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Mass rapid tests in Liverpool cut hospital stays by a third

Mass lateral flow testing cut the number of people needing hospital treatment for Covid by 32% and relieved significant pressure on the NHS when the measures were piloted last year, a study has shown.

Liverpool conducted the first city-wide testing scheme using rapid antigen tests in November last year, amid debate about whether or not lateral flow tests (LFTs) were accurate enough to detect the virus in asymptomatic carriers.

It expanded the project to cover the whole of the Liverpool region, offering people LFTs whether or not they had symptoms. Key workers did daily tests before going to work to show they were not infectious.

Now an analysis has shown that it was more successful than Liverpool’s scientists and public health teams had anticipated, after they compared Covid cases and outcomes in the region with other parts of England.

Professor Iain Buchan, dean of the Institute of Population Health, who led the evaluation, said: “This time last year, as the Alpha variant was surging, we found that Liverpool city region’s early rollout of community rapid testing was associated with a 32% fall in Covid-19 hospital admissions after careful matching to other parts of the country in a similar position to Liverpool but without rapid testing.

“We also found that daily lateral flow testing as an alternative to quarantine for people who had been in close contact with a known infected person enabled emergency services to keep key teams such as fire crews in work, underpinning public safety.”

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Source: The Guardian, 19 December 2021

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NHS mental health services in ‘desperate’ situation

NHS mental health services are facing a “desperate” situation as all hospitals across the country are dangerously full and leaked data shows hundreds of patients waiting over 12 hours in A&E, The Independent can reveal.

The news comes as the spread of Omicron risks outbreaks in mental health hospitals, with a large hospital in London forced to close its doors to new admissions on three wards.

In response to the growing bed pressures in the capital over the past month the NHS has commissioned 40 beds from private sector hospitals run by The Priory Group, The Independent understands.

NHS data, seen by The Independent, has revealed that almost all mental health hospitals in London have been at “black alert” levels of bed availability during October and November, meaning their beds were nearly 100 per cent full.

A senior national source has warned the situation is similar across the country, with nearly all mental health trusts 94 per cent full and services at their most stressed ever.

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Source: The Independent, 23 December 2021

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West Suffolk hospital chair resigns after whistleblowing scandal

The chair of West Suffolk hospital trust has resigned over a whistleblowing scandal exposed by the Guardian, as fresh questions are asked over why the trust continues to pay at least £270,000 a year to its former chief executive.

Sheila Childerhouse was criticised by an independent NHS report for her failure to question senior executives who had hounded Dr Patricia Mills after Mills had raised concerns about a colleague seen injecting himself with drugs while on duty.

Childerhouse has announced that she will step down in January after consultants at the Bury St Edmunds hospital told her last week that her position was “untenable”.

The NHS report, by Christine Outram, found that Childerhouse failed to take up Mills’ concerns when she was sent a “confidential” email in 2018 expressing alarm that the self-injecting doctor was being allowed to continue to treat patients.

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Source: The Guardian, 23 December 2021

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NHS 24 warns of call delays over high festive demand

NHS 24 is urging people to treat common illness at home as it faces its busiest period over the festive season.

Helpline bosses have warned that it will take longer to answer calls as the service faces staffing pressures and increased demand caused by Covid.

It expects 170,000 calls over Christmas and New year - including two four-day weekends with GP surgeries closed.

The public have been advised to use the NHS Inform website to check symptoms before phoning NHS 24.

Janice Houston, NHS 24 associate director of operations and nursing, said the spread of Omicron had left the service "missing key staff" with people required to self-isolate.

"This year is exceptional and particularly busy," she said.

"We plan within an inch of our life for our busiest period, so I would just ask the public to be patient with us.

"We need to re-plan depending on who can't come to work from self-isolating. It might take a bit longer to answer the phone, but you will always get good care."

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Source: BBC News, 24 December 2021

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NHS London’s plans for virtual wards create unnecessary risk

NHS London’s plan for dealing with the omicron wave needs to take a more multidisciplinary approach and be more evidence-based if it is to not build unwarranted variation into services, write Elaine Maxwell and Alison Leary in HSJ.

