what he had been told was a "life-changing opportunity". He thought he was going to get a better job.

But now doctors were talking to him about the risks of the operation and the need for lifelong medical care.

It was at that moment, Daniel told investigators, that he realised there was no job opportunity and he had been brought to the UK to give a kidney to a stranger.

"He was going to literally be cut up like a piece of meat, take what they wanted out of him and then stitch him back up," according to Cristina Huddleston, from the anti modern slavery group Justice and Care.

Luckily for Daniel, the doctors had become suspicious that he didn't know what was going on and feared he was being coerced. So they halted the process.

 The BBC's File on 4 has learned that his ground-breaking case alerted UK authorities to other instances of organ trafficking. 

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Source: BBC News, 4 July 2023

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US maternal deaths doubled in last 20 years, study finds

Maternal mortality rates have doubled in the US over the last two decades - with deaths highest among black mothers, a new study suggests.

American Indian and Alaska Native women saw the greatest increase, the study in Journal of the American Medical Association (JAMA) said.

Southern states had the highest maternal death rates across all race and ethnicity groups, the study found.

In 1999, there were an estimated 12.7 deaths per 100,000 live births and in 2019 that figure rose to 32.2 deaths per 100,000 live births in 2019, according to the research, which did not study data from the pandemic years.

Unlike other studies, this one examined disparities within states instead of measuring rates at the national level, and it monitored five racial and ethnic groups.

Dr Allison Bryant, one of the study's authors, said the findings were a call to action "to understand that some of it is about health care and access to health care, but a lot of it is about structural racism".

She said some current policies and procedures "may keep people from being healthy".

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Source: BBC News, 4 July 2023

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Long Covid causing 'debilitating impact' on doctors

A "significant" number of doctors are still suffering with the "debilitating effects" of Long Covid, according to a new report.

Many are left in financial limbo as they have been forced to quit work or reduce their hours, the British Medical Association (BMA) report warns.

Some 600 doctors with long COVID were quizzed about the impact on their day-to-day lives.

One in five told the BMA and the Long COVID Doctors for Action group they had been forced to stop work or significantly cut back on their hours.

Carrying out essential daily activities such as getting dressed, household activities, and childcare have become difficult or not possible for 60% of the medics who took part in the survey.

Nearly half (49%) said they have experienced loss of earnings as a result of Long Covid symptoms of which include: fatigue, headaches, muscular pain, nerve damage, joint pain, ongoing respiratory problems.

The BMA has made a series of calls to support doctors with Long Covid, including:

  • Financial support for doctors and other health workers with Long Covid.
  • Long Covid to be recognised as an "occupational disease".
  • Better access to physical and mental health services for those affected after the report said that access to NHS long COVID clinics is "patchy".
  • Greater "workplace protection" for staff.
  • More support to help healthcare workers return to work "safely".

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Source: Medscape, 3 July 2023

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PTSD affects 300,000 young people in England and Wales, Channel 4 finds

Thousands of young people are living with post-traumatic stress disorder, with most cases going untreated, a Channel 4 documentary has revealed.

About 311,000 16- to 24-year-olds in England and Wales have PTSD, with most cases linked to personal assault and violence, according to figures estimated for the show.

Low awareness of the symptoms and the difficulty of diagnosing PTSD means that 70% of cases go untreated. If the NHS offered more early intervention therapy, it could save £2.4bn in taxpayer money, according to Channel 4’s analysis of research by King’s College London and Office for National Statistics data.

“When untreated, PTSD – it becomes a chronic condition. It becomes highly disabling. People’s lives can be fundamentally changed,” said Dr Michael Duffy, a psychological trauma specialist at Queen’s University Belfast, who features on the show. He added that it could be more common in areas of high socioeconomic deprivation.

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Source: The Guardian, 4 July 2023

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Most doctors think ministers want to destroy NHS, BMA boss says

Most frontline medics believe ministers are seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff, the leader of Britain’s doctors has said.

Prof Philip Banfield also warned that the health service, which on Wednesday will mark the 75th anniversary of its creation, is so fragile that it may not survive until its 80th.

Banfield, the British Medical Association’s chair of council, mounted an unusually strong attack on the government’s handling of the NHS in an interview with the Guardian.

“This government has to demonstrate that it is not setting out to destroy the NHS, which it is failing to do at this point in time,” he said. “It is a very common comment that I hear, from both doctors and patients, that this government is consciously running the NHS down. [And] if you run it down far enough, it’s going to lead to destruction.

