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Theatre staff 'deliberately slow down' operations, review finds

Theatre staff at a major hospital “deliberately slowed down” elective activity to limit the number of operations that could be done each day, an NHS England review has been told.

The culture in theatres at the William Harvey Hospital in Ashford, run by East Kent Hospitals University Foundation Trust, was a “significant issue” according to an education quality intervention review report into trauma and orthopaedic training at the hospital.

The review, dated October and made public by NHSE in December 2023, was launched after concerns were raised by staff at the trust in the General Medical Council’s national training survey, published every July.

Problems raised by junior doctors and their supervisors to the NHSE review included perceptions that juniors were made to feel uncomfortable by the trauma theatre team and that there was also “animosity” from the trauma theatre team towards surgeons.

The review said trauma theatre staff were heard “bragging” about their behaviour towards surgeons and that they resisted the number of cases scheduled on a list, claiming it was “unrealistic".

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Source: HSJ, 19 January 2024

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Stark UK divide in health and wealth with sickness ‘clearly linked to poverty’

People living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent, a new report has revealed.

People in Liverpool are almost three times more likely to be in poor health than those in Oxfordshire, and twice as likely to be economically inactive, research by the cross-party IPPR Commission on Health and Prosperity found.

The researchers found a “stark divide” in health and wealth throughout the UK was leaving many “bad health blackspots”, with people more likely to be out of work.

Overall, people living in the most deprived parts of the country are more than twice as likely to be in poor health as those living in the most affluent – and are around 40% more likely to report economic inactivity.

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Source: The Independent, 18 January 2024

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Patients’ hearts stopping in ambulance queues for A&E

Patients have suffered cardiac arrests while waiting in A&E departments or in ambulances queueing outside because Scottish hospitals are overwhelmed, doctors have warned.

At least three cases in which patients’ hearts stopped beating while they were waiting for care have been reported to the Royal College of Emergency Medicine in Scotland. Some of the incidents, the college said, may have been preventable.

One frontline doctor told The Times that a patient with heart problems had died waiting in a queue of ambulances outside an emergency department. Staff could not take the patient inside because there was no capacity.

JP Loughrey, vice-president of the college and an A&E consultant in the west of Scotland, said that people who should be in resuscitation rooms with a team of experts and equipment to monitor their vital signs were instead lying in ambulances outside hospital buildings. He also said that tensions were growing between frontline staff and NHS managers in large hospitals because doctors and nurses, who were already struggling to cope, were under increasing demands to work harder to process more patients.

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Source: The Times, 19 January 2024

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Women feel ‘violated and traumatised’ by painful hysteroscopies – and say the NHS misinformed them

Caroline remembers screaming. It was like an electric shock which went from her neck to her toes. It was like being tasered in her most intimate area. She could not move because she was scared. She called out to the doctor to stop.

“I can’t believe what happened to me was done in an NHS hospital,” Caroline, 56, says. “I feel that if they were wearing black balaclavas it would have suited what I experienced more. I felt like I was subjected to a very violent assault. That is the trauma that I’m dealing with now.”

Caroline is one of thousands of women who have faced excruciating pain when undergoing a hysteroscopy, a medical procedure used to examine inside the womb, where biopsies may be taken. It is used to detect cancer, pre-cancer and other benign abnormalities.

One in three women face severe pain during a hysteroscopy – rating it at least seven out of 10 – according to the Royal College of Obstetricians and Gynaecologists. That means thousands of women in the UK could be left traumatised by this medical procedure each year.

Campaigners believe the NHS is failing to properly inform patients of the pain they may endure. The NHS website describes it as a “simple” and “relatively quick” procedure which is “not usually carried out under anaesthetic”.

But women who have spoken to The Big Issue describe feeling “violated” during a hysteroscopy. They believe they were unable to give “informed consent” and some have been left with long-term physical and psychological trauma.

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Source: The Big Issue, 18 January 2024

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National call for action as measles cases surge across UK

A “national call to action” has been made by the UK Health Security Agency (UKHSA) after a worrying surge in the spread of measles in London and the West Midlands.

Professor Dame Jenny Harries, chief executive of the health board, told BBC Radio 4’s Today programme that people have “forgotten what measles is like”, and that children can be unwell for a week or two with symptoms including a nasty rash, high fever and ear infections.