A key tenet of high reliability organisations is to expect the unexpected. The start of the global COVID-19 pandemic was perhaps a little too unexpected to have good plans in place, but nearly two years on there really is no excuse and the NHS London plan for the omicron wave leaves a lot to be desired. Standing down Covid Virtual Wards across the summer with limited capacity to restart them (and no clear evaluation) was, in hindsight, a mistake - but standing up a different model without careful forethought is perhaps a bigger mistake.

We have talked for at least a decade about unwarranted variation and we seem to be building it into services now, because we don’t spend the time considering the research evidence and consulting the whole multidisciplinary team in order to set meaningful standards. In safety science terms, this is a nightmare. We should and could do better.

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Source: HSJ, 23 December 2021

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Neglect was one of biggest killers in care homes during pandemic, report finds

The pandemic has disproportionately affected people living in care homes, who accounted for an estimated 30% of all deaths from covid-19 across 25 countries despite making up only 1% of the world’s population, a report has estimated.

The analysis was carried out by Collateral Global, a research group that says it is dedicated to reporting on the effects of governments’ mandatory COVID-19 mitigation measures. The report said the pandemic had exacerbated long running problems in the care sector, such as chronic underfunding, poor structural organisation, staff undertraining, underskilling, and underequipping, and a “lack of humanity in dealing with the most vulnerable members of society.”

“Neglect, thirst, and hunger were—and possibly still are—the biggest killers,” the group said. They also said that care home residents faced barriers in access to emergency treatments during the pandemic.

The study authors suggested that undiagnosed COVID-19, poor testing, and inadequate staffing and infection control were the likely factors contributing to the excess deaths in care homes.

Martin Green, chief executive officer of Care England, said, “Adult social care and the NHS are two sides of the same coin and need to be treated as such. The government shouldn’t have placed such a myopic focus on the NHS without due consideration for social care too.”

He said that he was “phenomenally” proud of the care workforce and wanted to ensure that they were recognised as professionals with proper career pathways and commensurate funding.

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Source: The BMJ, 22 December 2021

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US Patients can order ‘don’t weigh me’ cards to take to doctors

 

Patients in the US are able to order “don’t weigh me” cards to take to the doctors in a move aimed at reducing anxiety and stress on a visit.

The US group behind the initiative said being weighed and talking about weight “causes feelings of stress and shame for many people”.

The cards say: “Please don’t weigh me unless it is (really) medically necessary.”

It adds: “If you really need my weight, please tell me why so that I can give you my informed consent”.

On the other side, it explains why the patient may not want to be weighed, including “when you focus on my weight I get stressed” and “weighing me every time I come in for an appointment and talking about my weight like it’s a problem perpetuates weight stigma”.

It also says most health conditions can be addressed without knowing the patient’s weight.

Public Health England guidance to health and care professionals says they are in a “unique position to talk to patients about weight management to prevent ill-health” and recommends brief interventions.

It says the first step in a brief intervention over a patient’s weight is to weigh and measure them. “You should view this as a normal part of a routine consultation,” it says.

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Source: The Independent, 23 December 2021

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More than a million of us are suffering with long Covid – yet still it’s not taken seriously

Nearly two years into the pandemic, people like me are still out of action. We need better support and more funding, writes Joanna Herman, consultant in infectious diseases in London.

Joanna caught Covid in March 2020, and was by definition a “mild” case: not admitted to hospital and no risk factors for severe disease, but how it has affected her and her  family is anything but mild. Having been fit and active, Joanna now finds that on bad days that she still struggle with everyday chores, and her usually quick-firing brain "remains in slo-mo ('brain fog')".

For many months, it has felt as though long Covid has not been on the political agenda, but many people are still struggling with their everyday lives, and struggling to get the help they need. Why is long Covid not included in the daily statistics, or as one of the main incentives to avoid Omicron, and to get a vaccine and booster jab? It’s never mentioned, and it often feels as if sufferers don’t exist.

Even if the new variant results in milder disease than previous ones, could more people still end up like Joanna? And how will an already stretched NHS cope if there are new cases of long Covid after this current viral surge? There’s a lot we still don’t know about Omicron; a fuller picture will become evident over the coming weeks and months...

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Source: The Guardian, 22 December 2021

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Ministers pledge to ‘reset the dial’ on women’s health in England

Ministers have pledged to “reset the dial” on women’s health to tackle decades of gender inequality in England, with plans to appoint a women’s health tsar, eradicate medical taboos, boost menopause support and ban harmful “virginity repair” operations.