“You’ll struggle to find someone [among doctors] on the frontline who thinks otherwise, because that’s what it feels like.”

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Source: The Guardian, 4 July 2023

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Ministers refuse to set target for ending maternal deaths disparity

The government has rejected calls to set a target and strategy to end ‘appalling’ disparities in maternal deaths.

In response to a Commons women and equalities committee report, published on Friday, ministers said a “concrete target does not necessarily focus resource and attention through the best mechanisms”.

The response added: “We do not believe a target and strategy is the best approach towards progress.”

The government said disparities will be monitored through local maternity and neonatal systems, which are partnerships comprising commissioners, providers and local authorities.

A recommendation to increase the annual budget for maternity services to up to £350m per year, backed by the now chancellor Jeremy Hunt, and maternity investigator Donna Ockenden, was also rejected.

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Source: HSJ, 3 July 2023

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Smartwatches may provide early Parkinson's diagnosis

Smartwatches might help diagnose Parkinson's disease up to seven years ahead of symptoms, a study suggests.

The UK Dementia Research Institute team at Cardiff University used artificial intelligence to analyse data from 103,712 smartwatch wearers.

By tracking their speed of movement over a single week, between 2013 and 2016, they were able to predict which would go on to develop Parkinson's.

It is hoped this could ultimately be used as a screening tool.

But more studies, comparing these findings with other data gathered around the world, are needed to check how accurate it will be, the researchers say, in the journal Nature Medicine.

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Source: BBC News, 3 July 2023

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Sight-saving drug to be offered to premature babies, announces NHS

Premature babies across England will be offered a sight-saving drug, the NHS has announced.

Retinopathy of prematurity (ROP) is an eye disease that can occur among babies who are born early or those born with a low birth weight.

The NHS routinely screens these babies for the condition, which affects blood vessels in the retina, creating damaging scar tissue and causing blindness.

Traditionally the condition is treated with laser eye surgery but some babies are too unwell or fragile to have the treatment.

Now the NHS is offering new “life-changing” drug ranibizumab to babies with ROP across England who are unable to receive traditional treatment.

NHS chief executive Amanda Pritchard said: “The impacts of vision loss can be absolutely devastating, particularly for children and young people, so it’s fantastic that this treatment will now give families across the country another life-changing option to help save their child’s precious sight."

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Source: The Independent, 4 July 2023

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Men on epilepsy drug may have higher risk of children with disabilities

 

Men who take the epilepsy drug sodium valproate could beat increased risk of having children with disabilities, research has found.

A study ordered by the European Medicines Agency (EMA) has suggested a link between fathers taking the drug three months before babies are conceived and a small increased likelihood that the children will have neurodevelopmental disorders.

The drug manufacturer Sanofi has not published the full results, leading to confusion among patients and doctors.

Sodium valproate, sold in the UK as Epilim, is prescribed to treat epilepsy, bipolar disorder and migraines. It is known to cause deformities in one in ten babies exposed to it in the womb because their mothers are taking the drug. Four in ten babies suffer developmental delays.

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Source: The Times, 2 July 2023

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ICB failure creating ‘absolute nightmare’ for vulnerable patients needing covid treatment

Many vulnerable patients are struggling to access covid treatments after commissioning responsibility switched to integrated care boards this week, charities have warned.

Approximately two million vulnerable patients must now contact local services themselves to access treatments designed to combat covid infections, such as the antivirals Paxlovid and Sotrovimab. Integrated care boards are expected to coordinate and fund “equitable” access.

Prior to 27 June, identification of patients and the delivery of treatment was coordinated nationally under pandemic arrangements.

However, a group of 20 patient charities have written to Steve Barclay warning that most ICBs have not drawn up plans to deliver this new responsibility, leaving patients and primary care clinicians unclear on how to access the treatments.

“Despite continually raising our concerns with those carrying out the planning, implementation, and communication of this [policy], we now find that we are in exactly the position we warned against,” they said. 

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Source: HSJ, 3 July 2023

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‘A future worth fighting for’: five health experts on the state of the NHS at 75

 

As the NHS turns 75, it is under unprecedented pressure: record waiting lists, demand for care and delays in discharging patients who are well enough to go home are putting all parts of the health service under immense strain. 

Sickness absence is at record levels, while nearly 170,000 NHS workers in England quit their jobs last year. Recent strikes by nurses, ambulance staff and junior doctors, coupled with the historic decision by consultants and radiographers to strike, too, show the depth of anger.