She added that the virus is highly infectious, with health officials warning that serious complications can arise that include hospitalisations and death.

This comes as official figures show uptake of the measles, mumps and rubella (MMR) vaccine is at its lowest point in more than a decade.

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Source: The Independent, 19 January 2024

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Long Covid: NHS legal action launched by family of girl

The mother of an 11-year-old Aberdeenshire girl with Long Covid has launched a legal action against their health board, in what lawyers claim is the first case of its kind in Scotland.

Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy.

The action claims the health board is responsible for "multiple failings" in Anna's treatment and care.

The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening.

Anna became unwell after contracting Covid in 2020.

The action alleges a number of failings by the health board.

These include claims that requests for Anna to be referred to the specialist paediatric services of immunology and neurology were refused.

It also claims no further help was offered after Anna was diagnosed with Chronic Fatigue Syndrome (CFS) and Paediatric Acute-onset Neuropsychiatric Syndrome (PANS).

And it says these failings "could have been avoided had NHS Grampian followed contemporary guidance on diagnosis and treatment".

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Source: BBC, 19 January 2024

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Leak reveals trust omitting two-year waits from reported figures

A hospital trust has been breaching national guidance by excluding some long waiters from its reported waiting list figures, in a move experts warned could put patient safety at serious risk.

The practice appears to have helped Sandwell and West Birmingham Hospitals report zero patients waiting more than two years for treatment during most of last year.

Its policy means cases that unexpectedly “pop up” as two-year waits in its datasets are temporarily removed. The trust will then review whether the cases are data errors or genuine two-year waits, and if genuine, aim to provide treatment within a month.

If not treated within a month, the cases would be added back to the reported waiting list the following month.

Rob Findlay, an expert on RTT waiting lists, said the implications of the SWBH policy are far more serious than simply reporting incomplete numbers for a month.

He said allowing a month to deal with the pop-up without declaring it “relieves them of pressure to solve the problems that are causing patients to be lost in the first place”.

He added: “Some patients – the hospital would never know – might never pop up and be lost from the waiting list forever.

“[This is] a serious patient safety issue which could potentially have a significant impact on how long patients are waiting for treatment.”

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Source: HSJ, 19 January 2024

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US cancer death rates down but younger Americans see rise in certain cancers

Fewer Americans are dying of cancer, part of a decades-long trend that began in the 1990s as more people quit smoking and doctors screened earlier for certain cancers.

However, the American Cancer Society warned that those gains are threatened by an increase in cancers among people younger than 55, in particular cervical and colorectal cancer, and by the continued disparities between white Americans and people of colour.

“The continuous sharp increase in colorectal cancer in younger Americans is alarming,” said Dr Ahmedin Jemal, senior vice-president for surveillance and health equity science at the American Cancer Society.

“We need to halt and reverse this trend by increasing uptake of screening, including awareness of non-invasive stool tests with follow-up care, in people 45-49 years, [old]” said Jemal.

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Source: The Guardian, 17 January 2024

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Thousands of surgeons blame burnout as half consider leaving NHS

Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows.

More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed.

As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge.

RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased.

“The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery.

“There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.”

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Source: The Independent, 18 January 2024

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Physician associates aren’t doctors and shouldn’t be regulated as such, says BMA

Senior doctors are urging MPs to reject government plans to regulate “physician associates”, whose growing use in the NHS has divided the medical profession.

The British Medical Association has said that allowing the General Medical Council (GMC) to regulate physician associates (PAs) would “blur the lines” between doctors and non-doctors.

Many medics are opposed to the increased use of PAs, who they fear patients will wrongly see as doctors, even though they do not have a medical degree. They have expressed concern that letting the GMC – which regulates doctors – regulate PAs from April, as ministers plan, is “potentially dangerous” because it could confuse the public, diminish the status of doctors, and leave patients at risk of being treated by someone without the appropriate skills.

The BMA is running advertisements in the Guardian and on social media asking MPs on a Commons committee examining the plan to vote against it when they consider it on Thursday. “PAs are not the same as doctors, and blurring the lines can have tragic consequences for patients who think they have seen a doctor when they have not,” the adverts say.