The Department of Health and Social Care has published its Vision for Women’s Health strategy after 100,000 women came forward to share their healthcare concerns. Maria Caulfield, the minister for women’s health, described some of their experiences as “shocking”.

The vision document sets out initial government commitments on women’s health, recognising that “systemwide changes” are needed to tackle “decades of gender health inequality”. The final plan – the Women’s Health Strategy – will be published in spring 2022.

On Wednesday night, ministers pledged to introduce legislation criminalising hymenoplasty or any procedure to rebuild or repair the hymen. Such surgery creates scar tissue so that a woman will bleed the next time she has intercourse, making it appear she has never had sex. Young women can be forced to prove they are “pure” on their wedding night. Doctors have called for a ban on the surgery for years, saying it can never be justified on health grounds and is harmful.

Separately, the government will appoint a women’s health ambassador to raise the profile of key issues and boost awareness of taboo topics. Ministers will also establish a UK-wide menopause taskforce to investigate how women going through the menopause can be better supported. The cost of hormone replacement therapy (HRT) prescriptions will also be cut by implementing longer prescribing cycles so women will need fewer prescriptions and therefore pay less.

The consultation provided “stark and sobering insights” into women’s experiences of health and care and highlighted entrenched problems within the NHS, officials said.

Ministers are also considering compulsory training for GPs on women’s health after the idea was raised by women who came forward. The vision document said: “We also heard about a lack of awareness amongst some GPs of the causes of infertility, miscarriages and their relationship with infertility, and the reasons for in vitro fertilisation (IVF) failure.”

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Source: The Guardian, 22 December 2021

Related reading

Gender bias: A threat to women’s health (August 2020)

Dangerous exclusions: The risk to patient safety of sex and gender bias

Patient Safety Learning: Women’s Health Strategy Consultation Response

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Safety fears found at home where gran was killed

A watchdog found there were safety concerns at a south-east London care home weeks after a resident killed a woman in her bedroom, it has emerged.

Alexander Rawson, 63, beat 93-year-old Eileen Dean to death at Fieldside Care Home in Catford on 3 January. 

Inspectors visited the care home on 26 January after the murder of the grandmother-of-five triggered alarm about patient safety. Inspectors concluded that the home failed to record dangers properly and residents "were not always safe".

Mrs Dean suffered catastrophic injuries after she was attacked by Rawson with a walking stick, about two weeks after he had been moved into the home from a mental health unit.

According to the Local Democracy Reporting Service, the report said: "People were not always safe. The provider had not ensured risks to people were always documented and mitigated.

"Risk assessments and care plans contained conflicting information which could potentially lead to people being exposed to harm."

Specific concerns were also raised to the watchdog about the home's "risk management processes."

The 63-year-old was sentenced to indefinite detention in a secure psychiatric unit on Monday.

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Source: BBC News, 22 November 2021

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Immensa lab closed one month after ‘unusual’ Covid results first detected

Authorities were aware of discrepancies in Covid test results across England one month before the lab responsible was ordered to shut down its operations, legal papers show.

An estimated 43,000 incorrect false negative tests were processed for the NHS by the Immensa laboratory in Wolverhampton between 8 September and 12 October.

UK Health Security Agency became aware of an “unusual spike” in suspicious test results on 14 September, with large numbers of people testing positive on lateral flow devices but negative via PCR.

It took a month before the UKHSA determined that the “likely cause was a technical issue at the Immensa laboratory”, according to court papers filed by the government in response to a lawsuit.

The Independent also revealed in October how machines at the Wolverhampton lab were poorly maintained, concerns over quality control dismissed and untrained staff regularly “left to their own devices”.

Samples at the site were wrongly processed or cross-contaminated, leading to incorrect test results, while faulty air conditioning and fluctuating humidity levels within the lab also led to spoiled tests, whistleblowers said.

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Source: The Independent, 22 December 2021

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Suspected Covid outbreaks in UK hospitals double in a week

Suspected Covid outbreaks in hospitals across the UK have doubled in a week, official figures reveal – though the number of people admitted to wards with the virus is falling across much of England.