Five experts spell out what’s needed to make the health service thrive again.

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Source: The Guardian, 3 July 2023

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National mental health review must address ‘lack of compassion’ towards patients, watchdog says

The government’s national review of mental health hospitals must urgently address the “lack of sympathy and compassion” towards patients if safety is to improve, the health ombudsman has said.

Rob Berhens said the investigation, prompted by The Independent’s reporting on deaths and abuse of vulnerable patients, must look at three key issues, including a lack of empathy for those with mental health challenges, a lack of resources and poor working conditions for staff.

Health Secretary Steve Barclay announced last week that a new safety body, the Health Services Safety Investigations Body (HSIB), would look into the care of young people, examine staffing levels and scrutinise the quality of care within mental health units.

Mr Berhens said: “I trust [HSIB] to be able to understand what are the key issues, they’re about the lack of sympathy and compassion for people who have mental health challenges, which to me is a human rights issue."

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Source: The Independent, 1 July 2023

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NHS health chiefs demand an ‘urgent’ plan to tackle the social care crisis

Healthcare leaders have called for an urgent plan to tackle the social care crisis, warning Rishi Sunak there is “clear concern” over an ongoing failure to tackle staff shortages.

The warning from Matthew Taylor, chief executive of NHS Confederation which represents hospitals and community services, comes after the publication of the long-awaited £2.4bn NHS workforce plan, which committed to 300,000 extra nurses and doctors in the coming years.

Mr Taylor said any benefits to improve NHS staffing will be “limited” without an equivalent strategy for the social care sector, which currently has 165,000 vacant posts.

Health bosses, represented by NHS Confederation, have now written to the prime minister asking for “urgent intervention” and calling for a clear plan for improving pay and conditions to attract staff.

Martin Green, chief executive for Care England that represents care homes, warned that the sector “is in the midst of a workforce crisis, which is going to get worse not getting better”.

He welcomed the NHS Confederation’s letter and said unless similar improvements were made within social care, there would be more “cancelled operations, more people languishing in hospital when they don’t need to and the whole breakdown of the system”.

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Source: The Independent, 2 July 2023

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Huge leap in breast cancer survival rate

The number of people who die after a breast cancer diagnosis has decreased by two-thirds since the 1990s, a study of more than half a million women in England has shown.

The research has taken ten years to complete, says Carolyn Taylor, lead author of the study and an oncologist at the University of Oxford, UK. The analysis includes the 512,447 women in England who were diagnosed with early invasive breast cancer between January 1993 and December 2015.

The results published in the BMJ found women who were diagnosed in 1993–99 had a 14.4% risk of dying within 5 years. This fell to 4.9% for women diagnosed in 2010–15.

Patient involvement was important to the study, Taylor says. The scientists appointed two patient representatives to guide their research. “They helped us in the questions to be addressed. They looked at the analyses and gave comments and suggestions throughout the study. And they helped us to interpret the results in the way that patients can understand.”

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Source: Nature, 23 June 2023

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‘Misogyny’ and ‘medical patriarchy’ widespread at major trust, reports find

A major teaching trust is dominated by a “medical patriarchy”, while “misogynistic behaviour” is a regular occurrence, two investigations have discovered. 

Two reports into University Hospitals Birmingham Foundation Trust  have been published. They are the outcome of an investigation into the trust’s leadership carried out by NHS England, and an oversight review by former NHSE deputy medical director Mike Bewick.

They follow major concerns being raised over recent months about safety, culture, and leadership at the trust.

The NHSE review said the trust “could do more to balance the medical patriarchy that dominates” the organisation. It noted consultants are invited to observe a chief executive’s advisory group meeting, but nursing, midwifery and allied health professional leaders are not.”

On culture, NHSE said the trust should take steps to ensure staff can work in psychologically safe environments where “poor behaviours are consistently addressed” and to “eradicate bullying and cronyism at all levels of the organisation”. Staff had described “inequity and cronyism” being a feature of recruitment processes at all levels.

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Covid pandemic linked to surge in child and teen diabetes

There has been an unusual rise in the number of children and teenagers around the world diagnosed with type 1 diabetes since Covid, say researchers.

A new study in JAMA Network Open journal has collated available data from different countries, including the UK, on more than 38,000 young people diagnosed during the pandemic.

The authors describe the increase in cases of diabetes as "substantial".

More work is needed to understand why the rise is happening, they say.