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Source: The Guardian, 18 January 2024

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Final infected blood inquiry report delayed until May

The publication of a final report into the infected blood scandal has been delayed until May.

The chairman of the public inquiry, Sir Brian Langstaff, said more time was needed to prepare "a report of this gravity".

Victims and their families were initially told they would learn the findings in autumn last year.

That date was pushed back until March, and the inquiry has now confirmed the further delay to 20 May 2024.

"I am sorry to tell you that the report will be published later than March. That is not what I had intended," added Sir Brian.

"When I reviewed the plans for publication, I nonetheless had to accept that a limited amount of further time is needed to publish a report of this gravity and do justice to what has happened."

It is thought about 30,000 people were infected with HIV and hepatitis C through contaminated blood products in the 1970s and 1980s.

More than 3,000 have died in what has been described by MPs as the worst treatment disaster in NHS history.

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Source: BBC News, 17 January 2024

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Mapped: Areas of England with the highest risk of dying from cancer

Large regional variations in the risk of death from cancer by the age of 80 have been revealed in research by Imperial College London based on NHS data for England.

Analysis of the figures by The Independent shows the risk of dying is highest in northern England cities, while men and women living in the London boroughs had the lowest chance.

Although the risk of dying from cancer has decreased across all areas of England in the last two decades, it is now the leading cause of death in England, having overtaken cardiovascular diseases.

The Less Survivable Cancers Taskforce has that warned Britain has some of the worst cancer survival rates among the world’s wealthiest countries. It ranked the UK 28th out of 33 countries for five-year survival rate for stomach and lung cancer; for pancreatic cancer the UK was 26th, and it was 25th for brain cancer.

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Source: The Guardian, 13 January 2024

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A high-security hospital is so under-staffed that patients are not safe, watchdog warns

One of Britain’s three high-security hospitals – where notorious people including Ian Huntley and Charles Bronson have been detained – is so understaffed that neither workers nor patients are safe, a damning new report has found.

Rampton Hospital in Nottingham faces severe staff shortages, leading workers to restrain patients and lock them away in their rooms and putting patients at risk of self harm, according to the Care Quality Commission.

In a report looking into the hospital, inspectors – who rated the hospital as inadequate – said there were around half the staff needed on one ward.

In one example of those at the hospital being at risk, a patient self-harmed with glass from their watch, while another was able to harm themselves with a CD while they were confined to their room.

One deaf patient was secluded several times on another ward for “being loud”, according to the CQC.

“We spoke with people in the learning disabilities services who told us they sometimes get locked in their room from dinner time until the next morning,” the report said. “They told us that they don’t like being locked in their rooms.”

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Source: The Independent, 17 January 2024

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People buying opioids and sedatives online face deadly fakes, expert warns

People trying to buy illicit synthetic opioids and sedatives online to treat pain, anxiety and insomnia increasingly risk taking a different drug that has caused dozens of deaths among heroin users, a leading expert has warned.

Nitazenes – synthetic and extremely powerful drugs implicated in fatalities of chronic powdered heroin users in Birmingham, Bristol and London in recent months – have been detected in illicit supplies of tablets being sold as diazepam and codeine that appeal to a wider market.

New figures released to the Guardian by the National Crime Agency reveal 65 people have died from taking nitazenes in the past six months – more than two a week, while detections in drug supplies have increased more than fivefold in the last two years.

“[Nitazenes] are being mixed into heroin but it is also in fake diazepam, fake codeine and the person buying the tablets online is a very different kind of user to a heroin user,” Dr Caroline Copeland, the director of the National Programme on Substance Abuse Deaths said. “It means the risk is much wider.”

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Source: The Guardian, 17 January 2024

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‘We must act now’: Expert’s stark measles warning after outbreaks erupt in parts of England

Health experts have warned “we must act now” as measles cases have soared across the country amid an increase in unvaccinated children.

There were 1,603 suspected cases of measles in England and Wales in 2023, new statistics from the UK Health Security Agency (UKHSA) show.

MMR cases have increased significantly in the last two years - in 2022, there were 735 cases, and just 360 the year before.

On Friday, Birmingham Children’s Hospital said it had become inundated with the highest number of children with measles in decades. The hospital treated more than 50 children for the disease in the last month.