As parts of the NHS battle to cope with a surge in infected staff and patients, UK Health Security Agency (UKHSA) data show there were 66 acute respiratory infection incidents in UK hospitals in the seven days to 16 December.

Coronavirus was confirmed in most of these incidents, according to a UKHSA document reviewed, by the Guardian. It represents a doubling in outbreaks compared with the previous week (33) and is the highest total recorded since the third week of January 2020.

Most of the outbreaks happened in London, with 28 recorded in the last week, almost half of all those in England (62). Nine were recorded in West Midlands hospitals, six in the east of England and five in the east Midlands.

Hospitals are scrambling to try to stop the highly transmissible Omicron variant spreading between patients and staff, NHS leaders said, while trying to cope with more pressure than last year.

Saffron Cordery, deputy chief executive of NHS Providers, said: “The safety of staff and patients is a key priority of trust leaders, and trusts are doing everything they can to keep nosocomial [hospital-acquired] infections to a minimum, including following stringent infection control measures and social distancing rules.”

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Source: The Guardian, 22 December 2021

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NHS hospitals are not ‘scaremongering’ about a winter Covid wave

David Oliver, NHS consultant physician and a columnist for the BMJ makes a plea on behalf of his colleagues as they face a surge of admissions due to the spread of the omicron variant of COVID-19 this Christmas.

"Pandemic health protection measures are not all about you and your own personal risk or appetite for it, your own ‘natural immunity’ or fitness, your own liberty or freedom. They are about protecting everyone else. 

It might be your own parent, grandparent or sibling that dies from COVID-19 or from lack of access to overwhelmed services. It might be your neighbour’s or someone in another town or from another social class or ethnic group,

This isn’t a game and we need to take it seriously and stop posturing and point-scoring, before, once again, we have left it too late to act"

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Source: Byline Times, 21 December 2021

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‘Their whole sky has fallen’: more than 167,000 US children have lost a caregiver to Covid

 More than 167,000 children are believed to have lost parents or caregivers to Covid during the pandemic – roughly one in every 450 young people in the US under age 18.

The count updates the October estimate that 140,000 minors had lost caregiving adults to the virus, and is four times more than a springtime tally that found nearly 40,000 children had experienced such loss. In a report titled Hidden Pain, researchers from the COVID Collaborative and Social Policy Analytics published the new total, which they derived by combining coronavirus death numbers with household-level data from the 2019 American Community Survey.

The death toll further underscores the daunting task facing schools as they seek to help students recover not just academically, but also emotionally, from a pandemic that has already stretched 22 months and claimed more than 800,000 American lives. It’s an issue of such elevated concern that Surgeon General Vivek Murthy, on 7 December, used a rare public address to warn Americans of the pandemic’s “devastating” effects on youth mental health. An accompanying 53-page report calls out the particular difficulties experienced by young people who have lost parents or caregivers to the virus.

Bereaved children have higher rates of depression and post-traumatic stress disorder than those who have not lost parents, according to a 2018 study that followed grieving children for multiple years. They are more than twice as likely to show impairments in functioning at school and at home, even seven years later, meaning these children need both immediate and long-term counseling and support to deal with such a traumatic loss.

“For these children, their whole sky has fallen, and supporting them through this trauma must be a top priority.”

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Source: The Guardian, 22 December 2021

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We’re being asked to save the NHS again. But isn’t it supposed to save us?

“Protect the NHS” sounds like the team name for an illegal Downing Street quiz, but it won’t be winning any prizes for patient safety, writes Dr Phil Hammond in The Times.

The fact is, the NHS, as was the case long before the pandemic, is woefully understaffed. Even more billions have been thrown at the system, but, as ever, so little of it finds its way to the frontline carers we all clapped for. The NHS is always fighting a losing battle.

When the government first asked us to protect the NHS, it may as well have said: “Stay at home, die alone, protect the NHS.” Thousands of people have done just that since the pandemic started, for reasons not fully understood. They may have had Covid or non-Covid diseases, or both. They didn’t ask for, or couldn’t find, help when they were seriously ill. They followed their “stay at home” orders. Many died.

"The NHS does some amazing things but the truth is it has never had the staff nor capacity — and sometimes not the culture — to provide safe, effective and timely care to all its citizens," says Hammond. 

"We also have appalling levels of public health inequality. The rich live a decade longer than the poor, and the poor suffer 20 more years of chronic disease and NHS dependency. No health service can cope with such high demands, many of them avoidable."