Some of the rise could be attributed to catch-up - from backlogs and delays when health services were shut - but does not explain all of the newly diagnosed cases, say scientists.

Before the pandemic, the incidence rate of childhood type 1 diabetes was already increasing - by about 3% a year.

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NHS England boss: Patients paying the price for strikes

The head of NHS England has warned that July's planned strikes in the health service could be the worst yet for patients.

Amanda Pritchard said industrial action across the NHS had already caused "significant" disruption - and that patients were paying the price.

This month's consultant strike will bring a "different level of challenge" than previous strikes, she said.

Junior doctors and consultants will strike for a combined seven days.

Ms Pritchard told the BBC's Sunday with Laura Kuenssberg programme that the work of consultants - who are striking for the first time in a decade - cannot be covered "in the same way" as junior doctors.

"The hard truth is that it is patients that are paying the price for the fact that all sides have not yet managed to reach a resolution," she said.

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Source: BBC News, 2 July 2023

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NHS whistleblowers need to be better protected by the law, says BMA

NHS whistleblowers need stronger legal protection to prevent hospitals using unfair disciplinary procedures to force out doctors who flag problems, the British Medical Association has said.

Doctors are being “actively vilified” for speaking out, which has resulted in threats to patient safety, including unnecessary deaths, according to the council chair of the doctors’ union, Phil Banfield.

Despite a series of scandals in recent years, it is becoming more common for hospitals to use legal tactics and “phoney investigations” to undermine or force out whistleblowers rather than address their concerns, he warned.

Banfield said: “Someone who raises concerns is automatically labelled a troublemaker. We have an NHS that operates in a culture of fear and blame. That has to stop because we should be welcoming concerns, we should be investigating when things are not right.

“Whistleblowers are pilloried because some NHS organisations believe the reputational hit is more dangerous than unsafe care,” he added. “Whereas the safety culture in aviation took off after some high-profile airplane crashes in the 70s, the difference is that the aviation industry embraced the need to put things right and understand the systems that led to the disaster – the NHS has not invested in solving the system, it’s been bogged down in blaming the individual instead of the mistake.”

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Source: The Guardian, 2 July 2023

 

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Record 170,000 staff leave NHS in England as stress and workload take toll

Nearly 170,000 workers left their jobs in the NHS in England last year, in a record exodus of staff struggling to cope with some of the worst pressures ever seen in the country’s health system, the Observer can reveal.

More than 41,000 nurses were among those who left their jobs in NHS hospitals and community health services, with the highest leaving rate for at least a decade. The number of staff leaving overall rose by more than a quarter in 2022, compared to 2019.

The figures in NHS workforce statistics of those leaving active service since 2010 analysed by the Observer show the scale of the challenge facing prime minister Rishi Sunak. He launched a new workforce plan on Friday to train and keep more staff.

Sir Julian Hartley, chief executive of NHS Providers, said: “Staff did brilliant work during the pandemic, but there has been no respite. The data on people leaving is worrying and we need to see it reversed.

“We need to focus on staff wellbeing and continued professional development, showing the employers really do care about their frontline teams.”

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Source: The Guardian, 1 July 2023

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Colorado surgeon guilty of manslaughter in teen patient's death after breast augmentation

A Colorado surgeon has been convicted of manslaughter in the death of a teenage patient who went into a coma during breast augmentation surgery and died a year later.

Emmalyn Nguyen, who was 18 when she underwent the procedure 1 August 2019, at Colorado Aesthetic and Plastic Surgery in Greenfield Village, near Denver, fell into a coma and went into cardiac arrest after she received anaesthesia, officials said.

She died at a nursing home in October 2020.

Dr. Geoffrey Kim, 54, a plastic surgeon, was found guilty of attempted reckless manslaughter and obstruction of telephone service.

At Kim’s trial, a nurse anesthetist testified that he advised Kim that the patient needed immediate medical attention in a hospital setting and that 911 should be called, prosecutors said.

An investigation determined Kim failed to call for help for five hours after the patient went into cardiac arrest, prosecutors said. The obstruction charge was linked to testimony that multiple medical professionals, including two nurses, requested permission to call 911 to transfer care for Nguyen, but Kim, the owner of the surgery centre, denied the request, prosecutors said.

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Source: ABC News, 15 June 2023

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Government aims to boost NHS with thousands more doctors and nurses

Thousands more doctors and nurses will be trained in England every year as part of a government push to plug the huge workforce gaps that plague almost all NHS services.