Professor Sir Andrew Pollard, Chair of the UK Health Department's Joint Committee on Vaccination and Immunisation, warned that unless more children are vaccinated there will be an increase in hospital admissions and even deaths.

He told The Independent: “The main reason for this new outbreak is the increase in unvaccinated children in the last few years.

“Vaccinations have decreased below 90 per cent and this is dangerous. The vaccine is powerful if we use it, and it will protect our children.

“We must act now and the increased cases are a warning that there will be consequences if we don’t. There will be children with severe infections, brain damage and even death.”

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Source: The Independent, 15 January 2024

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27 ICSs without a plan to combat cyber attacks

At least half of all integrated care systems lack a plan to defend the services they oversee from a cyber attack, HSJ has discovered.

Integrated care systems are responsible for bolstering the cyber resilience of the organisations in their area. This includes having a “system-wide plan for maintaining robust cyber security”.

However, research by HSJ has found that only ten ICSs would confirm they had such a plan. Twenty-six ICSs admitted they did not have a plan in place, while six systems did not respond to HSJ’s inquiries. See the end of the story for the full list.

Of those without a plan, only 10 said they were developing one. NHS England had initially asked each ICS to submit draft cyber security strategies by the end of May, before sending final versions by the end of September but is now thought to be drawing up new timelines.

Some regions appear particularly exposed.  All four ICSs in the North East and Yorkshire region admitted they did not have a cyber security plan, while no ICS in either the London or South East region could confirm they did.

An NHSE spokesman told HSJ it was “vital” that ICSs have “robust plans in place to manage the specific cyber risks in their local areas to protect patient data and systems”. 

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Source: HSJ, 15 January 2024

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NHS across UK spends a ‘staggering’ £10bn on temporary staff

Ministers are facing calls to tackle the NHS’s chronic lack of staff as figures reveal that the bill for hiring temporary frontline workers has soared to more than £10bn a year.

Hospitals and GP surgeries across the UK are paying a record £4.6bn for agency personnel and another £5.8bn for doctors and nurses on staff to do extra “bank” shifts to plug gaps in rotas.

Widespread short staffing has increasingly forced the service in all four home nations to hand colossal sums to employment agencies to hire stand-in workers. In England alone, the bill for agency staff, particularly nurses and GPs, has risen from £3bn to £3.5bn over the past year – a 16% rise.

Wes Streeting, the shadow health secretary, said years of neglect of the growing NHS staffing crisis by Conservative governments had obliged “desperate” hospitals to spend “huge” sums on agency staff, including doctors who can cost more than £5,000 to hire for a single shift.

The Royal College of Nursing said the levels of agency spending were “staggering”. It would be cheaper to employ more nurses as staff instead of having tens of thousands of vacancies, the general secretary Pat Cullen said. The NHS in England currently has 42,306 vacant nursing posts.

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Source: The Guardian, 16 January 2024

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Covid jab skipped by 44%, entire UK study finds

More than 7,000 Covid-related hospital admissions could have been prevented in the UK in the summer of 2022 if the population had received the full number of jabs recommended, according to research in The Lancet.

Some 44% of the UK population was under-vaccinated, with younger people among the most likely to skip doses.

In a first, health records for everyone over five in the UK were analysed. The same approach could now be used to understand other diseases.

The entire population of the UK is 67 million, and all those over the age of five had their anonymised electronic health data analysed for The Lancet study.

With about 40,000 severe hospital admissions related to Covid during that summer, the research estimates that more than 7,000 - 17% - would have been avoided if everyone had taken up the offer of the vaccine and booster doses for which they were eligible.

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Source: BBC News, 16 January 2024

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Record 420,000 patients in England had ‘more than 12 hour wait’ in A&E last year

A record 420,000 patients had to wait more than 12 hours in A&E last year, analysis has shown.

The latest NHS England figures revealed a 20% increase on 2022 in people facing lengthy delays after a decision to admit them to hospital from the emergency department.

In 2023, 419,560 people – or one in 15 A&E patients – faced “trolley waits” of 12 hours or more, according to the Liberal Democrats, who compiled the analysis. It marks by far the highest number since records began in 2011, and amounts to an average of 1,150 patients a day.

Ed Davey, the party leader, criticised the “appalling delays” and accused Rishi Sunak’s government of “ignoring the suffering of patients and driving our health service into the ground”.