Today, many people can’t even access care, never mind the quality of it. But we don’t need to dismantle the NHS, we need to staff it safely. We need to start with a proper, costed workforce plan for now and the future. If we put even more money into healthcare, we need to prove it’s being spent on frontline care that is proven to work.

Just as we didn’t plan properly for Covid, we have never had a proper workforce plan for the NHS to estimate what staff increases we need to cope with an ageing, anxious and increasingly isolated population chock full of chronic diseases. How did we get in this mess?

There is good evidence that safe staffing levels deliver better care, and that continuity of care and a long-standing relationship with your GP or nurse is hugely beneficial to your health. It’s much more rewarding for health professionals too. Alas, they don’t grow on trees and there’s a global shortage. There’s a limit to how many we can steal from countries who may need them more. No matter how much money we throw at the NHS in a pandemic panic, this tanker won’t be turned around quickly.

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Source: The Times, 18 December 2021

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Care home under investigation following claims of unsafe conditions

A care home with some of the highest Covid death rates recorded in the pandemic is facing whistleblower claims over unsafe conditions.

Golfhill Nursing Home, in Dennistoun in Glasgow's East End, Scotland, is run by Advinia Healthcare, which confirmed a "large scale" investigation was taking place.

A report by the Crown Office, published in April, showed Golfhill care home recorded 11 deaths related to coronavirus, among the highest rates.

The Care Inspectorate investigation is said to have followed "months of complaints" about sub-standard and unsafe conditions at the home, including residents being admitted to hospital suffering from dehydration.

The problems are said to centre on the intermediate care unit, where elderly residents are transferred after being discharged from hospital, requiring a higher level of care and remaining there for around a month before being sent home or into long-term care.

According to a source, the unit has been short staffed "almost on a daily basis" because employees were being transferred to other areas of the home.

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Source: The Scotsman, 17 December 2021

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The paramedics keeping patients out of hospital

Chest pains for a 63-year-old man might typically mean a hospital trip to check it out. But after Clive Pietzka's 999 call, an advanced paramedic practitioner carried out tests and discharged him.

The Welsh Ambulance Service Trust (WAST) job is one of those in a growing team who work to keep people out of hospital.

Solutions like this are being sought following ambulance queues for hospital and worst ever performance figures.

Mr Pietzka, from Barry, who has a heart problem, said initially he did not want to call an ambulance because of high demand.

"They're very busy with Covid and everything else. But the GP practice said to call 999," he said.

However, on this occasion a rapid response vehicle - a car with a single paramedic - came within 15-20 minutes and tests were performed, without a hospital trip.

Advanced paramedic practitioner John McAllister who attended said he sees people more medical low acuity cases rather than emergency and trauma conditions.

"I use assessment techniques and diagnostic tools to assess patients, formulate a diagnosis then put a plan in place," he said.

"It's about trying to treat them at the right time and the right place, without having to take them to A&E."

Adding to the pressure of the pandemic and winter demand, a shortage of social care workers to support patients' safe discharge means a large number of patients find themselves in hospital longer than medically necessary. The knock-on impact means it is becoming harder for new patients to be treated and admitted.

Penny Durrant, the service manager for the clinical support desk at WAST regional headquarters in Cwmbran, said current challenges had led to growth in her team.

She said it was a "recognition of needing to do something different".

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Source: BBC News, 21 December 2021

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Autistic man was 'loneliest man in the hospital'

A whistle-blower in the case of an autistic man who has been detained in hospital since 2001 says he feels complicit in his "neglect and abuse".

A BBC investigation found 100 people with learning disabilities have been held in specialist hospitals for 20 years or more, including Tony Hickmott. His parents are fighting to get him rehoused in the community.

A support worker at a hospital where Mr Hickmott has been detained said he was the "loneliest man in the hospital".

Mr Hickmott was sectioned under the Mental Health Act in 2001. His parents, Pam and Roy Hickmott, were told he would be treated for nine months, and then he would be able to return home.

He is now 44 - and although he was declared "fit for discharge" by psychiatrists in 2013, he is still waiting for authorities to find him a suitable home with the right level of care for his needs.