The number of places in medical schools will rise from 7,500 to 10,000 by 2028 and could reach 15,000 by 2031 as a result of the NHS’s first long-term workforce plan.

There will also be a big expansion in training places for those who want to become nurses, with the number rising by a third to 40,000 by 2028 – matching the number of nurses the health service currently lacks.

Amanda Pritchard, the chief executive of NHS England, hailed the long-awaited plan as “a once in a generation opportunity to put staffing on a sustainable footing for years to come”.

Medical groups, health experts and organisations representing NHS staff welcomed the plan as ambitious but overdue. Richard Murray, chief executive of the King’s Fund thinktank, said it could be a “landmark moment” for the health service by providing it with the staff it needs to provide proper care.

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Source: The Guardian, 29 June 2023

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Government launches consultation on minimum standards for GP autism training

The Government is consulting on a draft code of practice which will ensure health and care staff, including GPs, receive training on learning disabilities and autism ‘appropriate to their role’.

Since July last year, all CQC-registered health and social care providers including GP practices in England have been required to provide training for their staff in learning disability and autism, including how to interact with autistic people and people who have a learning disability.

The legal requirement was introduced by the Health and Care Act 2022, but the Government has now launched a consultation on the Oliver McGowan Code of Practice, which outlines how providers can meet the new requirement.

The BMA’s GP Committee last month said that the Act does not specify a training package or course for staff and that the CQC ‘cannot tell practices specifically how to meet their legal requirements in relation to training’.

The Government’s draft code says that CQC-registered providers must ensure that all staff, regardless of role or level of seniority, have ‘the right attitude and skills to support people with a learning disability and autistic people’ and will need to demonstrate to the CQC how their training meets or exceeds the standards set out in the code.

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Source: Pulse, 29 June 2023

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Trust leadership rated ‘inadequate’ as CQC accuses staff of ‘ignoring’ problems

An acute trust’s leadership has been downgraded to ‘inadequate’ after some staff ignored concerns raised directly by CQC inspectors, while others said bullying was ‘rife’.

The Care Quality Commission (CQC) found multiple reports of staff raising concerns at York and Scarborough Foundation Trust, but that staff felt they were “ignored”, dismissed or “swept under the carpet”.

The trust’s leadership has been rated as “inadequate”, down from “requires improvement”, although its overall rating remains “requires improvement”.

The CQC said “poor leadership was having an impact across all of the services” and there were occasions “where leaders displayed defensiveness or appeared to tolerate poor behaviours from staff.”

The trust said it had been under “sustained pressure” but had already begun to make improvements, including a new information system in maternity services and a review of nursing establishment numbers.

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Source: HSJ, 30 June 2023

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No new barriers to EU staff working in the NHS until at least 2028, government announces

Healthcare staff from the European Union can join or continue to work in the NHS for the next five years without undergoing additional exams or further assessments, the government has decided.

The “standstill provisions”, which were put in place after the UK left the European Union in 2020, have been extended by government until 2028.

The NHS has become increasingly reliant on recruiting staff from overseas, particularly nurses, but has seen a significant drop in the number of staff joining from the European Union post-Brexit.

The review by the Department of Health and Social Care said: “Retaining the standstill provisions for a temporary period of five years will support the [DHSC’s] ambition to attract and recruit overseas healthcare professionals, without introducing complex and burdensome registration routes.

“[European Economic Area]-qualified healthcare professionals will be able to continue to register with the relevant professional regulator, without the need to sit additional professional exams, mitigating delays to registration and employment in the NHS.”

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Source: HSJ, 29 June 2023

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Malta to allow abortion but only when woman’s life is at risk

Maltese lawmakers have unanimously approved legislation to ease the strictest abortion laws in the EU, voting to allow terminations – but only in cases where a woman’s life is at risk.

Ahead of the vote on Wednesday, pro-choice campaigners withdrew their support, saying last-minute changes make the legislation “vague, unworkable and even dangerous”.

The original bill allowing access to abortion if a pregnant woman’s life or health is in danger was hailed as a step in the right direction for Malta, a majority-Catholic country. It was introduced last November after an American tourist who miscarried had to be airlifted off the Mediterranean island nation to be treated.

Under the amendments, however, a risk to health is not enough. A woman must be at risk of death to access an abortion, and then only after three specialists consent. The new legislation allows a doctor to terminate a pregnancy without specialist consultation only if the mother’s life is at immediate risk.

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Source: The Guardian, 28 June 2023

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