Significant waits in A&E have been linked to excess deaths and increased harm to patients, as their condition could deteriorate before they are admitted or given a bed on a ward.

Davey said: “Every year A&E delays are getting worse and worse under this Conservative government as hospitals are starved of the resources and staff they need. These appalling delays are leaving often vulnerable and elderly patients waiting for hours on end in overcrowded A&Es."

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Source: The Guardian, 14 January 2024

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Virtual wards ‘not a silver bullet’ for NHS as occupancy levels grow

More than 8,500 patients in England were being treated on virtual wards in the run-up to Christmas, figures have revealed, as the NHS moves to ease pressures on hospital capacity.

However, experts said the so-called hospitals at home are not a “silver bullet to solve the crisis in health and social care”.

Figures published by NHS Digital revealed some 8,586 patients were treated virtually in December 2023, up from 7,886 in November.

The snapshot was taken on 21 December 2023, meaning it is likely those patients spent Christmas on a virtual ward rather than an actual hospital.

Virtual wards allow patients to receive care in their own homes, with clinical staff using apps or wearable technology to monitor them remotely.

Professor Sir Stephen Powis, NHS national medical director, said the “rapid expansion” of virtual wards beds and patients “is a real NHS success story”.

He added: “This not only frees up vital hospital beds for those who need them most but ensures patients can recover in the place they are most comfortable with support from families, carers and friends, and while occupancy has been growing rapidly as NHS teams make the most of all bed capacity available, we want to see continued growth right across the country so as many patients as possible can benefit."

However, Wendy Preston, the head of nursing practice at the Royal College of Nursing (RCN), said “virtual wards aren’t a silver bullet to solve the crisis in health and social care”.

“Whether they’re in a physical bed or on a virtual ward, patients still need to be able to see a nurse,” she added.

“But there are over 40,000 nursing vacancies across the NHS, and social care is chronically understaffed. Run effectively, virtual wards can relieve pressure, but on every single shift nursing staff are fighting an uphill battle to care for too many patients.

“If the UK government wants to turn around the state of the NHS and deliver the ‘hospital level’ care at home that patients expect, nursing staff need to see game-changing investment in the workforce.”

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Source: The Independent, 15 January 2024

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Social care crisis laid bare as quarter of NHS beds occupied by dementia patients

The scale of the crisis in social care is laid bare as figures show that dementia patients occupy a quarter of all beds in the NHS. People living with the disease often go into hospital after falls or infections as well as for acute medical or surgical problems.

Dementia patients often experience longer hospital stays than the average patient and can be delayed leaving wards due to a shortage of care in the community.

At any one time in the NHS, one in four hospital beds are occupied by people living with dementia, according to the National Institute for Health and Care Excellence, which says stays on wards can trigger distress, confusion and delirium for patients.

Doctors must carry out a discharge assessment of patients to ensure they are healthy before they can leave hospital. Medics assess a dementia patient’s care needs outside of hospital and discharge can be delayed if these are deemed not adequate.

Demand for social care continues to rise as the population grows older but there is a shortage of workers in the sector. Skills for Care estimated that, in 2022/23 an average of 9.9 per cent - or 152,000 - roles in adult social care in England went unfilled.

This was the equivalent to 152,000 vacancies - down by 11,000 from the previous year, although vacancies remain high compared to the wider UK economy.

Services are so overstretched that people are left struggling without vital support to carry out everyday tasks in their own homes, and lives are being blighted.

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Source: The Independent, 14 January 2024

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‘A real gift to women’s health’: The Pap smear era is over. Enter the DIY test

Thousands of Australian women who had previously feared uncomfortable Pap smears and speculum examinations have now had cervical screening tests for the first time because of a new option to take their own swab in private.

The federal government expanded eligibility for a new self-collected cervical screening test in July 2022, resulting in a 25-fold increase in people doing their own tests.

In the past, some people have avoided a potentially life-saving cervical screening test with a doctor because they had suffered sexual violence or trauma, had cultural objections, or had a bad experience with a test in the past.

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Source: The Sydney Morning Herald

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NHS medicines shortage putting lives at risk, pharmacists warn

An unprecedented medicines shortage in the NHS is endangering lives, pharmacists have said, as unpublished figures reveal that the number of products in short supply has doubled in two years.