Following the report, Phil Devine, who worked in the hospital as a cleaner and a support worker, came forward to talk about conditions at the hospital. 

Mr Devine said only Mr Hickmott's basic needs were met. "Almost like an animal, he was fed, watered and cleaned. If anything happened beyond that, wonderful, but if it didn't, then it was still okay."

In 2020, the hospital was put into special measures because it did not always "meet the needs of complex patients". A report highlighted high levels of restraint and overuse of medication, a lack of qualified and competent staff and an increase of violence on many wards.

The hospital has now been taken out of special measures but still "requires improvement", according to the Care Quality Commission.

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Source: BBC News, 

 

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NHS drug pledge broken for asthma sufferers and smokers, report reveals

A promise to ensure that people with severe asthma and smokers who want to quit can get the drugs they need has been broken by ministers and the NHS, a health service report reveals.

Health charities criticised the persistent lack of access to vital medications for patients in England as very worrying and warned that it could damage the health of those affected.

In 2019 the Department of Health and Social Care (DHSC), NHS England, Association of the British Pharmaceutical Industry (ABPI) and makers of branded medicines signed an agreement, called the voluntary scheme, to increase the number of patients able to obtain cost-effective medicines on the NHS.

It covered five key areas of disease in which receipt of drugs would result in “high health gain”. These were cystic fibrosis, severe asthma, stopping smoking by using the drug varenicline, hepatitis C and atrial fibrillation and thromboembolism. 

However, a report which NHS England commissioned – but has not published – shows that while the target has been met for cystic fibrosis and hepatitis C, it has been missed for severe asthma and smokers seeking to quit using varenicline. It compares England’s progress against that in 10 other European countries, including France, Spain and Italy.

“It’s deeply concerning that England languishes near the bottom of the league table for uptake of biologic treatments for severe asthma, the deadliest form of the condition,” said Alison Cook, the director of external affairs at Asthma UK and the British Lung Foundation.

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Source: The Guardian, 20 December 2021

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Staff absence forecasts reveal ‘bleak picture’ for coming days

The number of NHS staff in London absent due to Covid has more than doubled in four days, and one in three of the workforce would be absent by new year’s eve if the growth rate continues.

The rapid increase in recent days is set out by internal NHS monitoring figures seen by HSJ.

t comes amid growing concern about the impact of the omicron variant, particularly in London, in the coming days and weeks. Sajid Javid this morning said the impact on the NHS was uncertain and it was still possible it may be overwhelmed.

Covid-related absences in the capital increased 140% from 1,926 on Sunday 12 December to 4,695 on Thursday 16 December. If the daily growth rate of around 20% continued, 1 in 10 would be off for covid-related reasons by Christmas Day, and around 1 in 3 by New Year’s Eve.

Asked about the data, NHS England pointed to guidance issued this week which asked trusts to prepare for workforce pressures, including to ”consider contingency options for significant staff absences to ensure essential services can be maintained”.

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Source: HSJ, 18 December 2021

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Government commits to public repository of consultant details “in principle”

The government has committed “in principle” to creating a public repository of consultants’ practice details that sets out their practising privileges and key performance data, including how many times they have performed a particular procedure and how recently.

The commitment was part of the response to an independent national inquiry, launched in 2017, following the malpractice of rogue surgeon Ian Paterson. Now serving a 20 year prison sentence, Paterson had undertaken numerous unnecessary breast operations in both private and NHS practice, causing harm to hundreds of patients.

The inquiry, published February 2020, found that Paterson was able to harm patients over more than decade because of the “dysfunctional” healthcare system. It outlined 17 recommendations for the government to respond to, mainly focusing on improving oversight and governance, as well as ensuring greater scrutiny of private providers.

At the time, some saw the report as a missed opportunity to tackle the systemic patient safety risks of the private hospital business model, such as financial incentives which can lead to overtreatment.

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Source: BMJ, 17 December 2021

 

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Covid: Vulnerable NHS patients to be offered new drug

A new Covid drug designed to reduce the risk of vulnerable patients needing hospital treatment will be available on the NHS from today.

Sotrovimab is a monoclonal antibody given as a transfusion to transplant recipients, cancer patients and other high-risk groups. If given quickly after symptoms develop it is should help prevent people from falling seriously ill with the disease.

Initial tests suggest it should still work against the Omicron variant.

"These new drugs have an important role to play," said Prof Steven Powis, the national medical director of NHS England.

"If you test positive and are at high risk then we will be contacting you, and, if eligible, you will be able to get access to these new treatments."

Around 1.3 million of the highest risk NHS patients are eligible to receive Sotrovimab, along with other new Covid treatments as they become available.

The drug is most effective if taken in the first five days after infection and is likely to be given in clinics or to outpatients in hospital.

It has been approved for use in vulnerable groups - such as those with cancer, diabetes or heart disease.

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Source: BBC News, 20 December 2021

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England hospital units may close as staff revolt over jab mandate, says NHS leader

Entire hospital units could be forced to shut because of staff quitting in protest at the government’s order that they must all be vaccinated against COVID-19, a senior NHS leader has warned.

Chris Hopson, the chief executive of NHS Providers, said that at one hospital trust in England, 40 midwives were refusing to get jabbed, raising fears that the maternity unit may have to close.

“Trust leaders are acutely aware that, from April onwards, when Covid vaccinations will become mandatory, decisions by staff to remain unvaccinated could – in extreme circumstances – lead to patient services being put at risk,” said Hopson.

“If sufficient numbers of unvaccinated staff in a particular service in a particular location choose not to get vaccinated, the viability and/or safety of that service could be at risk.”

Hopson did not name the trust. But he cautioned that its maternity unit is “one representative example” of potential closures on grounds of patient safety that the government’s decision to compel NHS staff in England to be vaccinated or risk losing their job could lead to.

Hopson said: “I was talking to a [trust] chief executive who said that 40 of the midwives on their midwifery service … were saying they were not prepared to be vaccinated. Those staff, given their skills and their expertise, are not easily redeployed but they’re also extremely difficult to replace."

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Source: The Guardian, 20 December 2021

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Resident died after treatment at failing care home

A resident at an inadequate care home died after their blood glucose increased to high levels and staff acted too slowly, a report found.

Inspectors said The Berkshire Care Home in Wokingham breached guidelines in nine areas and must improve. They found residents were put at risk after medicines were not used properly and that records were not up to date.

The Care Quality Commission (CQC) said an ambulance was only called for the person who died when they were found to be unresponsive. They later died in hospital.

Its report said staff were "not sufficiently skilled" to safely care for people with diabetes.

A resident was given paracetamol and co-dydramol eight times over three days, when they should not be used together because they both contain paracetamol, the report said.

Another person was burned by a cup of tea and staff did not treat the injury properly, leading to the person developing an infection and later being admitted to hospital.

Staff sometimes felt "rushed and under pressure", the report found.

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Source: BBC News, 18 December 2021

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People hospitalised with COVID-19 are likely to face a limited recovery

People who were hospitalised with COVID-19 and continued to experience symptoms at five months show limited further recovery one year after hospital discharge, a key finding of the Post-hospitalisation COVID-19 study (PHOSP-COVID) has revealed.

The NIHR/UKRI-funded study, led by the NIHR Leicester Biomedical Research Centre, also confirmed that people who were less likely to make a full recovery from COVID-19 were female, obese, and required invasive mechanical ventilation (IMV) to support their breathing during their hospital stay.

The study found that one year after hospital discharge, less than three in ten patients reported they felt fully recovered, largely unchanged from at five months. The most common ongoing symptoms were fatigue, muscle pain, physically slowing down, poor sleep and breathlessness. Participants felt their health-related quality of life remained substantially worse one year after hospital discharge, compared to pre-COVID. This suggests the physical and mental health impairments reported in the study are unlikely to be pre-existing conditions.

Professor Chris Brightling said: “The PHOSP-COVID study is further evidence of the UK’s ability to combine expertise across both disease area and geography to rapidly gather data to help us understand the longer term implications of Long-COVID in hospitalised patients with persistent symptoms. Our findings show that people who were hospitalised and went on to develop Long-COVID are not getting substantially better a year after they were discharged from hospital. Many patients in our study had not fully recovered at five months and most of these reported little positive change in their health condition at one year.

“When you consider that over half a million people in the UK have been admitted to hospital as a result of COVID-19, we are talking about a sizeable population at risk of persistent ill-health and reduced quality of life.”

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Source: National Institute for Health Research, 16 November 2021

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