A treatment for controlling epileptic seizures was the latest to be added on Wednesday to a UK drugs shortage list that includes treatments for conditions ranging from cancer to schizophrenia and type 2 diabetes.

Causes of the crisis are thought to include the plummeting purchasing value of the pound since the Brexit referendum, which reduces the NHS’s ability to source medicines abroad, and a government policy of taxing manufacturers.

According to Department of Health and Social Care (DHSC) figures provided to the British Generic Manufacturers Association, there were 111 drugs on a shortages list on 30 October last year and 96 on 18 December, with supply notifications issued for a further 10 treatments to NHS providers in the UK since then.

It amounts to a 100% increase in shortages compared with January 2022, with pharmacists and health charities claiming the conditions of some patients were deteriorating as a result.

Delyth Morgan, the chief executive of Breast Cancer Now, said her organisation had been contacted over the past 12 months by several patients unable to source the medicines they needed to control the spread of their disease.

She said: “Last year many people shared with us, via Breast Cancer Now’s helpline, that they’d been facing difficulties accessing their hormone treatment including letrozole, anastrozole and tamoxifen, causing them huge worry and anxiety. Trying to track down a treatment by travelling to a number of different pharmacies is an added burden for patients at an already difficult time.

“It may also sometimes be that certain brands of drugs are out of stock and people may have to switch to another brand or different drug. In the worst case someone may have a period of time without the medication, a drug which could help reduce the risk of their breast cancer coming back or spreading.”

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Source: The Guardian, 14 January 2024

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Bariatric tourism care costs NHS more than actual surgery

People who go abroad for weight-loss surgery, and then need urgent medical care back in the UK, cost the NHS more than it costs to carry out the operation itself, according to new research.

A study featuring five London hospitals recorded the details of 35 people who had suffered complications after travelling abroad for gastric surgery during 2022.

The data, shared with the BBC's Disclosure programme, shows the patients suffered from a range of symptoms including severe malnutrition, vomiting, sepsis, hernias and haemorrhaging. Five of them needed feeding tubes inserted, while the average stay in hospital was 22 days.

The interventions at the five hospitals for the 35 patients cost the NHS a total of £560,234, or £16,006 per patient, in 2022.

The equivalent amount would have covered the cost of about 110 bariatric surgeries in UK hospitals.

Consultant bariatric surgeon Omar Khan, one of the lead authors of the study, said the paper was intended "to try and quantify" the effect on the NHS of increasing numbers of people going abroad for weight-loss surgery - sometimes known as bariatric tourism.

"We know that the waiting lists in the NHS are unfortunately long. We also know that there are new units, particularly in Turkey, which have been set up to cater for an international market," he explained.

"We focused on patients with major complications, patients who were severely ill. They had leaks from the stomach, they had bleeding, they had infections. A significant portion required further surgery and some required revisional surgery."

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Source: BBC News, 15 January 2024

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Widespread failings discovered in EPR launch linked to patient death

“Better upfront planning, training and testing” were needed in a tech launch which was tied to patient harm and service disruption, an NHS England review has found. 

Royal Surrey and Ashford and St Peter’s Hospitals foundation trusts went live with Oracle Cerner’s electronic patient record in May 2022 – under a programme called Surrey Safe Care – but the implementation has since been linked to incidents of patient harm, including one death, and significant disruption to trust services.

Now, a lessons learned review, carried out by NHSE’s frontline digitisation team and obtained by HSJ via a Freedom of Information request, has identified 24 areas of improvement.

The key lessons cited by the review are “better upfront planning, roles and responsibilities, training and testing”. 

It recommended that, in future implementations, trust boards should be supported by others experienced with implementing EPRs within the NHS to “aid board level decisions and ‘what questions to ask when’”, while clearer responsibilities should also be agreed upon for programme leads and EPR suppliers.

The review also found the content of training must be evaluated thoroughly, while the EPR supplier should provide “upfront and continuous training”. It added the “full end-to-end testing [by] representatives from all end user groups” should be completed before go-live.

It also said EPR readiness needs to incorporate “data readiness, such as data quality, and mapping how data has originally been captured [which] may impact reporting and organisational readiness”.

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Source: HSJ, 15 January 2024

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